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Preeclampsia and Eclampsia Quiz





Preeclampsia and Eclampsia Quiz

Preeclampsia and Eclampsia Quiz

I. Introduction

Preeclampsia (PE) and eclampsia (E) are two dangerous complications of pregnancy that can pose risks to both the mother and the fetus. This article will provide basic knowledge about PE and E by explaining multiple-choice questions.

Note:

  • This article is for informational purposes only and should not be considered a substitute for professional medical advice.
  • Always consult with a healthcare professional for diagnosis and treatment.

II. Content

1. Definition of Preeclampsia and Eclampsia

  • Preeclampsia: A pregnancy complication characterized by high blood pressure after the 20th week of pregnancy, accompanied by protein in the urine and/or swelling.
  • Eclampsia: A severe complication of PE, marked by generalized seizures, posing a risk to both the mother and the fetus.

2. Multiple Choice Questions and Explanations

  1. Question 741: Which of the following complications is not related to preeclampsia?

    • A. Miscarriage.
    • B. Stillbirth.
    • C. Eclampsia.
    • D. Fetal growth restriction.

    Answer: A. Miscarriage.
    Explanation: PE and E can lead to Stillbirth, Eclampsia, and Fetal growth restriction. Miscarriages are often caused by other factors such as infections, fetal abnormalities, or chromosomal abnormalities.

  2. Question 742: What is the sequence of stages in a typical eclampsia seizure?

    • A. Tonic – clonic – prodromal – coma.
    • B. Prodromal – tonic – clonic – coma.
    • C. Prodromal – clonic – tonic – coma.
    • D. Prodromal – clonic – coma – tonic.

    Answer: B. Prodromal – tonic – clonic – coma.
    Explanation: A typical E seizure usually follows these stages:

    • Prodromal stage: The patient may experience symptoms like fever, dizziness, nausea, vomiting, headache, etc.
    • Tonic stage: The patient’s body becomes rigid, with clenched jaw, eyes rolling back.
    • Clonic stage: The patient experiences violent muscle spasms, with limb jerking, foaming at the mouth, etc.
    • Coma stage: The patient becomes unconscious, with snoring breaths, loss of reflexes.
  3. Question 743: High blood pressure (HBP) during pregnancy occurs:

    • A. Before delivery.
    • B. After delivery.
    • C. From the 20th week of pregnancy and disappears at the latest 6 weeks after delivery.
    • D. Any stage of pregnancy.

    Answer: C. From the 20th week of pregnancy and disappears at the latest 6 weeks after delivery.
    Explanation: HBP in pregnancy occurs after the 20th week, typically disappears after childbirth, and at the latest 6 weeks postpartum.

  4. Question 744: How is blood pressure measured?

    • A. The patient must rest for at least 15 minutes, take 2 readings, 2 hours apart, and take 2 measurements for each reading.
    • B. Take 2 measurements 10 minutes apart.
    • C. Just one measurement when the patient arrives for an appointment.
    • D. The patient only needs to rest for 5 minutes, one measurement.

    Answer: A. The patient must rest for at least 15 minutes, take 2 readings, 2 hours apart, and take 2 measurements for each reading.
    Explanation: To ensure accurate BP readings, the patient should rest for at least 15 minutes, take 2 readings 2 hours apart, and take 2 measurements for each reading to confirm the result.

  5. Question 745: The HELLP syndrome essentially consists of the following symptoms:

    • A. Microangiopathic hemolytic anemia.
    • B. Elevated liver enzymes (SGOT; SGPT)
    • C. Reduced platelet count (<100,000/mm3 of blood).
    • D. All 3 symptoms above combined with severe PE signs.

    Answer: D. All 3 symptoms above combined with severe PE signs.
    Explanation: HELLP syndrome is a severe complication of PE and includes:

    • H: Hemolysis (Microangiopathic hemolytic anemia)
    • E: Elevated Liver enzymes (Increased liver enzymes)
    • L: Low Platelet count (Reduced platelet count)
    • P: Combined with symptoms of severe PE
  6. Question 746: Mild PE includes the following symptoms:

    • A. Diastolic BP 90-110 mmHg.
    • B. Proteinuria (+) or (++).
    • C. Liver enzymes slightly elevated.
    • D. Other signs of eyes, blood biochemistry, fetus… are normal.
    • E. All 4 symptoms above represent mild PE symptoms.

