Mehl. HTN Flashcards
chronic HTN. definition?
“Chronic hypertension” = HTN prior to the pregnancy or diagnosed before 20 weeks’ gestation;
usually persists postpartum since BP present in early pregnancy, or prior to
it, often reflects underlying issue unrelated to the pregnancy.
chronic HTN. Can pre-exist or persist beyond pregnancy, while gestational hypertension is specific to the pregnancy period. Both conditions require close monitoring due to potential risks to the mother and fetus.
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Gestational HTN. definition?
new-onset HTN that develops after 20 weeks’ gestation;
typically resolves postpartum.
What drugs can be used to for chronic and gestational HTN.? 4
Both chronic and gestational HTN can be managed with methyldopa (a2
agonist), labetalol, or nifedipine.
Hydralazine can be used in acute settings.
Preeclampsia. True Obgyn definition is more expansive to incorporate signs of damage to other
organs, but for USMLE, 4/5 Qs will just be HTN + proteinuria.
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In Qs that don’t give you the strict HTN >20 weeks’ gestation + proteinuria combo,
they will usually just give straight-up HELLP syndrome (discussed below), which is considered to be a severe form of preeclampsia involving damage to the liver.
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Eclampsia definition?
preeclampsia + seizures.
Mechanism for preeclampsia/eclampsia?
uteroplacental insufficiency, where
inadequate perfusion to the placenta causes a compensatory attempt by the
cardiovascular system to increase/force perfusion, thereby resulting in systemic HTN.
The uteroplacental insufficiency can be?
idiopathic or due to secondary factors such as smoking and SLE.
“Severe preeclampsia”?
BP > 160/110 (either number), proteinuria 3+ on dipstick, or
any evidence of multi-organ system involvement (i.e., liver, CNS, lungs). L
iver damage
can be overt HELLP syndrome or just any elevation in hepatic enzymes.
CNS involvement can refer to visual disturbance or headache. Pulmonary involvement refers to pulmonary edema or cyanosis.
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When is given Mg?
Magnesium is only given prophylactically to prevent eclampsia (seizures) if patient
has severe preeclampsia.
If patient already has overt eclampsia with seizures, first Tx is magnesium.
nu cia taip buvo parasyta, bet pries tai buvo mineta kad mg tik profilaktikai kai preeclampsia
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Definitive management for both preeclampsia and eclampsia?
delivery of the fetus.
HELLP abreviation?
Hemolysis, Elevated Liver enzymes, Low Platelet count.
