Abnormal Pregnancy (Santillan)

Question 1

cardiovascular condition of pregnancy thought to arise by poor placentation, that may lead to long term cardiovascular events in mother and future stroke, CV events and epilepsy in child

Answer 1

preeclampsia

Question 2

True or false: women who get preeclampsia in 2nd trimester are at greater risk of developing preeclampsia in a subsequent pregnancy compared to women who get preeclampsia in the 3rd trimester.

Answer 2

True. 53% risk for subsequent pregnancies compared to 20% risk if preeclampsia developed at >37 weeks

Question 3

True or false: treatment with antihypertensives has been shown to decrease the risk of developing preeclampsia in pregnancy.

Answer 3

False. Treatment of mild to moderate HTN however has been shown to prevent development of severe HTN and development of stroke.

Question 4

What is the benefit of treatment of preeclamptic mothers with magnesium sulfate after delivery?

Answer 4

cuts down risk of seizure by half

Question 5

Why would stimulation of oxytocin production cause, as a possible side effect, water intoxication?

Answer 5

because both oxytocin and vasopressin are made in the posterior pituitary, and cross talk between their receptors can cause an increase in ADH and reabsorption of water from the kidneys.

Question 6

Overdistension, uterine infection, prolonged labor, and retained placenta are all reasons why a woman might develop ____, leading to postpartum hemorrhage

Answer 6

atony (lack of uterine tone)

Question 7

Which of the following statements is TRUE regarding postpartum hemorrhage?

A. PPH is defined as >1000 cc following vaginal delivery
B Most cases of PPH are due to coagulation defects.
C. Increasing intracellular Ca++ helps control postpartum bleeding
D. Women who have had prolonged labor are at decreased risk for PPH, because of increased contraction tone of the uterus

Answer 7

C. Prostaglandin analogs (cytotec and hemabate) and oxytocin all cause an increase in intracellular calcium which helps staunch the flow of blood.

A is wrong because PPH is defined as >500 cc for vaginal delivery and >1000cc for c-section. B is wrong because most cases of PPH are due to atony of the uterus. D is wrong because prolonged labor is in fact a risk factor for PPH.

Question 8

Atrial fibrilation, elevated BMI, trauma and surgery are all risk factors for what condition that symptomatically affects ~3/1000 women during pregnancy?

Answer 8

venous thromboembolism (VTE)

Question 9

the differential diagnosis for this condition may include UTI, mastitis and C/S surgical site infection

Answer 9

endometritis (uterine infection)

Question 10

urinary tract infections are most often caused by what kind of bacteria?

Answer 10

e. coli