Renal, GI, Endo

Question 1

Hallmark finding in nephrotic syndrome in pregnant patients

Answer 1

Proteinuria

Question 2

Complications of asymptomatic bacteruria

Answer 2

Pyelonephritis Preterm birth Low birth weight infants

Question 3

Indications for surgery in GI conditions if pregnant

Answer 3

Appendicitis Adnexal mass Cholecystitis

Question 4

Hyperemesis gravidarum can have what type of acid base disorder?

Answer 4

Metabolic alkalosis

Question 5

Life threatening complications of hyperemesis gravidarum

Answer 5

Diaphragmatic rupture Esophageal rupture

Question 6

Screening for T2DM is done when

Answer 6

ALL FILIPINO gravidas screened for T2DM in the 1 st prenatal visit:

o Fasting blood sugar [FBS] or

o Glycosylated hemoglobin [HbA1c] or

o Random blood sugar [RBS])

Question 7

A diagnosis of GDM is made if the FBS is

Answer 7

>92 mg/dl

Question 8

A diagnosis of GDM is made if the OGTT is

Answer 8

GDM is made if any one (1) of the following plasma values are exceeded:

• FBS > 92 mg/dl (ADA/IADPSG/POGS
• 1 hour > 180 mg/dl
• 2 hour > 153 mg/dl (ADA/IADPSG) or > 140 mg/dl (WHO/POGS)

Question 9

Risk of fetal death is 3-4x higher for pregnant women with this type of diabetes

Answer 9

Type 1

Question 10

Women with TPO antibodies has an associated increased risk of

Answer 10

Placental abruption Spontaneous miscarriage Preterm delivery

Question 11

What antithyroid drug is associated with hepatotoxicity?

Answer 11

PTU

Question 12

Preeclampsia is associated with this thyroid disease

Answer 12

Hypothyroidism

Question 13

Screening for GDM is done at what AOG

Answer 13

24 - 28 wks AOG using a 2-hour 75 gram OGTT

Question 14

If OGTT at 24-28 weeks is NORMAL; when will you retest?

Answer 14

32 weeks or earlier if clinical signs and symptoms of hyperglycemia are present both in the mother and the fetus (e.g. polyphagia, polyhydramnios, accelerated fetal growth, etc.)

Question 15

In a patient with GDM, until what AOG can you do expectant management?

Answer 15

• Expectant management until 40 weeks, but not beyond 40 weeks.
• Early induction <39 weeks may be associated with neonatal complications.
• Elective delivery typically on or after 39 weeks.
• Spontaneous labor
  
  • Antenatal testing, fetal kick counts, EFM remains reassuring
  • Fetus is not macrosomic (<4,000 g)
  • DM is well-controlled and no complicating factors,
  • Expectant management beyond EDD generally is NOT RECOMMENDED
  • DM is not a contraindication to trial VBAC.
• Elective CS should be considered on the ff:
  
  • Fetus is suspected to be significantly obese.
  • EFW >4,500 grams (ACOG)