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on 03-Nov-2016 (Thu)

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#incremental #ir #srs
To repeat Derrida’s terms, these essays always affirm that the “texture” of texts makes any assemblage of them a “basted” one, i.e., permits only the kind of fore-sewing that emphasizes the necessary spaces between even the finest stitching. In practical terms, I would suggest a “basted,” well-spaced reading of Writing and Difference. Instead of reading through the book as a unified, well-sewn volume, one could follow both its arguments and its design in a way that would make them more comprehensible by choosing any of the essays to start with, and by reading the major works it refers to. (
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Flashcard 1410769751308

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Question
Is intercourse safe in pregnancy?
Answer
As long as comfortable and no bleeding or cramping, intercourse is safe in pregnancy

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Question
Steroid hormones are synthesized? (4)
Answer
Adrenal cortex, gonads, corpus luteum, and placenta.

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Steroid hormones are synthesized and secreted by the adrenal cortex, gonads, corpus luteum, and pla- centa.

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Flashcard 1414587354380

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Question
postpartum mood disorder is an early/late complication?
Answer
late

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Flashcard 1414589451532

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Question
What are the 6 B's covered in the 6 week postpartum visit?
Answer
Bleeding
Baby (how's baby doing)
Bladder (is peeing okay)
Bum (perineum & stitches)
Blues (mood)
Birth control (address co-morbidities, PAP smear if due)

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Flashcard 1414593121548

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Question
postpartum blues sx's begin [...] ​days postpartum
Answer
3-4

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Flashcard 1414594956556

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Question
postpartum blues peak on the [...] ​day postpartum
Answer
5th

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Flashcard 1414596791564

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Question
postpartum blues last [...] ​ days
Answer
10

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Flashcard 1414598888716

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Question
List 5 characteristics of postpartum mood disorders:
Answer
• Mood lability - from elation to sadness
• Irritability
• Tearfulness
• Low spirit (rather than sadness)
• Anxiety
• Feeling overwhelmed
• Decreased concentration
• Insomnia

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Flashcard 1414600723724

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Question
List 5 risk factors for postpartum mood disorders:
Answer
• History of depression
• Antepartum history of depression
• Family history of depression
• Premenstrual or oral contraceptive associated mood changes
• Psychological impairment around work, relationships, and leisure activities

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Flashcard 1414602558732

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Question
List 5 points on treatments for postpartum mood disorders:
Answer
• Self-limiting, resolves with conservative management
• Reassurance
• Family support
• Ensuring adequate sleep
• Limited use of benzodiazepine for insomnia (risks of addiction and crosses breast milk)
• Further evaluation if symptoms persist (increased risk of postpartum depression)

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Flashcard 1414604393740

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Question
Postpartum depression may start in the [...] ​ or [...] ​ period
Answer
prenatal (and extend into postpartum) or postpartum period

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Flashcard 1414606228748

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Question
List 5 PPD (and MDD) sx's:
Answer
• Depressed mood
• Diminished interest
• Loss of concentration
• Loss of appetite
• Feeling of worthlessness
• Excessive guilt
• Loss of energy
• Significant weight loss of gain
• Psychomotor retardation or agitation
• Recurrent thoughts of suicide or death

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Postpartum depression:
-The presence of 5 or more of MDD symptoms for a period of two weeks or more
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Flashcard 1414608063756

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Question
Postpartum depression:
-The presence of [...] or more of MDD symptoms for a period of two weeks or more
Answer
5

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Postpartum depression: -The presence of 5 or more of MDD symptoms for a period of two weeks or more







Flashcard 1414609636620

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Question
Postpartum depression:
-The presence of 5 or more of MDD symptoms for a period of [...] weeks or more
Answer
two

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Postpartum depression: -The presence of 5 or more of MDD symptoms for a period of two weeks or more







Flashcard 1414612520204

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Question
List 5 risk factors for PPD:
Answer
• Depression during pregnancy
• Anxiety during pregnancy
• Low levels of social support
• Previous history of depression
• Infant temperament
• Poor Marital adjustment
• Low self esteem
• Postpartum blues
• Unplanned/unwanted pregnancy
• Abuse of the mother
• History of psychiatric disorder in the mother

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Flashcard 1414614355212

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Question
[...] and [...] are drug classes used for pharmacologic treatment of PPD
Answer
antidepressants & TCAs

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Flashcard 1414616190220

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Question
What are classes of antidepressants used for PPD?
Answer
SSRIs (Sertraline (Zoloft)), Fluoxetine (Prozac) and Paroxetine (Paxil)

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Flashcard 1414618025228

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Question
What are classes of TCAs used in PPD?
Answer
Amitriptyline (Elavil) and Imipramine (Tofranil)

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Antidepressants may take up to [...] ​ weeks before a therapeutic level is reached in PPD
Answer
4-6

