Pathophysiology Year 3 Quiz
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Questions and Answers

Which of the following is a potential consequence of untreated pre-eclampsia?

  • Hypoglycemia
  • Fetal development issues
  • Chronic hypertension
  • Postpartum hemorrhage (correct)

What is the primary goal when managing a patient experiencing seizures due to eclampsia?

  • Prevent placental abruption
  • Control blood pressure
  • Stop seizures and deliver the baby (correct)
  • Administer high-dose aspirin

What is the recommended daily dosage of aspirin for prophylaxis in women at risk of pre-eclampsia?

  • 100-200 mg
  • 400-500 mg
  • 250-300 mg
  • 60-150 mg (correct)

Which treatment acts as a non-specific muscle relaxant to prevent seizures in patients with eclampsia?

<p>Magnesium sulfate (C)</p> Signup and view all the answers

What is a common recommendation for bed rest in pregnant women at risk for complications, despite limited evidence?

<p>Reducing the risk of organ damage (C)</p> Signup and view all the answers

What role does tissue factor (TF) play in the coagulation cascade?

<p>Responsible for thrombin activation (D)</p> Signup and view all the answers

Which mediators are involved in the inflammatory response that enhances TF secretion?

<p>IL1, IL6, IL8, and adhesion molecules (A)</p> Signup and view all the answers

What effect does TNF-alpha have on the plasminogen system?

<p>Limits plasmin due to PAI production (A)</p> Signup and view all the answers

What is a consequence of elevated maternal glucose levels during pregnancy related to GDM?

<p>Increased insulin secretion from the fetal pancreas (D)</p> Signup and view all the answers

What can be the result of microvascular clots in organs during increased inflammation?

<p>Organ ischemia or necrosis (A)</p> Signup and view all the answers

What are the potential consequences of decreased ATP production in the body?

<p>Poor perfusion leading to acidosis (A)</p> Signup and view all the answers

Which symptom is NOT typically associated with neurogenic shock?

<p>Tachycardia (C)</p> Signup and view all the answers

During metabolic acidosis, why does lactate production increase?

<p>Because protons originate from hydrolysis during glycolysis (A)</p> Signup and view all the answers

What role does lipolysis play when glucose availability decreases?

<p>Mobilizes free fatty acids and triglycerides for energy (C)</p> Signup and view all the answers

Which of the following treatments is NOT used to address shock?

<p>Immediate surgical intervention for all types of shock (A)</p> Signup and view all the answers

What happens to blood pH during an increase in lactate levels?

<p>It decreases and causes decreased oxygen affinity of hemoglobin (C)</p> Signup and view all the answers

Why is rapid intervention critical in the treatment of shock?

<p>Delays can lead to irreversible organ failure (C)</p> Signup and view all the answers

What effect does using proteins for energy source have during shock conditions?

<p>Leads to increased urea and toxic ammonia levels (B)</p> Signup and view all the answers

What is the primary function of placental corticotropin-releasing hormone (CRH) during pregnancy?

<p>Facilitate fetal lung maturation (A)</p> Signup and view all the answers

At what week of gestation can the fundus of the uterus typically be palpated above the pelvic bone?

<p>12 weeks (A)</p> Signup and view all the answers

What hormone is primarily responsible for maintaining pregnancy and supporting the uterine lining?

<p>Progesterone (A)</p> Signup and view all the answers

What change occurs to the heart's position during pregnancy due to the enlarging uterus?

<p>It is laterally displaced to the left (C)</p> Signup and view all the answers

What is the expected outcome of excessive weight gain during pregnancy?

<p>Increased risk of gestational diabetes (B)</p> Signup and view all the answers

How does estrogen affect the uterus during pregnancy?

<p>Promotes enlargement of the uterus (A)</p> Signup and view all the answers

Which hormone signals the fetal lungs to begin producing surfactant?

<p>Cortisol (C)</p> Signup and view all the answers

What is a common method for calculating the expected date of confinement (EDC)?

<p>Using Naegele’s Rule (D)</p> Signup and view all the answers

What is the typical presentation position of an ideal fetus for vaginal delivery?

<p>Occiput anterior (A)</p> Signup and view all the answers

What do Montgomery’s tubercles represent during pregnancy?

<p>Enlarged sebaceous glands (D)</p> Signup and view all the answers

What is the volume increase of the uterus throughout pregnancy?

<p>From 10mL to 20L (D)</p> Signup and view all the answers

Which placental hormone rises significantly during the third trimester, especially before labor?

<p>Corticotropin-releasing hormone (CRH) (D)</p> Signup and view all the answers

What is the role of relaxin hormone during pregnancy?

<p>Relaxes pelvic ligaments (C)</p> Signup and view all the answers

What is the role of Metformin in treating PCOS?

<p>To regulate hormonal levels and reduce steroidogenesis (D)</p> Signup and view all the answers

What risks do pregnant women with PCOS face?

<p>Higher incidence of GDM and preterm birth (C)</p> Signup and view all the answers

What is a potential sequelae of having PCOS later in life?

