Maternal Adaptations to Pregnancy Flashcards
(114 cards)
1
Q
What does not affect weight gain in pregnancy
A
smoking
2
Q
Fetus is dependant on mother for
A
glucose
calcium
Thyroxine.
3
Q
Insulin resistance in mother is max @
A
24-28 wks of pregnancy
4
Q
in pregnancy there is Fasting ____ and PP ______
A
fasting hypoglycemia and PP hypreglycemia
5
Q
Vit D req in pregnancy
A
10 mcg / 400 IU
6
Q
RDA of calcium in Pregnancy
A
1200 mg
7
Q
Fat metabolism in pregnancy
A
Hyperlipidemia .
all are inc. = LDL, HDL. VLDL, Cholesterol, Lipoprotein, Apolipoprotein.
8
Q
Shape of Non Pregnant Uterus
A
Pear.
9
Q
Shape of Pregnant uterus.
A
Globular to Spherical (12 w) to Ovoid
10
Q
Braxton hicks contraction.
A
Sporadic, Infrequent contractions in second trimester.
False Labour pain.
11
Q
VEGF and PGF in Normal and PIH.
A
Inc in Normal preg and dec in PIH
12
Q
microRNAs that cause remodelling of spinal arteries.
A
mir - 34 and mir 17-92
13
Q
Predictors of PIH
A
VEGF - dec
PGF - dec
S-Flt1 - inc
NO - dec
14
Q
Appearance of Cervical mucus on slide.
A
Beaded appearence
15
Q
Flora of Vagina.
A
Lactobacilli - Doderlein bacteria.`
16
Q
pH of vagina in pregnancy
A
3.5
17
Q
only organism that can survive acidic media.
A
Candida.
18
Q
Most common vaginitis in pregnancy
A
Candidiasis.
19
Q
Theca lutein cyst is seen in
A
Inc HCG conditions - Molar P, Choriocarcinoma, Twin Preg.
Placentomegaly.
Hyperthyroidism and Preeclampsia.
20
Q
KFC in colostrum .
A
Dec K- Potassium
F- Fat.
C- Carbs
21
Q
Extra caloric req in preg.
A
+ 350 kcal/day
22
Q
Extra Caloric req in lactation.
A
+ 650 kcal/day.
23
Q
Blood volume ___ during pregnancy.
A
Inc by 40-45 %
24
Q
Plasma volume ___ during pregnancy.
A
Inc by 40 %
25
RBC volume ___ during pregnancy
Inc by 20%
26
Viscosity ____ during preg.
Dec coz of hemodilution = Physiological Anemia.
27
Hb Mass ____ during preg
Inc. so Inc oxygen carrying capacity.
28
Hb Concentration ___ during preg.
Decreases.
29
Total plasma protein ___ during preg.
Inc
30
Plasma protein concentration ___ during preg.
dec.
31
Globulin ___ during preg.
Inc.
| SHBG and Thyroid binding globulin - inc
32
Albumin ___ during preg.
Dec.
33
WBC ___ during preg
Inc
34
TLC during Preg
15000
35
DLC during preg
Neutrophils and T lymphocytes - Inc
| Monocytes- Dec
36
Pregnancy is a _____ state
Diabetogenic. Immunocompromised state. Hypercoagulable state.
37
Humoral Immunity _____ in preg
Inc - TH2
38
Cell mediated immunity ____ in preg
Dec - TH1
39
IL- that inc in pregnancy
4, 10, 13
40
Clotting factors that dec in Pregnancy
Factor 11 and 13
41
Inflammatory markers ____ during preg.
Inc - ESR and CRP
42
Fibrinolytic Activity ____ during preg
Dec - More clots.
43
TPA - tissue plasminogen activator ___ during preg.
Inc.
44
Bleeding time and clotting time ____ during preg.
Unchanged.
45
parameters of iron metabolism____ during preg.
Dec Exception- Serum transferrin and TIBC - Inc
46
RDA of Iron during pregnancy
4-6 mg / day
47
Anemia Mukt bharat Programme.
60 mg elemental iron + 500 mcg folic acid
48
Iron Salt in Anemia mukt programme.
Ferrous sulphate.
49
Iron salt in Mala D and Mala N
Ferrous fumarate.
50
Hyperemesis gravidarum
Excessive vomiting plus Wt loss, Dehydration, Alkalosis, Hypokalemia, Starvation ketosis.
51
Mx of Mild Morning sickness
Vit B6
Doxylamine.
Doxylamine + Pyridoxine (b6)
Diphenhydramine.
52
Mx of Moderate Vomiting.
Promethazine.
Prochlorperazine.
Metoclopramide.
Ondansetron.
53
Mx of Severe vomiting.
IV fluids + Thiamine.
| IV metoclopramide / Promethazine / Promethazine / Ondansetron.
54
Mx of Intractable vomiting.
Enteral or parenteral nutrition.
55
Resp changes in Preg.
RV- Residual Volume - Dec.
ERV- Exp reserve Volume - Dec
TV- Tidal volume - Inc.
Minute Ventilation- Inc.
56
Transverse diameter ___ during preg.
inc by 2 cms.
57
Circumference of chest ___ during preg.
Inc by 6 cms.
58
Subcostal angle ___ during preg.
Inc from 68 to 103 degree
59
Functional residual capacity ___ during pregnancy.
Dec.
| FRC= RV + ERV
60
Inspiratory capacity ____ during pregnancy
Inc.
| IC= IRV + TV
61
Total lung capacity ___ during preg.
