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Flashcards in Medical Complications Deck (25):
1

diabetes

Preexisting diabetes, pregnancy leads to worsening
No diabetes at all leading to gestational diabetes

2

HTN

140/90 or greater

3

HTN triad

Elevated BP, excessive weight gain, albuminemia

4

Pre-eclampsia

new onset of HTN and either proteinuria or end organ dysfunction after 20 weeks gestation in previously normotensive pt

5

patho of preeclampsia

Spiral arteries from myometrium become thickened, wider, and spiraled in preparation for the placenta
Something goes wrong with spiral arteries, so body releases enzymes to make endothelium of spiral arteries behave normally. This has systemic effect leading to increased BP

6

HELLP syndrome

hemolysis
elevated
liver enzymes
low
plateltes

schistocytes-broken up RBCs seen

7

preeclampsia dx

systolic bp >140 or diastolic >90 on two occasions at least 4 hours apart after 20 weeks gestation
if systolic>160 or diastolic >110, confirmed in minutes
proteinuria >0.3 grams in 24 hours

8

eclampsia

development of grand mal seizures in a pt with preeclampsia, in the absence of any neuro conditions

9

Pre-eclampsia is a disease of the...

placenta, once removed the pre-eclampsia goes away....treatment is delivery of baby and placenta

10

seizure prophylaxis meds
HTN meds

magnesium sulfate
labetolol, hydralazine

11

EJ inpregnancy

normal is 55%, can drop down to below 45%

12

ABG O2 should be what in 3rd trimester?

ABG O2 of pregnant woman in 3rd trimester should be at least 100 but could be up to 108

13

normal ABG values during pregnancy

pH:7.45-7.53 from resting hyperventilation
P02: 100-108
pC02: 25-30
HCO3: 16-22

14

a pulse ox of 90% indicates...
80%...

P02 of 60
Po2 of 40

15

is d-dimer a good test for PE i pregnancy?

no, levels will be increased regardless

16

tx of bronchial asthma

albuterol,
ipatropium
systemic prednisone

17

what if pt have a VP shunt?

in 3rd trimester, increased abdominal pressure results in cessation of drainage and increased ICP

18

what do you think of if there is abdominal pain in the 3rd trimester

abruption of placenta or appendicits

19

MC general surgical problem during pregnancy

appendicits, may have pain in RLQ or RUQ

20

what % of blood volume can be lost before symptoms occur?

35%
15% blood loss shows no significant symtoms

21

supine hypotensive syndrome

Fetus weight causes pressure on inferior vena cava/aorta causes hypotension, lift pt on right side up....pt should always be evaluated on her left side (right hip elevated)

22

what test should you quickly do on a pregnant pt that comes into the ER?

finger stick for hypoglycemia

23

alkalotic pH of vagina may indicate

PROM

24

MCC of trauma during pregnancy
2nd MCC

IPV
MVA

25

GI consideration in trauma

insert an NG tube, stomach emptying is delayed