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Exam 2.1

QuestionAnswer
What is the benchmark for a diagnosis of gestational hypertension? 140/90 BP 6 hours away from eachother.
What is gestational hypertension caused by? Gestational hyprtension is causde by an inflammation response to the pregnancy.
What is preeclampsia? Organ damage in lab results. I.e proteinuria
What is the difference between eclampsia and preeclampsia? In eclampsia, seizure activity has started.
HELLP syndrome stands for. H- Hemolysis EL - Elevated liver enzymes LP - Low platelets, less than 100k,
Risk factors for GHTN, Preeclampsia, eclampsia, and HELLP syndrome includee Fmhx, kidney disease, nullipara, DM, lupus, multiples, new paternal partner.
Clinical manifestations of preeclampsia, eclampsia Generalized or behind the eyes headaches that are not easily relieved with meds, blurred or double vision, AMS/Seizures, Platelets less than 100k, elevated liver enzymes, and creatinine greeater than 1.
Why is platelet count important? Platelet counts are important due to the increased chance of bleeding. These patients can not get an epidural and usually opt for a c section.
Mgmt of hypertension Bedrest/modified bed rest, labetalol, hospitalization, MgSO4
What is the function of MGSO4? What is the dosing? How often are blood and neuro checks required? What are we watching out for while the patient is on this medication? The function of MgSO4 is to relax the muscles and prevent seizing. It is given at a high dose of 4g over 30 min, then maintenance of 2g per hour. Hourly blood and neuro checks are required, and it can lead to third spacing, which can lead to pulmonaryedem
What is the highest level of magnesium acceptable? 7
What is DIC? All platelets in the body rush to one place, and the rest of the body has no platelets so it begins hemorrhaging.
When does DIC typically happen? Happens when the clotting pathway is disrupted, and endothelial damage releases tissues into the circulation.
Risk factors for general population with DIC Older age, septicemia, hemolytic reaction to blood transfusion, improperly formed blood vessels, leukemia, pancreatitis, liver disease, and severe tissue damage.
What are the clinical manifestations of DIC? You may not see clotting since its mostly internal, but the patient will bleed out of every hole in their body.
Chronic DIC Develops slowly, no excessive bleeding but will have excessive clotting.
Diagnostics for DIC H&H, RBC, Platelets, Coagulation studies, Fibrin degradation products, fibrinogen, and d dimer(increases)
Tx of DIC includes Fresh frozen plasma, cryoprecipitate, platelets, PRBC, heparin
Why is heparin used in DIC? Given to stop bad clotting cascade and shock the body into a normal clotting cascade.
DIC risk factors for infants and children include Vit. K deficiencies, birth trauma, asphyxia, necrotizing enterocolitis, sepsis
With infants with DIC, where will blood ooze from? The umbilical cord usually
DIC in pregnancy risk factors Risk increases if preeclamptic, fetal death, amniotic fluid embolism, or placental abruption.
 

 



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