Pregnancy

Question 1

What hormone increases in pregnancy and is detected by a pregnancy test?

Answer 1

Human chorionic gonadotrophin (hCG)

Question 2

Name 3 hormones a placenta secretes?

Answer 2

Human placental lactogen (hPL)
Placental oestrogen
Placental progesterone

Question 3

What type of diabetes can women get during pregnancy?

Answer 3

T1DM
T2DM
GDM

Question 4

What is gestational diabetes and what causes it?

Answer 4

Diabetes in 2nd or 3rd trimester with no previous history

Placental hormones cause insulin resistance in mother which increases blood glucose

Question 5

Which 2 hormones increase insulin resistance?

Answer 5

Progesterone

hPL

Question 6

Gestational diabetes is a risk factor for what condition?

Answer 6

T2DM

Question 7

How does gestational diabetes affect an unborn baby?

Answer 7

Mum’s hyperglycaemia

Baby hyperinsulinemia

Question 8

Name 5 effects of gestational diabetes on a foetus.

Answer 8

Congenital defect
Premature birth
Death
Macrosomnia
Polyhydramnios

Question 9

Name 3 effects of gestational diabetes on a neonate.

Answer 9

Hypoglycemia
RDS
Hypocalcemia

Question 10

What is macrosomia + link to gestational diabetes?

Answer 10

Baby > 90th size centile
Baby produces own insulin in 3rd trimester as a growth factor
Extra insulin from compensatory hyperinsulinemia causes excess growth

Question 11

4 treatments for gestational diabetes?

Answer 11

Metformin
Insulin
Folic acid
Aspirin

Question 12

What 2 drugs need to be avoided in gestational diabetes?

Answer 12

ACEIs

Statins

Question 13

What follow up test is done to diagnose T2DM after gestational diabetes?

Answer 13

6 week post-natal OGTT

Question 14

What is the percentage risk of T2DM 10-15 years after gestational diabetes?

Answer 14

50%

Question 15

Gestational hypothyroidism is caused by?

Answer 15

History of hypothyroidism and inability to compensate for increased thyroid demand

Question 16

Treatment adjustment for gestational hypothyroidism?

Answer 16

Increase thyroxine by 25 micrograms

Question 17

Monitoring of gestational hypothyroidism + target?

Answer 17

TSH every month for 5 months then every 2 months

TSH < 3

Question 18

What is hyperemesis gravidarum caused by?

Answer 18

hCG increased thyroxine and suppresses TSH

Question 19

When should hyperemesis gravidarum resolve?

Answer 19

20 weeks

Question 20

Treatment for gestational hyperthyroidism?

Answer 20

PTU for 1st trimester then carbimazole

Beta blockers

Question 21

What trimester should TRAb antibodies be tested + why?

Answer 21

3rd trimester

Hyperthyroidism can cause transient neonatal hyperthyroidism

Question 22

What is postpartum thyroiditis?

Answer 22

Transient hyperthyroid resolving to hypothyroid