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ENRP Exam 1 > Medical Conditions in Pregnancy > Flashcards

Medical Conditions in Pregnancy Flashcards

1
Q

gestational DM screening

A

24-28 weeks
50 mg one hour oral glucose challenge
> 130 is abnormal

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2
Q

risk factors for gestational DM

A 
obesity
previous gestational DM
fam hx of DM
known glucose intolerance
advanced age
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3
Q

maternal complications of GDM

A

gestational HTN
preeclampsia
C-section delivery
DM later in life

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4
Q

fetal complications of GDM

A 
macrosomia
neonatal hypoglycemia
hyperbilirubinemia
operative delivery
shoulder dystocia
birth trauma
stillbirth
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5
Q

GDM management

A

blood glucose monitoring
diabetic teaching
diet control vs medication tx
increase exercise

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6
Q

maternal evaluation for GDM

A

urine every trimester
EKG
eye exam in 1st trimester
daily glycemic monitoring

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7
Q

fetal evaluation for GDM

A

early dating US
fetal EKG
biochemical testing for congenital malformations
fetal US every 3-4 weeks starting at 28 weeks
fetal testing every week starting at 32 weeks

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8
Q

maternal hyperthyroidism

A

dx made by elevated T4 and suppressed TSH

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9
Q

tx for maternal hyperthyroidism

A

propylthiouracil in 1st trimester

methimazole in 2nd and 3rd trimester

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10
Q

fetal effects of maternal hyperthyroidism

A 
fetal hypothyroidism
goiter
prematurity
growth restriction
stillbirth
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11
Q

thyroid storm triggers

A

infection
noncompliance with meds
*labor
*C-section

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12
Q

thyroid storm sx

A

hyperthermia
tachycardia
perspiration
high output cardiac failure

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13
Q

thyroid storm tx

A 
beta-blockers
propylthiouracil
dexamethasone
IVFs
antipyretics
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14
Q

risks of untreated maternal hypothyroidism

A 
spontaneous abortion
preeclampsia
abruption
low birth weight
stillbirth
cretinism
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15
Q

maternal hypothyroidism management

A

levothyroxine

monthly TSH and T3/T4 monitoring

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16
Q

neonatal thyrotoxicosis

A

due to transplacental transfer of thyroid-stimulating Abs

16% mortality rate

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17
Q

neonatal hypothyroidism causes

A

thyroid dysgenesis
inborn errors of thyroid function
drug-induced

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18
Q

postpartum cardiomyopathy

A

develops within the last weeks of pregnancy or within 6 months of postpartum

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19
Q

risk factors for developing postpartum cardiomyopathy

A

preeclampsia
HTN
poor nutrition

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20
Q

pregnancy with underlying cardiac dz management

A 
co-management with cardiologist
avoid excess weight gain and edema
avoid strenuous activity
prevent anemia
avoid infection
anticoagulation prn
maternal and fetal EKGs
maternal ECHO
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21
Q

immune idiopathic thrombocytopenia

A

immunoglobulins attach to maternal platelets

tx:
prednisone
IVIg
platelet transfusion
splenectomy
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22
Q

SLE flare tx while pregnant

A

prednisone

23
Q

fetal complications of SLE

A

preterm delivery
fetal growth restrictions
stillbirth
miscarriage

24
Q

antiphospholipid syndrome tx during pregnancy

A

heparin and low-dose ASA

full coagulation if hx of thrombosis

25
Q

acute renal failure management

A

labs - urine, creatinine, etc
cardiovascular studies
urologic studies

26
Q

acute renal failure tx

A

pre-renal: fluid replacement
renal: diuretic or hemodialysis
post-renal: remove obstruction

27
Q

is it recommended to get pregnant post-renal transplant?

A

nah

28
Q

causes of asymptomatic bacteriuria

A

urinary stasis and glucosuria

tx: abx

29
Q

pyelonephritis risks

A

may cause increased uterine activity and preterm labor

30
Q

pyelonephritis tx

A

IVFs
abx
antipyretics
tocolytics prn

31
Q

tx for nausea and vomiting of pregnancy

A

Vit B6
doxylamine
promethazine

32
Q

hyperemesis gravidarum

A

persistent N/V associated with >5% loss of pre-pregnancy weight, ketonuria, and dehydration

unknown cause

33
Q

hyperemesis gravidarum tx

A

OP management as tolerated
may need hospitalization for IVFs, glucose, vitamins, etc.
if severe - nasogastric feeding or parental nutrition

34
Q

GERD tx

A 
small meals
avoid lying down after meals
elevate head when sleeping
antacids
H2 blockers/PPIs
35
Q

peptic ulcer tx

A

avoid caffeine, alcohol, tobacco and spicy foods
antacids, H2 blockers/PPIs
abx for H. pylori

36
Q

Mendelson’s syndrome

A

acid aspiration syndrome

due to delayed gastric emptying and increased pressure

37
Q

Mendelson’s syndrome prevention

A

decrease acid in stomach

do not feed in labor

38
Q

Mendelson’s syndrome tx

A

O2
maintain airway
watch for ARDS

39
Q

intrahepatic cholestasis of pregnancy (ICP)

A

cholestasis and pruritis in second half of pregnancy
benign course for mom
increased risk of meconium and fetal demise

40
Q

ICP tx

A

cold baths and bicarbonate washes
ursodeoxycholic acid
fetal surveillance
possible early fetal delivery

41
Q

acute fatty liver of pregnancy

A

hepatic failure due to an unknown cause

42
Q

acute fatty liver of pregnancy tx

A

pregnancy termination

supportive care

43
Q

anemia of pregnancy

A

secondary to iron deficiency

hgb < 11 in 1st trimester
hgb < 10.5 in 2nd and 3rd trimester

44
Q

anemia tx

A

iron supplementation

45
Q

why are pregnant women at increased risk for DVT and PE?

A

pregnancy is a hypercoagulable state

5 fold increased risk for DVT

46
Q

when are pregnant women at the greatest risk for DVT?

A

first 5 weeks postpartum

47
Q

DVT tx

A

lovenox or heparin

no coumadin during pregnancy!!

48
Q

most common pulmonary dz of pregnancy

A

asthma

tx same as non-pregnant

49
Q

which antiepileptics should absolutely not be used in pregnancy?

A

valproic acid, phenytoin or phenobarbital

*technically all anti-epileptics are teratogenic BUT these 3 are the worst

50
Q

risk factors for postpartum depression

A

personal or fam hx of depression
hx of abuse
drug abuse
hx of personality disorder

51
Q

depression tx during pregnancy

A

avoid antidepressants during 1st trimester if possible

Lol I’m fucked

52
Q

incidence of postpartum blues

A

70-80%

due to hormone fluctuations

53
Q

incidence of postpartum depression

A

10-15%

ENRP Exam 1 (20 decks)

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