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OBSTETRICS > Maternal Physiology > Flashcards

Maternal Physiology Flashcards

1
Q

In early pregnancy, what causes the increase in the size of the uterus?

A

Estrogen and progestrone

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2
Q

After 12 weeks, what causes the increase in uterine size?

A

enlarging product of conception

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3
Q

thickening is most marked on which part of the uterus

A

fundus

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4
Q

when does the uterus become palpated suprapubically

A

12 weeks

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5
Q

by the 20th week, the fundus can be palpated where?

A

umbilicus

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6
Q

by the 36th week, the fundus of the uterus has reached where?

A

Xyphoid process

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7
Q

3 layers of the uterine musculature

A

outer hood like layer
thick middle layer composed of muscles perforated by blood vessels
inner layer with sphincter like fibers around the cervical os the fallopian tube orifices

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8
Q

What is the shape of the uterus at the start of the pregnancy?

A

pear shaped

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9
Q

at 12 weeks, the uterus will be shaped as

A

spherical

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10
Q

at term what is the shape of the uterus

A

ovoid

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11
Q

the enlarged uterus, when supine rests upon what great vessel?

A

inferior vena cava and aorta

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12
Q

early in the pregnancy (before 12 weeks) where can the uterus be palpated?

A

Pelvis

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13
Q

cervical wall thickens during pregnancy? t or f

A

true

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14
Q

what causes cyanosis and softening of cervix during pregnancy?

A

increased vascularity, edema hypertrophy and hyperplasia of cervical glands

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15
Q

eversion of the endocervical glands result into?

A

prolapsed cervical cavities and seen as reddish growth on the cervical os or squamocolumnar junction

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16
Q

this serves as a a mechanical plug that serves a barrier of the cervix from infection coming from the vagina

A

cervical mucus (rich in Ig and cytokines)

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17
Q

the cervical mucus of pregnant women when spread on a glass slide would show what pattern?

A

Beaded due to progesterone

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18
Q

if there is amniotic fluid leakage, what would be the pattern of the cervical mucus when spread on a glass slide?

A

fern due to estrogen

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19
Q

the endocervical gland hyperplasia and hypersecretory appearance is called

A

Arias Stella reaction

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20
Q

Arias stella reaction can be mistaken as what under pap smear?

A

atypical glandular cells

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21
Q

the corpus luteum produces progesterone up to how many weeks of pregnancy?

A

6-7 weeks

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22
Q

after the corpus luteum stops production of progesterone, what replaces it?

A

Placenta - from 8 weeks onward

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23
Q

besides progesterone, what other substance is produced by the corpus luteum to remodel the cervix and accommodate parturition

A

relaxin

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24
Q

a benign solid ovarian tumor due to exaggerated luteinization of normal ovary

A

pregnancy luteoma

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25
Q

benign ovarian tumors resulting from exaggerated follicle stimulation by high levels of HCG

A

theca lutein cysts

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26
Q

the increased vascularity of the vagina results in a violaceus color, this is called

A

Chadwick sign

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27
Q

what bacteria causes the vaginal ph to be acidic especially when pregnant

A

Lactobacillus acidophilus

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28
Q

breast tenderness and paresthesia is normal early in the pregnancy? t or f

A

true

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29
Q

when can colostrum start to be expressed

A

2nd trimester

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30
Q

scattered around the areola are sebaceous glands called

A

Montgomery glands

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31
Q

where does most of the weight gain obtained during pregnancy come from?

A

uterus and its contents, the breast, increase in blood volume and extravascular extracellular fluids

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32
Q

how many additional kcal per day is needed by the pregnant

A

300 k/cal per day

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33
Q

what is the total weight gain during pregnancy?

A

12.5 kg

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34
Q

water retention caused fall in plasma osmolality is about 6.5 liters, how many liters is retained by the fetus, placenta and the amniotic fluid?

A

3.5L

the other 3L comes from the increase in blood volume, increased size of the uterus and breast

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35
Q

amino acid concentrations are higher in fetal or maternal?

A

fetal

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36
Q

With regard to carbohydrate metabolism, the normal pregnancy is characterized by,

A

mild fasting hypoglycemia, postprandial hyperglycemia and hyperinsulinemia

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37
Q

when does maternal hyperlipidemia take place?

A

3rd trimester

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38
Q

How is increased demand for calcium by the fetus met?

A

by doubling calcium absorption in the intestines

39
Q

sodium and potassium concentrations are increased or decreased?

A

Decreased due to increase in plasma volume

40
Q

serum phosphate levels are increased, decreased or unchanged?

A

Unchanged

41
Q

the blood volume increase by how many percent after the 32-34th week?

A

40-45%

42
Q

Which shows a greater increase during pregnancy? erythrocytes or plasma?

A

Plasma

43
Q

The much greater increase in plasma than erythrocytes results to?

A

Dilutional anemia

44
Q

Hemoglobin at term should be?

A

12-16g/dL

45
Q

a hemoglobin concentration of lower than __ is considered as iron deficiency anemia

A

11 g/dL

46
Q

What Ig are elevated in the mucus?

