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35 Cards in this Set
- Front
- Back
What do you always ask about in pre-eclampsia? |
1. Headache 2. Epigastric pain 3. Visual disturbances |
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Define Gestational Hypertension |
Sustained Increased BP, no proteinuria in Gestation > 20 wks |
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Gestational Hypertension normalizes by 12 weeks postpartum. Retrospectively, this is called? |
Transient HTN |
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Patient history |
History (due to protein in urine, mild weightgain and HTN) is consistent with |
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Mild preeclapsia triad is? |
Gestation > 20 wks Sustained HTN > 14/90 |
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Two demographic risk factors for PreEclampsia? |
1. Nullipara |
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Three Obstetric risk factors for PreEclampsia? |
1. Multiple gestation 2. Molar pregnancy 3. Non-immune hydrps |
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Four Medical risk factors for PreEclampsia? |
1. DM 2. Chronic HTN 3. Renal disease 4. SLE |
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Pathophys for Mild preeclampsia? |
Diffuse vasospasm, capillary injury |
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Patient management in Mild PreEclampsia when patient is > 36 wk? |
MgSO4 (to prevent convulsions) + delivery |
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What is the mechanism of PreEclampsia? |
Prostaglandins are involved! Increased Thromboxane (vasoconstrictor) Decreased Prostacycline (vasodilator) |
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Patient history |
Severe PreEclampsia |
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What is the BP level differentiating Mild from Severe PreEclampsia? |
>/ 160/110 is Severe |
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Mild hypertension, mild proteinuria in addition to any of the following: 4. Oligura 5. Cyanosis |
Sever end organ involvement, SEVERE PreEclampsia |
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Discovery of a Schistocyte in a pregnant woman, will point to which diagnosis? |
DIC, which again points to SEVERE PreEclampsia |
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Aggressive management of Severe PreEclampsia includes? |
IV MgSO4 --> prevent convulsions |
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Which compound is given to a baby for lung maturation? |
Bethamethasone |
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Why give a baby Betamethasone? |
To mature the lungs |
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Patient History |
Eclampsia |
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Pathophysiology of Eclampsia? |
Cerebral vasospasm, ischemia & brain edema |
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Symptoms of Eclampsia? |
Tonic-clonic Seizures |
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Lab findings in Eclampsia |
Hemoconcentration, increased liver enzymes and evidence of DIC |
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Management of Eclampsia? |
1. Stop convulsions with MgSO4 (continue for 24 hrs postpartum) 2. Prompt delivery at any gestational age to save the mother 3. Lower diastolic BP to 90-100 mm/Hg |
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Diagnosis of Chronic HTN in pregnancy? |
Gest <20 wks or pre pregnancy |
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3 Factors signifying poor prognosis in Chronic HTN |
Kidneys: Renal disease Heart: LVH |
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What signifies the worst prognosis in Chronic HTN? |
Uncontrolled HTN: 250/140 |
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How to diagnose Chronic HTN w/ superimposed PIH? |
Chronic HTN |
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Which HTN medication should never be used in pregnancy? |
1. ACE inhibitors (fetal renal failure) 2. Diuretics (decrease fetal profusion) |
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Management in Chronic HTN & superimposed PIH/PreEclampsia? |
1. IV MgSO4 2. Lower BP --> dias 90-100 mm Hg 3. Induce labor - if mom & fetus stable. Regardless of gestational age IV oxytocin & amniotomy |
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HELLP syndrome abreviation? |
Hemolysis |
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Patient history |
HELLP Syndrome |
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Management of HELLP? (like all the others...) |
IV MgSO4 - prevent convulsions +++ give Maternal steroids - Dexamethazone |
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Which HTN related condition has the highest incidence of abruptio placenta? |
HELLP syndrome |
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If Chronic HTN is uncomplicated during pregnancy, which antihypertensive drug can be used to treat the mother? |
Alpha Methyl-Dopa |
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Eclampsia prior to 20 wk gestation is rare and should raise the possibility of an underlying _____ or ___________ syndrome |
Molar Pregnancy |