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Integrative Analysis II > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

A normal pregnancy is 40 weeks counted from…

A

the start of the last menstrual period

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2
Q

Pregnancy is considered full term at

A

37 weeks

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3
Q

What is preterm?

A

born before 37 weeks

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4
Q

What is premature?

A

organ systems are not fully developed (usually lungs)

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5
Q

of times a mother has been pregnant (regardless of results)

A

gravida

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6
Q

of births > 20 weeks (multiples count as 1)

A

parity/para

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7
Q

How do you notate a mother pregnant with her second child?

A

gravida 2, para 1

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8
Q

Pre-eclapsia/eclampsia is more common in

A

primigravids aka first pregnancy

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9
Q

T/F IOP commonly increases in late pregnancy

A

false, decreases

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10
Q

19% in normal 24% in OHTN

A

decrease in IOP late pregnancy

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11
Q

What vascular effects account for reduced IOP?

A

increased aqueous outflow, reduced episcleral venous pressure, decreased scleral rigidity, general acidosis during pregnancy

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12
Q

What is a potential glaucoma tx for pregnant patients?

A

SLT

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13
Q

What are pregnancy corneal changes?

A

decreased sensitivity, increased curvature, changes in thickness/index of refraction

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14
Q

T/F OSD commonly leads to CL intolerance?

A

true

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15
Q

How is tear film physiology altered?

A

immune reaction in lacrimal duct cells, destruction/disruption of acinar cells by prolactin, and other growth factors, general dehydration from vomiting and anti-emetics

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16
Q

What are ocular physiologic changes?

A

pigmentation, ptosis, Graves

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17
Q

What two pigment changes occur?

A

melasma or chloasma “pregnancy mask”

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18
Q

Melasma

A

increased pigmentation of the skin

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19
Q

Chloasma

A

specifically pigmentation to the face

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20
Q

Who is at the highest risk for pregnancy mask

A

patients with light brown skin in areas with high sun exposure

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21
Q

What causes increased pigmentation around the eyes?

A

increased estrogen, progesterone, and melanocytes-stimulating hormones

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22
Q

When is eye pigmentation common other than pregnancy?

A

patch contraceptive and HRT

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23
Q

When does pregnancy mask resolve?

A

after delivery or d/c of meds

24
Q

Why is ptosis common?

A

fluid retention and hormonal effect on levator aponeurosis– typically unilateral (resolves postpartum)

25
Q

T/F Graves orbitopathy may develop or worsen in those with Graves hyperthyroidism during pregnancy

A

true, tends to resolve postpartum

26
Q

Development of krukenberg spindles…

A

develop early in pregnancy and usually tend to decrease in size during the third trimester and postpartum

27
Q

T/F a decrease in autofluorescence is reported (lens?)

A

true

28
Q

Does pregnancy affect cataracts?

A

increased liquid volume during pregnancy might result in development or exacerbation of cataracts

29
Q

What lens refractive changes occur?

A

increasing in central and thinnest corneal thickness in the second and third trimesters of pregnancy which returns to the normal value with delivery

30
Q

When does pregnancy induced hypertension occur?

A

after the 20th week

31
Q

Pre-eclampsia

A

HTN systolic >140 or dialstolic >90 + peripheral edema, proteinuria (>300 mg/24 hours)

32
Q

Eclampsia

A

pre-eclampsia + seizures

33
Q

Risk factors of pre-eclampsia

A

having multiples, older or younger mom, vascular disease, fetal abnormalities

34
Q

Finland study on pre-eclampsia

A

mother’s with first pregnancy over the age of 35 had higher rate of pre-eclampsia (9.4%) compared to those under 35 (6.4%)

35
Q

Ocular effects of pregnancy induced HTN

A

arterial narrowing, exudate and edema, RNFL infarct, neo or vit heme, serous RD, papillary edema, NA-AION, optic atrophy, cortical blindness from occipital lobe infarcts

36
Q

How often do serous RDs occur?

A

1% pre-eclampsia 10% eclampsia

37
Q

Article on pre-eclampsia and visual effects

A

Pre-eclampsia occurs in about 5% of pregnancies and visual/ocualar effects of pre-eclampsia occur in 1/3 of those cases

38
Q

HELLP syndrome

A

hemolysis, elevated liver enzyme, low platelets

39
Q

Retinal findings of HELLP syndrome

A

bilateral serous RD, sub-retinal opacities, vitreous hemes

40
Q

PEHPES

A

pre-eclampsia-eclampsia HTN posterior encephalopathy syndrome

41
Q

Ocular effects of PEHPES

A

HA, blurred vision, cortical blindness

42
Q

Central serous retinopathy

A

localized serous RD with white exudate and fibrin in pregnancy and resultant pigment mottling

43
Q

When does central serous develop?

A

3rd trimester

44
Q

T/F pregnancy increased risk of CSCR up to 9x

A

true

45
Q

Does CSR recur after delivery?

A

Yes, there is a higher chance

46
Q

What makes pregnancy CSR different?

A

90% of pts have fibrin layer within

47
Q

Is pregnancy a risk for diabetic retinopathy?

A

yes, duration of diabetes prior to pregnancy is important

48
Q

What factors increase risk of diabetic retinopathy?

A

presence of DR at conception, poor glycemic control, rapid normalization of glycemic levels, HTN/pre-eclampsia

49
Q

How do you treat diabetic retinopathy during pregnancy?

A

photocoagulation if severe

50
Q

Normal and diabetic FBG

A

normal: <100 mg/dL and diabetic >/=126

51
Q

Normal and diabetic RBG (same as 2 hr OGTT)

A

normal: <140 mg/dL and diabetic >/= 200

52
Q

Normal and diabetic HbA1c

A

normal: <5.7% and diabetic >/=6.5%

53
Q

Recommendations for pregnant diabetics

A

have eye exam prior to conceptions, and during 1st trimester

54
Q

What is DM follow up during pregnancy?

A

No ret to moderate NPDR 2-12 months and severe NPDR or worse 1-3 months

55
Q

Do gestational diabetics require an eye exam?

A

no

56
Q

Medication categories A-X

A

A: human studies no risk. B: animal no risk/no human evaluated. C: animal risk, no human study. D: risk to fetus in humans use caution. X: contraindicated

57
Q

New drug label system

A

pregnancy, lactation and male/female reproduction paragraphs

Integrative Analysis II (5 decks)

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