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OBGYN > OBN: Maternal Anatomy and Physiology > Flashcards

OBN: Maternal Anatomy and Physiology Flashcards

1
Q

At 32-34 weeks AOG, the blood volume is ____% above the non-pregnant volume

A

40-45%

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2
Q

Hemoglobin cut off during the 2nd trimester

A

More than 10.5g/dL

1st - 10mg/dL
3rd - 11g/dL

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3
Q

What is the compensatory mechanism of the heart as a response to the increase of CO during pregnancy?

A

Increase in SV, Increase HR

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4
Q

The decrease in SVR is due to what hormone ____

A

progesterone

it leads to smooth muscle relaxation

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5
Q

The Tidal volume during pregnancy increases by how many percent

A

30 to 40%

Also increase in minute ventilation of 30 to 40%

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6
Q

What pulmonary parameter decrease in pregnancy?

A

Expiratory reserve volume decreases due to elevation of the diaphragm

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7
Q

Morning sickness is attributed to elevation of what hormone

A
  1. Estrogen
  2. Progesteron
  3. hCG
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8
Q

What are the changes in the GI system during pregnancy?

A
  1. Prolonged gastric emptying time

2. Decreased LES tone

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9
Q

What are the changes in the renal system during pregnancy?

A
  1. GFR increases by 50%

2. BUN, Crea decrease by 25%

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10
Q

RAAS system is activated during pregnancy resulting to increased aldosterone. In order to compensate with the increase in sodium reabsorption, the kidneys ___

A

increases GFR

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11
Q

What happens to the plasma volume during pregnancy?

A

increases by 50%

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12
Q

What happens to the RBC volume during pregnancy?

A

Increases by 20 to 30%

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13
Q

Pregnancy is considered to be a hypercoaguable state is primarily attributed to

A

Elevation in the level of fibrinogen and factors VII-XI

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14
Q

Estrogen increase during pregnancy is due primarily to what orgen?

A

placenta

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15
Q

The alpha subunit of hCG is identical to what hormones?

A
  1. LH
  2. FSH
  3. TSH
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16
Q

In early pregnancy, hCG is produced in the placenta to maintain

A

Corpus luteum

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17
Q

What hormone maintains the endometrium?

A

Progesterone

It also causes smooth muscle relaxation

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18
Q

What hormone during pregnancy is important for ensuring a constant nutrient supply to the fetus?

A

hPL

also known as hCS

It induces lipolysis with concomitant increase in circulating free fatty acids

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19
Q

MSK condition associated during pregnancy

A

Carpal tunnel syndrome (compression of the median nerve)

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20
Q

Enlargement of the uterus are due to

A
  1. Stretching

2. Hypertrophy

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21
Q

Most of the uterine wall is formed by the ___ layer

A

middle layer

this is perforated by blood vessels in all direction

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22
Q

Myocytes in the middle layer form a figure of ____ permitting it to contract after felivery

A

Forms a figure of 8

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23
Q

Dextrorotation of the uterus is due to

A

rectosigmoid

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24
Q

What are the hormones that augment NO synthase and NO production

A
  1. Estrogen
  2. Progesterone
  3. Activin
  4. Placental Growth factor
  5. Vascular endothelial growth factor
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25
Q

_____ poor crystalization of cervical mucus

A

Beading

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26
Q

____ amniotic fluid leakage; arborization of ice crystals

A

Ferning

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27
Q

___ endocervical gland hyperplasia and hypersecretory appearance which is difficult to differentiate from atypical glandular cells

A

arias stella reaction

28
Q

___ greater vascularity and hyperemia in the skin and muscles of perineum; cervix becomes violet color in characteristic

29
Q

___ slightly elevated clear or red patches that bleed easily; seen just beneath the ovarian surface; stimulated by progesterone

A

Decidual reaction

30
Q

__ hormone aids in remodeling of reproductive tract connective tissue to accommodate labor

31
Q

___ exaggerated physiological follicle stimulation; bilateral, moderately to massively enlarged cystic ovaries

A

Theca Lutein Cust

32
Q

What are the factors that is responsible for insulin resistance in pregnancy?

