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Reproduction > Exam 2- lecture 2 > Flashcards

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
Q

N/V pharmacotherapy

A
  • pyroxidine (B6)
  • antihistamines (doxylamine, dimenhydrinate-dramamine)
  • dopamine antagonists (prochlorperazine, promethazine, metoclopramide)
  • serotonin antagonists (ondansetron)
  • corticosteroids
  • ginger
26
Q

prenatal T2DM screening at INITIAL visit if

A

overweight(BMI>25)+ other risk factor

27
Q

screen all prego for GDM at

A

24-28 weeks using 75g 2-hr OGTT

28
Q

OGTT diagnostic criteria

A

fasting >92mg/dl
1h>180mg/dl
2h>153mg/dl

29
Q

screen women with GDM for persistent DM at

A

6-12 weeks post-partum using a test other than A1C

30
Q

women with history of GDM should have

A

lifelong screening for DM every 3 years

31
Q

GDM first line treatment

A

dietary modification & additional caloric restriction for obese women

32
Q

glucose goals in prego

A

fasting <120-127

33
Q

diastolic BP >110mmgHg at risk for

A

placental abruption & fetal growth restriction

34
Q

systolic BP>160mmHg at risk for

A

maternal intracerebral hemorrhage

35
Q

HTN treatment goals

A

diastolic <160

36
Q

chronic HTN in prego

A
  • use of antihypertensives before prego
  • onset of HTN before 20th week**
  • HTN >12weeks post partum
    mild: 140-159/90-109
    severe: >160/110
37
Q

chronic HTN in prego treatment

A
  • labetalol: 200-2400mg/day in 2-3 doses
  • methyldopa: 0.5-3g/ day in 2-3 doses
  • nifedipine XL: 30-120mg/day
38
Q

HTN treatment to avoid in prego

A

ACEI/ARBs

39
Q

gestational DM

A

AFTER week 20

40
Q

preeclampsia prevention

A

supplemental Ca (1g) & aspirin 81mg after 12 weeks

41
Q

preeclampsia treatment

A

mild: bed rest
severe: delivery w/in 24 hours- lactated ringer, MG, hydralazine

42
Q

thyroid monitoring in prego

A

every 4 weeks during first half of prego, then once between 26-36 weeks

43
Q

safest epileptic drugs

A

carbamasepine & lamotrigine & supplement w/ folic acid

44
Q

epilepsy can cause

A

major malformations- neural tube defects

45
Q

benefits of breast feeding for infant

A

reduced risk of

-otitis media, gastrienteritis, RTI, dermatitis, asthma, obesity, DM, leukemia, SIDS

46
Q

benefits of breast feeding for mother

A
  • enhanced weight loss

- reduced risk of: T2DM, breast cancer, ovarian cancer, bone loss

47
Q

Dr. Hale’s lactation risk

A

how drugs are categorized based on their safety in passing through breast milk

48
Q

L1

A

safest- large study;no ADE in infant

49
Q

L2

A

safer- limited study; no ADE in infant

50
Q

L3

A

moderately safe- no controlled studies; risk is possible

51
Q

L4

A

possibly hazardous- positive risk to infant

benefit may > risk

52
Q

L5

A

contraindicated- positive infant risk

risk > benefit

53
Q

in post-partum depression, the risk of not treating is

A

greater than risk of medication

54
Q

post-partum depression treatment

A

exercise, massage, counseling

  • SSRIs (sertraline, paroxetine)
  • TCAs (nortriptyline)

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