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Exam 2- lecture 2 Flashcards

1
Q

gestational age

A

age of embryo or fetus from first day of last menstrual period

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2
Q

gravidity

A

number of times a women is prego

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3
Q

parity

A

of prego exceeding 20 weeks & provides info about outcome

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4
Q

TPAL:2-1-1-3 means

A

2 term deliveries, 1 premature, 1 aborted/ectopic, 3 living children

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5
Q

teratogenic risk <day 15

A
  • all or nothing

- spontaneous abortion or no harm

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6
Q

teratogenic risk day 15-60 (organogenesis)

A
  • fetus is VERY susceptible

- structural anomalies

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7
Q

teratogenic risk >day 60

A
  • function defects (CNS, growth retardtion)

- minor anomalies

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8
Q

prego category A

A

human studies fail to demonstrate fetal risk in 1st trimester
-no evidence of risk in later trimesters

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9
Q

prego category B

A
  • animal studies have not shown risk (no human studies)
    OR
  • animal studies have shown risk not confirmed in humans in 1st trimester
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10
Q

prego category C

A
  • animal studies have shown risk to fetus (no human studies)
    OR
  • studies in animals or prego women not available
  • only use if benefit?risk
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11
Q

prego category D

A
  • positive human fetal risk
  • benefit to mother may > fetal risk
  • life-threatening diease
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12
Q

prego category X

A
  • studies in humans or animals have shown fetal abnormalities
  • risk > benefit
  • CI in prego
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13
Q

when do most severe birth anomalies occur?

A

first trimester

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14
Q

drugs that require special handling

A 
finasteride
dutasteride
testosterone
mycophenolate
ganciclovir
ribavirin
flurouracil
chemotherapy
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15
Q

folic acid supplementation

A

400mcg/day

- high risk or history of neural tube defects: 4mg/day

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16
Q

prenatal immunizations

A

influenza, rubella, hep B

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17
Q

important components of prenatal vitamins

A

Ca, iron, folic acid

- also available with docusate, DHA< extra B6

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18
Q

constipation first line treatment

A

light exercise, increased dietary fiber & fluid

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19
Q

constipation pharmacotherapy

A
  • supplement fiber +/- stool softener (docusate)

- osmotic laxatives (polyethylene glycol-Miralax)

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20
Q

avoid what constipation treatment during prego?

A

castor oil & mineral oil

- reduce nutrient absorption

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21
Q

GERD first line treatment

A

lifestyle & dietary changes

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22
Q

GERD pharmacotherapy

A
  • antacids or sucralfate
  • H2 receptor antagonists (ranitidine & cimetidine)
  • promotility drugs (metoclopramide)
  • PPIs (omeprazole, esomeprazole)
23
Q

avoid what GERD treatment in prego

A

sodium bicarbonates

- cause metabolic alkalosis & fluid overload

24
Q

nausea & vomiting first line therapy

A

eat frequent, small meals & avoid fatty foods

25
N/V pharmacotherapy
- pyroxidine (B6) - antihistamines (doxylamine, dimenhydrinate-dramamine) - dopamine antagonists (prochlorperazine, promethazine, metoclopramide) - serotonin antagonists (ondansetron) - corticosteroids - ginger
26
prenatal T2DM screening at INITIAL visit if
overweight(BMI>25)+ other risk factor
27
screen all prego for GDM at
24-28 weeks using 75g 2-hr OGTT
28
OGTT diagnostic criteria
fasting >92mg/dl 1h>180mg/dl 2h>153mg/dl
29
screen women with GDM for persistent DM at
6-12 weeks post-partum using a test other than A1C
30
women with history of GDM should have
lifelong screening for DM every 3 years
31
GDM first line treatment
dietary modification & additional caloric restriction for obese women
32
glucose goals in prego
fasting <120-127
33
diastolic BP >110mmgHg at risk for
placental abruption & fetal growth restriction
34
systolic BP>160mmHg at risk for
maternal intracerebral hemorrhage
35
HTN treatment goals
diastolic <160
36
chronic HTN in prego
- use of antihypertensives before prego - onset of HTN before 20th week** - HTN >12weeks post partum mild: 140-159/90-109 severe: >160/110
37
chronic HTN in prego treatment
- labetalol: 200-2400mg/day in 2-3 doses - methyldopa: 0.5-3g/ day in 2-3 doses - nifedipine XL: 30-120mg/day
38
HTN treatment to avoid in prego
ACEI/ARBs
39
gestational DM
AFTER week 20
40
preeclampsia prevention
supplemental Ca (1g) & aspirin 81mg after 12 weeks
41
preeclampsia treatment
mild: bed rest severe: delivery w/in 24 hours- lactated ringer, MG, hydralazine
42
thyroid monitoring in prego
every 4 weeks during first half of prego, then once between 26-36 weeks
43
safest epileptic drugs
carbamasepine & lamotrigine & supplement w/ folic acid
44
epilepsy can cause
major malformations- neural tube defects
45
benefits of breast feeding for infant
reduced risk of | -otitis media, gastrienteritis, RTI, dermatitis, asthma, obesity, DM, leukemia, SIDS
46
benefits of breast feeding for mother
- enhanced weight loss | - reduced risk of: T2DM, breast cancer, ovarian cancer, bone loss
47
Dr. Hale's lactation risk
how drugs are categorized based on their safety in passing through breast milk
48
L1
safest- large study;no ADE in infant
49
L2
safer- limited study; no ADE in infant
50
L3
moderately safe- no controlled studies; risk is possible
51
L4
possibly hazardous- positive risk to infant | benefit may > risk
52
L5
contraindicated- positive infant risk | risk > benefit
53
in post-partum depression, the risk of not treating is
greater than risk of medication
54
post-partum depression treatment
exercise, massage, counseling - SSRIs (sertraline, paroxetine) - TCAs (nortriptyline)

Reproduction (12 decks)

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