Endocrinology of Pregnancy Flashcards Preview

Endo/Repro Exam 2 > Endocrinology of Pregnancy > Flashcards

Flashcards in Endocrinology of Pregnancy Deck (48):
1

What does Kisspeptin do?

Profoundly stimulates GnRH and initiate puberty

2

When is Kisspeptin usually seen to spike during menstrual period?

Right before ovulation causing LH surge

3

What is seen in a Basal Body Temperature chart?

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

4

What is Resting Core Temperature?

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

5

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

Because progesterone is thermogenic

6

What time range must the ovum be fertilized around ovulation?

Within 24-48 hours
(48 hours around ovulation)

7

Where does fertilization normally occur?

In the ampulla

8

What is the first source of hCG?

Corpus luteum

9

What does hCG have similar functions as?

FSH
LH
TSH

10

hCG titer for "not pregnant"?

Below 5 mIU/mL

11

hCG titer for "pregnant"?

Greater than 25 mIU/mL

12

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

48-72 hours

13

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

72-96 hours

14

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

Over four days

15

What cells create hCG?

Syncytiotrophoblasts

16

What releases relaxin?

Corpus luteum and later the placenta

17

What does relaxin do?

Promotes decidual angiogenesis of the endometrium

18

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

Cytotrophoblasts
Synctiotrophoblasts

19

What anchors the placenta to the endometrium?

Columns of invading cytotrophoblasts

20

What forms Synctiotrophoblasts?

Fusion of cytotrophoblasts

21

What do Synctiotrophoblasts do?

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

22

What is a marker for corpus luteum and why?

17-hydroxyprogesterone because the placenta lacks 17alpha-hydroxylase

23

What effects does hCG have?

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

How much does progesterone increase in pregnancy?

100x increase in concentration

25

Roles of progesterone:

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

26

What are the four estrogen types?

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

27

Where are the estrogens primarily made?

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

28

Where are most of the placental estrogens derived from?

Fetal androgens mostly DHEAS

29

What is estrogens effect on clotting?

Stimulates fibrinogen

30

What does estrogen cause in the myometrium?

Hypertrophy
Hyperplasia
Increased vascularity and blood flow to uterus

31

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

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

What does the placenta produce to negate uterine contractions?

Oxytocinase: an enzyme that negates effects of OT on contractions

33

What markers are used to screen for Down syndrome?

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

34

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

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

35

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

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

36

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

Progesterone withdrawal

37

What produced relaxin and what does it do?

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

38

Progesterone affect on GI tract?

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

39

What occurs to osmolarity in a pregnant women?

Decreased plasma osmolarity due to marked water retention

40

Why does edema occur in pregnancy?

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

41

What effect does progesterone have on chemoreceptors?

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

42

What does a fall in maternal pCO2 cause?

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

43

What accounts for the darkening or dermatologic adaptations of pregnancy?

Increased MSH (melanocyte stimulating hormone)

44

What occurs to bone metabolism in pregnant patients?

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

45

Effect of pregnancy on biliary system?

Estrogen inhibits bile transport
Gallbladder contraction decreased by progesterone inhibiting CCK

46

What occurs to HR, CO, BP in pregnancy?

HR increase
CO increase
BP decrease

47

In first half of pregnancy what causes increased CO?

Increased SV

48

In latter half of pregnancy what causes increased CO?

Increased HR