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Life Cycle > Endo of Pregnancy > Flashcards

Endo of Pregnancy Flashcards

1
Q

Is placenta more permeable to lipophilic or hydrophilic substances?

What are two hormones that get degraded by the placenta?

A
  • Placenta is permeable to lipophilic molecules
  • T4 and cortisol get degraded by placenta
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2
Q

What hormone causes hypercoagulability and increased binding proteins during pregnancy?

A

Estrogen

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3
Q

How does progesterone affect smooth muscle?

A

Progesterone -> Smooth muscle relaxation

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4
Q

Describe the levels of TSH throughout pregnancy

A
  • TSH is suppressed during first trimester b/c hCG takes over this role
  • TSH then rises again once hCG has fallen
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5
Q

What hormone maintains the corpus luteum?

What hormone causes the maternal switch to fat metabolism?

What placental hormone is most involved in parturition?

A

hCG -> maintains corpus luteum in early pregnancy

hPL -> switch to fat metabolism

CRH -> parturition

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6
Q

How does respiratory rate and O2 consumption change in pregnancy?

What hormone mediates this effect?

A

Hyperventilation

Increased oxygen consumption

Mediated by progesterone

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7
Q

What is the main function of hPGH?

Does it cross the placenta?

A

hPGH is the primary hormone that causes insulin resistance

hPGH does not cross the placenta

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8
Q

What is suggested by ketones in the urine of a pregnant woman?

What hormone is causing this?

A

Ketonuria is normal in pregnant women

Due to hPL inducing a switch to fat metabolism

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9
Q

What hormone causes peripheral vasodilation during pregnancy?

A

Estrogen

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10
Q

What hormone is responsible for morning sickness/vomiting during pregnancy?

A

bHCG

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11
Q

How does pituitary GH release change during pregnancy?

A

Pituitary GH release is suppressed due to hPGH, which takes over these functions

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12
Q

Why doesn’t a female baby from a mom with PCOS appear hypervirilized from the excess androgens?

A

Any excess androgens can get converted to estrogen by aromatase at the placenta

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13
Q

What are the effects of Estrogen on…?

  • Cardiovascular system (4)
  • Uterus (1)
  • Endocrine system (2)
A
  • Endocrine
    • Increased pituitary size
    • Increased binding protein synthesis
  • Uterus
    • Myometrium growth
  • CV
    • Hypercoagulability
    • Increased CO
    • Increased blood volume
    • Peripheral vasodilation
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14
Q

What hormone causes peripheral vasodilation during pregnancy?

A

Estrogen

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15
Q

Why are pregnant patients at higher risk of pancreatitis?

A

estrogen increases TG level -> pancreatitis

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16
Q

What hormone increases pituitary size during pregnancy?

A

Estrogen

17
Q

What hormone is responsible for smooth muscle relaxation during pregnancy?

A

Progesterone

(eg. decreased peristalsis)

18
Q

Why are pregnant women more susceptible to pyelonephritis? (2)

A

Decreased ureter peristalsis

Reflux due to smooth muscle relaxation

19
Q

What is the function of mifepristone?

What is one clinical use?

A

Progesterone receptor antagonist

Used to induce abortion (b/c progesterone normally inhibits uterine contraction)

20
Q

How does pregnancy affect the GI tract? (3)

Name complication(s) of each

A
  1. Relaxed lower esophageal sphincter
    • Aspiration pneumonia and GERD
  2. Slow peristalsis
    • Constipation
  3. Slow gall bladder emptying
    • Cholecystitis
21
Q

How does pregnancy affect renal blood flow, GFR, BUN, Cr, and Na?

What does glucosuria suggest?

A
  1. Increased RBF
  2. Increased GFR
  3. Low Cr, BUN
  4. Hyponatremia

Glucose in the urine can be normal during pregnancy

22
Q

How does pregnancy affect the cardiovascular system (4)?

What hormone mediates these effects

A
  1. Increased CO
  2. Increased HR
  3. Lower SVR -> Low BP
  4. Dilutional anemia

*Mediated by estrogen

23
Q

What hormone is responsible for immune system suppression during pregnancy?

A

Progesterone

24
Q

When does placenta replace the corpus luteum in synthesizing hormones?

A

8-10 weeks

25
Q

What are the two main functions of hPL?

A
  1. Maternal insulin resistance
  2. Maternal switch to fat metabolism
26
Q

How does Progesterone affect each system?

  • Uterus (2)
  • Smooth muscle
  • Immune system
  • Breast
  • Respiratory
A
  • Uterus: promotes decidua formation & inhibits contraction
  • Smooth muscle: promotes relaxation
  • Immune system: suppressed
  • Breast: development of lobules
  • Respiratory: hyperventilation
27
Q

The alpha subunit of bHCG is the same as what other 3 hormones?

How quickly should bHCG double, and when does it peak?

A
  • Alpha subunit like LH, FSH, TSH
  • bHCG should double every 48 hours
  • Peaks at 10-12 weeks
28
Q

Where is most estrogen made during pregnancy?

A

Placenta!

B/c placenta contains aromatase

29
Q

What hormone causes myometrial growth during pregnancy?

A

Estrogen

30
Q

Which part of the placenta makes hormones?

Do most hormones go to the mom or fetus?

A

Syncytiotrophoblast

Most hormones go into maternal circulation

Life Cycle (27 decks)

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