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Reproduction > Exam 2- lecture 1 > Flashcards

Exam 2- lecture 1 Flashcards

1
Q

define fertilization

A

fusion of 2 haploid gametes to produce a diploid zygote with 35 chromosomes

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2
Q

where does fertilization occur?

A

ampulla of uterine tube

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3
Q

how long does it take the zygote to reach the uterus?

A

3-5 days

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4
Q

fertilized egg aka

A

zygote

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5
Q

what transports the zygote from fallopian tube to uterus?

A

ciliated cells & peristaltic movements

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6
Q

what is a zygote known as when it reaches the uterus?

A

blastocyst

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7
Q

how long does it take the blastocyst to implant?

A

1-2 days

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8
Q

uterine milk

A

nutrition from the endometrial secretions before implantation

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9
Q

after contacting uterine endometrium, blastocyst becomes surrounded by a layer of

A

trophoblasts

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10
Q

trophoblasts erode

A

the endometrium & the blastocys burrows in (implants)

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11
Q

after implantation, the trophoblasts develop into

A

the placenta

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12
Q

when is it considered an embryo

A

weeks 2-8

after week 8 it is a fetus

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13
Q

functions of trophoblasts

A
  • digest decidual cells & release their nutrients
  • secrete hCG until placenta takes over
    form chorionic villi
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14
Q

progesterone plays an important role in converting endometrial cells into

A

decidual cells

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15
Q

maternal circulation & fetal circulation are

A

separated by endothelial cells of maternal sinuses & chorionic villi
they do NOT mix

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16
Q

chorionic villi carries

A

fetal blood

- surrounded by sinuses containing maternal blood

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17
Q

umbilical arteries carry

A

DEOXYGENATED blood from the fetus to placenta

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18
Q

umbilical vein carries

A

OXYGENATED blood back to the fetus

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19
Q

maternal blood flow

A

uterine arteries->maternal sinuses-> uterine veins

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20
Q

fetal blood flow

A

2 umbilical arteries->capillaries of the villi-> 1 umbilical vein into the fetus

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21
Q

solute transfer between maternal & fetal circulation occurs

A

across the placenta

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22
Q

the fetal and maternal circulatory systems are separated by

A

the placental trophoblasts & fetal capillary wall

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23
Q

hormones synthesized by the placenta

A

hCG, estrogen, progesterone, human chorionic somatomammotropin, relaxin
released into maternal circulation

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24
Q

when does hCG production begin?

A

within a few days of implantation

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25
Q

role of hCG

A

stimulates corpus luteum to continue to make progesterone during early stages of prego

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26
Q

hCG is a functional analog of

A

LH

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27
Q

how much does estrogen increase during prego?

A

30 fold increase

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28
Q

primary effects of estrogen on mother

A
  • growth of uterus, breast, ductal tissue, enlargement of external genitalia, relaxes pelvic ligaments, increase blood flow to uterus
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29
Q

how much does progesterone increase during prego

A

10 fold

30
Q

function of progesterone in prego

A
  • causes decidual cells to develop in uterine endometrium
  • prevents contractions & sloughing
  • prepare breasts for lactation
31
Q

labor & parturition are driven by

A

oxytocin & increased oxytocin receptors in uterus

32
Q

positive feedback look of oxytocin

A

baby descends, contracting the cervix-> oxytocin release-> contraction-> push baby further down-> stretch cervix more-> more oxytocin released

33
Q

Hyperemesis gravidarum (HEG)

A

condition that is” N/V on steroids”; so severe that she can lose ~5% of pre-prego weight; Ketosis; Sometimes requires hospitalization, needs medical intervention

34
Q

gestational diabetes (GDM)

A

by inducing some insulin resistance, able to allow more glucose for fetus

35
Q

gestational HTN

A

> 140/90

36
Q

preeclampsia

A

HTN with proteinuia

37
Q

exclampsia

A

preeclampsia with seizures

38
Q

preeclampsia arises from

A

abnormal placentation- imperfect vascular exchange, fetal hypoxia & release of inflammatory mediators from placenta to maternal circulation

39
Q

preeclampsia leads to

A

HELLP:
hemolysis
elevated liver enzymes
low platelet count

40
Q

eclampsia treatment

A

emergency c-section

magnesium sulfate may be needed to control seizures during labor

41
Q

gestational transient thyrotoxicosis

A

increased free T4, may be asymptomatic or present with vomiting
usually resolves later in prego when hCG <

42
Q

hCG is structurally similar to:

A

TSH & can stimulate thyroid

43
Q

post partum throiditis

A

increased TH secretion
usually resolves spontaneously
beta-blockers provide symptomatic relief

44
Q

thromboembolism

A

occurs 5-10X more in prego

45
Q

prego creates a

A

hypercoagulable state

46
Q

anticoagulant therapy in prego

A

UFH or LMWH

NOT warfarin

47
Q

when do neural tube defects occur?

A

days 20-28 of prego

48
Q

folic acid and B12 play an important role in

A

neural tube development

49
Q

most common forms of neural tube defects

A

anencephaly & spina bifida

50
Q

anencephaly

A

when a major portion of the babies brain is missing or fails to develop-> death

51
Q

spina bifida

A

vertebrae covering spinal cord are not fully fused

-can be surgically corrected

52
Q

maternal physiologic changes

A
  • blood volume, cardiac output & GFR increase 30-50%
  • < [] of renally cleared drugs(diluted & excreted faster)
  • > body fat-> > Vd of fat-soluble drugs
  • < plasma albumin-> gastric pH
53
Q

drugs pass through the placenta by

A

diffusion

54
Q

factors increasing drug transfer across placenta

A
  • MW protein binding (>albumin on fetal side, so get trapped there)
  • neutral & basic drugs (fetal pH is more acidic)
55
Q

prolactin promotes

A

production of milk

56
Q

oxytocin promotes

A

ejection of milk by increasing contractions of mammary myoepithelial cells

57
Q

during prego, milk production is suppressed by

A

estrogen & progesterone

58
Q

slight amount of milk formed during prego is called

A

colostrum

59
Q

colostrum contents

A

NO fat

high in antibodies9IgA), macrophages & lymphocytes- passive immunity

60
Q

feedback between nursing & prolactin

A

positive feedback

61
Q

how much milk is produced /day

A

1.5L/day

containing lactose, calcium phosphate, acidic, protein & fast, mostly iron free

62
Q

why do parathyroid glands increase in siz

A

due to maternal loss of calcium-> decalcification of maternal bones

63
Q

igG is transported

A

transplacentally

64
Q

first 3 days postpartum

A

leaky paracellular route, little active secretion of milk fluid

65
Q

by day 7

A

prolactin causes alveolar epithelial cells to proloferate & fill in gaps

66
Q

drugs penetrate milk more during

A

colostral period due to leak barrier

67
Q

medications enter breast milk if

A
  • highly lipid soluble
  • reach high maternal []
  • MW<500
  • LOW protein bindin
  • long half-life
  • weak bases (milk pH+6.8-7)
68
Q

mastitis

A

inflammation of the breast

- tenderness, redness, warmth, flu-like symptoms

69
Q

most common cause of mastitis

A

staph aureus

70
Q

treat mastitis

A

antibiotics if infection or NSAIDs

Reproduction (12 decks)

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