Uwise Qbank Flashcards
Idiopathic cardiomyopathy that presents with heart failure secondary to LV systolic dysfunction that occurs during the end of pregnancy or within several months of delivery.
Peripartum Cardiomyopathy
Symptoms: fatigue, SOB, palpitations, edema.
Tachycardia, tachypnea, hypoxia, chest pain, and signs of DVT during pregnancy.
Pulmonary Embolism of Pregnancy
Common causes of acute pulmonary edema (4)
1) tocolytic use
2) cardiac dz
3) fluid overload, especially isotonic fluids (NS, D5W, LR)
4) preeclampsia
Why is there greater dilation in the R>L ureter during pregnancy?
- cushioning provided by sigmoid colon to L ureter
- greater compression of R ureter due to dextrorotation of uterus
- compression by the uterus and R ovarian vein
What is the most common site of metastasis with gestational trophoblastic dz?
Lungs
Recommended guidelines for weight gain during pregnancy?
Underweight (<18.5) = 28-40 lbs
Normal (18.5-24.9) = 25-35 lbs
Overweight (25-29.9) = 15-25 lbs
Obese (30+) = 11-20 lbs
Genetic dz risks for Ashkenazi Jews (7)
1) Fanconi anemia
2) Tay-Sachs
3) CF
4) Niemann-Pick dz
5) Canavan dz
6) Bloom syndrome
7) Gaucher’s dz
Beta-Thalassemia anemia is more common in which population?
Mediterranean
What fetal defect is noted with valproic acid use during pregnancy?
Neural tube defects
What is the risk of poorly controlled diabetes immediately prior to conception?
Increased risk for fetal structural anomalies, especially neural tube defects and CV system defects.
Chorionic villus sampling (CVS)
10-12 wks gestation
Samples chorionic frondosum which contains most mitotically active villi in the placenta
Used to assess: fetal chromosomal abnormalities and DNA mutations
MCC of inherited mental retardation?
Fragile X syndrome–most cases of Down syndrome are not heritable
Goals for blood sugar management during pregnancy?
fasting <120
Risk factors for developing gestational diabetes (4)
1) hx of a big baby (+9 lbs)
2) hx of abnormal glucose tolerance
3) pre-pregnancy weight of 110% or more of ideal BW
4) American Indian or Hispanic descent
Risks of gestational diabetes (4)
1) polyhydramnios
2) neonatal hypoglycemia
3) preeclampsia
4) macrosomia
Recommended dose of folic acid for non-high risk pregnant women? For high-risk pregnant women?
Non-high risk pregnant women = 0.4 mg/day
High risk pregnant women = 4 mg/day
Warnings of Labor (3)
1) ctx q5 minutes for one hour
2) fetal movements less than 10 per 2 h
3) vaginal bleeding
What to do during an umbilical cord prolapse?
Elevate the fetal head with a hand in the pt’s vagina and perform a c/s.
Elevating the fetal head is an attempt to avoid compression of the umbilical cord.
Definition of postpartum hemorrhage in a vaginal delivery? c/s?
vaginal delivery = >500 ml
c/s = >1000 ml
Significant blood loss during delivery causes anterior pituitary necrosis, leading to loss of gonadotrophin, TSH, and ACTH production.
Sheehan syndrome
Sx: slow mental function, weight gain, fatigue, difficulty staying warn, no milk production, hypotension, amenorrhea
Tx: E2 and P replacement and supplementation with thyroid and adrenal hormones
Tx of Sheehan syndrome
1) E2 and P replacement
2) Thyroid supplementation
3) Adrenal hormone supplementation
Inflammation of the endometrium, the inner lining of the uterus.
Endometritis
MCC of endometritis?
infection
Symptoms of endometritis?
- lower abdominal pain
- fever
- vaginal bleeding
- vaginal discharge
Risk factors for endometritis? (6)
- c/s
- prolonged ROM
- prolonged labor with multiple vaginal examinations
- internal fetal monitoring
- manual removal of the placenta
- low SES
MCC of postpartum fever?
Endometritis
Most causative agents of postpartum endometritis?
- Staph aureus
- Streptococcus
MC type of bacterial infection in postpartum endometritis?
Polymicrobial–a mix of aerobic and anaerobic bacteria in the genital tract.
Signs and symptoms of depression that lasts for <2 wks postpartum.
postpartum blues
Depression occurring within 2 wks to 6 months after delivery?
Postpartum depression
How to distinguish postpartum blues from postpartum depression?
ambivalence toward the newborn
Most significant risk factor for developing postpartum depression?
prior hx of depression
Breastfeeding is associated with a decreased incidence of…?
ovarian cancer
Risk factors for using hormonal interventions to prevent lactation?
Bromocriptine is associated with HTN, stroke, and seizures. Hormonal interventions predispose to thrombotic events.
