[1] Hypertension in Pregnancy and Gestational Diabetes Mellitus

Question 1

Leading cause of maternal and fetal morbidity

Answer 1

HPN in Pregnancy

Question 2

Most benign in spectrum of hypertensive disorders in pregnancy

Answer 2

Gestational Hypertension

Question 3

Define: Gestational HPN

Answer 3

BP> 140/90 mmHg after 20 weeks in previously normotensive women

Question 4

Is there proteinuria in Gestational HPN?

Answer 4

No

Question 5

Criteria for Pre-eclampsia

with regards to Proteinuria

Answer 5

HPN + Proteinuria >= 300mg/24 hours

OR

Protein:Creatinine Ratio >= 0.3

OR

Dipstick 1 + Persistent

Question 6

Criteria for Pre-eclampsia

alternate criteria without Proteinuria

Answer 6

HPN +

Thrombocytopenia: Platelets < 100,00/uL

Renal Insufficiency: Creatinine > 1.1mg/dL or double baseline

Liver Involvement: Serum Transaminase 2x normal

Cerebral Symptoms: Headache, visual disturbances, convulsions

Pulmonary Edema

Question 7

Criteria for Proteinuria in Pre-Eclampsia

Answer 7

1. Urinary protein spillage of 300mg or more in 24 hours
2. Urinary protein concentration of 100mg/dL
3. More in 2 random specimens taken 6 hours apart

Question 8

[Exam Tip Card]

This is a marker for diagnosis of severe pre-eclampsia in HPN pregnant women

Answer 8

Growth restricted fetus

Question 9

[Exam Tip Card]

Cases will be given and we are supposed to define the different terminologies in HPN

Answer 9

Go memorize them!

Question 10

Define: Eclampsia

Answer 10

Presence of convulsions in a woman with pre-eclampsia, in which the convulsions cannot be attributed to any other cause

Question 11

[Non-severe vs. Severe Pre-eclampsia]

Diastolic BP

Answer 11

N: 110 mmHg

Question 12

[Non-severe vs. Severe Pre-eclampsia]

Diastolic BP

Answer 12

N: 160 mmHG

Question 13

Indicators present in severe pre-eclampsia but absent in non-severe cases

Answer 13

1. Headache
2. Visual Disturbances
3. Upper Abdominal Pain
4. Oliguria
5. Eclampsia
6. Thrombocytopenia
7. Fetal Growth Restriction
8. Pulmonary Edema

Question 14

A fetus is a prerequisite for pre-eclampsia

Answer 14

It is not, pregnancy does not require a fetus, it could be a hydatidiform mole

Question 15

Describe the Endothelial dysfunction in the Pathogenesis of Pre-eclampsia

Answer 15

Normal Pregnancy: Prostaglandin to Thromboxane ratio is high, but in HPN the Thromboxane levels are increased while Prostaglandins are decreased

Question 16

Modality used to check uteroplacental flow

Answer 16

Doppler Ultrasound

Question 17

One can use Doppler UTZ to check uteroplacental flow as early as how many weeks AOG

Answer 17

16-22 Weeks

Question 18

Persistence of uterine artery notching beyond how many weeks is predictive of hypertensive complications during pregnancy?

Answer 18

22-24 Weeks

Question 19

Drug of Choice as Anticonvulsant

Answer 19

Magnesium Sulfate

Question 20

Surefire Cure for Pre-Eclampsia

Answer 20

Delivery

Question 21

Glycemic Control Pre-Prandial Glucose Aim

Answer 21

≤95mg/dL

Question 22

Glycemic Control 1 Hour Post-Prnadial Glucose Aim

Answer 22

≤140mg/dL

Question 23

Glycemic Control 2 Hour Post-Prnadial Glucose Aim

Answer 23

≤120 mg/dL