Medical Disease Flashcards
(18 cards)
What are the medical diseases found in obstetrics?
Asx Bacteriuria Cystitis Pyelonephritis HTN Thyroid Seizure DM
What are the bugs for Asx bacteriuria?
Gram negatives
Group B strep
What is the symptoms, dx, Tx and F/U for asx bacteriura?
No symptoms
Dx- U/A positive
Tx- Amoxicillin, Nitrofurantoin (if pen all), TMP-SMX
F/U Do rescreen a pregnant woman
What are the bugs of cystitis?
Gram negative
GBS
What are the symptoms, dx, tx and F/U for cystitis?
Symptoms - Urgency, Frequency, Dysuria
Dx- U/A positive
Tx - treat for 7 days complicated UTI. Treat with amoxicillin, Nitrofurantion (if pen all),
TMP- SMX
F/U- rescreen pregnant woman
What is the bugs for pyelonephritis?
Gram negatives,
GBS
What the symptoms, dx and tx for pyelonephritis?
Symptoms - urgency, frequency, Dysuria, fever, chills, N/V, CVA tenderness
Dx- U/A positive wbc cast
Tx - ceftriaxone, if no improvement after 3 days, U/S looking for abscess
What is the goal for HTN in pregnancy?
<140, <90, onset before 20 weeks before gestation
What are the symptoms, Dx, and treatment for HTN in pregnancy?
ASX
Dx- ambulatory BP
Tx- alpha methyl dopa (best), Labetalol, hydralazine
F/U- strict screening for eclampsia
What is the pathology of the thyroid?
Hyperthyroid - dead baby
Hypothyroid - cretinism
What is the symptoms and dx of thyroid?
Hyper - decreased TSH, increased T4
HYpo - increased TSH, decreased T4
What is the Tx and F/U of Thyroid?
Hyper- PTU safe in pregnancy, if surgery needed do in 2nd trimester
HYpo - levothyroxine
F/U - increase in thyroid binding Globulin means increase levothyroxine 25%
Trend TSH every 4 weeks
How is epilepsy Dx?
Clinical
What is the tx and F/U for seizures in pregnancy?
Remember all antiepileptics are teratogens
Risk benefit analysis
If possible avoid in first trimester
Increase in frequency = increase in treatment
Levetiracetam and Lamotrigine
F/U- phenobarbitals to abort seizures in pregnancy (Benzos ok especially late in pregnancy)
Folate for all woman
What is the Pathology for type I and Type II DM?
Type I - Autoimmune destruction of the pancreas
Type II - obesity, insulin sensitivity
What are the symptoms of DM?
Increased blood glucose, Fasting glucose or A1c
What is the treatment for DM before, During ad post pregnancy?
Pre - weight loss, diet, excersize, oral medications (Insulin), A1c <7
During - increase insulin requirements, basal bonus, A1c is useless
Post- decrease insulin demands at delivery
What are complications of DM during pregnancy?
Macrosomia, Shoulder dystocia (Tri3)
Transposition of the great vessels (Tri1)
