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Flashcards in Maternal Adaptation Deck (68)
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1

What is the average uterine weight at term?
A. 200 g
B. 450 g
C. 780 g
D. 1100 g

D. 1100 g

2

What is the intact survival rate of an otherwise normal infant born at 28 weeks gestation?
A. 25%
B. 50%
C. 75%
D. 90%

D. 90%

3

Uterine enlargement in pregnancy is primarily due to what process involving myocytes?
A. hyperplasia (new myocyte production)
B. hypertrophy and stretching
C. atrophy with replacement by collagen
D. hyperplasia and hypertrophy play equal roles

B. hypertrophy and stretching

4

What is the major biological target of relaxin in assisting accommodation to pregnancy?
A. cardiovascular system
B. musculoskeletal system
C. nervous system
D. reproductive tract

D. reproductive tract

5

The gene encoding for androgen receptor has had over 100 mutations identified and is located
on which chromosome?
A. 6
B. 16
C. X
D. Y

C. X

6

For whom are the painless, irregular uterine contractions that begin early in gestation named?
A. Braxton Hicks
B. Casey Alexander
C. Sheffield Yost
D. Wendel Smith

A. Braxton Hicks

7

Uteroplacental blood flow is apparently sensitive to the regulatory effects of which of the
following?
A. catecholamines
B. estrogens
C. nitric oxide
D. all of the above

D. all of the above

8

What is the most likely complication resulting froma large pregnancy luteoma?
A. ambiguous genitalia in a male fetus
B. virilization of a pregnant woman
C. virilization of a female fetus
D. no fetal or maternal effects result

B. virilization of a pregnant woman

9

In pregnancy, what is the Chadwick sign?
A. bluish discoloration of the hyperemic vaginal mucosa
B. lower uterine segment softening
C. tenderness of breasts with enlargement
D. uterus palpable above the pubic symphysis

A. bluish discoloration of the hyperemic vaginal mucosa

10

What is the approximate uteroplacental blood flow at term?
A. 100 mL/min
B. 250 mL/min
C. 550 mL/min
D. 800 mL/min

C. 550 mL/min

11

Surgical removal of the corpus luteum of pregnancy consistently results in spontaneous
abortion if performed prior to what gestational age?
A. 7 weeks
B. 9 weeks
C. 11 weeks
D. 13 weeks

A. 7 weeks

12

Which of the following is a factor responsible for the softening and cyanosis of the cervix in
early pregnancy?
A. increased vascularity
B. decreased stromal edema
C. decreased venous oxygen concentration
D. atrophy of cervical glan

A. increased vascularity

13

What is the minimum amount of extra water that the average woman accrues during normal
pregnancy?
A. 1.0 L
B. 3.5 L
C. 6.5 L
D. 8.0 L

C. 6.5 L

14

What happens to total maternal serum levels of calcium and magnesium in pregnancy?
A. decrease
B. increase throughout pregnancy
C. increase during the third trimester
D. remain unchanged

A. decrease

15

Which of the following conditions predisposes to the development of theca-lutein cysts?
A. diabetes
B. gestational trophoblastic disease
C. multiple gestation
D. all of the above

D. all of the above

16

What are hypertrophic sebaceous glands visible on the breast areolae in pregnancy called?
A. Gatcliffe nodules
B. glands of Montgomery
C. mammary vesicles
D. papillae of Li

B. glands of Montgomery

17

What is pigmentation of the midline, anterior abdominal skin during pregnancy called?
A. striae gravidarum
B. linea nigra
C. chloasma
D. melasma

B. linea nigra

18

Despite increased red cell volume, hemoglobin and hematocrit decrease slightly during normal
pregnancy. Below what hemoglobin concentration is apregnant woman considered anemic?
A. 9 g/dL
B. 10 g/dL
C. 11 g/dL
D. 12 g/dL

C. 11 g/dL

19

Which of the following skin conditions, common in pregnancy, is likely related to
hyperestrogenemia?
A. angiomas
B. melasma gravidarum
C. palmar erythema
D. all of the above

D. all of the above

20

How does hyperreactio luteinalis differ from a pregnancy luteoma?
A. cystic, not solid
B. may cause maternal virilization
C. has a different cellular pattern
D. associated with low serum chorionic gonadotropin levels

A. cystic, not solid

21

Total body iron of an adult woman is 2.0 to 2.6 mg.What is the average iron store of a
healthy young woman?
A. 300 mg
B. 500 mg
C. 1000 mg
D. 1500 mg

A. 300 mg

22

Given the date of a pregnant woman's last menstrualperiod (LMP), what method is used to
quickly estimate the due date?
A. subtract 7 days, subtract 3 months
B. add 7 days, subtract 3 months
C. add 7 days, add 3 months
D. subtract 7 days, add 3 months

