Block B

Question 1

What are the main physiological changes in demand whilst pregnent?

Answer 1

Cardiovascular - increased bp and heart rate
Respiratory - decrease in CO2, increased ventralation
Haematological - coagulation issues, haemodilation
Kidney - increased blood flow and plasma
Other - GI: acid reflux, liver: synthetic capacity
Hormones - Thyroid hormone increased need
Ions - increased calcium uptake from the baby

Question 2

What is hCG

Answer 2

human chorionic gandrotrophin

Question 3

Why do we test b hcg

Answer 3

More specific to pregnancy as the cause, also more sensitive in early pregancy

Question 4

How can we test for pregnancy?

Answer 4

Lab tests - chemical lumiscense
Automated testing
At home test (POCT) - works like a lateral flow but only tracks up to 25iu/l

Question 5

What are 5 common complications of pregancy?

Answer 5

Ectopic
Molar
Pre-Eclampsia
Obstetric choleostasis
Gestational diabetes

Question 6

What are key features of ectopic?

Answer 6

Abnomally low B hCG
Bleeding and abdominal pain
Surgical removal or spontanous abortion

Question 7

What are the key features of molar?

Answer 7

High BhCG
Chromosomal imbalance is the cuase - too much or too little
Ultrasound, how bHCG rises after 10 weeks
Remove this, and chemo if cancerous

Question 8

Key features of pre-ecampsia

Answer 8

Severe inflammatory disorder-> hypertension, proteinuria and reduria
Can lead to ecamplsia - which can cause many severe side effects as far as coma and death of the mother and the baby HELLP
Palcental growth factor will be low and soluble FMS will be high

Question 9

Key features of gestational diabetes

Answer 9

T2DM develops
Want to treat this to avoid macrosomic baby through the absorption of Hb1Ac

Question 10

Key features of obstetric choleostasis

Answer 10

Increased GGT
Bile acid in the blood causes ichiness of the skin - puritis
Can cause prematurity and still birth
Treatment is repliensihing VitK and treating with creams for the itchiness