Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

OBS > PIH > Flashcards

PIH Flashcards

(76 cards)

Start Studying
1
Q

HTN in pregnancy - BP value

A

> 140/90 on 2 separate occasion 4 hours apart.

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

Chronic HTN in pregnancy

A

Previous history of HTN.
HTN woman has conceived.
Inc in BP before 12 weeks of pregnancy

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

PIH.

A

Normotensive woman has conceived and during pregnancy due to Placental pathology has developed HTN @ 20 weeks.

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

PIH types.

A

Gestational HTN and Pre eclampsia

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

Gestational HTN

A

HTN after 20 weeks of pregnancy and normal 12 weeks post pregnancy
No Proteinuria or EOD.

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

Pre Eclampsia

A

HTN after 20 weeks of pregnancy and normal 12 weeks post pregnancy
Either Proteinuria or EOD is present,

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

Criteria for proteinuria in Pre Eclampsia

A

> 300 mg / 24 hrs or 30 mg / dl or 0.3 g/ l

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

Urine Protein : Creatinine ratio for Pre eclampsia

A

0.3

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

EOD signs in Pre eclampsia

A 
S. creatinine > 1.1
Platelet count < 1 lakh
2X raised Liver enzymes - SGPT and SGOT
Pulmonary edema 
Cerebral or Visual symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Types of pre eclampsia

A

Mild - 140/90 - 160/110 with no EOD

Severe - > 160/110 with EOD

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

Chronic HTN with superimposed Pre eclampsia

A

HTN on conceiving @ 20 weeks has uncontrolled HTN with signs of EOD and new onset Proteinuria.

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

Pathogenesis of PIH

A

Failure of Trophoblastic invasion leads to persistence of High resistance maternal spiral arteries in the intervillous space.

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

Angiogenesis is ___ in normal pregnancy

A

INC

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

Levels of VEGF and Placental GH are _____ in normal pregnancy

A

Inc

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

Levels of VEGF and Placental GH are _____ in PIH

A

Dec.

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

sFlt-1 and endoglin levels are _____ in PIH

A

Inc.

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

Thromboxane a2 and Prostacyclin levels are _____ in normal pregnancy

A

Dec.

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

Thromboxane a2 and Prostacyclin levels are _____ in PIH

A

Inc

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

Pathogenesis of EOD in PIH

A

Placental Ischemia - due to high resistance in maternal spiral arteries less blood comes into IVS so blood flow to fetus is reduced.
Inc inflammatory mediators cause Hemoconcentration and capillary leakage leading to Edema and Platelet dysfunction causing thrombosis in blood vessels leading to EOD.

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

C/I in PIH.

A

Diuretics - Coz of Hemoconcentration.

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

Severe Preeclampsia - Pathogenesis.

A

Decreased blood flow to all organs.
Brain - Cerebral hypoxia - Convulsions.
Kidney - Dec RBF - Dec GFR- Inc S. creat, urea and uric acid.
Fetus - IUGR and Dec RBF in fetus - Oliguria and oligohydramnios.

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

MC organ involved in PIH

A

Kidney

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

HPE finding of Kidney in PIH

A

Glomeruloendotheliosis.

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

Risk factor for PIH..

