Close help

How to use this Learning Station

On this Learning Station, you can read and test your knowledge. Tap on a book to open its chapter list. In each chapter, you can take a quiz to test your knowledge.

To take tests, you must register with your email address or cell number. It is free to register and to take tests.

For help email info@bettercare.co.za or call +27 76 657 0353.

Printed books and CPD points

Learning is easiest with printed books. To order printed books, email info@bettercare.co.za or call +27 76 657 0353.

Visit bettercare.co.za for information.

Test 3: Hypertensive disorders of pregnancy

  1. What is the definition of hypertension in pregnancy?
    • A diastolic blood pressure of 80 mm Hg or above and/or a systolic blood pressure of 120 mm Hg or above.
    • A diastolic blood pressure of 90 mm Hg or above and/or a systolic blood pressure of 140 mm Hg or above.
    • A diastolic blood pressure of 100 mm Hg or above and/or a systolic blood pressure of 160 mm Hg or above.
    • A rise in diastolic blood pressure of 10 mm Hg.
  2. What is the definition of significant proteinuria in pregnancy?
    • A trace of protein.
    • 1+ protein or more.
    • 2+ protein or more.
    • 3+ protein.
  3. How should you define pre-eclampsia?
    • Hypertension and proteinuria present before the start of pregnancy.
    • Hypertension and proteinuria presenting in the first half of pregnancy.
    • Hypertension and proteinuria presenting in the second half of pregnancy.
    • Hypertension and proteinuria presenting any time in pregnancy.
  4. What is the correct definition of chronic hypertension?
    • Hypertension, without proteinuria, that is present in the first half of pregnancy.
    • Hypertension together with proteinuria, that is present in the first half of pregnancy.
    • Hypertension that is present in the first half of pregnancy plus proteinuria that presents in the second half of pregnancy.
    • Hypertension alone, which is present at the time of booking at 28 weeks.
  5. How common is pre-eclampsia?
    • Most pregnant women develop pre-eclampsia.
    • About 25% of all pregnant women develop pre-eclampsia.
    • About 5–6% of all pregnant women develop pre-eclampsia.
    • Very rare.
  6. Which fetal condition is common in pregnancies complicated by pre-eclampsia?
    • Congenital malformations.
    • Heart failure due to hypertension.
    • Haemorrhagic disease of the newborn.
    • Intra-uterine growth restriction.
  7. Pre-eclampsia may cause fetal distress because it results in:
    • Decrease in placental blood flow.
    • Fetal hypertension.
    • Severe protein loss in the mother’s urine.
    • Congenital abnormalities caused by antihypertensive drugs.
  8. A patient with pre-eclampsia who develops a diastolic blood pressure of 105 mm Hg and 2+ proteinuria at 36 weeks of pregnancy should be graded as having:
    • Pre-eclampsia.
    • Severe pre-eclampsia.
    • Imminent eclampsia.
    • Eclampsia.
  9. What is an important sign of imminent eclampsia?
    • 3 + proteinuria.
    • Increased tendon reflexes.
    • A diastolic blood pressure of 110 mm Hg or more.
    • Tenderness on palpating the calves.
  10. A patient with pre-eclampsia has a diastolic blood pressure of 95 mm Hg and 1+ proteinuria. She complains of flashes of light in front of her eyes and upper abdominal pain. In which of the following grades of pre-eclampsia should you put this patient?
    • Pre-eclampsia.
    • Severe pre-eclampsia.
    • Imminent eclampsia.
    • Eclampsia.
  11. Which of the following women has the highest risk of pre-eclampsia?
    • A patient with a history of pre-eclampsia starting early in the third trimester of a previous pregnancy.
    • A patient with a history of a preterm delivery in her previous pregnancy.
    • Grande multiparas.
    • A patient who previously had a twin pregnancy.
  12. Which one of the following may be an early warning sign of pre-eclampsia?
    • Weight loss during the last months of pregnancy.
    • Generalised oedema especially of the face.
    • Oedema of the feet at the end of the day.
    • Pain on passing urine.
  13. What is the management of a patient with pre-eclampsia?
    • Oral antihypertensive drugs.
    • Diuretics to reduce oedema.
    • Hospitalisation.
    • A loading dose of magnesium sulphate.
  14. What is an important complication of pre-eclampsia?
    • Placenta praevia.
    • Oedema of the face.
    • Glycosuria.
    • Intracerebral haemorrhage.
  15. What is management of a patient with severe pre-eclampsia?
    • Prevent eclampsia by giving magnesium sulphate.
    • Prevent intracerebral haemorrhage by decreasing the blood pressure.
    • Transfer the patient to hospital.
    • All of the above.
  16. What drug is used to manage a diastolic blood pressure of 110 mm Hg or more or a systolic blood pressure of 160 mm Hg or more?
    • Alpha methyldopa (Aldomet).
    • Nifedipine (Adalat).
    • Diazepam (Valium).
    • Propranolol (Inderal)
  17. What is the first step in the management of a patient with eclampsia?
    • Give intramuscular phenobarbitone to stop the convulsions.
    • Give dihydralazine (Nepresol) to lower the blood pressure.
    • Turn the patient on her side and ensure an open airway.
    • Insert a Foley’s catheter.
  18. What drug is used to prevent and manage eclampsia?
    • Magnesium sulphate.
    • Magnesium trisilicate.
    • Alpha methyldopa (Aldomet).
    • Diazepam (Valium).
  19. How should a patient, who feels well but has a diastolic blood pressure of 90 mm Hg at 36 weeks gestation, be managed? At all her previous antenatal visits the blood pressure was normal and she has no proteinuria.
    • She must be given an intramuscular injection of dihydralazine (Nepresol).
    • She must be hospitalised.
    • Weekly antenatal visits should be arranged with additional visits to measure the blood pressure and check for proteinuria.
    • A full blood count should be done to exclude a low platelet count.
  20. A rise in blood pressure or the development of proteinuria in a patient with chronic hypertension:
    • Could be a result of the pregnancy and should not be of any concern.
    • Requires urgent referral to hospital.
    • Requires an increase in her daily dose of alpha methyldopa (Aldomet).
    • Requires the addition of a beta blocker or ACE inhibitor.