CC Pregnancy (Reece) Flashcards Preview

P&T Block 5 Renal > CC Pregnancy (Reece) > Flashcards

Flashcards in CC Pregnancy (Reece) Deck (13)
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1
Q

Since it makes since that BV increases during pregnancy, use this to explain changes to cardiac PE, BP, and CO.

A

PE: murmurs everywhere
BP: drops due to increase TPR
CO: increases to a plateau (32 wks)

2
Q

Explain the increase in CO during labor

A

The blood that was pooling in the placenta goes through contractions
Returns to the heart
Increased BV transient - higher CO

3
Q

Why do pregnant women get edema?

A

↑Prorgsterone = relax vasc SM

Fluid into extremities: ↑venous pressure + ↓plasma oncotic pressure

4
Q

Changes to coag factors during preg - effects on PTT/PT

A

↑ factors 1 7 8 9 10
Pregnancy is a hypercoag state
BUT PTT/PT normal

5
Q

How do you manage wedge pressure (pulm) during deliviery if mom has mitral vs aortic stenosis?

A

MS: ↓wedge b/c expecting increase in blood return during preg
AS: ↑wedge to prevent downstream hemorrhage

6
Q

What change in resp physiology causes some preggo women to feel SOB?

A

↓Exp reserve volume -> ↓residual volume

7
Q

pH change during peggo

A

pH same!!

But to do this ↓PCO2 + ↓bicarb

8
Q

Changes to urine in pregnancy

A

Proteinuria - transient for preggo only

BUT if you had some underlying proteinuria, preg will make it worse (↑U protein faster)

9
Q

What heart issue is a CI to pregnancy?

A

CAD esp w/ diabetes
All the other worries: HTN, existing diabetes, retinopathy, nephropathy - can be managed
Ideally you’re bypassing pre-preg b/c no way you’re doing it during preg

10
Q

What is the teratogen in diabetes?

A

Hyperglycemia in setting of pre-existing T1 or 2 (not gestational) - control this, fix the problem
Membrane damage - free radical events to try to increase glucose metabolism
↑Apoptotic cascade (caspase)
Think big birth defects (neural tube)

11
Q

Why don’t you want to get gestational diabetes for your kid?

A

Higher risk childhood obesity

12
Q

Is transient hyper or hypothyroidism normal in preggo?

A

Hyper

More protein - binds more TH - but you need to keep the same active amount

13
Q

How do you treat a preggo woman with hyperthyroidism?

A

Goal in preggo is not to normalize blood values for T3/4
B/c any changes to meds from mom’s thryoid will affect baby’s normal thyroid (no T lowering meds)
Treat the symptoms of hyperT