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Obs Gynae > RELEVANT PHYSIOLOGY > Flashcards

RELEVANT PHYSIOLOGY Flashcards

1
Q

What are the probable/presumptive signs of pregnancy

A

Chadwick’s sign aka Jacquiemers sign - bluish discolouration of Cx , vagina , vulva
Hegar’s sign (6 weeks )
Goodles sign - softening of cervix (6 weeks )

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2
Q

Mc site of implantation

A

Upper part of posterior uterine wall

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3
Q

Which of the following is true

  1. Implanatation is always eccentric (one half bigger then the other side )
  2. PISKACEKS SIGN means unequal growth of uterus d/t lateral implantation
  3. OSLANDER’S SIGN means lateral vaginal fornix pulsations
  4. PALMER’S SIGN means regular rhythmic uterine contraction
  5. HARTMAN’S SIGN means spotting during implantation (implantation bleeding not a problem )
  6. All these signs at 8 weeks
A

All of the above are correct

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4
Q

Other name of PALMER’S sign

A

Brackton hick contractions / braxton hicks

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5
Q

What is implantation window

A

D20-D24 of menstural cycle is implanatation window

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6
Q

Retaintion of salt and water in pregnant state is brought about by

A

Estrogen

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7
Q

2 conditions in pregnancy where progesterone has no role and are totally controlled by estrogen

A

Obstetric cholestasis

Salt and water condition

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8
Q

Amount of water retention in pregnancy

A

6.5 L

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9
Q

Which of the following is true

  1. Plasma osmolality decreases 10mos/kg
  2. BMR increases by 10-20%
  3. Extra calories required per day
A

All of the following are TRUE

Extra calories required per day are - 350 k.cal/day

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10
Q

Which of the following is false

  1. Pregnancy is a state of insulin resistance
  2. Pregnancy is characterised by fasting hypoglycaemia and post-prandial hyperglycaemia
  3. in pregnancy pt. have hypolipidaemia
  4. Pregnant lady have mild hypotrhyroidism
  5. Mc anemia in pregnancy is iron deficiency anemia
A

I pregnancy pt. have hyperlipidaemia

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11
Q

Total iron requirement in pregnancy is

A

1000mg

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12
Q

Total iron required by foetus in Px
Iron requirement in 1st half of Px
Iron requirement in 2nd half of Px

A

300mg
3-4mg/day
6-7mg /day

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13
Q

Range of anemia in Px
Anemia
Severe anemia
Very severe anemia

A

Anemia - <11g/ml
Severe anemia - <7g/ml
Very severe anemia - <4g/ml

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14
Q

W.B.C count in pregnancy

W.B.C count immediate after post-partum

A 
Increase upto 15K (neutrophilia)
Upto 30K (d/t physiological)
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15
Q

What happens to the avg platelet count in Px

A

Decreases but thrombocytopenia does not occur

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16
Q

What happens to the following clotting factors in pregnancy

1,2,5,7,8,9,10,11,12,13

A

11 and 13 decreases
2,5,12- constant
1,7,8,9,10-increases

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17
Q

The following increase or decreases

  1. Fibrinogen
  2. CRP
  3. ESR
A
  1. Fibrinogen-increases
  2. CRP-increases
  3. ESR-increases
18
Q

Which of the following is false

  1. In pregnancy plasma volume increases by 40%(40-50%)
  2. In pregnancy RBC mass increases by 20%
  3. Increase in plasma volume begins as early as 6th week
  4. Increase in RBC mass begins as early as 6th week
A

4 is false

Increase in RBC mass begins as early as 8th weeks

19
Q

What happens to O2 carrying capacity in pregnancy

A

It decreases

Reason being it is function of Hb

20
Q

Cardiac output increases by what % in pregnancy
Starts increasing by which weeks of Px
Maximum at

A

40%
7th week
30-32 weeks

21
Q

Which of the following is false

  1. O2 requirement increased by 20%
  2. Arterio-venous O2 gradient is decreased
  3. Mean arterial pressure falls by 15-30mmHg
A

Mean arterial pressure falls by 5-10mmHg

22
Q

CNS changes that occurs in Px

A

Pituitary gland is mainly effected
Pituitary gland size increases in size by 135%
Pt. may also suffer from Sheehan syndrome

