Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Master the boards: Obstetrics > Medical Complications in pregnancy > Flashcards

Medical Complications in pregnancy Flashcards

(80 cards)

Start Studying
1
Q

What is hyperemesis Graviarum?

A

severe N/V in pregnancy that leads to >5% decrease in body weight or loss of >6lb compared with prepregnancy weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What electrolyte changes can be seen with Hyperemesis Gravidarum?

A

Hypokalemia
Hypochloremic metabolic acidosis
hypogamnesemia
Hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the best initital therapy for Hyperemesisi Gravidarum?

A

Dietary modification and avoidance of triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the nest best step in Hyperemesis Gravidarum if it doesn’t improve?

A

Dopamine Antagonists: Metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the final choice in treatment for Hyperemesis Gravidarum?

A

Serotonin Antagonist: Ondansetron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How much weight should be gained in pregnancy with BMI of <18.5?

A

28-40lb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How much weight should be gained in pregnancy with BMI of 18.5-24.9?

A

25-35lb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How much weight should be gained in pregnancy with BMI of 25-29.9?

A

15-25lb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How much weight should be gained in pregnancy with BMI of >30?

A

11-20 lb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is Asymptomatic Bacteriuria screened for?

A

12-16 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Should a positive urine Cx without symptoms be treated?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the best empiric treatment for Asymptomatic Bacteriuria?

A

Nitrofurantoin, amoxicillin or cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drug for Asymptomatic Bacteriuria do you avoid in the 3rd trimester?

A

Nitrofurantoin: risk of kernicterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is Acute Cystitis diagnosed in pregnancy?

A

Urine frequency, dysuria, WBC on UA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you treat acute cystitis in the 1st and 2nd trimesters?

A

Empiric Nitrofuratnoin until cx results are available then tailor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is needed to treat Acute Pyelonephritis in pregnancy?

A

Hopsital admission and IV Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is used for acute pyelonephritis in pregnant patients allergic to penicilin?

A

Aztreonam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the best diagnostic test for PE in pregnancy?

A

V/Q scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

If a V/Q scan in a pregnant patient is indeterminate what do you do next?

A

CT pulmonary angiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you treat PE/DVT in pregnant patients?

A

LMW Heparin
-stop 24 hours before deliveyr
-resume 12 hours after C-section and 6 hours after vaginal delivery

Continue for 6 weeks postpartum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What anticoagulant are contraindicated in pregnant patients?

A

Warfarin
Direct Thrombin Inhibitors
Factor Xa inhibitors

But can be used during breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you screen for cervical cancer in pregnancy?

A

PAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is needed if PAP in pregnancy shows Atyipical glandular cells or high-grade squamous intraepithelial lesion?

A

Colposcopy with biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are Polymorphic Eruption of Pregnancy (PEP) and Pruritic Urticarial Papules and Plaques of Pregnancy (PUPPP)?

