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  • DIABETES DURING PREGNANCY

    1. Pregnancy Hormones

    In normal pregnancy, levels of all of the following hormones increases EXCEPT:

    a) Total thyroxine (T4)
    b) Parathyroid hormone (PTH) in the 2ND & 3RD trimesters.
    c) Free cortisol.
    d) Prolactin.
    e) Estradiol

    Correct Answer: Parathyroid hormone in 1st trimester. Option 'b' should have been PTH in 1st trimester. Parathyroid hormones plasma concentration decreases during the first trimester, and then increases progressively throughout the remainder of pregnancy (because of chronic lowering of calcium concentration in 2nd and 3rd trimester).

    2. Estrogen in Pregnancy

    During pregnancy, maternal estrogen levels increases markedly. Most of this estrogen is produced by

    a) Ovaries.
    b) Adrenals.
    c) Testes.
    d) Placenta.
    e) Uterus.

    Correct Answer: d) Placenta. In early pregnancy, estrogen promotes the growth of breasts; later on, it helps develop their milk-making machinery. Baby benefits too: Estrogen triggers the development of genital organs and regulates bone density.

    3. The placenta produces the following substances

    a) Oestrone
    b) 5 alpha-reductase
    c) Oxytocinase
    d) Histaminase
    e) Progesterone

    Correct Answer: All are correct. Placenta synthesizes an enormous amount of steroid, protein and peptide hormones. Cosmetic industry purchases tons of placenta for the extraction of hormones and proteins to be used in hair, face and skin care products.

    4. Human Chorionic Gonadotropin

    a) Glycoprotienb) Has 2 subunitsc) Increased to maximum level in 3rd trimesterd) Secreted by trophoblastic tissuee) The alpha subunit is specificCorrect Answer: a, b, d. A maximum level of hCG is usually reached by the 10th or 11th week thereafter it decreases.Alpha subunit of hCG identical to that of luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), and β (beta) subunit that is unique to hCG.

    5. hCG

    Human Chorionic Gonadotropin (hCG), all of the following are true EXCEPT:

    a) It is produced by the placenta.
    b) Is responsible for the maintenance of corpus luteum.
    c) It's level doubles every 48 hours in ectopic pregnancy.
    d) Reaches a peak concentration in maternal serum by 10 weeks gestation.
    e) Forms the main tumor marker for trophoblastic neoplastic diseases.

    Correct Answer: c) It's level doubles every 48 hours in ectopic pregnancy is false. Below an hCG level of 1,200 mIU/ml the hCG usually doubles every 48–72 hours, though a rise of 50–60% is still considered normal. Between 1,200 and 6,000 mIU/ml serum the hCG usually takes 72–90 hours to double, and above 6,000 mIU/ml, the hCG often takes more than four days to double. Failure to increase normally may indicate an increased risk of miscarriage or a possible ectopic pregnancy. Serial beta-hCG levels that do not increase appropriately in a woman with suspected ectopic pregnancy are only 36 percent sensitive and approximately 65 percent specific for detection of ectopic pregnancy.

    6. Oxytocin

    a) It is secreted by anterior pituitary
    b) It acts on the myoepithelial cells of breast
    c) It causes contraction of uterus in labor
    d) It causes retention of water
    e) It has sympathetic activity

    Correct Answer: b,c,d1) Oxytocin is secreted by the posterior pituitary gland.2) Oxytocin acts on the myoepithelial cells of the breast ducts to cause milk let-down.3) Oxytocin has amino-acid homology similar to arginine vasopressin. It has similar antidiuretic action, and when infused at dosages of 20mIU/min or more, renal free water clearance decreases markedly.4) Oxytocin dampens sympathetic nervous system activity. It specifically modulates phasic activity of the parasympathetic nervous system. 

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    Dr. Niraj Mahajan

    MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.

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