Cardiovascular System

Question 1

When does mitral stenosis in women classically present?

Answer 1

During pregnancy

Question 2

What populations are at high risk for mitral stenosis?

Answer 2

Women from countries with restricted access to antibiotics.

Question 3

What is the most common cause of mitral stenosis?

Answer 3

rheumatic fever

Question 4

Women with hypertension during pregnancy are at risk for the following:

Answer 4

1. Cardiovascular disease
2. Chronic kidney disease
3. Diabetes Mellitus

Question 5

How is chronic, pre-existing, primary hypertension defined during pregnancy?

Answer 5

BP > 140/90 before 20 weeks gestation, or that persists beyond 12 postpartum.

Question 6

What is the most common risk factor for placental abruption?

Answer 6

hypertension

Question 7

List the potential complications of hypertension in pregnancy.

Answer 7

1. Placental abruption (most common cause)
2. Superimposed preeclampsia
3. Intrauterine growth retardation
4. Preterm birth
5. Cesarean delivery

Question 8

Treatment:

Hypertension in most patients on OCPs

Answer 8

Discontinue OCP and switch to alternative birth control

Question 9

Treatment:

What is the first-line treatment for gestational hypertension?

Answer 9

1. Labetalol
2. Methyldopa
3. Calcium channel blocker (acceptable alternative treatment)
4. Hydralazine (acceptable alternative treatment)

Question 10

Treatment:

Second-line treatment for gestational hypertension

Answer 10

1. Thiazide diuretics

2. Clonidine

Question 11

Treatment:

Which hypertensive medications are contraindicated in pregnant women?

Answer 11

1. Angiotensin-converting enzyme inhibitors (ACEi)
2. Angiotensin receptor blockers (ARB)
3. Aldosterone blockers
4. Direct renin inhibitors
5. Furosemide

Question 12

Diagnosis:

Patient with:
1. Bilateral edema of the lower extremities

Denies: SOB, hypertension, chest pain, calf tenderness

Answer 12

In the absence of symptoms of pre-eclampsia, this is most likely a benign problem.