Ch Ch 10

Question 1

The most common cyanotic congenital heart disease in pregnancy is

Answer 1

tetralogy of Fallot.

Question 2

Signs of heart disease include the following

Answer 2

• Any diastolic or continuous heart murmur
• Any systolic murmur associated with a thrill • Any severe arrhythmias
• Unequivocal cardiac enlargement

Question 3

Corrected Tetralogy of Fallot (TOF) refers to a patient who has undergone surgical repair for Tetralogy of Fallot, a congenital heart defect that includes four anatomical abnormalities:

Answer 3

1. Pulmonary stenosis (narrowing of the pulmonary valve or artery),
   
   2. Ventricular septal defect (VSD) (a hole between the right and left ventricles),
   3. Overriding aorta (the aorta is positioned directly above the VSD),
   4. Right ventricular hypertrophy (thickening of the right ventricular muscle).

Question 4

Eisenmenger syndrome is characterized by

Answer 4

pulmonary hypertension and a bidirectional intra-cardiac shunt

Question 5

symptoms present at rest, increasing with any physical activity

Answer 5

Class IV

Question 6

no symptoms at rest, but marked limitations with activity

Answer 6

Class III

Question 7

no symptoms at rest, but minor limitations with activity

Answer 7

Class II

Question 8

Fetal thyroid function begins as early as ——— with minimal transfer of T3 or T4 across the placent

Answer 8

12 weeks

Question 9

Management of Antepartum cardiac disease

Answer 9

Left lateral rest, 2 g sodium diet, digitalis as indicated, diuretics as indicated, avoid strenuous activity, avoid anemia, fetal echocardiogram (if patient has congenital heart disease).

Question 10

The underlying etiology of hyperthyroidism may be

Answer 10

Graves’ disease,
toxic nodular goiter ( Plummer’s disease),
hydatidiform mole
toxic diffuse goite

Question 11

Thyroid storm

Answer 11

is a life-threatening hypermetabolic state presenting with pyrexia, tachycardia, and severe dehydration.

Question 12

Management of thyroid strong is

Answer 12

propylthiouracil (PTU), β-blocking agents, steroids, and iodine.

Question 13

(most common kind of hyperthyroidism in pregnancy)

Answer 13

Graves disease

Question 14

TSHR-Ab can cross the placenta, potentially causing fetal hyperthyroidism. In

Answer 14

Graves’ disease

Question 15

Diagnosis of Graves disease is

Answer 15

confirmed by elevated free T4 and TSHR-Ab, as well as low TSH in the presence of clinical features described above

Question 16

Management of Graves’ disease

Answer 16

• Antithyroid medications are the first line of therapy in pregnancy, but they can cross the placentae leading to fetal hypothyroidism.
• PTU and methimazole are thioamides that block thyroid hormone synthesis.
• Subtotal thyroidectomy is primarily indicated when antithy- roid medical therapy fails and is ideally performed in the second trimeste

Question 17

are the first line of therapy in pregnancy, but they can cross the placentae leading to fetal hypothyroidism.

Answer 17

Anti thyroid medication

Question 18

is contraindicated in pregnancy because it can cross the placentae, destroying the fetal thyroid

Answer 18

Thyroid ablation with radioactive iodine (I131)

Question 19

is most commonly a primary thyroid defect and often results in an ovulation and infertility

Answer 19

Hypothyroidism

Question 20

Hypothyroidism is associated with

Answer 20

Increase level of TSH
Decrease level of free T4
An ovulation

Question 21

Management of hypothyroidism in pregnancy

Answer 21

Increase supplemental thyroid hormone by 30% in pregnancy

Question 22

إذا تمت معالجة مشكلة الغدة الدرقية في الحمل فان النتيجة هي

Answer 22

Normal pregnancy

Question 23

How we can treat hyperthyroidism in pregnancy

Answer 23

• Polythyrouracil PTU in first trimester
• methimazole in 2ed @ 3ed trimester

Question 24

How we treat Hypothyroidism in pregnancy

Answer 24

Synthroid طبعا مع ريادة الجرعة بنسبة ٣٠٪؜ عن السيدة العادية

Question 25

How we treat Hypothyroidism in pregnancy

Answer 25

Synthroid طبعا مع ريادة الجرعة بنسبة ٣٠٪؜ عن السيدة العادية

Question 26

The most common risk factors for gestational diabetes are

Answer 26

obesity,
age >30,
positive family history.
Other risk factors are fetal macrosomia, unexplained stillbirth or neonatal death, poly- hydramnios, and previous traumatic delivery.

Question 27

Prevalence of glucose intolerance in pregnancy is

Answer 27

2–3%.

Question 28

………… is the most common anemia in women because of pregnancy and menstrual needs

Answer 28

Iron deficiency anemia

Question 29

………… is the most common anemia in women because of pregnancy and menstrual needs

Answer 29

Iron deficiency anemia

Question 30

Hypersegmantal neutrophil

Answer 30

Folate anemia

Question 31

are peripheral blood tests used to detect the presence or absence of haemoglobin s

Answer 31

Screening tests