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EndocrineJaz > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

hormone that ovum produces

A

oestradiol

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2
Q

hormone that corpus luteum secretes

A

progesterone

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3
Q

implanted embryo secretes this hormone

A

hCG

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4
Q

hPL stands for ___

secreted by the ___

A

human placental lactogen

placenta

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5
Q

placenta secretes these three hormones

A

hPL
oestrogen
progesterone

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6
Q

__+__ (hormones) cause insulin resistance in pregnant mother if predisposed this =>

A

progesterones and hPL

increased bg and gestational diabetes

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7
Q

complications of diabetes in pregnancy

A 
congenital malformation
premature
IUGR (intrauterine growth retardation - if existing T1/2D)
macrosomnia (>90th centile)
polyhydramnios
intrauterine death
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8
Q

2 neonatal complications of diabetes in pregnancy

A 
respiratory distress (immature lungs)
hypoglycaemia/calcaemia (fits)
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9
Q

CNS defects of neonate if diabetes in pregnancy

A 
spina bifida (risk x5)
anencephaly
caudal regression (x200)
ereteric duplication (x20)
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10
Q

why does diabetes in pregnancy cause macrosomnia and neonatal hypoglycaemia?

A

maternal bg increased causes foetal bg to increase too

insulin therefore increases (in 3rd trimester baby produces their own) = major growth factor

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11
Q

definition by weight of macrosomnia in a neonate

A

> 4kg

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12
Q

if have T1/2D and become pregnant:

give ____, 3 monthly ___, avoid __+__

A

5mg folic acid
eye check up (accelerates retinopathy)
ACEI and statins

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13
Q

bp control in pregnancy can be (3)

A

nifedipine
methyldopa
labetolol

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14
Q

when in labour if diabetic then give __+__ so that the mother has ___

A

IV insulin and IV dextrose

good bg control

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15
Q

Rx for T1D during pregnancy =

A

insulin

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16
Q

Rx for T2D during pregnancy =

A

metformin but may go on to need insulin

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17
Q

Rx for MODY during pregnancy =

A

sulfonylureas

18
Q

Rx for gestational diabetes =

A

lifestyle and metformin

may go on to need insulin

19
Q

if have GDM the 6wk post-natal get a ___ if +ve = __

___% (80% if obese) go on to develop T2D

A

OGTT = T2D

50%

20
Q

the demand on the thyroid increases/decreases during pregnancy?

A

increases

21
Q

hCG acts like ___ in pregnancy and so fT4 ___, TSH ___ and causes ____

A

TSH
increases
decreases
hyperemesis gravidarum

22
Q

hyperemesis gravidum is caused by high ___

A

hCG

23
Q

thyroid __ in size and ___ production increases in pregnancy

A

increases

t4

24
Q

TSH and hCG return to normal at ___ in pregnacy

A

20wks

25
Q

if pregnant with existing hypothyroidism increase dose of levothyroxine by ____ asap
average overall dose increase = ___ by 20wks

A

25microg

100-150microg (50%)

26
Q

aim for TSH levels in pregnant ladies with existing hypothyroidism

A

<3mU/l

27
Q

features of hyperemesis gravidum that distinguish it from hyperthyroidism in pregnancy

A

hCG high causes TSH to be low
TRIg -ve
resolves by 20wks

28
Q

hyperthyroid drug used in 1st trimester

A

PTU (and beta blocker)

29
Q

Hyperthyroid drug used in 2nd/3rd trimester

A

carbimazole

30
Q

TRIgs +ve in the third trimester can cross the placenta and cause

A

transient neonatal thyrotoxicosis

31
Q

__% of females (___% if T1D) get postpartum thyroiditis = __>___
usually lasts ___ but can be up to ___

A 
5%
25%
hyperthyroid
hypothyroid 
1-4 months up to 1yr
32
Q

post partum thyroiditis causes a ___ goitre

and hypo phase is associated with

A

small, diffuse, non-tender goitre

postpartal depression

33
Q

if bg ___ then advise a diabetic not to get pregnant

A

> 85mmol/mol

34
Q

HbA1c is less accurate in pregnancy because

A

increased rate of RBS turnover

35
Q

IFG =

its associated predominantly with __ insulin resistance and causes ___ to increase

A

impaired fasting glucose
hepatic
fasting bg

36
Q

IGT =

ass predominantly with ___ insulin resistance and causes ___ to increase

A

impaired glucose tolerance
muscle
post prandial bg

37
Q

if reduced visual acuity improves by looking through a pinhole =

A

a refractive error

38
Q

hazy cornea and fixed mid-dilated pupil =

A

acute glaucoma

39
Q

swollen optic disk =

A

papilloedema

40
Q

curtain drawn across one eye’s vision, no pain =

A

retinal detachment

EndocrineJaz (15 decks)

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