Maternal Adaptation Flashcards
What is the average uterine weight at term? A. 200 g B. 450 g C. 780 g D. 1100 g
D. 1100 g
What is the intact survival rate of an otherwise normal infant born at 28 weeks gestation? A. 25% B. 50% C. 75% D. 90%
D. 90%
Uterine enlargement in pregnancy is primarily due to what process involving myocytes?
A. hyperplasia (new myocyte production)
B. hypertrophy and stretching
C. atrophy with replacement by collagen
D. hyperplasia and hypertrophy play equal roles
B. hypertrophy and stretching
What is the major biological target of relaxin in assisting accommodation to pregnancy? A. cardiovascular system B. musculoskeletal system C. nervous system D. reproductive tract
D. reproductive tract
The gene encoding for androgen receptor has had over 100 mutations identified and is located on which chromosome? A. 6 B. 16 C. X D. Y
C. X
For whom are the painless, irregular uterine contractions that begin early in gestation named? A. Braxton Hicks B. Casey Alexander C. Sheffield Yost D. Wendel Smith
A. Braxton Hicks
Uteroplacental blood flow is apparently sensitive to the regulatory effects of which of the following? A. catecholamines B. estrogens C. nitric oxide D. all of the above
D. all of the above
What is the most likely complication resulting froma large pregnancy luteoma? A. ambiguous genitalia in a male fetus B. virilization of a pregnant woman C. virilization of a female fetus D. no fetal or maternal effects result
B. virilization of a pregnant woman
In pregnancy, what is the Chadwick sign?
A. bluish discoloration of the hyperemic vaginal mucosa
B. lower uterine segment softening
C. tenderness of breasts with enlargement
D. uterus palpable above the pubic symphysis
A. bluish discoloration of the hyperemic vaginal mucosa
What is the approximate uteroplacental blood flow at term? A. 100 mL/min B. 250 mL/min C. 550 mL/min D. 800 mL/min
C. 550 mL/min
Surgical removal of the corpus luteum of pregnancy consistently results in spontaneous
abortion if performed prior to what gestational age?
A. 7 weeks
B. 9 weeks
C. 11 weeks
D. 13 weeks
A. 7 weeks
Which of the following is a factor responsible for the softening and cyanosis of the cervix in
early pregnancy?
A. increased vascularity
B. decreased stromal edema
C. decreased venous oxygen concentration
D. atrophy of cervical glan
A. increased vascularity
What is the minimum amount of extra water that the average woman accrues during normal pregnancy? A. 1.0 L B. 3.5 L C. 6.5 L D. 8.0 L
C. 6.5 L
What happens to total maternal serum levels of calcium and magnesium in pregnancy? A. decrease B. increase throughout pregnancy C. increase during the third trimester D. remain unchanged
A. decrease
Which of the following conditions predisposes to the development of theca-lutein cysts? A. diabetes B. gestational trophoblastic disease C. multiple gestation D. all of the above
D. all of the above
What are hypertrophic sebaceous glands visible on the breast areolae in pregnancy called? A. Gatcliffe nodules B. glands of Montgomery C. mammary vesicles D. papillae of Li
B. glands of Montgomery
What is pigmentation of the midline, anterior abdominal skin during pregnancy called? A. striae gravidarum B. linea nigra C. chloasma D. melasma
B. linea nigra
Despite increased red cell volume, hemoglobin and hematocrit decrease slightly during normal
pregnancy. Below what hemoglobin concentration is apregnant woman considered anemic?
A. 9 g/dL
B. 10 g/dL
C. 11 g/dL
D. 12 g/dL
C. 11 g/dL
Which of the following skin conditions, common in pregnancy, is likely related to hyperestrogenemia? A. angiomas B. melasma gravidarum C. palmar erythema D. all of the above
D. all of the above
How does hyperreactio luteinalis differ from a pregnancy luteoma?
