Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction & Sexual Health > Hypertension > Flashcards

Hypertension Flashcards

1
Q

What percentage of pregnancies are affected by hypertension?

A

10-15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define hypertension in pregnancy

A

> 140/90 on 2 occasions
160/110 once
30/15mmHg compared to first trimester BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name three types of hypertension in pregnancy

A

Pre-existing
Pregnancy induced
Pre-eclampsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the secondary causes of hypertension in early pregnancy?

A 
Renal 
Cardiac 
Cushing's 
Conn's 
Phaeochromocytoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the risk of pre-existing hypertension?

A

PET
IUGR
Abruption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe pregnancy induced hypertension

A

Second half of pregnancy usually resolves within 6 weeks of delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the triad of pre-eclampsia?

A

Hypertension
Proteinuria
Oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define pre-eclampsia

A

A pregnancy specific multi-system disorder with unpredictable variable and widespread manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the pathogenesis of pre-eclampsia

A

Genetic and environmental factors

Cause defective deep placentation, the injured placenta releases factors into the maternal circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

State the two stages of pre-eclampsia

A

Stage 1 - abnormal placental perfusion (ischaemia)

Stage 2 - maternal syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does abnormal placentation and trophoblast invasion do?

A

Failure of vascular remodelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens as a result of endothelial activation?

A

Increased capillary permeability
Increased expression of CAM
Increased prothrombotic factors, platelet aggregation and vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does HELLP stand for?

A 
Haemolysis 
Elevated
Liver enzymes
Low
Platelets
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does HELLP syndrome present?

A

Epigastric/RUQ pain
Abnormal enzymes
Hepatic capsule rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the symptoms of pre-eclampsia?

A 
Headache 
Visual disturbance 
Epigastric/RUQ pain 
Nausea, vomiting 
Rapidly progressive oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the signs of pre-eclampsia?

A 
Hypertension 
Proteinuria 
Oedema 
Abdominal tenderness 
Small for gestational age 
Intra-uterine foetal death 
Involuntary movements/clonus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name the investigations done in suspected pre-eclampsia

A 
Urea and electrolytes 
Serum urate 
Liver function tests 
Full blood count 
Coagulation screen 
Urine-Protein Creatinine ration 
Cardiotocography 
Ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How often should bloods be done in women with pre-eclampsia?

A

2 weekly

19
Q

How often should urinalysis be done in women with pre-eclampsia?

A

daily

20
Q

How often should BP be measured in women with pre-eclampsia?

A

4 hourly

21
Q

Name the risk factors for pre-eclampsia

A 
Maternal age 
BMI 
Parity 
Previous PE 
Family History - hypertension, diabetes, APLS, autoimmune
Multiple/molar pregnancy 
Birth interval >10 years 
UTI
22
Q

What is the mode of action of aspirin?

A

Inhibits cycle-oxygenase to prevent TXA2 synthesis

23
Q

What is classed as high risk and what dose of aspirin is required?

A

Hypertension, CKD, autoimmune disease, diabetes

150mg daily 12-36 weeks

24
Q

What is classed as moderate risk and what dose of aspirin is required?

A

> 40 years old, BMI >35, family history, multiple pregnancy, first pregnancy, birth interval >10 years

25
Q

When should a women be admitted?

A 
BP >170/110 or >140/90+proteinuria 
Significant symptoms 
Abnormal biochemistry 
Significant proteinuria >300mg/24 hours 
Requires anti-hypertensives 
Signs of fetal compromise
26
Q

At what MAP is there a risk of cerebral haemorrhage?

A

> 150

27
Q

What is the BP aim?

A

140-150/90-100mmHg

28
Q

What BP requires immediate treatment?

A

> 170/110

29
Q

Name the first line for hypertension in pregnancy

A

Methyl dopa - alpha agonist
Labetolol - alpha and beta blocker
Nifedipine - CCB

30
Q

Are there any contraindications for the first line hypertension treatment?

A

Methyl dopa - depression

Labetolol - asthma

31
Q

Name the second line hypertension drugs

A

Hydralazine - vasodilator

Doxazocin - alpha agonist

32
Q

What drug cannot be used while breast feeding?

A

Doxazocin

33
Q

What is the only cure to pre-eclampsia?

A

Delivery

34
Q

When is delivery indicated?

A 
Inability to control BP 
Rapidly deteriorating 
Eclampsia crisis 
Fetal compromise 
Term gestation
35
Q

What is a pre-eclampsic crisis?

A 
Eclampsia 
HELLP 
Pulmonary oedema 
Placental abruption 
DIC 
Cerebral haemorrhage 
Cortical blindness 
Acute renal failure 
Hepatic rupture
36
Q

What is eclampsia?

A

Tonic-clonic seizure with features of pre-eclampsia

37
Q

Which age group is eclampsia more common?

A

Teenagers

38
Q

What antihypertensives can be given in eclampsia?

A

IV labetolol

IV hydralazine

39
Q

What is given in eclamptic seizures?

A

Magnesium sulphate
Diazepam if persistent
Usually self limiting and will settle

40
Q

Describe the mechanism of action of magnesium suphate

A

Calcium channel blocker - improves foetal neurology in preterm labour

41
Q

Name two steroids that cross the placenta

A

Betamethasone

Dexamethasone

42
Q

How often do you given steroids in eclampsia and why?

A

IM corticosteroids 12-24 hours apart to help maturation of foetal lungs up to 34 weeks

43
Q

What do steroids reduce risk of?

A 
Neonatal death 
Intraventricular haemorrhage 
Necrotising enterocolitis 
NICU/ICU admission 
Systemic infection

Reproduction & Sexual Health (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions