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Drew 921 > 4_8LactationNeonatal > Flashcards

4_8LactationNeonatal Flashcards

1
Q

What factors cause neonate hypoxia during/after delivery?

A

1) general anesthetics, 2) umbilical compression; 3) premature placental separation; 4) contractions that restrict blood flow

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2
Q

How long can a newborn go without a breath?

A

10 minutes

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3
Q

What are the bypasses present in the fetal circulation?

A

1) ductus venosus; 2) foramen ovale; 3) ductus arteriosus

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4
Q

What is the ductus venosus

A

liver bypass

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5
Q

What is the foramen ovale?

A

shunts RA to LA

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6
Q

What is the ducturs arteriousus?

A

shunts pulmonary artery to aorta

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7
Q

Why is fetal thermoregulation poor?

A

poor establishment of neural control; hi SA:V ratio

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8
Q

What does APGAR stand for?

A

appearance, grimace, pulse, activity, respiratory

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9
Q

What does APGAR measure at 1 minute?

A

tolerance to birth

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10
Q

What does APGAR measure at 5 minutes?

A

adapation to extra-uterine environment

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11
Q

What is associated with a low APGAR score?

A

1) c-section; 2) difficult labor; 3) fluid in airways

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12
Q

What APGAR score needs medical attention

A

less than 7

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13
Q

What APGAR score means healthy baby?

A

7 to 9

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14
Q

What weight loss is expected after delivery?

A

5-10%

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15
Q

How long do a baby’s nutrition stores last?

A

glycogen = 3 hours; fats, protein = 2-3 days

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16
Q

What nutreitns are critical to the infant and are also found in mom’s milk?

A

D, C, Fe

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17
Q

What is cholostrum?

A

leukocytes and macrophages in early secretions of breast milk at the end of pregnancy for GI protection

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18
Q

What elements of passive immunity are passed from mom?

A

1) IgA, 2) lysozyme, 3) lactoferrin, 4) cholostrum

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19
Q

When does a baby start producing immunoglobulins?

A

IgA at 3 months; IgG at 6-12 months

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20
Q

What causes respiratory distress syndrome?

A

decreased pulmonary surfactant, common in premature babies

21
Q

What causes patent ductus arteriosus?

A

ductus arteriousus fails to close

22
Q

How is patent ductus arteriosus treated?

A

prostanoids to close

23
Q

How is neonatal jaundice treated?

A

photooxidation to increase solubiliy; blood transfusion if severe

24
Q

What are the differences between human and cow milk?

A

humans have more lactose; cows have more casein, albumin, ash

25
How is PRL secreted?
from pituitary in pulses of 10-20x basal [PRL] with suckling (pulses necessary to maintain lactation response)
26
How is PRL inhibited?
PIH from HT
27
How is milk fat synthesized?
in ER to form membrane-bound lipid droplets
28
How is milk protein synthesized
in vacuoles and exocytosed
29
What factors determine the amount of milk secreted?
frequency, duration and intensity of suckling
30
What determines basal [PRL]?
suckling frequency
31
What determines PRL burst strength?
strength and duration of suckling
32
How long does a PRL burst stay at high concentration?
1 hour
33
What factors can stimulate milk letdown, and what can inhibit?
handling baby and crying; stress
34
Describe milk ejection.
only upon suckling: 1) HT release of oxytocin; 2) oxytocin dis-inhibits PRL; 3) alveolar myoepithelium contracts
35
How long for milk to flow after initation of suckling?
30 seconds to 1 minute
36
How long after birth does normal reproduction occur and why?
3-6 months; PRL suppresses initiation of GnRH/FSH/LH
37
What hormones are involved in the lactogenic response and what are their effects?
1) E2/P4 (inhibit milk secretion); 2) GH, cortisol, PTH, insulin (required for milk constituents); hCS
38
What is a lobule?
cluster of alveoli/acini opening into milk ducts and then larger ducts
39
What are alveoli?
structures containing milk-secreting epithelium
40
What is a lactiferous sinus?
milk reservoirs that open up onto nipple
41
How is immunity passed to the placenta?
antibodies can cross
42
When does a baby walk alone?
12 months
43
When does a baby crawl?
7 months
44
When does a baby have head control
3 months
45
Describe bilirubin production in the neonate
increases from 1-5 mg/dL due to compromised liver function
46
What is physiological jaundice
normal elevation of unconjugated bilirubin in the healthy neonate
47
What are causes of hyperbilirubinemia?
1) congenital enzyme defect; 2) structural RBC defect; 3) polycythemia; 4) hematoma; 5) Gilber's; 6) Crigler-Najjar
48
What is gilbert's syndrome?
reduced hepatic uptake of bilirubin
49
What is crigler-najjar syndrome?
reduced hepatic conjugation of bilirubin

Drew 921 (33 decks)

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