Labs, Labs, Labs
The following labs are most consistent with:
TSH 15.2 (ref range 0.36-3.7)
Free T4 1.2 (ref range 0.9-2.3)
Subclinical Hypothyroidism
Name three symptoms of hyperthyroidism:
What are wt loss, rapid heartbeat, nervousness, irritability, fatigue, shaky hands, muscle weakness, intolerance of heat, sweating, diarrhea?
Not used during the first trimester but other trimesters is fine. Used to treat hyperthyroidism in pregnancy
What is Methimazole (MMI)?
Weeks gestation that women normally screened for diabetes
What are weeks 24-28 weeks gestation?
Postpartum thyroiditis definition and lab results
What is an autoimmune inflammaton of the thyroid gland, resulting in hypothyroidism, transient and resolves postpartum. TSH will be high, Free T3 and T4 will be decreased.
Name 3 symptoms of hypothyroidism.
What are tiredness, sensitive to cold, constipation, dry skin, wt gain, course hair and skin.
What is Propylthiouracil (PTU). blocks the conversion of T4 to T3.
The 3 hours GTT is provided, the lab results of the fasting blood sugar, 1, 2, 3 hour results that are abnormal.
What are fasting blood sugar > 95, 1-hour >180, 2- hour>155 and 3-hour>140 2 or more of the 4 abnormal is needed to diagnose gestational diabetes
The following labs are most consistent with:
TSH 9.2 (ref range 0.34 - 3.7)
Free T4 0.8 (ref range 0.9 - 2.3)
Thyroid Peroxidase Antibody 183 (ref range 5-33)
What is Autoimmune Hypothyroidism/ or Hashimoto's disease?
Name 3 risk factors for diabetes in pregnancy
What are overwt or obese, prior history of GDM, Prior large baby weighing more than 9 lbs, Strong family history of type 2 diabetes, PCOS
Name two medications used to control hyperthyroidism:
Propylthiouracil (PTU)
Methimazole
What step 1 gestational diabetes screening results will diagnose the patient with gestational diabetes without performing the step 2 screening.
What is a 1 hour post 50 gram screening equal to or exceeds 200 mg/dL
The following labs are most consistent with:
TSH 0.1 (ref range 0.34 - 3.7)
Free T4 4.1 (ref range 0.9 - 2.3)
Thyroid Stimulating Immunoglobulin 192 (ref range <122)
Graves Disease or Hyperthyroidism
Those screened for diabetes at first prenatal visit
Who are those with a BMI of 25 and one other risk factor?
What is 50-gram glucola, no fasting required, and glucose 1 hour after drinking is greater than 130 mg/dL abnormal screen
Recommendations for follow up on gestational diabetes during postpartum.
6 weeks to 6 months postpartum, women who had gestational diabetes should be screened with either a fasting glucose, hemoglobin A1C, or 75 mg 2 hour GTT and if positive, follow up with primary care.
The following labs are most consistent with:
T4 12 (ref range 4.5-10.9)
T3 210 (ref range 80-185)
TSH 0.2 (ref range 0.36-3.7)
ESR 42 (ref range 0-10)
Subacute Thyroiditis
The weight recommendation during pregnancy for women with BMI in overweight and obese category.
What is the overwt category of BMI 25 -<30, wt gain max during pregnancy of 15-25 lbs; and BMI 30 or greater, maximum wt gain during pregnancy should be 11-20 lbs.
3 hour GTT for abnormal screen. How much glucola, does the patient fast the night before, and the results that indicate gestational diabetes.
Step 2 is 100 gram glucola, fasting 8 hrs the night before, and 2 of 4 labs are out of range.
When antenatal fetal monitoring begins in women with gestational diabetes.
What is 32 weeks gestation with either BPP or NST?