Medical condition in pregnancy

Question 1

Causes of thrombocytopenia in pregnancy (8)

Answer 1

1. Idiopathic
2. Pre-eclampsia
3. ITP
4. APS
5. DIVC
6. Sepsis
7. HIV
8. Malignancy

Question 2

Features of life-threatening athma (10)

Answer 2

PEFR < 35% ecpected p02 < 8kPa pCO2 > 4.6kPa Silent chest Cyanosis Bradycardia Arrthymia Hypotension Confusion

Question 3

Pneumonia warning signs (7)

Answer 3

RR > 30/min Hypoxemia p02 < 7kPa RA Acidosis pH < 7.3 Hypotension DIVC Elevated blood urea MOF Note: CURB65 score is used to asses severity

Question 4

Causes of chronic hypertension in pregnancy (10)

Answer 4

Idiopathic: essential hypertension Renal disease: Polycystic disease Diabetic nephropathy Chronic glomerulonephritis Nephrotic/nephritic syndrome Vascular: RAS Coarctation of aorta Collagen vascular disease: Systemic sclerosis SLE Rheumatoid disease Endocrine: Phaeochromocytoma Conn’s syndrome Cushing’s syndrome Diabetes mellitus

Question 5

American College of Rheumatology criteria for SLE (4 out of 11)

Answer 5

Malar rash Discoid rash Photosensitivity Oral ulcer Non-erosive arthritis Pleuritis/pericarditis Renal disorder Neurologic disorder Hematologic disorder Immunologic disoders Positive ANA

Question 6

Diabetes 1) Target HbA1c in pregnancy 2) Target pre-meal level

Answer 6

1) < 6.5% 2) 4-7 mmol/L

Question 7

Treatment of hyperthyroidism in pregnancy (3)

Answer 7

1) Propylthiouracil 2) Corticosteroids 3) Beta-blockers