Acute and chronic respiratory diseases
Pregnant women often sick:
Аcute rhinitis, laryngitis, tracheitis
Acute sinusitis, pharyngitis
Acute bronchitis, pneumonia
Acute tonsillitis
Acute rhinitis, tonsillitis, pharyngitis
How often have upper respiratory tract ill pregnant and non-pregnant women:
Pregnant women suffer more
The frequency of the disease is the same
Pregnant on sick less often
As a rule, pregnant women do not suffer from these diseases
In pregnant dramatically increases the incidence
What disease is often found among pregnant women and is dangerous to the fetus
Flu Virus
Cytomegalovirus infection
Herpes simplex virus
Bacterial infection
Extra-genital chlamydia
If a woman is in labor and ill with acute influenza virus, what is its danger:
There is not danger both mother and fetus
High risk of fetal asphyxia
High risk of septic complications
High risk of bleeding in the early postpartum period
High risk of late postpartum hemorrhage
If a pregnant woman is ill flu during the first trimester of pregnancy, there is:
High risk of birth defects
There is not risk the fetus
High risk of down syndrome in the fetus
High risk of preterm delivery in the second trimester of pregnancy
High risk of premature detachment of placenta in the ii &iii trimester of pregnancy
Where are pregnant should be treated with uncomplicated flu:
At home
In the day hospital
In the infectious diseases hospital
In the medical ward General Hospital
In a maternity hospital
The pregnant lives in Almaty. She is complaining of headaches, increased body temperature during the day, chills, severe weakness, shortness of breath, muscle pain, nausea. One time there was vomit. After the examination there was diagnosis: 15-16 weeks of pregnancy. Flu. Suspected myocarditis? Where this patient should be treated:
At home
In the day hospital
In the infectious diseases hospital
In the City General Hospital
In a maternity hospital
The prevention of influenza and other viral respiratory infections in the Republic of Kazakhstan are regulated by Order of the Ministry of Health of the Republic of Kazakhstan №:
Note the wrong answer. The flu virus:
Suppresses the immune response, incidence of flu increases
Leads the aggravation of chronic diseases (if any)
Leads pneumonia, otitis (sometimes turning in meningitis)
Leads the defeat of the cardiovascular and central nervous system
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Leads the defeat of vision including blindness
Where is a person vaccinated against influenza (The order MH RK № 722 of 15.09.2010):
In any private medical facility
In any public health facility
In the establishment of an infectious
In specialized centers (grafting surgeries) for vaccination
Any medical or sanatorium institutions
Below is a list of the main anti-influenza drugs (The order MH RK № 722 of 15.09.2010). Note the extra point:
Of Antivirals
Antipyretics
Immunomodulatory agents
Vitamins and Minerals
Drugs for the prevention of heart failure
At what stage of pregnancy women cannot be vaccinated against the flu:
At any stage of pregnancy
In the second trimester
In the third trimester
In the first trimester
In the eighth month of pregnancy
When you need immunize the population, including pregnant women, against flu (order MH RK number 722 of 15.09.2010):
From September 15 to November 15
From September 1 to December 1
From October 1 to November 15
From October 1 to December 1
From October 15 to November 30
Why does the pregnant women ill primary bronchitis and aggravation to chronic bronchitis (what is the mechanism)
Diaphragm movement during pregnancy is limited
During pregnancy there is an edema
Placental lactogen increase
The bronchial mucosa swells, the movement of the diaphragm is limited
During pregnancy the immune system is reduced
The patient with chronic obstructive bronchitis is diagnosed 6-7 weeks of pregnancy. What is the doctor's tactic:
Pregnancy must be terminated
It is necessary treating with antibiotics
