105 - Skin Changes and Diseases in Pregnancy

Question 1

Most common physiologic change in pregnancy

Answer 1

Pigmentary disturbances

Question 2

Y/N: Significant change in nevi size is a feature of most pregnancies

Answer 2

No - not a feature

Question 3

Y/N: Any pigmented lesion in a pregnant women that undergoes change in morphology or symptoms should be considered for histopathologic review

Answer 3

Yes

Question 4

Most common structural change during pregnancy

Answer 4

Striae distensae

Question 5

Strongest predictors of an individual’s risk of developing striae

Answer 5

Family history
Personal history
Race

Question 6

Most common vascular lesions to develop in pregnancy

Answer 6

Spider angioma

Question 7

Dermatoses associated with fetal risk in pregnancy

Answer 7

Pemphigoid gestationis
Intrahepatic cholestasis of pregnancy
Pustular psoriasis of pregnancy

Question 8

Dermatosis in pregnancy that includes periumbilical skin

Answer 8

Pemphigoid gestationis

Question 9

Y/N: PG is associated with premature delivery and a risk of low birth weight; the risk of these fetal complications correlate with maternal disease severity

Answer 9

Yes

Question 10

Y/N: First-generation antihistamines are favored over second-generation antihistamines in PG

Answer 10

Yes

Question 11

Only pregnancy dermatosis that presents without primary skin lesions

Answer 11

ICP

Question 12

Symptoms of _____ are generally more severe at night

Answer 12

ICP

Question 13

Single most sensitive indicator of ICP

Answer 13

Elevation in serum bile acids

Question 14

Total serum bile acid levels greater than _____ are consistent with ICP

Answer 14

11 microM/L

Question 15

Y/N: Degree of pruritus and disease severity generally correlate with bile acid concentrations

Answer 15

Yes

Question 16

Particularly sensitive, as an elevation in this enzyme is not a feature of healthy pregnancies but is commonly seen in ICP

Answer 16

Alanine transaminase

Question 17

Y/N: Cutaneous biopsy aids in the diagnosis of ICP

Answer 17

No

Question 18

Maternal outcomes are generally favorable in ICP, although women with severe cases are predisposed to

Answer 18

Postpartum hemorrhage secondary to vitamin K depletion

Question 19

Women affected with ICP have a tendency toward the later development of

Answer 19

Cholelithiasis or gallbladder disease

Question 20

Current treatment of choice in ICP

Answer 20

Ursodeoxycholic acid (UDCA), a naturally occurring hydrophilic bile acid

Question 21

Pustular psoriasis of pregnancy typically originates in ______, spreads _____ and sometimes generalizes

Answer 21

Flexural areas

Centrifugally

Question 22

Life-threatening maternal complications are infrequent in impetigo herpetiformis but may result from

Answer 22

Profound hypocalcemia

Bacterial sepsis

Question 23

Most feared complications of impetigo herpetiformis

Answer 23

Placental insufficiency and consequent stillbirth or neonatal death

Question 24

Distinguish impetigo herpetiformis from pustular psoriasis

Answer 24

Absence of a positive family history
Abrupt resolution of symptoms at delivery
Tendency to recur only during subsequent pregnancies

Question 25

Recurrences of impetigo herpetiformis in subsequent pregnancies are common and characteristically (less/more) severe with onset (earlier/later) in gestation

Answer 25

More

Earlier

Question 26

First-line therapy in impetigo herpetiformis

Answer 26

Cyclosporine

Infliximab

Question 27

Dermatoses not associated with fetal risk in pregnancy

Answer 27

Polymorphic eruption of pregnancy

Atopic eruption of pregnancy

Question 28

Occurs almost exclusively in primigravidas

Answer 28

Polymorphic eruption of pregnancy

Question 29

Lesions of PEP are most commonly

Answer 29

Urticarial

Question 30

Eruption begins on the abdomen classically within the striae gravidarum, and demonstrates periumbilical sparing

Answer 30

Polymorphic eruption of pregnancy

Question 31

Y/N: In PEP, spontaneous remission within days of delivery is the rule. Recurrences in subsequent pregnancies or with exposure to oral contraceptives are usual

Answer 31

No - unusual

Question 32

Most common pruritic condition of pregnancy

Answer 32

Atopic eruption of pregnancy

Question 33

Types of atopic eruption of pregnancy

Answer 33

E-type (eczematous)

P-type (papular)

Question 34

Distinguishing features of AEP

Answer 34

Onset early in pregnancy (before the third trimester)

Personal and/or family history of atopy