Pregnancy and water balance Flashcards

1
Q

What are the three key events in the ovarian cycle?

A
  1. Follicular growth
  2. Ovulation
  3. Luteal function
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2
Q

What are the gonadotrophic hormones involved in the ovarian cycle?

A

Follicle stimulating hormone (FSH)

Luteinizing hormone (LH)

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3
Q

What are the ovarian hormoes involed in the ovarian cycle?

A

Estrogen

Inhibin

Progesterone

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4
Q

Name all the hormones involved in the ovarian cycle

A

Folicular stimulating hormone FSH
Luteinizing hormone LH

Estrogen

Inhibin

Progesterone

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5
Q

When are FSH and LH at their highest?

A

Ovulation

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6
Q

When does ovulation usually occour in the ovarian cycle?

A

day 14

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7
Q

When is progesterone at its highest and when is it at its lowest?

A

Low in menses and proliferative phase

High in secretory phase

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8
Q

What happens to the foetus in maternal hyperglycaemia

A

Macrosomia

(birth weight >4kg)

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9
Q

What suppliment should diabetic patients who are pregnant take ?

A

Folic acid

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10
Q

What common drugs must be avoided in diabetic pregnancy?

A

ACE inhibiors

Statins

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11
Q

What are the blood sugar targets before and after a meal in diabetic pregnancies?

A

pre-meal <4-5.5 mmol/L

2h post meal <7 mmol/L

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12
Q

How can Type 2 diabetes be prevented after gestational diabetes?

A

Low density foods

keep weight low

exercise

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13
Q

What usually happens to the thyroid during pregnancy?

A

Increaces in size

Increased T4 production

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14
Q

What stimulates increased thyroxine production in pregnancy?

A

hCG

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15
Q

What must you do in a patient with hypothyroidism who gets pregnant?

A

increase thyroxine dose by 25mg as soon as pregnancy is suspected

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16
Q

What will happen to the child of a mother with untreated hypothyroidism ?

A

Increased abortion

preeclampsia

postpartum haemorrhage

preterm labour

less intelligent child

17
Q

What is a pregant woman with hyperthyroidism at risk of?

A

Infertility

spontaneous miscarriage

still birth

thyroid crisis in labour

Transient neonatal thyrotoxicosis

18
Q

How do you approach hyperthyroid management in pregnancy?

A

Weight and see

19
Q

What drugs can be used in hyperthyroidisim in pregnancy?

A

1st trimester - Propylthiouracil

2/3rd trimester- Carbimazole

20
Q

What percentage of woman experiance postpartum thyroiditis?

A

5%

21
Q

What regulates sodium in the body?

A

Mineralocorticoid activity

22
Q

What does mineralcorticoid activity mean?

A

sodium retention in exchange for potassium and/or hydrogen ions

23
Q

What is the main steroid with mineralocorticoid activity?

A

Aldoserone

24
Q

what hormone controls water?

A

Anti-diuretic hormone

25
Q

What releases ADH?

A

Posterior pituitary gland

26
Q

What does ADH do?

A

Acts on renal tubules to cause water reabsorption

27
Q

What does high urine osmolality mean?

A

concentrated urine

28
Q

How are sodium/water balance disorders classified?

A

Hyponaturaemia

or

Hypernaturaemia

29
Q

What does SIAD mean?

A

Syndrome of inappropriate antidiuresis

30
Q

What are the two kinds of stimuli for ADH release?

A

osmotic ( in health)

non-osmotic (in disease)