which feature best distinguishes adaptive immunity from innate immunity

memory and specificity

which antibody crosses the placenta to protect the fetus

IgG

which cells mediate cell mediated immunity

T cells

passive immunity refers to…

immunity generated by preformed antibodies

which immunoglobulin is produced first during a primary infection

IgM

when would you give a Tdap vaccine

27-32 weeks

when would you give rotavirus vaccine

15 weeks - completed before 8 months

name the live vaccines

MMR, varicella

correct RSV schedule for newborn protection in ontario…

single monoclonal antibody

newborn exposed to hep B requires immuno prophylaxis within…

12-24 hours

what type of immunity does influenza vaccine produce

active

which vaccine is safe in breastfeeding but not in pregnancy

MMR

36 week patient, non immune to varicella, had prolonged contact with a child with chicken pox. what would you do. what would you give

variZIG immediately

newborn, born to hep B positive parent, what would you do

HBIG and a dose of single antigen hep B vaccine < 12 hours of birth in separate thighs

rotavirus: 16 week infant prevent for first vaccines. what would you do?

get rotavirus vaccine immediately

client received MMR at 2 weeks pregnant before knowing they were pregnant

reassurance

oxytocin provides uterine contractions by increasing…

calcium

misoprostol is a synthetic analog of…

PGE1

carboprost is contraindicated in patients with…

asthma

what is TXA for

to prevent or reduce excessive bleeding

what is the first line uterotonic for PPH

oxytocin

misoprostol for PPH is typically given how…

SL or PR

which uterotonic has the highest risk of hypertension

ergot alkaloid

TXA would ideally be given within how many hours

3 hours

PPH after vaginal birth… where the uterus is boggy and bleeding is continuous… what is the first line medication

oxytocin

asthma and PPH, a patient with asthma requires a second line uterotonic, which one would you avoid

carboprost

client with preeclampsia, has uterine atony… what do you do which one would you avoid

methylergonovine

retained placenta, bleeding continues after birth, placenta is not delivered, what would you do

manual removal

lidocaine works by blocking

voltage gated sodium channels

epinephrine is avoided in end artery areas because… and name one area that is an end artery area

ischemia

labia minora

which LA is safest in pregnancy

lidocaine

which symptom is most concerning for LA toxicity

seizures

why do you add epinephrine to LA

to increase duration and effect of LA

which LA has the longest duration of action?

bupivicaine

a true allergy to LA is most common due to and why

esters because they share a structure with PABA

client reports swelling after benzapine spray… what are they likely allergic to

ester

i accidentally gave someone lidocaine while suturing - i gave it IV… what would i do

stop!!!!

first line medication for nausea and vomiting

doxylamine-pyridoxine

ondansetron mechanism of action

5H3 antagonist

common side effects of doxylamine

drowsiness

PUQE score of 5 and person is being diagnosed with mild NVP what would you give

doxylamine

somebody with severe hyperemesis and cannot tolerate anything orally, but is seeking meds, what would i do and give

IV fluids, lactate ringers,

client on ondansetron 8mg TID - look at hCG and have got QT prolongation what do i do

stop immediately and switch to doxylamine

*****pregnancy increases thyroid requirements mainly due to…

increased levels of TBG

*****LT4 dose should be increased by

20-30%

when do you use beta blockers… in what kind of thyroid dysfunction and what phase

thyroitoxic phase of postpartum thyroiditis (PPT)

*****which trimester has physiologic lowest TSH

1st

which drug is preferred for hyperthryoidism in the first trimester before you switch it out

PTU

high TSH and low FT4 - what is the diagnosis

hypothyroidism

an LT4 must be separated from iron for how many hours

4 hours

patient in early pregnancy hypothyroidism TSH is 3.8 at 6 weeks and she is on levothyroxine (LT4)… how would i manage this

increase the dose 25-30% promptly

high FT4, suppressed TSH, and positive TR antibodies, patient is in second trimester, what is the best drug

methimazole (MMI)

omeprazole MoA

H+/K+/ATPase enzyme system

why was ranitidine taken of the market

NMDA contamination

whats the first step if somebody needs PPI what are you going to do first

lifestyle, antacids, H2 blocker, AND THEN ppi if others did not work

PPI in breastfeeding, is that compatible or not

yes

dark stools while on PPIs what do you do

referral

penicillin allergy: which reaction would suggest true allergies

wheezing, hypotension

penicillin allergy: person only has hives, whats the second option

cefazolin

true penicillin allergy, what are you going to give them

vacomycin