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OB GYN > Maternal Physiology > Flashcards

Maternal Physiology Flashcards

0
Q

Uterine enlargement is primarily stimulated by ___ and also by ___

A

ESTROGEN

Progesterone

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1
Q

Uterine enlargement causes the ___ and ___ of muscle cells

A

Stretching

Hypertrophy

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2
Q

Other accumulation in part of the uterine enlargement

A

Accumulation of fibrous tissue

Increased in elastic tissue

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3
Q

The production of new myocytes are ___

A

LIMITED

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4
Q

The weight of a nonpregnant uteus and its capacity

A

70 grams

10ml or less

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5
Q

The weight of a prenant uterus and its capacity

A

1100 gram at term

5-20 liters

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6
Q

The position of a pregnant uterus

A

Dextrorotated

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7
Q

Layer of the uterus which is composed of dense muscle fibers perforated in all direction by blood vessels

A

Middle layer

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8
Q

The layer of uterus which consist of sphincter like fiber around the fallopian tube and internal os of the cervix

A

Inner layer

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9
Q

Irregular, painless contractions which is unpredictable, sporadic, nonrhythmic and intensity varies

A

Braxton hicks

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10
Q

Braxton hicks approximates __ mmhg

A

15-25 mmHg

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11
Q

The uteroplacental blood flow near tearm

A

450-650ml/min

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12
Q

Vasodilation in the maternal placental blood flow is mediated by?

A

Estrogen
Progesterone
Nitric oxide

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13
Q

Increased in fetal-placental blood flow happens on the ___ weeks were uterine artery doubles

A

20

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14
Q

Changes in the cervix during pregnancy

A

Increased vascularity and edema

Hypertrophy and hyperplasia of cervical gland

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15
Q

Copius amount of a tenacious mucus that obstruct the cervical canal soon after conception

A

Mucus plug

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16
Q

Only a __ corpus luteum of pregnancy can be found in the ovaries of a pregnanct women

A

SINGLE

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17
Q

Corpus luteum functions maximally during the first ___ weeks of pregnancy

A

6-7 weeks

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18
Q

The ovarian pedicle increases in about __ cm at term

A

2.5 cm

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19
Q

This is secreted by the corpus luteum, placenta, decidua and also be expressed by the heart, brain, kidney

A

Relaxin

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20
Q

Functions of relaxin:

A

☑️ Remodelling of the reproductive tract tissue during pregnancy
☑️ Initiation of AUGMENT renal hemodynamics and DECREASE osmolality

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21
Q

Solid ovarian tumor composed of large acidophile luteinized cells

A

Pregnancy luteoma

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22
Q

Solid, complex appearing UNILATERAL mass, with cystic features that correspond to areas of hemorrhage

A

Pregnancy luteoma

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23
Q

Pregnancy luteoma can cause ___ virilization only

A

Maternal

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24
Q

This is a self limited, due to exaggerated physiological follicle stimulation (hyperreactio luteinalis)

A

Theca lutein cyst

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25
Q

This is usually BILATERAL and associated with gestational trophoblast disease

A

Theca lutein cyst

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26
Q

Theca lutein cyst is also associated in large palacentas such as those found in patients with _ and in patients with _

A

DM, D-isoimmunization, Multiple fetuses

Chronic renal disease, Hyperthyroidism

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27
Q

What are the three change in the fallopian tubes?

A

☑️ Undergoes little hypertrophy during pregnancy
☑️ Epithelium of tubal mucosa flattened
☑️ Decidualization may be seen

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28
Q

Vaginal and perineal changes on labor and delivery:

A

✔️ Increased in the thickness of the mucosa
✔️ Loosening of the connect tissue
✔️ Hypertrophy of the smooth muscle cells

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29
Q

What is the vaginal pH?

