Week 2 Facts Flashcards

1
Q

Prenatal Care Tests: Time Duration!

1) Multiple Marker Tests
2) Gestational Diabetes
3) RBC Antibody
4) STI Check (GBS)
5) FHR Patterns

A

1) Multiple Marker Tests = 15 - 20 weeks
2) Gestational Diabetes = 24 - 28 weeks
3) RBC Antibody = 26 - 28 weeks + within 72 hrs of delivery
4) STI Check (GBS) = 35-37 weeks, GBS antibiotics at labor
5) FHR Patterns = > 28 weeks.

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2
Q

Screening: alpha-fetal protein (Yolk Sac, then Fetal liver/GI)

A
Low = Down Syndrome
High = Neural tube defect, fetal abdomen wall defect, or placenta
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3
Q

Screening: hCG (Synctiotrophoblasts in placenta)

A
Low = Ectopic or Failed Pregnancy, Edward/Patau Syndrome
High = Multiple Gestation, Down Syndrome
VERY High (100,000+) = Molar Pregnancy or Choriocarcinoma
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4
Q

Screening: Estriol (E3, only from placenta)

A

Low: Adrenal hypoplasia, fetal growth restriction, down syndrome
High: Nothing

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5
Q

Screening: Inhibin (Corpus Luteum/placental synctiotrophoblats)

A

High : Preeclampia, fetal growth restriction, Down syndrome

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6
Q

Rupture of Membrane DX

A

1) U/S to see if fluid is around the fetus
2) Pooling of fluid on the bottom blade of speculum
3) Nitrazin Test (+) = amniontic fluid > 7.1 pH
4) Ferning = wet mount

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7
Q

Non Stress Test + Contraction Stress Test

A

Non Stress Test = if nonreactive, could mean hypoxia or cardiac/neurologic anomalies. (meaning movement doesn’t show an acceleration in FHR)

Contraction Stress Test (via oxytocin) = Negative CST means that there is good compensation and labor should be fine. If Positive CST = could be difficult for labor.

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8
Q

Fetal Circulation:

Umbilical Vein
Ductus Venosum
Ductus Arteriosum 
Foramen Ovale
Umbilical Artery
A

1) Umbilical Vein = 80% saturated O2 blood
2) Ductus Venosum = bypass liver to IVC
3) Ductus Arteriosum = Take blood from Pulmonary trunk to right atrium
4) Foramen Ovale = Take blood from Left atrium to Right Atrium
5) Umbilical Artery = take 50% deoxygenated blood back to the mother.

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9
Q

Maternal Complications in Pre-eclampsia

A

HELLP Syndrome: Hemolysis, Elevated Liver Enzymes, Low Platelet. = Shistocytes (helmet cells) for hemolytic anemia

Thrombocytopenia, Placental abruption, pulmonary edema

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10
Q

MGSO4 = Use + Contraindication

A

Used for epilepsy in eclampsia but contraindicated in women with myastenia gravis (weakness and rapid fatigue of voluntary muscles)

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11
Q

Histology Preeclampsia

A

Placental: Chorionic villi surrounded by trophoblasts (underperfusion)

Renal: enlarged + endothelial cells are swollen within glomeruli. Fibrin also present.

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12
Q

hPL

A

Secreted by Placenta, “growth hormone” for fetus, induces lipolysis

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13
Q

Anti Rh (IgG) effects on fetus

A

Phagocytosis: hyperbilirubinemia/jaundice, hemolytic anemia, hepatosplenomegaly

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14
Q

Nontensive Pregnancy: Immunology

A
IL-12 = normal
TH1 > TH2
Treg = elevated, T17 = depressed
IL-6 and endoglin = normal/depressed
IL-10 = normal
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15
Q

HTN (preeclampsia) pregnancy: Immunology

A
IL-12 = Increased (involved in Th1 differentiation
Th2 > Th1 
Treg = depressed, T17 = elevated
IL-6 and endoglin = elevated
IL-10 = depressed (antiinflammatory)
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16
Q

Mechanisms of Protection from recurrent pregnancy loss

A

Trophoblast = no HLA II Antigen, Unique HLA1 molecule (HLA-G)

HLA-G = binds to ILT (immunoglobulin like transcript) receptors on immunocells and induces apoptosis

17
Q

Antiphospholipid Syndrome + Anti Nuclear Antibodies

A

Antiphospholipid Syndrome

  • Autoimmune disease = increased clotting
  • APL antibodies affects endothelial cells (increased TF) and platelets (increased thrombin)
  • Acts on complement system: Beta2GPI

Anti Nuclear Antibodies = related to systemic lupus erythematous.