Goad Test 1 Flashcards
What is this test about?
sexual development, sexual anatomy, ovulation, conception, fetal development, labor, delivery, STIs
What is the cultural diversity question?
Pregnancy is a hot condition & meat is a hot food in some cultures, so some women may not want to eat meat when pregnant.
Teen pregnancy is associated with high incidence of what 6 risk factors?
Pregnancy Iinduced HTN,
iron-deficiency anemia • Preterm labor with low-birth weight infants • Cephalopelvic disproportion (CPD) • Immature partner abuse, poor nutrition
What are signs and symptoms of iron-deficiency anemia?
chronic fatigue, Hgb less than 11 g/dl, pallor, pale mucous membranes, pica
If maternal cocaine level is 50 units, what will fetal level be?
25
sIGNS AND SYMPTOMS OF FETAL DRUG WITHDRAWAL
nervousness, irritability, lethargy,
seizures, muscle rigidity, poor feeding (esp.amphetamines)
Who should not breastfeed?
Drug using mom.
WHat is the mechanism by which cocaine increases pregnancy risk?
Vasoconstriction is extreme and can impair placental circulation
What complication might yhou see in infant whose mother uses cocaine?
intracranial hemorrhage, withdrawal, learning defects
What complication might you see in a narcotic using mom’s neonate?
SGA
• Have incidence of fetal distress & meconium aspiration
• Withdrawal symptoms—irritability, tremors, high-pitched crying, possible seizures (mom may experience also)
Maternal and infant mortality, black vs. white. Go.
The maternal mortality rate in the United States is 7.7 per 100,000 live births for white women, and 23.8 for black women. The mortality rate for white infants is 5.6, and for black infants it is 13.2.
How does Affordable Care Act affect maternal-child health
Prohibiting insurance companies from denying care based on preexisting conditions for children younger than 19 years • Keeping young adults on their family’s health insurance plan until age 26 years • Coordinated management for children and other individuals with chronic diseases • Expanding the number of community health centers • Increasing access to preventive health care • Providing for home visits to pregnant women and newborns • Supporting states to expand Medicaid coverage • Providing additional funding for the Children’s Health Insurance Program (CHIP)
What diseases are most common in postmenopausal women?
cardiovascular disease, breast cancer, osteoporosis, and colorectal cancer.
WHat re the womens health issues in Healthy People 2020?
obesity, breast, cervical and colorectal cancer, osteoporosis and pelvic inflammatory disease (which can be a complication of STDs), and 2 STDs: Chlamydia trachomatis and gonorrhea.
What organ stimulates what gland to make what hormone to start puberty?
Hypothalamus, ant. pituitary, GnRH: gonadotropin-releasing hormone
Anterior pituitary makes what hormones?
FSH, LH, GnRH
nexus of labia on the posterior rim of the vagina is the ________
fourchette
infundibulum is ringed with
fimbriae
trampoline-line muscles that support pelvic organs
levator ani
What factors increase breast cancer risk?
female gender and advancing age. White women have the highest risk of getting breast cancer, but black women have the greatest risk of dying from it. Early menarche, late menopause and late or no pregnancies increase the risk. Family history of breast and other cancer, and particular gene mutations: BRCA1 and 2, CHEK-2, ATM, PTEN, CDH1, STK11. Previous chest irradiation, previous abnormal breast biopsy, excessive alcohol consumption, being over normal body weight and physical inactivity all increase the risk of breast cancer.
What labs for pregnancy?
urine for protein, Rh
factor, rubella titer, blood glucose)
Ovum: does it have an x or a y chromosome?
X.
Say a person is born who makes no testosterone and no estrogen at all. What gender does the person appear to be>
Female. Testosterone makes male structures, without it the structures stay female.
If Sam starts puberty at 8, when does Ted start?
8 years 6 months to 9 years old.
Sam’s breasts start to bud at 13. How old will she be at menarche?
15 to 15 years six months
Sam’s menarche is at 10. When does she get axillary hair?
10
Sam’s breasts bud at 9. When does her growth spurt start?
10
What female organ makes estrogen and progesterone? What has its own estrogen so FSH can affect it
ovary, corpus luteum, placenta. Follicles secrete their own estrigen that makes them sensitive to FSH
How can Sam have primary amenorrhea at age 14?
Her mom and sisters all started by 13.
How many cycles do you have to miss for secondary amenorrhea?
3
First visible sign of male puberty
bigger testes
Which does more stuff: FSH or LH?
LH
What hormones does a corpus luteum make?
estrogen and progesterone
What hormones does a placenta make?
estrogen and progesterone
Graafian follicle to corpus luteum via what hormone?
LH
Matures reproductive organs and breasts. Gets the endometrium started. Grows and limits long bones in girls. In pregnancy, grows uterus, limits milk production, relaxes ligaments.
