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Maternal Physiology Flashcards

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0
Q

Uterine enlargement is primarily stimulated by ___ and also by ___

A

ESTROGEN

Progesterone

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1
Q

Uterine enlargement causes the ___ and ___ of muscle cells

A

Stretching

Hypertrophy

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2
Q

Other accumulation in part of the uterine enlargement

A

Accumulation of fibrous tissue

Increased in elastic tissue

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3
Q

The production of new myocytes are ___

A

LIMITED

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4
Q

The weight of a nonpregnant uteus and its capacity

A

70 grams

10ml or less

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5
Q

The weight of a prenant uterus and its capacity

A

1100 gram at term

5-20 liters

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6
Q

The position of a pregnant uterus

A

Dextrorotated

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7
Q

Layer of the uterus which is composed of dense muscle fibers perforated in all direction by blood vessels

A

Middle layer

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8
Q

The layer of uterus which consist of sphincter like fiber around the fallopian tube and internal os of the cervix

A

Inner layer

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9
Q

Irregular, painless contractions which is unpredictable, sporadic, nonrhythmic and intensity varies

A

Braxton hicks

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10
Q

Braxton hicks approximates __ mmhg

A

15-25 mmHg

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11
Q

The uteroplacental blood flow near tearm

A

450-650ml/min

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12
Q

Vasodilation in the maternal placental blood flow is mediated by?

A

Estrogen
Progesterone
Nitric oxide

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13
Q

Increased in fetal-placental blood flow happens on the ___ weeks were uterine artery doubles

A

20

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14
Q

Changes in the cervix during pregnancy

A

Increased vascularity and edema

Hypertrophy and hyperplasia of cervical gland

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15
Q

Copius amount of a tenacious mucus that obstruct the cervical canal soon after conception

A

Mucus plug

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16
Q

Only a __ corpus luteum of pregnancy can be found in the ovaries of a pregnanct women

A

SINGLE

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17
Q

Corpus luteum functions maximally during the first ___ weeks of pregnancy

A

6-7 weeks

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18
Q

The ovarian pedicle increases in about __ cm at term

A

2.5 cm

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19
Q

This is secreted by the corpus luteum, placenta, decidua and also be expressed by the heart, brain, kidney

A

Relaxin

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20
Q

Functions of relaxin:

A

☑️ Remodelling of the reproductive tract tissue during pregnancy
☑️ Initiation of AUGMENT renal hemodynamics and DECREASE osmolality

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21
Q

Solid ovarian tumor composed of large acidophile luteinized cells

A

Pregnancy luteoma

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22
Q

Solid, complex appearing UNILATERAL mass, with cystic features that correspond to areas of hemorrhage