A. cystic, not solid
B. may cause maternal virilization
C. has a different cellular pattern
D. associated with low serum chorionic gonadotropin levels
A. cystic, not solid
Total body iron of an adult woman is 2.0 to 2.6 mg.What is the average iron store of a healthy young woman? A. 300 mg B. 500 mg C. 1000 mg D. 1500 mg
A. 300 mg
Given the date of a pregnant woman's last menstrualperiod (LMP), what method is used to quickly estimate the due date? A. subtract 7 days, subtract 3 months B. add 7 days, subtract 3 months C. add 7 days, add 3 months D. subtract 7 days, add 3 months
B. add 7 days, subtract 3 months
Which of the following coagulation factors is NOT increased during pregnancy? A. factor VII B. factor VIII C. factor IX D. factor XI
D. factor XI
What is the average increase in maternal blood volume during pregnancy? A. 10% B. 25% C. 40% D. 75%
C. 40%
What is the average weight gain during pregnancy? A. 5.5 kg B. 9.5 kg C. 12.5 kg D. 15.5 kg
C. 12.5 kg
Of the total 1000 g net gain of protein in normal pregnancy, how much is used by the fetus and placenta? A. 100 g B. 300 g C. 500 g D. 750 g
C. 500 g
What is the average increase in fibrinogen concentration during pregnancy? A. 10% B. 25% C. 50% D. 75%
C. 50%
What are the iron requirements of normal pregnancy? A. 300 mg B. 500 mg C. 1 g D. 4 g
C. 1 g
Which of the following characterizes carbohydrate metabolism in pregnancy relative to the nonpregnant state? A. hypoinsulinemia B. mild fasting hypoglycemia C. postprandial hypoglycemia D. fasting hyperglycemia
B. mild fasting hypoglycemia
Approximately how much iron is required by the fetus and placenta during pregnancy? A. 150 mg B. 300 mg C. 500 mg D. 1 g
B. 300 mg
What is the average blood loss with cesarean delivery of a singleton fetus? A. 500 mL B. 750 mL C. 1000 mL D. 1500 mL
C. 1000 mL
What is the average daily iron requirement during the second half of pregnancy? A. 1 to 2 mg/day B. 3 to 4 mg/day C. 6 to 7 mg/day D. 15 to 20 mg/day
6 to 7 mg/day
What volume of blood is lost on average with a singleton vaginal delivery? A. 250 mL B. 500 mL C. 750 mL D. 1000 mL
B. 500 mL
What is the only characteristic ECG finding in normal pregnancy? A. shortening of the QRS complex B. shortening of the ST segment C. slight depression of the ST segment D. slight left axis deviation
D. slight left axis deviation
Which of the following is NOT increased in pregnancy?
A. cervical mucous IgA and IgG
B. C-reactive protein
C. leukocyte alkaline phosphate activity
D. interferon
D. interferon
Which of the following inhibits coagulation? A. antithrombin B. protein C C. protein S D. all of the above
D. all of the above
Which of the following is commonly excreted in large amounts in the urine of a normal pregnant woman? A. amino acids B. glucose C. hemoglobin D. protein
B. glucose
What is the average increase in the resting pulse during pregnancy? A. 0 bpm B. 5 bpm C. 10 bpm D. 20 bpm
C. 10 bpm
Which of the following is decreased in normotensivepregnant women?
A. renin activity and concentration
B. angiotensinogen
C. sensitivity to pressor effects of angiotensin II
D. aldosterone
C. sensitivity to pressor effects of angiotensin II
In which of the following positions is cardiac output most increased in the pregnant patient? A. left lateral recumbent B. right lateral recumbent C. standing D. supine
A. left lateral recumbent
Which of the following hemodynamic values remains unchanged in pregnancy? A. systemic vascular resistance B. pulmonary vascular resistance C. colloid osmotic pressure D. pulmonary capillary wedge pressure
D. pulmonary capillary wedge pressure
What is the average increase in the volume of circulating erythrocytes during pregnancy? A. 150 mL B. 250 mL C. 450 mL D. 850 mL
C. 450 mL
Alteration of the ratio of which of the following is thought to be important in the etiology of
preeclampsia?
A. atrial natriuretic peptide:B-type natriuretic peptides
B. angiotensin:angiotensinogen
C. progesterone:dihydroprogesterone
D. prostacyclin:thromboxane
D. prostacyclin:thromboxane
Which of the following does NOT contribute to enlargement of the cardiac silhouette noted in
radiographs in normal pregnant women?
A. displacement of the heart to the left and upward
B. right atrial and ventricular dilatation
C. increase in uterine size
D. benign pericardial effusion of pregnancy
B. right atrial and ventricular dilatation
Which of the following shows an increased incidenceduring pregnancy? A. epulis B. hemorrhoids C. pyrosis D. all of the above
D. all of the above
Which of the following is decreased during normal pregnancy? A. glomerular filtration rate B. renal plasma flow C. creatinine clearance D. serum concentration of urea nitrogen
D. serum concentration of urea nitrogen
What compensated acid–base state exists during normal pregnancy? A. metabolic acidosis B. metabolic alkalosis C. respiratory acidosis D. respiratory alkalosis
D. respiratory alkalosis
What alterations in bladder function characterize term pregnancy?
