Respiratory, Endocrine, &Genetic Disorders

Question 1

There is a peak in relative insulin insensitivity during which part pf pregnancy?

Answer 1

26-28 weeks gestation

Question 2

Gestationl Diabetes timeframe?

Answer 2

Begins 24-26 wks, up to 6 wk PP

Question 3

What causes the insulin resistance during pregnancy

Answer 3

human placenta hormone (hPL)

Question 4

When does gestational dibetes screning take place?

Answer 4

24-28 wks

Question 5

Gestational Diabetes Screening: 3 Hour OGTT

Answer 5

• Uses 100 g Fasting for 3 Hour OGTT

- If 2 or more abnormal values = GDM

Question 6

Diabetes Screening: 3 Hour OGTT Normal serum values?

Answer 6

Fasting <105 mg/dl
1 hour <190 mg/dl
2 hours <165 mg/dl
3 hours <145 mg/dl

Question 7

Diabetes Screening: 2 hour OGTT

Answer 7

• One or more of the values must be equaled or exceeded for the diagnosis of GDM.
• Fasting 92 mg/dl
• 1 hour 180 mg/dl
• 2 hours 153 mg/dl

Question 8

Potential Pregnancy Dangers with Diabetes (Fetus)

Answer 8

• increase Neural tube defects
• Macrosomia
• IUGR

Question 9

Potential Pregnancy Dangers with Diabetes (Neonate)

Answer 9

• Hypoglycemia
• Hypocalcemia
• Polycythemia
• Hyperbilirubinemia

Question 10

What happens to insulin needs after delivery?

Answer 10

insulin needs drop significantly in 1st 24hrs

Question 11

What happens to the thyroid during pregnancy?

Answer 11

usually enlarges

Question 12

What effect does Hcg and estrogen have on T3/T4 levels?

Answer 12

they increase

Question 13

Labs that differentiate hyperthyroidism in pregnancy?

Answer 13

-increased T4/T3, significantly decreased TSH

Question 14

Do thyroid meds cross the placenta?

Answer 14

yes (ex. synthroid)

Question 15

Labs that differentiate hypothyroidism in pregnancy and tx?

Answer 15

• increased TSH with or without decreased T4(free Thyroxine)
• Treatment: Levothyroxine (eg. Synthroid)

Question 16

How is Sickle Cell transmitted?

Answer 16

autosomal recessive inheritance (25% chance)

Question 17

Complications of Sickle Cell Anemia in Pregnancy include an increased risk of?

Answer 17

• High fetal wastage (Spontaneous AB, stillbirth)
• Hemolytic anemia
• UTIs & pyelonephritis
• Urinalysis each trimester even with SC Trait
• Hematuria
• Leg ulcers
• Increased maternal mortality & morbidity (5-10 %)
• Increased susceptibility to infection
• Pre-eclampsia

Question 18

How is Cystic Fibrosis transmitted?

Answer 18

Autosomal Recessive Inheritance 25% risk of inheritance

Question 19

Most common fatal autosomal recessive genetic disorder in Caucasian children?

Answer 19

Cystic Fibrosis

Question 20

The below are potential dangers for neonates in which disorder:

• Hypoglycemia
• Hypocalcemia
• Polycythemia
• Hyperbilirubinemia

Answer 20

Diabetes

Question 21

The below are potential dangers for a fetus in which disorder:

• increase Neural tube defects
• Macrosomia
• IUGR

Answer 21

Diabetes