03b: Pregnancy

Question 1

(Paternal/maternal) chromosomes make placental tissue.

Answer 1

Paternal

Question 2

(Paternal/maternal) chromosomes make fetal tissue.

Answer 2

Maternal (hence full mole has no fetal tissue - fully paternal)

Question 3

Oocytes remain in (X) phase of (meiosis/mitosis) from fetal life until (Y).

Answer 3

X = prophase
Meiosis I
Y = ovulation

Question 4

(X) aneuploidy is a disjunction error but, unlike the rest, is NOT associated with advanced maternal age.

Answer 4

X = Turners (46, XO)

Question 5

List two (AR/AD/X-linked) single gene defects associated with advanced paternal age.

Answer 5

AD

1. Achondroplasia
2. Marfan

Question 6

Most progesterone in mom is coming from (X) during pregnancy and circulates (free/bound).

Answer 6

X = placenta

Bound (to CBG)

Question 7

Which hormone acts to inhibit uterine contractility during pregnancy?

Answer 7

Progesterone

Question 8

T/F: Cholesterol can cross placenta and enter fetal compartment.

Answer 8

False - placenta converts it to progesterone (sent into fetal compartment and out into maternal circulation)

Question 9

T/F: Exogenous progesterone cannot cross into fetal compartment.

Answer 9

True - broken down in placenta

Question 10

Most E1 in mom is made in (X) during pregnancy from (fetal/maternal) precursors. It circulates (free/bound).

Answer 10

X = placenta
From maternal adrenal androgens - DS/DHEA
Bound (to SHBG)

Question 11

Most E2 in mom is made in (X) during pregnancy from (fetal/maternal) precursors. It circulates (free/bound).

Answer 11

X = placenta
From maternal adrenal androgens - DS/DHEA
Bound (to SHBG)

Question 12

Most E3 in mom is made in (X) during pregnancy from (fetal/maternal) precursors.

Answer 12

X = placenta
Fetal precursors (from fetal compartment)

Question 13

Which form of estrogen is used to detect aneuploidies/trisomies?

Answer 13

E3 (made from fetal precursors, so production is driven by genetic makeup of fetus)

Question 14

ACTH is (increased/decreased) in pregnancy because of placental expression of (X).

Answer 14

Increased

X = CRH and POM-C

Question 15

T/F: Exogenous glucocorticoids can be given to decrease placental CRH excretion in pregnancy.

Answer 15

False - have positive feedback on CRH from placenta, but not enough to contraindicate their use during pregnancy

Question 16

Pregnancy: Increase in circulating blood volume by (X)% per fetus.

Answer 16

X = 40

Question 17

Pregnancy: (increase/decrease) peripheral responsiveness to angiotensin.

Answer 17

Decrease

Question 18

List some cardiac abnormalities that can be particularly dangerous in pregnant woman.

Answer 18

1. MV stenosis

2. Pulm HT (50% mortality!)

Question 19

T/F: Both HR and RR should be normal in pregnant woman.

Answer 19

False - HR high, but RR should be normal (better ventilation due to increase in TV, not RR)

Question 20

Pulm changes in pregnancy: (high/low) pO2, (high/low) pCO2, (high/low) HCO3, (high/low) pH.

Answer 20

High; low; low; high

Question 21

Renal changes in pregnancy: GFR and RPF (increase/decrease), filtered sodium (increases/decreases) by (X)%, glucose resorption (increases/decreases).

Answer 21

Increase
Increases (60-70%)
Decreases

Question 22

Pylonephritis is relatively common in pregnancy. Why?

Answer 22

Urine V in pelves and ureters can double

Question 23

What’s the mechanism behind (constipation/diarrhea) in pregnancy?

Answer 23

Constipation; all parts of GI tract relax

Question 24

List some hematologic system changes in pregnancy.

Answer 24

1. Mild dilutional anemia
2. Modest leukocytosis
3. Hypercoagulability

Question 25

Endocrine changes in pregnancy: (increase/decrease) prolactin, (increase/decrease) total circulating thyroid hormone.

Answer 25

Increase; increase (and increase TBG)

Question 26

T/F: Cell immunity decreases during pregnancy.

Answer 26

True

Question 27

Which Ig can cross placenta?

Answer 27

IgG (teeny weeny in size)