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【正文】 gr(1/2) im in each buttock then 5 gr im q4h If platelet is below 100000 then 20 gr in 1000cc infused in 100cc/hrs (check of I/O,RR,DTR, prep CPR set with 2 gr 20% MgSO4 ready) +Amp Dexa 6 mg im bid for 4 doses OTHER: Control of vital sign q15 min , control of FHR, fix foley, mededonline 2022 Emergency C/S ? Prep 2 units of pc ? Amp keflin 2 gr iv ? Prepare for C/S ? Transfer to OR mededonline 2022 The night before elective C/S ? CBC, BG, Rh, (FBS,BUN/CR, CXR, ECG) ? Prep 2 units of pc ? NPO from 12 am ? Iv Ringer KVO ? Check of FHR and contractions mededonline 2022 8 hours after C/S ? fair, RBR, surgical diet, ? IV 2 lit Ringer ? Continue keflin ? Supp bisacodyl 2 stat then tab bisacodyl bid ? Foley DC, ? I/O DC ? F/U CBC mededonline 2022 24 hours after C/S ? Condition good ,RBR, reg diet, ? IV as heparin lock ? Continue keflin ? tab bisacodyl bid mededonline 2022 3648 hours after C/S ? Remove dressing ? Discharge with Cap cephalexin 500 mg qid Cap mefenamic acid 500 mg tds Cap hematinic (according to Hb) mededonline 2022 Diabetic C/S NPO from 12 am Prep 2 units of PC 1000 cc Ringer IV fluid q8 hrs the night before surgery Amp keflin 2 gr iv stat half an hour before surgery ? Before operation: 10 units of regular +1000 cc DW5% 150cc/hr ? Check of BS q6h after operation Inform in cases of ROM or bleeding or pain Asthma management mededonline 2022 mededonline 2022 mededonline 2022 Heavy vaginal bleeding in a 14 year old girl with Hb value of 7 gr/dl and normal coagulation tests and platelets and pelvic sonography: Conjugate estrogen 2540 mg IV q6h or Conjugated estrogen mg q6h PO until bleeding is controlled followed by medroxy progesterone mededonline 2022 Prolonged spotting in a 14 year old anemic girl Low dose OCP 21 days for 36 cycles mededonline 2022 DUB in a 16 year old girl with stable vital signs: Monophasic OCP q6h for 7 days + Iron supplements mededonline 2022 Recurrent abortion tests ? Karyotype ? HSG ? Luteal phase biopsy of endometrium ? TSH and prolactin level ? ACL ab ? LAC ? CBC Abortion without fever: Doxy 100 mg bid or tetracycline 250 mg qid for 57 days mededonline 2022 mededonline 2022 Beta HCG below 2022+ no visible intrauterine sac+ mass in tube below cm ______________________ control of beta HCG q 48 h AIf a dead IP is confirmed (beta HCG increase less than 50% or below 1000mIu/mL P below 5 ng/mL + visible intrauterine sac) then curettage BIf EP is confirmed (beta HCG more than 2022 and mass cm) then laparascopy CIf a dead IP and EP is confirmed (beta HCG more than 2022 and mass cm) then MTX FETUS SHOULD BE VISIBLE ON DAY 45 OF GESTATION mededonline 2022 Indication of MTX for EP ? Hemodynamic stability ? No intra uterine pregnancy ? Max sac diameter not equal or more than 4 cm EP ? Adenexal mass cm MTX ? adenexal mass= cm laparascopy ? uncertain US + beta HCG increase less than 50% Damp。C ? unstable conditionslaparatomy mededonline 2022
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