S11C102 - Comorbid Diseases in pregnancy

Question 1

Hyperthyroidism tx

Answer 1

• PTU

- methimazole

Question 2

Thyroid storm in pregnancy

Answer 2

• decrease thyroid hm synthesis (PTU)
• block thyroid hormone release (Na iodide)
• block peripheral effects (propranolol)
• cool pt
• supportive (O2, IV, dex, L lat decub)

Question 3

Chronic HTN in pregnancy

Answer 3

• dx before 20w

- tx: methyldopa, labetalol, nifediipine

Question 4

Hypertensive crisis in pregnancy

Answer 4

• labetalol 10mg IV q5-10min up to total dose of 300mg

- or hydralazine 5-10mg IV bolus q15min

Question 5

SVT in pregnancy

Answer 5

• cardioselective BB, adenosine, verapamil and diltiazem are safe
• LMWH and UFH are safe

Question 6

DVT in pregnancy

Answer 6

• d-dimer, then doppler u/s

- if u/s neg repeat at 3 and 7d

Question 7

Cystitis in pregnancy

Answer 7

• AVOID: spetra, fluoroquinolones, tetracyclines
• 2nd/3rd gen cephalosporin
• ampicillin plus gentamicin
• macrobid

Question 8

Headache in pregnancy: ddx

Answer 8

• life-threatening: SAH, intraparenchymal hemorrhage, central venous thrombosis, ischemic stroke, tumor, infection, preeclampsia/eclampsia
• non-life-threatening: tension h/a, migraine, sinus ha/, benign intracranial HTN (pseudotumor cerebri)

Question 9

Opiate w/d in pregnancy

Answer 9

-tx: clonidine

Question 10

Fetal radiation exposure

Answer 10

-