Repro 4 maternal/fetal physio USMLE 2
Terms
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- what mouth problem increases w/ pregnancy?
- Gingival Dz
- how does glucose cross the placenta?
- faciliated diffusion
- how do amino acids cross the placenta?
- active transport
-
how does pregnancy effect appetite?
gastric motility? -
apetite Increases
motility Decreases - how does pregnancy affect GB emptying?
- emptying is delayed
- how does pregnancy affect liver enzymes?
- Increase
- when does "morning sickness" begin?
- 4 - 8 weeks
- what causes Ptyalism?
- inability for patient to swallow normal amounts of saliva
- what causes the decreased GI motility during pregnancy?
- increased Progesterone
- how many additional calories is allowed daily w/ pregnancy?
- 300
- transit time in the stomach and small intestines increases by what percent in the second and third trimesters?
- 15 - 30%
- during pregnancy how does the tone of the gastroesophageal sphinctor change?
-
it Decreases
(GERD increases) -
Definition:
pregnancy-related vascular swelling of the gums - Epulis
- what pulmonary measurement is decreased throughout pregnancy?
- Carbon dioxide pressure
- what pulmonary measurement is decreased in late pregnancy?
-
Functional Reserve Capacity
(FRC) - what is the maternal acid-base balance in pregnancy?
- mild Respiratory Alkalosis
- the Tidal volume in pregnancy increases by what percent?
- 30 - 40%
- in a normal singleton pregnancy what is the percent increase of maternal blood volume?
- 45%
- in what position is maternal BP the highest?
- Seated
- what is the BP change in the lateral recumbent position of the inferior arm of a pregnant mother?
- BP in inferior arm is higher then superior arm
- pregnancy-assoc systolic ejection murmurs are heard best where?
- over left upper sternal boarder
- compensation for the occlusion of the inferior vena cava by the pregnant uterus is accomplished by shunting blood through what?
- Paravertebral collateral circulation
- what causes inferior vena cava syndrome?
- compression by the gravid uterine corpus
- what causes the decrease in peripheral vascular resistance during pregnancy?
- increased Progesterone
- plasma volume begins to increase at the sixth week of pregnancy and reaches its maximum at what time?
- 30 - 34 weeks
- what hematologic parameter is decreased in pregnancy?
- Hematocrit
- what lab value related to iron is increased in pregnancy?
- Total Iron-binding capacity
- what CV risk increases w/ pregnancy?
- thromboembolism
- what does lack of maternal iron ingestion during pregnancy result in?
- Maternal Anemia
-
what renal functions increase during pregnancy?
(3) -
GFR,
Renal Plasma Flow,
Renin - during pregnancy, what is the effect of progesterone on the ureters?
- there is more dilation of the right versus the left
- what (3) urinary labs decrease in pregnancy?
-
Creatinine,
Uric Acid,
Blood Urea Nitrogen -
Definition:
change in facial pigmentation during preganacy - Chloasma
- what causes blurred vision during pregnancy?
- swelling of the lens
- what percent of total CO is channeled to the uterus during pregnancy?
- 20%
- what is the main metabolic change that occurs w/ pregnancy?
- Hyperglycemia
- what causes the "hemorrhoids" that develop late in pregnancy?
- elevated pelvic venous pressure
- what is the thyroid change in pregnancy?
- none...Euthyroid
- what is Diastasis recti?
- Midline separation of the rectus muscles
- how does the CO2 gradient b/t fetus and mother change in the later half of pregnancy?
- Increases
- how much does the BUN fall in the first trimester?
- 25%
- what is the urinary protein loss in pregnancy?
- 100 - 300 mg/24 hrs
- how long after the delivery will the hair loss assoc w/ pregnancy return?
- 6 - 12 months
- when does breast enlargement occur w/ pregnancy?
- first trimester
- the vision changes in pregnancy assoc. w/ increased thickness of the cornea regresses within what time?
- 6 - 8 weeks postpartum
- why is supplemental vitamin K given to newborns?
- b/c of their fetal liver immaturity in the immediate newborn
- what is the change in serum bicarb levels during pregnancy?
- significantly lower
- the umbilical blood flow represents about what percent of the combined output of both fetal ventricles?
- 40%
- the fetal kidney froms urine at what rate?
- 400 - 1200 mL/day
- in the later half of pregnancy, umbilical blood flow is what?
- 300 mL/mg/minute
- what is the normal constant fetal heart rate?
- 120 - 180 bmp
- maternal diastolic BP and Mean Arterial volume nadir when?
- 16 - 20 weeks
- an increase in breast volume of what percent is common in pregnancy?
- 25 - 50%