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REPRO TEST 3 > preggers > Flashcards

preggers Flashcards

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
Q

in general uterus is at the pelvic brim by__wks

A

12

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26
Q

uterus is to the umbilicus at

A

20wks

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27
Q

renin is stimulated by __ and __

A

progesterone and placenta

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28
Q

increased renin means what 3 things

A

increased sodium absorption, potassium excretion and water retention (6-8L)

leads in increase in blood volume

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29
Q

with high blood volume what renal changes do you see?

A

GFR increases by 50%

dilution of plasma proteins = lower colloid oncotic pressure = increase edema

30
Q

hydroureter due to

A

progesterone relax peristaltic ureter muscles

uterus obstrunction leads to slow down on right

urinary stasis = dilation

31
Q

complications of hydroureter

A

dilation renal pelvices, calyce

increased kidney size

32
Q

__ diameter increases by 2 cm and circumference by 5-7cm

A

transverse thorax

increased min. ventilhation

33
Q

tidal volume increases with pregd by

34
Q

FRC is reduce by ___ due to ?

A

20% due to smaller lung size at end of respiration

35
Q

3 resp changes

A

less IRV l
larger tidal vol
smaller residual vol

36
Q

ph changes

A

compensated respiratory alkalosis

at placenta: more co2 exits fetal circ.
more co 2 exhealed per min

37
Q

6 main GI changes

A
  1. slower motility - progesterone
  2. LES relax
  3. increased clot risk
  4. increased GB stones
  5. variation free hormone levels
  6. vomiting
38
Q

what causes HEG

39
Q

highest point of HCG

40
Q

HEG is more common with multipreg why?

A

more placentas = more HCG

41
Q

___mimics TSH

42
Q

HCG increases T3/T4 which leads to

43
Q

if TSH level abnormal in 1st tri check t3/t4 and then..

A

recheck in 2nd tri

44
Q

3 main ortho changes

A
  1. altered center of gravity
  2. altered gait
  3. greater joint laxatiy
45
Q

why spider angiomata and palmar erythema?

A

increased CO

46
Q

maternal glucose crosses placenta by __

A

diffusion baby gets more glucose

higher mom’s glucose = more insulin baby makes

47
Q

neonates of DM moms become hypoglycemic post birth due to..

A

too much insulin

48
Q

3 areas baby stores glucose

A

liver, trunk and shoulders

49
Q

higher prevalence of gestation DM in what races

A

Hispanic, AA, NA, Asian and pacific islander

50
Q

fetal gestational DM complication with bile

A

hyperbilirubinemia

51
Q

t/f all preg should screen for gestation dm

52
Q

gestation screen occurs at __wks

53
Q

screen for gestation dm early?

A

yes if pt has RF: BMI over 30, hx

54
Q

if early gestation screen is normal..

A

repeat screen at 24-28wks

55
Q

test for gestation dm

A

give 50 gm sugar wait 1 hr - check

if abnormal 3hr GTT or FBS at 2 hr

56
Q

preggers more susceptible to

A

CMV, HSV, Varicella, Malaria

57
Q

pregnancy decrease sx of autoimmune dz t/f

58
Q

what is included in torch titer

A 
Toxoplasmosis  
Other
Rubella 
CMV 
HSV
59
Q

dz bad if preggers get for kid

A 
toxoplasmosis 
hep B 
syphilis 
varicella 
rubella 
rubeola 
CMV 
HSV
60
Q

across all tri this ifxn can cause still birth

A

toxoplasmosis
most severe in 1st tri
raw meat or cat feces

61
Q

varicella most dang in 1st tri may cause

A

life threatening dz for infant

62
Q

has 50% rate of malformation

hearing loss, deafness, blind, heart and neuro, mental retardation

63
Q

t/f cmv part of herpes family

64
Q

mental retardation, hydrocephalus, microcephaly blind, deaf

A

CMV

if occur in first tri try abx

65
Q

HSV 1 or 2

A

blind, MR..death if ll1st outbreak with preg
HSV encephalopathy
check lesions prior delivery

66
Q

varicela can cause

A

infant encephalopathy

maternal PNA

67
Q

CMV risk

A

retinitisis

68
Q

HIV risk

A

perinatal transmission

69
Q

parvovirus B19 risk

A

fetal hydrops

70
Q

syphillis

A

PTL, PTD, IUGR, fetal hydrops

71
Q

group b strep

A

GBS PNA or sepsis

REPRO TEST 3 (7 decks)

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