Medicine (Pregnancy)

Question 1

What are cardiovascular changes during pregnancy?

Answer 1

-Decrease in systemic vascular resistance
-Increased cardiac output
-Increase in HR

Question 2

What are hematologic changes during pregnancy?

Answer 2

-Anemia due to hemodilution
-Hypercoagulable state increases risk of DVT

Question 3

What are the respiratory changes during pregnancy?

Answer 3

-FRC decreases
-Respiratory alkalosis
-Increase in oxygen consumption

Question 4

What are endocrine changes in pregnancy?

Answer 4

-Insulin resistance
-Hypoglycemia can result

Question 5

What are oral manifestations of pregnancy?

Answer 5

-Chronic gingivitis
-Pyogenic granulomas (usually self resolve)
-Melanosis of the skin and mucosa

Question 6

What is preeclampsia?

Answer 6

-Pregnancy-induced condition due to abnormal placental implantation that can result in hypertension
-Treat conservatively vs in severe cases deliver fetus

Question 7

What is eclampsia?

Answer 7

-Severe preeclampsia characterized by seizures or coma
-Emergent delivery, HTN medication, seizure management

Question 8

What is HELLP syndrome?

Answer 8

-Hemolysis
-Elevated liver transaminases
-Low platelet

-Deliver baby

Question 9

What are Class A pregnancy drugs?

Answer 9

-Controlled studies in humans, no/little risk to fetus
-No known medications category A

Question 10

What are Class B pregnancy drugs?

Answer 10

-Low risk (animal studies show no risk, no human studies)
-Lidocaine, acetaminophen, oxycodone, fentanyl, PCN, (most antibiotics)

Question 11

What is your patient management for a pregnant patient?

Answer 11

-Consult OBGYN
-Second trimester best/safest
-Pt lay on left side
-Monitor and report HTN early
-Aspiration risk
-No N20

Question 12

Describe radiation considerations in pregnancy?

Answer 12

-10 Gy (5 Gy in 1st trimester), associated with congenital anomalies
-Fetus gets 1/50,000 compared to mothers head
-Dental estimated between 0.00001 to 0.01 Gy

-Only obtain necessary radiographs