OB Inpatient Certification Test - Questions and Answers In women with preexisting DM, near the end of the first trimester insulin needs [----], and then [... [Show More] -----] during the 2nd and 3rd trimester, eventually [-------]. ...near the end of the first trimester, insulin needs may slightly decrease, then STEADILY INCREASE during the 2nd and 3rd trimester, eventually INCREASING 2-3x pre-pregnancy needs. [-----------] complicated with diabetes is a potential contraindication to pregnancy Coronary Artery Disease The most common cause of DKA is [---] Infection Hyperglycemia is the 2d/3d trimester causes an increase in fetal [-------], leading to LGA [> ----gm] and [-----]. ...causes an increase in fetal insulin production, leading to LGA (>4000gm) and Macrosomia. In a nondiabetic patient, by 37weeks infant have mature pulmonary profiles, but in diabetic patients this occurs at [--]. 39 weeks Hypoglycemia is a term infant is [----] and in a preterm infant is [-----]. Hypoglycemia in a term infant is plasma glucose level of less than 35mg/dl, and less than 25mg/dl in a preterm infant The peak incidence of hypoglycemia is [--] to [----] after birth 6-12hrs In DM mothers, HbA1C should be done... every 4-6 weeks to monitor glucose control The three hallmarks in the treatment of DM during pregnancy include: - Medical Nutritional Therapy - Exercise - Insulin Therapy As a general rule, diabetic women should be delivered between [--]- [--]weeks. 39-40weeks If a diabetic women is being delivered before [--] an amniocentesis should be performed to determine [---------] before 39weeks, an amniocentesis should be performed to determine fetal lung maturity A cesarean delivery is recommended if the estimated fetal weight is... ...greater than 4,500 gm GDM patients are at risk for (4): - Preeclampsia and HTN disorders - Polyhydramnios - Cesarean section because of fetal macrosomia - Excessive weight gain Long term complication for offspring of GDM pregnancies include.. ... increased risk for obesity and impaired glucose tolerance (DM later in life) Results of a 1hr Glucose Challenge Test (GCT) greater than [---] requires further testing; greater than [---] requires immediate tx for GDM >140mg/dl requires a 3hr-GCT; > 200mg/dl requires immediate tx for GDM The 1hr- GCT should be performed... ...between 24-28 weeks gestation Recommended blood glucose levels are: - fasting: [--] - 1hr postprandial: [--] - [--] - 2hr posprandial: [--] - [--] - fasting: <95mg/dl - 1hr PP: < 130-140mg/dl - 2hr PP: <140mg/dl Glyburide can be used an alternative to .... ...insulin therapy The starting dose of glyburide is [--]mg, with a max dose of [--]mg. starting is 2.5mg, max dose is 10mg GDM should begin fetal kick counts at... ... 28weeks. "Count to 10" Technique Time how long it takes to feel 10 fetal movements. If more than 2hrs, call your doctor. A major risk factor during delivery of all DM patients is.. ... shoulder dystocia Indications of shoulder dystocia include: (4) - fetal weight >4,000gm - a dysfunctional labor curve - a prolonged second stage - the "turtle sign" during the delivery of the head The hbA1C reflects glucose control over the past [--] - [--] weeks. A normal HbA1C is [--] - [--]% the past 4-6 weeks, and normal values are [Show Less]
