Physiology in Pregnancy

Question 1

how does metabolism of fat change of pregnancy

Answer 1

used more readily. Risk of becoming ketotic faster in DM1

Question 2

why do women get heartburn in pregnancy

Answer 2

LOS relaxes and there is delated gastric emptying

Question 3

true/false - leg edema is only common in pre-eclampsia

Answer 3

false - 80% of full term pregnancies have oedema

Question 4

why do pregnant women have oedema

Answer 4

they are more prone to salt and water retention

Question 5

in what disease do TSH mimicking antibodies cross the placenta

Answer 5

Graves

Question 6

effect of pregnancy on immune system

Answer 6

immunosuppressed

Question 7

changes to breasts in pregnancy

Answer 7

increase in size and vascularity, pigmentation of areola and nipple
montgomery tubercles appear

Question 8

what is the first milk expressed called

Answer 8

colostrum

Question 9

how much does blood volume increase by

Answer 9

50-70%

Question 10

name 4 cardiac quantities that increase in pregnancy

Answer 10

blood flow, cardiac output, heart rate and stroke volume

Question 11

true/false O2 consumption increases in pregnancy

Answer 11

true

Question 12

when in the supine position CO will increase/reduce by 25%

Answer 12

reduce - baby presses on IVC meaning less return and less blood available to pump out

Question 13

which heart chamber might get bigger

Answer 13

RV and LA

Question 14

effect of pregnancy on systemic vascular resistance

Answer 14

falls - means that BP falls through pregnancy

Question 15

what stage of pregnancy will BP rise

Answer 15

mid 3rd trimester

Question 16

why might a pregnant woman appear anaemic

Answer 16

blood volume increases more than haemoglobin so it becomes diluted and at an anaemic level

Question 17

which cardiovascular values decreases in pregnancy

Answer 17

BP and total peripheral resistance

Question 18

post delivery cardiac output increases/decreases

Answer 18

increases - by 80%

Question 19

what are catecholamines

Answer 19

adrenal gland hormones (dopamine, nor/epinephrine)

Question 20

deficiency of what mineral causes hypothyroidism in pregnancy

Answer 20

iodine

Question 21

decrease of blood volume postpartum

Answer 21

10% in 3 days

Question 22

describe changes to the CVS postpartum

Answer 22

straight after delivery BP falls and CO increases by 80%.

Over several weeks/months BP and TPR will increase and HR, CO and blood volume decrease back to normal

Question 23

which cardiovascular parameter takes longest to return to normal postpartum

Answer 23

cardiac output (24 weeks)

Question 24

how long does CVS generally take to return to normal

Answer 24

3 months

Question 25

respiratory things that increase in pregnancy

Answer 25

resp rate, tidal volume and oxygen demand

Question 26

what is minute ventilation

Answer 26

total volume of air that enters lungs in a minute

Question 27

respiratory things that decrease in pregnancy

Answer 27

function residual capacity and PCO2

Question 28

measures of resp function that are unchanged in pregnancy

Answer 28

PEFR and FEV1

Question 29

what is function residual capacity

Answer 29

the amount of air left in the lungs at the end of a tidal breath (more than what you can forcibly expel)

Question 30

renal values that increase

Answer 30

renal plasma flow, GFR, creatinine clearance, protein excretion, urate, size of collecting system

Question 31

renal values that decrease

Answer 31

urea and creatinine

Question 32

is GFR better or worse

Answer 32

better, up 50%

Question 33

name 3 normally pathological findings in renal system that are fine in pregnancy

Answer 33

glycosuria, microscopic haematuria and hydronephrosis

Question 34

would you expect a pregnant woman’s urea to be high or low

Answer 34

low

Question 35

pregnant women are hyper/hypocoaguable

Answer 35

hypercoaguable - go on LMW heparin to prevent DVT but stop before induced labour to reduce bleeding risk?

Question 36

what minerals increase in the blood

Answer 36

iron and folate

Question 37

WCC in pregnancy

is up/down

Answer 37

up - but immunosupressed?

Question 38

which of the following doesn’t decrease in pregnancy

a. haemoglobin
b. haematocrit
c. plasma volume
d. platelet count
e. red cell count

Answer 38

c. plasma volume