Hypertensive Disease Of Pregnancy

Question 1

What is the definition of gestational hypertension?

Answer 1

SBP >/= 140 and DBP >/=90 on two occasions at least 4 hours apart after 20 weeks gestation in women with previously normal BP.

Question 2

What percentage of patients with preeclampsia with severe features develop HELLP syndrome?

Answer 2

10%

Question 3

What are the components of HELLP Syndrome?

Answer 3

Hemolysis
Elevated Liver enzymes
Low platelets

Question 4

When should you deliver in a patient with with preeclampsia without severe features ?

Answer 4

37 weeks

Question 5

When should you deliver in a patient with with preeclampsia with severe features ?

Answer 5

34 weeks

Question 6

What is eclampsia?

Answer 6

Grand mal seizures in a preeclamptic patient with no other cause.

Question 7

What is the serum concentration of MgSO4 used in therapeutic seizure prophylaxis?

Answer 7

4.8 -8.4 mg/mL

Question 8

What is the serum concentration of MgSO4 used in therapeutic seizure prophylaxis?

Answer 8

4.8 -8.4 mg/mL

Question 9

What should you administer in cases of MgSO4 overdose?

Answer 9

10ml 10% Calcium chloride or
Calcium gluconate IV

Question 10

Case of G1P0 on 39 weeks AOG with BP 160/90, with second reading 150/100, negative urine protein and no other symptoms. What is the diagnosis?

Answer 10

Gestational Hypertension

Question 11

Most practical way to measure MgSO4 Toxicity?

Answer 11

Patellar Reflex

Question 12

Blood product to be transfused in a patient with massive hemorrhage?

Answer 12

Whole blood

Question 13

Which is true about conforming elevated blood pressure during pregnancy?

Answer 13

Patient should be seated when blood pressure is taken on 2 occasions 4-6hrs apart.

Question 14

Which simple laboratory test you request to help diagnose possible preeclampsia?

Answer 14

Urine protein

Question 15

If the mean blood pressure of the patient is 148/96 mmHg after repeat measurements , what is the possible diagnosis of the patient?

Answer 15

Mild preeclampsia

Question 16

What is the ideal increase in weight for the patient per week during this period of her pregnancy?

Answer 16

1 lb

Question 17

Diagnosis of severe preeclampsia? (10)

Answer 17

1. SBP >/= 160 mmHg
2. DBP >110mmHg
3. Thrombocytopenia
4. Oliguria <500ml / 24 hrs
5. Elevated serum Creatinine
6. RUQ pain
7. AST ALT elevation
8. Headache , visual changes
9. Fetal IUGR
10. DIC

Question 18

Accepted pathophysiology of preeclampsia?

Answer 18

Generalized arteriolar constriction

Question 19

Primary goal of treatment for preeclampsia?

Answer 19

Prevention of seizures
Magnesium sulfate 4g loading dose and 2g maintenance

Question 20

Risk factors for preeclampsia?

Answer 20

1. Chronic hypertension, Renal diseases , Collagen Vascular Disease, Diabetes
2. Nulliparity , previous preeclampsia, multiple gestational, abnormal placentation
3. Female relatives of parturient with preeclampsia

Question 21

Abnormal findings in HELLP Syndrome?

Answer 21

Hemolysis
Elevated liver enzymes
Low platelets

Question 22

What percentage of neonatal death can occur with HELLP Syndrome?

Answer 22

20-25%

Question 23

Diagnosis of gestational hypertension?

Answer 23

BP above 140/90 on at least two occasions taken 4-6 hours apart while patient is seated.