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ENRP > Hypertensive Disorders in Pregnancy > Flashcards

Hypertensive Disorders in Pregnancy Flashcards

1
Q

Normal BP

A

< 120/80

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2
Q

Elevated BP

A

120-129 / < 80

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3
Q

Stage 1 HTN

A

130-139 / 80-89

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4
Q

Stage 2 HTN

A

> 140/90

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5
Q

What defines a Hypertensive Crisis?

A

Systolic > 180 and/or Diastolic > 120

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6
Q

Chronic HTN

A

HTN present before pregnancy OR
HTN that presents in the 1st half of the pregnancy OR
HTN that persists 12 weeks after delivery

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7
Q

Superimposed Preeclampsia/Eclampsia

A

Transposed onto Chronic HTN

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8
Q

What defines Mild Chronic HTN and what is the treatment?

A

BP < 160 / 110

–> Aspirin daily or start an Antihypertensive

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9
Q

What defines Severe Chronic HTN and what is the treamtent?

A

BP > 160 / 110

–> Start Antihypertensive Therapy

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10
Q

What are 3 options of medications that can be used for Severe Chronic HTN (BP > 160/110)?

A

Methyldopa
Labetalol
Nifedipine

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11
Q

With the treatment of Severe Chronic HTN (>160/110), what medications should you avoid?

A

ACEi

Angiotensin Receptor Blockers

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12
Q

ACEi and ARBs can cause fetal malformations. What are 3 examples of what can occur?

A

Renal dysgenesis
Calvarial hypoplasia
Restricted growth

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13
Q

What is Gestational HTN?

A

HTN withOUT features of Preeclampsia

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14
Q

HTN without features of preeclampsia?

A

Gestational HTN

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15
Q

When does Gestational HTN occur and resolve?

A
  • After 20 weeks gestation
  • Within 72 hours of delivery
  • Resolves within 12 weeks of delivery
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16
Q

What causes Preeclampsia?

A

Unknown

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17
Q

What is Preeclampsia?

A

HTN and Proteinuria

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18
Q

What are the risk factors for Preeclampsia?

A
  • Age < 20 or > 40, black race, assisted reproductive technology
  • No prior pregnancies or > 7 years since last pregnancy
  • Multifetal gestation
  • Obesity, diabetes, renal disease
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19
Q

What are the risk factors for Preeclampsia?

A
  • Age < 20 or > 40, black race, assisted reproductive technology
  • No pregnancies or > 7 years since last pregnancy
  • Multifetal gestation
  • Obesity, diabetes, renal disease
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20
Q

List some possible symptoms with Preeclampsia

A

Headache
Blurred vision/Scotoma (blind spot)
Abdominal pain

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21
Q

What causes the headache with Preeclampsia?

A

Cerebral edema and possible vascular issues

22
Q

When there are changes in vasculature pressure with Preeclampsia, what can that cause?

A

Pulmonary edema

Edema

23
Q

What causes the vision changes with Preeclampsia?

A

Retinal vasospasm or edema

24
Q

What causes the proteinuria with Preeclampsia?

A

Enlarged glomerular endothelial cells and narrowed capillary lumen

25
What can cause the RUQ pain with Preeclampsia?
Liver hemorrhage, thrombi, rupture
26
Preeclampsia is further categorized into what 2 categories?
1. Preeclampsia without severe features | 2. Preeclampsia with severe features
27
What BP defines Preeclampsia without severe features?
> 140 / 90 BUT LESS THAN 160 / 110
28
What BP defines Preeclampsia without severe features?
> 140 / 90 BUT LESS THAN 160 / 110
29
How can the proteinuria be diagnosed with Preeclampsia without severe features?
- Urine protein > 300 mg in a day - Urine protein:creatinine ratio of 0.3 - Urine dipstick reading of 2+
30
How can the proteinuria be diagnosed with Preeclampsia without severe features?
- Urine protein > 300 mg in a day - Urine protein:creatinine ratio of 0.3 - Urine dipstick of 2+
31
Symptoms of Preeclampsia without severe features?
NONE
32
What are the treatments for preeclampsia without severe features if less than 37 weeks gestation and after 37 weeks gestation?
< 37 weeks = observe with fetal tests | > 37 weeks = Induction
33
What BP defines Preeclampsia with severe features?
> 160 systolic or > 110 diastolic | -- on 2 occasions 4 hours apart
34
What BP defines Preeclampsia with severe features?
> 160 systolic or > 110 diastolic | -- 2 occasions 4 hours apart
35
What urine change will be present with Preeclampsia with severe features?
Oliguria (< 500 ml in a day)
36
Preeclampsia with severe features involves symptoms. What are 4?
Headache that does not respond to meds Vision changes Pulmonary edema Abdominal pain
37
What will the liver enzymes and platelets be with Preeclampsia with severe features?
LOW platelets | Liver enzymes 2X the ULN
38
What will be found on exam with Preeclampsia with severe features?
Brisk reflexes | Clonus
39
What will be decreased and increased with labs with Preeclampsia with severe features?
- LOW platelets | - HIGH liver enzymes, LDH, Hematocrit, uric acid
40
A patient with Preeclampsia with severe features should be hospitalized. What 3 antihypertensive meds can be given?
Labetalol Nifedipine Hydralazine
41
What 3 antihypertensive meds can be given for Preeclampsia with severe features?
Labetalol Nifedipine Hydralazine
42
If the patient is less than 37 weeks and has preeclampsia with severe features, what should be given?
Corticosteroids
43
What should be given for seizure prophylaxis with Preeclampsia with severe features?
Magnesium Sulfate
44
What is Magnesium sulfate given for?
Seizure prophylaxis with Preeclampsia with severe features
45
Eclampsia
New onset tonic clonic seizure
46
What are the treatments for Eclampsia?
Protect airway Magnesium Sulfate Lorazepam if persistent
47
What can be given for the prevention of Preeclampsia?
Low dose aspirin
48
HELLP Syndrome
Hemolysis Elevated Liver enzymes LOW Platelets
49
Treatment for HELLP Syndrome?
Immediate delivery
50
What 3 medications can be given for Preeclampsia with severe features?
Labetalol Nifedipine Hydralazine

ENRP (45 decks)

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