    Answer: E. All 4 symptoms above represent mild PE symptoms.
    Explanation: Mild PE is diagnosed based on the following signs:

    • Diastolic BP 90-110 mmHg.
    • Proteinuria (+) or (++).
    • Liver enzymes slightly elevated.
    • Other signs of eyes, blood biochemistry, fetus… are normal.
  7. Question 747: A typical E seizure includes:

    • A. It must have 4 stages: prodromal, tonic, clonic, and coma.
    • B. Only generalized tonic seizures.
    • C. After generalized tonic seizures, the patient remains conscious.
    • D. Clonic seizures and coma.

    Answer: A. It must have 4 stages: prodromal, tonic, clonic, and coma.
    Explanation: A typical E seizure consists of 4 stages:

    • Prodromal stage: The patient may experience symptoms like fever, dizziness, nausea, vomiting, headache, etc.
    • Tonic stage: The patient’s body becomes rigid, with clenched jaw, eyes rolling back.
    • Clonic stage: The patient experiences violent muscle spasms, with limb jerking, foaming at the mouth, etc.
    • Coma stage: The patient becomes unconscious, with snoring breaths, loss of reflexes.
  8. Question 748: Differential diagnosis of E seizures from:

    • A. Hypocalcemic seizures.
    • B. Epilepsy.
    • C. Diabetic coma.
    • D. Hepatic coma, coma due to high blood urea nitrogen.

    Answer: All the above answers need to be differentiated from E seizures.
    Explanation: E seizures need to be differentiated from other seizures like:

    • Hypocalcemic seizures: Due to low blood calcium, causing spasms and stiffness.
    • Epilepsy: Caused by neurological disorders, causing seizures, loss of consciousness, may be accompanied by symptoms like tremors, poor communication, etc.
    • Diabetic coma: Due to excessively high blood sugar, causing unconsciousness, coma.
    • Hepatic coma, coma due to high blood urea nitrogen: Caused by severe liver or kidney failure, resulting in unconsciousness, coma.
  9. Question 749: Medications for treating E seizures include:

    • A. Antihypertensives combined with diuretics.
    • B. Antihypertensives combined with antibiotics and sedatives.
    • C. Antihypertensives combined with Magnesium Sulfate.
    • D. Antihypertensives + Seduxen + Magnesium Sulfate + Diuretics + Antibiotics.

    Answer: D. Antihypertensives + Seduxen + Magnesium Sulfate + Diuretics + Antibiotics.
    Explanation: Treating E is a complex process involving multiple medications:

    • Antihypertensives: To control BP, prevent cardiovascular complications.
    • Seduxen: To control seizures, reduce seizure intensity.
    • Magnesium Sulfate: To prevent seizures, reduce the risk of recurrence.
    • Diuretics: To reduce swelling, eliminate excess fluids in the body.
    • Antibiotics: To treat infections, prevent infectious complications.
  10. Question 750: Prognosis for the severity of PE and E depends on:

    • A. Severity of BP elevation.
    • B. Severity of proteinuria.
    • C. Severity of edema.
    • D. Urine volume.

    Answer: A. Severity of BP elevation.
    Explanation: The degree of BP elevation is the most important prognostic factor in PE and E. Prolonged high BP can lead to serious complications such as: heart failure, liver failure, kidney failure, cerebral hemorrhage, etc.

  11. Question 751: The incidence of PE is:

    • A. Below 5%
    • B. 5- 15%
    • C. 15-25%
    • D. 25- 35%

    Answer: B. 5- 15%
    Explanation: The incidence of PE ranges from 5% to 15% in pregnancies.

  12. Question 752: How much increase in systolic BP from the baseline value is considered high blood pressure?

    • A. 15 mmHg
    • B. 20 mmHg
    • C. 25 mmHg
    • D. 30 mmHg

    Answer: D. 30 mmHg
    Explanation: A 30 mmHg increase in systolic BP from the baseline is considered high blood pressure in pregnancy.

  13. Question 753: The purpose of administering Magnesium Sulfate in severe PE is:

    • A. Stop seizures.
    • B. Prevent seizures.
    • C. Stabilize kidney function.
    • D. Lower BP.

    Answer: B. Prevent seizures.
    Explanation: Magnesium Sulfate is used in severe PE to prevent seizures, reduce the risk of progressing to E.

  14. Question 754: Which of the following medications is used to counteract Magnesium Sulfate toxicity?

    • A. Dextose 5%
    • B. Calcium gluconate
    • C. Magnesium gluconate
    • D. Adrenaline

    Answer: B. Calcium gluconate.
    Explanation: Calcium gluconate is the antidote for Magnesium Sulfate toxicity, used to treat Magnesium Sulfate poisoning.