A. increased bladder pressure
B. reduced bladder capacity
C. increased in functional urethral length
D. all of the above
D. all of the above
Which of the following characterizes arterial bloodpressure in normal pregnancy?
A. nadir in midpregnancy, rising thereafter
B. nadir in the first trimester, rising thereafter
C. peaks in the first trimester, falling thereafter
D. peaks in the second trimester, falling thereafte
A. nadir in midpregnancy, rising thereafter
Approximately what percentage of women report new onset stress urinary incontinence during pregnancy? A. 10 B. 20 C. 50 D. 80
C. 50
What is the average change in elevation of the diaphragm during normal pregnancy? A. 0 to 1 cm B. 2 cm C. 4 cm D. 6 cm
C. 4 cm
Pruritus gravidarum is caused by elevated tissue levels of which of the following? A. bile salts B. bile acids C. bilirubin, direct D. bilirubin, indirect
A. bile salts
Which of the following has a positive effect on prolactin secretion? A. estrogen B. serotonin C. thyroid releasing hormone D. all of the above
D. all of the above
Which of the following is decreased in normal pregnancy? A. tidal volume B. minute ventilatory volume C. minute oxygen uptake D. functional residual capacity
D. functional residual capacity
At what level does compression of the ureters by the gravid uterus occur? A. bladder trigone B. pelvic brim C. sacrospinous ligaments D. ureterovesical junction
B. pelvic brim
Which of the following central nervous system and cognitive changes has been observed in late pregnancy? A. concentration deficit B. increased irritability C. memory decline D. sleep quality improvement
C. memory decline
The increased joint mobility seen in pregnancy correlates with increased levels of which hormone? A. estradiol B. progesterone C. relaxin D. none of the above
D. none of the above
Prolactin is essential to which of the following? A. initiation of labor B. lactation C. myometrial quiescence D. placental growth
B. lactation
Which of the following is NOT true of the maternal pituitary gland during pregnancy?
A. Function is essential for the maintenance of pregnancy.
B. Prolactin-secreting macroadenomas tend to enlarge.
C. The pituitary gland enlarges by approximately 135%.
D. Pituitary enlargement does not cause significant visual changes.
A. Function is essential for the maintenance of pregnancy.
Which of the following changes in cardiac sounds iscommonly found during pregnancy?
A. muffling of the first heart sound
B. wide splitting of the second heart sound
C. systolic murmur
D. diastolic murmur
C. systolic murmur
Which of the following is NOT known to increase theconversion of 25-hydrovitamin D 3to 1,25-dihydrovitamin D 3? A. calcitonin B. low plasma calcium levels C. low plasma phosphate levels D. parathyroid hormone
A. calcitonin
Which of the following does NOT increase as a result of maternal physiological hyperparathyroidism? A. bone resorption B. kidney reabsorption of calcium C. intestinal absorption of calcium D. serum phosphate levels
D. serum phosphate levels
What is the level of testosterone in umbilical venous plasma likely to be in a pregnant woman
with an androgen-secreting tumor?
A. undetectable
B. slightly lower than maternal serum levels
C. equal to maternal serum levels
D. higher than maternal serum levels
A. undetectable
Which of the following is increased during pregnancy? A. adrenal cortisol secretion B. cortisol half-life C. cortisol clearance rate D. none of the above
B. cortisol half-life
Which of the following has a pronounced stimulatoryeffect on maternal thyroid function? A. chorionic gonadotropin B. placental growth hormone C. prolactin D. vasopressin
A. chorionic gonadotropin
Which hormone opposes the action of parathyroid hormone, protecting skeletal calcium content? A. calcitonin B. gastrin C. thyroxine D. vasopressin
A. calcitonin
Which of the following shows decreased plasma levels during pregnancy? A. aldosterone B. dehydroepiandrostenedione sulfate C. deoxycorticosterone D. androstenedione
B. dehydroepiandrostenedione sulfate
Increased maternal cardiac output is detectable as early as what gestational age? A. 5 weeks B. 10 weeks C. 20 weeks D. 15 weeks
A. 5 weeks
