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Maternal Medical Conditions Flashcards

1
Q

Type I Diabetes

A

Autoimmune disorder that destroys Beta cells in pancreas > progressive decline in insulin (complete lack of insulin results > body cells are unable to uptake glucose from blood >hyperglycaemia

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2
Q

Type II Diabetes

A

Insulin resistance possibly caused by:
- down regulation of insulin receptors due to large amounts of fat stores
- decreased cell sensitivity to insulin due to age, infection, insulin opposing drugs
Leads to decrease in glucose uptake > hyperglycaemia

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3
Q

Gestational Diabetes

A

(could be undiagnosed type I or II)
Decreased insulin production > decreased cell response to insulin or exaggerated insulin resistance > hyperglycaemia. Most GDM cases resolve after birth

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4
Q

Hyperglycaemia- two compnonets

A

Glucose deprivation and of body cells and excessive amount of glucose in the blood

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5
Q

Glucosuria

A

Glucose transporters for reabsorbing glucose back in to blood are saturated > glucose is lost in urine

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6
Q

Diabetes: thirst

A

Glucose in filtrate creates osmotic gradiant attracting water retaining > increased water volume > increased plasma osmolarity > thirst mechanism triggured

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7
Q

Glucolysation

A

deposition of glucose on blood vessels and nerves

  • NERVES: impacts function leading to neuropathies: sensory/motor reception/response slow increasing risk of injury and lack of response to stimuli
  • BLOOD VESSELS reduces gas exchange and filtration in capillaries resulting in ischemia and reduced inflammation response (healing time)
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8
Q

Cellular deprivation of glucose

A
  • Cell signalling to hypothelamus is disrupted > feelings of hunger
  • Increased lipolysis > ketoacidosis >fat deposition in blood vessels
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9
Q

Hyperglycaemia in pregnancy

A

foetal blood is also hyperglycaemic > foetal pancreas develops with overactive Beta cells and underactive alpha cells that produce glycogen > longer time for neonatal pancreas to adjust

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10
Q

Hyperthyroidism

A

increas in TH production > inc BMR > O2 consumption. Temp remission in pregnancy may occur due to the increase in thyroid binding globulins that bind excess TH

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11
Q

Hypothyroidism

A

Decrease TH > Decreases BMR > dec O2 consumption and use of metabolic fuel

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12
Q

ulcerative colitis

A

Mucosal inflammation of the bowel, comonlly the rectum characterised by active phases

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13
Q

Ulcerative colitis manifestations

A

bloody diarrhoea
fecal incontinence
abdominal pain

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14
Q

ulcerative colitis causes

A

auto immune disease stimulating inflammatory response of bowel mucosa > ulcers

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15
Q

ulcerative colitis in pregnancy

A 
remission: no problems
active phase:
increased risk of:
   - preterm birth
   - IUGR
   - inc chance of CS
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16
Q

Chron’s

A

chronic inflammation and scarring of GI tract > dec nutrient absorption (anaemia common).

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17
Q

Chron’s in pregnancy

A 
inactive = no inc risk in pregnancy 
active = will remain active during pregnancy and is associated with pregnancy loss, IUGR, preterm labour and birth
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18
Q

Cholelithiasis and cholecytitis definitions

A

Cholelithiasis: crystallisation of cholesterol due to super saturation of bile with cholesterol
Cholecytitiis: inflammation of gallbladder often caused by gall stones irritating mucosa layers

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19
Q

Pathophysiology of cholelithiasis

A

Gall stones inc risk of biliary inflammation, obstruction and pancreatitis
Obstruction > further bile concentration > reduced breakdown and absorption of fat > liver dysfunction as bile ‘backs up’ in to liver

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20
Q

Cholelithiasis and pregnancy (3 x aetiology 1 x outcome)

A
  • increased cholesterol production in pregnancy
  • oestrogens increase saturation of cholesterol in bile
  • progesterone relaxes gall bladder and bile ducts
  • cholelithiasis increases likelihood of preterm labour and birth
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21
Q

Demands on normal cardiac function in pregnancy

A
  • Increase workload (inc CO, plasma volume, SR)
  • labour and birth further increase workload
  • hypercoagulable state of pregnancy increase chance of thromboembolism
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22
Q

Rheumatic heart disease pathophysiology

A

GAS causes infalmmation of endocardium > necrosis of tissue > scarring and lesion formation > permanent deformity of heart valves (mitral valve stenosis is most common)

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23
Q

Ischemic heart disease

A

Reduced blood flow to cardiac tissue > loss of cardiac function > potentially death of ischemic tissue

24
Q

Ischemic heart disease pathophysiology

A

Narrowing of CA (by atherosclerosis) > ischemia of cardiac tissue > loss of function of tissue > angina > MI > death

