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Hypertension in Pregnancy Maternal medicine module part 2

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A 33-year-old primigravida presents at 34 weeks of gestation with raised BP >160/110.There
is no proteinuria and SFH is normal. She is admitted to the hospital and started on
antihypertensive therapy.

1) What is the most appropriate further management plan?

2)

A 30-year-old woman presents at 34 weeks of gestation in her first pregnancy with a blood
pressure of 152/103 (blood pressure at the beginning of pregnancy – 130/60) with significant
proteinuria on urinalysis

3)

34 weeks pregnant. Worsening hypertension and proteinuria over 4 weeks.
Booking BP was 160/100 mmHg with 3 g proteinuria/24 h quantifi ed. Oral
labetalol therapy commenced at booking. Now BP 180/100 mmHg and 9 gproteinurea/24hr

4)

Your junior trainee sees a primi woman who is 8 weeks pregnant and demanding aspirin
therapy. Which of the following is an indication to start aspirin therapy?

5) Which of the following is used to prevent hypertensive disorders during pregnancy?

A 35-year-old G4P3 is currently 16 weeks pregnant and has uncomplicated chronic
hypertension.

6) What should be the ideal target BP with treatment?

7)

The first line drug for 39 yr old primi with preeclmpsia and BP 150/93 at 32 weeks of
pregnancy

8)

20 weeks pregnant. Episodic headaches, palpitations, sweating and tremor.
Examination shows BP 160/110 mmHg. BP tends to be highly labile.

9)

Which of the following statements regarding physiological blood pressure changes in
pregnancy is incorrect?

10) Regarding pre-eclampsia in pregnancy, which of the following statement is correct:

11)

A 22 yrs old nulliparous woman at 30 weeks of pregnancy with BP 160/105 mm Hg,
complaining og upper abdominal discomfort and headache

12)

Following statements are true regarding risk prediction models for hypertension in
pregnancy;

13)

Which of the following supplements is recommended to prevent hypertensive disorders in
pregnancy?

14)

The first line treatment for 24 yr old asthamatic woman with BP 150/93 at 28 weeks of
pregnancy

15) Moderate risk factors for pre-eclampsia are

16) Regarding proteinuria assessment in pregnancy, all are true except;

17)

The most appropriate drug for 34 yrs postnatal breastfeeding woman with persistent high
BP of 150/100

18) A 40-year-old woman presents at 32 weeks of gestation in her first pregnancy with a blood

pressure of 143/90 mmHg. Blood pressure at the beginning of her pregnancy was 100/60 mmHg.
Quantitative testing indicated no proteinuria. She feels well, with no headaches or visual
disturbance.

19)

A woman with chronic hypertension was converted from Lisinopril to methyldopa in a
preconception counselling clinic.
The pregnancy was uncomplicated and she delivered spontaneously at term.
At what stage postnatally should the antihypertensive medication be switched back to
Lisinopril?

A 25 yr old woman has been having persistently high BP>150/100 for 3 days following
delivery with no biochemical and hematological abnormalities. She has no underlying medical
problem and was not on any antihypertensive drugs during the pregnancy. She id breastfeeding.

20) Which is the most appropriate antihypertensive drug that can be prescribed for her?

21)

13 weeks pregnant with BP 160/100 mmHg. History of childhood glomerulonephritis.
Urine dipstix shows +++ proteinuria. Similar BP recorded at prepregnancy
counselling review 6 months earlier.

A 25 yr old woman has been having persistently high BP>150/100 for 3 days following
delivery with no biochemical and hematological abnormalities. She has no underlying medical
problem and was not on any antihypertensive drugs during the pregnancy. She id breastfeeding.

22) Which is the most appropriate antihypertensive drug that can be prescribed for her?

23)

40 weeks pregnant. Admitted with headache, hypertension 150/105 mmHg and
+++proteinuria on urine dipstix. Obstetric ultrasound shows fetal IUGR. At
pregnancy booking, her BP was 100/60 mmHg and her urinalysis showed no
abnormality

24)

A 27-year-old woman presents at 28 weeks of gestation in her second pregnancy with a
blood pressure of 152/ 105 (blood pressure at the beginning of pregnancy – 132/58), but with no
evidence of proteinuria on urinalysis. She is commenced on oral labetalol and is sent home from
the triage department to return in a week for a repeat blood pressure monitoring. At this time,
she returns and her blood pressure has increased to 167/115 mmHg, with significant proteinuria
on urinalysis. She has a frontal headache and describes spots

25)

A 36 yrs old woman on two medications for preeclampsia undergoes vaginal delivery
following induction of labour. Which medication should be stopped or changed postnatally<

26) High risk factors for pre-eclampsia

27)

32 weeks pregnant with proteinuria (0.2 g/24 h) and BP of 150/100 mmHg.
Booking BP at 12 weeks was 90/60 mmHg and BP at 20 weeks 95/60 mmHg.
No urine proteinuria detected antenatally until 32w. Normal fetal growth. Mild
peripheral oedema

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