Endocrinology of Pregnancy

Question 1

what is oestradiol made from?

Answer 1

cholesterol

Question 2

what day of the menstrual cycle is luteinizing hormone at its peak?

Answer 2

14

Question 3

what is the relationship between oestradiol and follicular growth?

Answer 3

once the ovarian follicle is fully grown, oestradiol is released

Question 4

what happens to the follicle after ovulation?

Answer 4

forms a corpus luteum that produces progesterone

Question 5

what hormone is measured using a pregnancy test?

Answer 5

human chorionic gonadotropin

Question 6

what is HCG released by?

Answer 6

cells in the placenta

Question 7

main role of HCG?

Answer 7

to nourish and protect the newly fertilised egg that has implanted on the uterine wall

Question 8

what hormones are released by the placenta?

Answer 8

HCG
human placental lactogen
placental progesterone
placental oestrogens

Question 9

what hormone involved in pregnancy is produced by the pituitary gland?

Answer 9

prolactin

Question 10

name the gonadotrophic hormones

Answer 10

luteinizing hormone

follicle stimulating hormone

Question 11

name the ovarian hormones?

Answer 11

oestrogen
inhibin
progesterone

Question 12

name the 3 phases of the menstrual cycle in order

Answer 12

follicular phase
ovulation
luteal phase

Question 13

after how many weeks of pregnancy can gestational diabetes be diagnosed?

Answer 13

24-28 weeks of high blood glucose

Question 14

what is macrosomia?

Answer 14

birth weight over 4kg

Question 15

in what trimester does the foetus start making its own insulin?

Answer 15

3rd trimester

Question 16

what folic acid dose is given to mothers with diabetes?

Answer 16

5mg

Question 17

what drugs should be avoided in diabetic pregnant women?

Answer 17

ACEi

statin

Question 18

what drug can be used instead of an ACEi in diabetic mothers

Answer 18

labetalol

Question 19

how is good blood glucose during labour?

Answer 19

IV insulin

IV dextrose

Question 20

drug treatment for pregnant mothers who have MODY?

Answer 20

glibenclamide

Question 21

drug treatment for gestational diabetes?

Answer 21

metformin

Question 22

when should GTT be done post natally?

Answer 22

6 weeks

Question 23

how likely are obese people with gestational diabetes to get type 2?

Answer 23

80%

Question 24

what kind of cycle does hypo and hyperthyroid disease cause?

Answer 24

anovulatory

Question 25

how is thyroid demand increased in pregnancy?

Answer 25

increase in size | increase in T4 production

Question 26

what pregnancy hormonesi increase thyroxine production?

Answer 26

TSH | hCG

Question 27

what is the effect of increased thyroxine in pregnancy?

Answer 27

suppressed TSH

Question 28

how should you treat pregnant mothers with hypothyroidism?

Answer 28

increase thyroxine dose by 25mcg

Question 29

what TSH level should you aim for in pregnant mothers with hypothyroidism?

Answer 29

<3mU/l

Question 30

risks of untreated hypothyroidism in pregnancy?

Answer 30

``` increased abortion preeclamspsia abruption postpartum haemorrhage preterm labour ```

Question 31

risks of untreated hyperthyroidism in pregnancy?

Answer 31

infertility spontaneous miscarriage stillbirth thyroid crisis in labour

Question 32

what is hyperemesis gravidarum?

Answer 32

hcg associated thyrotoxicosis

Question 33

what effect does hyperemesis have on hCG and TSH levels?

Answer 33

increased hcG | decreased TSH

Question 34

when should hyperemesis gravidarum resolve?

Answer 34

20 weeks gestation

Question 35

similarities in presentation of hyperemesis and hyperthyroid?

Answer 35

``` tachycardia warm sweaty weight loss nausea/vomiting ```

Question 36

treatment for hypothyroid in each trimester of pregnancy?

Answer 36

propylthiouracil - 1 | carbimazole - 2/3

Question 37

what trimester should TRAb antibodies ideally be checked?

Answer 37

third

Question 38

what are TRAb tests looking for

Answer 38

hyperthyroid in baby

Question 39

what is a significant postpartum thyroid problem that presents with a small, diffuse, non tender goitre

Answer 39

postpartum thyroiditis

Question 40

what antithyroid drug has a risk of liver toxicity?

Answer 40

propylthiouracil

Question 41

what antithyroid drug can cause GI abnormalities in baby?

Answer 41

carbimazole