Exam #2 Pregnancy at risk

Question 1

Insulin levels in pregnancy

Answer 1

Insulin levels increased in early pregnancy. In second half, increased resistance to insulin.

Question 2

High glucose levels in pregnancy pose a risk of

Answer 2

behavior and learning disabilities due to circulating FFAs

Question 3

Maternal risks of DM

Answer 3

Hydramnios (increased amniotic fluid), risk of preterm labor and prolasped cord
Preeclampsia/eclampsia
Hyperglycemia and ketoacidosis
Dystocia
Infection risk
Retinopathy

Question 4

Fetal risks of DM

Answer 4

mortality
Congenital anomalies
Macrosomia
IUGR
Respiratory distress syndrome
Polycythemia
Hyperbilirubinemia
Hypocalcemia
Jaundice

Question 5

Timing of gestational diabetes screenings

Answer 5

low risk_24-28 weeks

high risk—as early as feasible

Question 6

Risk factors for gestational diabetes

Answer 6

Age >40
Family hx of diabetes
Prior large, malformed, or stillborn infant
Obesity
HTN
Glucosuria

Question 7

Glucose tolerance test for GDM: what levels indicate need for further testing?

Answer 7

130-140mg/dL, proceed to 3 hour test

Question 8

Timing of exercise with gestational diabetes

Answer 8

after meals, carry sugar with you

Question 9

Hb levels that indicate anemia in the pregnant woman

Answer 9

<11g/dL

Question 10

Causes of anemia in pregnancy

Answer 10

insufficient Hb production
Hb Destruction
Hemodilution

Question 11

Iron deficiency anemia increases risk of

Answer 11

postpartum hemorrhage

Question 12

Iron should be supplemented by ___ mg daily to prevent anemia

Answer 12

at least 30

Question 13

To treat anemia, iron should be supplemented by ___ daily

Answer 13

60-120

Question 14

Folic acid deficiency anemia is associated with a risk of

Answer 14

Neural tube defects

Question 15

Prevention of NTD

Answer 15

supplement with .4mg of folic acid daily

Question 16

Risks of SCD/SCT in pregnancy

Answer 16

increased risk of nephritis, bacteriuria, hematuria, anemia, vaso-occlusive crisis, infection, fetal death, prematurity, IUGR

Question 17

rx for Sickle Cell anemia during pregnancy

Answer 17

Folic acid
Ifx treatment
rehydration, O2, antibiotics, analgesics
FHR monitoring
Positioning during labor

Question 18

Thalassemia minor during pregnancy— maternal and fetal risks

Answer 18

Mild anemia, small RBCs

Question 19

Thalassemia major during pregnancy— maternal and fetal risks

Answer 19

Pregnancy rare
Transfusion therapy
Risk for congestive heart failure

Question 20

Rx for thalassemia

Answer 20

Folic acid— no iron supplementation
Tranfusions
Chelation

Question 21

Diagnostic criteria for gestational diabetes

Answer 21

HbA1c level equal to or greater than 6.5% would be considered diagnostic, as would a fasting plasma glucose level equal to or greater than 126 mg/dL, or a

2-hour plasma glucose level equal to or greater than 200 mg/dL during an oral glucose tolerance test

Question 22

Nicotine use in pregnancy can cause

Answer 22

Increased rate of spontaneous abortion, increased incidence of placental abruption, small for gestational age (SGA), small head circumference, decreased length, SIDS, attention deficit hyperactivity disorder (ADHD) in school-age children