Physiology Flashcards
HCG physiology?
Glycoprotein
Produced by syncytiotrophoblasts
Detected in maternal serum by 7 days post conception
Morning sickness caused by?
HCG
Main estrogen of pregnancy?
Estriol
High estrogen to progesterone ratio causes?
Partition
Human placental lactogen is similar in structure to?
GH and PRL
How human placental lactogen is a diabetogenic hormone?
It causes hyperinsulinemic response to glucose load
So insulin resistance is seen in pregnancy
Shift of maternal energy from ?
Anabolic to catabolic state leading to accelerated starvation
Energy metabolism shifts toward?
Fat utilisation (lipolysis)with glucose sparing
Why androgens are increased in pregnancy?
Because testosterone bonds to SHBG and free testosterone gets lower
Why DHEA hormones decreases in pregnancy?
Do not bind to SHBG
Used by placenta to conver to estrogens
Why cortisol increases ?
Due to estrogen causing increase in CBG( corticosteroids binding globulins)/transcortin
What cause abdominal striae and contribute to insulin resistance ?
High cortisol
What stimulates liver angiotensinogen production?
Estrogen
What stimulates renin ?
Estrogen and progesterone
Although high aldosterone no hypokalamia or hyponatremia in pregnancy?
Antagonistic actions of progesterone in kidney!
Why does DOC increases is it from adrenals?
No it’s because of the placental progesterone conversion to DOC
What causes volume expansion?
Aldosterone and DoC
What stimulates the thyroid gland is it TSH ??
No it’s the HCG!!
What causes iodine deficiency?
Increased renal clearance of iodide
What stimulates TBG?
HCG and estrogens
Why extra blood flow is needed?
Increased perfusion to other organs( like kidney)
Extra blood flow to the uterus
Extra metabolic needs of the fetus
Extra volume compensates for blood loss in pregnancy
What stimulates erythropoiesis
Prolactin
Human placental lactogen
Progesterone
High blood volume is much more than increase erythropoiesis leading to ?
Drop of hematocrit causing physiological anemia
How is the clotting and lysing activity equilibrated?
Increase in fibrinogen and increase in plasminogen
Total peripheral resistance decrease due to ?
Progesterone and
Increased diversion of blood from artery to venous system
Decreased vascular response to angiotensin II
Why voice changes and breathing through the nose is difficult ?
Capillary dilatation by progesterone occur in larynx and nasopharynx
What is progesterone effect on respiratory?
Lowers the set point of regulation by Co2 leading to increase in minute volume and tidal volume
The progesterone induced hyperventilating causes a mild?
Compensatory respiratory alkalosis with a decrease in pCo2
How is significant respiratory alkalosis prevented?
Decrease in Hco3
How does vital capacity remains the same while TLC decreases?
Because Tidal volume increases
What causes increase stomach volume and decrease stomach PH?
Increase of gastrin
Decrease in gastric and intestinal motility caused by?
Decrease motilin
What causes heartburn?
Decrease in gastric emptying
Increased intraabdominal pressure
Decrease lower esophageal sprinter tone by progesterone
What causes glucosuria and aminoaciduria?
Increase GFR
What predispose pregnant to UTI ?
Glucosuria
