Pregnancy eruptions

Question 1

T/F Pempigoid gestationis is a rare, pruitic, vesiculobullous eruption that typically develops mid pregnancy

Answer 1

F- late pregnancy of immediate postpartum period. Although later says can develop during any trimester

Question 2

T/F Pempigoid gestationis-there is no risk to the neonate

Answer 2

F- increased risk of prematurity and small for gestational age neonates, risk correlates with disease severity.

Question 3

T/F Pempigoid gestationis The histology is exactly the same is bullous pemphigoid- IgG1 autoantibodies directed against a transmembrane hemidesmosomal protein (BP180 BPAG2, collagen XVII)

Answer 3

True

Question 4

T/F Pempigoid gestationis usually does not reoccur in subsequent pregnancies

Answer 4

T

Question 5

T/F Pempigoid gestationis Risk 1:1700- 1:50,000 pregnancies

Answer 5

T

Question 6

T/F Pempigoid gestationis Genes HLA DR3 and DR4

Answer 6

T

Question 7

T/F Pempigoid gestationis Patients who experience pemphigoid getationis are at increased risk of Hashimoto disease

Answer 7

False Graves

Question 8

T/F Pempigoid gestationis Starts in abdo typically around umbilical area

Answer 8

T (starts abdo)

Question 9

T/F Pemphigoid gestationis mucous membrane involvemen

Answer 9

F (spares mucous membrane)

Question 10

T/F Pemphigoid gestationis- skipped pregnancies have occured in 10% women

Answer 10

F 5-8%

Question 11

. T/F Pempigoid gestationis 10% neonates blisters T mild and transient in upto 10%

Answer 11

T

Question 12

. T/F Intrahepatic cholestasis of pregnancy has no cutaneou involvement to neonate

Answer 12

T

Question 13

T/F Atopic eruption of pregnancy commonly reoccurs

Answer 13

T due to atopic diathesis

Question 14

T/F Intrahepatic cholestasis of pregnancy frequently reoccurs in 80% pregnancies and can be triggered by the OCP

Answer 14

F 45-70%

Question 15

T/F Intrahepatic cholestasis of pregnancy has the worst prognosis for the neonate

Answer 15

T increased risk of premature labour 20-60%, intrapartal fetal distress 20-30% and stillbirths 1-2%

Question 16

T/F Pemphigoid gestationis- the risk to the neonate correlates with disease severity eg early onset, bullae rather than use of corticosteroids

Answer 16

T

Question 17

T/F EOs are the classic histological finding of pemphigoid gestationis

Answer 17

T

Question 18

T/F Pemphigoid gestationis Linear deposition of C3 along BMZ is observed in 100% patients, and linear IgG is seen in 30%

Answer 18

T

Question 19

T/F Prednisolone is largely inactivated in the placenta

Answer 19

T (mother:fetus=10:1)

Question 20

T/F Chlopherinamine, Diphenhydramine, Clemastine, Dimethindene preferred antihistamines first trimester

Answer 20

T

Question 21

T/F If non sedating required, Loratadine is first choice and Cetrizine is second choice

Answer 21

T

Question 22

T/F Polymorphic eruption of pregnancy. Urticarial papules and plaques usually first appear in the striae during the first part of the third trimester

Answer 22

F latter part of 3rd trimester immediately post-partum

Question 23

T/F PEP Development of polymorphous features (vesicles, erythema, target and eczematous) correlate with disease progression

Answer 23

T

Question 24

T/F PEP usually reoccurs

Answer 24

F does not usually reoccur, usually first pregnancy, multi-parous or if new partner

Question 25

T/F PEP Laboratory tests are norma

Answer 25

T

Question 26

T/F PEP Incidence is about 1 in 500 deliveries

Answer 26

F 1 in 160

Question 27

. T/F PEP cause unknown, perhaps due to increased maternal weight gain

Answer 27

T

Question 28

T/F PEP rapid weight gain may lead to damage of connective tissue and illicit an allergic-type reaction

Answer 28

T

Question 29

T/F PEP erruption typically spreads over a matter of weeks, generally sparing the face, palms and soles

Answer 29

F matter of days

Question 30

T/F PEP erruption like pemphigoid gestationis, commonly presents periumbilical

Answer 30

T

Question 31

T/F IHC Pregnancy reoccurs in 45-70% subsequent pregnancies

Answer 31

T

Question 32

T/F IHC Pregnancy + family history in 60% patients

Answer 32

F 50%

Question 33

T/F IHC Pregnancy key element is reduced excretion of bile acids

Answer 33

T

Question 34

T/F IHC Pregnancy may be due to mutation in ABCB4 gene

Answer 34

T

Question 35

T/F IHC Pregnancy generally starts around the umbilicus

Answer 35

F palms and soles

Question 36

T/F IHC Pregnancy Jaundice risk 55%

Answer 36

F 10%

Question 37

T/F IHC Pregnancy total serum bile acids >11umol/L in contrast to normal 0-6

Answer 37

T

Question 38

T/F IHC Pregnancy in 1 study 46% patients HCV RNA-positive developed condition

Answer 38

T

Question 39

T/F IHC Pregnancy treatment is oral ursedeoxycholic acid 15mg/kg daily or 1g daily

Answer 39

T

Question 40

T/F Atopic eruption of pregnancy is the most common pruitic disorder of pregnancy

Answer 40

T 1 in 5 to 1 in 20

Question 41

T/F Atopic eruption of pregnancy appears in third trimester

Answer 41

F 75% before third trimester