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URN Biweekly 2 > Pregnancy and Kidney Disease- Das > Flashcards

Pregnancy and Kidney Disease- Das Flashcards

1
Q

key anatomical change to kidney during pregnancy

A

changes to renal pelvis

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2
Q

normal creatinine in patient who is pregnant means what

A

a problem; it should decline

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3
Q

in _____, glucose can still be in urine w/out exceeding renal threshold

A

pregnancy

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4
Q

what threshold is decreased during pregnancy

A

threshold for AVP/ADH release

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5
Q

in a pregnant patient with CKD, what risk increases dramatically

A

risk for preeclampsia

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6
Q

advanced CKD (severe) has what serum creatinine

A

> 2.4

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7
Q

as serum creatinine gets higher, ______ in pregnancy increases

A

problems

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8
Q

as serum creatinine increases during pregnancy, what decreases

A

fetal growth

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9
Q

first step in assessment of fetal well-being

A

non-stress test

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10
Q

2nd step to assess fetal well-being

A

ultrasonic (amniotic fluid, fetal breathing and movements)

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11
Q

how to assess fetal umbilical artery vascular resistance

A

umbilical artery doppler assessment

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12
Q

what is a major risk factor for complications during pregnancy

A

HTN

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13
Q

4 types of HTN seen in pregnancy

A

chronic HTN
gestational HTN
pre-eclampsia
white coat HTN

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14
Q

sometimes during the progression of pregnancy there is a natural decline in what

A

blood pressure

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15
Q

what happens if you reduce bp too much in pregnant patient

A

fetal growth is impaired

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16
Q

if you dont control bp= higher frequency of severe maternal ____

A

HTN

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17
Q

if you achieve a bp goal of ______ = better pregnancy outcomes

A

140/90

18
Q

what medication used for HTN is contraindicated in pregnancy

A

ACEIs and ARBs

19
Q

least risk of pregnancy complications with HbA1c of ____

A

7

20
Q

target bp for pregnant patient w/ diabetes and HTN and proteinuria

A

<130/80

21
Q

4 maternal/neonatal outcomes for pregnant patient with diabetes and HTN

A

preeclampsia
renal impairement
microvascular disease
neonatal outcomes poor

22
Q

what medication to start to prevent preeclampsia

A

aspirin

23
Q

main thing to do for managing bp and bg for pregnant patient

A

reassure the patient

24
Q

pregnant pt has worsening lower extremity edema and protein in urine; what med to give

A

diuretic

25
Q

what not to give pregnant patient with nephrotic syndrome

A

statins

26
Q

what does nephrotic syndrome predispose pregnant patient to

A

thrombotic events (lose antithrombin III)

27
Q

this is a likely result of preeclampsia and pt has N/V and RUQ pain

A

AKI

28
Q

what is difficult to diagnose

A

superimposed preeclampsia

29
Q

what 2 biomarkers are helpful in detecting preeclampsia

A

placenta growth factor (PlGF) and tyrosine-kinase 1

30
Q

what drug will help in fetal lung development

A

corticosteroid

31
Q

what drug is administered for neuroprotection for fetus

A

Mg sulfate

32
Q

pregnant patient with lupus nephritis and CKD should be taking what med

A

not mycophenolate but azathioprine

33
Q

peak in ____ hormone and ovulation must occur for pt to conceive

A

LH

34
Q

this drug has a negative impact on fertility

A

cyclophosphamide

35
Q

can pt on dialysis conceive

A

yes

36
Q

can pt receiving kidney transplant conceive

A

yes 1 year after transplant

37
Q

increase in hemodialysis hours= _______

A

live births

38
Q

dont let pt lie on back while undergoing dialysis b/c compression of _____ on IVC can cause HTN

A

uterus

39
Q

risk remains high in patient with________ but they can still conceive if kidney function is good

A

kidney transplant

40
Q

immunosuppressor that blocks calcineurin

A

Tacrolimus

41
Q

immunosuppressor used instead of mycophenolate or cyclophosphamide

A

Aziathioprine

42
Q

what other immunosuppressor can be used but just monitor for gestational diabetes

A

prednisone

URN Biweekly 2 (15 decks)

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