  15. Question 755: When using high doses of Magnesium Sulfate, what clinical signs should be monitored?

    • A. Patellar reflex.
    • B. Urine volume.
    • C. Respiratory rate.
    • D. Monitoring on ECG.

    Answer: All 3 answers A, B, C need to be monitored.
    Explanation: When using high doses of Magnesium Sulfate, monitor:

    • Patellar reflex: To detect reduced reflexes, a sign of Magnesium Sulfate toxicity.
    • Urine volume: To assess kidney function, Magnesium Sulfate toxicity can damage kidneys.
    • Respiratory rate: To monitor for respiratory failure, Magnesium Sulfate toxicity can cause respiratory failure.
  16. Question 756: Choose one incorrect statement regarding PE:

    • A. Proteinuria is a significant sign of PE.
    • B. The degree of BP elevation always correlates with the severity of organ damage.
    • C. Edema has little value in disease prognosis.
    • D. Mild PE can still have E complications.

    Answer: B. The degree of BP elevation always correlates with the severity of organ damage.
    Explanation: The level of BP elevation does not always correlate with the severity of organ damage. There are cases where mild PE has severe internal organ damage, and conversely, severe PE has minimal organ damage.

  17. Question 757: Choose one incorrect statement regarding PE treatment:

    • A. Mild PE can be monitored and treated outpatient.
    • B. Long-term diuretics can negatively affect fetal condition.
    • C. Antihypertensives are the main drugs to prevent E seizures.
    • D. Antihypertensives are only used when BP is at or above 160/110mmHg.

    Answer: C. Antihypertensives are the main drugs to prevent E seizures.
    Explanation: Magnesium Sulfate, not antihypertensives, is the main drug to prevent E seizures. Antihypertensives are used to control BP, prevent cardiovascular complications.

  18. Question 758: Choose one incorrect statement about monitoring severe PE:

    • A. Perform non-stress test (NST) once a day.
    • B. Daily weight monitoring.
    • C. Proteinuria measurement: once a week.
    • D. BP monitoring: 4 hours/time.

    Answer: C. Proteinuria measurement: once a week.
    Explanation: In severe PE, proteinuria should be monitored regularly, at least twice a day, to assess disease severity and treatment effectiveness.

  19. Question 759: Good response to severe PE treatment is indicated by the following signs, except:

    • A. Weight gain.
    • B. Increased urine volume.
    • C. Gradually decreasing BP.
    • D. Reduced proteinuria.

    Answer: A. Weight gain.
    Explanation: Weight gain is a sign of edema, not a sign of good response to severe PE treatment.

  20. Question 760: When a patient has an E seizure, the first medication to be used is:

    • A. Hypnotics-ganglion blocking mixture.
    • B. Magnesium Sulfate.
    • C. Antihypertensives.
    • D. Sedatives.

    Answer: B. Magnesium Sulfate.
    Explanation: Magnesium Sulfate is the first medication to be used when a patient has an E seizure, to prevent seizures, reduce the risk of recurrence.

  21. Question 761: When a patient has an E seizure, a urinary catheter should be inserted:

    • A. Once every hour.
    • B. Every 2 hours.
    • C. Every 3 hours.
    • D. Every 4 hours.

    Answer: C. Every 3 hours.
    Explanation: When a patient has an E seizure, insert a urinary catheter every 3 hours to assess kidney function, risk of kidney failure.

  22. Question 762: When a patient has an E seizure, the minimum urine output needed in 3 hours is:

    • A. t 100 ml
    • B. t 150 ml
    • C. t 200 ml
    • D. t 250 ml

    Answer: A. t 100 ml
    Explanation: The minimum urine output needed in 3 hours is 100 ml. Less than 100 ml/3 hours is a sign of kidney failure, requiring prompt monitoring and treatment.

  23. Question 763: Severe PE may include the following symptoms:

    • A. Proteinuria t 2g/24 hours.
    • B. Urine output < 400 ml / 24 hours.
    • C. Creatinine < 1,2 mg / dl.
    • D. Platelets < 100,000 / mm3.

    Answer: B. Urine output < 400 ml / 24 hours.
    Explanation: In severe PE, urine output falls below 400 ml/24 hours, a sign of kidney failure.

  24. Question 764: When mild PE signs are present, immediate treatment is required:

    • A. Antihypertensives.
    • B. Strong diuretics.
    • C. Magnesium Sulfate.
    • D. Rest and monitoring.

