Neuro in OB

Question 1

Most common neurological complaint in pregnancy.

Answer 1

hedake

Question 2

Main treatment for migraines in pregnancy.

Answer 2

Acetaminophen

however can cause medication overuse headaches if used daily

Question 3

Medication absolutely contraindicated for migraine treatment in pregnancy because it can induce uterine contractions.

Answer 3

Ergotamine

neurotransmitter mimetic similar to 5-HT, DA, and Epi

Question 4

Name 5 prophylactic meds (classes) used for migraines in pregnancy.

Answer 4

1. Beta Blockers and CCB
2. Anti-depressants and Antiepileptics (in refractory patients)
3. Cyproheptadine

Question 5

What must be considered in any pregnant patient over 20 weeks with headache?

Answer 5

Preeclampsia

Question 6

What is considered if a pashent has preeclampsia and unremitting headaches?

Answer 6

Hemorrhage from malignant HTN or venous thrombosis

Question 7

Drug of choyss for Eclampsia.

Answer 7

Magnesium Sulfate

phenytoin and diazepam are also used

Question 8

What are some characteristics of patients with that have Idiopathic Intracranial HTN (soodowtumor cerebri)?

Answer 8

Headache
Vision Changes
Papilledema
Pulsatile Tinnitis
CN VI palsy

Question 9

What is the major cause of increased occurrence of seizures in pregnancy?

Answer 9

Pregnancy affects general metabolism of the body and of drugs

• hormone changes
• reduced Anti-epileptic drug (AED) bioavailability
• impaired medication absorption
• fateeeg
• sleep deprivation
• changes in binding proteins

Question 10

Main AED associated with neural tube defects.

Answer 10

Valproic Acid

Question 11

Main AED that causes spina bifida and GU malformation.

Answer 11

Carbamazepine

Question 12

Main 2 AEDs known to cause cleft lip and palate deformities.

Answer 12

Penobarbital

Phenytoin

Question 13

What is recommended for seizure patients that plan to get pregnant?

Answer 13

Slowly taper of AEDs at least 6 months prior

supplying folic acid to all women of child bearing age on AEDs is also recommended

Question 14

What are the 3 mechanisms leading to increased risk of stroke in pregnancy?

Answer 14

1. Arterial Infarction/ Ischemia
2. Hemorrhage
3. Venous Thrombosis

Question 15

Most common cause of stroke in pregnancy

Answer 15

Preeclampsia

Question 16

Name one condition actually improved in pregnancy.

Answer 16

Multiple Sclerosis

-relapses decrease in pregnancy

Question 17

Bell Palsy has increased prevelance in pregnancy. When is the most common time it occurs and what class of meds should be avoided?

Answer 17

Most commonly occurs in 3rd trimester or 1st week post partum.

However if it occurs in the first 9 weeks, don’t treat with corticosteroids because it can cause a cleft palate

Question 18

Medikayshun that is contraindicated in patients with myasthenia gravis because it can precipitate severe myasthenic crisis.

Answer 18

Magnesium Sulfate

Question 19

What movement disorder can occur in pregnancy due to iron deficiency, folate deficiency, or hormonal changes?

Answer 19

Restless Leg Syndrome