AHN 548 Unit 4 Quizlet Combined Latest Study
Questions And Answers
3 or more consecutive spontaneous abortions before 20 weeks of gestation ANS Recurrent
abortion
When should a pregnant woman receive RhoGAM? ANS 28 weeks gestation
3 or more consecutive spontaneous abortions before 20 weeks of gestation ANS Recurrent
abortion
When should a pregnant woman receive RhoGAM? ANS 28 weeks gestation
What are the 4 types of diabetes? ANS 1. Type 1
2. Type 2
3. Gestational
4. Other
What is Type 1 diabetes, formerly IDDM or juvenile -onset..... ANS Autoimmune destruction
of the beta cells in the islets of the pancreas = absolute insulin deficiency. usual onset is young,
can appear for the first time at pregnancy. If both parents are affected , 33% risk for infant.
What is idiopathic Type 1 DM? ANS rare- not assoc with autoimmunity, pts suffer from
episodic attacks of ketoacidosis, they may have absolute insulin def only during attack
What is type 2 diabetes, formerly referred to as NIDDM or adult-onset.... ANS characterized
by insulin resistance & beta cell dysfunction, if both parents have type 2, 60-75% chance in
offspring, ketoacidosis is rare
Maximum % of fat, carbs, and protein for disease modification are... ANS 40%fat & carb,
20%protein/3 meals
,What is gestational diabetes (GDM)..... ANS Hallmark of GDM is insulin resistance,
etiologically similar to Type 2 (unmasked by the metabolic changes of pregnancy)
What % of pts with GDM, will go on to have Type 2 DM later in life? ANS 50%
What are other specific types of diabetes? A variety of .... ANS genetic, drug, or chemical-
induced diabetes
Risk factors for GDM include.... ANS Obesity: BMI >30, family Hx, minority ethnicity (AA,
Hispanic), older age >35-40, , Hx of unexplained stillbirth, PCOS (polycystic ovaries).
Insulin resistance that occurs in normal pregnancy is associated with.... ANS with an increase
in insulin release by the beta cells of the pancreas in order to maintain glucose homeostasis.
GDM becomes apparent when... ANS the beta cells are unable to overcome the decreased
insulin sensitivity & hyperglycemia results.
Routine screening for Gestational Diabetes consists of performing a..... ANS glucose
challenge test between 24 and 28 weeks.
What is a glucose challenge test? ANS Patient ingests 50g of glucose followed by glucose
level 1 hour after. If the results are >140 then a glucose tolerance test (GTT) should be done.
A GTT consists of .... ANS A baseline glucose, then 100g of glucose. Testing at 1 hour, 2
hours and 3 hours after. Considered positive if 2 of the 4 levels are elevated.
When should glucose monitioring be done? ANS fasting, 1-2h after meals, night time
,Normal glucose values are... ANS fasting 70-95, 1-hour after meal: <130-140, 2-hour after:
<120
If normoglycemia cannot be achieved with diet and exercise, start with.... ANS insulin
(glucose crosses the placenta, insulin does not), Glyburide and metformin are used.
S/S of HYPERGLYCEMIA & DKA include... ANS N/V, dehydration, abdominal pain,
confusion
Labs that reflect an anion gap metabolic acidosis include... ANS (pH <7.3), serum HCO3
<15, hyperglycemia & elevated serum ketones
To prevent neonatal hypoglycemia... ANS o in labor 5% dextrose in LR @ 125ml/h = 6.25g
glucose/h
o Monitor glucose Q2-4h early labor, 1-2h in active labor
o Continuous insulin infusion: 0.5-2.0u/h, titrated to glucose
How should diabetes be managed if patient has a scheduled C-section? ANS take evening
insulin or oral meds preceding night, but not in a.m., glucose level is monitored and treated with
IV insulin infusion to maintain at 70-120
Postpartum diabetes management includes... ANS Start back on ADA diet, glucose 140-
150mg/dL to assist in healing, insulin sensitivity increases- Closely monitor glucose.
Fetal well-being- (stress of labor) is assessed by... ANS Scalp stimulation or fetal O2 sats.
Expeditious delivery if shoulder dystocia or Erb's palsy evident.
Breastfeeding is strongly encouraged because... ANS protective against childhood DM
Contraception recommended for diabetes.... ANS no estrogen is recommended due to
vascular complications in DM, progesterone only and levonorgestrel IUD
, 3 types of CNS abnormalities in central precocious puberty ANS ACQUIRED,
CONGENITAL AND TUMORS
Med TX for central precocious puberty ANS leuprolide and histrelin
Types of precocious puberty ANS central and peripheral
How do you determine treatment for peripheral puberty? ANS depends on underlying cause
1. Ovarian cyst: not tx indicates
2. Congenital adrenal hyperplasia: glucocorticoids & surgery
3. McCune Albright Syndrome: antiestrogens or aromatase inhibitors
Most common Childhood Malignancy and is associated with trisomy 21? ANS ALL
1st line antihypertensive in pregnancy ANS Methylodopa
The medication used for tocolysis and tx of HTN during pregnancy ANS Nifedipine: Ca+
channel blocker
adrenergic blocker and a nonselective-
adrenergic blocker used doing pregnancy ANS Labetolol
What classic symptom has been eliminated as a sign of preeclampsia? ANS edema
What syndrome is a variant of preeclampsia? ANS HELLP
What electrolyte is used to prevent preeclampisia? ANS Calcium; a least 1g daily