    Answer: D. Rest and monitoring.
    Explanation: When mild PE signs are present, rest, close monitoring of BP, proteinuria, urine output, etc. is required. Medication is only used when necessary, not immediately.

  25. Question 765: The formula for calculating mean arterial pressure (MAP) is:

    • A. (Systolic BP + 2 * Diastolic BP)/ 3
    • B. (Systolic BP + Diastolic BP)/ 2
    • C. (2 * Systolic BP + Diastolic BP)/ 3
    • D. (2 * Systolic BP + 2 * Diastolic BP)/ 3

    Answer: A. (Systolic BP + 2 * Diastolic BP)/ 3
    Explanation: The formula for calculating MAP is: (Systolic BP + 2 * Diastolic BP)/ 3

  26. Question 766: The most valuable prognostic factor for the mother in PE is based on:

    • A. BP readings.
    • B. Proteinuria measured in g/l.
    • C. Severity of edema.
    • D. Urine volume in 24 hours.

    Answer: A. BP readings.
    Explanation: BP readings are the most important prognostic factor for the mother in PE, as prolonged high BP can cause serious complications for the mother.

  27. Question 767: Mild gestational hypertension includes the following symptoms, except:

    • A. 100 mmHg =< Systolic BP <=150 mmHg.
    • B. 90 mmHg =< Diastolic BP <=100 mmHg
    • C. Generalized edema.
    • D. Proteinuria < 2g/l.

    Answer: C. Generalized edema.
    Explanation: Mild gestational hypertension does not include generalized edema. Generalized edema can be a sign of PE or other conditions.

  28. Question 768: The most valuable prognostic symptom in gestational hypertension is:

    • A. Edema.
    • B. Proteinuria.
    • C. High BP.
    • D. Oliguria.

    Answer: C. High BP.
    Explanation: High BP is the most important prognostic symptom in gestational hypertension, as it can lead to serious complications for the mother.

  29. Question 769: To diagnose gestational hypertension early, you need to:

    • A. Weigh the patient regularly.
    • B. Perform routine urine tests.
    • C. Measure BP.
    • D. Do a good job of managing pregnancy at all levels.

    Answer: D. Do a good job of managing pregnancy at all levels.
    Explanation: To diagnose gestational hypertension early, good pregnancy management at all levels is essential, with regular BP measurements, urine tests, monitoring for any abnormalities, etc.

  30. Question 770: Edema appearing in the last trimester of pregnancy is always a sign of PE. T/F
    Answer: F (False)
    Explanation: Edema appearing in the last trimester of pregnancy is not always a sign of PE. Edema can be caused by various factors such as heat, salty diet, circulatory disorders, cardiovascular disease, etc.
  31. Question 771: Eclampsia always requires protein in the urine. T/F
    Answer: F (False)
    Explanation: Eclampsia is a complication of PE, and it can occur in cases of mild PE (no proteinuria) or severe PE (with proteinuria).
  32. Question 772: HELLP is a severe complication of PE and Eclampsia. T/F
    Answer: T (True)
    Explanation: HELLP syndrome is a severe complication of PE, and it can occur before or after an E seizure.
  33. Question 773: Edema appearing in the last trimester of pregnancy is a definitive sign for diagnosing PE and Eclampsia. T/F
    Answer: F (False)
    Explanation: Edema is not a definitive sign for diagnosing PE. PE diagnosis requires clinical and laboratory findings: high BP, proteinuria, urine output, etc.
  34. Question 774: In PE and Eclampsia, proteinuria is the last sign in the triad of symptoms (proteinuria, edema, high BP). T/F
    Answer: T (True)
    Explanation: In PE, proteinuria usually appears last in the triad of symptoms: high BP, edema, proteinuria.
  35. Question 775: The mode of termination of pregnancy in Eclampsia is:

    • A. Oxytocin-induced labor induction. T/F
    • B. Posthypophyse-induced labor induction. T/F
    • C. Cesarean section immediately upon seizure onset. T/F
    • D. Sufficient conditions for forceps delivery. T/F
    • A. Sufficient conditions for vacuum extraction. T/F

    Answer:

    • A. T (True)
    • B. T (True)
    • C. F (False)
    • D. F (False)
    • A. F (False)

    Explanation: The mode of termination of pregnancy in Eclampsia depends on the mother and fetus’s condition:

