Maternal Physiology

Question 0

Uterus

Week 12

Answer 0

Abdominal organ
Dextrorotation
Isthmus enlargement and thinning

Question 1

Softening and compressibility of the isthmus occurring on the 6th to 8th w AOG

Answer 1

Hegar’s sign

Question 2

Softening of cervix pronounced on 6th to 8th wk AOG

Answer 2

Goodell’s sign

Question 3

Poor pap smear quality during pregnancy

Answer 3

Arias Stella reaction

Question 4

Bluish or purplish discoloration of vagina at 6 w AOG

Answer 4

Chadwick’s sign

Question 5

Cervical mucous changes

Vaginal secretion changes

Answer 5

Crystallization or beading

Acidic

Question 6

T or F

Montgomery glands of the breast increase in size starting the 3rd month of pregnancy

Answer 6

2nd

Question 14

Melanocyte Stimulating Hormone effects

Answer 14

Linea nigra
Darkening of the areola
Chloasma or melasma

Question 15

Hyperestrogenemia

Answer 15

Spider nevi

Palmar erythema

Question 16

Corticosteroids

Answer 16

Striae gravidarum at breast and abdomen

Question 17

Water metabolism

Answer 17

Inc water retention

Fall in plasma osmolality

Question 18

Protein metabolism

Answer 18

+500g fetus and placenta

+500g uterus breast blood

Question 19

CHO metabolism

Answer 19

Periph insulin resistance
Mild fasting hypoglycemia
Postprandial hyperglycemia

Question 20

Resets lipostat in hypothalamus causing hyperlipidemia

Answer 20

Progesterone

Question 21

Na and K
Ca and Mg
Fe

Answer 21

Inc: Enhanced tubular reabsorption of Na and K
Dec: Total calcium levels decline but ionized ca is unchanged
100 mg requirement

Question 22

Weight gain
First trimester
2nd
3rd

Answer 22

2
11
11

Question 23

Hypercoaguable state

All coag factors inc except

Answer 23

11 and 13

Question 24

Dec in CBC

Answer 24

Hematocrit

Platelets

Question 25

Ocular changes

Answer 25

Dec IOP inc vitreous outflow
Dec corneal sensitivity
Inc corneal thickness edema

Question 26

Skeletal changes

Answer 26

Progressive lordosis

Inc mobility of pelvic joints

Question 27

Pulmonary changes

Answer 27

TV and Resting minute ventilation inc

FRC and RV dec due to elevation of diaphragm

Question 28

ABG

Answer 28

Relative alkalosis

Blowing off more CO2 than nonpregnant

Question 29

Cardiac changes

Answer 29

HR + 10 bpm
Inc plasma volume by 40-60
Inc CO by 30-40
Dec DBP TPR
Inc venous pressure in LE

Question 30

Periods of inc CO

Answer 30

28 w
Labor
Postpartum
1st week pp

Question 31

GUT changes

Answer 31

Urinary stasis Asx bacteriuria Freqency and nocturia Hydroureter

Question 32

Renal changes

Answer 32

Inc GFR by 50% RPF Clcr | Dec serum BUN Crea UA

Question 33

GIT changes

Answer 33

Appendix displaced downward and laterally Inc gastric emptying time and Dec LES tone causing heart burn Progesterone inhibits CCK causing cholelithiasis and pancreatitis Estrogen inhibits bile acid transmission to GB causing pruritus Epulis

Question 34

Endocrine changes

Answer 34

Pituitary gland enlarges by 135% Inc prolactin and oxytocin Adrenal and thyroid hyperplasia

Question 35

Immunologic changes

Answer 35

Inc WBC IgA IgG | Dec T helper cells and neutrophils