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OB > A&P > Flashcards

A&P Flashcards

1
Q

Lupron

A

this is a GNRH inhibitor

used in tx of prostate cancer and in women who have endometriosis. If shut down activity of GnRH, the female will get menopause.

shuts down the whole thing
inhibiting the release of gonadotropin and eveyrthing stops

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2
Q

medically speaking, how do we target estradiol and progesterone

A

OTC

mimic the feedback into the HPO axis by keeping some level of estrogen and progesterone from the target organ at all times, thereby suppressing further ovulation events

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3
Q

when, during a women’s cycle, is a pap difficult to perform and why

A

low and closed
very dry
early in the cycle

better to do it around day 14

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4
Q

Stage 1 of follicular development

A

in utero: independent of FSH

a. Born with the follicles and they go under a state of arrested development until puberty

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5
Q

Stage 2/3

A

 Estradiol from ovary (FSH) accelerates growth of 6-12 secondary follicles each cycle. Can see up to 20 per month – it is different in every woman

a. Dominant follicle determined at about 1 week – others die

probably

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6
Q

follicular development does not happen if there is no

A

if there is no LH

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7
Q

corona radiate

A

Outer wall of graffian follicle swells allowing stigma from center to protrude. Stigma ruptures and ovum is carried within fluid and cells

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8
Q

hormone responsible for the spike in body temperature

A

progesterone

-the likes this weird mortor analogy

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9
Q

maximum window of fertilization is

A

before the ovary release just prior to the LH surge

once estrogen is opposed by progesterone the cervix is low closed and dry

the pinbark height test is better than an ovulation kit

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10
Q

where does fertilization occur

A

Happens high in tube if implantation is to occur

  1. sperm needs travel time to get to the fimbria

if you can implant around day 8 you have a better chance.

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11
Q

_____ effects the pituitary which triggers the release of FSH

A

GNRH effects the pituitary which triggers the release of FSH

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12
Q

the ___phase is governed by the CL and is a solid ____ days

A

The luteal phase governed by the CL is a solid 12-16 days. After ovulation the cycle should be very consistent

  • 3x more cycles than ever in
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13
Q

embryonic portion of the placenta responsible for sustaining the luteum through the first semester

A

initially by embryo (trophoblasts), then placenta

hCG keeps the corpus luteum from degenerating in the first trimester. So it can keep making the progesterone. If the progesterone levels fall, the wall falls down and menses start

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14
Q

when do we see the degradation of the CL in pregnancy what happens at this point

A

10-12 weeks

placenta becomes the major produce of steroids

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15
Q

HPL

A

human placental lactogen secreted into maternal circulation, rises throughout pregnancy

  1. Protein hormone, like prolactin, antagonizes maternal glucose consumption
    Provide nutritional support by making glucose readily available to the fetus but also puts mom at risk for gestational DM

this hormone is indicated in GDM

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16
Q

chloasma

A

otherwise known as melasma
is the mask of pregnancy
seen with pigment changes related to hormones affecting melanocytes

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17
Q

role of relaxin in pregnancy

and what are the associated changes with this

A

enlarges ribacage and subcostal diaphragm diameter, volumes and capacities effected by mechanical changes

  1. DOE increases throughout pregnancy
  2. Pelvis is not as stable as it used to be so can be a fall risk
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18
Q

why do we see a decrease in BP early in pregnancy

A

iii. BP decreased early, then compensated
1. Vasodilation causes decrease in BP

iv. BP higher than pre-preg = MONITOR

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19
Q

what BP drugs should be avoided in pregnancy

A

Never use ACEi d/t renal damage

first line:
Labetalol
Hydralazine
Nifedipine
Methyldopa
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20
Q

renal changes seen in pregnancy (3)

A

i. Kidneys enlarge
ii. Increased GFR increases CrCl

iii. Glucose load and excretion increased d/t insulin insensitivity
iv. Trace protein in UA – normal from expanded volume, enhanced perfusion

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21
Q

bladder changes

A

reduced capacity, increased pressure

i. Nerves of the bladder respond to both internal/external pressure

22
Q

when do we see blood volume increase in pregnancy

A

i. BV increased at 6 weeks

23
Q

other than BV changes

what other hematological changes do we see in pregnancy

A

ii. Physiologic anemia – red cell production will not keep up early but it will come back
iii. Two fold normal risk of embolism

24
Q

pregnancy is a hyper or hypo coagulable state?

A

hypercoaguble

25
Q

hypertrophy or breast tissue is due to prolactin or progesterone?

