endocrine dis In Pregnancy

Question 1

One of Uncontrolled diabetes is Septal hypertrophy can be complicated by:

Answer 1

Aortic stenosis > still-born

Question 2

By which percentage Increased risk for metabolic syndrome and type II diabetes later in life of GDM mothers

Answer 2

(>50% women with gestational diabetes develop type II DM)

Question 3

diabetes can developed early In certain Genetic syndromes like

Answer 3

Down syndrome, klinefelter, Turner

Question 4

Infectious etiologies of diabetes

Answer 4

CMV, coxsackievirus, congenital rubella

Question 5

— to — % of women with GDM are found to have DM immediately after pregnancy

Answer 5

5-10 %

Question 6

The incidence of macrosomia rises significantly when maternal blood glucose concentrations chronically exceed

Answer 6

130 mg/dL

Question 7

The risk of fetal death in women with pregestational diabetes is …x higher

Answer 7

3-4 times higher in DM alone

While 7 fold in pregnant with HTN and DM

Question 8

Complications of Diabetes in pregnancy:

Fetal and neonatal

Answer 8

• Fetal: spontaneous abortion- unexplained fetal demise- preterm delivery- malformations- altered fetal growth- hydramnios.
• neonatal: greater risk of NEC, late-onset sepsis, RDS, hypoglycaemia, hypocalcemia, hyperbillirubinemia, polycythemia, hypertrophic cardiomyopathy of intraventricular septum, long- term cognitive dysfunction, inheritance of diabetes,

Question 9

The risk of developing type1 DM if either parent is affected is — to — %, while with Type2 DM, if both parent affected the risk of developing it approaches —%

Answer 9

The risk of developing type1 DM if either parent is affected is 3 to 5 %, while with Type2 DM, if both parent affected the risk of developing it approaches 40%

Question 10

Maternal Complications of Diabetes in pregnancy:

Answer 10

• Maternal: PET(3-4X in overt DM), increase risk of HTN, cardiac and respiratory complications and retinopathy, infection, depression, DKA, hypoglycaemia

Question 11

pregnant with DM and chronic HTN are — times more likely to develop Preeclampsia

Answer 11

pregnant with DM and chronic HTN are 12 times more likely to develop Preeclampsia

Question 12

Perinatal mortality rates from single episode of DKA may reach —-%

Answer 12

Perinatal mortality rates from single episode of DKA may reach 35 %

Question 13

The optimal glycemic control prior to conception

Answer 13

HbA1C <6.9 %
(Congenital malformation 4x greater risk in >10%)
Preprandial Glucose level 70-100
2 hrs postprandial 100-120

Question 14

Reducing or withholding the dose of long-acting insulin before delivery is recommended and to continue on regular insulin

Answer 14

T

Question 15

__fold greater risk for shoulder dystocia in newborns weighing >/= 4200 gm

Answer 15

76 fold greater risk for shoulder dystocia in newborns weighing >/= 4200 gm compared to those wt < 3500 g

Question 16

In GDM management pharmacological are usually recommended if diet modification doesn’t consistently maintain the fasting Plasma Glucose < ? or 2hrs PP plasma Glu < ? (ACOG)

Answer 16

In GDM management pharmacological are usually recommended if diet modification doesn’t consistently maintain the fasting Plasma Glucose < 95 or 2hrs PP plasma Glu < 120 (ACOG)

Question 17

ACOG recommends considering insulin in GDM women with 1 hr PP levels that exceeds —- or with 2 hrs levels > —-

Answer 17

ACOG recommends considering insulin in GDM women with 1 hr PP levels that exceeds 140 or with 2 hrs levels > 120

Question 18

The starting dose of insulin is typically

Answer 18

0.7-1 units/ kg/ d, given in divided doses 2/3 in morning before breakfast and lunch
And 1/3 of in dinner

Question 19

ACOG recommends that routine labor induction in GDM on diet women shouldn’t occur before ?wks

Answer 19

39 wks

Question 20

ACOG recommends fasting glucose or 75 g 2hrs OGTT at 4-12 wks postpartum for dx of overt diabetes

Answer 20

ADA recommends testing every 3yrs in women with h/o GDM but normal postpartum glucose screening

Question 21

In follow up of pregnant with hyperthyroidism serum free T4 concentration measured every

Answer 21

4-6 wks

Question 22

The most common cause of hypothyroidism in pregnancy is

Answer 22

Hashimoto thyroiditis

Question 23

Pregnant with positive Anti-TPO and thyroglobulin carry ??? fold increased risk of early pregnancy loss

Answer 23

Pregnant with positive Anti-TPO and thyroglobulin carry 2-5 fold increased risk of early pregnancy loss

Question 24

Up to ? % of women who are thyroid-antibody positive in the first trimester will develop postpartum thyroiditis

Answer 24

Up to 50 % of women who are thyroid-antibody positive in the first trimester will develop postpartum thyroiditis

Question 25

Hypercalcemic crisis manifests as

Answer 25

Stupor, Nausea, Vomiting, weakness, Fatigue and dehydration.

Question 26

Parathyroidectomy indications in hyperparathyroidism:

Answer 26

1) symptomatic hyperparathyroidism
2) serum Ca 1 ml/dL above the upper normal range
3) calculated creatinine clearance < 60
4) reduced bone density assessment every 1 -2 yrs

Question 27

Pheochromocytoma called

(10 precent tumor) because

Answer 27

10% are bilateral
10% are extraadrenal
10% are malignant
Arise from Adrenal medulla, can be associated with medullary thyroid Ca and hyperparathyroidism

Question 28

Lymphocytic hypophysitis

Answer 28

Rare autoimmune pituitary disorder many are temporary due to pregnancy
Similar to signs of adenoma but with modestly elevated labs

Question 29

What does NICE Guidelines advice pregnant diabetic women should keep their HBA1C below:

Answer 29

6.5% or 48 mmol/mol

Question 30

Addison vs. Cushing vs. Conns disease

Answer 30

Question 31

The American College of Obstetricians and Gynecologists (ACOG) recommends the following blood glucose targets in pregnancy:

Answer 31

fasting <90 mg/dL,
preprandial <105 mg/dL,
1-h postprandial <130–140 mg/dL, and 2-h postprandial <120 mg/dL.

Question 32

Postpartum thyroiditis is most likely to recur in up to –% of subsequent pregnancies.

Answer 32

Postpartum thyroiditis is most likely to recur in up to 70% of subsequent pregnancies

Question 33

The risk of congenital malformation rises to —% if mothers had HbA1c values of more than —%.

Answer 33

The risk of congenital malformation rises to 22% if mothers had HbA1c values of more than 10%.

Question 34

The risk of congenital malformation rises to —% if mothers had HbA1c values of more than —%.

Answer 34

The risk of congenital malformation rises to 22% if mothers had HbA1c values of more than 10%.