Conditions of pregnancy

Question 1

Acute fatty liver hepatic derangment?

AST/ALT> ALP / GGT?
AST/ALP> ALT/GGT
ALP/GGT> AST/ALT?

Answer 1

AST/ALT> ALP / GGT?

Question 2

what happens in acute fatty liver diease in pregnancy?

Answer 2

liver damaged due to fat accumulation

deranged LFTs, and INR increaseed

ALT is elevated - 500u/L

Question 3

Epilepsy in pregnancy - what drug is best?

what kind of drug therapy should you aim for?

Answer 3

Lamotrigine, carbamazepine and levetiracetam

mono

Question 4

what anti-epileptic drugs are worse?

Answer 4

Phenytoin - cleft lip
phenobarbitone -
sodium valproate - neural tube defect

Question 5

why is a risk of OBstretic cholestasis stillbirth?

Answer 5

build up of bile acid is detrimenta, to foetal well-being
foetal liver cannot break it down
bile salts have a vasoconstricting effect on human placental chorionic veins
= anoxia and fetal death

Question 6

RA - methotrexate use by male partner
can it be continued
if it needs to be stopped how early before trying to conceive?

Answer 6

6 months prior stop

Question 7

why is methotrexate so bad?
methSEXate

Answer 7

it is a dihydrofolate reducatse inhibitor
damages sperm and can cause early spontaneous abortion
> minimise DNA changes

Question 8

chickenpox- exposure and 21 weeks

Answer 8

if not immune give VZIg / acyclovir after 7-14 days

Question 9

chickenpox developed in pregnancy
>20 weeks
<20 weeks

Answer 9

giev aciclovir within 24hr of rash
consider aciclovir

Question 10

once chickenpox symptoms have developed what is the role of VZIG?

Answer 10

nothing just give oral aciclovir