Pregnancy should be terminated if there is evidence of pulmonary heart disease
Pregnancy should be terminated if the patient has more children
Pregnancy should be terminated if the patient is unable to give up smoking
The patient was hospitalized with a diagnosis: Pregnancy of 10 weeks. Acute bronchitis. Which antibiotic (according to the evidence-based medicine) must you assign to the patient:
Ceftiraxon
Ofloxacin
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Ampicillin
Erythromycin
Tetracycline
Pregnant suffers from chronic bronchitis. What will happen to the fetus:
Congenital heart disease
Fetal growth retardation
Prenatal sepsis
Malformation of the lung
Neural tube defects
Classification of pneumonia is based on the condition of the disease and the immunological status of the patient. From the list, select the UNNECESSARY:
Community-acquired pneumonia (synonyms: home, outpatient)
Nosocomial pneumonia (synonyms: hospital, in-hospital)
Unspecified pneumonia
Aspiration pneumonia
Pneumonia in patients with severe immune deficiencies
Emergency doctor has diagnosed: Pregnancy 34-35 weeks. Community-acquired pneumonia. The patient has symptoms: Tachypnea - 30 per minute. The lungs have decreased breath sounds in the lower parts of both sides; there is single, moist and finely crepitations. BP - 90 \ 55 mm Hg, pulse 96 beats\ min. Subdued heart sounds and tachycardia. In which department the patient should be hospitalized:
Department of Pathology pregnant maternity
The emergency and intensive department of maternity hospital
Therapeutic department of General Hospital
Department of Intensive Care General Hospital
Department of Intensive Care Infectious Diseases Hospital
After the X-ray light the patient was diagnosed: 33-34 weeks of pregnancy. Community-acquired pneumonia. In order MH RK № 869 02.12.2011 is a list of key diagnostic procedures for the diagnosis of pneumonia. One of the following researches is an additional:
Сoagulogram
Smear microscopy of sputum Gram-stained
Cultures of sputum
Biochemical analysis of blood
General blood analysis
It is well known that pregnancy significantly increases the risk of death from varicella pneumonia. Mortality rate of 11-35%. What amount of vesicles is dangerous for the development of varicella pneumonia (Order of the Ministry of Health of the Republic of Kazakhstan № 869 dated 02.12.2011)
More than 30 vesicles
More than 40 vesicles
More than 60 vesicles
More than 90 vesicles
More than 100 vesicles
What time since the beginning of varicella pneumonia in pregnancy can be detected immunoglobulin M to the virus Varicella zoster (The order MH RK number 869 dated 02.12.2011)
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week
2 weeks
4 weeks
5 weeks
3 weeks
Newborns will have a generalized form of chicken pox, if vesicles on the skin of the mother appear in the pregnancy \ labor:
A week before giving birth - immediately after birth
2 weeks before giving birth - a week after giving birth
For 4-5 days before the birth - 2 days after giving birth
During the 21 days prior to delivery - 21 days after birth
A week before childbirth - a week after giving birth
Treatment varicella pneumonia in pregnancy is:
Intravenous injection Acyclovir at a dose 5 mg / kg after 8 hours
Acyclovir per os 200mg 5 times a day
Oseltamivir per os 75 mg twice daily
Rimantadine per os according to scheme
Rovamycine per os 3 ml 2 IU twice daily
There is а list of general principles of treatment of pneumonia in pregnancy (Order of the Ministry of Health of the Republic of Kazakhstan № 869 dated 02.12.2011). Find the extra point:
Monitoring in a hospital
Monitoring of blood gases: Pa2> 60-70 mm Hg, at the lowest possible level of FiO2
Monitoring of the fetus
Limit the exposure tradiation and medicine
Blood pressure control
Antibiotic therapy of pneumonia in pregnancy associates with the possible embryotoxic effects. One of the following antibiotics little crosses the placenta:
