MATERNAL PHYSIOLOGY

Question 1

Hegar’s sign

Answer 1

softening of the ISTHMUS

Question 2

Braxton-Hicks Contraction

Answer 2

painless uterine contraction without cervical dilatation

Question 3

Arias-Stella Reaction

Answer 3

endocervical gland hyperplasia and hypersecretory appearance

Question 4

Corpus Luteum

Answer 4

production of progesterone 6th-7th week

Question 5

Relaxin

Answer 5

secreted by corpus luteum, decidua, and placenta in similar pattern as hCG

for remodeling of reproductive tract to accomodate parturition

Question 6

Theca Lutein Cyst

Answer 6

benign ovarian lesion that results from exaggerated physiological follicle stimulation (hyper reaction)

Question 7

Hyperreactio luteinalis

Answer 7

exaggerated physiological follicle stimulation (hyper reaction)

Question 8

weight gain if BMI before pregnancy is normal

Answer 8

12.5 kg or 27.5 lbs

Question 9

pitting edema

Answer 9

INCREASED venous pressure BELOW the level of the uterus d.t. PARTIAL occlusion of the vena cava by the gravid uterus

DECREASED interstitial colloid osmotic pressure

Question 10

Leptin Deficiency

Answer 10

associated with ANOVULATION and INFERTILITY

Question 11

Abnormally elevated Leptin

Answer 11

associated with PREECLAMPSIA and GESTATIONAL DM

Question 12

Hypervolemia begins to increase

Answer 12

1st trimester

Question 13

Hypervolemia expands most rapidly

Answer 13

2nd trimester

Question 14

Iron requirement during normal pregnancy

Answer 14

1000 mg

Question 15

T - helper and T cytotoxic cells (suppressed activity in pregnancy)

Answer 15

DECREASE secretion of IL-2, interferon-y and TNF-B

Question 16

Coagulation and Fibrinolysis during Pregnancy

Answer 16

INCREASE - fibrinogen, factor VII, factor X, plasminogen

DECREASE - activated PTT, tPA, antithrombin III, protein C and total protein S

Question 17

Increased in cervical mucus plug which act as barrier against infection for the fetus

Answer 17

IgA and IgG

Question 18

Increased during the 1st trimester in cervical and vaginal mucus

Answer 18

IL-1B

Question 19

Factors associated with thrombocytopenia in pregnancy

Answer 19

hemodilution
increased platelet consumption
production of thromboxane A2 –> platelet aggregation

Question 20

Increased CO in pregnancy is due to

Answer 20

DECREASED systemic vascular resistance

INCREASED HR

Question 21

Cardiac sounds during pregnancy

Answer 21

exaggerated splitting of the first heart sound
loud easily heard 3rd sound
systolic murmur

Question 22

Arterial pressure decreases during

Answer 22

24-26 weeks

Question 23

Principal prostaglandin of endothelium; ↑ during late pregnancy and regulates blood pressure and platelet function

Answer 23

Prostacyclin (PGI2)

Question 24

Endothelin 1

Answer 24

Potent vasoconstrictor produced in endothelial and vascular smooth muscle cells and regulates local vasomotor tone

Question 25

Nitric Oxide

Answer 25

Potent vasodilator is released by endothelial cells and may have important implications for modifying vascular resistance during pregnancy

Question 26

Renal Function Tests

Answer 26

DECREASE serum creatinine | INCREASE CrCl

Question 27

Dried cervical mucus d.t. progesterone

Answer 27

Beading/ Crystallization

Question 28

Seen on a glass slide as a result of amniotic fluid leakage which is an ARBORIZATION OF ICE CRYSTALS

Answer 28

Ferning

Question 29

Greater vascularity and hyperemia in the perineum, vulva, vagina and cervix --> violet color characteristic

Answer 29

Chadwick sign

Question 30

Represents exaggerated luteinization reaction of normal ovary

Answer 30

Luteoma of Pregnancy

Question 31

Secreted by corpus luteum, decidua and placenta For REMODELING of reproductive tract CT to accommodate parturition

Answer 31

RELAXIN

Question 32

Exaggerated physiological follicle stimulation (hyperreaction luteinalis)

Answer 32

Theca Lutein Cyst

Question 33

Normal pregnancy characterized by (related to carbohydrate metabolism)

Answer 33

mild fasting HYPOglycemia postprandial HYPERglycemia HYPERinsulinemia

Question 34

Factors responsible for INSULIN RESISTANCE

Answer 34

``` Progesterone Placentally derived growth hormone Prolactin Cortisol Tumor Necrosis Factor Leptin ```

Question 35

Secreted by adipose tissue Important for implantation, cell proliferation and angiogenesis Important for development of pancreas, kidney, heart and brain

Answer 35

Leptin

Question 36

Cooperates w/ leptin (neuroendocrine factor) in energy for homeostasis modulation; role in fetal growth and cell proliferation

Answer 36

Ghrelin

Question 37

Iron and Iodine requirement

Answer 37

INCREASED

Question 38

Total serum calcium and serum magnesium

Answer 38

DECREASED

Question 39

DECREASED during pregnancy (Hematologic and Immunologic changes)

Answer 39

Hgb and Hct Whole blood viscosity TH1 response TH1 secretion of IL-2, IF-1, TNF

Question 40

INCREASED concentrations of ALL clotting factors in pregnancy EXCEPT

Answer 40

Factors XI and XIII

Question 41

Secreted in response to chamber-wall stretching

Answer 41

ANP (atrial natriuretic) and BNP (brain natriuretic peptide) regulate blood volume by natriuresis, diuresis and vascular smooth-muscle relaxation BNP - INCREASED IN SEVERE PREECLAMPSIA

Question 42

Principal prostaglandin of endothelium INCREASED in LATE pregnancy

Answer 42

Prostacyclin (PGI2) regulates blood pressure and platelet function maintain VASODILATION DECREASED in PREECLAMSPIA

Question 43

Produced in endothelial and vascular smooth muscle Production stimulated by angiotensin II, arginine, vasopressin and thrombin

Answer 43

Endothelin (+) secretion of ANP, aldosterone and catecholamines ELEVATED LEVELS -- associated with preeclampsia potent VASOCONSTRICTOR

Question 44

Potent VASODILATOR Released by endothelial cells

Answer 44

Nitric Oxide Mediator of PLACENTAL VASCULAR TONE and DEVELOPMENT abnormal synthesis linked to preeclampsia development

Question 45

Changes in lung volumes during pregnancy

Answer 45

REDUCED Functional Residual Capacity (FRC) Expiratory Reserve Volume (ERV) Residual Volume (RV) ``` INCREASED Inspiratory Capacity (IC) Tidal Volume (VT) ``` UNAFFECTED Lung compliance Maximum breathing capacity Forced Vital Capacity

Question 46

Tests of renal function

Answer 46

DECREASED Serum Creatinine INCREASED Creatinine Clearance