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FINALS - OBS, GYNAE, BREAST > conditions in pregnancy > Flashcards

conditions in pregnancy Flashcards

1
Q

supplement for women with epilepsy

A

5mg folic acid prior to pregnancy

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2
Q

mx for epilepsy in pregnancy

A

mono therapy with levetiracetam, or lamotrigine, or carbamazepine

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3
Q

which AEDs can be taken in breastfeeding

A

all EXCEPT barbiturates

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4
Q

congenital problem with phenytion

A

cleft lip

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5
Q

if a mother is taking phenytion what else should be given

A

vit K in last month to prevent clotting disorder

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6
Q

risk with valproate

A

neural tube

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7
Q

consequence of cholestasis in pregnancy

A

preterm birth

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8
Q

symptoms cholestasis in pregnancy

A

itch (esp palms, soles, abdomen) // raised bilirubin // jaundice (20%)

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9
Q

when should labour be aimed for in cholestasis in pregnancy

A

37-38 weeks

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10
Q

mx cholestasis in pregnancy

A

ursodeoxycholic acid + vit K

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11
Q

when is biggest DVT/PE risk pregnancy

A

last trimester

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12
Q

why does pregnancy increase risk of DVT

A

hypercoagulable

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13
Q

invx DVT in pregnancy

A

USS (d dimer not helpful as usually raised in pregnancy)

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14
Q

invx PE pregnancy

A

ECG + CXR –> CTPA or V/Q

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15
Q

CTPA risks pregnancy

A

maternal breast cancer

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16
Q

V/Q risk pregnancy

A

childhood cancer

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17
Q

mx DVT/PE pregnancy

A

LWMH (also given prophylactically to high risk patietns)

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18
Q

what is contraindicated for DVT/PE mx in pregnancy

A

warfarin (+ DOAC)

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19
Q

APS assoc

A

SLE, other autoimmune conditions

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20
Q

features APS

A

recurrent feotal loss // venous or arterial thrombosis // livedo reticularis // pre-eclampsia, pulm HTN

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21
Q

invx APS

A

antibodies - antiocardiolipin, anti B2 // thrombocytopenia (low platelets) // raised APTT

22
Q

primary thromboprophylaxis APS (NOT pregnant)

A

low dose aspirin

23
Q

secondary thromboprophylaxis APS (NOT pregnant)

A

lifelong warfarin (INR 2-3 if first, 3-4 if second)

24
Q

medications given to women with APS when pregnant

A

aspirin + LMWH

25
Q

advice when getting pregnant RA

A

good control prior to pregnancy

26
Q

which DMARDs are not safe in pregnancy

A

methotrexate or leflunomide // NSAIDs after week 32

27
Q

what Hb indicates iron therapy in 1st trimester

A

<110

28
Q

what Hb indicates iron therapy in 2nd/3rd trimester

A

<105

29
Q

what Hb indicates iron therapy postpartum

A

<100

30
Q

at what BMI is obesity a problem in pregnancy

A

30

31
Q

mx obese pregnant women

A

5mg folic acid // OGTT at 24-28 weeks // BMI >35 = consultant

32
Q

symptoms acute fatty liver of pregnancy

A

abdo pain // N+V // headache // jaundice // hypoglycaemia

33
Q

invx acute fatty liver pregnancy

A

ALT >500

34
Q

what happens to thyroid hormones in pregnancy

A

raised TBG, raised total thyroixine but not free thyroxine

35
Q

Mx hyperthyroid in pregnancy

A

propythyiouracil in first trimester –> carbimazole 2nd semester

36
Q

mx hypothyroid pregnancy

A

measure TSH each trimester and post partum / increase thyroxine by 50% ASAP

37
Q

what is Gestational thrombocytopenia

A

low platelets as pregnancy progresses

38
Q

ITP vs Gestational thrombocytopenia

A

ITP is dangerously low platelets // test for serum antiplatelet antibodies

39
Q

mx ITP pregnancy

A

steroids

40
Q

HTN in pregnancy

A

> 140 or ?90

41
Q

pre-existing hypertension

A

> 140/90 before pregnancy or 20 weeks // no proteinuria or oedema

42
Q

which Anti hypertensives are not allowed in pregnancy

A

STOP ACEi or ARBs

43
Q

features pregnancy induced hypertension

A

high BP after 20 weeks - no proteinuria or oedema // resolves after pregnancy

44
Q

mx HTN in pregnancy

A

oral labetolol or nifedipine (if asthmatic)

45
Q

RG GDM

A

BMI > 30 // previous macrosmic baby // previous GDM // FH first degree with diabetes

46
Q

screening for GDM

A

OGTT asap and again at 24-28 weeks

47
Q

diagnosis GDM

A

fasting >5.6 // 2 hour >7.8

48
Q

mx GDM if fasting glucose <7

A

trial of diet and exercise –> metformin –> short acting insulin

49
Q

mx GDM if fasting glucose >7

A

start insulin

50
Q

mx pre-existing diabetes in pregnancy

A

weight loss // stop meds except metformin + insulin // folic caid 5mg

FINALS - OBS, GYNAE, BREAST (27 decks)

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