011315 liver dis in pregnancy Flashcards Preview

Gastrointes 2 > 011315 liver dis in pregnancy > Flashcards

Flashcards in 011315 liver dis in pregnancy Deck (17)
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1
Q

liver disease and pregancy share what symptoms

A

spider angiomata, palmar erythema
decreased gallbaldder contractility (stones)
increased alkaline phosphatase
etc

2
Q

hyperemesis gravidarum occurs in what trimester

A

first

3
Q

hyperemesis gravidarum

A

vomiting repeatedly throughout day–dehydration, electrolyte abnormalities

ALT raised 2-3 fold, can reach 20 fold

4
Q

intrahepatic cholestasis of pregnancy–consequences

A

pruritis resolving within 2 days of pregnancy

increased risk of prematurity, perinatal deaths, fetal distress

5
Q

what trimester does IHCP typically occur

A

3rd trimester

6
Q

what labs do you see in IHCP

A

serum bile acids increased 30-100 fold (deposits in skin to cause severe pruritis)
up to 4 fold AST/ALT elevation

7
Q

tx for IHCP

A

supportive:
cholestyramine (binds bile acids)
ursodeoxycholic acid (modifies bile acid pool and inhibitis absorption of more hydrophobic bile acids)

8
Q

preeclampsia

A

HTN, proteinuria, edema

AST and ALT elevation in 25-50%

9
Q

when does precclampsia and eclampsia occur

A

after 20 wks usually

10
Q

eclampsia

A

preeclampsia and seizures

AST and ALT elevations in 80-90%

11
Q

acute fatty liver of preganancy occurs when

A

3rd trimester

12
Q

acute fatty liver of pregnancy-its etiology?

A

fatty acid oxidation defects in fetus (long chain 3 hydroxyacyl coenzyme dehydrogenase deficiency in a fetus with heterozygous mother)

13
Q

in acute fatty liver pregnancy–20-40% of its pts have?

A

preeclampsia

14
Q

symptoms of AFLP

A

mild liver test abnormalities

severe jaundice, coagulopathy and encepathlopathy (so fulminant liver failure)

15
Q

HELLP syndrome

A

hemolytic anemia
elevated liver tests (blirubin, ALT, AST)
low platelets (not the same mechanism as cirrhosis)

16
Q

HELLP syndrome occurs in what trimester

A

3rd

17
Q

4-12% of women having HELLP syndrome have also

A

preeclampsia/eclampsia