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OBGYN Clerkship > Physiology of Pregnancy > Flashcards

Physiology of Pregnancy Flashcards

1
Q

What at what point does an embryo become a fetus

A

8 weeks (cardiac activity?)

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2
Q

Defn of grand multip

A

parity >/= 5

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3
Q

What is Charwicks sign

A

blue discoloration of cervix (early sign of preg)

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4
Q

What is goodell sign

A

softening of cervix (early sign of preg)

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5
Q

What is hegar/ladin sign?

A

softening of uterus

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6
Q

What is naegele’s rule

A

EDC = LMP + 1yr -3m + 7d

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7
Q

What are indications for US

A

uncertain gestational age
size/date discrepencies
multiple gestations

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8
Q

uterus at
pubic symphysis = __ wks
umbilicus = ___ wks
xiphoid process = ___ wks

A

12
20
36

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9
Q

How can heart sounds change in preg?

A

split S1
S3
systolic murmur (2/2 inc BV)

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10
Q

What is avg materanl HR when baby is at term

A

108 bpm

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11
Q

how does BP change in preg

A

dec 2/2 to dec in scr (2/2 effecrts of progesterone/vasodil substances being produced)

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12
Q

acid base state in preg + why?

A

compensated repiratory alkalosis

Bohr effect, inc RR inc CO2 gradient to inc gas exchange with fetus

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13
Q

Tidal volume inc or dec in preg

A

increase (dec in FRC) (also dec FRC due to elevated diapragm)

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14
Q

What is the cause of morning sickness?

A

elevated E/P/hCG

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15
Q

how do kidneys change in pregnancy?

A

they enlarge, ureters dilate (R>L), hydronephrosis, GFR increased by 50%

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16
Q

what causes ureters to dilate/hydronephrosis

A

progesterone and compression by enlarging uterus

17
Q

is preg a hypercoagulable state?

A

yes! inc E2

18
Q

why are preg women anemic

A

dilutional,there is an inc in plasma volume > inc RCV

** but still need inc Fe bc they are making more RBCs

19
Q

What is the signaling for increased intravascular volume during pregnancy

A

inc renin –> inc angiotensin –> inc Na retention –> retain fluid to inc intravascular volume

20
Q

when does hCG peak?

A

~10 weeks (doubles every 48 until this point)

21
Q

What is responsible for maintianing fetal nutrition? Effects on mom?

A

hPL: inc maternal lipolysis and dec glc uptake by mom (anti-insulin effect) which allows for more glc to be available for fetus

–> mom in diabetogenic state with glucosuria and ketonuria

22
Q

change in posture late in preg

A

hyperlordosis

23
Q

Skin changes in preg? cause?

A

spider angiomata and palmar eryethema (2/2 inc E)

linea nigra and melasma/chlosasma (2/2 inc MSH)

24
Q

How does PTH change in preg? Why?

A

increases, to cause inc Ca abs and vit D for growing fetal bones

25
Q

changes in TSH, T3/4 during preg

A

transient dec TSH nc hCG is structurally similar to TSH tp the pit gland dec production
Total T3/4 increases because thyroid binding globilin increases, howevere free T3/4 remains normal

26
Q

vits/minerals/diet changes needed in preg

A

inc kcal, folate, iron, vit C, omega 3 FA

dec vit A (teratogenic), calcium (still need but it chalates Fe)

27
Q

what are braxton-hicks contractions?

A

irreg contractions w/o cervical dilation

28
Q

how to manage GERD in preg

A

antacids , PPIs or H2 blockers if severe

29
Q

What is round ligament pain + Tx?

A

shooting pelvic pain due to round ligament stretching, Tx is tylenol + warm compress

30
Q

Tx for varicose veins in preg

A

elevate legs + compression stockings

31
Q

management for hyperemesis gravidarum

A

NPO x 3 days, IVFs + anti-emics, if very severe give doxylamine/unisom (1st gen antihistamine)+ vit B6

32
Q

management of hemorroids in preg

A

topical steroids, fiber, stool softeners, sitz baths

33
Q

how often should preg pt be seen in office during preg

A

1x in first trimester
q4wk until 28 weeks
q2wks until 36
qwk until delivery

34
Q

When is Rh status checked? how it it interpreted

A

before 28 wks, if Rh- give rhogam at week 28 and postpartum (if baby Rh+)

35
Q

how to manage baby if mom is HBsAg +?

A

infant HBIG anf HBV vaccine

36
Q

What is the biobyphysical profile (BPP)? What are the components? How it scored/interpreted?

A

prenatal US evaluation to assess baby”

The BPP has 5 components: 4 ultrasound things +NST.
The NST evaluates fetal heart rate and response to fetal movement.

The five discrete biophysical variables:
Fetal movement
Fetal tone
Fetal breathing
Amniotic fluid volume
Fetal Heart Rate

BPP >8: normal
BPP =6: get CST** see next card
BPP <4: deliver

37
Q

What is CST/OCT

A

CST/OCT (ctx stress test/oxytocin challenge test): give oxytocin, look for 3 ctx/10 min w/o late decels

**assessed if baby can tolerate labor

OBGYN Clerkship (31 decks)

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