Show:
Respiratory & DM
HTN
seizures
Infections/ Inflammatory
HIV
100
What is treatment of asthma in pregnancy?
same as not pregnant
100
What is chronic HTN?
HTN diagnosed before 20weeks pregnant
100
What is the concern with new-onset seizure in pregnant woman?
eclampsia
100
What therapy should pregnant moms receive if exposed to HBV?
BOTH Hep B immune globulin and vaccine
100
What is rate of vertical transmission if mom not treated? and if treated?
20% 1%
200
Is it safe to give oral corticosteroids to pregnant woman?
Yes recommended in severe asthma but caution in 1st trimester bc can cause facial clefts
200
What is treatment for HTN in pregnancy?
Methyldopa, Labetalol, Hydralazine hydralazine 5mg, then 10mg every 20-30mins, go to another agent after 25mg, Labetalol 20mg IV then 40, then 2 doses of 80 every 10mins go to another agent after 220, sodium nitroprusside- start at 0.25 mic/kg/min only after nothing else worked
200
True or false? Epileptics experience less seizures when pregnant?
FALSE: 15% experience more seizures
200
What is the tx for HCV in pregnant moms?
- no treatment - very low transmission in mothers with anti HCV antibodies and no HCV RNA circulating - in HCV viremia no treatment - screening not even recommended
200
At which point in the pregnancy is HIV tested for?
Everyone at beginning Near term if high risk or have other STDs rapid HIV in labor if unknown status
300
What is the concern in fetus during asthma exacerbations?
- hypoxia - fetus is more sensitive to it and always give mom oxygen and monitor baby
300
What is HTN tx contraindicated in pregnancy?
ACE, ARBS diuretics are 2nd line 2/2 hypovolemia
300
What is the treatment for seizure in pregnant woman who is known epileptic or in status?
- treat like non-preg - risk of seizing out weight teratogens and put mom lateral decub to avoid supine hypotension
300
True or false? Chronic inflammatory diseases worsen during pregnancy?
FALSE: Inflammatory diseases improve in pregnancy because of immunosuppressive effects related to effects of progesterone on maternal lymphocytes post partum there is often a rebound effect
300
What is 3 part optimal therapy to prevent HIV transmission?
1) antepartum administration of highly active antiretroviral therapy (HAART), 2) intrapartum intravenous zidovudine dosing 3) treatment of the infant with 4 to 6 weeks of zidovudine. **No efavirenz in 1st trimester
400
How is the pH affect in DKA in pregnancy?
pH maybe normal bc in pregnancy baseline respiratory alkalosis from increased respiratory rate so with the metabolic acidosis of DKA pH of Pt may actually be normal
400
What is preeclampsia in chronic hypertension?
1) new onset of proteinuria after 20 weeks of gestation in a patient with known hypertension and 2) pregnant patients with HTN and proteinuria before 20 weeks of gestation who have thrombocytopenia, increased transaminase levels, or an acute increase in proteinuria or blood pressure
400
What are the teratogenic effects of anticonvulsants?
-NTDs, facial clefts, cardiac abnomalities (2-3 fold increased risk)
400
What is the treatment of TB in pregnancy?
Isoniazid, ethambutol, and rifampin in their usual doses. streptomycin causes fetal ototoxicity
400
When do you deliver vaginally or C-section?
vaginal is best for low risk with effective HAART but elective C-section recommended in moms with viral load >1000
500
What is treatment of choice for hyperglycemia in pregnancy?
insulin
500
What agent to you use to anti coagulate in pregnancy? in PE, DVT, Afib? Which agent is bad?
Heparin and Lovenox OK Warfarin BAD
500
What oral supplementation is recommended when taking anticonvulsants?
folate 0.4 mg/day is recommended for all women of childbearing age taking these drugs bc meds interfere with folate metabolism
500
What is the treatment of syphilis in pregnant woman?
benzathine penicillin G pen allergic- use macrolides congenital syphilis causes: hepatosplenomegaly, osteochondritis, jaundice, rash, lymphadenopathy, rhinitis, Hutchinson's teeth, and anemia
500
When are infants considered not infected?
1) 2 negative viral assays after 1 mo, with one of the assays being done after 4mo 2) with negative results of two antibody tests done on separate occasions after 6 mo