Hormones

Question 1

Causes Insulin resistance in preg?

Answer 1

hPL and hPGH

hPL moreso incr insulin secretion, hPGH desensitizes insulin receptors

Question 2

Increases lipolysis and insulin secretion in preg?

Answer 2

hPL

Question 3

Makes prolif retinopathy worse?

Answer 3

Estrogen (due to hypercoag state, anemia)

Question 4

Causes TSH to be suppressed?

Answer 4

hCG - shares a-subunit with TSH

Question 5

Causes TOTAL T4/T3 to be elevated?

Answer 5

Estrogen (due to increase in TBG)

So get a FREE T4/T3 and it should be normal

Question 6

Causes GERD, constipation, incr risk of pylenephritis?

Answer 6

Progesterone (SM relaxant)

Question 7

Causes 50% of women with HG to become hyperthyroid?

Answer 7

hCG

Question 8

Causes Graves to improve 3rd trim?

Answer 8

Progesterone (immune modulation - humoral –> cell mediated)

Question 9

Which one crosses placenta? T3 or T4?

Timeline of fetal production?

Answer 9

Both a bit, but there are no T3 receptors on fetal brain
Baby starts to make own after 8-10 weeks
By 16-18 weeks independent production but needs maternal iodine
By 2nd-3rd trim - fully independent of maternal status