B. add 7 days, subtract 3 months

23

Which of the following coagulation factors is NOT increased during pregnancy?
A. factor VII
B. factor VIII
C. factor IX
D. factor XI

D. factor XI

24

What is the average increase in maternal blood volume during pregnancy?
A. 10%
B. 25%
C. 40%
D. 75%

C. 40%

25

What is the average weight gain during pregnancy?
A. 5.5 kg
B. 9.5 kg
C. 12.5 kg
D. 15.5 kg

C. 12.5 kg

26

Of the total 1000 g net gain of protein in normal pregnancy, how much is used by the fetus
and placenta?
A. 100 g
B. 300 g
C. 500 g
D. 750 g

C. 500 g

27

What is the average increase in fibrinogen concentration during pregnancy?
A. 10%
B. 25%
C. 50%
D. 75%

C. 50%

28

What are the iron requirements of normal pregnancy?
A. 300 mg
B. 500 mg
C. 1 g
D. 4 g

C. 1 g

29

Which of the following characterizes carbohydrate metabolism in pregnancy relative to the
nonpregnant state?
A. hypoinsulinemia
B. mild fasting hypoglycemia
C. postprandial hypoglycemia
D. fasting hyperglycemia

B. mild fasting hypoglycemia

30

Approximately how much iron is required by the fetus and placenta during pregnancy?
A. 150 mg
B. 300 mg
C. 500 mg
D. 1 g

B. 300 mg

31

What is the average blood loss with cesarean delivery of a singleton fetus?
A. 500 mL
B. 750 mL
C. 1000 mL
D. 1500 mL

C. 1000 mL

32

What is the average daily iron requirement during the second half of pregnancy?
A. 1 to 2 mg/day
B. 3 to 4 mg/day
C. 6 to 7 mg/day
D. 15 to 20 mg/day

6 to 7 mg/day

33

What volume of blood is lost on average with a singleton vaginal delivery?
A. 250 mL
B. 500 mL
C. 750 mL
D. 1000 mL

B. 500 mL

34

What is the only characteristic ECG finding in normal pregnancy?
A. shortening of the QRS complex
B. shortening of the ST segment
C. slight depression of the ST segment
D. slight left axis deviation

D. slight left axis deviation

35

Which of the following is NOT increased in pregnancy?
A. cervical mucous IgA and IgG
B. C-reactive protein
C. leukocyte alkaline phosphate activity
D. interferon

D. interferon

36

Which of the following inhibits coagulation?
A. antithrombin
B. protein C
C. protein S
D. all of the above

D. all of the above

37

Which of the following is commonly excreted in large amounts in the urine of a normal
pregnant woman?
A. amino acids
B. glucose
C. hemoglobin
D. protein

B. glucose

38

What is the average increase in the resting pulse during pregnancy?
A. 0 bpm
B. 5 bpm
C. 10 bpm
D. 20 bpm

C. 10 bpm

39

Which of the following is decreased in normotensivepregnant women?
A. renin activity and concentration
B. angiotensinogen
C. sensitivity to pressor effects of angiotensin II
D. aldosterone

C. sensitivity to pressor effects of angiotensin II

40

In which of the following positions is cardiac output most increased in the pregnant patient?
A. left lateral recumbent
B. right lateral recumbent
C. standing
D. supine

A. left lateral recumbent

41

Which of the following hemodynamic values remains unchanged in pregnancy?
A. systemic vascular resistance
B. pulmonary vascular resistance
C. colloid osmotic pressure
D. pulmonary capillary wedge pressure

D. pulmonary capillary wedge pressure

42

What is the average increase in the volume of circulating erythrocytes during pregnancy?
A. 150 mL
B. 250 mL
C. 450 mL
D. 850 mL

C. 450 mL

43

Alteration of the ratio of which of the following is thought to be important in the etiology of
preeclampsia?
A. atrial natriuretic peptide:B-type natriuretic peptides
B. angiotensin:angiotensinogen
C. progesterone:dihydroprogesterone
D. prostacyclin:thromboxane

D. prostacyclin:thromboxane

44

Which of the following does NOT contribute to enlargement of the cardiac silhouette noted in
radiographs in normal pregnant women?
A. displacement of the heart to the left and upward
B. right atrial and ventricular dilatation
C. increase in uterine size
D. benign pericardial effusion of pregnancy

B. right atrial and ventricular dilatation

45

Which of the following shows an increased incidenceduring pregnancy?
A. epulis
B. hemorrhoids
C. pyrosis
D. all of the above