A

3.5 - 6.0

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30
Q

Two changes in the skin:

A

Striae gravidarum

Diastasis recti

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31
Q

Hyperpigmentation cause __ and __ this is due to __

A

Linea negra
Chloasma or Melasma gravidarum
Increase MSH

32
Q

Vascular changes are due to ___ examples are __ and __

A

Hyperestrogenemia
Vascular spiders, angioma, nevus os telangiectasia
Palmar erythema

33
Q

Breast will have HYPERTROPHIC sebaceous gland formation called __

A

Galnds of montgomery

34
Q

Weight gain in pregnant women is attributed to:

A

Uterus and its content
Breast
Blood volume
Extravascular extracellular fluid

35
Q

What is the approximate weight gain during pregnancy:

A

12.5 kg or 27.5 lbs

36
Q

Maternal reserve is attributed to ___ and ___

A

Increased in water and deposition of new proteins and fats

37
Q

Total water retention during pregnancy ___, divided into two parts with their corresponding volumes

A

6.5 liter
Fetus, placenta, amniotic fluid (3.5 liters)
Increased in plasma volume, uterine, and breast size (3.0 liters)

38
Q

Pitting edema in pregnancy is due to?

A

Partial vena cava occlusion

Decreased in interstitial colloid osmotic pressure

39
Q

Protein metabolism:
Grams contained in the fetus and placenta
Grams added to the uterus, breast, maternal blood

A

500 grams

500 grams

40
Q

CHO metabolism in normal pregnancy:

A

Mild fasting hypoglycemia
Post prandial hyperglycemia
Hyperinsulinemia

41
Q

Insulin resistance is ___ in pregnancy to about ____

A

INCREASED

45-70%

42
Q

Insulin resistance is mediated by:

A

Estrogen
Progesterone
Human Placental Lactogen

43
Q

This is the most consistent change in lipid metabolism durinjg pregnancy

A

Maternal hyperlipidemia

44
Q

Maternal hyperlipidemia is due to:

A

✔️ Decreased circulating levels and activity of lipoprotein lipase
✔️ Estradiol and Progesterone hepatic effects

45
Q

Leptin and Ghrelin serum levels are ___ and these are mainly secreted by ___

A

INCREASED

Adipocytes

46
Q

How many mEq of sodium is retained? How many in potassium?

A

1000 mEq

300 mEq

47
Q 
Increased or decreased or Unchanged:
Ionized calcium
Total calcium
Magnesium
Phosphate
GFR of Na and K
Reabsorption of electrolytes
Excretion of electrolytes
A 
Unchanged
Decreased
Decreased
Unchanged
Increased
Increased
Unchanged
48
Q

Fetus accumulates __ grams of calcium at term which is met by:

A

30 grams
☑️ Doubling maternal calcium intestinal absorption
☑️ Dietary intake of sufficient calcium

49
Q

Hypervolemia accounts for:

A

☑️ To meet metabolic demands of the enlarging uterus
☑️ To provide abundant nutrients and elements to support the growing fetus and placenta
☑️ To protect mother and fetis against deleterious effects of impaired venous return in the supine and erect position
☑️ To safeguard the mother against the adverse effect of blood loss associated in parturition

50
Q

___ in both RBC and Plasma begins within the ____ and expans rapidly in the ___

A

Increased
1st trimester
2nd trimester

51
Q

Total iron requirement during pregnancy: _____ mg
To the fetus and placenta: ___ mg
Lost portion: ___ mg
To 450 ml of circulating erythrocytes: ___ mg

A

1000 mg
300 mg
200 mg
500 mg

52
Q

Blood volume increased at near term by ___%

A

40-45%

53
Q

Rate of increase in iron requirement

A

6-7 mg/day

54
Q 
Increased or decreased or unchanged:
Iron requirement
Blood volume 
Hgb
Hct
A

Increased
Increased
Decreased
Decreased

55
Q 
Increased or decreased or unchanged:
All clotting factors except XI and XIII
Platelets
Anti-thrombin levels
Clotting time
Fibrinogen
Thromboxane A2
Activated C protein resistance
Protein S
Protein Z
Clotting factors XI and XIII
A 
Increased
Decreased
Unchanged
Unchanged
Increased
Increased
Decreased
Decreased
Increased
Increased
56
Q

