medical diseases of pregnancy

Question 1

do we treat pregnant women for asymptomatic UTI (asymptomatic bacteruria)? and with what

Answer 1

yes.
amoxicillin
nitrofuratoin

Question 2

what must you do after treatment of asymptomatic bacteruria

Answer 2

repeat urinanalysis

Question 3

how do you treat cystitis in pregnancy

Answer 3

same as asymptomatic bacteruria
amoxicillin
nitrofuratoin and repeat

Question 4

what are the criteria for diagnosing asymptomatic bateruria

Answer 4

no symptoms with positive U/A

Question 5

what are the criteria for cystitis

Answer 5

urgency, frequency, dysuria, positive sym and UA

Question 6

what are the criteria for pyelonephritis

Answer 6

urgency, frequency, dysuria, nausea, vomiting, tenderness, fever, chills, positive sym and UA white blood cells and bacteria in the UA

Question 7

what does a good urianalysis look liek

Answer 7

nitirites, leukocyte esterase, without epithelial cells

Question 8

what is a positive UA for bacteria colony

Answer 8

> 100,000 colonies

Question 9

how do we treat pyelo in pregnancy

Answer 9

admit with ceftriaxone and then reassess

Question 10

what happens if reassess for pyelo is improvement

Answer 10

then 10 days oral course abs with cultures and sensitivity

Question 11

what happens if reassess for pyelo is no improvement

Answer 11

abscess need ultrasound for draining

Question 12

thyroid disease in pregnancy what does it cause

Answer 12

hyper -fetal demise

hypo -cretinism

Question 13

how do we treat hypothyroid

Answer 13

levo.
test TSH levels
usually need to increase by 25% in pregnancy because of increased protein in the blood that binds T4

Question 14

how to treat hyperthyroid in pregn

Answer 14

PTU or ressection, but have to wait until 2nd trimester.

Question 15

How to treat seizures

Answer 15

L drugs are safe. leviteracetan and lemotrogine

Question 16

why do we have to be careful when treating seizures in pregnancy

Answer 16

all epileptics are teratogens.

Question 17

what meds never use for seizure treatments in pregnancy

Answer 17

valproic acid, carbamezeipime, fenytoin.

Question 18

what do you do if a pregnant woman has a seizure?

Answer 18

phenobarbitol is safe.

need to give folic acid for NTD

Question 19

what levels must hypertensino be kept at during pregnancy

Answer 19

lower than usual. <140/<80

Question 20

what are the safe HTN meds for pregn

Answer 20

alphamethodopa
labetalol
hydralazine

Question 21

what do we NOT use for HTN in pregnancy and why

Answer 21

ACE inhibitors, ARBs, calcium channel blockers, diuretics. because they are teratogens

Question 22

Diabetes goals for pregnancy

Answer 22

<7%A1c. diet and exercise. goal is also to remove oral medications and go on insulin.

Question 23

what insulin strategy used for pregna

Answer 23

basal-bolus. basal level in morning and then bolus for postorandials. need to check daily

Question 24

what happens to diabetics postpartem

Answer 24

massive reduction in the required insulin.

Question 25

what happens when diabetes is pre-partem

Answer 25

fetal anamolies such as cardiovascular transposition

Question 26

what happens with diabetes during pregnancy

Answer 26

macrosomia and increased risk for shoulder.