Cardiac, Resp, Kidney disease in pregnancy Flashcards
1
Q
Cardiac risks in pregnancy
A
Pulmonary HTN
Heart Failure
Arrythmia
Thrombus
2
Q
Management of cardiac patient in pregnancy
A
optimise iron status metoprolol aspirin or clexane passive 2nd stage early epidural telemetry in labour active 3rd stage frusemide maintain euvolaemia caution with syntometrine and carboprost
3
Q
Renal disease risks in pregnancy
A
IUGR PTB SB PET flare of disease HTN and CKD (potential to worsen) Anaemia
4
Q
Management of Renal disease in Pregnancy
A
high dose folic acid aspirin and calcium Target BP <140/90 BP medication steroids if nephrotic syndrome +/- loop diuretics Monthly PET screen Monthly growth uterine artery dopplers
5
Q
immunosuppressive drugs ok in pregnancy
A
Prednisone
Azathioprine
Tacrolimus
Cyclosporine
6
Q
Preconception optimisation in renal transplant
A
No acute feto-toxic infection 2 yrs post transplant no rejection in previous year stable Cr<130 No or minimal proteinuria
7
Q
Risks with renal transplant patient
A
graft failure/loss of graft reduced life expectancy IUGR PTB SB PET HTN Anaemia
8
Q
AFLP dx
A
Vomiting o Abdominal pain o Polydipsia and/or polyuria o Encephalopathy o Raised bilirubin o Raised urate o Raised WCC o Raised ALT and AST (3-10 times UL) o Raised ammonia o Raised creatinine o Low glucose o Coagulopathy o Ascites or bright liver on USS o Microvesicular steatosis on liver biopsy
9
Q
Marfan syndrome aortic root dilatation management
A
Mortality risk 1% if <4cm; 25% if >4cm Offer TOP if >4cm C/S if >4cm Treat with beta blockers Manage HTN Monthly ECHOS
10
Q
Pre-pregnancy counselling template
A
Diagnosis Severity Assessment Contraindication? Prognosis/Risks Adjust medications Refer Routine antenatal (booking bloods, folic acid, iodine)
