preclampsia

Question 1

signs of pre-eclampsi

Answer 1

excess weight gain (edema)
leg and hand sweeling 
headaches 
high Bp
RUQ pain due to liver streching capsule

Question 2

why is it so deadly

Answer 2

can lead to hemmrogahoc shcok due to placental abruption ?

Question 3

preclamsipa before 20 weeks

Answer 3

think MOLAR pregnancy

Question 4

high risk factor

Answer 4

thrombophillia, CKD, DM 1 + 2, SLE, antiphospholipid synsdromem

Question 5

modertae risk

Answer 5

nulliparity, FH, AMA , pregnancy interval >10 years

Question 6

prophylaxis

Answer 6

if you 1 high risk factor or 2 moderate be on 150mg aspirin from 12 weeks

Question 7

mcq subjective triad of preclamppsi a

Answer 7

headache
abdo pain
visual distrubances

Question 8

what is the major casue of death in preclampsia

Answer 8

stroke

Question 9

TX of HELLP

Answer 9

platelet transfusion
dexomethososn
anti hypertensives

Question 10

severe preclampsia + tx

Answer 10

> 160 and 110 ranitidine ( h2 blocker)

Question 11

indication for delivery

Answer 11

BP consistently hight
HELLP syndrome
urine outpus <400ml
severe IUGR

Question 12

AFTER delivery

Answer 12

can take up to 24 h to cure after
continue labetalol and other drugs but not methyldopa as caused post partum depression
check at 6 weeks for proteinuria - may be renal damage or underlying HTN

Question 13

whats the danger of MG SO4

Answer 13

very narrow therapeutic window - can overdose and cause respiratory suprression + cardiac arrest

Question 14

when to stop using the magnesisum

Answer 14

RR <14
urine output falls <100ml in 4 h
o2 sats fall
tendon reflexes stpped

Question 15

describe the seizure and issue for baby

Answer 15

following the seizure there is usually a period of confusion or coma

o2 supply to fetus is drastically reduced

Question 16

what are headaches and visual disturbances a sign of

Answer 16

severe eclampsia because now we are lookign at signs of cerebral edema

Question 17

consequences of eclampsia

Answer 17

IUGR , oligohydramnios, placental insufficiency HEMORRHAGIC STROKE, preterm delivery

Question 18

def severe precmlapsis

Answer 18

the high values but at least 6 hours apart and you have >5 g , edema of the legs arms face as well as pulnary edema causing s.b

Question 19

the most feared complication

Answer 19

abruption + hemorrhagic stroke

Question 20

whats the pathophysioly

Answer 20

its unlcear but to do with abnormal placenta! the psiral arteries rather than be dilated are narrow and fibrosis so less perfusion to placenta leading to IGUR -

the hypoperfused placenta start releaseing proinflammatory proteins- damage blood vessels — vasconatriction

due to the endothelial damage, lots of microthrombi which is a cause of DIC- and this is dangerous for the rbc which get consumed too- this makes up HELLP devlops in about 10-20%

also endothelia injury increases permebaility - edema