Pregnancy

Question 1

Global changes during first trimester

Answer 1

Fatigue and tendency toward syncope and postural hypotension

Question 2

Global changes of second trimester

Answer 2

Sense of well being, relatively few symptoms

Question 3

Global changes of third trimester

Answer 3

Increasing fatigue and discomfort

Question 4

Endocrine changes in pregnancy result from what?

Answer 4

Increased production of maternal and placental hormones and from modified activity of target end organs

Question 5

Elevated estrogen may lead to

Answer 5

vascular permeability manifesting as increased gingival inflammation

Question 6

Cardiac outpu increases by

Answer 6

30-50%

Question 7

Blood volume increased by

Answer 7

40-50%

Question 8

When does blood pressure fall

Answer 8

During 2nd trimester

Question 9

Increase in blood volume is associated with a benign

Answer 9

systolic ejection murmur

Question 10

Supine hypotensive syndrome occurs in

Answer 10

late pregnancy mainly after 2nd trim

Question 11

What is supine hypotensive syndrome caused by?

Answer 11

Compression of the inferior vena cava by the uterus, which leads to impaired venous return to the heart

Question 12

What are signs and symptoms of supine hypotensive syndrome

Answer 12

• Abrupt fall in BP
• Bradycardia
• Sweating
• Nausea
• Weakness
• Air hunger
• Impairment/loss of consciousness

Question 13

How do you prevent supine hypotensive syndrome?

Answer 13

Place rolled blanket under patients right side to tip uterus off the inferior vena cava

Question 14

What is treatment for supin hypotensive syndrome

Answer 14

Roll pt onto left side to lift the uterus off the vena cava

Question 15

Why does anemia occur in pregnancy?

Answer 15

Blood volume increases more rapidly than RBC mass

Question 16

In pregnancy, several blood clotting factors are increased, esp

Answer 16

VII-X and fibrinogen

Question 17

Elevation of the diaphragm does what to the volume of the lungs in resting state?

Answer 17

Decreases, reducing total lung capacity

Question 18

Dyspnea is worsened by

Answer 18

supine position

Question 19

What are GI changes in pregnancy?

Answer 19

• Nausea/vomiting
• Increased appetite
• Taste alterations
• Icnreased gag reflex
• Gastric reflux

Question 20

Why does gastric reflux occur in pregnancy?

Answer 20

Descres esophageal sphincter tone, raised gastric pressure and slower gastric emptying

Question 21

During first trim, what is fetus especially at risk from?

Answer 21

Developmental defects and is most susceptible to malformation

Question 22

What is fetal dentition suscpetible to

Answer 22

Malformation from toxins or radiation and to tooth discoloration caused by administration of tetracycline

Question 23

What does preeclampsia manifest as?

Answer 23

-Persistent hypertension
- Proteinuria
- Edema
- Blurred vision

Question 24

What is eclampsia?

Answer 24

Complication of severe preeclampsia defines as new onset of grand-mal seizure activity and/or unexplained coma during pregnancy/postpartum

Question 25

Based on data, no increase in congenital anomalies or growth retardation occurs with radiographic exposure during pregnancy totaling less than

Answer 25

5cGy

Question 26

Maximum risk attributable to 1cGy of in utero radiation exposure is estimated to be

Answer 26

0.1%

Question 27

1cGy is more than

Answer 27

1000 FMXs

Question 28

What is the maximum permissible radiation dose for whole body exposure of the pregnant dental care worker?

Answer 28

0.005 Gy or 5mSv per year

Question 29

How does a pregnant provider ensure safety during radiographs?

Answer 29

- Wear film badge - Stand more than 6 ft from tube head - Position self between 90 and 130 degrees of beam

Question 30

Respiratory depressants may cause maternal hypoxia, resulting in

Answer 30

fetal hypoxia, injury or death

Question 31

Describe local anesthetics use in pregnancy

Answer 31

- Local with epi generally safe - Use lidocaine (cat B) - Use Mepivacaine, articaine and Tupi with caution (category C)

Question 32

What is the analgesic of choice in pregnancy?

Answer 32

Acetaminophen

Question 33

Why avoid NSAIDs and aspirin during pregnancy?

Answer 33

- Can cause premature closure of ductus arteriosus - Associated with fetal renal dysfunction

Question 34

When may aspirin be rec from OB for pregnant women?

Answer 34

To prevent preeclampsia if at risk. Low dose tablet daily after 12 weeks of pregnancy

Question 35

What category are opioids and narcotics in pregnancy?

Answer 35

Cat C

Question 36

What category are penicillin, amoxicillin, cephalosporins, clindamycin and metronidazole?

Answer 36

Cat B (generally safe)

Question 37

What category are tetracylcine and doxycycline?

Answer 37

Cat D (contraindicated in pregnancy)

Question 38

What category are bentos?

Answer 38

Cat D

Question 39

What cat are barbiturates?

Answer 39

Cat D

Question 40

Nitrous oxide may cause

Answer 40

altered DNA metabolsim leading to cellular abnormalities and birth defects

Question 41

ADA recommends what for nitrous oxide?

Answer 41

Pregnant patients and staff avoid exposure

Question 42

If using nitrous oxide during pregnancy, what would you do?

Answer 42

- Consult with OB - Minimize to less than 30 min - Deliver at least 50% oxygen - Oxygenation should be provided at termination - Avoid repeated exposures - Avoid use in the 1st trimester

Question 43

Drugs that may be used in dentistry but are contraindicated in breast feeding mothers include

Answer 43

- Aspirin - Etodolac - metronidazole - Tetracycline - Benzo - Barbiturate - Carbamazepine

Question 44

Pregnancy gingivitis usually affects the

Answer 44

marginal and interdental gingiva

Question 45

When does pregnancy gingivitis usually begin?

Answer 45

2nd month of pregnancy

Question 46

Pyogenic granuloma is commonly on

Answer 46

labial aspect of interdental papilla

Question 47

Is SRP safe in pregnancy?

Answer 47

Yes