Obgyn L.3

Question 1

What triggers stage 2 of lactogenesis or secretory activation of lactogenesis?

Answer 1

The rapid decline in progesterone after delivery of the placenta

Question 2

What are the hormones that when elevated lead to stage 2 or secretory activation of lactogenesis?

Answer 2

Elevated levels of cortisol, prolactin, and insulin

Question 3

What causes plasma cortisol levels to increase by the third trimester?

Answer 3

Increase in level of corticosteroid binding globulin (CBG; transcortin) stimulated by estrogen

Question 4

What would elevated free cortisol levels contribute to by the third trimester?

Answer 4

1) insulin resistence
2) abdominal striae

Question 5

Why does elevated serum aldosterone in pregnancy not cause hypokalemia or hypernatremia?

Answer 5

Because of the antagonistic actions of progesterone

Question 6

What stimulates the thyroid glad during pregnancy?

Answer 6

hCG (thyroid gland becomes palpable during first trimester)

Question 7

What causes increased serum thyroxine during pregnancy?

Answer 7

hCG and estrogens stimulate thyroid hormone binding globulin (TBG) production by the liver

Inc. TBG= thyroid hormone level elevated

Question 8

What is the only anterior pituitary hormone that increases progressively during pregnany?

Answer 8

Prolactin

Fyi.

ACTH, TSH, and GH remain unchanged

FSH and LH fall to lower limits of detection, due to -ve feedback from sex steroids fetoplacental unit taking over

Question 9

What process can immune cells enter the milk?

Answer 9

Diapedesis or extravasation