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REPRO TEST 3 > preggers > Flashcards

preggers Flashcards

(71 cards)

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1
Q

EDD

A

expected date of delivery

LMP + 7 days, go back 3 mo add 1 yr

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2
Q

endometrium before and after preggers

A

before: basal arteries and spiral art shed with each LH change
after: spiral arteries confluent and drop womens SBP by 20%

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3
Q

what IGg crosses placenta?

A

IgG maternal immunity

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4
Q

hcg

A

human chorionic gonadotropin maintains corpus luteum

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5
Q

maintains uterine lining and stim. mammary glands

A

estrogen

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6
Q

stimulates mammary glands, gives fetus energy

A

placental lactogen

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7
Q

mimics GH, promote maternal insulin resistance and high blood glucose

A

placental lactogen

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8
Q

softens cervix and weakens pubic symphysis

A

relaxin

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9
Q

complciations of relaxin

A

pelvic pain y

double jointedness

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10
Q

3 main vascular changes

A

decreased tone
decreased SVR by 20%
vena cava compression

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11
Q

2 blood changes

A

blood volume increase by 50-100%
RBC mass increase 25-40%

anemia relative - dilutional

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12
Q

t/f placenta keeps acth and cortisol levels high

A

true

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13
Q

release of ACTH triggers

A

release of POMC
= hyperpigmentation of pregnancy
linea nigra, melisma

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14
Q

CO dramatically…mester

A

increases during 2nd and 3rd tri 35+%
by
decreases during post partum 6 mo

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15
Q

BV

A

increases a ton 2 and 3rd tri

by 30+%

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16
Q

HR increases

A

2nd and 3d tri

by 10-15%

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17
Q

SV

A

increases in 2nd and 3rd by about 10%

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18
Q

by 8 wks gestation mom cardiac changes underway t/f?

A

true

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19
Q

changes in maternal pump

A

cardiac axis displaced cephalad and left
PMI elevated and lateral
Left axis deviation

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20
Q

t//f preggers have increase in dysrhythmias

A

true

to hypokalemia may be part of this due to increased mineral corticoid activity

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21
Q

during contractions SVR increases by..

A

10-15%

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22
Q

PVR decreases by

A

34%

78 in pregnant and 119 in not pregnant

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23
Q

CO increases by

A

43%

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24
Q

why does SVR increase during labor?

A

autotransfusions 300-500cc

labor causes SNS overdrive = increase constriction

blood is squeezed back into central circulation during contractions

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25
in general uterus is at the pelvic brim by__wks
12
26
uterus is to the umbilicus at
20wks
27
renin is stimulated by __ and __
progesterone and placenta
28
increased renin means what 3 things
increased sodium absorption, potassium excretion and water retention (6-8L) leads in increase in blood volume
29
with high blood volume what renal changes do you see?
GFR increases by 50% | dilution of plasma proteins = lower colloid oncotic pressure = increase edema
30
hydroureter due to
progesterone relax peristaltic ureter muscles uterus obstrunction leads to slow down on right urinary stasis = dilation
31
complications of hydroureter
dilation renal pelvices, calyce | increased kidney size
32
__ diameter increases by 2 cm and circumference by 5-7cm
transverse thorax | increased min. ventilhation
33
tidal volume increases with pregd by
30-40%
34
FRC is reduce by ___ due to ?
20% due to smaller lung size at end of respiration
35
3 resp changes
less IRV l larger tidal vol smaller residual vol
36
ph changes
compensated respiratory alkalosis at placenta: more co2 exits fetal circ. more co 2 exhealed per min
37
6 main GI changes
1. slower motility - progesterone 2. LES relax 3. increased clot risk 4. increased GB stones 5. variation free hormone levels 6. vomiting
38
what causes HEG
HCG
39
highest point of HCG
9-12 wks
40
HEG is more common with multipreg why?
more placentas = more HCG
41
___mimics TSH
HCG
42
HCG increases T3/T4 which leads to
nausea
43
if TSH level abnormal in 1st tri check t3/t4 and then..
recheck in 2nd tri
44
3 main ortho changes
1. altered center of gravity 2. altered gait 3. greater joint laxatiy
45
why spider angiomata and palmar erythema?
increased CO
46
maternal glucose crosses placenta by __
diffusion baby gets more glucose higher mom's glucose = more insulin baby makes
47
neonates of DM moms become hypoglycemic post birth due to..
too much insulin
48
3 areas baby stores glucose
liver, trunk and shoulders
49
higher prevalence of gestation DM in what races
Hispanic, AA, NA, Asian and pacific islander
50
fetal gestational DM complication with bile
hyperbilirubinemia
51
t/f all preg should screen for gestation dm
true
52
gestation screen occurs at __wks
24-28wks
53
screen for gestation dm early?
yes if pt has RF: BMI over 30, hx
54
if early gestation screen is normal..
repeat screen at 24-28wks
55
test for gestation dm
give 50 gm sugar wait 1 hr - check if abnormal 3hr GTT or FBS at 2 hr
56
preggers more susceptible to
CMV, HSV, Varicella, Malaria
57
pregnancy decrease sx of autoimmune dz t/f
true
58
what is included in torch titer
``` Toxoplasmosis Other Rubella CMV HSV ```
59
dz bad if preggers get for kid
``` toxoplasmosis hep B syphilis varicella rubella rubeola CMV HSV ```
60
across all tri this ifxn can cause still birth
toxoplasmosis most severe in 1st tri raw meat or cat feces
61
varicella most dang in 1st tri may cause
life threatening dz for infant
62
has 50% rate of malformation | hearing loss, deafness, blind, heart and neuro, mental retardation
rubella
63
t/f cmv part of herpes family
true
64
mental retardation, hydrocephalus, microcephaly blind, deaf
CMV | if occur in first tri try abx
65
HSV 1 or 2
blind, MR..death if ll1st outbreak with preg HSV encephalopathy check lesions prior delivery
66
varicela can cause
infant encephalopathy | maternal PNA
67
CMV risk
retinitisis
68
HIV risk
perinatal transmission
69
parvovirus B19 risk
fetal hydrops
70
syphillis
PTL, PTD, IUGR, fetal hydrops
71
group b strep
GBS PNA or sepsis

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