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Pregnancy Revision questions and Answers

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Pregnancy Revision questions and Answers describe the PE features in pregnant pts (bp, cervical mucus appearance, breast features) - ANSW Decreased blood pressure (progesterone-mediated): 90-115ish/60-70 Cervical mucus thickening Breast tenderness, increase in nipple size/pigmentation

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  • February 6, 2024
  • 18
  • 2023/2024
  • Exam (elaborations)
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Pregnancy Revision questions and Answers
describe the PE features in pregnant pts (bp, cervical mucus appearance, breast
features) - ANSW Decreased blood pressure (progesterone-mediated): 90-115ish/60-
70

Cervical mucus thickening

Breast tenderness, increase in nipple size/pigmentation

describe Chadwick sign - ANSW dark blue/purple coloring of vaginal mucosa near
cervix

when is beta-hCG detectable in the serum? how much should it increase in normal
pregnancy? - ANSW present at 8 days after ovulation

increase: should double every 2 days

describe the discriminatory zone (level and what gestational age it ocurs at, what can be
seen) - ANSW Discriminatory level: beta-hCG 1200-1500 after 14 wks (to ID congenital
anomaly on US)

Level at which US findings show intrauterine structure

describe ectopic pregnancy (+/-hCG, S&S, US features, when its diagnosed, tx, risk
factors) - ANSW +hCG test, lower than expected

S&S: abdominal pain, vaginal spotting, amenorrhea, enlarged uterus

US: empty uterus

Diagnosed at 6-8 wks

Tx: surgical removal (if rupture), medical tx = methotrexate *(if <4cm, no fetal heart
tones, hCG <3500)

Risk factors: PID, endometriosis, Hx of ectopics, tubal disease, IUD, infertility

describe the 4 types of spontaneous abortion (threatened, incomplete, anembryonic,
missed) - ANSW Threatened: vaginal bleeding, closed cervix

Incomplete: open cervix, partial products of pregnancy (bleeding)

Anembryonic: gestational sac is present, beta-hCG is high, but no fetal product is
present (blighted ovum)

,Missed: sac with no growth OR fetus with prior heart tones but presents now with no
heart tones; products are intact (stillbirth)

are labs for pregnant pts different btwn countries? - ANSW NO

list the major lab tests that all pregnant pts get (Ab screens, what TORCH microbe is
screened, what viruses are screened, genetic screens, what everyone in TN gets, what
test is used for aneuploidy, what it screens for, and what 4 markers it measures) -
ANSW ABO-Rh status

Ab screen (IgG or IgM) to any blood/vascular proteins

CBC - Hb, Hct, WBC, platelets especially

Rubella titer (IgG)

HBsAg and HCV titer

UA and culture

(21+) pap smear and tests for gonorrhea, chlamydia

Genetic screens: Hb electrophoresis and CF

Everyone in TN gets a urine drug screen

Aneuploidy: *quad screen - measured AFP, hCG, serum estriol, inhibin (valid for weeks
15-20; 1 test that screens for trisomy 21, 18, and neural tube defects)

what is the rate of blood flow to a pregnant uterus? - ANSW 500 cc/min

what is normal for a fetal HR? - ANSW 120-160 bpm

describe the 4 stages of labor - ANSW 1st: Regular contractions - 6cm dilated = active
labor

2nd: Complete dilation - deliver fetus (2-3hrs)

3rd: Delivery of placenta (10-30 min)

4th: Postpartum - urination should've occurred and bleeding should be done (2 hrs after
placenta is delivered)

define an incompetent cervix (what it is, when it presents) - ANSW cervical dilation
without contractions; usually occurs in 2nd trimester (results in miscarriage)

, when does premature labor occur? - ANSW prior to 37 weeks

define postpartum hemorrhage (vaginal and C-section) - ANSW anything >500cc

>1000cc for C section

define preeclampsia (what it is, when it occurs, what it's associated with) - ANSW bp
>140/90 after 20wks, associated with proteinuria

define gestational HTN (what it is, when it occurs) - ANSW Gestational HTN: bp
>140/90 after 20wks, no proteinuria

what is the cure for preeclampsia? - ANSW delivery

what are the 3 main functions of estrogen and progesterone? (at uterus, pituitary gland,
breast) - ANSW Maintain endometrium

Suppress ovarian follicular function (inhibit FSH and LH)

Stimulate breast development

describe the stages of development after fertilization (days 1, 2, 3, 4, 5, 6-10) - ANSW
Day 1: fertilization
Day 2: 2 cell stage
Day 3: 4 cell stage
Day 4: morula
Day 5: blastula (inner cell mass=embryoblast, outer cell mass=trophoblast)
Day 6-10: implantation (requires low estrogen:progesterone ratio)

what is the source of steroid hormones in the first trimester? second/third? - ANSW
first: corpus luteum

second/third: placenta, fetal adrenal glands

what cells make up the 2 cell masses in the blastula? - ANSW inner cell mass:
embryoblasts

outer cell mass: trophoblasts

what cells are present in the outer cell mass of the blastula on day 6? - ANSW
trophoblasts proliferate and differentiate into cytotrophoblasts and syncytiotrophoblasts

describe the fx of cytotrophoblasts and syncytiotrophoblasts - ANSW
Syncytiotrophoblasts: grow to make contact with endometrial vessels (no mitosis!); also
secrete beta-hCG to act as LH at corpus luteum

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