Pregnancy

Question 1

hormone that ovum produces

Answer 1

oestradiol

Question 2

hormone that corpus luteum secretes

Answer 2

progesterone

Question 3

implanted embryo secretes this hormone

Answer 3

hCG

Question 4

hPL stands for ___

secreted by the ___

Answer 4

human placental lactogen

placenta

Question 5

placenta secretes these three hormones

Answer 5

hPL
oestrogen
progesterone

Question 6

__+__ (hormones) cause insulin resistance in pregnant mother if predisposed this =>

Answer 6

progesterones and hPL

increased bg and gestational diabetes

Question 7

complications of diabetes in pregnancy

Answer 7

congenital malformation
premature
IUGR (intrauterine growth retardation - if existing T1/2D)
macrosomnia (>90th centile)
polyhydramnios
intrauterine death

Question 8

2 neonatal complications of diabetes in pregnancy

Answer 8

respiratory distress (immature lungs)
hypoglycaemia/calcaemia (fits)

Question 9

CNS defects of neonate if diabetes in pregnancy

Answer 9

spina bifida (risk x5)
anencephaly
caudal regression (x200)
ereteric duplication (x20)

Question 10

why does diabetes in pregnancy cause macrosomnia and neonatal hypoglycaemia?

Answer 10

maternal bg increased causes foetal bg to increase too

insulin therefore increases (in 3rd trimester baby produces their own) = major growth factor

Question 11

definition by weight of macrosomnia in a neonate

Answer 11

> 4kg

Question 12

if have T1/2D and become pregnant:

give ____, 3 monthly ___, avoid __+__

Answer 12

5mg folic acid
eye check up (accelerates retinopathy)
ACEI and statins

Question 13

bp control in pregnancy can be (3)

Answer 13

nifedipine
methyldopa
labetolol

Question 14

when in labour if diabetic then give __+__ so that the mother has ___

Answer 14

IV insulin and IV dextrose

good bg control

Question 15

Rx for T1D during pregnancy =

Answer 15

insulin

Question 16

Rx for T2D during pregnancy =

Answer 16

metformin but may go on to need insulin

Question 17

Rx for MODY during pregnancy =

Answer 17

sulfonylureas

Question 18

Rx for gestational diabetes =

Answer 18

lifestyle and metformin

may go on to need insulin

Question 19

if have GDM the 6wk post-natal get a ___ if +ve = __

___% (80% if obese) go on to develop T2D

Answer 19

OGTT = T2D

50%

Question 20

the demand on the thyroid increases/decreases during pregnancy?

Answer 20

increases

Question 21

hCG acts like ___ in pregnancy and so fT4 ___, TSH ___ and causes ____

Answer 21

TSH
increases
decreases
hyperemesis gravidarum

Question 22

hyperemesis gravidum is caused by high ___

Answer 22

hCG

Question 23

thyroid __ in size and ___ production increases in pregnancy

Answer 23

increases

t4

Question 24

TSH and hCG return to normal at ___ in pregnacy

Answer 24

20wks

Question 25

if pregnant with existing hypothyroidism increase dose of levothyroxine by ____ asap average overall dose increase = ___ by 20wks

Answer 25

25microg | 100-150microg (50%)

Question 26

aim for TSH levels in pregnant ladies with existing hypothyroidism

Answer 26

<3mU/l

Question 27

features of hyperemesis gravidum that distinguish it from hyperthyroidism in pregnancy

Answer 27

hCG high causes TSH to be low TRIg -ve resolves by 20wks

Question 28

hyperthyroid drug used in 1st trimester

Answer 28

PTU (and beta blocker)

Question 29

Hyperthyroid drug used in 2nd/3rd trimester

Answer 29

carbimazole

Question 30

TRIgs +ve in the third trimester can cross the placenta and cause

Answer 30

transient neonatal thyrotoxicosis

Question 31

__% of females (___% if T1D) get postpartum thyroiditis = __>___ usually lasts ___ but can be up to ___

Answer 31

``` 5% 25% hyperthyroid hypothyroid 1-4 months up to 1yr ```

Question 32

post partum thyroiditis causes a ___ goitre | and hypo phase is associated with

Answer 32

small, diffuse, non-tender goitre | postpartal depression

Question 33

if bg ___ then advise a diabetic not to get pregnant

Answer 33

>85mmol/mol

Question 34

HbA1c is less accurate in pregnancy because

Answer 34

increased rate of RBS turnover

Question 35

IFG = | its associated predominantly with __ insulin resistance and causes ___ to increase

Answer 35

impaired fasting glucose hepatic fasting bg

Question 36

IGT = | ass predominantly with ___ insulin resistance and causes ___ to increase

Answer 36

impaired glucose tolerance muscle post prandial bg

Question 37

if reduced visual acuity improves by looking through a pinhole =

Answer 37

a refractive error

Question 38

hazy cornea and fixed mid-dilated pupil =

Answer 38

acute glaucoma

Question 39

swollen optic disk =

Answer 39

papilloedema

Question 40

curtain drawn across one eye's vision, no pain =

Answer 40

retinal detachment