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Clinical Chem 2 > pregnancy > Flashcards

pregnancy Flashcards

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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
Q

how is MS AFP measured

A

multiples of median (MoM)
mothers AFP/median of referance range

26
Q

how is MS-AFP treated when it is higher than expected

A

amniotic fluid testing
- blood interferes

27
Q

what is the MoM value indicative for spina bifida

A

7

28
Q

what is the MoM value indicative of anencephaly

A

20

29
Q

what analyte is used to screen for trisomy 21 and 18

A

unconjugated estriol, made in placenta

30
Q

trisomy 21

A

downs syndrome

31
Q

trisomy 18

A

edwards syndrome
do not live past 8 wks of gestation

32
Q

inhibin A

A

increased in trisomy 21 during second trimester
inhibites FSH

33
Q

what is included in a triple screen

A

AFP, hCG, eE3

34
Q

what does a quad screen include

A

AFP, hCG, uE3 and inhibin A

35
Q

what is the purpose of triple and quad screening

A

screening and risk estimate - not diagnostic

36
Q

describe acetylcholinesterase

A

cholinergic enzyme in neuromuscular junctions in muscle and nerves
- diagnostic for anencephaly, spina bifida and abdominal wall defects

37
Q

Pregnancy Associated Plasma Protein A (PAPP-A)

A

large glycoprotein produced in placenta
1st trimester screening
low concentrations seen w/ trisomy 21 (downs), 18 (edwards), 13 (pateu) and Turners

38
Q

what is a low concentration of PAPP-A associated with

A

trisomy 13
trisomy 18
trisomy 21
turner syndrome

39
Q

progesterone

A

establishment and maintenance of healthy pregnancy
- measured in multiple miscarriage patients

40
Q

describe complications of gestational diabetes

A
  • macrosomic (big baby)
  • low blood sugar and breathing difficulties after birth
  • CNS malformations
41
Q

fetal fibronectin

A
  • mucosal lining of uterus and amniotic fluid
  • positive result indicates labor
42
Q

neural tube defects

A
  • one of the most common birth defects
  • neural tube does not close completely
43
Q

myelomeningocele

A

spina bifida
fusion not complete along the spinal cord

44
Q

isoimmunization

A

fetal hemolytic disorder

45
Q

pre-exlampsi

A

hypertension, edema and prteinuria in third trimester - delivery to cure

46
Q

hyperemesis gravidarum

A

morning sickness - 70% of pregnancies

47
Q

ectopic pregnancy

A

trophoblasts attach to fallopian tube instead of uterine lining

Clinical Chem 2 (25 decks)

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