ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

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  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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Hyperthyroidism/GRAVES DISEASE from tog Thyroid dysfunction and reproductive health

 

Thyroid Function and Pregnancy: Key Points to Know 🤰💡

Effects of Pregnancy on Thyroid Function 🩺

  • b-hCG and TSH Cross-Reactivity:
    • Beta human chorionic gonadotropin (b-hCG) rises sharply in early pregnancy.
    • It mimics TSH, stimulating thyroid hormone release and suppressing TSH levels. 📉
  • Second Trimester Onward:
    • b-hCG levels drop, leading to a rise in TSH.
    • Pregnancy increases the demand for thyroid hormones, making women with overt or subclinical thyroid disease more vulnerable to dysfunction. ⚠️

Hyperthyroidism in Pregnancy ⚡

  • Graves’ Disease:
    • The most common cause of hyperthyroidism in pregnancy, affecting ~1% of pregnancies. 🛑
    • Diagnosed using TSH receptor antibodies, which are positive in Graves’ disease.
    • Associated with adverse outcomes:
      • Preterm delivery. 🍼
      • Pre-eclampsia. 🤰⚠️
      • Fetal growth restriction. 🚼
      • Maternal heart failure. 💔
      • Stillbirth. 💔
  • Gestational Hyperthyroidism:
    • Affects 1–3% of pregnancies, caused by elevated b-hCG stimulating TSH receptors.
    • Free T4 levels are raised, but TSH receptor antibodies are negative.
    • Resolves in the second trimester with supportive management—thyroid replacement therapy is not required. 🌟

Management of Hyperthyroidism During Pregnancy 🛠️

  • Pre-Pregnancy Recommendations:
    • Women with Graves’ disease should achieve euthyroidism before planning a pregnancy. ✅
    • Conception should be delayed for 6 months after radioactive iodine therapy. ⏳
  • Medications:
    • Propylthiouracil (PTU): Preferred in the first trimester due to lower teratogenic risks. 💊
    • Carbimazole: Recommended in the second trimester to avoid PTU-associated hepatotoxicity. ⚠️
    • Use the lowest effective dose of anti-thyroid medication to maintain euthyroidism.
  • Monitoring During Pregnancy:
    • Trimester-specific thyroid ranges should guide treatment. 📊
    • Fetal growth and heart rate must be closely monitored, particularly in women with anti-thyroid antibodies.

Postpartum Care 🎉

  • Graves’ Disease Remission:
    • Many women experience remission toward the end of pregnancy. 🔄
    • There’s a high risk of recurrence or exacerbation postpartum, so reassessment within 2 months is critical. 🔔

Fetal and Neonatal Considerations 

  • Neonatal Review: Babies of mothers with anti-thyroid antibodies (whether hyperthyroid or euthyroid) should undergo neonatal review to rule out neonatal hyperthyroidism. 🍼

Key Takeaways 📝

  • Pregnancy alters thyroid function significantly, requiring careful monitoring and management for women with thyroid disorders. ❤️
  • Timely diagnosis and appropriate treatment can minimize risks for both the mother and baby. 🌟
  • Postpartum care is essential to manage thyroid levels and prevent complications. 🩺


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ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

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  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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