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Clinical Chem 2 > pregnancy > Flashcards

pregnancy Flashcards

1
Q

progesterone levels throughout pregnancy

A

increases until close to term -> used to maintain pregnancy

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2
Q

describe relationship between estrogen and progesterone

A

estrogen rise as progesterone drops

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3
Q

describe plasma volume changes during pregnancy

A

increases steadily and proportional to fetus weight in 3rd trimester
due to increased aldosterone released

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4
Q

what is the purpose of increased plasma vol in pregnancy

A
  • maintains BP
  • dilutes peripheral whole blood
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5
Q

describe action of RAAS during pregnancy

A

activated to increase plasma vol

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6
Q

describe analyte changes during pregnancy

A
  • decreased
  • protein catabolism decreases
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7
Q

what is the purpose of upregulation of hormones and steroids in pregnancy

A

causes peripheral dilation to increase cardiac output

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8
Q

GFR during pregnancy

A

increases dur to increased plasma vol

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9
Q

increased demand for oxygen impact

A

increased arterial pO2
decreased arterial pCO2

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10
Q

endocrine impacts of pregnancy

A

increased TBG and T3/T4
increased HCG (acts in place of TSH)
increased ACTH, cortisol and free cortisol

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11
Q

describe hCG assessment

A
  • early pregnancy detection
  • doubles every day until 8th week
  • decreases until 16 weeks
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12
Q

where is hCG found to test

A

urine and blood

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13
Q

how does trisomny 21 (downs) impact hCG

A

hCG levels 2x higher than expected

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14
Q

composition of hCG

A

4 subunits (2 alpha and 2 beta)

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15
Q

list multiple molecules of hCG

A
  • pituitary hCG
  • free beta subunit
  • fetal hCG
  • hyperglycosylated hCG
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16
Q

true or false
before placenta developed, primary hCG is hyperglycosylated

A

true

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17
Q

what form of hCG is detect in pregnancy tests

A

hyperglycosylated hCG

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18
Q

what can cause a false positive serum immunoassay of hCG

A
  • heterophilic Ab
  • RA factor
  • IgA deficiency
  • chronic renal failure
  • end stage renal disease
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19
Q

describe where AFP is made

A

by embryonic yolk sac first then parenchymal cells in fetal liver

20
Q

AFP binds what hormone

A

estradiol (primary estrogen)

21
Q

what can elevated levels of maternal AFP indicate

A
  • neural tube defects (mainly)
  • anencephaly
22
Q

define anencephaly

A

undeveloped brain brain and incomplete skull

23
Q

define omphalocele

A

abdominal wall defect (intestines outside)

24
Q

what can decreased maternal AFP (MS-AFP) indicate

A
  • downs syndrome
  • risk of trisomy 18
25
how is MS AFP measured
multiples of median (MoM) mothers AFP/median of referance range
26
how is MS-AFP treated when it is higher than expected
amniotic fluid testing - blood interferes
27
what is the MoM value indicative for spina bifida
7
28
what is the MoM value indicative of anencephaly
20
29
what analyte is used to screen for trisomy 21 and 18
unconjugated estriol, made in placenta
30
trisomy 21
downs syndrome
31
trisomy 18
edwards syndrome do not live past 8 wks of gestation
32
inhibin A
increased in trisomy 21 during second trimester inhibites FSH
33
what is included in a triple screen
AFP, hCG, eE3
34
what does a quad screen include
AFP, hCG, uE3 and inhibin A
35
what is the purpose of triple and quad screening
screening and risk estimate - not diagnostic
36
describe acetylcholinesterase
cholinergic enzyme in neuromuscular junctions in muscle and nerves - diagnostic for anencephaly, spina bifida and abdominal wall defects
37
Pregnancy Associated Plasma Protein A (PAPP-A)
large glycoprotein produced in placenta 1st trimester screening low concentrations seen w/ trisomy 21 (downs), 18 (edwards), 13 (pateu) and Turners
38
what is a low concentration of PAPP-A associated with
trisomy 13 trisomy 18 trisomy 21 turner syndrome
39
progesterone
establishment and maintenance of healthy pregnancy - measured in multiple miscarriage patients
40
describe complications of gestational diabetes
- macrosomic (big baby) - low blood sugar and breathing difficulties after birth - CNS malformations
41
fetal fibronectin
- mucosal lining of uterus and amniotic fluid - positive result indicates labor
42
neural tube defects
- one of the most common birth defects - neural tube does not close completely
43
myelomeningocele
spina bifida fusion not complete along the spinal cord
44
isoimmunization
fetal hemolytic disorder
45
pre-exlampsi
hypertension, edema and prteinuria in third trimester - delivery to cure
46
hyperemesis gravidarum
morning sickness - 70% of pregnancies
47
ectopic pregnancy
trophoblasts attach to fallopian tube instead of uterine lining

Clinical Chem 2 (25 decks)

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