A
  1. Progesterone
  2. Placentally-derived growth hormone
  3. Prolactin
  4. Cortisol
  5. TNF
  6. Leptin
33
Q

Lipolysis during pregnancy

34
Q

___ hormone released by adipose tissue that is important for implantation and cell proliferation and angiogenesis

35
Q

[Electrolytes and Minerals]

What electrolytes has increased requirement

A

Iron and Iodine

36
Q

[Electrolytes and Minerals]

decreased in the serum

A
  1. Total serum calcium

2. Serum magnesium

37
Q

[Hematologic and Immunologic changes]

What increases during pregnancy

A
  1. Blood volume
  2. TH2 secretion IL4, IL10, IL13
  3. IgA and IgG
  4. Leukocyte
  5. ESR
  6. CRP
  7. Procalcitonin
38
Q

[Hematologic and Immunologic changes]

What decreases during pregnancy

A
  1. Hgb Hct
  2. Whole blood viscosity
  3. TH1 response
  4. TH1 secretion og IL2, IF alpha, TNF
39
Q

[Coagulation and Fibrinolysis]

What increases during pregnancy

A
  1. Fibrinogen
  2. Factor VII
  3. Factor X
  4. Plasminogen
  5. tPA
  6. Antithrombin 3
40
Q

[Hematologic and Immunologic changes]

What decreases during pregnancy

A
  1. Protein C
  2. Protein S
  3. Platelet count
41
Q

What are the ECG changes during pregnancy?

A
  1. Q wave in lead III
  2. Reduction in PR interval
  3. Leftward deviation of the QRS complex due to elevated diaphragm in 3rd trimester
42
Q

___ are secreted in response to chamber wall stretching; regulates blood volume by natriuresis, diuresis and vascular smooth muscle relaxation

A

ANP and BNP

43
Q

What hormone produced by the heart in response to chamber wall stretching increases in severe preeclampsia?

44
Q

____ is the principal prostaglandin of endothelium; increases in late pregnancy, decreased amount is related to preeclampsia

A

prostacyclin

45
Q

___ elevated levels is associated with preeclampsia; produced in endothelial and vascular smooth muscle; production is stimulated by Ang II, arginine, vasopressin and thrombin

A

Endothelin

46
Q

____ potent vasodilator released by endothelial cells; mediates placental vascular tone and development;

47
Q

In pregnancy, this pulmonary function parameter will not change

A

Lung comploance

48
Q

[Test of renal function: increase or decrease]

Serum creatinine

49
Q

[Test of renal function: increase or decrease]

creatinine clearance

A

increased about 30%

50
Q

[Test of renal function: increase or decrease]

kidney size

A

increase to 1cm

51
Q

[Test of renal function: increase or decrease]

GFR

A

Increase to 50%

52
Q

Ureter is displaced in this direction

A

laterally, compressed at pelvic brim

53
Q

[Increase or decrease]

Bladder muscle

A

Hyperplasia of bladder muscle, reduced bladder capacity

54
Q

Why is the proteinuria in pregnancy minimal?

A

Due to hyperfiltration and reduced tubular reabsorption

55
Q

What GI-related hormones and factors increase during pregnancy?

A
  1. ALP
  2. Serum albumin
  3. Serum globulin
  4. Leucine aminopeptidase
56
Q

What GI-related hormones and factors decrease during pregnancy?

A
  1. AST
  2. ALT
  3. GGT
  4. Bilirubin
  5. GB contractility
57
Q

What hormone in pregnancy inhbits CCK-mediated GB contraction?

A

progesterone

58
Q

[Increase of decrease]

pituitary size

59
Q

[Increase of decrease]

growth hormone (maternal)

A

increase

from 10 weeks to 28 weeks

60
Q

[Increase of decrease]

growth hormone (placental)

A

increases

secreted by syncitiotrophoblast

61
Q

[Increase of decrease]

prolactin

A

increases during normal pregnancy

62
Q

___ weeks AOG where fetal thyroid begin to concentrate iodine?

A

10-12 weeks AOG

63
Q

___ week AOG where fetus starts to secrete thyroid hormone

A

20 weeks AOG

64
Q

What is the principal glucococorticoid during pregnancy

A

Cortisol

Adrenal secretion is not elevated

65
Q

What is the principal mineralocorticoid during pregnancy?

A

aldosterone

as early as 15 weeks

OBGYN (33 decks)

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