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Obstetrics > Hypertension Disorders of Pregnancy > Flashcards

Hypertension Disorders of Pregnancy Flashcards

1
Q

What are the 2 criteria that needs to be met to define preeclampsia?

A
  • hypertension
  • proteinuria

*edema no longer part of diagnosis

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2
Q

What are the 3 criteria that can be used to diagnose proteinuria for preeclampsia?

A
  • protein/creatinine ratio of >0.3 mg/dL
  • 300 mg/liter in a 24hr collection
  • 1+ or greater on a dipstick
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3
Q

A patient presents with a BP of 160/115. She has noticed a low urine output. Associated symptoms include headaches, visual disturbances, and epigastric pain. Labs demonstrate a 2 fold increase in ALT/AST. What is the diagnosis?

A
  • severe preeclampsia
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4
Q

What are the 2 most common risk factors for preeclampsia?

A
  • nulliparity
  • age under 20 and over 35

*most common risk factors Dr. Marino sees

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5
Q

An abnormal PGI2/TXA2 ratio is associated with this condition.

A
  • preeclampsia
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6
Q

What medication do we give to try and prevent preeclampsia?

A
  • low dose aspirin (81 mg)
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7
Q

In order to make the diagnosis of preeclampsia you need to know these 3 things.

A
  • normal physiologic changes in pregnancy
  • baseline BP
  • baseline proteinuria in someone at risk
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8
Q

T/F: There is no effective method for identifying women at risk for preeclampsia.

A

True

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9
Q

What is the ultimate treatment for preeclampsia?

A

delivery of baby

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10
Q

What are the 2 main treatment goals of preeclampsia?

A
  • prevention of seizures

- treatment of HBP

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11
Q

What medication is used to prevent seizures in preeclampsia?

A
  • Magnesium Sulfate
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12
Q

Magnesium is excreted by what organ?

A

kidneys

*so if patient has impaired kidney function need to be cautious in administration

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13
Q

If a mother has severe preeclampsia that is life-threatening by what week can they have a pre-term delivery?

A

by 34 weeks

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14
Q

Recurrence rate of severe preeclampsia in subsequent pregnancies is greater in what situation?

A
  • if it occurs early in gestation
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15
Q

What is the most common type of hypertension in pregnancy?

A

primary hypertension (90%)

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16
Q

How is chronic hypertension defined?

A

hypertension diagnosed before 20th week of gestation

17
Q

What are the 2 main risks for the fetus with maternal hypertension?

A
  • fetal growth restriction

- oligohydramnios

18
Q

What labs do you want to order for a pregnant female who presents with chronic hypertension to help differentiate from preeclampsia?

A
  • 24 hr urine collection, BUN, creatinine, CrCl
19
Q

What drug is given for chronic hypertension to prevent preeclampsia?

A

low dose aspirin

20
Q

This is one of the oldest antihypertensives that reduces systemic vascular resistance and has a good safety profile.

A

Aldomet (Alphametyldopa)

21
Q

What are the 2 most commonly used antihypertensives for pregnancy?

A
  • Labetalol (BB)

- Nifedipine (CCB)

22
Q

What beta-blocker also has some alpha receptor activity?

A

labetalol

23
Q

These antihypertensive drugs are contraindicated after the first trimester.

A
  • ACE inhibitors
24
Q

How is gestational hypertension defined?

A

hypertension diagnosed after 20 weeks of gestation that returns to normal 6 weeks postpartum

25
Q

What is the purpose in delivering early at 37 weeks in mothers with gestational hypertension?

A

prevent preeclampsia

26
Q

What are the 3 factors that makes up HELLP syndrome?

A
  • hemolytic anemia
  • elevated liver function
  • low platelets
27
Q

20% of women with preeclampsia present with this syndrome.

A

HEELP syndrome

28
Q

This condition usually happens in the 2nd trimester and consists of neurological symptoms, fever, and more renal involvement.

a. HELLP
b. TTP
c. HUS
d. AFLP

A

b. TTP

29
Q

This condition usually happens in the younger age group. It is classified as a post-partum disease and the hallmark sign is severe renal dysfunction.

a. HELLP
b. TTP
c. HUS
d. AFLP

A

c. HUS

30
Q

This condition is defined by DIC, hypoglycemia, low fibrinogen, and renal failure.

a. HELLP
b. TTP
c. HUS
d. AFLP

A

d. AFLP (Acute Fatty Liver of Pregnancy)

31
Q

This is defined as new onset of proteinuria in women with chronic hypertension.

A

superimposed preeclampsia

32
Q

This is defined as the presence of grand mal seizure in patient with preeclampsia

A

eclampsia

most severe form of preeclampsia

33
Q

What is the medical treatment of eclampsia?

A

Magnesium Sulfate (MgSO4)

Obstetrics (12 decks)

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