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Obstetrics > 1 Reproductive Basics > Flashcards

1 Reproductive Basics Flashcards

1
Q

Produced by placental syncytiotrophoblast

Starts to appear by 10th week post fertilization, peaks at 9-10th week and plateaus by 20-22nd week

It has 2 subunits: alpha and beta

A

Human Chorionic Gonadotrophin

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2
Q

3 functions of HCG

A
  1. Maintains corpus luteum
  2. Regulate steroid biosynthesis (placenta, fetal adrenal gland)
  3. Testosterone source for male testes
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3
Q

HCG subunit specific for PREGNANCY

A

Beta Subunit

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4
Q

Pregnancy related hormone that is diabetogenic

A

HPL

parallels placental growth

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5
Q

Sources of Progesterone during Pregnancy

A

Upto 6-7th week - corpus luteum

7-9th week CL + placenta

9th wk onwards - placenta only

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6
Q

Early pregnancy fxn of progesterone

A

Endometrial secretory changes favorable for blastocyst implantation

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7
Q

Late pregnancy fxn of progesterone

A

Immune tolerance and prevent myometrial contractions

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8
Q

Estrogen moeities

A
  • Estriol - non pregnant, reproductive years (follicle, granulosa, aromatase enzyme)
  • •Estradiol - placenta (fetal adrenal DHEAS, sulfatase enzyme)
  • ••Estrone - menopause (adipose)
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9
Q

Cardiovascular Changes

A

Arterial BP
•systolic⬇️
•diastolic ⬇️⬇️

Venous Pressure
•central unchanged
•femoral ⬆️

Plasma volume ⬆️ by 50%

SVR - ⬇️ by 30%

Cardiac Output - ⬆️ by 50%

Murmurs (+) systolic ejection murmur at left SB

Slight Axis Deviation

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10
Q

Hematologic Changes

A

⬆️ RBC mass, ⬆️ Plasma volume = Hemodilutional Anemia

WBC ⬆️

ESR ⬆️

Platelet “none”

Coag Fx - ⬆️⬆️ “hypercoaguble state”

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11
Q

Pulmonary Changes

A

⬆️ TV, Minute Ventilation

Maintained VC

⬇️ Residual volume

Blood Gas - resp alkalosis

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12
Q

In utero Shunts

A 
Ductus Venosus (UV ⏩ IVC, RA)
•bypass liver sinusoids
Foramen Ovale (RA ⏩ LA)
•bypass pulmo circ
Ductus Arteriosus ( PA ⏩ Desc Aorta)
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13
Q

Breast and Hormones

A

Estrogen
•from ovarian follicle
•duct, nipples, fat devt

Progesterone
•Corpus luteum
•Lobules and alveolar growth

Prolactin
•APG - milk production

Oxytocin
•PPG milk ejection

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14
Q

Starts at conception ends with blastocyst implantation

Morula (intratubal phase) ⏩ Blastocyst (intrauterine)

A

1st week postconception

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15
Q

Starts with implantation ends with devt of bilaminar germ disk

Development of syncytiotrophoblast

A

2nd week postconception

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16
Q

Starts with 2-layer embryo ends with devt of trilaminar germ disk

A

3rd week postconception

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17
Q

Earliest period of detecting serum B-HCG

A

2nd week (syncytiotrophoblast formation)

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18
Q

Primordium of female internal reproductive system

In males ⏩ secretion of inhibitory factor to cause involution

A

Parasmesonephric (Mullerian) Duct

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19
Q

Primordium of male internal reproductive system

Requires androgenic (testosterone) stimulation

A

Mesonephric (Wolffian) Ducts

20
Q

Devt of male external genitalia requires _____________ stimulation

A

DHT

21
Q

Period of greatest TERATOGENIC risks

A

3rd-8th week PC

22
Q

Teratogenic Agents

A

Ionizing Radiation - at 8-15th wk at least 20 rads

Chemo - 1st tri phenomenon

Tobacco - IUGR, preterm delivery, NO SYNDROME

Alcohol - FAS, midfacial hypoplasia, microcephaly, MR, IUGR

Cocaine - Abruptio, PD, IVH, IUGR

Marijuana - PD

23
Q

IUGR, MIDFACIAL HYPOPLASIA, LONg PHILTRUM, devt delay, short palpebral fissures, multiple joint anomalies, cardiac defects

A

Fetal Alcohol Syndrome

24
Q

T shaped uterus, vaginal adenosis, cervical hood, incompetent cervix, PD

A

Diethylstilbesterol DES syndrome

25
Q

IUGR, CF DYSMORPHISM, MR, MICROCEPHALY, nail hypoplasia, heart defects

Neonatal ⬇️⬇️ Vit K dependent CF : II, VII, IX, X

A

Fetal Hydantoin (Dilantin) Syndrome

26
Q

Congenital Deafness, microtia, CNS defects, CHD

A

Isotretinoin

27
Q

Ebstein’s Anomaly (R heart defect)

A

Lithium

28
Q

VII nerve damage, hearing loss

A

Streptomycin

29
Q

Phocomelia, limb reduction defects, ear/nasal anomalies, pyloric/duodenal stenosis

A

Thalidomide

30
Q

Neural Tube Defects

Cleft lip, renal defects

A

Valproic Acid

31
Q

CHONDRODYSPLASIA (stippled epiphysis), microcephaly, MR, optic atrophy

A

Warfarin

32
Q

Most common aneuploidies in miscarriage

A

Trisomy 16

Monosomy X

33
Q 
Cystic hygromas
Streak gonads
1 amenorrhea, infertility
Short stature
Neck webbing
A 
Monosomy X (45 X)
aka Turner’s Syndrome
34
Q

Tall stature, testicular atrophy , azospermia, gynecomastia

A

Klinefelter Syndrome (47, XXY)

35
Q

Short stature, MR, endocardial cushion defects (and/or) duodenal atresia

A

Trisomy 21

36
Q

Profound MR
Rocker-bottom feet
Clenched fists

A

Edward Syndrome (T18)

37
Q

IUGR, holosprosencephaly, cyclopia, severe cleft lip with palate fat

A

Patau Syndrome (T13)

38
Q

Transmission M=F, serial
Delayed onset, variable c/e
50% of offsprings
No carrier states

A

Autosomal Dominant

39
Q

AD : presence of carrier states

A

False

40
Q

Male=Females
Skips generations
Early, consistent c/e
Carrier states

A

Autosomal Recessive

41
Q

AR genes

Both parents HZ
1 parent HZ, HO
Both parents, HO

A

50% aff

25% aff, 50% carrier, 25% N

100% aff

42
Q

HO females, Male carriers

HO females, lethality in males

A

X-linked Dominant

43
Q

No male-male trans
Exp only in males
Female are carriers

A

X-linked Recessive

44
Q

Womem who are high risk for NTD should take _______ of Folic acid.

A

4mg (Absence of risk : 0.4mg)

45
Q

NTD, CHD, CL/P and pyloric stenosis are birth defects with _______ inheritance

A

Polygenic

Obstetrics (14 decks)

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