    • Oxytocin-induced labor induction: May be used if the mother is stable, the fetus is full-term, and vaginal delivery is possible.
    • Posthypophyse-induced labor induction: May also be used if the mother is stable, the fetus is full-term, and vaginal delivery is possible.
    • Cesarean section: Is indicated in cases where the mother is unstable, the fetus is premature, vaginal delivery is not possible, placental abruption, etc.
    • Forceps, vacuum extraction: Are not recommended in Eclampsia due to the risk of causing further complications for the mother and fetus.
  36. Question 776: Moderate preeclampsia has the following symptoms:

    • A. Abdominal and hand edema. T/F
    • B. BP = 150/100 mmHg. T/F
    • C. Proteinuria 1-2 g/liter. T/F
    • A. Urine output below 800ml/24h. T/F
    • B. Normal vision. T/F

    Answer:

    • A. T (True)
    • B. T (True)
    • C. T (True)
    • A. F (False)
    • B. F (False)

    Explanation: Moderate preeclampsia may present with the following symptoms:

    • Abdominal and hand edema: Common signs in preeclampsia.
    • BP = 150/100 mmHg: Mild to moderate BP elevation, which can cause cardiovascular complications.
    • Proteinuria 1-2 g/liter: A sign of kidney damage, which can lead to kidney failure.
    • Urine output below 800ml/24h: A sign of kidney failure requiring timely monitoring and treatment.
    • Normal vision: Vision is often affected in preeclampsia, resulting in blurry vision, double vision, etc.
  37. Question 777: Name 3 main symptoms of PE:

    • A. …(high BP)…….
    • B. ……(Edema)…..
    • C. ……(Proteinuria)….

    Answer:

    • A. (High BP)
    • B. (Edema)
    • C. (Proteinuria)

    Explanation: The three main symptoms of PE are:

    • High BP: The primary symptom, usually appearing first.
    • Edema: Appears after high BP, usually edema in legs, hands, face.
    • Proteinuria: A sign of kidney damage, appearing later, and is a sign of severe prognosis.
  38. Question 778: List the proteinuria levels defined in g/l and (+):

    • A. ……..0,1g/l(Trace)……..
    • B. ………0,3g/l(+)……….
    • C. ………1g/l(++)……….
    • D. ……..3g/l(+++)………
    • E. ……..10g/l(++++)……….

    Answer:

    • A. 0,1g/l (Trace)
    • B. 0,3g/l (+)
    • C. 1g/l (++)
    • D. 3g/l (+++)
    • E. 10g/l (++++)

    Explanation: The degree of proteinuria is defined according to a scale:

    • Trace: 0,1g/l
    • (+): 0,3g/l
    • (++): 1g/l
    • (+++)**: 3g/l
    • (++++)**: 10g/l
  39. Question 779: List 4 complications of E for pregnant women:

    • A. ……(Tongue biting)……
    • B. ……(Heart failure, liver failure, kidney failure)…….
    • C. ……(Cerebral hemorrhage)…….
    • D. ……(Acute pulmonary edema, death.)……

    Answer:

    • A. (Tongue biting)
    • B. (Heart failure, liver failure, kidney failure)
    • C. (Cerebral hemorrhage)
    • D. (Acute pulmonary edema, death.)

    Explanation: E seizures can cause dangerous complications for pregnant women, such as:

    • Tongue biting: Due to forceful spasms, the patient may bite their tongue, causing bleeding.
    • Heart failure, liver failure, kidney failure: Caused by prolonged high BP, organ damage.
    • Cerebral hemorrhage: Caused by high BP, leading to brain hemorrhage, causing coma, death.
    • Acute pulmonary edema: Caused by high BP, leading to acute pulmonary edema, causing shortness of breath, respiratory failure.
  40. Question 780: List 3 paraclinical signs of severe PE:

    • A. …..(Proteinuria t 3g/ 24 hours or 3+ or more)……
    • B. …..(Platelets ¬ 150,000mm3)…….
    • C. …..(Increased liver enzymes SGOT, SGPT)……….

    Answer:

    • A. (Proteinuria t 3g/ 24 hours or 3+ or more)
    • B. (Platelets ¬ 150,000mm3)
    • C. (Increased liver enzymes SGOT, SGPT)

    Explanation: Paraclinical signs of severe PE include:

    • Proteinuria t 3g/ 24 hours or 3+ or more: A sign of severe kidney damage.
    • Platelets ¬ 150,000mm3: A sign of coagulation disorder, which can cause cerebral hemorrhage.
    • Increased liver enzymes SGOT, SGPT: A sign of liver damage, which can lead to liver failure.
  41. Question 781: List 3 complications caused by PE and E for the fetus:

    • A. ……(Fetal growth restriction)………
    • B. …….(Premature birth)……..
    • C. …….(Still

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