<p>Dyslipidemia (B)</p> Signup and view all the answers

What type of fibroid grows within the muscle wall of the uterus?

<p>Intramural fibroid (A)</p> Signup and view all the answers

What is intrauterine insemination (IUI) primarily designed to do?

<p>Instill semen directly into the uterus (D)</p> Signup and view all the answers

What defines septic shock in the context of sepsis?

<p>Profound circulatory, cellular, and metabolic abnormalities leading to high mortality (D)</p> Signup and view all the answers

Which age group is most susceptible to sepsis?

<p>Infants and the elderly (B)</p> Signup and view all the answers

What characterizes organ dysfunction in severe sepsis according to the definition proposed in Sepsis-3?

<p>Increase in SOFA score by 1 or more (D)</p> Signup and view all the answers

What defines the development of a subserosal fibroid?

<p>Developing on the surface of the uterus (B)</p> Signup and view all the answers

What is required for the diagnosis of septic shock clinically?

<p>Elevated serum lactate levels and need for vasopressors (D)</p> Signup and view all the answers

What is menarche?

<p>The first menstrual cycle (D)</p> Signup and view all the answers

Which hormone is primarily responsible for ovulation?

<p>Luteinizing Hormone (LH) (D)</p> Signup and view all the answers

What is the function of relaxin during the menstrual cycle?

<p>Relaxing uterine smooth muscle (C)</p> Signup and view all the answers

During which phase of the menstrual cycle does the endometrium thicken in preparation for a potential pregnancy?

<p>Post-ovulatory phase (B)</p> Signup and view all the answers

What is polyhydramnios?

<p>Excessive amniotic fluid (A)</p> Signup and view all the answers

What defines macrosomia during fetal development?

<p>Fetal head size larger than can be passed vaginally (A)</p> Signup and view all the answers

What does the GTPAL acronym stand for in obstetric history?

<p>Gravida, Term, Preterm, Abortions, Living (B)</p> Signup and view all the answers

Which hormone primarily contributes to the development of secondary female sexual characteristics?

<p>Estrogen (C)</p> Signup and view all the answers

During which phase of the menstrual cycle is there a surge of FSH and LH?

<p>Ovulation phase (D)</p> Signup and view all the answers

What does parity refer to in obstetrics?

<p>Total number of deliveries over 20 weeks gestation (D)</p> Signup and view all the answers

What is the role of inhibin in the female reproductive system?

<p>To provide feedback for FSH and LH release (A)</p> Signup and view all the answers

What structure is responsible for the secretion of progesterone after ovulation?

<p>Corpus luteum (D)</p> Signup and view all the answers

What does the endometrium do during menstruation?

<p>Sheds if no fertilization occurs (C)</p> Signup and view all the answers

What is the main function of the myometrium during pregnancy?

<p>To induce uterine contractions (D)</p> Signup and view all the answers

Flashcards

Pre-eclampsia

A pregnancy complication characterized by high blood pressure and protein in the urine, often occurring after 20 weeks of gestation.

Aspirin Prophylaxis in Pre-eclampsia

Daily low-dose aspirin (60-150 mg) taken after the first trimester can reduce the incidence of pre-eclampsia in high-risk women by at least 10%.

Eclampsia

A potentially life-threatening condition characterized by seizures in women with pre-eclampsia. It's a severe form of pre-eclampsia.

Magnesium Sulfate in Eclampsia

Magnesium sulfate is a medication used to prevent seizures in women with eclampsia. It functions as a non-specific muscle relaxant.

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Post-Partum Hemorrhage (PPH)

Excessive bleeding within the first 24 hours after delivery, often caused by uterine atony (failure of the uterus to contract properly).

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Tissue Factor (TF)

A protein that initiates the coagulation cascade, leading to the formation of fibrin clots. It is released from endothelial cells and monocytes in response to inflammation.

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Thrombin

An enzyme in the coagulation cascade that converts fibrinogen into fibrin, forming a mesh-like structure that traps blood cells and forms a clot.

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Plasmin

An enzyme that breaks down fibrin clots, helping to dissolve the clot and restore blood flow.

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Plasminogen Activator Inhibitor (PAI)

A protein that inhibits the activity of plasmin, preventing the breakdown of fibrin clots and contributing to a pro-thrombotic state.

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How does inflammation affect clotting?

Inflammation promotes clot formation by increasing the release of tissue factor (TF), which activates the coagulation cascade. It also inhibits plasmin activity by increasing the levels of plasminogen activator inhibitor (PAI), leading to less clot breakdown.

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PAPP-A

A protein produced by the placenta, often used in pregnancy tests and fertility treatments.

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Placental hCC

Human chorionic gonadotropin (hCG) is a hormone produced by the placenta, often used in pregnancy tests.

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What does PAPP-A stand for?

Pregnancy-Associated Plasma Protein-A

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What is the role of CRH in pregnancy?

CRH (Corticotropin Releasing Hormone) regulates the timing of parturition and helps mature fetal lungs.

