Physiology

Question 1

HCG physiology?

Answer 1

Glycoprotein
Produced by syncytiotrophoblasts
Detected in maternal serum by 7 days post conception

Question 2

Morning sickness caused by?

Answer 2

HCG

Question 3

Main estrogen of pregnancy?

Answer 3

Estriol

Question 4

High estrogen to progesterone ratio causes?

Answer 4

Partition

Question 5

Human placental lactogen is similar in structure to?

Answer 5

GH and PRL

Question 6

How human placental lactogen is a diabetogenic hormone?

Answer 6

It causes hyperinsulinemic response to glucose load

So insulin resistance is seen in pregnancy

Question 7

Shift of maternal energy from ?

Answer 7

Anabolic to catabolic state leading to accelerated starvation

Question 8

Energy metabolism shifts toward?

Answer 8

Fat utilisation (lipolysis)with glucose sparing

Question 9

Why androgens are increased in pregnancy?

Answer 9

Because testosterone bonds to SHBG and free testosterone gets lower

Question 10

Why DHEA hormones decreases in pregnancy?

Answer 10

Do not bind to SHBG

Used by placenta to conver to estrogens

Question 11

Why cortisol increases ?

Answer 11

Due to estrogen causing increase in CBG( corticosteroids binding globulins)/transcortin

Question 12

What cause abdominal striae and contribute to insulin resistance ?

Answer 12

High cortisol

Question 13

What stimulates liver angiotensinogen production?

Answer 13

Estrogen

Question 14

What stimulates renin ?

Answer 14

Estrogen and progesterone

Question 15

Although high aldosterone no hypokalamia or hyponatremia in pregnancy?

Answer 15

Antagonistic actions of progesterone in kidney!

Question 16

Why does DOC increases is it from adrenals?

Answer 16

No it’s because of the placental progesterone conversion to DOC

Question 17

What causes volume expansion?

Answer 17

Aldosterone and DoC

Question 18

What stimulates the thyroid gland is it TSH ??

Answer 18

No it’s the HCG!!

Question 19

What causes iodine deficiency?

Answer 19

Increased renal clearance of iodide

Question 20

What stimulates TBG?

Answer 20

HCG and estrogens

Question 21

Why extra blood flow is needed?

Answer 21

Increased perfusion to other organs( like kidney)
Extra blood flow to the uterus
Extra metabolic needs of the fetus
Extra volume compensates for blood loss in pregnancy

Question 22

What stimulates erythropoiesis

Answer 22

Prolactin
Human placental lactogen
Progesterone

Question 23

High blood volume is much more than increase erythropoiesis leading to ?

Answer 23

Drop of hematocrit causing physiological anemia

Question 24

How is the clotting and lysing activity equilibrated?

Answer 24

Increase in fibrinogen and increase in plasminogen

Question 25

Total peripheral resistance decrease due to ?

Answer 25

Progesterone and Increased diversion of blood from artery to venous system Decreased vascular response to angiotensin II

Question 26

Why voice changes and breathing through the nose is difficult ?

Answer 26

Capillary dilatation by progesterone occur in larynx and nasopharynx

Question 27

What is progesterone effect on respiratory?

Answer 27

Lowers the set point of regulation by Co2 leading to increase in minute volume and tidal volume

Question 28

The progesterone induced hyperventilating causes a mild?

Answer 28

Compensatory respiratory alkalosis with a decrease in pCo2

Question 29

How is significant respiratory alkalosis prevented?

Answer 29

Decrease in Hco3

Question 30

How does vital capacity remains the same while TLC decreases?

Answer 30

Because Tidal volume increases

Question 31

What causes increase stomach volume and decrease stomach PH?

Answer 31

Increase of gastrin

Question 32

Decrease in gastric and intestinal motility caused by?

Answer 32

Decrease motilin

Question 33

What causes heartburn?

Answer 33

Decrease in gastric emptying Increased intraabdominal pressure Decrease lower esophageal sprinter tone by progesterone

Question 34

What causes glucosuria and aminoaciduria?

Answer 34

Increase GFR

Question 35

What predispose pregnant to UTI ?

Answer 35

Glucosuria