Pregnancy Flashcards

1
Q

Describe the pattern of lutenizing hormone throughout the ovarian cycle

A

Peaks just before ovulation then sharply falls

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2
Q

What happens in stage one of the ovarian cycle?

A

Follicle grows and produces oestrodiol

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3
Q

What is stage two of the ovarian cycle?

A

Ovulation

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4
Q

What is stage three of the ovarian cycle?

A

Formation of corpus luteum

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5
Q

Which hormones do the corpus luteum produce?

A

Oestradiol and progesterone

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6
Q

In which stages are oestrogen found?

A

1 2 and 3

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7
Q

In which stages are progesterone found?

A

3 alone

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8
Q

What hormone, measurable in urine, does the fertilised ovum produce?

A

HCG

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9
Q

Which hormones do the placenta secrete?

A

Human placental lactogen
Placental progesterone
placental oestrogen

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10
Q

Which hormones can cause insulin resistance?

A

hPL

Progesterones

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11
Q

In which trimester is gestational diabetes most likely?

A

3rd

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12
Q

What complications can be present in GDM?

A

Macrosomia
Polyhydramnios
IU death

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13
Q

What complications may be present in the neonate?

A

If premature, respiratory distress
Hypoglycaemia
Hypocalcaemia

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14
Q

By how much is the risk of CNS defects increased due to GDM?

A

5x

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15
Q

Why does hypoglycaemia occur?

A

If mother producing too much insulin and foetus makes own insulin at 3 months then after birth, loses insulin supply.

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16
Q

What is the definition of macrosomia?

A

Heavier than 4kg/ 8 8oz

17
Q

What folic acid dosage is given to pre-conception women?

18
Q

What can be given for BP control?

A

Labetalol
Nifedipine
Methyldopa

19
Q

What are some side effects of labetalol?

A

Postural hypotension
Tiredness
Liver damage
difficulty in micturition

20
Q

What are some side effects of nifedipine?

A

GI disturbance
oedema
headache

21
Q

What are some side effects of methyl dopa?

A

Depression
Liver damage- routine LFTs in first 12 weeks
Drowsiness affecting driving
xerostomia

22
Q

What pre-meal blood sugar is ideal?

A

less than 5.5 - 6

23
Q

What is given during delivery?

A

IV insulin

IV dextrose

24
Q

Which one of the SU are appropriate for use in pregnancy?

A

Glibenclamide

25
How is the resolution of gestational diabetes tested?
Glucose tolerance test (GTT)
26
If a patient is already on thyroxine how much should this be increased by during pregnancy?
50%
27
What effect can hyperemesis have on TFT?
Lowered TSH | High fT4
28
How often should thyroid be checking during pregnancy in pre-existing hypothryoidism?
Every month for 20 weeks
29
What are the risks with untreated hypothyroidism?
Pre-eclampsia, postpartum haemorrhage, abortion. | Neurological underdevelopment
30
How can thyrotoxicosis occur in pregnancy?
Hyperemesis increases hCG which lowers TSH which results in high T4
31
What is the treatment for thyrotoxicosis?
Should resolve by 20 weeks
32
What are the risks involved with hyperthyroidism and pregnancy?
Infertility Spontaneous abortion Thyroid storm in labour
33
What drugs can be given to settle hyperthryoidism?
Labetalol PTU in 1st trimester Carbimazole in 2/3rd trimester
34
What is the risk with using PTU?
Liver toxicity
35
What are the issues around using carbimazole?
Scalp abnormalities | GI abnormalities
36
What are the issues with TRAb?
Can cross the placenta and cause neonatal transient hyperthryoidism
37
When can the patient become hypothryoid, after pregnancy?
Around 3 months
38
What symptom can appear with hypothyroidism?
Post natal depression
39
What drug can you add if become hypothryoid?
Thyroxine