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What is the decrease in the minimum alveolar concentration (MAC) during pregnancy at term?
Oxygen consumption decreases during pregnancy.
False
What percentage increase in plasma volume often leads to dilutional anemia during pregnancy?
55%
The average blood loss during vaginal delivery is ______ mL.
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Match the following physiological changes with their respective systems during pregnancy:
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Which trimester is characterized as the first three months of pregnancy?
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Functional residual capacity (FRC) increases during the term of pregnancy.
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What happens to blood volume after delivery?
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Respiratory rate and ______ volume increase during pregnancy.
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The average blood loss during a cesarean section ranges from:
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What percentage increase in cardiac output is observed at term due to pregnancy?
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Supine hypotension syndrome affects approximately 10% of women at term.
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What physiological change occurs in renal plasma flow during pregnancy?
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During pregnancy, there is an increase in fibrinogen and factors VII, VIII, IX, X, and XII, resulting in a ______________ state.
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Match the following cardiovascular changes with their descriptions:
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What is the primary cause of supine hypotension syndrome in pregnant women?
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Creatinine levels typically increase during pregnancy.
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Which drugs are known to reduce lower esophageal sphincter pressure during pregnancy?
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The decrease in serum pseudcholinesterase activity at term is approximately ______________.
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Which of the following factors typically does NOT change significantly during pregnancy?
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What is the average increase in blood volume during pregnancy?
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Respiratory alkalosis is facilitated by an increase in plasma bicarbonate concentration during pregnancy.
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What is the effect of pregnancy on the minimum alveolar concentration (MAC)?
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The significant increase in plasma volume during pregnancy can lead to __________ anemia.
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Match the physiological changes with their respective systems during pregnancy:
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Which of the following occurs in the respiratory system during pregnancy?
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Blood viscosity increases during pregnancy due to the greater increase in red cell mass compared to plasma volume.
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What physiological change occurs regarding functional residual capacity (FRC) at term during pregnancy?
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The average blood loss during a cesarean section is approximately __________ mL.
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Which trimester of pregnancy is characterized by major physiological adaptations to support the developing fetus?
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What is the primary cause of supine hypotension syndrome in pregnant women?
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Cardiac chambers enlarge and myocardial hypertrophy is rare in pregnancy.
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What percentage of increase in cardiac output is observed at term during pregnancy?
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During pregnancy, renal plasma flow and glomerular filtration rate _____ (increase/decrease).
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Match the following hematological changes with their characteristics during pregnancy:
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Which of the following drugs may facilitate gastroesophageal reflux during pregnancy?
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Plasma osmolality increases by 8-10 mOsm/kg during pregnancy.
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What common gastrointestinal issue may occur during pregnancy?
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Pregnancy is associated with a __________ state due to increased fibrinogen and factors VII, VIII, IX, X, and XII.
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How much does stroke volume increase during pregnancy by term?
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Study Notes
Pregnancy
- Pregnancy is the state of carrying and developing a fetus inside the female body
- Pregnancy is divided into three trimesters: first, second and third trimesters.
- Each trimester encompasses three months of pregnancy.
Central Nervous System (CNS)
- The minimum alveolar concentration (MAC) decreases during pregnancy, by as much as 40% at term.
- Pregnant patients exhibit increased sensitivity to local anesthetics during regional anesthesia and analgesia.
Respiratory System
- Oxygen consumption and minute ventilation increase during pregnancy.
- Tidal volume, respiratory rate, and inspiratory reserve volume also increase during pregnancy.
- PaCO2 decreases to 28 - 32 mmHg.
- Thoracic breathing is favored over abdominal breathing.
- Functional residual capacity (FRC) decreases up to 20% at term.
- The combination of decreased FRC and increased O2 consumption promotes rapid oxygen desaturation during periods of apnea.
- Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration.
- Hyperventilation may slightly increase PaO2.
- Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest.
Cardiovascular System
- Cardiac output and blood volume increase to meet maternal and fetal metabolic demand.
- An increase of 55% in plasma volume, exceeding the increase in red cell mass (45%), produces dilutional anemia and reduces blood viscosity.
- Hemoglobin concentration typically remains greater than 11 g/dL.
- At term, blood volume has increased by 1000 - 1500 mL in most women.
- Total body volume reaches 90 mL/kg.
- Average blood loss during vaginal delivery is 400 - 500 mL, compared with 800 - 1000 mL for a Cesarean section.
