Ward 38 Flashcards
(33 cards)
What is alkaline phosphatase (ALP)?
ALP is a protein enzyme that is found in high concentration in the placenta, bone, and bile duct.
What is high ALP a sign of?
Cholestasis
Why is ALP physiologically high in pregnancy?
ALP is found in high concentration in the placenta, thus as the placenta grows, there is more ALP.
What is alanine transaminase (ALT)?
ALT is an enzyme found in high volume within the hepatocytes.
What is high ALT a sign of?
Hepatocellular injury
What is bilirubin?
A breakdown product of haemoglobin
What do pale stools and dark urine suggest about the cause of jaundice?
Post-hepatic cause
What does normal stools and dark urine suggest about the cause of jaundice?
Hepatic cause
What does normal stools and normal urine suggest about the cause of jaundice?
Pre-hepatic cause
What does a ALT>AST suggest?
Chronic liver disease
What does AST>ALT suggest?
Cirrhosis/acute alcoholic hepatitis
What is a GI differential of pruitis during pregnancy?
Intrahepatic cholestasis of pregnancy (ICP)
What are symptoms of pre-eclampsia?
Headache, visual disturbance, RUQ pain, nausea and vomiting (2nd and 3rd trimester), oedema
What causes pre-eclampsia?
Vessel reorganisation to the small arteries suppling the kidney, placenta and liver (thus also the foetus)
Why is there oedema in pre-eclampsia?
Vascular hyperpermeability due to low serum albumin
What blood test can determine whether RUQ pain is due to cholestasis or something else?
Bile salts
Why might you not be concerned if CRP is raised but WBC are coming down?
CRP lacks behind WBC
What is CRP?
CRP is c-reactive protein. This is a protein made by the liver. It enters the bloodstream in response to inflammation.
What is the reason behind physiological anaemia of pregnancy?
In pregnancy the circulating blood volume increases. Plasma rises proportionally more in comparison to red cells. This causes haemodilution. There are still more RBC than before pregnancy, but these red cells are more diluted.
What happens to asthma during pregnancy?
1/3 get better
1/3 stay the same
1/3 get worse
Why do some asthmatics get worse during pregnancy?
Dampened immune response to allergens
When do you give iron infusion after delivery?
Hb < 85
When is hypertension deemed gestational hypertension and not chronic hypertension?
When hypertension occurs after 20 weeks gestation.
What BP is deemed as hypertension in pregnancy?
> 140/90
