TEALE FENNING

cpeedahsa · Century Club Joined: 21 Apr 2007 Posts: 921

The following parturients have chronic hypertension well controlled with medication. Match most likely medication/s used with case scenario/s.

A)Ca Channel Blocker
B)Beta Blocker
C)Thiazide diuretic
D)ACE inhibitor

1)32y old at 32w gestation with severe superimposed preeclampsia and is currently recieving Magnesium sulphate is undergoing indcution of labor. BP- 70/30mm Hg and she is somnolent.

2)37y old at 29w gestation has severe muscle weakness and has had muscle cramps for 3 days.

3)36y old at 31w gestation has decreased amniotic fluid volume.

4)Newborn has fetal limb abnormalities, lung hypoplasia, renal dysplasia.

5)1 hour old newborn has jitteriness, irritability, apnea, seizures. Serum Glucose- 10mg/dl.

masooma · Joined: 22 Jan 2007 Posts: 10

hello cpeedahsa,
good set of emq, let me try

1- a calcium channel blocker
2-c thiazide diuretic Question

3-d ACE inhibitor
4-d ACE inhibitor
5-b beta blocker

i'm not sure about no. 2, coz thiazide diuretic has a risk of neonatal thrombocytopenia and in the latter half of pregnancy may also be associated with reduced maternal blood flow and decreased uteroplacental perfusion. Ref-- High risk pregnancy.

farha · Century Club Joined: 18 May 2007 Posts: 156

Hi masooma and cpeedahsa
I totally agree with masooma regarding explanations of stems and refrences and for stem 2 I m very much sure that it thiazide diuretics because thiazide diuretics causes potassium loss from the body as they are not potassium sparing diuretics and loss of potassium is associated with muscle weekness and cramps

To add on thiazide diuretics also causes sodium loss which in turn can lead to confusion tiredness , convulsion irritability , mental slowing,
un usual tiredness and weakness.

Nick Raine-Fenning · Posted: Thu Jun 07, 2007 5:29 pm Post subject:

I agree - nice question and good idea.

You could expand this to include a series of 'obstetric drugs' and then set a range of different questions. Some of the patients could be this group of chronic hypertensives but you could include other medical disorders.

N

cpeedahsa · Century Club Joined: 21 Apr 2007 Posts: 921

Good to see your prompt response-Masooma , Farha --Agree with your answers. Very Happy