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Obstetrics > 9 Medical Complications > Flashcards

9 Medical Complications Flashcards

1
Q

ASD, VSD, PDA

Corrected TOF has a MMR of

A

<1% low maternal mortality risk

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2
Q

MS with AF, uncorrected TOF, artificial heart valve, Marfan syndrome with normal aortic root diameter has an MMR of

A

5-15% (moderate)

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3
Q

Presence of pulmo HTN ⏩ Eisenmenger’s syndrome raises MMR upto

A

25-50% (high)

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4
Q

Most common acquired lesion

A

RHD

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5
Q

MC valvular defects

A

Mitral stenosis

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6
Q

MMR in the setting of biventricular cardiac failure seen in late pregnancy or months postpartum among multiparous

A

Peripartum Cardiomyopathy

MMR upto 75%

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7
Q

Management of Eisenmenger Syndrome

A

Avoid ⬇️ BP

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8
Q

⬇️TSH
⬆️free T4
(+) TSHR Ab

A

Graves Disease

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9
Q

Management of Graves Dse

A

PTU (1st tri), Methimazole (later part)

Subtotal Thyroidectomy

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10
Q

⬆️TSH
⬇️ free T4
Anovulation

A

Hypothyroidism

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11
Q

MCF of hypo/hyperthyroidism

A

Graves Dse

Hashimotos Thyroiditis

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12
Q

Mngt of Hypothyroidism

A

Synthroid (⬆️ dose 30% prepregnancy)

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13
Q

Effects of Pregnancy in Seizure Dso

A

Seizures unchanged (upto 75%)

Anticonvulsant metabolism ⬆️⬆️⬆️

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14
Q

Congenital malformation rate with use of anticonvulsants

A

3-10%

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15
Q

Antiseizure drug implicated in neonatal deficiencies of vit K dependent CF

A

Phenytoin

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16
Q

Overt DM with calcified vessels

with nephropathy

with retinopathy

A

Class E

Class F

Class R

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17
Q

GDM screening is performed on all gravida at 24-28w aog. Why?

A

Anti insulin effect of HPL is maximal

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18
Q

GDM is

A

FBS >95mg/dl, screening value >200mg/dl

OR

2/3 abN 3h 100g OGTT

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19
Q

Overt Diabetes is

A

FBS > 125mg/dl

20
Q

Computation for total daily insulin units

A

Actual BW in kg X

0.8 (1st tri)
1 (2nd)
1.2 (3rd)

21
Q

OHA in GDM

A

Glyburide

22
Q

AbN screening value (1hr 50g OGTT)

A

> 140mg/dl

23
Q

Most common fetal anomalies in overt DM

A

NTD

CHD

24
Q

What should be done among with highest fetal demise risk factors?

A

NST and AFI weekly at 32 wks aog

25
Q

Fetal Demise Risk Fx

A

Insulin or glyburide therapy
Previous stillbirth
Macrosomia
HTN

26
Q

Neonatal problems in GDM

A 
Hypoglycemia
Hypocalcemia
Polycythemia
Hyperbilirubinemia
ARDS
27
Q

LS ratio of _____ in the presence of phosphatidylglycerol ensures fetal lung maturity

A

2.5

28
Q 
Hgb <10g
MCV <80 um3
RDw > 15%
⬇️serum iron and iron stores
⬆️TIBG
A

IDA

29
Q

Anemia in general predisposes to

A

IUGR and preterm birth

30
Q

A 29 yo primigravida is at 33wks aog, mentally confused. Flu like symptoms.

Icteric and febrile. No seizures.
⬆️BP, ⬇️Plt, prolonged PR
⬆️liver enzymes, serum crea, uric acid, LDH
Urine dipstick 3+

⬇️RBG, ⬆️ammonia

A

Acute Fatty Liver

31
Q

The previous condition is caused by

A

Disorder of FA metabolism by fetal mitochondria due to deficiency in long-chain 3-hydroxyacyl coenzyme A DH enzyme

32
Q

Parameters that set it apart from preeclampsia

A

Hypoglycemia

⬆️serum ammonia

33
Q

No urgency, frequency or burning
No fever
Urine culture > 100k CFU of one organism

A

ASB

34
Q

(+) urgency, frequency or burning
(-) fever
(+) Urine culture

A

Cystitis

35
Q

Presence of fever and CVAT

A

Pyelonephritis

36
Q

MC serious medical complications in pregnancy that predisposes to preterm L/D

A

Acute Pyelonephritis

37
Q

Antiphospholipid syndrome dx requires at least 1 clinical and laboratory criterion each.
Clinical parameters include either:

A

Vascular thrombosis

Unexplained pregnancy morbidity : fetal demise or consecutive miscarriages at least 3

38
Q

Laboratory parameter for APA: 1 or more of the ff is/are positive on 2 or more occasions at least 12w apart

A

Lupus anticoagulant
Anticardiolipin Ab
Anti 132-gp I Ab

39
Q

Superficial TP is managed with

A

Bed rest
Heat application
NSAIDs

40
Q

DVT is managed by

A

IV heparin (to cause an ⬆️ in PTT by 1.5-2.5x
SQ heparin once therapeutic level is achieved
Warfarin only at PP
Thrombophilia work ups

41
Q

PE is the MC complication of DVT, presenting with chest pain and dyspnea. MC sources of emboli are

A

Pelvic veins

Lower ext

42
Q

Most definitive dx in PE

A

Pulmonary angiography

43
Q

High risk thrombophilias

A

Homozygous FVL and PGM; all ATD

44
Q

Low risk thrombophilia

A

Hererozygous FVL and PGM; PCD and PSD

45
Q

Antipartum and PP anticoagulants:

  • oral, inexpensive, reversed by ProtSO4
  • IV, longer half life, no monitoring
A

UFH - APTT monitoring

LMWH

46
Q

AC used only during PP

It needs ______ monitoring

A

Warfarin, INR monitoring

Obstetrics (14 decks)

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