- Blood volume does not return to normal until 1 - 2 weeks after delivery.
- The increase in cardiac output (40% at term) is due to increases in heart rate (20%) and stroke volume (30%).
- Cardiac chambers enlarge and myocardial hypertrophy is often noted on echocardiography.
- Approximately 5% of women at term develop the supine hypotension syndrome.
- The cause of this syndrome appears to be complete or near-complete occlusion of the inferior vena cava by the gravid uterus.
Renal & Gastrointestinal System
- Renal plasma flow and glomerular filtration rate increase during pregnancy.
- Creatinine and blood urea nitrogen may decrease.
- Plasma osmolality decreases by 8 - 10 mOsm/kg.
- Gastroesophageal reflux and esophagitis are common during pregnancy.
- Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, potentially facilitating gastroesophageal reflux and delaying gastric emptying.
Hepatic System
- Overall hepatic function and blood flow remain unchanged during pregnancy.
- There is a 20 - 30% decrease in serum pseudocholinesterase activity at term.
Hematological System
- Pregnancy is associated with a hypercoagulable state.
- Fibrinogen and concentrations of factors VII, VIII, IX, X, XII all increase.
Pregnancy
- The state of carrying and developing a fetus within the female body.
- Divided into three trimesters: First, second and third trimesters, each lasting three months.
- Pregnancy affects most organ systems.
- Many physiological changes are adaptive and useful for the mother to tolerate the stresses of pregnancy, labor, and delivery.
Central Nervous System
- Minimum alveolar concentration (MAC) decreases during pregnancy, by as much as 40% at term.
- Pregnant patients have enhanced sensitivity to local anesthesia during regional anesthesia and analgesia.
Respiratory System
- Oxygen consumption and minute ventilation increase during pregnancy.
- Tidal volume, respiratory rate, and Inspiratory Reserve Volume increase.
- PaCO2 decreases to 28-32 mmHg.
- Thoracic breathing is favored over abdominal breathing.
- Functional residual capacity (FRC) decreases up to 20% at term.
- Combination of decreased FRC and increased O2 consumption promotes rapid oxygen desaturation during periods of apnea.
- Significant respiratory alkalosis is prevented by a compensatory decrease in plasma bicarbonate concentration.
- Hyperventilation may increase PaO2 slightly.
- Elevation of the diaphragm is compensated by an increase in the anteroposterior diameter of the chest.
Cardiovascular System
- Cardiac output and blood volume increase to meet maternal and fetal metabolic demands.
- Increase (55%) in plasma volume in excess of increased red cell mass (45%) produces dilutional anemia and reduces blood viscosity.
- Hemoglobin concentration usually remains greater than 11g/dL.
Cardiovascular System - At Term
- Blood volume has increased by 1000-1500 mL in most women.
- Total body volume reaches 90mL/kg.
- Average blood loss during vaginal delivery is 400-500 mL, compared with 800-1000 mL for a cesarean section.
- Blood volume does not return to normal until 1-2 weeks after delivery.
- The increase in cardiac output (40% at term) is due to increases in heart rate (20%) and Stroke Volume (30%).
- Cardiac chambers enlarge and myocardial hypertrophy is often noted upon echocardiography.
- Approximately 5% of women at term develop the supine hypotension syndrome.
- The cause of this syndrome appears to be complete or near-complete occlusion of the inferior vena cava by the gravid uterus.
Renal & Gastrointestinal System
- Renal plasma flow and glomerular filtration rate increase during pregnancy.
- Creatinine and blood urea nitrogen may decrease.
- Plasma osmolality decreases by 8-10 mOsm/kg.
- Gastroesophageal reflex and esophagitis are common during pregnancy.
- Opioid and anticholinergic drugs reduce lower esophageal sphincter pressure, may facilitate gastroesophageal reflex and delay of gastric emptying.
Hepatic System
- Overall hepatic function and blood flow remain unchanged.
- A 20-30% decrease in serum pseudocholinesterase activity at term.
Hematological System
- Pregnancy is associated with a hypercoagulable state.
- Fibrinogen and concentrations of factors VII, VIII, IX, X, XII all increase.
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Description
This quiz covers the physiological changes during pregnancy, particularly focusing on the respiratory and central nervous system adaptations. Understand how pregnancy affects oxygen consumption, minute ventilation, and anesthetic sensitivity. Test your knowledge on the trimesters and their impact on respiratory function.
