OB4 29 Endocrine

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lrnino
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213122
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OB4 29 Endocrine
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2013-04-12 17:22:45
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OB4 29 Endocrine
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OB4 29 Endocrine
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  1. what is type 2 DM usually treated with?
    oral hypoglycemics
  2. why is a mother devloping gest. DM? how does that work?
    the body increases resistance to insulin because it doesn't want the sugar. it wants to give it to the baby.
  3. What is glyburide?
    med used with diet and exercise to control blood glucose in DMII
  4. what numbers do they have to get on their A1c to have excellent diabetic control? will the infant have malformations?
    <2.5% (no infant malformations)
  5. what reading on their A1c will they have to have to have good diabetic control? what chance will the baby have malformations?
    2.5-5.9% (5%)
  6. the pt has a reading of 7% (6-8%) on their A1c. What level of diabetic control do they have? what are they chances of malformations?

    excellent
    good
    fair
    poor
    fair. 10%
  7. the pt has an A1c of >8%. what level of diabetic control fo they have? what chances does the fetus have for malformations?
    poor. 22%
  8. How does the A1c blood test work? what does it measure?
    the amount of RBC that is saturated with sugar even when someone isn't eating. it just has it for the life of the RBC.
  9. usually, when (what week) does GDM develop?
    after 20th.
  10. a new mother is being screened. given the 1-hr GTT. it's reading 120. do we do routine prenatal care or the 3hr GTT?
    routine
  11. what reading does the GTT have to hit for a mother to move into a 3hr GTT?
    >140
  12. what is the glucose level for pregs women who are fasting?
    65-95
  13. what is the target blood glucose for a mother after a meal?
    <140
  14. what are s/s in hypoglycemia? what can you do?
    cranky, shaky, weak, dizzy, shallow resp, fainting (trouble)

    grab a carb if possible (piece of bread, cracker)
  15. what are the s/s of hyperglycemia? what can you do to fix?
    thirst, n/v, vision problems, headache, rapid breathing, pee all the time, fruity breath odor. 

    insulin!
  16. how much calories are recommneded for a DM pregs during the 1st trimester?
    2200
  17. how many calories should a DM pregs get during the 2/3 trimester?
    2500
  18. for pregestational DM mothers, when is the maternal serum alpha fetoprotein (MSAFP) screened for neural tube defects?
    16-20wks
  19. a mother with preGDM, will the mom still use the same dose of insulin after giving birth?
    no. insulin requirements drop sharply for the first day.
  20. does gestational DM go away after the placenta is gone?
    yes.
  21. what is hyperremesis gravidarum?
    weight loss of at least %5 of pre-pregs state d/t vomiting
  22. why does the hyperemesis gravidarum show a decreased risk of spontaneous abortion?
    the hormone levels are at a level that will sustain a pregs. that's why they're feeling nauseated.
  23. what kind of care is expected for a mother with hyperemesis gravidarum?
    zofran (fight the n/v), phenergan, IV therapy (fluid imbalance)
  24. what does hyperthyroidism in a pregs look like?
    weight loss, pulse of 100+ bpm. tachy.
  25. what does elevated T4 and T3 levels, suppressed TSH levels indicate?
    hyperthyroidism.
  26. what is used to treat hyperthyroidism?
    Propyltheiouracil
  27. what does hypothyroidism look like?
    weight gain, lethargy, cold intolerance, hoarseness, dry skin, constipation, brittle hair.
  28. what does low levels of T4, T3, elevated TSH levels indicate?
    hypothyroidism
  29. what is used to treat hypothyroidism?
    synthroid
  30. what is maternal phenylketonuria? (PKU)
    don't have enzyme phenylalanine hydrolase. if you don't have this, can't break down phenylalanine (found in protein foods). it can pool in brain = mental retardation.

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