Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproductive Exam 1 > DM in Pregnancy > Flashcards

DM in Pregnancy Flashcards

1
Q

What are the 2 groups of patients?

A
  1. Preexisting diabetes

2. Diabetic during/from being pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 4 complications of pre-existing diabetes?

A
  1. Macrosomia (large babies) and associated traumatic delivery
  2. Delayed organ maturation
  3. Fetal growth restriction (IUGR- Intrauterine growth restriction)
  4. Congenital Anomalies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What organ is delayed in development with pre-existing diabetes in Mom?

A

Lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What congential anomalies are assocaited with pre-existing diabetes in mom?

A
  1. Cardiac
  2. Neural Tube
  3. Sacral agenesis: Caudal regression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the L:S ratio indicating fetal maturity for a healthy patient? What about for a diabetic mother?

A

2: 1
3: 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should BS be kept at with pre-existing diabetes to avoid complications?

A

70-90

-They NEED PERFECT CONTROL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are fetal complications of gestational diabetes?

A
  1. Macrosomia and associated traumatic delivery
  2. Delayed organ maturation
  3. FGR and IUGR

NO CONGENTIAL ABNORMALITIES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does gestational diabetes normally present?

A

Last half…3rd trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 2 circumstances of pre-exisiting diabetes?

A
  1. Can be previously diagnosed
  2. Present, but not yet diagnosed

-SO ALWAYS DO A FASTING BLOOD SUGAR ON PREGGO LADIES IN 1ST TRIMESTER

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When do you screen for gestational diabetes?

A

Beginning of the 3rd trimester or just before

-24-48 weeks gestation: Usually presents in last half of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the 1st step screening test for gestational diabetes?

A 
1hr 50g Glucola test
No fasting (although better change of passing if you do fast), drink glucose (50g) in water and draw labs in 1 hour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If the value of the 1hr 50G Glucola test is above what, do you have to move on and do the diagnostic test for gestational diabetes?

A

Over 140 (really 135)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If their 1hr 50G Glucola test was 150, what’s next?

A

3 hour glucose tolerance test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the loading dose for the 3 hour glucose toelrance test?

A

100G

-Remember, non-preggo it is 75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the fasting, 1, 2, 3 hour values for the 3 hour glucose tolerance test in a preggo lady?

A

Fasting: 95
1 Hour: 180
2 Hour: 155
3 Hour: 140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Is the 3 hour glucose tolerance test fasting?

A

YES (8 hours)

17
Q

So when do you say a lady has gestational diabetes?

A

If 2 abnormal values are found on the glucose tolerance test (now, it’s really just 1 value)

18
Q

White classification, what does A mean?

A

Gestational diabetes

19
Q

What is the difference between A1 and A2?

A

A2 requires insulin, A1 doesn’t

20
Q

So fancy wording for A1?

A

Abnormal GTT, normal values- Treat with diet and exercise, no insulin is needed

21
Q

Fancy wording for A2?

A

Abnormal GTT, abnormal values- Treat with diet and exercise, insulin is needed

22
Q

So you get a letter other then A for White classification, what does that mean?

A

Overt (pre-existing) diabetes

-Different letters dictate the severity of the underlying diabetes

23
Q

What is initial treatment for gestational diabetes?

A
  1. Diet and exercise

2. If fasting or post-prandial values are still elevated–> Insulin

24
Q

What are the 3 components of antepartum management of gestational diabetes?

A
  1. Serial US
  2. Serial tests for fetal well being: NST, CST, BPP, Cord Doppler Studies
  3. Maintain normal glucose levels (Euglycemic)
25
Q

Why isn’t fundus measurement good enough with gestational diabetes?

A

Because fundus can also account for this like placenta, amniotic fluid, other crap floating around in your belly… whereas a US will tell us exactly how big baby is, which is what we are worried about (too big/too little)

26
Q

In a non-pregnant diabetic, what is goal for blood glucose?

A

150

27
Q

If you are prego, what are you blood sugar goals?

A

70-90 fasting, 2 hour post-prandial under 120

28
Q

What does brittle diabetes mean?

A

Even with treatment, sugars are all over the place and require treatment multiple times a day… most prego ladies with diabetes get diabetes like this

29
Q

During labor (intrapartum) what do you do for your diabetic patient?

A

If they require insulin….IV insulin at a rate of 0.5-2.0 units of insulin per hour, maintain glucose levels of 80-120

30
Q

Why do insulin requirements drop sharply after delivery?

A

Insulin antagonists from the placenta are no longer present

31
Q

True or False: Most insulin dependent diabetics do not need insulin for the 1st 48-72 hours after delivery

A

TRUE

  • Monitor glucose every 6 hours and treat if glucose goes over 150
  • After that 24-36ish window, their insulin levels can go crazy again
32
Q

Do gestational diabetics need insulin post-partum?

A

No

33
Q

What do you do to test is a gestational dibetic returned to normal?

A

A 75**g GTT at 6-8 weeks post partum

-Do the test for non-preggo since they delivered already

34
Q

What future monitoring is required for someone with gestational diabetes?

A

Yearly screening with fasting BS for dibetes

35
Q

Do patients with gestational diabetes have an increased likelihood of becoming diabetic later in life?

A

YESSS (this is different from HTN during pregnancy)

36
Q

True or False: History of previous gestational diabetes usually does not result in future pregnancies with gestational diabetes

A

FALSE

37
Q

True or False: History of previous gestational diabetes increases likelihood for future type 2 diabetes

A

TRUE

38
Q

What is recommended yearly for patients with a history of gestational DM?

A

Yearly FBS

Reproductive Exam 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions