Pregnancy

Question 1

limit caffeine intake to < ___ mg/day

Answer 1

200 mg/day

Question 2

Folate reduces risk of ___ tubal defects
* ___ mcg daily
* ___ mg for higher risk patients

Answer 2

• neural
• 400-600 mcg
• 4 mg

Question 3

Calcium dereases risk of maternal ___ loss, HTN, and ___
* ___ mg daily

Answer 3

• bone, preeclampsia
• 1000-1300 mg

Question 4

Iron helps with blood ___
* ___ mg daily

Answer 4

• oxygenation
• 27-30 mg

Question 5

vitamins are ideally started ___ months prior to conception

Answer 5

3 months

Question 6

Vaccine recommendations

Answer 6

• inactivated flu before october
• Tdap between 27-36 weeks of pregnancy
• COVID-19

Question 7

T or F: live vaccines can be given during pregnancy

Answer 7

FALSE

Dont give a pregnant person a live vaccine goofy

Question 8

T or F: Clinicians should weight the benefits and risks or initiating or continuing opioids in a pregnant patient

Answer 8

True

Question 9

Drugs that are teratogenic

Answer 9

• Warfarin
• Lisinopril
• Li
• alcohol
• methotrexate
• isotretinoin
• statins

Question 10

Pregnancy PK

• ___ in rate of absorption
• ___ GI motility
• ___ Vd of hydrophilic drugs
• ___ protein binding
• ___ CYP2C19 activity
• ____ CYP3A4 activity
• ___ renal and hepatic blood flow
• ___ CrCl

Answer 10

• decreased
• decreased
• increased
• decreased
• decreased
• increased
• increased
• increased

Question 11

Diabetes Management in Pregnancy

• Prefered Treatment: ___
• Avoid: ___ and ___
• check blood sugar ___ times daily
• fasting blood glucose shold be below ___ mg/dL

Answer 11

• insulin
• metormin and glyburide
• QID
• 95 mg/dL

Question 12

Hypertension Management in Pregnancy

• Prefered Treatment (6)
• Avoid (2)

Answer 12

Prefered:
1. Labetalol
2. amlodipine
3. nifedipine
4. HCTZ
5. hydralazine
6. methyldopa

Avoid
* ACE inhibitors (lisinopril, ramipril)
* ARBs (valsartan, candesartan)

Question 13

T or F: N/V usually ocurrs in the 3rd trimester

Answer 13

False: occurs in the first trimester

Question 14

Drugs for N/V

Answer 14

1. pyridoxine.
2. doxylamine + pyridoxine
3. meclizine, dimenhydrinate, diphenhydramine 4. Last line: ondansetron, metoclopramide

Question 15

T of F: heart burn occurs in the first half of pregnancy

Answer 15

False; last half of pregnancy

Question 16

Drugs of heartburn

Answer 16

1. antacids (magnesium hydroxide, calcium caronate)
2. sucralafate
3. H2 antagonists and protin pump inhibitors

Question 17

Drugs for constipation

Answer 17

• osmotic laxatives (polyethylene glycol and lactulose)
• stooll softeners (docusate)
• bulk laxatives (psyllium)

Question 18

Treatment of Pain, Fever, and Headache in Pregnancy

Answer 18

• Acetaminophen

AVOID NSAIDs after 32 weeks

Question 19

Treatment of Cough and Cold in Pregnancy
* Congestion: ___ (2nd/3rd trimester) or ___
* Rhinorrhea and sleeplessness: ___ or ___

Answer 19

• pseudoephedrine, nasal saline spray
• chlorpheniramine, diphenhydramine

Question 20

Treatment of Urinary Tract Infections in Pregnancy
* 1st gen ___ (4)
* AVOID: ___

Answer 20

cephalosporins
1. Cephalexin
2. Nitrofurantoin
3. amoxicillin
4. ampicillin

AVOID: Fluoroquinolones (cipro/levoloxacin, tetracyclines, doxycyclines, SMZ/TMP

Question 21

Treatment of Thromboembolism in Pregnancy
* ___ for at least 6 months
* AVOID: ___

Answer 21

• anticoagulant
• warfarin

Question 22

preeclampsia definition:
spike in blood pressure above ___ mmHg plus ___ (300mg/dL)

Answer 22

• 140/90 mmHg
• proteinuria

Question 23

eclampsia definition:
___ or coma

Answer 23

seizure

Question 24

complications of preeclampsia and eclampsia

Answer 24

• premature birth
• low birthweight
• growth retardation
• death

Question 25

preeclampsia prevention * ___ 60-80 mg starting in late ___ trimester

Answer 25

aspirin, 1st

Question 26

severe preeclampsia (4)

Answer 26

* hydralazine * labetalol * nitroprusside * nifedipine AVOID: ACE inhibitors/ARBs

Question 27

seizure management medication

Answer 27

magnesium sulfate 4-6g IV bolus

Question 28

what does HELLP syndrome stand for?

Answer 28

* Hemolysis * Elevated Liver enzymes * Low Platelet count

Question 29

HELLP Syndrome treatment

Answer 29

* platelets * corticosteroids * monitoring diagnostic lab values

Question 30

Treatment of Group B Strep in Pregnancy (antibiotics)

Answer 30

1. Penicillin G or Ampicillin 2. PCN allergy (mild) - Cefazolin 3. PCN allergy (severe) - Clindamycin and Vancomycin

Question 31

preterm labor is anytime before ___ weeks

Answer 31

37 weeks

Question 32

Prevention of Preterm Labor * No history of preterm birth: progesterone ___ mg vaginal suppository * History of preterm birth: progesterone ___ IM weekly

Answer 32

* 200 mg * 250 mg

Question 33

Premature Membrane Rupture Definition: water breaks but no ___.

Answer 33

contractions

Question 34

Premature Membrane Rupture Treatments (4)

Answer 34

* corticosteroids * antibiotics * tocolytics * magnesium sulfate

Question 35

Premature Membrane Rupture Treatments - Corticosteroids Purpose: reduce the risk of ___ distress syndrome * 2 examples

Answer 35

respiratory * betamethasone * dexamethasone

Question 36

Premature Membrane Rupture Treatments - antibiotics Purpose: Group ___ strep prophylaxis (if indicated) * 3 examples

Answer 36

B * Penicillin G * Cefazolin * Vancomycin

Question 37

Premature Membrane Rupture Treatments - tocolytics Purpose: inhibit uterine ___ * 4 examples

Answer 37

contractions * nifedipine * indomethacin * terbutaline * magnesium sulfate

Question 38

Premature Membrane Rupture Treatments - magnesium sulfate Purpose: fetal ___ protection

Answer 38

neutral