A

IgA and IgG

47
Q

coagulation factors during pregnancy are elevated except?

A

factors XI and XIII

48
Q

spleen enlarges during pregnancy? t or F

A

true

49
Q

there is a decrease in the platelet concetration? t or f

A

true

50
Q

Placenta transfers iron to the fetus even when there is marked iron deficiency of the mother? t or f?

A

true

51
Q

The heart moves to what direction during pregnancy?

A

Upwards and laterally

52
Q

The displacement of the heart during pregnancy is caused by

A

the diaphragm elevating progressively

53
Q

What happens to the first heart sound during pregnancy?

A

There is splitting of the heart sound

and an easily heard third heart sound

54
Q

On chest exam, the mother exhibits cardiac murmurs, is this normal during pregnancy? y or n

A

Yes

and this disappears after delivery

55
Q

when does the cardiac output peak? Give all three

A

at 28 weeks (40%), during labor and right after delivery of placenta

56
Q

what happens with mean arterial pressure and systemic vascular resistance? increases or decrease?

A

Decrease

57
Q

stroke volume elevates by how many during pregnancy?

A

30%

58
Q

what is the effect on cardiac output when the gravid uterus compresses on the inferior vena cava?

A

Decrease due to decreased venous return

59
Q

which position causes a higher blood pressure in pregnant women? sitting or left lateral decubitus position?

A

left lateral decubitus position

60
Q

At supine position, a pregnant women may experience hypotension? t or f?

A

true

61
Q

prostaglandins in pregnancy are increased and can cause increase in blood pressure? t or f

A

true

62
Q

this substance comes from endothelial and vascular smooth muscles which is a potent vasoconstrictor. It is stimulated by angiotensin II

A

Endothelin 1

63
Q

this is a potent vasodilator from endothelial cells

A

Nitric Oxide

64
Q

the diaphragm elevates by how many during pregnancy?

A

4cm

65
Q

During pregnancy, respiratory rate increases? t or f?

A

false

66
Q

the increased respiratory effort experienced in pregnancy is caused by?

A

progesterone

67
Q

this is the shift to the left of the oxygen dissociation curve which increases affinity of maternal hemoglobin for oxygen

A

Bohr effect

68
Q

mechanical obstruction caused by the uterus results in hydronephrosis? t or f

A

True

69
Q

Glomerular filtration rate increases by 50% during pregnancy? t or f?

A

True

70
Q

BUN and creatinine clearance is lower in the pregnant women? t or f?

A

False

71
Q

What substance may be responsible for the increase in renal blood flow?

A

relaxin by nitric oxide production and vasodilation

72
Q

glucosuria may be normal during pregnancy because there is no glucose resorption increase? t or f?

A

True

73
Q

ureter compression is greater on which side? left or right?

A

right

left is cushioned by the sigmoid colon

74
Q

What hormone can possibly also cause ureteral dilatation?

A

Progesterone

75
Q

Ureteral elongation causes what to show on xray?

A

Folds

76
Q

During pregnancy, bladder pressure, increase or decrease?

A

increase

77
Q

bladder capacity, increase or decrease?

A

decrease

78
Q

what cause gum bleeding during pregnancy?

A

Gums become soft and hyperemic

79
Q

what do you call the vascular swelling of the gums?

A

Epulis

80
Q

the enlarging uterus pushes the intestines and stomach upward causing?

A

frequent heartburn and decreased gastric emptying time

81
Q

What GI abnormalities are common during pregnancy?

A

constipation
hemorrhoids
bile stasis
gallstones

82
Q

the appendix is displaced where during pregnancy?

A

Superiorly

83
Q

what happens to the endocrine system and hormones increase during pregnancy?

A

Basal metabolic rate increases
thyroid gland can become enlarged
protein bound iodine increases
parathyroid gland size increases and PTH increases
Adrenal gland hormones increase
Pituitary gland size increases and may cause visual disturbances

84
Q

The placenta produces what enzyme for the degradation of inuslin?

A

insulinase

85
Q

slightly depressed lines or streaks in the abdomen and thighs seen during pregnancy?

A

Striae gravidarum

86
Q

Strongest risk factors for striae gravidarum?

A

younger maternal age, family
history and prepregnancy weight and weight gain
during pregnancy

87
Q
  • brownish-black pigmented line in

the middle of the abdomen

A

Linea Nigra

88
Q

pigmented spots on the face

A

Chloasma or “mask of pregnancy”

89
Q

vascular elevation on

the neck, chest, abdomen, legs and arms

A

Spider nevi or angiomas

90
Q

During pregnancy, the mother may experience lordosis or jyphosis?

A

lordosis

91
Q

Separation of the recti muscles because of the

abdominal distention

A

diastasis recti

92
Q

neurological condition common in the 1st
and 2nd trimester, due to tension and increasing
hormone levels.

A

Mild frontal headaches

93
Q

Give common neurological changes during pregnancy

A

headaches due to tensin and increasing hormone levels
dizziness due to hypotension or hypoglycemia
tingling sensation due to hyperventilation leading to decreased pCO2
difficulty falling asleep

OBSTETRICS (36 decks)

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