Wed- DM in pregnancy and ectopics Flashcards Preview

Year2 Repro exam II > Wed- DM in pregnancy and ectopics > Flashcards

Flashcards in Wed- DM in pregnancy and ectopics Deck (56)
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1

What is class B DM

onset at age 20 or older with duration less than 10 yrs

2

what is class C DM

onset age 10-19 duration 10-19 years

3

what is class D DM

onset before age 10 duration >20 yrs

4

what is class E DM

over DM with calcified pelvic vessels

5

what is class F DM

diabetic nephropathy

6

class R DM

proliferative retinopathy

7

class RF DM

retinopathy and nephropathy

8

class H DM

ischemic heart disease

9

class T DM

prior kidney transplant

10

what is DM I

destruction of beta cells o pancreas
absolute insulin deficiency

11

what is DM II

insulin R and relative insulin deficiency

12

how to manage DM II

lifestyle modification, diet, exercise, pharm

13

what is gestational DM

any degree of glucose intolerance with onset or first recognition during pregnancy

14

what causes gestational DM

condition in which a hormone made by placenta prevents body from using insulin effectively

15

what is risk of DM after GDM

50-70%

16

what happens to excess glucose in GDM

stored as fat in the fetus

17

risk factors GDM

increasing maternal age and weight
previous GDM
previous macrosomic infant
FMH DM
ethnic background with increased DM

18

what occurs to metabolism in first trimester

fasting blood glucose decreases from insulin production and sensitivity increases

19

what occurs to metabolism after first trimester

insulin sensitivity decreases
increase in insulin production

20

how is euglycemia maintained in pregnancy

beta cells produce enough insulin to counteract increasing resistance

21

complications GDM

HTN
preeclampsia
SAB
worsening of DM complicaitons
fetal growth restriction with vasculopathy
ketoacidosis or severe hypoglycemia

22

complications of GDM for baby

macrosomia
hypoglycemia at birth
hyperbilirubinemia
low ca and Mg
RDS
polycythemia
hyperviscosity
increased risk for childhood and adult obesity
increased risk DM II later in life

23

risks of preterm birth

GDM
uncontrolled preexisting DM
vascular disease
HTN disorders
obesity

24

what are the tests to order for GDM

50 g glucose challenge test
oral glucose tolerance test, 75 or 100g

25

what glucose levels are Dx for GDM

fasting plasma glucose of 126
random plasma glucose of 200

26

indications for delivery in GDM

poorly controlled blood glucose
abnormal fetal testing
fetal growth restriction
deterioration of vascular complications
significant macrosomnia

27

indications for increased surveillance uring labor

macrosomia
growth restriction
abnormal level of amniotic fluid
uncontrolled blood glucose
elevated A1C
frequent hospital admissions during pregnancy
little or no prenatal care

28

what to do in a woman with DM with anticipated labor 6-8 hours

IV dextrose administered hourly at a rate of 100ml to 150ml

29

what level of blood glucose in maintained during labor to reduce risk of maternal and fetal hyperglycemia

<110

30

what patients must have insulin during labor

DM I