hypertension in pregnancy

Question 1

chronic hypertension

Answer 1

begins before pregnancy or prior to 20 weeksdoesn’t resolve within 12 weeks postpartumBP > 140/90

Question 2

gestational hypertension

Answer 2

increased BP > 140/90 occurring after 20 weeks without proteinuriageneral term to classify until definitive diagnosis made

Question 3

preeclampsia

Answer 3

after 20 weeks- elevated BP >140/90 – 2x 4 hours apart- proteinuria [> 300mg/24 hour urine collectionprotein/creat > 0.3 -or- urine dipstick > 1+]OR- thrombocytopenia (platelet 1.1 mg/dL)- impaired liver function (LFTs > 2x normal)- pulmonary edema- cerebral/visual symptoms

Question 4

severe preeclampsia

Answer 4

SBP > 160 & DBP > 110+thrombocytopenia, renal insufficiency, impaired liver function, pulmonary edema, cerebral disturbance

Question 5

eclampsia

Answer 5

preeclampsia criteria +- grand mal seizure activity- increased maternal mortality

Question 6

chronic hypertension superimposed preeclampsia

Answer 6

hypertension before 20 weeks +- new onset proteinuria- sudden increased BP (previously controlled)- any severe preeclampsia features

Question 7

grand mal seizure

Answer 7

?

Question 8

fibrinogen

Answer 8

?

Question 9

fibrin split products

Answer 9

?

Question 10

disseminated intravascular coagulation

Answer 10

pathologic diffuse clotting causing widespread bleeding/clotting (consumes large amounts of clotting factors = widespread int and/or ext bleeding)never primary diagnosis, always results from problem that triggered clotting cascade

Question 11

cardiogenic pulmonary edema

Answer 11

congestive heart failure w or w/o fluid overload

Question 12

non-cardiogenic pulmonary edema

Answer 12

leaky vessels allow fluid into extravascular space and alveoli

Question 13

scotomata

Answer 13

altered vision

Question 14

colloid osmotic pressure

Answer 14

gradient controlling whether fluid remains inside the capillary or moves into the interstitial space. The force to keep the fluid inside the vessel is the pulling pressure of the colloids, or proteins, present in the plasma

Question 15

thrombocytopenia

Answer 15

low platelet count!!

Question 16

hellp syndrome

Answer 16

severe preeclampsiavague s/s, dx by lab valuescan have atypical presentationincreases maternal mortality

Question 17

hellp syndrome s/s

Answer 17

malaise, n/v, ruq pain, headache, visual change, proteinuria (may see without increased BP)

Question 18

hellp syndrome lab values

Answer 18

elevated liver enzymes (ldh, alt, ast) low platelets (

Question 19

hydralazine IV

Answer 19

arteriolar vasodilator1st line med for acute hypertensive crisis (preeclampsia)

Question 20

labetalol IV

Answer 20

beta blocker1st line med for acute hypertensive crisis (preeclampsia)

Question 21

nifedipine IV

Answer 21

ca+ channel blocker1st line med for acute hypertensive crisis (preeclampsia)

Question 22

sodium nitroprusside

Answer 22

potent vasodilator2nd line med for acute hypertensive crisis (preeclampsia)

Question 23

nitroglycerine

Answer 23

potent vasodilator2nd line med for acute hypertensive crisis (preeclampsia)