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ABIM NEP Pregnancy
ABIM Nep Pregnancy & Kidney
| Question | Answer |
|---|---|
| —-% of women with chronic hypertension develops preeclampsia. | 25% |
| T/F worsening proteinuria during pregnancy suggest preeclampsia | FALSE. It can be from CKD with increased GFR. |
| Preeclampsia increases risks of ______. | HTN, CKD, ESRD, CVA, CAD, cardiomyopathy |
| T/F blood pressure control reduces the risk of preeclampsia | FALSE, but it lowers rate of complications. |
| BP meds and breast-feeding | Labetalol okay to use, avoid atenolol |
| T/F ACE-I are safe during breast-feeding. | TRUE |
| How do you distinguish preeclampsia from TTP/HUS? | preeclampsia develops after 22 weeks, TTP/HUS and intrinsic renal disease can present earlier |
| Factors associated with adverse renal outcomes during pregnancy? | creat > 1.3 and microalbuminuria |
| Lupus nephritis and pregnancy recommendations? | Optimal timing is to wait 6-12 months w/o activity. 20-60% chance of flare. |
| T/F cyclophosphamide is safe during pregnancy. | FALSE, cyclophosphamide is teratogenic. |
| When is it safe to perform biopsy during pregnancy? | before 23 weeks |
| T/F ACE-I are contraindicated during breast-feeding. | False |
| What is major effect of blood pressure control during pregnancy in those w HTN? | lowers complications from severe HTN but does not reduce risk of preeclampsia. |
| Creatinine > _____ is associated with acceleration of renal function loss during pregnancy. | greater than 1.4 |
| T/F diabetes increases risk of overt nephropathy and women with normal renal function at conception. | False |
| Best BP agents during pregnancy? | methyldopa, labetalol, nifedipine XR. Diuretics are safe to continue, But usually not started during pregnancy. Hydralazine, diltiazem, verapamil are also acceptable. |
| What BP meds are contraindicated during pregnancy? | ACE-I and RAAS antagonists. Both associated with fetal anomalies |
| Thrombotic microangiopathy eval? | ADAMTS13 < 5% is likely from TTP. Levels >5% suggest a typical HUS (pregnancy, genetics, cancer, drugs) |
| Usually initiate antihypertensive therapy in adult pregnant women at BP of ____. | 150/100. Some wait ≥160/110 mmHg |
| Usual goal BP for HTN in pregnancy? | 140 to 150 / 90 to 100 mm |
| BP goal in pregnancy WITH complicated or 2cdary HTN(eg, target-organ damage [left ventricular hypertrophy, microalbuminuria, retinopathy], dyslipidemia, maternal age >40 years,CVA, previous perinatal loss, DM)? | UTDOL suggests treatment of hypertension, even if mild—> goal: 120 to 140 / 80 to 90 mmHg |
| T/F Women with a hypertensive disorder of pregnancy are 2x as likely to develop HTN in the 12 months after delivery compared to those normotensive during pregnancy. | TRUE |
| Preeclampsia-related hypertension usually resolves how soon? | Usu within few wks (average 16±9.5 days) and is almost always gone by 12 weeks postpartum. But may take as long as 6 mos to resolve |
| The majority of pregnancy related ____ (name complication) occur in 1st 48 hours postpartum, with ____ (cause) being the strongest risk factor. | strokes in PP are usu from hypertension |
| T/F methyldopa is recommended to take during pregnancy and postpartum. | FALSE. safe during pregnancy, but avoid postpartum d/t risk of postnatal depression |
Created by:
ka1usg
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