Anti-tuberculosis agents
Cephalosporins
Ftorchynolons
Macrolides
Aminoglycosides
What medicine is used for treatment not-heavy bacterial pneumonia (purulent sputum, chest pain) in the I trimester of pregnancy (order MH PK number 869):
Penicillins
Macrolides (rovamitsin)
Glycopeptides (Vancocin)
Carbapenem (merapenem)
Cephalosporins
If a pregnant woman has an atypical bacterial pneumonia (non-productive cough, symptoms of intoxication, shortness of breath), we have tassign a cure (Order of the Ministry of Health of the Republic of Kazakhstan № 869):
Macrolides (rovamitsin)
Glycopeptides (Vancocin)
Penicillins
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Carbapenem (merapenem)
Cephalosporins
If a pregnant woman has an atypical bacterial pneumonia (non-productive cough, symptoms of intoxication, shortness of breath), the prescription will have been (Order of the Ministry of Health of the Republic of Kazakhstan № 869):
Macrolides (Rovamicin)
Glycopeptides (Vancocin)
Penicillins
Cephalosporins
Carbapenem (Merapenem)
When should be the vaccination for the prevention of chickenpox women without immunity carried out:
In II and III trimester of pregnancy
3 weeks before childbirth
In the II trimester of pregnancy
In the I trimester of pregnancy
For 1-3 months before pregnancy
When do you have to start antibiotic therapy if a pregnant woman has clinical symptoms of viral pneumonia (Order of the Ministry of Health of the Republic of Kazakhstan № 869 dated 02.12.2011)
At the time of admission
Not later than the first 4 hours after hospitalization
The first 12 hours of the receipt
The first day of receipt
If the bacterial etiology of pneumonia is proven
The patient is diagnosed with influenza A. She has the following symptoms: body temperature within 38,10-40 ° C, the symptoms of intoxication. Pulse 90-120 beats / min. Systolic blood pressure less than 110 mmHg. Respiratory rate is 24\min. Dry painful cough with pain behind the breastbone. What form of the clinical course is described:
Asymptomatic
Mild
Moderate
Extremely hard form (hypertoxic)
Heavy
What form of influenza is characterized by the following symptoms: fever up t38 ° C, moderate headache and catarrhal conditions. Pulse less than 90 beats / min. Systolic blood pressure of 115-120 mm Hg. Respiratory rate is less than 24 in min.
Extremely hard form (hypertoxic)
Heavy
Mild
Asymptomatic
Moderate
The patient was taken to the hospital with a pregnancy of 28-29 weeks. She’s symptoms are: body temperature 40,5 ° C, intoxication symptoms - severe headache, general aches, insomnia, delirium, anorexia, meningeal symptoms. Pulse over 120 beats / min, sometimes is arrythmic. Systolic blood pressure less than 90 mmHg. Heart sounds muffles. Respiratory rate is over 28\ min. Painful, painful cough, chest pain. Diagnosis: Pregnancy 28-29 weeks. Flu. Complete... diagnosis:
Extremely hard form (hypertoxic)
Heavy
Moderate form
Mild form
Asymptomatic form
The patient in 2nd days after delivery was produced fluoroscopy. Pulmonary tuberculosis was suspected. The tactics of the doctor:
Make an overview of chest radiography
Consultation of phthisiatrician
Perform 3 times smear microscopy of sputum for MT
Conduct a non-specific antibiotic therapy for 2 weeks
Conduct microbiological testing of sputum for MT
If the mother has TB, the fetus has:
Growth retardation
Increased risk of birth defects
Usually a child is born tb patients
The risk of down syndrome
Increased risk of genetic diseases
The typical symptom of tuberculosis in pregnancy is:
A woman stops gaining weight or losing weight
The clinic does not differ from non-pregnant women suffering
Pleural effusion develops quickly
The disease begins with hemoptysis
fetal death
Особенности острых и хронических заболеваний мочевой системы у беременных. Осложнения беременности и послеродового периода. Алгоритм диагностики, лечение, профилактика. Значение скрытой бактериурии во время беременности.
