NM 702 MODULE 6 EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED
How is the hypothalamic-pituitary-adrenal (HPA) axis affected by pregnancy?
HPA function increases: changes are mediated primarily by placental hormones
(including placental ACTH, GH, and CRH, cortisol, thyroid hormones and TBG), and
alterations in liver and kidney function
This is the second most common endocrine disorder in pregnancy.
Thyroid disorders
When does thyroid changes start to occur?
First half of pregnancy
Circulating thyroid hormone that are metabolically active:
T3
Bound thyroid hormones are not metabolically active
What is the main negative effect of thyroid imbalance in pregnancy?
Affects neurointellectual developmental in early childhood
The pituitary will grow to _______% of it original size
135%.
Due to increased vascularity and hyperplasia of normal gland cell.
The growth in the pituitary gland is caused by which hormone?
Estrogen
The anterior/posterior pituitary gland secretes prolactin
,Anterior.
Prolactin cells grow from from 20% to 60%. Become bioactive to prepare breasts for
lactation
Prolactin increases in pregnancy and peaks at _______________
Delivery
The posterior pituitary gland secretes ________________ and
____________________
Antidiuretic hormone (ADH) and oxytocin
The increase in oxytocin during lactation causes
Milk let down
T/F. It is very common that the thyroid gets large enough to increase the
intracranial pressure on the optic chiasm causing headaches and vision changes
that resolve after birth.
False. Rare
A goiter is a normal finding in pregnancy.
No. It should be considered abnormal
T/F. The adrenal gland changes in size about twice its original size and their
function is enhanced.
False. Does not change size, but the function does enhance.
TSH lab draw would be decreased during which gestational weeks due to the
increase of which hormone?
, 8-14 weeks due to the increase of hCG
TSH should be less than 4
How does human chorionic gonadotropin (hCG) affect thyroid function?
Is structurally similar to thyroid-stimulating hormone (TSH), so it stimulates increased T3
and T4 leading to negative feedback to the pituitary gland which causes a decrease in
TSH
Due to the increased estrogen, the liver produces more _________ early in
pregnancy
Thyroid binding globulins (TBGs)
How are thyroid hormones transported throughout the body?
Attached to thyroid binding globulins (TBGs)
What lab test would you use to screen for altered thyroid function in pregnancy?
TSH
To measure thyroid hormones, you would check the:
Free hormone. What's metabolically active.
When reviewing thyroid function labs in pregnancy, what is it important to
remember about normal values?
You need to use trimester-specific values because the norms change throughout the
course of pregnancy.
Ex. In the first trimester you would expect TSH to normally be lower than in a non
pregnant woman because of presence of hCG.
COMPLETE SOLUTIONS VERIFIED
How is the hypothalamic-pituitary-adrenal (HPA) axis affected by pregnancy?
HPA function increases: changes are mediated primarily by placental hormones
(including placental ACTH, GH, and CRH, cortisol, thyroid hormones and TBG), and
alterations in liver and kidney function
This is the second most common endocrine disorder in pregnancy.
Thyroid disorders
When does thyroid changes start to occur?
First half of pregnancy
Circulating thyroid hormone that are metabolically active:
T3
Bound thyroid hormones are not metabolically active
What is the main negative effect of thyroid imbalance in pregnancy?
Affects neurointellectual developmental in early childhood
The pituitary will grow to _______% of it original size
135%.
Due to increased vascularity and hyperplasia of normal gland cell.
The growth in the pituitary gland is caused by which hormone?
Estrogen
The anterior/posterior pituitary gland secretes prolactin
,Anterior.
Prolactin cells grow from from 20% to 60%. Become bioactive to prepare breasts for
lactation
Prolactin increases in pregnancy and peaks at _______________
Delivery
The posterior pituitary gland secretes ________________ and
____________________
Antidiuretic hormone (ADH) and oxytocin
The increase in oxytocin during lactation causes
Milk let down
T/F. It is very common that the thyroid gets large enough to increase the
intracranial pressure on the optic chiasm causing headaches and vision changes
that resolve after birth.
False. Rare
A goiter is a normal finding in pregnancy.
No. It should be considered abnormal
T/F. The adrenal gland changes in size about twice its original size and their
function is enhanced.
False. Does not change size, but the function does enhance.
TSH lab draw would be decreased during which gestational weeks due to the
increase of which hormone?
, 8-14 weeks due to the increase of hCG
TSH should be less than 4
How does human chorionic gonadotropin (hCG) affect thyroid function?
Is structurally similar to thyroid-stimulating hormone (TSH), so it stimulates increased T3
and T4 leading to negative feedback to the pituitary gland which causes a decrease in
TSH
Due to the increased estrogen, the liver produces more _________ early in
pregnancy
Thyroid binding globulins (TBGs)
How are thyroid hormones transported throughout the body?
Attached to thyroid binding globulins (TBGs)
What lab test would you use to screen for altered thyroid function in pregnancy?
TSH
To measure thyroid hormones, you would check the:
Free hormone. What's metabolically active.
When reviewing thyroid function labs in pregnancy, what is it important to
remember about normal values?
You need to use trimester-specific values because the norms change throughout the
course of pregnancy.
Ex. In the first trimester you would expect TSH to normally be lower than in a non
pregnant woman because of presence of hCG.
