emergency presentation pregnancy (not-bleed)

Question 1

triad pre-eclampsia

Answer 1

new HTN // proteinuria // oedema

Question 2

features severe pre-eclampsia

Answer 2

BP >160/110 // proteinuria +++ // headache, vision, papilloedmea // RUQ, epigastric // hyperreflexia

Question 3

diagnosis pre-eclampsia

Answer 3

new BP >140/90 at 20 weeks + 1 of: proteinuria, other organ involvement

Question 4

consequences pre-eclampsia

Answer 4

eclampsia // fetal IUGR // liver enzymes // haemorrhage // cardiac failure

Question 5

high RF pre-eclampsia

Answer 5

previous HTN (gestational or chronic) // CKD // SLE or APS / diabetes

Question 6

moderate RF pre-eclampsia

Answer 6

1st baby // 40+ // pregnancy interval 10+ yeaars // BMI >35 // FH high RF pre-eclampsia // twins

Question 7

who should take medication to reduce risk of high RF pre-eclampsia

Answer 7

1 major or 2 minor RF

Question 8

what medication is given to reduce risk of high RF pre-eclampsia

Answer 8

aspirin 75-150mg from 12 weeks –> birth

Question 9

assessment for pre-eclampsia

Answer 9

suspect pre-eclampsia = refer

Question 10

when to admit in pre-eclampsia

Answer 10

BP >160/110

Question 11

mx pre-eclampsia

Answer 11

1 = oral labeteolol // 2 = nifedipine (eg asthma) // 3 = hydralazine // methyldopa can also be used

Question 12

invx pre-eclampsia

Answer 12

U+E, LFT, FBC, coag

Question 13

what is eclampsia

Answer 13

seizures secondary to pre-eclampsia (tonic clonic)

Question 14

mx + prevention eclampsia

Answer 14

IV mag sulphate (IV bolus 4g over 5-10 minutes –> 1g/hr)

Question 15

what should be monitored when treating eclampsia

Answer 15

UO, reflexes, resp rate, O2 sats

Question 16

complication + mx of eclampsia treatment

Answer 16

resp depression –> calcium gluconate

Question 17

how long should mx be given in eclampsia

Answer 17

24 hours after last seizure or 24 hours after delivery

Question 18

what should be restricted in severe pre-eclampsia/ elcampsia

Answer 18

fluid to prevent overload

Question 19

what is HELLP syndrome

Answer 19

Haemolysis, Elevated Liver enzyme // Low Platelets

Question 20

RF HELLP

Answer 20

pre-eclampsia

Question 21

symptoms HELLP

Answer 21

N+V + RUQ pain + tiredness

Question 22

mx HELLP

Answer 22

delivery

Question 23

what is an amniotic fluid embolism

Answer 23

fetal cells or amniotic fluid enter maternal circulation –> reaction

Question 24

RF amniotic fluid embolism

Answer 24

age, IOL

Question 25

when does amniotic fluid embolism occur

Answer 25

delivery or immediate post-partum

Question 26

symptoms amniotic fluid embolism

Answer 26

chills, shivering, sweating, anxiety, cough

Question 27

signs amniotic fluid embolism

Answer 27

cyanosis, hypotension, bronchosopasm, tachycardia, arrythmia, MI

Question 28

invx + mx amniotic fluid embolism

Answer 28

diagnosis of exclusion // critical care