Hypertensive Disorders in Pregnancy (Wootton) Flashcards
__1__ Hypertension presents before or recognized during first half of pregnancy.
__2__ Hypertension is recognized after 20 weeks gestation.
__3__ occurs after 20 weeks gestation and coexists with proteinuria.
__4__ is new onset seizure activity associated with preeclampsia.
__5__ occurs in women who have been diagnosed with chronic high blood pressure before pregnancy, but then develop worsening high blood pressure and protein in the urine.
1) Chronic
2) Gestational
3) Preeclampsia
4) Eclampsia
5) Chronic hypertension with superimposed preeclampsia
What is the most common type of chronic HTN?
Essential HTN (Idiopathic)
What labs/tests should you order during evaluation of chronic HTN during pregnancy in order to assess for maternal end-organ damage?
1) CBC
2) Glucose
3) CMP
4) 24 hour urine collection for total protein
5) EKG
6) Echo
In the management of mild chronic HTN (BP less than 160/110 mmHg) you should begin __1__ therapy at 81 mg daily at 12 weeks till delivery.
Aspirin
In the management of severe chronic HTN (BP greater than 160/110 mmHg) you should begin antihypertensive therapy with?
1) Methyldopa
2) Labetalol
3) Nifedipine
In the management of severe chronic HTN, what antihypertensive medications are absolutely contraindicated as they can increase the risk of malformations (renal dysgenesis, calvarial hypoplasia and fetal growth restriction)?
1) ACE inhibitors (drugs end in -pril)
2) Angiotensin receptor blockers (drugs end in -sartan)
Gestational HTN occurs without any features of __1__.
It occurs after __2__ weeks gestation.
It also can occur within 48-72 hours after __3__.
It resolves by __4__ weeks postpartum.
1) Preeclampsia
2) 20 weeks
3) Delivery
4) 12 weeks
What common findings of preeclampsia are diagnostic?
1) HTN
2) Proteinuria
3) Edema
Symptoms of preeclampsia include?
1) Blurred vision
2) Epigastric and/or RUQ pain
3) Headache
Is multiparity or nulliparity a risk factor for preeclampsia?
What abnormal uterine growth is a risk factor?
1) Nulliparity
2) Hydatidiform mole
What does preeclampsia cause that results in headaches?
What manifestation to the lung does preeclampsia cause?
What does preeclampsia cause that results in the RUQ pain?
Preeclampsia causes elling and enlargement of glomerular capillary endothelial cells which leads to?
1) Cerebral edema
2) Pulmonary edema
3) Hepatic hemorrhage
4) Proteinuria
__1__ Preeclampsia is characterized as BP > 140/90 but less than 160/110 at least 4 hours apart.
The proteinuria is __2__ mg/24 hour or a single specimen urine protein:creatinine ratio of __3__ mg/dL or a urine dipstick reading of __4__.
1) Mild
2) > 300 mg/24 hour
3) 0.3 mg/dL
4) 2+
__1__ Preeclampsia is characterized as BP systolic >160 or diastolic >110 (2 occasions 4 hours apart).
Urine production is described as __2__.
__3__ enzymes are twice the upper limits of normal.
1) Severe
2) Oliguria (less than 500 ml in 24 hours)
3) Liver enzymes
What symptoms are noted with severe preeclampsia?
1) Visual disturbances
2) Pulmonary edema
3) Epigastric or right upper quadrant pain
4) Thrombocytopenia
A physical examination of preeclampsia can reveal?
1) Brisk reflexes
2) Clonus
What lab findings are increased with preeclampsia?
1) Hematocrit
2) LDH
3) AST, ALT
4) Uric acid
What lab finding is decreased with preeclampsia?
Thrombocytopenia (low platelets)
Between ____ weeks gestation in a patient with mild preeclampsia you should begin induction at time of diagnosis at this gestational age.
37-40 weeks
In the management of blood pressure with antihypertensives what should be given for severe preeclampsia?
1) Labetalol
2) Nifedipine
3) Hydralazine
What is the MOA of hydralazine?
What is the MOA of labetalol?
What is the MOA of nifedipine?
1) Direct vasodilator
2) Nonselective alpha-1 and beta-1 blocker
3) Calcium channel blocker
What should be administered for seizure prophylaxis in preeclampsia patients?
The loading dose is?
The maintenance dose is?
The therapeutic value is between?
1) Magnesium sulfate
2) 4 gm bolus
3) 2 gm/hr
4) 5-9 mg/dL
Eclampsia is defined as new onset __1__ seizures.
__2__ is the first line treatment.
__3__ is indicated if it is persistent.
1) Tonic clonic
2) Magnesium sulfate
3) Lorazepam
HELLP syndrome is a variant of?
It stands for?
1) Preeclampsia
2) Hemolysis, Elevated Liver Enzymes, and Low Platelets
What symptoms are common with HELLP syndrome?
1) RUQ pain
2) N/V
What is found on labs for HELLP syndrome?
1) LDH greater than 600 IU/L
2) AST/ALT elevated twice the upper limit of normal
3) Platelets less than 100,000
What should be done with HELLP syndrome in regards to the delivery?
Immediate delivery