D. all of the above

46

Which of the following is decreased during normal pregnancy?
A. glomerular filtration rate
B. renal plasma flow
C. creatinine clearance
D. serum concentration of urea nitrogen

D. serum concentration of urea nitrogen

47

What compensated acid–base state exists during normal pregnancy?
A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis

D. respiratory alkalosis

48

What alterations in bladder function characterize term pregnancy?
A. increased bladder pressure
B. reduced bladder capacity
C. increased in functional urethral length
D. all of the above

D. all of the above

49

Which of the following characterizes arterial bloodpressure in normal pregnancy?
A. nadir in midpregnancy, rising thereafter
B. nadir in the first trimester, rising thereafter
C. peaks in the first trimester, falling thereafter
D. peaks in the second trimester, falling thereafte

A. nadir in midpregnancy, rising thereafter

50

Approximately what percentage of women report new onset stress urinary incontinence during
pregnancy?
A. 10
B. 20
C. 50
D. 80

C. 50

51

What is the average change in elevation of the diaphragm during normal pregnancy?
A. 0 to 1 cm
B. 2 cm
C. 4 cm
D. 6 cm

C. 4 cm

52

Pruritus gravidarum is caused by elevated tissue levels of which of the following?
A. bile salts
B. bile acids
C. bilirubin, direct
D. bilirubin, indirect

A. bile salts

53

Which of the following has a positive effect on prolactin secretion?
A. estrogen
B. serotonin
C. thyroid releasing hormone
D. all of the above

D. all of the above

54

Which of the following is decreased in normal pregnancy?
A. tidal volume
B. minute ventilatory volume
C. minute oxygen uptake
D. functional residual capacity

D. functional residual capacity

55

At what level does compression of the ureters by the gravid uterus occur?
A. bladder trigone
B. pelvic brim
C. sacrospinous ligaments
D. ureterovesical junction

B. pelvic brim

56

Which of the following central nervous system and cognitive changes has been observed in
late pregnancy?
A. concentration deficit
B. increased irritability
C. memory decline
D. sleep quality improvement

C. memory decline

57

The increased joint mobility seen in pregnancy correlates with increased levels of which
hormone?
A. estradiol
B. progesterone
C. relaxin
D. none of the above

D. none of the above

58

Prolactin is essential to which of the following?
A. initiation of labor
B. lactation
C. myometrial quiescence
D. placental growth

B. lactation

59

Which of the following is NOT true of the maternal pituitary gland during pregnancy?
A. Function is essential for the maintenance of pregnancy.
B. Prolactin-secreting macroadenomas tend to enlarge.
C. The pituitary gland enlarges by approximately 135%.
D. Pituitary enlargement does not cause significant visual changes.

A. Function is essential for the maintenance of pregnancy.

60

Which of the following changes in cardiac sounds iscommonly found during pregnancy?
A. muffling of the first heart sound
B. wide splitting of the second heart sound
C. systolic murmur
D. diastolic murmur

C. systolic murmur

61

Which of the following is NOT known to increase theconversion of 25-hydrovitamin D
3to
1,25-dihydrovitamin D
3?
A. calcitonin
B. low plasma calcium levels
C. low plasma phosphate levels
D. parathyroid hormone

A. calcitonin

62

Which of the following does NOT increase as a result of maternal physiological
hyperparathyroidism?
A. bone resorption
B. kidney reabsorption of calcium
C. intestinal absorption of calcium
D. serum phosphate levels

D. serum phosphate levels

63

What is the level of testosterone in umbilical venous plasma likely to be in a pregnant woman
with an androgen-secreting tumor?
A. undetectable
B. slightly lower than maternal serum levels
C. equal to maternal serum levels
D. higher than maternal serum levels

A. undetectable

64

Which of the following is increased during pregnancy?
A. adrenal cortisol secretion
B. cortisol half-life
C. cortisol clearance rate
D. none of the above

B. cortisol half-life

65

Which of the following has a pronounced stimulatoryeffect on maternal thyroid function?
A. chorionic gonadotropin
B. placental growth hormone
C. prolactin
D. vasopressin

A. chorionic gonadotropin

66

Which hormone opposes the action of parathyroid hormone, protecting skeletal calcium
content?
A. calcitonin
B. gastrin
C. thyroxine
D. vasopressin

A. calcitonin

67

Which of the following shows decreased plasma levels during pregnancy?
A. aldosterone
B. dehydroepiandrostenedione sulfate
C. deoxycorticosterone
D. androstenedione

B. dehydroepiandrostenedione sulfate

68

Increased maternal cardiac output is detectable as early as what gestational age?
A. 5 weeks
B. 10 weeks
C. 20 weeks
D. 15 weeks

A. 5 weeks