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Flashcard 1414621695244

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Question
What risk may increase during initial period of PPD treatment?
Answer
suicide

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Question
Continue pharmacologic treatment of PPD for [...] after full remission to minimize risk of relapse.
Answer
1 year

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Flashcard 1414625365260

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Question
Sx's of postpartum psychosis usually occur within [...] ​of childbirth but remain high for [...] ​after delivery
Answer
first 2 weeks; months

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Flashcard 1414627200268

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Question
list 3 clinical features of postpartum psychosis:
Answer
• Loss of touch with reality
• Alternating lucidity and psychosis
• Impairment of functioning
• Delusions
• Hallucinations
• Symptoms of depression: low mood, feeling of worthlessness and guilt
• Manic symptoms: mood elation, distractibility and increased activity

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Flashcard 1414629035276

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Question
List 3 risk factors for postpartum psychosis:
Answer
• Background history of depression, mania, schizophrenic or schizoaffective disorder
• Severe life event in the preceding year
• Pre-existing psychotic illness or bipolar disorder
• Young age
• Primiparity
• Family history of psychiatric illness

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Question
postpartum psychosis is a [...]
Answer
psychiatric emergency

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Flashcard 1414632705292

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Question
List 3 treatments for postpartum psychosis:
Answer
• Hospitalization may be necessary
• Mood stabilizers + antipsychotics (relationship between psychosis and bipolar disorder)
• Lithium – teratogenic concerns, excreted in breast milk, toxicity has been reported in breastfed infants
• Clozapine – an atypical antipsychotic can be used
• ECT – can be effective

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Question
What is postpartum thyroiditis?
Answer
A destructive thyroiditis induced by an autoimmune mechanism within one year after parturition.

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Question
in postpartum thyroiditis, there is a sequence of [...] ​followed by a period of [...], ​then recovery.
Answer
hyperthyroidism ; hypothyroidism

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Flashcard 1414638210316

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Question
List 5 sx's of hyperthyroidism in postpartum thyroiditis:
Answer
fatigue, weight loss, palpitations, heat intolerance, anxiety, irritability, tremor etc.

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Flashcard 1414638734604

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Question
List 5 sx's of hypothyroidism in postpartum thyroiditis
Answer
lack of energy, constipation, cold intolerance, dry skin and sluggishness.

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Flashcard 1414641880332

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There may be [...] ​ level of T3 and T4, [...] ​TSH in the hyperthyroid state in postpartum thyroiditis
Answer
elevated or high normal; low

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Flashcard 1414642404620

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The TSH is [...] ​in the hypothyroid state in postpartum thyroiditis
Answer
low

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Flashcard 1414645550348

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Question
What is the tx of postpartum thyroiditis in asx women?
Answer
observation and monitoring of Thyroid function tests (TFT) every 4 to 8 weeks until resolution or progression to permanent hypothyroidism.

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Flashcard 1414647385356

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Question
What is the tx of postpartum thyroiditis in symptomatic hyperthyroidism?
Answer
treat with Propanolol or Atenolol until TFT become normal.

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Flashcard 1414649220364

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What is the tx of postpartum thyroiditis in symptomatic hypothyroidism of TSH >10mU/L?
Answer
treat with Levothyroxine 50-100mcg/day

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Flashcard 1414651055372

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Question
Postpartum breast engorgement results from [...] ​and [...] ​ of the breasts
Answer
congestion ; increased vascularity

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Question
postpartum breast engorgement causes:
Answer
breast fullness, firmness, pain and tenderness or a transient fever

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Question
breast engorgement usually occurs within [...] ​hours of birth
Answer
24

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Flashcard 1414656560396

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Question
What is the tx for postpartum breast engorgement?
Answer
-exclude other causes of fever
-Treat with analgesia - acetaminophen
-breast support, ice packs

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Flashcard 1414658395404

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Question
What is mastitis?
Answer
Inflammation of the mammary glands

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When does mastitis usually occur?
Answer
Usually occurs when breastfeeding is well established, weeks and months after delivery

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Question
postpartum mastitis is almost always [uni/bilat]
Answer
unilateral

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Flashcard 1414663900428

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Question
The breast is [describe characteristics] ​ in mastitis
Answer
hard, red, fluctuant and painful

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Mastitis is preceded by breast engorgement, followed by fever, chills and tachycardia
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Flashcard 1414665735436

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Question
Mastitis is preceded by [...], followed by fever, chills and tachycardia
Answer
breast engorgement

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Mastitis is preceded by breast engorgement, followed by fever, chills and tachycardia







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Mastitis is preceded by breast engorgement, followed by [...]
Answer
fever, chills and tachycardia

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Mastitis is preceded by breast engorgement, followed by fever, chills and tachycardia







Flashcard 1414670191884

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Question
What is the commonest organism causing mastitis?
Answer
staph aureus (from infant)

