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Intrapartum Fetal Heart Rate Monitoring (Usmle)

OBGYN: Intrapartum Fetal Heart Rate Monitoring (Usmle)

Mnemonic to remember : VEAL CHOP

Variable Cord compression
Early Head compression
Acceleration OK
Late Placental Insufficiency

Early Deceleration: Head compression. Fetus deceleration is symmetrical to mother's contraction. Tx = No treatment

Late Deceleration : Placental insufficiency : Fetal deceleration is after the mother's contraction Tx= test fetal blood from scalp sample to diagnose hypoxia or acidosis.

Variable Deceleration : Cord compression. Fetal deceleration can be symmetric or after mother's contraction (Onset of fetal deceleration to the nadir should be < 30 sec.)
Tx = 1. Change the mother's position
2. Amnioinfusion

Parkinson plus syndromes

There are number of ''Parkinson plus'' Syndromes, which are characterized by their relative lack of response to therapy with levodopa/carbidopa

1.Parkinsonism + Vertical gaze palsy = Supranuclear palsy
2.Parkinsonism + prominent ataxia = olivopontocerebellar palsy
3. Parkinsonism + prominent orthostatic hypotension = Shy-Drager syndrome (now called multiple- system atrophy)

A useful mnemonic is to think of Mr. Parkinson as fine BRITish gentleman

Bradykinesia
Rigidity (cogwheel)
Instability (postural)
Tremor (resting)