Renal blood flow and glomerular filtration during pregnancy increase on:
10-15%
15-20%
20-30%
35-40%
40-50%
The cause of proteinuria and cylindruria in physiological pregnancy is:
Kidney glomerular filtration reduces
Renal tubular reabsorption increases
Permeability of the renal epithelium increases
Reabsorption of sodium and water increases
Kidney glomerular filtration increases
The most common causative agents of pyelonephritis in pregnancy are (Савельева Г.М. и соавторы, 2006):
Coliform organisms
Candida species
Microbial association
Anaerobes
The simplest (trichomonas)
Pyelonephritis often occurs in 12-15 weeks and 23-28 weeks. The reason is:
Formation and the maximum development of the placenta
Compression of the ureter by growing uterus
Maximum release of corticosteroids
Changes the ecosystem of the vagina
A gradual rise in blood pressure
The peculiarity of pyelonephritis in the I trimester of pregnancy is:
Worn clinical
Acute course of the disease
Lack of temperature response of pregnant women
Lack pielourii
Always have hematuria
The peculiarity of pyelonephritis in the II and III trimester of pregnancy is:
During Acute
The lack of temperature
Worn clinical
Often complicated anuriey
Often accompanied by hematuria
Which antibiotics should be prescribed for the treatment of gestational pyelonephritis in the I trimester of pregnancy:
Group penicillins
Cephalosporins
Nitrofurans
Macrolides
The aminoglycosides
At what stage of pregnancy can be cephalosporins, aminoglycosides, macrolides, nitrofurans, 8-hydroxyquinoline derivatives administered for treatment pyelonephritis:
From 13 weeks
From 15 weeks
From 24 weeks
From 28 weeks
From 36 weeks
Which antibiotic should be in the postpartum period administered cautiously, because its concentration in breast milk is very high:
Ampicillin
2nd generation cephalosporins
5th generation cephalosporins
The aminoglycosides
Erythromycin
The differential diagnosis of chronic pyelonephritis should be the following complication of pregnancy carried out with:
Premature detachment of placenta
Preeclampsia
Pregnancy-induced hypertension
The risk of preterm birth
Proteinuria in physiological pregnancy
If a pregnant woman has a latent (asymptomatic) bacteriuria, in 1ml. of urine has been detected:
100 000 or more bacteria
10,000 or more bacteria
50,000 or more bacteria
Not less than 90,000 bacteria
Not less than 70,000 bacteria
The antibiotic therapy is prescribed for pregnant patients with asymptomatic bacteriuria, because it…:
Does not impact on the incidence of pyelonephritis
Reduces frequency of pyelonephritis
Has a toxic effect
Leads to allergies
Leads to the development of pyelonephritis
Asymptomatic bacteriuria increases the risk (Order of the Ministry of Health of the Republic of Kazakhstan № 239 dated 07.04.2010)
Premature birth, birth low weight infants, acute pyelonephritis
Horionamnionit, acute glomerulonephritis, pyelonephritis
High water, low water, premature birth
Pre-eclampsia, premature detachment of placenta
Acute polyhydramnios, premature labor, fetal distress
All pregnant women should be screened urine (seeding midstream urine) for asymptomatic bacteriuria (Order MH RK number 239 of 07/04/2010):
1 time when registering
During the registration and gestational age of 30-32 weeks
3 times: when registering in the 30-32 weeks of pregnancy, a week before the birth
1 time in 37 weeks gestation or later
1 every 23-28 weeks of gestation
For the treatment of asymptomatic bacteriuria can be used (Order MH RK number 239 of 07/04/2010):
Erythromycin or other macrolides
Penicillin
The aminoglycosides
Ampicillin, Cephalosporins 1st generation
Sulfonamides
The duration of antibiotic therapy for asymptomatic bacteriuria in pregnancy (Order of the Ministry of Health of the Republic of Kazakhstan № 239 dated 07.04.2010) is:
4-day course
7-day course
single dose
3-days course
5-day course
Pyelonephritis can cause severe obstetric complications. This list does not include:
Pre-eclampsia
Placental insufficiency
Septicemia and pyosepticemia
Toxic shock
Hemorrhagic insult
Which of instrumental studies has adverse effects on the fetus:
Renal ultrasound
Doppler sonography of renal vessels
Ureteral catheterization
Cystoscopy
Renal scintigraphy
The etiology of glomerulonephritis is:
Escherichia coli
Staphylococcus
Proteus
Hemolytic Streptococcus
Association of microbes
Glomerulonephritis often occurs after:
Angina, flu
Pharyngitis, acute respiratory
Acute cystitis
Is a complication of pyelonephritis
Inflammatory diseases of the pelvic organs
The most probable complication of pregnancy in glomerulonephritis is:
Wasting, fetal hypoxia
Fetal death
The early development of pre-eclampsia
The development of cardio-renal failure
Bleeding during pregnancy
Treatment of acute glomerulonephritis begins with:
Corticosteroids
Antibiotics
Antihistamine drugs
Immunomodulator
Antispasmodics
If the patient is ill with glomerulonephritis, pregnancy will be possibled after:
Year
2-3 years
3-5 years
6-7 years
8-9 years
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