23
Q

Sheehan syndrome is seen in

Earliest feature of Sheehan syndrome

A 
Post partum haemorrhage 
Blood loss 
Hypovolumic shock 
-lacks lactation 
-ammenorric 
-all ant. Pituitary hormones decrease but post. Pituitary is spared
24
Q

What happens to the gastric emptying time during Px

Comment on the statement - Px pt suffers form reflux esophagitis

A

It shows no change
Only during labour it increases therefore we keep them on oral fluids
True Px pt suffers from reflux esophagitis ……this occurs due to progesterone that relaxes L.E.S d/t this reflux is increased

25
Q

Comment on spleen in a Pregnant pt

A

Splenic area increases by 50%

26
Q

Only ALP which is heat stable is

A

PALP (Placental ALP)

27
Q

Comment on the following during Px
ALP
ALT
AST

A

AST,ALT shows physiological fall

ALP shows physiological increase (occurs d/t release of placental ALP)

28
Q

Comment on the following during px

  1. Size of kidney
  2. Renal blood flow
  3. Serum creatinine
  4. BUN
  5. GFR
  6. Ureter
  7. Bladder pressure
A
  1. Kidney increase in length by 1cm
  2. Increase by 80%
  3. Decrease
  4. Decrease
  5. Increase by 50%
  6. Hydroureter (smooth muscle relaxation by progesterone )
    * hydronephrosis also found
  7. Increase from 8cmH2O to 20cm H2O
29
Q

State the following true or false
1. Hydroureteric changes more on right as compared to left
Why? Support your answer

A

True
In pregnant female uterus is dextro
Therefore right ureter is compressed by uterus on pelvic brim

30
Q

Comment on the following during Px

  1. Heart rate
  2. Heartsounds
  3. Murmur
  4. Position of heart
  5. ECG
  6. Chest X-ray
  7. BP
A
  1. Increase at term by 20%
  2. Loud , S3 heard (gallop rhythm), splitting of S1
    3.
    -Systolic murmur (physiological upto grade 2 )
    -diastolic murmur (pathological)
    -ejection systolic murmur
  3. Heart moves upwards and rotates anteriorly therefore apex beat at 4 ICS
  4. Left axis deviation
  5. -Straightening of left heart border
    -cardiac silhoutle appears bigger but no cardiomegaly ( it would be pathological)
  6. DBP>SBP (but both falling , SBP more falling
31
Q

When does maximum fall in BP occurs during px

More cases of pre eclampsia tends to aggravate during 3rd trimester. why?

A

2nd trimester

Because during 3rd trimester BP begins to increase

32
Q

What happens to after load ,preload and central venous pressure in px

A

After load -Decreases (d/t decrease in systemic vascular resistance )
Preload- increases
Central venous pressure - no change

33
Q

Supine hypotension syndrome in px

A

In left lateral position their is increase in fetal O2 saturation by 10%

34
Q 
Absence seizures 
State true or false 
1. Loss of consciousness present 
2. Tone normal
3. Gradual Onset
4. Last for less than 30 sec
5. No post ictal paralysis 
6. Start at age of 4-8 yrs
A

3 is wrong as it has abrupt onset

35
Q

Seizures affecting minor motor movements are

Comment on the remission method of these seizures

A

Absence seizures they are subtle Motor signs positive that is minor Motor movement seen
It has got spontaneous remission 60 to 70% by 18 years of age

36
Q

Diagnosis of absence seizure is made by

A

EEG
In it we find bilateral 2 to 4 Hz spike and wave forms precipitated by hyperventilation
Last for 1 to 3 minute
Aka Spike and dome pattern

37
Q

What is Spike and dome pattern

A

Seen in absence seizures on EEG these are bilateral 2 to 4HZ Spike and wave precipitated by hyperventilation

38
Q

What are the features of atypical absence seizures

A 
Loss of consciousness is less abrupt
Associated with mental retardation
Resistant to drugs (anti-epileptic drugs)
EEG =2.5 HZ Spike and wave
Structural abnormalities
39
Q

Causes of myoclonic seizures

A

Hypoxia
Degeneration
Metabolic causes

40
Q

A patient with hanging will develop which type of seizure

A

Myoclonic seizure

41
Q

A patient with any arrythmia will develop which type of seizure

A

Myoclonic seizure

Obs Gynae (7 decks)

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