Normal or Slightly dec.
62
Proteinuria >300 mg/dl in pregnancy
PIH
63
GFR ___ during Pregnancy
Inc
64
S. urea, S. uric acid, S. Creatinine ___ during pregnancy
Dec.
65
Size of liver ___ during pregnancy
Normal / unchanged
66
All liver enzymes _____ During Pregnancy
Decrease.
| Excpt- Alkaline phosphatase.
67
Serum alkaline phosphatase ___ during pregnancy
Increase
68
Serum alkaline phosphatase is synthesised by ____ during pregnancy
Liver and placenta
69
Cholestasis of pregnancy aka
recurring jaundice of pregnancy
70
Icterus gravidarum aka
Recurring jaundice or Cholestasis of pregnancy
71
Icterus gravidarum is seen in
3rd trimester
72
Cholestasis / Icterus gravidarum - Pathogenesis
Improperly cleared bile acids leads to accumulation causing preterm labour, RDS, fetal distress
73
Cholestasis - Obstetric MX
TOP @ 38-39 wks
74
Cholestasis of pregnancy - Medical Mx
Anti histamines for pruritus
| DOC for bile acid removal- Ursodeoxycholic
75
Why is Cholestyramine C/I in cholestasis of pregnancy
It reduces absorption of vit k causing Hemorraghic problems
76
MCC of acute liver failure in pregnancy
Acute fatty liver of pregnancy
77
Acute fatty liver of Pregnancy- Pathogenesis.
Defective Long chain fatty acid oxidation .
Gene defective is LCH AD
Long chain 3 Hydroxyacyl CoA Dehydrogenase.
Accumulation leads to Acute liver injury and Hemoconcentration leading to Ascites and pulmonary edema with renal failure and fetal death.
78
Clinical features of Acute fatty liver of pregnancy
Nausea vomiting in 3rd trimester
1 week later jaundice.
inc - BP, Proteinuria and edema.
79
Acute fatty liver of pregnancy- Investigative findings.
```
inc bilirubin - <10
Inc SGOP, SGPT <1000
Inc alkaline phosphatase
dec Clotting factors.
inc BT, CT, PTT
inc S. Urea, S. Creatinine, S. Uric Acid.
```
80
Acute fatty liver - Mx
TOP - Immediate.
| Mode of delivery- Vaginal > CS
81
Acute liver injury - Complications in recovery phase.
Pancreatitis and diabetes insipidum.
81
Acute liver injury - Complications in recovery phase.
Pancreatitis and diabetes insipidum.
81
Acute liver injury - Complications in recovery phase.
Pancreatitis and diabetes insipidus.
81
Acute liver injury - Complications in recovery phase.
Pancreatitis and diabetes insipidum.
81
Acute liver injury - Complications in recovery phase.
Pancreatitis and diabetes insipidum.
82
Cholestasis - best Investigation
inc Serum Bile acids.
mild jaundice - <4-5
SGOT and SGPT - normal or slightly elevated <250 IU/l
Alkaline phosphatase in inc.
83
Hormones produced by adrenal glands.
Mineralocorticoid- Aldosterone.
Glucocorticoid- Cortisol.
Androgens- Testosterone.
84
All hormones produced by Adrenal glands ____ during pregnancy excpt..
Inc...
| Excpt DHEA and DHEA-S
85
Inc Na+ and K+ _____ is seen in pregnancy
Retention.
86
Hormones produced by Antr Pituitary
LH, FSH, TSH, GH, ACTH, Prolactin.
87
Hormones produced by Antr pituitary _____ during pregnancy
Inc
| Excpt- LH and FSH - due to inc Negative feedback by progesterone and estrogen.
88
Platelet count _____ during pregnancy
Decreases.
| Known as Benign gestational thrombocytopenia.
89
MCC of Hypothyroidism in pregnancy in developing countries.
Iodine deficiency
90
MCC of hypothyroidism in pregnancy in developed countries
Hashimoto thyroiditis.
| TH1 mediated ds.
91
RDA of iodine in pregnancy
250 mcg / day
92
Iodine req ____ during pregnancy
Ince
93
Thyroid binding globulin ____ during preg
inc .
94
Free T3 and Free T4 levels ____ during pregnancy
Normal coz of Inc Thyroid binding globulins.
95
Size of thyroid ___ during pregnancy
Inc.
96
T3 and T4 levels ____ during pregnancy .
inc.
97
Dose of Thyroxine should be ______ in preg.
increased by 30-50 %
98
Size on Pituitary _____ during pregnancy
Inc by 135 %
99
SHEEHAN syndrome.
Postpartum necrosis of Anterior pituitary due to Excessive blood loss due to PPH
100
Globulin, FIbrinogen, Leukocytes and Transferrin levels _____ during pregnancy
Inc
101
Acute fatty liver of acid : S. Bilirubin level.
<10 mg/dl
102
Cholestasis of liver during pregnancy : S. Bilirubin level
< 5 mg/dl
103
Colostrum contains all in excess except
KFC
104
Fibrin stabilizing factor ____ during pregnancy
Dec
105
____ cells predominate in vagina during pregnancy
Intermediate cells
106
Inspiratory capacity _____ during pregnancy
Increases .
| IC = IRV + TV
107
Arterio-venous Oxygen gradient ____ during pregnancy
Dec
108
Theca lutein cyst is seen in
Twin preg.
Hyperthyroidism.
Diabetes.
109
What causes Theca lutein cyst
inc HCG
110
Hyperemesis gravidarum is not associated with
post dated pregnancy .