A

Placentomegaly or inc Placental tissue
Extra Chorionic villi seen in twin / molar pregnancy.
Primigravida or New paternity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Complication of severe pre eclampsia
Eclampsia - Generalised tonic clonic seizures.
26
Antepartum Eclampsia
GTCS during pregnancy | MC and worst prognosis
27
Intrapartum Eclampsia
GTCS during Labour
28
Post partum Eclampsia
GTCS after delivery within 48 hrs.
29
Signs and symptoms of Impending eclampsia
Oliguria. Epigastric pain. Visual Symptoms. Headache.
30
Visual Symptoms in Severe pre eclampsia
Scotoma reversible blindness. Blurring of vision Diplopia
31
MC Visual symptom in Severe pre eclampsia
Scotoma.
32
Classification of visual symptoms in HTN retinopathy
Keith Wagner Classification.
33
Smoking is _____ in PIH
Protective.
34
Tests that can predict PIH
Uterine artery doppler - Diastolic notch disappearance VEGF, PLGH, sFLT-1, Endoglin, NO, Thromboxane a2 Dec urine calcium excretion.
35
Findings in PIH
Hemoconcentration. Oliguria Inc S. uric acid.
36
Drugs to prevent PIH
Aspirin. Heparin.
37
Definitive Mx of PIH
TOP @ 37 weeks in Mild and 34 weeks in Severe PIH and immediate TOP in eclampsia or HELLP syndrome.
38
Preferred Mode of delivery in PIH
Vaginal > CS . if CS is done epidural > Spinal. GA C/I
39
Medical Mx of Mild PIH
Anti Hypertensives. +/-
40
DOC to prevent Convulsion in Eclampsia
MgSO4
41
DOC to Rx Convulsions in Eclampsia
MgSO4
42
DOC to prevent impending eclampsia.
MgSO4
43
A-HTN DOC in PIH
Labetalol
44
A-HTN DOC in PE
Labetalol
45
A-HTN DOC in Chronic HTN
Labetalol > Alpha Methyldopa
46
A-HTN DOC in Hypertensive crisis
IV Labetalol > IV Hydralazine.
47
A-HTN DOC in resistance cases in pregnancy
Sodium Nitroprusside.
48
C/I A-HTN in Pregnancy
ACE and ARBs Beta blockers. Diuretics. Diazoxide.
49
Mx of HTN crisis in pregnancy.
IV labetalol > IV Hydralazine > Nifedipine > NTG | Last resort - Sodium Nitroprusside.
50
______ is contraindicated in Asthmatic pts with HTN crisis
IV Labetalol.
51
Mx of Eclampsia
1st step - Secure AIrway 2nd step - MgSO$ 3rd Step - IV labetalol. 4th Step definitive Mx - TOP.
52
MOA of MgSO4 in Eclampsia.
Vasodilation NMDA receptors - dec Cerebral hypoxia - reducing convulsions. Ca ++ blocking.
53
MgSO4 should not be administered with
CCBs
54
Prophylactic use of MgSO4
Impending eclampsia Severe Eclampsia HELLP syndrome.
55
MgSO4 Regimen
Pritchards and SIBAI.
56
Pritchard regimen of MgSO4
Loading dose - 4gm in 20% solution IV and 10 in 50% solution IM -5gm in each buttock Maintenance dose - 5 gm in 50% solution in each buttock - every 4 hrs for 24 hrs after delivery or Last convulsion
57
SIBAI regimen of MgSO4
IV only Loading dose = 6 gm iv over 20 mins Maintenance dose = 2 gm iv. If convulsion reoccurs = 2-4 gms in 5 mins.
58
Therapeutic range of MgSO4
Narrow range 4-7 mEq/L 2-3.5 mmol/L 4.8-8.4 mg/dL
59
Parameters to be checked before MgSO4 loading dose.
Knee jerk Urine output > 30ml/hr Resp rate > 12/min SpO2 > 96
60
Signs of MgSO4 toxicity
Loss of knee jerk or patellar response Slurring of speech or diaphoresis. Resp Depression / Arrest Cardiac Arrest
61
Sign at MgSO4 at > 12 mEq/L
Resp depression
62
Sign at MgSO4 at > 15 mEq/L
Resp arrest
63
Sign at MgSO4 at >25 mEq/L
Cardiac arrest
64
Antidote for MgSO4 toxicity
Calcium Gluconate - 10 ml of 10% Calcium gluconate. | Or Ca Chloride.
65
Absolute C/I of MgSO4
Myasthenia gravis and renal failure.
66
Status Eclampticus
uncontrolled convulsions in spite of MgSO4 administration. | DOC Thiopentone sodium
67
HELLP syndrome
H- hemolysis EL - Elevated liver enzymes LP- Low platelet count
68
TENNESSEE criteria
LDH - >600 IU SGOT and SGPT - > 70 IU Platelet < 1 lakh
69
DDx of HELLP
Acute fatty liver of Pregnancy
70
Mx of HELLP
Prophylactic use of MgSO4 A-HTN Definitive Mx- TOP immediate.
71
Umbilical artery doppler in Normal pregnancy
S/D < 3
72
Umbilical artery doppler in PIH
S/D > 3
73
Absent Diastolic flow in UA doppler.
Indication for TOP @ 34 wks. | Indicator for Reversal flow within a week.
74
Reversed Flow in UA doppler
Indication for Immediate TOP.
75
Indication for Immediate TOP irrespective of GA
``` eclampsia reversed flow in UA HELLP syn Fetal distress / Abruptio placenta Uncontrolled BP inc S. Creat ```
76
Indication for TOP @ 34 wks.
Severe pre eclampsia | Absent diastolic flow in UA doppler.

OBS (13 decks)

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