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Hct and Hb decrease, causing the physiologic anemia of pregnancy (because of increased plasma volume) *An Hb <11 is never normal and must be evaluated for iron/folate deficiency or a hemoglobinopathy When does the anemia of pregnancy reach its nadir What is the effect of pregnancy on BP Around 24 weeks BP decreases in the first trimester, nadirs at approximately 24 weeks, and then almost normalizes by term Diastolic is affected more than systolic

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No one can really be sure what the public is going to like, but if a game design calls for a new kind of user interface, or a type of gameplay never before seen, the publisher is likely to want to try it out before giving the go-ahead for the project Likewise, they will want to see what the game is going to look like, and maybe even get an idea of how it will feel to play This is where prototyping comes in A prototype is a partially working model of the game, normally constructed by a handful of people: a few programmers, maybe a couple of artists, a designer, and a team leader It doesn t even have to be a stand-alone application; a prototype can be built in Shockwave or Flash as long as it conveys the general idea; though some publishers will insist on more In addition to devising a prototype, the artists will be creating concept drawings, a few 3-D models, animations, and backgrounds, and looking in art books and on the Web for background material It s always valuable to have a lot of pictures around during the prototype phase, to help inspire the team and give everyone a shared sense of what you re aiming to achieve

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How does pregnancy affect pulmonary function tests (PFTs) Tidal volume increases by 40% Minute ventilation increases by 50% Functional residual capacity decreases by 20% Total lung capacity slightly decreases Expiratory reserve volume and total lung capacity decrease Forced expiratory volume (FEV1) does not change Respiratory rate does not change What hormone mediates these effects and how does it act Progesterone It acts centrally (through direct stimulation of the medulla and respiratory centers) as well as peripherally (through pulmonary vasodilation) Alveolar and arterial oxygen levels increase Arterial carbon dioxide levels decrease How is the acid base equilibrium affected during pregnancy What is the effect of pregnancy on oxygen consumption How does the gravid uterus affect respiratory function Respiratory alkalosis with metabolic compensation (pH between 740 and 745) Increases by over 20% owing to the placenta, fetus, and maternal organs The thorax becomes more barrelchested and dyspnea is a common symptom in advanced pregnancy because of the pressure of the gravid uterus and the central effects of progesterone

What is the effect of pregnancy on renal function Glomerular filtration rate (GFR) increases by 50% (because of the increase in glomerular plasma flow) Renal blood flow increases Plasma creatinine, BUN, and uric acid levels decrease (because of the increased GFR) [*Normalization of Cr, BUN, or UA may indicate underlying pathology (preeclampsia, renal insufficiency)] Why is the pregnant woman at increased risk for urinary tract infections Progesterone reduces ureteral tone and peristalsis, and relaxes the bladder wall allowing reflux through the incompetent vesico-ureteral valves This results in stasis of urine, dilated ureters, increased pressure in the renal pelvis, and bacterial proliferation

t one point in my career, I was a lead game designer at Bullfrog Productions, which I had joined because they were famous for some of the most innovative PC games ever made I was given a prototype team to research a new god game (a subgenre of real-time strategy games) called

What are the common causes of bacteriuria Escherichia coli >> Klebsiella > Proteus in pregnancy > Group B streptococcus (GBS) > Enterococci > Staphylococci What is a complication of pyelonephritis during pregnancy Where does hydronephrosis in pregnancy most commonly occur What happens to plasma osmolality during pregnancy Preterm labor On the right side (because of right uterine dextrorotation and right ureter compression) It falls because of increased levels of relaxin (stimulated by HCG) and antidiuretic hormone (ADH) These lead to an increase in intravascular fluid which then decreases plasma osmolality Pitting edema in gravity-dependent areas It is normal, because of increased GFR In 24 hours protein may increase to 200 mg (normal is less than 100 mg/24 hours) However, higher values suggest renal pathology or preeclampsia

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