A

progesterone

26
Q

first form of milk produced by mammory glands is known as

A

iii. Colostrum expression pre-partum

27
Q

musculoskeletal changes seen in pregnancy

A

i. Lumbar lordosis  helps with weight repositioning
ii. Unsteady gait w/ separation of PS
iii. (relaxin effect on pelvis) – fall risk

28
Q

changes in the reproductive organs with regards to cervix and uterine volume

A

i. Increased d/c
ii. Endocervix converts to ectocervix
iii. Mucus plug forms which will be extruded at the onset of labor
iv. Uterine volume increases x500

29
Q

umbilical vein is how saturated with oxygen

A

i. Umbilical vein blood is 80% sat (carries blood from the placenta to the fetal heart)

30
Q

physiological valve that exists in the liver of the fetus

A
  1. In order to get to the IVC, the umbilical vein has to travel to the liver. In the liver, you are going to encounter the DUCTUS VENOSUS which is a physiologic valve(structure that fxns like a valve but it does not have flaps)
31
Q

how does the ductus venosus work exactly?

A

In the fetus, the ductus venosus (Arantius’ duct after Julius Caesar Aranzi) shunts a portion of the left umbilical vein blood flow directly to the inferior vena cava. Thus, it allows oxygenated blood from the placenta to bypass the liver.

32
Q

how does the ductus venous and the greater liver protect the fetal heart

A

become a protective reservoir for excess flow when high pressure in the system so it is thought to control the pressures on the fetal heart.
The liver can take some of that volume when pressure is high and limit exposure to the heart. Under normal conditions, blood goes through DV, bypasses the liver and pours into the IVC.

33
Q

what triggers the function of the lungs after delivery

A

Reduced resistance in lungs invites flow

Buildup of CO2 with loss of maternal flow which works on the brain and stimulates respiratory drive

34
Q

why is the right ventricle thicker initially after birth

A

e. Greater workload on R ventricle in fetus means that wall of R ventricle is thicker until about 1 month of age. R ventricular wall atrophies

35
Q

why would a blood shunt exist after brith?

when would this be normal?

A

Often a small shunt of blood persists from aorta to L pulmonary artery for 24-48 hours after birth – NORMAL

36
Q

Neural tube formation (CNS primordium)

is a ___ week embryonic development

A

3 weeks

neural crest formation also occurs at this time

37
Q

Coelom

A

body cavity occurs in week 3)

38
Q

what is occuring around week .

A

Gastrulation forms

trilaminar embryo (meso, endo and ecto derm multi potent layers are formed)

primitive streak nad grove

39
Q

primordial axis of the embryo is known as

A

notocord

this a transient embryonic structure that is seen as the nucleus pulpulses in the human

this is a solid structure that helps determine how the embyro folds

40
Q

organogenetic period

A

4-8 weeks

41
Q

what is the fetal period

A

i. 9th week – birth = fetal period

42
Q

organogenetic period

A

Major portion of the embryonic period, all major organ systems form

C-shaped cylindrical embryo formed from embryonic disc by FOLDING IN 4th week

43
Q

when do we see the incorporation of the yoke sac

A

Incorporation of yolk sac and formation of gut from the yolk sac in 4th week

Heart moves ventrally as brain forms

44
Q

ductus venous

A

bypasses the liver and connects tot he IVC

mixed purple blood here mixes with the hepatic vein

all blood from placenta and body meet in the RA

45
Q

hypoxic pulmonary vasoconstriction

A

this is what exists in the lungs because of the absence of oxygen results really high pressures in the RV and the RA

very little blood makes it to the RV ductus arterioses shunts blood form the pulmonary artery to the aorta

46
Q

chemical that keeps the ductus arterioses open

A

prostaglandin

47
Q

ductus venosus turns into the

A

Ligamentum venosum of the liver

48
Q

the remnants of the umbilical vein turn into what in the adult

A

ROUND LIGAMENT

49
Q

important CRL measurement in the 9 week fetus

A

head is ½ crown rump length

50
Q

what is more saturated with oxygen the umbilical vein or the umbilical artery?

A

vein! 80%

arteries 58%

51
Q

what occurs with regards to blood formation during the 9th week

A

Blood formation shifts from liver to spleen from 9th-12th weeks

Skeletal ossification and coordinated limb movements. Blood cell production is shifting into the bones

52
Q

Scalp hair pattern determine by ____ week

A

Scalp hair pattern determine by 13-16th week

OB (14 decks)

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