EFA 11 Flashcards
Non-steroidal anti-inflammatory drugs and COX1/2 inhibitors such as indomethacin are sometimes used to prevent early (<32 weeks) pre-term labour. Suggest one mechanism by which inhibiting prostaglandin action in the female reproductive tract could prevent pre-term birth?
Possible answers include:
- Inhibit leukocyte recruitment
- Inhibit interleukin release
- Inhibit membrane destabilization
- Inhibit myocyte connectivity
- Inhibit uterine lower segment relaxation
What form of embryonic nutrition leads to the breakdown of maternal endometrial capillaries to form trophoblastic lacunae?
Histiotrophic
If a patient reports to his GP with symptoms such as cold and clammy skin, increased heart rate and no urine output. What is likely to be his blood fluid volume status?
Hypovolaemic
Erythema gyratum repens is associated with which underlying disorder?
Cancer
Maternal stress is associated with reduced expression of the 11βHSD2 enzyme in the placenta. What is the impact of this reduction on exposure of the fetus to cortisol?
Increased cortisol exposure / elevated cortisol exposure
SAQ
On a visit to her GP, a 42 year old woman is found to have blood pressure of 150/90 mm Hg, having previously been normotensive. The patient has a BMI of 28, and is 33 weeks’ into her first pregnancy, which was conceived through IVF.
- Given the information above, what condition might you expect the patient to have? (1 mark)
Pre-eclampsia (early onset)
On a visit to her GP, a 42 year old woman is found to have blood pressure of 150/90 mm Hg, having previously been normotensive. The patient has a BMI of 28, and is 33 weeks’ into her first pregnancy, which was conceived through IVF.
- What risk factors does the patient have that might lead you to suspect this condition? (3 marks)
Aged over 40 (1 mark)
First pregnancy (1 mark)
IVF conception (if frozen embryo) (1 mark)
BMI not likely to be a risk factor as under 30.
On a visit to her GP, a 42 year old woman is found to have blood pressure of 150/90 mm Hg, having previously been normotensive. The patient has a BMI of 28, and is 33 weeks’ into her first pregnancy, which was conceived through IVF.
- Relative to a placenta from a normal pregnancy, what histological changes would you expect to see in the placenta of this pregnancy (2 marks)?
Limited/no invasion of Endothelial Extravillous Trophoblast beyond decidual layer (1 mark)
Reduced spiral artery conversion (1 mark)
On a visit to her GP, a 42 year old woman is found to have blood pressure of 150/90 mm Hg, having previously been normotensive. The patient has a BMI of 28, and is 33 weeks’ into her first pregnancy, which was conceived through IVF.
- The chorionic villi of the placenta play a key role in this disorder. Summarise the process by which these structures form during placentation (3 marks)
Cytotrophoblasts grow out from chorion to form finger-like structures (primary) – 1 mark
Mesoderm cells invade into the cytotrophoblasts (secondary) – 1 mark
Blood vessels from the umbilical arteries and veins invade villus to provide blood supply (tertiary) – 1 mark
On a visit to her GP, a 42 year old woman is found to have blood pressure of 150/90 mm Hg, having previously been normotensive. The patient has a BMI of 28, and is 33 weeks’ into her first pregnancy, which was conceived through IVF.
- Following a blood test, the patient’s serum PLGF concentration is found to be >100pg/ml, what does this tell you about the likelihood of needing to deliver the fetus in the next two weeks? (1 mark)
Delivery is unlikely to be needed in the next two weeks (1 mark)
