Endocrinology of Pregnancy Flashcards

1
Q

Early in pregnancy, women can become more sensitive to ________.

A

insulin; later, however, women become resistant to insulin

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2
Q

Pregnant women have an early conversion to ____________.

A

fatty acid metabolism (because of the increased energy demands)

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3
Q

Although systemic vascular resistance decreases throughout pregnancy, ______________ stays the same.

A

pulmonary vascular resistance

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4
Q

Risk of aspiration pneumonia increases in pregnancy due to _______________.

A

the decreased tone in the LES from progesterone

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5
Q

Describe the hormone timeline of pregnancy.

A

hCG peaks first around 10 weeks and then hPL and hPGH rise from twenty weeks on.

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6
Q

When does the placenta take over hormonal regulation?

A

About 9 weeks’ gestation

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7
Q

Hormones greater than ___________ do not cross the placental barrier.

A

1,200 Daltons

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8
Q

List two functions of relaxin.

A
  • Relax the blood vessels, lowering SVR

* Increase renal blood flow and GFR

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9
Q

Explain how hCG can be used to evaluate for trisomies.

A

Down’s presents with raisd hCG and Edward’s presents with lowered hCG.

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10
Q

hPGH is very similar to GH, but because it is different by 13 amino acids it ________________.

A

is not regulated by the hypothalamus or pituitary

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11
Q

_____________ appears to be the main insulin resistance hormone of pregnancy.

A

hPGH

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12
Q

The only compound that you see exclusively in pregnancy is ____________.

A

estriol

The placenta converts DHEA to 16-OH DHEA which then gets converted to estriol.

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13
Q

Estrogen increases 100-fold during pregnancy due to _________________.

A

placental aromatase

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14
Q

Part of what makes thromboemboli in pregnancy so dangerous is _______________.

A

that they often develop in the pelvis and are asymptomatic (unlike those that develop in the legs)

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15
Q

Which placental cells accomplish most of the protein/steroid production?

A

Syncytiotrophoblasts

Syncyntio = Steroid… it also makes sense because these are the cells directly in contact with maternal blood

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16
Q

The corpus luteum is the primary producer of progesterone until _____________.

A

the placenta takes over at week 11

17
Q

___________ stimulates relaxin.

A

hCG

18
Q

Why do high levels of hCG cause hyperthyroidism?

A

The beta subunit of hCG is identical to TSH.

19
Q

Why does hPL cause diabetes?

A

hPL has weak activity at the GH receptor.

20
Q

Although hPGH does not cross the placenta, it can still ______________.

A

increase the levels of IGF in the maternal serum

21
Q

Why does the placenta need maternal LDL?

A

The placenta lacks HMG CoA reductase, so it cannot make cholesterol. Thus, all steroid hormones are synthesized from maternal precursors.

22
Q

Fetuses lack the enzyme _________, so they are protected from excess progesterone.

A

3-beta hydroxysteroid dehydrogenase

23
Q

_____________ increases the resting potential of the uterine myocyte.

A

Progesterone

24
Q

Gastroparesis typically ____________ due to the effects of progesterone.

A

worsens

Progesterone is a smooth muscle relaxant.

25
Q

Two things happen to the kidney during pregnancy (related to the endocrine system): _______________.

A

glucosuria and decreased ureteral peristalsis (leading to risk of pyelonephritis)

26
Q

_____________ induces apoptosis in endometrial T cells.

A

hCG

This is important for the protection of the fetus, which is an allograft to the mother.

27
Q

New research indicates that ____________ may have a more prominent role in causing gestational diabetes.

A

hPGH

28
Q

_________________ is given to women with luteal phase defects.

A

Progesterone

29
Q

are ketones in pregnant women worrisom?

A

no because they have an earlier shit to fatty acid metabolism because of decreased glycogen stores from the fetal-placental glucose demands.