Ethics #1
Ethics #2
Statistics
Urologic Considerations in Pregnancy #1
Urologic Considerations in Pregnancy #2
100
Adult patients (> 18 years of age) are presumed to have this for medical decision-making unless a physician determines otherwise
What is capacity
100
The obligation to seek the patient's benefit or good.
What is Beneficence
100
This variable is manipulated by researchers to influence the results of an experimental design
What is Independent Variable
100
Risk factors for postpartum urinary retention:
What are:
Epidural anesthesia, long duration of labor, episiotomy, high birth weight, caesarean section, elevated BMI, instrument assisted delivery, nulliparity
- During the postpartum period, the risk of urinary retention can range from 1.7 to 17.9%.
- Typically incomplete bladder emptying in this setting can be managed with clean intermittent catheterization and rarely results in long-term consequences.
100
The most common form of urinary incontinence during pregnancy with a prevalence of 41% and increases with gestational age
What is Stress Urinary Incontinence
-Related to increased strain on the pelvic diaphragm and the relaxing effect of progesterone on bladder and urethral musculature
-First line treatment of SUI during pregnancy is Kegels exercises and dedicated pelvic floor physical therapy
-Urinary incontinence during pregnancy increases the risk of future and persistent incontinence
200
The principle that one should keep one's promises about not disclosing information.
What is Confidentiality
200
A legal term that is often mistakenly used interchangeably with capacity.
What is Competence
Decision-making capacity is determined by a physician while competence is determined by a judge.
200
The two ways in which the dependent variable is measured and influences the type of statistical tests used to analyze data.
What are Continuous or Binary
-Variables that are measured as continuous variables produce descriptive statistics such as means, standard deviations, and variances.
-Variables that are measured as binary variables produce descriptive statistics such as frequency, or the number of subjects in each category, which are often reported as percent (example: 30% have ED, 70% do not have ED). Since binary outcomes are reported in percentages, it is not possible to calculate statistics such as means, standard deviations, or variance.
200
More often noted to occur on the right side vs left, this is estimated to occur in 43 to 100% of pregnant women and often physiologic with an increasing prevalence correlating with advancing gestational age
What is Hydronephrosis
-More often noted on the right side possibly from the dextrorotation of the gravid uterus and the angular trajectory of the right ureter as it traverses the pelvic brim
-They are often asymptomatic, but can have a variety of presentations
-Physiological right-sided hydronephrosis is common during pregnancy, while left-sided hydronephrosis associated with renal colic is more likely to be caused by an obstructing ureteral stone
200
Always screened for and treated during pregnancy due to increased risk of infection
What is Asymptomatic Bacteriuria
- Although pyelonephritis develops in 1 to 4% of all pregnant women, it increases to 15 to 45% in those with untreated bacteriuria.
-Most cases of pyelonephritis occur in the third trimester, when hydronephrosis and stasis in the urinary tract is most evident
300
An ethical principle in which the concept of impairment (that others are not capable of making a sound choice) is used by the decision-maker.
What is Paternalism
300
The obligation to avoid or minimize harms to the patient.
What is Non-Maleficence
300
The type of study design which does not compare groups, but is interested in the relationship between two or more variables within a group.
What is Correlational Design
An example of a simple correlational design is finding the association between age and erectile function. Note that there are no group differences in this design, and the focus is on the relationship between variables within a group. Correlational designs can also explore the relationship between multiple independent variables and one dependent variable (how age and diabetes are related to erectile function).
300
An antibiotic class that should be avoided during pregnancy due to high risk of tooth and bone discoloration
What is Tetracyclines
-The aminopenicillins and cephalosporins are considered safe and generally effective during pregnancy
-In patients with a penicillin allergy, nitrofurantoin is a commonly used alternative.
300
Although believed to be safe in pregnancy, this antibiotic should be avoided near term due to risk of hemolytic anemia in the neonate
What is Nitrofurantoin (Macrobid)
400
Disclosing the sexually transmitted disease status of an adolescent, even to a parent, is this in every state.
What is Illegal !!!
400
The obligation to seek and achieve fairness in the distribution of benefits and risks.
What is Justice
400
The type of statistical test which compares means from two independent or different groups
What is the Independent Measures t-test (typical t-test)
400
The most common non-obstetric cause of hospitalization during pregnancy
What is renal colic
-Incidence of symptomatic stones during pregnancy is estimated to be 1 in 200 to 1 in 1500 pregnancies
-Stone disease/renal colic during pregnancy is associated with adverse gestational events including preeclampsia, premature rupture of membranes, and premature onset of labor.
-No statistically significant correlation of compromised birth outcomes (e.g. perinatal mortality or low birth weight) in patients with nephrolithiasis
400
The first and second line imaging modalities of choice for pregnant patient with suspected kidney stones
What are #1- US, #2- noncontrast MRI
-Low dose CT exposures ranges from 2 to 14 mGy, well below dangerous threshold (50mGy), and can be a viable imaging option after joint discussion with the patient and the obstetrics team
500
This, also known as the Physician Self-Referral Law, is a set of US federal regulations that prohibit physicians from referring Medicare and Medicaid patients to receive certain healthcare services from entities with which they or an immediate family member have a financial relationship.
What is Stark Law
500
A legal doctrine based on the principle of autonomy in which information about a proposed procedure or treatment, including the risks/benefits/alternatives, must be provided so the patient or surrogate can decide if he/she is willing to participate.
What is Informed Consent
500
The most commonly used statistical test in medicine, where values ranges from zero to one, and negative or positive sign indicates the direction
What is Pearson Correlation Coefficient (“r”)
–Value ranges from zero (which indicates no relationship) to one (which indicates a perfect linear relationship)
–A good guide to interpret the strength of the correlation is: small, r=0.10; medium, r=0.30; and large r=0.50
500
Contraindicated procedure due to risk of fetal demise, hearing loss, and early induction of labor
What is Extracorporeal Shock Wave Lithotripsy (ESWL)
-For pregnant patients who fail conservative management of ureteral stones, the AUA guidelines specify that clinicians may offer ureteroscopy as a standard intervention
-Ureteral stenting and nephrostomy tube placement represent alternative options, that may require frequent stent or tube exchanges
500
Drugs, often prescribed for medical expulsive therapy, which should be avoided in pregnant patients with symptomatic stones
What are: alpha-blockers, Ca2+ channel blockers, NSAIDS, ASA
-Stone passage during pregnancy is very common, with an estimated 66-84% of patients not requiring surgical intervention
-Conservative therapy includes hydration, antiemetics, straining of urine, fetal monitoring, close collaboration with obstetrician
-Pain control with acetaminophen or opiates