Preeclampsia, gestational diabetes, ectopic pregnancy, and placental abruption concepts tested on USMLE Step 1, beyond the endocrinology and pathology overview.
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- What blood pressure reading, confirmed on two occasions, defines hypertension in preeclampsia after 20 weeks gestation?
- 140/90 mmHg or higher
- What urine protein level over 24 hours is a diagnostic criterion for preeclampsia?
- 300 mg or more per 24 hours
- What early placental defect underlies the pathophysiology of preeclampsia?
- Failure of trophoblastic remodeling of the spiral arteries, causing placental ischemia
- In preeclampsia, is maternal serum sFlt-1 (soluble fms-like tyrosine kinase-1) increased or decreased?
- Increased
- In preeclampsia, is maternal serum placental growth factor (PlGF) increased or decreased?
- Decreased
- HELLP syndrome, a severe complication of preeclampsia, stands for Hemolysis, Elevated Liver enzymes, and ____.
- Low Platelets
- What clinical event defines eclampsia in a patient with preeclampsia?
- New-onset generalized tonic-clonic seizures
- What drug is given to prevent and treat seizures in severe preeclampsia and eclampsia?
- Magnesium sulfate
- What is the only definitive treatment for preeclampsia?
- Delivery of the fetus and placenta
- At what point in pregnancy is universal screening for gestational diabetes typically performed?
- 24 to 28 weeks gestation
- What initial screening test is used for gestational diabetes?
- 1-hour 50-gram oral glucose challenge test
- What placental hormone is a major cause of maternal insulin resistance during pregnancy?
- Human placental lactogen (hPL)
- What is the first-line treatment for gestational diabetes?
- Diet and exercise (lifestyle modification)
- Poorly controlled gestational diabetes causes fetal hyperinsulinemia, which leads to what fetal growth complication?
- Macrosomia
- Why do infants of diabetic mothers often develop hypoglycemia shortly after birth?
- Fetal hyperinsulinemia persists after the maternal glucose supply is cut off at delivery