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Life Cycle > II: Pregnancy - Mother > Flashcards

II: Pregnancy - Mother Flashcards

1
Q

During pregnancy, TBW increases from __ to __.

A

6.5L; 8.5L

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2
Q

____ induces apoptosis of endometrial T cells to promote immune survival of the embryo

A

hCG

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3
Q

____ inhibits uterine contractions and may modulate immune system to prevent fetal rejection

A

Progesterone

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4
Q

____ is used in pregnancy tests and appears positive ___ days after fertilization

A

hCG; 9

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5
Q

____ promotes placental angiogenesis and uterine vascular remodeling via stimulating IGF production

A

hPGH

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6
Q

____ promotes prolactin production by lactotrophs

A

Estrogen

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7
Q

_____ are the major placental cells responsible for protein and steroid hormone production

A

Syncytiotrophoblasts

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8
Q

_____ contribute to insulin resistance during pregnancy; ____ is thought to be the primary driver

A

hPGH, hPL; hPGH

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9
Q

_____ increases the number of oxytocin receptors

A

Estrogen

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10
Q

_____ may contribute to sinus congestion

A

Estrogen

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11
Q

_____ promotes hepatic protein synthesis

A

Estrogen

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12
Q

_____ stimulates insulin secretion and islet cell numbers to increase lipolysis and free fatty acids

A

hPL

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13
Q

BNP increases most in the ___ trimester, especially in the case of pre-eclampsia

A

3rd

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14
Q

Cardiac output is lowest in the _____ positions.

A

Standing, supine

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15
Q

Decreases in SVR are mediated by _____ effects on smooth muscle and ____ production

A

Progesterone; NO

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16
Q

During delivery, when does cardiac output peak?

A

10-30 minutes after delivery

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17
Q

During pregnancy, _______ immunity is suppressed while _____ immunity is unchanged or enhanced

A

Cell-mediated; Humoral

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18
Q

During pregnancy, BP _____ until 22-24 weeks.

A

Decreases

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19
Q

During pregnancy, BP is at baseline at _____ weeks.

A

0, 36

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20
Q

During pregnancy, cardiac contractility _____ and cardiac compliance _____.

A

Increases; increases

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21
Q

During pregnancy, cardiac output ______, mainly due to increases in ______.

A

increases; stroke volume

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22
Q

During pregnancy, clotting factors ______ and fibrinolytic factors ______.

A

Increase; Decrease

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23
Q

During pregnancy, filtration fraction at the kidney ______.

A

decreases

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24
Q

During pregnancy, GFR ______ by __%; creatinine and BUN ______.

A

increases; 50%; decrease

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25
Q

During pregnancy, heart rate ______ during the ____ trimester.

A

Increases 10-20 bpm; 3rd

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26
Q

During pregnancy, PaO2 _____ and PaCO2 _____.

A

Increases; Decreases

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27
Q

During pregnancy, pH ____ and bicarbonate _____.

A

Increases; decreases

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28
Q

During pregnancy, preload ______, end diastolic volume _____, and afterload ______.

A

Increases; Increases; decreases

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29
Q

During pregnancy, RBC mass _____.

A

Increases

30
Q

During pregnancy, serum levels of angiotensin II ______ and aldosterone.

A

Increase; increase

31
Q

During pregnancy, serum sodium ____ 3-4mM, and plasma osmolarity ____ 6-8mOsm

A

decreases; decreases

32
Q

During pregnancy, systemic vascular resistance is ______.

A

Decreased

33
Q

During pregnancy, the white blood cell count _____.

A

Increases

34
Q

During pregnancy, tidal volume _____.

A

increases

35
Q

During pregnancy, venous pressure _____.

A

Increases

36
Q

During pregnancy, which type of valvular heart disease lesions are better tolerated?

A

Regurgitant

37
Q

DVT is more common on the ____ side.

A

left

38
Q

hCG peaks at weeks ___ gestation.

A

9 to 10

39
Q

How much does required caloric intake increase during pregnancy?

A

200kcal/day (1st/2nd), 300kcal/day (3rd)

40
Q

Hydronephrosis is more common on the ____ side.

A

right

41
Q

Hyperpigmentation of skin during pregnancy can be attributed to ____ stimulation of ______

A

hCG; melanocyte-stimulating hormone (MSH)

42
Q

Hyperthyroidism early in pregnancy is mediated by ____.

A

hCG

43
Q

In pregnancy, gallbladder volume ______ and risk of gallstones ______.

A

Increases; increases

44
Q

In pregnancy, mothers have ______ risk of peptic ulcer disease and ____ risk of GERD.

A

decreased; increased

45
Q

Increased Free T4 during the first trimester is an effect of ______.

A

hCG

46
Q

Increased Total T4 in pregnancy is an effect of ______

A

estrogen

47
Q

Insulin sensitivity is ______ early in pregnancy.

A

increased

48
Q

Loss of _____ of blood is normal during delivery.

A

500-1000ml

49
Q

Name 4 exam findings characteristic of the heart in pregnancy.

A

Left-displacement of PMI, systolic ejection murmur at left sternal border, S3 murmur, Exaggerated split S1 (increased preload)

50
Q

Name 4 possible complications of GDM for the mother.

A

C-section, Pre-eclampsia, infection, risk of developing T2DM

51
Q

Name a common developmental/birth complication assoicated with GDM.

A

Shoulder dystocia

52
Q

Name the 3 major steroid hormones produced by the placenta

A

Progesterone, Estrogen, 1,25-dihydroxy-vitamin D

53
Q

Name the 4 major polypeptide hormones produced by the placenta

A

hPGH, hPL, hCG, CRH

54
Q

Nausea and vomiting during pregnancy most closely correlates with ____ levels.

A

hCG

55
Q

Pyelonephritis is more common on the ____ side.

A

right

56
Q

The hyperthyroid phase of post-partum thyroiditis (___ months following pregnancy) should be treated with ______.

A

2-4; Beta-blockers

57
Q

The hypothyroid phase of post-partum thyroiditis (___ months following pregnancy) should be treated with ______.

A

4-8; Levothyroxine

58
Q

What are the signs of fetal Graves Disease?

A

Tachycardia, IUGR

59
Q

What birth defect may be associated with preexisting hypertension?

A

IUGR

60
Q

What histologic changes can be seen in the heart during pregnancy?

A

Ventricular hypertrophy

61
Q

What is normal net weight gain during pregnancy?

A

25-35 pounds

62
Q

What is the appropriate treatment in the context of maternal hyperthyroidism caused by Graves Disease?

A

Propylthiouracil (PTU)

63
Q

What is the leading preventable cause of mental retardation?

A

Iodine Deficiency

64
Q

What is the most common cause of maternal (not gestational) hyperthyroidism?

A

Graves Disease

65
Q

What is the most common cause of maternal hypothyroidism?

A

Hashimoto Thyroiditis

66
Q

What is the pathophysiologic cause of post-partum thyroiditis?

A

Anti-TPO antibodies

67
Q

What is the treatment/management for DVT in pregnancy?

A

LMWH up to 36 weeks; Unfractionated heparin until delivery

68
Q

Which lung volumes decrease during pregnancy?

A

RV, TLC, FRC

69
Q

Which lung volumes increase during pregnancy?

A

TV, IC

70
Q

Which pregnancy signs due to estrogen effects may mimic liver disease?

A

Spider angiomata, palmar erythema

Life Cycle (24 decks)

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