A

benign-self limiting prurutic inflammatory disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How does PEP/PUPPP present?
erythematous papules within striae that spread outward to form urticarial plaques : commonly in 1st pregnancy after 35 weeks or postpartum
26
What areas are spared in PEP/PUPPP?
Face, palms and soles
27
How do you treat PEP/PUPPP?
Topical corticosteroids: Clobetasol or Betamethasone
28
What characterizes Intrahepatic Cholestasis of pregnancy?
Pruritus without a rash + elevated serum bile acid concentration
29
How does Intrahepatic Cholestasis of Pregnancy (ICP) Present?
Usually 3rd trimester: moderate to severe pruritus: predominantly on the palms and soles that is worse at night
30
What lab results confirm the diagnosis of Intrahepatic Cholestasis of Pregnancy (ICP)?
Elevated bile acids Cholic acid chenodeoxycholic acid
31
What risk is associated with ICP?
Increased risk of intrauterine fetal death
32
How do you treat ICP?
Ursodeoxycholic acid + induction of labor at 36-37 weeks
33
What causes Acute Fatty Liver of Pregnancy (AFLP)?
microvesicular fatty infiltration of hepatocytes in the 3rd trimester
34
What are common symptoms of AFLP?
Nausea, Vomiting, Abdominal Pain, Malasie, Anorexia, and Jaundice
35
What lab results are associated with AFLP?
LFT and Bilirubin: Elevated WBC: elevated possibly Platelets: decreased occasionally Severe: high amonia, prolonged PT, hypoglycemia
36
What is the gold standard to diagnose AFLP?
liver biopsy
37
How do you treat AFLP?
Maternal Stabilization and prompt delivery
38
What is chronic hypertension in pregnancy?
BP >140/90 before the patient became pregnant or before 20 weeks gestation
39
How do you treat chronic hypertension in pregnancy?
Methyldopa, Labetalol or Nifedipine
40
What is Gestation Hypertension?
BP >140/90 that starts after 20 weeks gestation without proteinuria or edema
41
How is gestation hypertension treated in pregnancy?
Methyldopa, Labetalol or Nifedipine only during pregnancy
42
What are common risk factor for Preeclampsia?
Chronic Hypertension, Renal Disease, hx of preeclampsia in prior pregnancy
43
What can be given to patients with risk factors for preeclampsia to reduce risk?
Aspirin therapy
44
What is the only definitive treatment for Preeclampsia?
Delivery
45
Why do you not use ACE-I or ARBS in pregnant patients?
They cause fetal malformations
46
How does preeclampsia without severe features present?
BP >140/90 + Proteinuria 1+ to 2+ on dipstick or 24 hr urine >300mg
47
How does Preeclampsia with severe features present?
BP >160/110 Mental status changes, vision changes, RUQ pain, Severe headache Proteinuria not needed to diagnose due to severe features present
48
What causes RUQ pain in preclampsia?
Impaired liver function: swelling of Gilsson capsule: pain
49
How do you manage Mild preeclampsia at term?
Induce Delivery
50
How do you manage mild preeclampsia preterm?
Expectant management: BP monitoring, NST and BPP
51
How do you manage Severe preeclampsia?
Prevent Eclampsia Control BP Delivery
52
What do you use in Severe preeclampsia to prevent eclampsia?
Magnesium Sulfate
53
What do you use in severe eclampsia to control BP?
Labetalol Hydralazine
54
What is Eclampsia?
Tonic-clonic seizure occurring in a patient with a hx of preeclampsia
55
How do you treat Eclampsia?
Stabilize the mother then deliver the baby Control seizures: Mg Sulfate and BP drugs
56
How do you control seizures in eclampsia?
Magnesium Sulfate
57
How do you control BP in eclampsia?
Hydralazine or Labetalol
58
What is HELLP Syndrome?
Hemolysis: Elevated Liver Enzymes: Low Platelets
59
How do you treat HELLP Syndrome?
Same as eclampsia: Magnesium sulfate + Hydralazine or Labetalol
60
What is Pregestational Diabetes?
Patient had diabetes before becoming pregnant: can be Type 1 or Type 2
61
What Does pregestational diabetes increase the maternal risk of?
Preeclampsia Spontaneous abortion Infection Postpartum hemorrhage
62
What does pregestational diabetes increase the fetal risk of?
Congenital anomalies: heart and neural tube Caudal Regression syndrome: Sacral agenesis Macrosomia: Shoulder dystocia
63
What additional tests should be done in addition to the usual prenatal test for someone with pregestational diabetes?
EKG 24 hour urine for baseline renal function HbA1c Ophthalmological exam
64
What are potential complications of Gestational Diabetes?
Preterm birth Fetal Macrosomia Birth injuries Neonatal hypoglycemia: increased fetal insulin Increases risk of T2DM later in life
65
When routine screening for Gestational Diabetes performed?
24-28 weeks
66
What is the first test in screening for Gestational Diabetes?
50g glucose load test and serum glucose measured 1 hour later
67
What is done next if the Glucose load test is abnormal?
Glucose tolerance test if >130-140 -fasting blood glucose: ingest 100g of glucose -measure at 1,2 and 3 hours: if 2/4 are abnormal (+) test
68
How do you start treatment for gestational Diabetes?
Diabetic diet and exercise
69
What is the gold standard medication for use in gestational diabetes?
Insulin
70
What are alternatives to insulin that can be used in gestational diabetes?
Glyburide and metformin
71
What thyroid related hormones are able to cross the placenta?
TRH and Ig against TSH-R
72
What thyroid related hormones are not able to cross the placenta?
TSH and T4
73
What are the physiologic changes to the thyroid in pregnancy?
Increased TBG: increases total circulating thyroxine: no change in free hCG stimulates TSH-R due to common alpha subunit
74
How is Hyperthyroidism treated in the 1st trimester?
PTU
75
How is Hyperthyroidsm treated in the 2nd/3rd trimester?
Methimazole
76
What birth defects are associated with methimazole?
Aplasia Cutis: Scalp defect
77
What is Peripartum Cardiomyopathy?
Development of HF toward the end of pregnancy or within the first 5 moths postpartum
78
How do you treat Peripartum cardiomyopathy?
Similar to HFrEF
79
What drugs should be avoided in Peripartum cardiomyopathy?
ACE-I : teratogenic
80
Why should a pregnant pt with peripartum cardiomypathy not deliver the fetus?
HF will worsen under the ongoing hemodynamic changes of pregnancy

Master the boards: Obstetrics (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions