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Clinical Chem II spring > Pregnancy and prenatal testing > Flashcards

Pregnancy and prenatal testing Flashcards

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1
Q

normal human pregnancy

A

40wks starting at first day of missed period/last

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2
Q

describe the 3 stages of pregnancy

A

1st day of conception 12 wks
2nd 13-26wks
3rd 26wks - delivery

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3
Q

Describe gestation

A

indication of fetal development from the last period

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4
Q

Describe conception
indication of …

A

indication of development from the date the sperm fertilizes the ovum

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5
Q

Ovulation

A

egg into the fallopian tube

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6
Q

Zygote

A

ovum is fertilized

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7
Q

Blastocyte

A

cluster of cells 5 days past fertilization

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8
Q

placenta

A

made to support fetus

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9
Q

embryo
im

A

implantation

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10
Q

organogenesis
time?

A

organs of embryo 10 wks

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11
Q

what develops at 10wks

A

heart beats, arms legs

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12
Q

What develops during the 2nd trimester

A

hiccups/genitalia

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13
Q

can babies survive being born at 26 wks

A

most premature babies can survive

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14
Q

what happens during 3rd trimester
e/b/oz

A

eyes open and blink, 7 oz, breathing

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15
Q

what happens during the last 4 weeks

A

muscle developement, fat storage, life after delivery

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16
Q

Describe delivery
wks
what inc?
what rises?
what triggers?

A

38-42 wks
progesterone inc throughout preg until close to term then they drop
estrogen rises as progesterone drops
oxytocin triggers uterine contactions (PITOCIN)

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17
Q

Describe transformation
inc ….. proportional to…
what vol inc?
what effect on ….?

A

inc plasma vol steady prop to 3rd tri
extracellular vol inc
dilutional effect on BP

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18
Q

Describe Renin-angiotensisn
affected during?
releases?
hypoth releases?
what happens with aldosterone secretion?

A

affected during pregnancy, arteries, release relaxin
hypoth releases AVP/ADH
aldosterone sec - inc plasma vol

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19
Q

Describe natural decrease in analytes
I
I
P
C

A

iron - hgb synth
iodione
protein catabolism dec - increased LDL
calcium - taken from bones

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20
Q

Describe upreg. of hormones/steriods
upreg of e/p/e.D
cardiac output?
maternal hr?
what is increased?

A

upreg of estradiol, prostagland/endo peripheral dilation
cardiac output 20% 8wks
maternal hr 10-20bpm
relaxin/prolactin incr

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21
Q

Describe GFR
inc/dec?
causes what to arteries?
volume?
what causes decreased plasma?

A

Increased
vasodilation
inc plasma vol
increased creat/BUN = dec plasma

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22
Q

Describe hyperventilation

A

inc O2 demand
atrium po2 in
pco2 dec
fully compensated respiratory alk

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23
Q

Describe cholesterol
increased …..

A

inc trig/LDL

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24
Q

Describe endocrine
inc
HCG stims?
TSH decreases?
Inc A…?

A

TBG incr (T4/T3)
HCG stim TSH
TSH dec negative feedback
inc ACTH/Cortisol

25
Q

Describe immune response
altered…
what is dec

A

altered paternal Ag
pro-inflamm dec

26
Q

Describe neuroactive
k….secretor
TRh stimulates?

A

kisspeptin - insulin secretor
TRH stimulates TSH

27
Q

Describe HCG
early detect
measuremnt type (s)?
doubles?
dec

A

early det. of preg
serial measurment
doubles every 24hr peak at 10wk
dec until 16wk

28
Q

What does the placental hormone look like (HCG)
hetero….glyco
in?
units?

A

heterodimer glycoprotein
in urine and blood
4 sub units (alph and beta)

29
Q

When do HCG levels return to normal after pregnancy

A

7-60days

30
Q

T/F downsyndrom HCG levels are 3x higher

A

false they are 2x higher

31
Q

T/F before placenta is developed prim HCG is hyperglycolsated

A

true

32
Q

Describe point of care testing
CLIA ….. what kind of test
hyper…..is detected or not?
lower levels?

A

CLIA waved testing qualitiative
hyperglycated HCG not detected
lower levels 20mil/mL

33
Q

What creates false negatives in Point of care tests
t
d
h

False positives
m
sotl

A

false Neg: too early
diluted
hook effect of HCG

False post: Medications, sit out too long

34
Q

Describe analytes for assessment
serum immunoassay
mon/tra/radio
Quantitative….
Hormones per..
No ref
Estimated

A

serum immunoassay:
monoclonal/tracer/radiography Ag
Quantitative HCG serum
hormones per mL of blood
no ref range of B-HCG
estimated gestational age

35
Q

False positives for for analytes for assessment
H
RF
Igs
Ch
End-stg

Examples:?