A

Pregnancy luteoma

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23
Q

Pregnancy luteoma can cause ___ virilization only

A

Maternal

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24
This is a self limited, due to exaggerated physiological follicle stimulation (hyperreactio luteinalis)
Theca lutein cyst
25
This is usually BILATERAL and associated with gestational trophoblast disease
Theca lutein cyst
26
Theca lutein cyst is also associated in large palacentas such as those found in patients with _ and in patients with _
DM, D-isoimmunization, Multiple fetuses | Chronic renal disease, Hyperthyroidism
27
What are the three change in the fallopian tubes?
☑️ Undergoes little hypertrophy during pregnancy ☑️ Epithelium of tubal mucosa flattened ☑️ Decidualization may be seen
28
Vaginal and perineal changes on labor and delivery:
✔️ Increased in the thickness of the mucosa ✔️ Loosening of the connect tissue ✔️ Hypertrophy of the smooth muscle cells
29
What is the vaginal pH?
3.5 - 6.0
30
Two changes in the skin:
Striae gravidarum | Diastasis recti
31
Hyperpigmentation cause __ and __ this is due to __
Linea negra Chloasma or Melasma gravidarum Increase MSH
32
Vascular changes are due to ___ examples are __ and __
Hyperestrogenemia Vascular spiders, angioma, nevus os telangiectasia Palmar erythema
33
Breast will have HYPERTROPHIC sebaceous gland formation called __
Galnds of montgomery
34
Weight gain in pregnant women is attributed to:
Uterus and its content Breast Blood volume Extravascular extracellular fluid
35
What is the approximate weight gain during pregnancy:
12.5 kg or 27.5 lbs
36
Maternal reserve is attributed to ___ and ___
Increased in water and deposition of new proteins and fats
37
Total water retention during pregnancy ___, divided into two parts with their corresponding volumes
6.5 liter Fetus, placenta, amniotic fluid (3.5 liters) Increased in plasma volume, uterine, and breast size (3.0 liters)
38
Pitting edema in pregnancy is due to?
Partial vena cava occlusion | Decreased in interstitial colloid osmotic pressure
39
Protein metabolism: Grams contained in the fetus and placenta Grams added to the uterus, breast, maternal blood
500 grams | 500 grams
40
CHO metabolism in normal pregnancy:
Mild fasting hypoglycemia Post prandial hyperglycemia Hyperinsulinemia
41
Insulin resistance is ___ in pregnancy to about ____
INCREASED | 45-70%
42
Insulin resistance is mediated by:
Estrogen Progesterone Human Placental Lactogen
43
This is the most consistent change in lipid metabolism durinjg pregnancy
Maternal hyperlipidemia
44
Maternal hyperlipidemia is due to:
✔️ Decreased circulating levels and activity of lipoprotein lipase ✔️ Estradiol and Progesterone hepatic effects
45
Leptin and Ghrelin serum levels are ___ and these are mainly secreted by ___
INCREASED | Adipocytes
46
How many mEq of sodium is retained? How many in potassium?
1000 mEq | 300 mEq
47
``` Increased or decreased or Unchanged: Ionized calcium Total calcium Magnesium Phosphate GFR of Na and K Reabsorption of electrolytes Excretion of electrolytes ```
``` Unchanged Decreased Decreased Unchanged Increased Increased Unchanged ```
48
Fetus accumulates __ grams of calcium at term which is met by:
30 grams ☑️ Doubling maternal calcium intestinal absorption ☑️ Dietary intake of sufficient calcium
49
Hypervolemia accounts for:
☑️ To meet metabolic demands of the enlarging uterus ☑️ To provide abundant nutrients and elements to support the growing fetus and placenta ☑️ To protect mother and fetis against deleterious effects of impaired venous return in the supine and erect position ☑️ To safeguard the mother against the adverse effect of blood loss associated in parturition
50
___ in both RBC and Plasma begins within the ____ and expans rapidly in the ___
Increased 1st trimester 2nd trimester
51
Total iron requirement during pregnancy: _____ mg To the fetus and placenta: ___ mg Lost portion: ___ mg To 450 ml of circulating erythrocytes: ___ mg
1000 mg 300 mg 200 mg 500 mg
52
Blood volume increased at near term by ___%
40-45%
53
Rate of increase in iron requirement
6-7 mg/day
54
``` Increased or decreased or unchanged: Iron requirement Blood volume Hgb Hct ```
Increased Increased Decreased Decreased
55
``` Increased or decreased or unchanged: All clotting factors except XI and XIII Platelets Anti-thrombin levels Clotting time Fibrinogen Thromboxane A2 Activated C protein resistance Protein S Protein Z Clotting factors XI and XIII ```
``` Increased Decreased Unchanged Unchanged Increased Increased Decreased Decreased Increased Increased ```
56
Increased or decreased or unchanged: T helper 2 cells suppresion CD4 T lymphocytes Monocytes
All are decreased
57
``` Increased or decreased or unchanged: T helper 1 cells suppression T cytotoxic 1 cells Interleukins 4,6,13 IgA and IgG Leukocyte counts CD8 T lymphocytes CRP, ESR, C3, C4, leukocyte alkaline phosphatase ```
All are INCREASED
58
``` Increased or decreased or unchanged: Systemic vascular response ECG CO HR Plasma volume Pulmonary vascular resistance A2 and P2 Preload MAP Pulmonary capillary wedge pressure ```
``` Decreased Unchanged Increased Increased Increased Decreased Unchanged Unchanged Increased Decreased ```
59
``` Increased or decreased or unchanged: S1 splitting BP on sitting CVP Antecubital venous pressure S3 sound Basal metabolic rate ```
``` Increased Decreased Unchanged Unchaged Increased Increased ```
60
10% if women have this due to supine compression of great vessels that may affect directly the fetal heart rate patterns
Supine hypotension syndrome
61
Increased or decreased or unchanged: Renin Aniotensin Plasma volume
ALL are INCREASED
62
Renin is produce by:
Maternal kidney and Placenta
63
Angiotensinogen is produced by:
Maternal and Fetal liver
64
There is an ___ refractoriness in angiotensin II refractoriness in normal pregnancy and lost immediately after delivery of the placenta
Increased
65
Increased or decreased or unchanged: ANP BNP
ALL are UNCHANGED
66
Diaphragm rises about ___ during pregnancy Subcostal angle widens appreciably as the transverse diameter of the thoracic cage increase about ___ Thoracic circumference increases about ___
4cm 2cm 6cm
67
``` Increased or decreased or unchanged: Tidal volume FRC Maximum breathing capacity Minutes Ventilatory colume Residual volume Timed vital capacity Minute oxygen uptake Peak expiratory flow Total pulmonary resistance Lung compliance Airway conductance Critical losing volume Total oxygen carrying capacity ```
``` Increased Decreased No change Increase Decrease Unchange Increased Decreased Decreased Unchange Increased Increased Increased ```
68
Urinalysis: Glucosuria Proteinuria Hematuria
Normal Abnormal Contamination
69
Increased or decreased or unchanged: | Gastric emptying time
Increased
70
Common during pregnancy and is mostblikely caused by reflux of acidic secretions into the lower esophagus
Pyrosis
71
Increased or decreased or unchanged: | Lower esophageal tone
Decreased
72
Increased or decreased or unchanged: Intraesophageal pressure Intragastric pressure
Lower | Higher
73
Increased or decreased or unchanged: | Esophageal peristalsis have: speed and amplitude
Decreased | Decreased
74
``` Increased or decreased or unchanged: Serum aspartate transaminase Alanine transaminase Glutamyl transaminase Leucine aminopeptidase Bilirubin Gall bladder contractility Alkanine phosphatase Serum albumin ```
``` Decreased Decreased Decreased Increased Decreased Decreased Increased Decreased ```
75
The unchanged level in endocrine in pregnancy:
Growth hormones | TRH
76
The decreased level in endocrine pregnancy:
Dehyroepiandrosterone sulfate
77
IOP in pregnancy is ___ Vitreous outflow is ___ Corneal sensitivity ___
Decreased Increased Decreased
78
Brownish red opacity on the posterior surface of the cornea
Krukenberg spindles

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