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hypertension in pregnancy

Total questions: 16

Worksheet time: 13mins

Name
Class
Date
1.

28 yrs old primi at 38 weeks in early labor the CTG is reactive in admission. her nurse steps out for a moment and returns to find her having seizure. the nurse administers a bolus of Mg sulfate the seizure stops. the CTG shows absent baseline variability but there are no deceleration an the baseline is 130/min what would your next therapy be aimed at ?

a)

reducing pedal edema with diuretics

b)

give anti-htn until BP <110/70.

c)

prepare immediate delivary by c/s

d)

keeping the patient free of convulsion , acidosis and coma

2.

which of the following will be the warning sign for her condition? (Sign of impending eclampsia)

a)

degree of proteinuria

b)

severe throbbing headache or blurred vision

c)

facial edema

d)

BP>170/120

3.

The longer the women stays in state of eclampsia , the more risk of maternal morbidity and mortality. The women is most at risk for mortality for which of the following complications ?

a)

Sepsis

b)

Uremia

c)

congestive heart failure

d)

cerebral hemorrhage

4.

women with eclampsia and preeclampsia when compared to normal pregnant women will have decrease in which of the following ?

a)

plasma volume

b)

liver enzymes

c)

uric acid

d)

serum creatinine

5.

a 19 year old unbooked primigravida , term comes to ED with complains of severe headache for 2 days her RP= 90/minute , BP 150/90 mm Hg. while being examined she has a convulsion you have ordered the nurse to give a loading dose of magnisum sulfate, what is your plan meanwhile ?

a)

urgent US to r/o molar pregnancy.

b)

prepare for emergency c/s

c)

protect the patient airways

d)

give IV labetalol

6.

loading dose of magnesium sulfate is given , she awakens from her seizure and in her post ictal state and complains of blurred vision , what is the most likely finding on fundoscopic examination?

a)

exudate and hemorrhage

b)

retinal detachment

c)

arteriolar spasm

d)

Macular degeneration

7.

which of the following statement regarding preeclampsia is true

a)

it is totally preventable

b)

systolic rise of BP is more important that diastolic rise

c)

eclampsia is always preceded by acute fulminating preeclampsia

d)

endothelial dysfunction is the central pathology

8.

32 year old primigravida at 39 weeks gestational age has a blood pressure reading of 150/100 obtained during routine visit. her baseline blood pressure throughout pregnancy was 120/70. the patient denies any headache, visual changes , nausea , vomiting or abdominal pain. her repeat BP 160/90. urinalysis negative for protein. which of the following is most likely diagnosis?

a)

pre eclampsia

b)

chronic htn with super-imposed preeclampsia.

c)

eclampsia

d)

gestational hypertension

9.

32 years old primigravida came for her first ANC visit at 12 weeks . her BP 160/100 mmhg. there is no h/o hypertension pre pregnancy. Repeat BP after 4 hrs again 150/90 mm hg. there is no headache , pedal edema, blurring of vision, urine albumin +1. what is the most likely diagnosis

a)

pre eclampsia

b)

chronic hypertension

c)

chronic htn with super-imposed preeclampsia.

d)

gestational hypertension

10.

25 years old primi at 32 weeks gestation admitted to labor ward with BP 160/110. Urine albumin +1 by urine dipstick. there is no headache , pedal edema, blurring of vision , epigastric pain or decrease urine output. NST is reactive. further management includes all except :

a)

send for CBC , LFT and RFT

b)

Start anti hypertensive medication

c)

immediate c/s if cervix if unfavorable.

d)

steroid administration

11.

Fatima primi at 32 weeks gestation, her BP range between 150-160/94-110. Urine albumin +1 , LFT is normal , serum creatinine 1.2 mg/dl. platelet count 110000. cardiorespiratory examination is within normal. there is no headache , pedal edema, blurring of vision , epigastric pain or reduced urine output. the most important reason to give anti htn medication to this women is to decrease incidence of

a)

IUGR

b)

Fetal death

c)

maternal complications like stroke and placenta abruption

d)

Eclampsia

12.

all of the drugs can be used to control the BP except

a)

nifedipine

b)

Labetalol

c)

Methyldopa

d)

Diuretics

13.

a female with 35 weeks gestation presents to emergency with complaints with headache and blurred vision. her BP 170/110. How is the patient managed

a)

admit and observe

b)

admit control BP and continue pregnancy till term

c)

admit , start Mg sulfate and anti-HTN and terminate pregnancy

d)

start anti-HTN and folllow up as Outpatient

14.

36 y/o primigravida with known chronic hypertension came to ANC clinic at 6week gestation for routine checkup. her BP 140/90 mmhg and urine albumin by dipstick is negative. she is counselled about all the following except:

a)

baseline CBC, LFT and KFT is required

b)

baseline fundoscopy and 24hr urine protein estimation is done

c)

Review of anti hypertensive medication is done

d)

Negative screening of preeclampsia can definitely exclude the risk of developing preeclampsia

15.

36 y/o women with IVF conceived twin pregnancy at 12 weeks gestation. In her first pregnancy which was 10 years ago she developed preeclampsia in her third trimester for which she undergo c/s at 37 weeks of gestation after failed induction of labor . Her current BP is 110/70 mmhg. US showed normal pregnancy. she is counselled for all of the following except :

a)

she has high risk to develop preeclampsia in this pregnancy .

b)

normal uterine artery doppler can safely rule out pre eclampsia risk

c)

start aspirin 75mg and continue through the pregnancy.

d)

salt restriction has no rule in prevention.

16.

which of the following is not true about HELP syndrome

a)

BP may be normal

b)

Nulliparity is not risk factor

c)

LDH is not used to make diagnosis

d)

elevated conjugated bilirubin.