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Endo/Repro Exam 2 > Endocrinology of Pregnancy > Flashcards

Endocrinology of Pregnancy Flashcards

1
Q

What does Kisspeptin do?

A

Profoundly stimulates GnRH and initiate puberty

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2
Q

When is Kisspeptin usually seen to spike during menstrual period?

A

Right before ovulation causing LH surge

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3
Q

What is seen in a Basal Body Temperature chart?

A

Resting core temperature is measured every morning, mid-cycle there is first a decrease in BBT due to LH surge followed by an elevation in BBT showing ovulation, a dip past ovulation shows implantation and then a large increase to BBT due to progesterone

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4
Q

What is Resting Core Temperature?

A

Temperature taken as you wake up in the morning before energy is being consumed

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5
Q

Why does progesterone cause a 1 degree F increase after pregnancy?

A

Because progesterone is thermogenic

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6
Q

What time range must the ovum be fertilized around ovulation?

A

Within 24-48 hours

48 hours around ovulation

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7
Q

Where does fertilization normally occur?

A

In the ampulla

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8
Q

What is the first source of hCG?

A

Corpus luteum

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9
Q

What does hCG have similar functions as?

A

FSH
LH
TSH

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10
Q

hCG titer for “not pregnant”?

A

Below 5 mIU/mL

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11
Q

hCG titer for “pregnant”?

A

Greater than 25 mIU/mL

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12
Q

How long does 1,200 mIU/mL of hCG in early pregnancy take to double?

A

48-72 hours

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13
Q

How long does between 1,200-6,000 mIU/mL of hCG take to double?

A

72-96 hours

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14
Q

How long does it take for levels of hCG above 6,000 mIU/mL take to double?

A

Over four days

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15
Q

What cells create hCG?

A

Syncytiotrophoblasts

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16
Q

What releases relaxin?

A

Corpus luteum and later the placenta

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17
Q

What does relaxin do?

A

Promotes decidual angiogenesis of the endometrium

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18
Q

What are the two layers the placental epithelial cells form in the uterus?

A

Cytotrophoblasts

Synctiotrophoblasts

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19
Q

What anchors the placenta to the endometrium?

A

Columns of invading cytotrophoblasts

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20
Q

What forms Synctiotrophoblasts?

A

Fusion of cytotrophoblasts

21
Q

What do Synctiotrophoblasts do?

A

Are in direct contact with maternal circulation and is the major source of steroid hormone production

22
Q

What is a marker for corpus luteum and why?

A

17-hydroxyprogesterone because the placenta lacks 17alpha-hydroxylase

23
Q

What effects does hCG have?

A

Stimulates secretion of P4 from corpus luteum
Stimulates Leydig cells of male fetus to produce testosterone
Immunosuppressive activity (stops mom from rejecting baby as a graft)

24
Q

How much does progesterone increase in pregnancy?

A

100x increase in concentration

25
Q

Roles of progesterone:

A

Inhibits T cell mediated allograft rejection
Maintains uterine quiescence
Proliferation of breast lobular-alveolar structures
Suppression of milk protein synthesis during pregnancy

26
Q

What are the four estrogen types?

A

Estrone (E1)
Estradiol (E2)
Estriol (E3)
Estetrol (E4)

27
Q

Where are the estrogens primarily made?

A

Ovaries (largest)
Placenta (moderate amount)
Liver, adrenals and breasts (not as much)

28
Q

Where are most of the placental estrogens derived from?

A

Fetal androgens mostly DHEAS

29
Q

What is estrogens effect on clotting?

A

Stimulates fibrinogen

30
Q

What does estrogen cause in the myometrium?

A

Hypertrophy
Hyperplasia
Increased vascularity and blood flow to uterus

31
Q

Role of estrogen, progesterone, oxytocin and prolactin in lactation?

A

Estrogen: promotes development of ductal breast tissue
Progesterone: proliferative factor for formation of breast lobular-alveolar structures
Oxytocin: acts on muscle elements to cause contraction of ductal system
Prolactin: induces secretion of milk

32
Q

What does the placenta produce to negate uterine contractions?

A

Oxytocinase: an enzyme that negates effects of OT on contractions

33
Q

What markers are used to screen for Down syndrome?

A

Alpha-fetoprotein (AFP)
hCG
Inhibin-A
Unconjugated Estriol concentrations

34
Q

What will the levels of each of the markers in Down syndrome be?

A

AFP: low
hCG: high
Inhibin-A: high
Estriol: low

35
Q

What is the role of CRH in early and late pregnancy?

A

Early: low levels; increases DHEA; inhibit contractions by increasing cAMP in myometrium
Late: high levels; activate prostaglandins in uteroplacental tissues to cause contractions

36
Q

What allows prolactin to act on the posterior pituitary to secrete oxytocin in a pulsatile fashion?

A

Progesterone withdrawal

37
Q

What produced relaxin and what does it do?

A

Corpus luteum and placenta
Decidual angiogenesis
Soften and widens pubic symphysis and SI joints
Inhibit uterine contractions

38
Q

Progesterone affect on GI tract?

A

Increased secretions
Relaxation of SM
Decreased gastric emptying
Lowers esophageal muscle tone

39
Q

What occurs to osmolarity in a pregnant women?

A

Decreased plasma osmolarity due to marked water retention

40
Q

Why does edema occur in pregnancy?

A

Increased blood volume causes increased BP and decreased oncotic pressure due to decreased osmolarity

41
Q

What effect does progesterone have on chemoreceptors?

A

Sensitizes them to CO2 causing as increase in ventilation and decreases arterial pCO2

42
Q

What does a fall in maternal pCO2 cause?

A

More efficient transfer of CO2 from the fetus to the mothers blood

43
Q

What accounts for the darkening or dermatologic adaptations of pregnancy?

A

Increased MSH (melanocyte stimulating hormone)

44
Q

What occurs to bone metabolism in pregnant patients?

A

Increased parathyroid activity
Estrogens inhibit bone resorption as do progestins
Calcitonin levels slightly increase to counter PTH effect

45
Q

Effect of pregnancy on biliary system?

A

Estrogen inhibits bile transport

Gallbladder contraction decreased by progesterone inhibiting CCK

46
Q

What occurs to HR, CO, BP in pregnancy?

A

HR increase
CO increase
BP decrease

47
Q

In first half of pregnancy what causes increased CO?

A

Increased SV

48
Q

In latter half of pregnancy what causes increased CO?

A

Increased HR

Endo/Repro Exam 2 (18 decks)

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