False Negatives

A

heterophile Abs
rheumatoid factors
IgA def
chronic renal failure
end-stage renal disease

Ex: HCG weight loss

False negative: hook effect

36
Q

Describe Alpha-fetal protein
em, what type of cells
binds to
protects
passes
rise/fall?

A

embryonic yolk sac, parenchymal cells in liver of fetus
binds to estradiol
protects fetus from immune attack
Passes placenta
rise at the end of trimester/fall 32wks

37
Q

Describe MS-AFP
fetal ab….
Anec
Omph
Low
De

A

fetal abnormal, distress, preg health
NTD
anecephaly
omphalocele
low birth weight
death

38
Q

What does MS-AFP predict
g
Indicates

screening

A

generalized
indications of preclampsia
downsyndrome/trisomy 18

screening 15-20 wks

39
Q

Describe MoM

RR

A

AFP serum to median of RR
Overcome variables
Mothers AFP/Mo RR

0.5-2.0

40
Q

False positives in MoM
mult …
incorrect calc of
gest/tob
lab

A

multi parous preg
incorrect calc of fetal gestation
gestational diabetes/tobacco
lab tech error

41
Q

Describe Fetal Amnoic fluid AFP
when..

Spina bifida

anecepahly

avoid, stable
can be tested in

A

when Ms-AFP high/ultrasound inconclusive

MoM open spina bifida = 7

MoM anecephaly = 20

Avoid contamination, stable for 7 days RT
can be tested in serum/urine/fluids

42
Q

Describe Unconjugated estriol

what type of hormone
predicts?

tri…

stability

A

E3 - steroid hormone
predicts estrogen in pregnancy
Trisomy 21/trisomy 18 (downs/edwards)
NOT STABLE

43
Q

Describe Inhibin A
what type of protein….suppliments
units
downs inc?

stability

A

glycoprotein supp. FSH
2 units: large alpha/small B
downsyndrom (21) inc during 2nd tri
MORE STABLE IN SERUM

44
Q

Describe triple/quad screen tests
time period?
includes ?
estimates?
screen for?

A

16-20wks
includes AFP/HCG E3 inhibin A
risk estimates only, not diagnostic
screen for Tri 21

45
Q

Describe Acetycholinesterase
Chol…. found in
diagn for
A
O
A

A

cholinergic enzyme found in neuro junction
diagn for anecephaly
open spinal bifinia
abnormal wall deficient

46
Q

Describe PAPP-A
glyco
what type of screening
down…etc

A

glycoprotein in placenta
1st Tri screening test - low concentration
Pat/Ed/Do/turn

47
Q

Describe progesterone
what type of hormone
healthy…
spontaneous

A

steriod hormone
healthy preg
spontaneous abortion susp. of high risk to natural fetal abortion

48
Q

Describe glucose
macrso/low
body sites?
where do they test?

A

gestational diabetes
macrosomic/low blood sugar CNS, cardiac
oral testing

49
Q

Describe fetal fibronectin

high conc in

used to asses

+ means
- means

A

high concentration in mucus lining of uterus/conc in amnoic fluid

used to asses if pt will go into labor w in 7-14 days

+ = labor
- = 24-32wks will not go into labor

50
Q

Describe neural tube defects
myelomin

A

most common/neural tube doesnt close
myelominigocele

51
Q

Describe down syndrome

A

extra copy of long arm region chrom 21
3 copies of chrom 21/ 5% trans location
maternal age increases risk

52
Q

Describe Tris 18
hwo much dont live past 8wks
100 days?

A

extra chrom 18
80% dont live past 8wks
90% 100 days death

53
Q

Describe Isoimmunization

A

fetal hemolysis disorder maternal ab against fetus, Mom Rh (-) baby Rh (+)

54
Q

Describe pre-term delivery
resp dis
lack of ?

A

earlier than 37th wks
respiratory distress syndrome lack of pulm. surfactant

55
Q

Describe pre-eclampsia
hyper/prot
trimesters?

A

hyperfension/proteinuria not understood 2/3rd Tri

56
Q

Describe Hyperemesis gravidarium

A

70% morning sickness

57
Q

Describe etopic pregancies

A

trophoblast cells attach to lining of fallopian tubes

58
Q

Describe analyte deficiencies

A

calcium levels dec in 2/3rd tri
relative idodine deficiency

Clinical Chem II spring (16 decks)

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