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Preterm infant

A baby born before 37 weeks of gestation.

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Term infant

A baby born between 37 and 42 weeks of gestation.

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Post-term infant

A baby born after 42 weeks of gestation.

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Excessive weight gain in pregnancy

Excessive weight gain during pregnancy can lead to gestational diabetes, hypertension, and other complications.

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EDC

Expected Date of Confinement, the estimated due date of a pregnancy.

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LMP

Last Menstrual Period, the date of the woman's last period.

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SFH

Symphysis-Fundal Height, a measurement used to assess fetal growth.

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Fontanelle

Soft spots on a baby's skull where the bones are not yet fused.

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Occiput

The back of the baby's head.

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Hagar's Sign

A softening and compressibility of the uterine isthmus, a sign of pregnancy.

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Shock: Reduced ATP Production

Shock leads to a decrease in ATP production due to impaired oxygen delivery and cellular metabolism.

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Shock: Consequences of Reduced ATP

Reduced ATP production results in various intracellular consequences, including decreased membrane potential, impaired ion pumps, and reduced protein synthesis.

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Shock: Lactate Accumulation

Shock can lead to lactate accumulation due to anaerobic metabolism, an inefficient way to produce energy.

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Shock: Acidosis

Acidosis, a decrease in blood pH, occurs during shock due to the accumulation of lactic acid and other metabolic byproducts.

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Shock: Reduced Oxygen Affinity

Acidosis can further worsen oxygen delivery by reducing the hemoglobin's affinity for oxygen.

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Shock: Glucose Use

During shock, glucose delivery and uptake are reduced due to hypoperfusion, leading to reliance on alternative energy sources like fat and protein.

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Shock: Energy Store Depletion

Shock rapidly depletes the body's energy stores – liver glycogen, muscle glycogen, and fat.

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Shock: Liver, Muscle & Energy Stores

The liver, muscles, and energy stores are rapidly depleted due to increased demands for energy during shock.

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PCOS Cycle

Characterized by 10 or more follicles measuring 2-18mm in diameter, increased ovarian stroma and thickening of the tunica. This hormonal imbalance can impact fertility.

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PCOS Treatment

Treatment includes restoring normal hormonal levels using oral contraceptives and, sometimes, Metformin to reduce ovarian steroidogenesis.

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PCOS Pregnancy Risks

Pregnant women with PCOS have an increased risk of gestational diabetes, gestational hypertension, preterm birth, and perinatal mortality.

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Mullerian System

This is the term for the female genital tract. During embryogenesis, subtle developmental changes can lead to major anatomical anomalies in the mature system.

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Uterine Anomalies Impact

Uterine anomalies can increase the risk of preterm delivery and malpresentation at birth.

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Fibroids

Benign growths in the uterus that can affect its shape and function, potentially leading to fertility issues.

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Pedunculated Fibroid

A type of fibroid attached to the uterine wall by a stalk, growing both inside and outside the uterus.

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Submucosal Fibroid

This fibroid grows in the inner layer of the uterus, potentially blocking or distorting the fallopian tubes.

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Intramural Fibroid

A fibroid that grows within the muscle layers of the uterus.

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Subserosal Fibroid

A fibroid that grows on the outside of the uterus, connected through a stalk or directly.

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Menarche

The first menstrual cycle a woman experiences, marking the beginning of puberty.

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Fundus

The top part of the uterus, used to measure fetal growth during pregnancy and monitor uterine contraction after delivery.

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Viability

The point in pregnancy where a fetus has a reasonable chance of survival if born prematurely. Typically considered to be 5gm or more than 20 weeks gestation.

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Macrosomia

A term used to describe a fetus with a head size too large to pass through the vagina during delivery.

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Polyhydramnios

Excessive amniotic fluid surrounding the fetus, greater than 2 standard deviations above normal levels.

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Prenatal period

The time from conception to birth, also known as the antenatal period.

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Postnatal period

The time from birth to the full recovery of the body and uterus after childbirth, typically 6-8 weeks.

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Parity

The number of deliveries a woman has had after 20 weeks' gestation. Over 5 deliveries is considered grand multiparity.

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GTPAL

A shorthand description of a woman's obstetrical history, containing information about Gravida, Term, Preterm, Abortions, and Living children.

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Estrogen

Hormone crucial for development and maintenance of female reproductive organs and secondary female characteristics.

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Progesterone

Hormone mainly secreted by the corpus luteum, responsible for preparing and maintaining the endometrium for pregnancy.

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Relaxin

Hormone produced by the corpus luteum and responsible for relaxing the muscles of the uterus and pelvic area.

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Follicular Stimulating Hormone (FSH)

Hormone that stimulates the growth of follicles in the ovaries to produce estrogen and progesterone.

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Luteinizing Hormone (LH)

Hormone responsible for triggering ovulation and the formation of the corpus luteum.

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Study Notes

Patho year 3

  • Integrated pathophysiology for nurses (McMaster University)
  • Study material available on Studocu

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