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Emma Repro > Maternal Physio, Preconception Counseling > Flashcards

Maternal Physio, Preconception Counseling Flashcards

1
Q

during pregnancy, hemangioma can appear on genitals due to effect of…

A

estrogen

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2
Q

pH of vagina during pregnancy

A

3.5-6 (acidic, may become moreso)

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3
Q

changes to vascular tree during pregnancy

A
  • uterine a. diameter doubles
  • uterine BF inc
  • vasodilatation (estradiol, progesterone)
  • v. dilate, less competent
  • lymph channels open
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4
Q

breast changes during pregnancy

A

leakage at 12 wk

sebaceous gland hypertrophy at 5-15 wk

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5
Q

linea nigra

A

black pigmented area in midline

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6
Q

strie graviderum

A

stretch marks

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7
Q

skin changes during pregnancy

A
  • inc sweating, sebum

- hair loss

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8
Q

blood during preg

A
  • rbc mass inc
  • disproportionate inc in plasma and rbc vol –> HEMODILUTION
  • hypercoaguable state
  • inc hepatic synthesis of proteins
  • reduced total plasma proteins (albumin)
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9
Q

chest changes during preg

A
  • displaced diaphragm
  • heart displaced up, left
  • apex moves laterally
  • straightening of L border of heart
  • inc prominence of pulmonary conus
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10
Q

respiratory changes during preg

A
  • chest shape/circumference inc
  • inc in O2 consumption
  • mucosa of nasopharynx –> hyperemic and edematous
  • HYPERVENTILATION –> inc tidal vol
  • respiratory ALKALOSIS
  • arterial O2 is unchanged
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11
Q

progesterone effects on respiration

A

stimulant of respiration and respiratory drive

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12
Q

cardiovascular changes during preg

A
  • heart size inc
  • murmurs
  • ECG positional changes
  • extrasystoles
  • output rises
  • HR rises
  • progesterone dec SVR
  • inc angio II –> water and sodium retention
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13
Q

cardiac exam in pregnancy - which type of murmurs are common?

A

systolic

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14
Q

cardiac exam in pregnancy - which type of murmurs are potentially pathologic?

A

diastolic

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15
Q

ECG changes

A

left axis deviation

  • sagging ST segments, inversion or flattening of T wave
  • mammary souffle
  • arrythmias
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16
Q

best position to lay in while pregnant

A

lateral decubitus, avoids venocaval compression

17
Q

COP during preg

A

progesterone –> dec SVR –> low bp –> inc COP

18
Q

urinary changes during preg

A
  • inc renal BF
  • inc excretion and reduced blood urea, creatinine
  • mild glycosuria (inc GFR)
  • inc water retention –> dec plasma osmolality
  • HYDRONEPHROSIS
19
Q

GI tract changes during preg

A
  • progesterone –> relax LES –> reflux
  • reduced GI motility (inc absorption, inc constipation)
  • delayed emptying
  • gallbladder may dilate
  • CHL gallstomes
  • spongy, friable gums
20
Q

ptyalism

A

xs saliva

acidic saliva contents

21
Q

pseudocyesis

A

-false pregnancy, unknown cause

22
Q

follicle development - 2 phases

A
  1. gonadotropin independent phase

2. gonadotropin dependent phase

23
Q

meiosis of oocytes is arrested at

A

prophase I

24
Q

When is meiotic division of oocytes completed?

A

just prior to ovulation

25
Q

sperm binding protein on oocytes

A

ZP3

26
Q

endometrium stromal cells (fb-like)

A

get transformed by steroid hormones like progesterone into decidua

27
Q

implantation window

A

about 4d, 6-10d after LH peak

28
Q

decidua basalis

A

uterus at site of impact (interacts with trophoblast)

29
Q

immune protection of early implantation

A
  • maternal immune cells removed
  • maternal/decidual/conceptus cells release CRH which blinds to receptors on surface of trophoblast –> expression of Fas –> immune cell death
30
Q

placenta accreta

A

Abnormal adherence of the placenta to the uterine wall (attaches to myometrium)

31
Q

placenta increta

A

Abnormal adherence of the placenta THROUGH the myometrium.

32
Q

placenta percreta

A

Abnormal adherence in which the placenta invades through the myometrium to the uterine serosa and even to adjacent organs (bladder, rectum)

33
Q

low-pregnancy weight consequences

A

gastroschisis

34
Q

type I pregestational diabetes

A
  • AI, destroys beta
  • onset earlier in life
  • need insulin therapy
35
Q

type II pregrestational diabetes

A
  • MORE COMMON
  • onset later
  • peripheral insulin resistance
  • relative insulin deficiency
  • obesity
36
Q

human placental lactogen

A
  • anti-insulin, lipolytic effects
  • peripheral insulin sensitivity during 3rd trimester falls by 50%
  • higher basal hepatic glucose output
37
Q

specific genetic testing

A
  • Canavan (neuro, infancy, white matter, aspartoacylase)
  • Tay-Sachs
  • cystic fibrosis
38
Q

Comm meds to avoid during preg

A
  • acne
  • asthma
  • DM (stop oral, start insulin)
  • HTN ( NO ACEi or ARB)
  • hypERthyroidism (use propylthiouracil dur 1st trimester)
39
Q

Fick equation

A

kA(P2-P1)/D

k=diffusion constant
A=area for gas exchange
P=diff in partial pressure
D=diffusion distance

Emma Repro (23 decks)

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