October exam takers gather here................... - drfuture

[ArchivalUser]

Fetal distress with bright PV blood following amniotomy is likely vasa previa. Just did a few OBGYN q's on UMED and UW, they say the same

[ArchivalUser]

Yeah that it correct guys u got the questions

aminiotomy to induce labout u might injure an abnormally extendeign fetal umbilaicar vessels passing through the aminion that covers the Internall cevical os leading to fetal bleeding showing tachycardia as would us adults have but then with sever anemia bradu=y cardia and some thing called sinusoidal fetal herat pattern all are characterstic clues good luck guys

[ArchivalUser]

Answer to psychiatry Q

EE

[ArchivalUser]

Q Endocrinology?

patient with decreased cortisol we want to check if the problem is from the adrenal or pituitary!

So we do the Cosyntropine test then we got the result that there was no increase in cortisol in blood. this means two things what are they?

[ArchivalUser]

after giving cosyntro if no increase in cortisol AND ACTH high =primary(adrenal gland failure).
if no increase cortusol and ACTH low=2ndary failure

[ArchivalUser]

hey mili99

why when giving synthetic ACTH ( cosyntropin ) in 2ry failure ( pituitary failure ) there will be no increased cortisol. I mean the defect was abscence of ACTH from pituitary and now that we have the ACTH why the adrenal would not release the cortisol??

there is a small trick here and that is why I asked this question cuz I just fihured it out too reading MTB

[ArchivalUser]

YES u right.basal ACTH greater thn 50=primary
less thn 50=2ndary

[ArchivalUser]

oh thanks drfuture for the question. ..i was completely out...

[ArchivalUser]

i think
first when we give cosyntropin....and no response ....we have
either adrenal failure
or adrenal atrophy if chronic deficit of acth

[ArchivalUser]

well done soonck that is the key issue i wanted to raise