Increased or decreased or unchanged:
T helper 2 cells suppresion
CD4 T lymphocytes
Monocytes

A

All are decreased

57
Q 
Increased or decreased or unchanged:
T helper 1 cells suppression
T cytotoxic 1 cells
Interleukins 4,6,13
IgA and IgG
Leukocyte counts
CD8 T lymphocytes
CRP, ESR, C3, C4, leukocyte alkaline phosphatase
A

All are INCREASED

58
Q 
Increased or decreased or unchanged:
Systemic vascular response
ECG
CO
HR
Plasma volume
Pulmonary vascular resistance
A2 and P2
Preload
MAP
Pulmonary capillary wedge pressure
A 
Decreased
Unchanged
Increased
Increased
Increased
Decreased
Unchanged
Unchanged
Increased
Decreased
59
Q 
Increased or decreased or unchanged:
S1 splitting
BP on sitting
CVP
Antecubital venous pressure
S3 sound
Basal metabolic rate
A 
Increased
Decreased
Unchanged 
Unchaged
Increased
Increased
60
Q

10% if women have this due to supine compression of great vessels that may affect directly the fetal heart rate patterns

A

Supine hypotension syndrome

61
Q

Increased or decreased or unchanged:
Renin
Aniotensin
Plasma volume

A

ALL are INCREASED

62
Q

Renin is produce by:

A

Maternal kidney and Placenta

63
Q

Angiotensinogen is produced by:

A

Maternal and Fetal liver

64
Q

There is an ___ refractoriness in angiotensin II refractoriness in normal pregnancy and lost immediately after delivery of the placenta

A

Increased

65
Q

Increased or decreased or unchanged:
ANP
BNP

A

ALL are UNCHANGED

66
Q

Diaphragm rises about ___ during pregnancy
Subcostal angle widens appreciably as the transverse diameter of the thoracic cage increase about ___
Thoracic circumference increases about ___

A

4cm
2cm
6cm

67
Q 
Increased or decreased or unchanged:
Tidal volume
FRC
Maximum breathing capacity
Minutes Ventilatory colume 
Residual volume
Timed vital capacity
Minute oxygen uptake
Peak expiratory flow
Total pulmonary resistance
Lung compliance
Airway conductance
Critical losing volume
Total oxygen carrying capacity
A 
Increased
Decreased
No change
Increase
Decrease
Unchange
Increased
Decreased
Decreased
Unchange
Increased
Increased
Increased
68
Q

Urinalysis:
Glucosuria
Proteinuria
Hematuria

A

Normal
Abnormal
Contamination

69
Q

Increased or decreased or unchanged:

Gastric emptying time

A

Increased

70
Q

Common during pregnancy and is mostblikely caused by reflux of acidic secretions into the lower esophagus

A

Pyrosis

71
Q

Increased or decreased or unchanged:

Lower esophageal tone

A

Decreased

72
Q

Increased or decreased or unchanged:
Intraesophageal pressure
Intragastric pressure

A

Lower

Higher

73
Q

Increased or decreased or unchanged:

Esophageal peristalsis have: speed and amplitude

A

Decreased

Decreased

74
Q 
Increased or decreased or unchanged:
Serum aspartate transaminase
Alanine transaminase
Glutamyl transaminase
Leucine aminopeptidase
Bilirubin
Gall bladder contractility
Alkanine phosphatase
Serum albumin
A 
Decreased
Decreased
Decreased
Increased
Decreased
Decreased
Increased
Decreased
75
Q

The unchanged level in endocrine in pregnancy:

A

Growth hormones

TRH

76
Q

The decreased level in endocrine pregnancy:

A

Dehyroepiandrosterone sulfate

77
Q

IOP in pregnancy is ___
Vitreous outflow is ___
Corneal sensitivity ___

A

Decreased
Increased
Decreased

78
Q

Brownish red opacity on the posterior surface of the cornea

A

Krukenberg spindles

OB GYN (11 decks)

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