B8-018 Diseases/Disorders of Gestation Flashcards

1
Q

2 screening options for gestational diabetes

A

Two step approach: 1 hr glucose challenge test

One-step approach: 2 hr glucose tolerance test

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2
Q

what medication is the “gold standard” for controlling hyperglycemia in pregancy?

A

insulin

(metformin is a safe oral alternative)

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3
Q

advanced maternal age is considered any mother who will be […] or older at time of delivery

A

35

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4
Q

risk factors associated with AMA [4]

A

aneuploidy
early onset gestational diabetes
preterm delivery
stillbirth

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5
Q

preeclampia is new onset HTN on two separate occasions […] hours apart after […] weeks gestational age plus proteinuria

A

4 hours
20 weeks

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6
Q

new onset HTN with either proteinuria or end-organ dysfunction after 20 weeks gestation

A

preeclampsia

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7
Q

only intervention shown to decrease the risk of preeclampsia in subsequent pregnancies

A

aspirin

(decreases thromboxane: prostacyclin)

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8
Q

risk factors for the development of preeclampsia

A

hx of preeclampsia
multifetal gestation
chronic HTN
diabetes
kidney disease
autoimmune diseases
AMA
obesity

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9
Q

aspirin should be given to women at a high risk of developing preeclampsia beginning at […] weeks gestation

A

12

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10
Q

BP > 140/90 after 20 weeks gestation
no preexisting hypertension
no proteinuria or end-organ damage

A

gestational hypertension

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11
Q

hypertension prior to 20 weeks gestation suggests

A

chronic (overt) hypertension

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12
Q

antihypertensives safe in pregnancy [4]

A

hydralazine
a-methyldopa
labetalol
nifedipinie

(Hypertensive Moms Love Nifedipine)

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13
Q

caused by abnormal placement of the placental spiral arteries causing endothelial dysfunction, vasoconstriction, and ischemia

A

preeclampsia

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14
Q

prophylaxis for preeclampsia

A

aspirin

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15
Q

treatment for preeclampsia

A

antihypertensives
IV magnesium sulfate
delivery

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16
Q

preeclampsia with seizures

A

eclampsia

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17
Q

preeclampsia with thrombotic microangiopathy of the liver

A

HELLP syndrome

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18
Q

what does HELLP syndrome stand for?

A

Hemolysis
Elevated
Liver enzymes
Low
Platelets

19
Q

blood smear in HELLP syndrome will show

A

shistocytes

20
Q

treatment for HELLP syndrome

A

immediate delivery

21
Q

hormone that promotes insulin resistance to supply the growing fetus with glucose and amino acids

A

human placental lactogen

(implicated in gestational diabetes)

22
Q

PPROM is anytime before […] weeks gestational age

A

37

23
Q

preterm labor is defined as regular contraction that induce […]

A

cervical change

24
Q

signs of PPROM on speculum exam [3]

A

fluid pooling in vaginal vault
ferning on light microscopy
positive nitrazine pH test

(also can send fluid to lab form specific protein testing)

25
Q

if GBS status is unknown, what is should be done?

A

give antibiotics

26
Q

intraamniotic infection associated with significant maternal fetal mortality

A

chorioamnionitis

27
Q

signs of chorioamnionitis [5]

A

fever
changes in fetal heart rate
high maternal WBC with left shift
purulent fluid on speculum exam
fundal tenderness to palpation

28
Q

treatment of chorioamnionitis

A

delivery

29
Q

administration of […] decreases premature infant mobidity/mortality [2]

A

mag sulfate
corticosteroids

30
Q

fluorinated steroids [2]

A

betamethasone
dexamethasone

(can cross the placenta)

31
Q

there is no benefit to giving corticosteroids before […] weeks gestational age

A

22-23

32
Q

magnesium sulfate given within […] hours of delivery lowers the incidence of cerebral palsy and infant death

A

24 hours

33
Q

magnesium sulfate should be given to any pregnancy threatened to deliver before […] weeks gestational age to decrease chance of cerebral palsy/fetal death

A

32 weeks

34
Q

neurologic morbidity significantly decreases after […] weeks gestational age

A

32

35
Q

what is the definition of hypertension in a pregnant mother?

A

BP > 140/90 on more than one occasion

36
Q

a creatinine level that doubles from baseline or is greater than 1.1 mg/dl indicates severe

A

preeclampsia

37
Q

severe features of preeclampsia

A

thrombocytopenia
doubling of liver enzymes
pulmonary edema
papilledema
headaches
hyperreflexia
hemolysis

38
Q

proteinuria is defined as a 24 hour urine collection containing greater than […] mg of protein

A

300

39
Q

patients of AMA should be offered […] screening

A

aneuploidy

(higher incidence of trisomies 13, 18, 21)

40
Q

risks to the fetus associated with maternal hyperglycemia [4]

A

congenital anomalies
newborn episodes of hypoglycemia
newborn hyperbilirubinemia
injury during delivery due to size

41
Q

most appropriate test for determining if amniotic membranes have ruptured

A

sterile speculum exam

42
Q

definition of preterm labor

A

regular, painful contractions accompanied by cervical change prior to 37 weeks

43
Q

interventions shown to improve outcomes in PPROM [3]

A

antibiotics
corticosteroids
magnesium sulfate