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Old 06-06-2016
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Smile 4 questions from UW and FA

1. Does anyone know the exact definition for Arrest of labor in the first stage?
In UW, it is stated as dilation >6cm with no cervical change for 4hrs despite adequate contractions OR no cervical change for 6hrs with inadequate contractions.
This is so different from how I've been taught: no cervical dilations for 2hrs or no fetal descent for 1hr when dilation is >4cm. Can anyone clarify this is to me?

2. On FA rapid review p.527, the diagnosis for "A 10yr boy presents with B symptoms. Examinations shows an ant. mediastinal mass" is stated NHL.
However, regarding his young age and presence of B symptoms, Hodgkin lymphoma seems to be a more reasonable answer for this one. Can anyone explain why the answer is NHL?

3. Why does ketone level rise as DKA improve?
Ketone level initially seems to rise as DKA resolve, but I couldn't find any explantion.

4. Does anyone know why spironolactone is contraindicated in diastolic dysfunction?
Beta blockers and diuretics are clearly stated to be effective in treating diastolic dysfunction. However, I don't understand why spironolactone should be avoided.
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Old 06-06-2016
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2.anterior mediastinal mass (thymic)=NHL (can localize outside the lymph nodes)
Hodgkin's mostly localizes in the lymph nodes

3.once you start insulin therapy mobilization of fatty acid stops and logically ketones should fall and not increase

4. in modern medicine medications are gauged by their benefit on mortality
Appearantly spironolactone has no role in HFpef (it inhibits structural changes in dilating heart=HFref)
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