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HD 201 E2 > Maternal Adaptation: CV, Pulmo, Renal > Flashcards

Maternal Adaptation: CV, Pulmo, Renal Flashcards

1
Q

When do Cardiovascular changes become apparent during pregnancy?

A

By the first 8 weeks

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2
Q

What happens to the systemic vascular resistance?

A

Decrease

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3
Q

What happens to Cardiac Output, Heart Rate, Pulse rate, Volume, and Preload?

A

They all increase! (Doesn’t memorizing this make it easier?)

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4
Q

By how much does the pulse rate increase?

A

10 bpm

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5
Q

When does the volume increase?

A

10th-12th week

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6
Q

Where is the heart displaced during pregnancy?

A

To the left, upward, and rotated on its LONG axis

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7
Q 
Chest radiograph may show the heart as
A. Cardiomegaly
B. Apex moved medially
C. (-) benign pericardial effusion
D. with a larger cardiac silhouette
A

D. with a larger cardiac silhouette.

May be mistaken for cardiomegaly BUT IT’S NEVER CARDIOMEGALY.

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8
Q

True or False: Accdg. to 2D Echo, there is minimal regurgitation.

A

True. And accdg. to the ECG, there is a slight left-axis deviation.

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9
Q

Which cardiac sound exhibits no definite change in aortic and pulmonary elements?

A

S2

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10
Q

Which cardiac sound is exaggerated with splitting and increasing loudness?

A

S1

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11
Q

Which cardiac sound changes by 20% and may suggest pathology

A

Diastolic Murmur

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12
Q

Which cardiac sound is loud and easily heard?

A

S3

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13
Q

Which cardiac sound changes by 90% and disappear shortly after birth?

A

Systolic Murmur

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14
Q

Which heart sound changes by only 10% and is correlated with breast vasculature?

A

Soft diastolic murmur

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15
Q

Where is the ventricular muscle mass greater at term? (Right or Left?)

A

Left

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16
Q

Physiological growth and pathological hypertrophy are encompassed by what cardiac quality?

A

Cardiac Plasticity

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17
Q

What happens to the mean arterial pressure and the vascular resistance?

A

Decrease. Kaya lumalaki ang Cardiac Output kasi walang resistance, malakas pa ang pagbomba.

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18
Q

What happens to the blood volume and metabolic rate?

A

Increase. Naturally after the increase in CO.

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19
Q

During the late pregnancy, is the cardiac output increased or decreased? Why?

A

Decreased due to large uterus compressing the IVC and aorta. Uterine blood flow is decreased by 1/3

20
Q

How much higher is fetal oxygen saturation in labor? In what position of the mother?

A

10%. Left recumbent position.

21
Q

By how much is maternal CO increased?

A

approx. 40%

22
Q

True or False: Increased HR and inotropic contractility implies that Cardiovascular reserve is increased in multifetal gestation.

A

False. CV reserve is DECREASED. There’s more than one fetus being supported.

23
Q

3 Peaks in CO during pregnancy

A

28-32 weeks (7-8 months) AOG, labor, post-partum

24
Q

2 important hemodynamic fxns that do NOT change

A

capillary wedge and central venous pressure

25
Q

True or False: Pregnancy is a continuous high-output state.

A

False

26
Q

Significant decreased gradient b/w colloid osmotic pressure and pulmonary wedge pressure increases the risk of what pulmonary condition?

A

Pulmonary Edema

27
Q

When does arterial pressure decrease to nadir (lowest point)?

A

24-26 weeks (6th month)

28
Q

True or false: systolic pressure decreases more than the diastolic pressure

A

False. Diastolic pressure decreases more than the systolic pressure.

29
Q

Syndrome that affects fetal heart patterns by compressing great vessels and lowering uterine arterial pressure

A

Supine hypOtension syndrome

30
Q

RAA hormonal regulation

A

dure to estrogen and progesterone

31
Q

Cardiac natriuretic peptides secreted by myocytes

A

atrial and B-type

32
Q

Prostaglandins increased in late pregnancy

A

E2 (natriuretic), prostacyclins (PGI2) are

33
Q

Main changes in pulmonary system during pregnancy

A

Diaphragm elevated by 4 cm, Residual Volume is decreased, and Tidal Volume is increased. Vital Capacity remains the same.

34
Q

By how much does the subcostal angle widen as the transverse diameter increases?

A

by 2 cm

35
Q

The thoracic circumference increases by how much?

A

6 cm

36
Q

What happens to the minute ventilatory volume (total volume of gas exhaled per minute)

A

Increased

37
Q

What happens to minute oxygen uptake? Airway conductance?

A

Increased

38
Q

What happens to alveolar ventilation (amt of air reaching the alveoli and available for exchange w/ blood per unit time)?

A

Increased

39
Q 
Arrange the ff accdg to magnitude of increase:
Tidal Volume
RR 
Minute Ventilation
Alveolar Ventilation
A

Alveolar Ventilation > Minute Ventilation > Tidal Volume > RR

40
Q

What hormone causes total pulmonary resistance?

A

Progesterone

41
Q 
Which among the ff CHANGES during pregnancy?
A. Vital Capacity
B. Residual Volume
C. Lung Compliance
D. Total Lung Capacity
A

D. Total Lung Capacity. It decreases.

42
Q

True or False: The kidney width increases by 1-1.5 cm

A

False. The kidney LENGTH increases by 1-1.5 cm

43
Q

What does the increase in renal blood flow and interstitial volume contribute to the kidney volume?

A

3% increase

44
Q

Renal condition wherein there is a dilation of renal pelvises, calyces, and ureter in 80% of women

A

Physiological hydronephrosis

45
Q

True or False: There is a decrease in the vasopressin release and thirst osmotic threshold, causing hormones to be disposed more rapidly

A

True

HD 201 E2 (5 decks)

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