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Question
List 3 treatments for postpartum mastitis:
Answer
• Culture breast milk
• Commence antibiotic therapy as soon as possible before abscess formation
• Staphylococcus aureus is sensitive to Penicillin and Cephalosporin
• Use erythromycin if Penicillin allergic
• Vancomycin if methicillin-resistant staphylococcus (MRSA)
• Encourage continuing breast feeding to minimise the risk of abscess formation
• Breast pumping if unable to breast feed

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Postpartum breast abscess requires [...] ​ under general anesthesia
Answer
drainage

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Question
Baby feeding well if soaking ~ [...] ​diapers/day
Answer
6

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baby getting enough milk if by day [...] ​, has [...] ​stools per day.
Answer
day 3; 2-3 stools

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Question
What can you give for not enough milk production?
Answer
domperidone 30mg po TID

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Question
List 5 acceptable drugs during breastfeeding:
Answer
• Analgesics: acetaminophen, non-steroidal anti-inflammatory (NSAIDs), sumatriptan
• Anticoagulants: acenocoumarol, heparin
• Antidepressants: Sertraline, Fluoxetine
• Antiepileptics: Phenytoin, carbamazepine, valproic acid
• Antihistamines
• Antimicrobials
• Beta adrenergics: propranolol, labetalol
• Insulin
• Steroids

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Question
List 3 medications contraindicated in breastfeeding
Answer
• Bromocriptine: causes milk suppression
• Cyclophosphamide: suppresses immune system
• Cocaine: intoxication
• Lithium, phenindione, radioactive iodine, methotrexate, cyclosporin

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Question
List 5 contraindications to breastfeeding:
Answer
• Women who abuse drugs and alcohol
• Infant with galactosemia
• HIV infection
• Untreated tuberculosis
• Hepatitis C
• Hepatitis B not contraindicated, as long as the baby is vaccinated (at birth, 1 and 6 months of life). Cytomegalovirus is transmitted in breast milk. However, the colonization does not lead to actual disease because of IgG transfer via the placenta during the pregnancy.

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WORKFLOW SUMMARIZED:

So, here is the very simple workflow I’ve worked out, again.

1. Add a citation record to Zotero from any of the convenient methods discussed above and attach the searchable PDF document to it. Make sure the full text document carries the name of citation as opposed to a book review or audio file that may also be attached.

2. Click “send to tablet” on the PDF in Zotero. This sends the document to your cloud account under a specially designated ‘tablet readings’ folder.

3. Open the document from the cloud in a PDF annotation program like iAnnotate from your tablet or phone.

4. Joyfully read and annotate with highlighting, underlining, striking out, in text notes, etc.

5. When you finish reading, close the tablet and open Zotero on the computer and click the citation and choose “retrieve from tablet.” This saves the annotated doc, as well as a back up clean version in Zotero.

6. Finally, click “extract annotations” and Zotero extracts all the annotations with related page numbers and saves them as a separate note file which can also be viewed online at the Zotero website even without saving any PDFs to the site.

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In Pursuit of a Digital Academic Workflow: Putting Digital Reading, Annotating, and Citation Management to Work for Your Studies – Cultural Heritage Informatics Initiative
computer easily. I also think it’s useful to use programs like Evernote to take notes and sync them through multiple devices, but I always add the notes to Zotero afterward so that all notes have a central location tied to citation data. <span>WORKFLOW SUMMARIZED: So, here is the very simple workflow I’ve worked out, again. 1. Add a citation record to Zotero from any of the convenient methods discussed above and attach the searchable PDF document to it. Make sure the full text document carries the name of citation as opposed to a book review or audio file that may also be attached. 2. Click “send to tablet” on the PDF in Zotero. This sends the document to your cloud account under a specially designated ‘tablet readings’ folder. 3. Open the document from the cloud in a PDF annotation program like iAnnotate from your tablet or phone. 4. Joyfully read and annotate with highlighting, underlining, striking out, in text notes, etc. 5. When you finish reading, close the tablet and open Zotero on the computer and click the citation and choose “retrieve from tablet.” This saves the annotated doc, as well as a back up clean version in Zotero. 6. Finally, click “extract annotations” and Zotero extracts all the annotations with related page numbers and saves them as a separate note file which can also be viewed online at the Zotero website even without saving any PDFs to the site. Be sure to download the Zotero internet browser plugin, the ZotFile Reader plugin for Zotero, and any of the useful Zotero mobile applications which can be found at http://www.zotero.




Academic libraries serve institutions of post-secondary learning.
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Some colleges and universities choose to have decentralized libraries. There is one main library where acquisitions and cataloguing are completed. The main library houses a complete catalogue of all materials belonging to the library, no matter where the resources are stored. General interest and reference books are retained in the main library, and more specialized resources on specific subjects are housed near the department teaching that subject. The circulation function can be handled in the small departmental library. An example of this type of organization is a university that keeps a departmental library in its school of education.
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