25
Cardiomyopathy definition and types (4)
disease resulting in ventricular dysfunction > heart failure - dilated - hypertrophic - restrictive - postpartum
26
Dilated Cardiomyopathy
vetricular dilation with reduced systolic function
27
hypertrophic Cardiomyopathy
enlargement of ventricular myocardium > inc energy needs of heart
28
Restrictive Cardiomyopathy
stiffness of myocardium with reduced contractility
29
Postpartume Cardiomyopathy
centricular dysfunction occuring during the last month of pregnancy and up to 5 months postpartum in absence of prior cause
30
Cardiomyopathy pathophysiology
Affected ventricle is unable to pump blood > backup of blood > pulmonary hypertension, oedema and reduced CO
31
right sided cardiac failure pathophysiology
inc blood in systemic venous system > inc pressure in R heart and systemic venous system > peripheral oedema and congestion of abdominal organs
32
left sided cardiac failure pathophysiology
dec cardiac output > pulmonary hypertension and L heart pressure > pulmonary oedema (fluid in alveoli) > decrease in gas exchange
33
Thrombus
blood clot that forms in the heart of blood vessels which partially or completely occludes the flow of blood
34
Embolus
Foreign mass transported in blood that obstructs small blood vessels
35
DVT
Thrombus formation within dep veins (most common in legs). in pregnancy: - Blood stasis - Hypercoagulability - Abnormalities/damage to vessel wall
36
DVT manifestations (6)
- pain in area - unilateral oedema - redness - difficulty weight bearing - low grade pyrexia - lower abdominal pain (if pelvic veins are affected)
37
DVT and pregnancy impacts
occlusion > reduced CO > - impact foetus - impact BF - increase strain on immune system
38
Pulmonary embolism
occlusion of pulmonary arterial circulation by an embolus size will determine severity (amunt of alveoli affected) severity = speed of tissue hypoxia
39
Pulmonary embolism and baby
reduced gas exchange at placenta > risk of foetal tissue hypoxia > death
40
Anaemia
Reduction in O2 carrying capacity RBC's - IDA - Megaloblastic anaemia - sickle anaemia - Thalassemia
41
Anaemia and foetus (3)
- IUGR - preterm birth - Foetal hypoxia
42
Essential hypertension
>140/90mmHg prior to 20/40
43
Essential hypertension risk factors
- High Na intake - Excessiveve caloric intake - Advanced age - Sedentary - Excessive caloric consumption
44
Essential hypertension pathophysiology
inc arterial BP > inc strain on blood vessels > damage blood vessels and capillaries ? reduce time for gas exchange > tissue hypoxia and organ failure
45
essential hypoxia foetal impact (5)
``` IUGR Preterm birth Stillbirth Placental abruption PET ```
46
Asthma
inflammatory obstructive disease: hyper-responsiveness of airwaays to stimuli Exposure > release of inflammatory substances > initiate disruption of epithelial membrane: - cilia stop beating - disruption of mucosal integrety - damage/sloughing of epithelial cells > bronchoconstriction > hypersecretion > mucosal oedema
47
Asthma in pregnancy
``` May be improvement (bronchodilation) Uncontrolled asthma > reduced external respiration > tissue hypoxia > reducing O2 availability to foetus: - preterm labour and birth - congenital abnormalities - IUGR and low birth weight ```
48
TB
Bacterial infection of pulmonary system (myobacterium tuberculosis) > infect microphages that engulf it and may lay dormant > when active stimulates T-lymphocytes > lung necrosis > access lymph system > lymph node granulomas
49
TB during pregnancy
rarely crosses placenta untreated = maternal morbidity > impact foetal growth neonate is at risk
50
UTI types (2)
cytitis | pyelonephritis
51
UTI manifestations
- Urinary frequency - Urinary urgency - Dysuria Pyelonephritis: - Abdominal/LBP - Fever/chills - generally feeling ill
52
UTI pathophysiology
bacteria gain entry to urinary tract > ascent tract > infect urethra, bladder and kidenys.
53
Pyelonephritis
Asymptomatic bacteria can lead to pyelonephritis > acute & chronic renal pathology
54
UTI complications of pregnancy
- Preterm labour and birth - Hypertensive conditions - IUGR/SGA - Chorioamnionitis
55
Epilepsy
Group of conditions that cause seizures > abnormal discharge of electricity spreads throughout brain involving: - Cortex - Basal Ganglia - Thalamus - Brainstem > (TONIC) generalised muscle contraction and increased tone, may stop respiration > (CLONIC0 inhibitory neurons disrupt seizure > contraction/relaxation of muscles
56
Epilepsy and pregnancy
- may/may not change pattern of seizures - risks include: - injury/traima - pregnancy loss - developmental delay - epilepsy in offspring

Bioscience Complications (6 decks)

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