Estrogen.
Finishes up endometrium develpoment, maintains pregnancy (prevents endometrial shedding) and gets breasts ready to lactate, but inhibits prolactin.
Progesterone.
Stimulates milk letdown
oxytocin
define climacteric. average age?
phys and emo changes at end of reproductive period, 45-50
Perimenopause starts when? ends when?
onset of climacteric symptoms to 1 year after LMP
labia minora aka
beave curtains
Vestibule enclosed by
labia minora
Skene’s glands lubricate
urethra
How long is a vagina
3-4 inches
Can the cervix secrete?
yes, lubrication
What’s the lace in the vag behind the opening of cervix?
fornix
size of nulliparous uterus
3”x 2”x 1”
How long is a fallopian tube?
about 4 and a half inches
cilia v fimbria
inside v outside
Once the fimbriae draw the ovum in, how long is it in the tube? How does it stay?
stays 3 days because tube contracts around it
hOw many ova was i born with
2 million
what’s day 1 of menstrual cycle
1st day of menstruation
Name the ovarian phases
follicular, ovulation, luteal
When in the cycle does ovarian estrogen and progesterone dip? What does this trigger?
RIght before menstruation. triggers FSH and LH
What hormone does the fertilized ovum secrete to maintain pregnancy? How does it work?
hCG signals corpus luteum to keep making estrogen and progesterone
The first 14 days of the ovarian cycle are what part of the endometrial cycle?
proliferative
How much blood is menses?
40mL
What event triggers prolactin?
expulsion of placenta
What can a cremaster muscle do?
Pull testicles in.
What is a zygote
under 2 weeks and not implanted
What is an embryo
over 2 weeks to week 8
what is a fetus
over week 8
what is the fertilization window?
48 hours before and 24 hours after ovulation
what % of zygotes do not implant?
50%
What is decidua?
Endometrium nurturing zygote
What causes hydramnios/polyhydramnios? How many mLs
Atresia (orifice sealed) anencephaly, maternal diabetes third spaces into amniotic fluid, 2000+
Oligohydramnios: what causes? How many mLs
Fetal kidney problems, under 300 mL.
what are chorionic villi? how many Does it secrete hormones?
little extensions of umbilical cord into maternal blood in placenta- there are about 200. It secretes hormones.
Placenta: what does fetal surface look like? What is maternal side made of
a frisbee covered with shiny gray amnion and vascular vascular vascular. Mom’s side is made of decidua basalis.
Active phase contractions, how long, how often, how strong?
By the end of the active phase, contractions are usually coming every 2 - 3 minutes, lasting around 60 seconds and reaching strong intensity.
How many uterine arteries supply the placenta
about 100
HPL means? aka? job?
human placental lactogen, somatomammotropin, regulates maternal fat, protein, glucose
what is the mnemonic for number of umbilical arteries and veins
ava
_______ jelly in umb cord
Wharton’s
TORCH
toxoplasma gondi, other, rubella, cytomegalovirus (Herpes) and HIV
WHen is fetal heartbeat audible
10-12th wk
What is typical newborn O2 sat?
80%
What is special about fetal hgb. When does it go to adult levels?
more affinity for O2, more concentrated, hgb 17 in neonate vs adult’s 11, Hct 53% vs. adult’s 45%. gets to adult levels at 6 mos.
What week of pregnancy might baby make surfactant?
24+
What is surfactant made of? Which is predominant early? What is lecithin:sphing ratio at 40 weeks
Lecithin & Sphingomyelin, Sphing is predominant early, 2:1
How does amnio assess fetal maturiry
the ratio of lectithin to sphing is 2:1 ate maturity, the higher the sphing ratio, the more immature
What causes intestinal volvulus, omphalocele, gastroschisus, Meckel’s diverticulum.
Intestine is too large to fit in fetal abd until week 10 and if this resolves badly problems result.
Whaen does fetus get mature suck/swallow reflex?
32 weeks
When can fetus digest carbs and protein well?
36 weeks
Is liver fully developed at birth? What if it isnt?
no- can cause hypoglycemia and hyperbilirubinemia
earliest fetal movement that can be seen on ultrasoind
11th week
quickening felt around week ___
20
why is newborn skin translucent
no subq fat
What maternal antibody gives fetus temporary passive immunity? What disease is it helpless against?
IgG, herpes
Milestones 8-12 weeks
all organ systems are formed &
simply require maturation, heart beat audible by doppler (10-12 week)
Milestones 16 weeks
the sex can be determined
visually, lanugo is present, fetus swallowing amniotic fluid
Milestones 20 weeks
mom can feel movement
(quickening), active antibody transfer from mom to baby begins
Milestones 24 weeks
vernix caseosa covers the entire
body, meconium is present in colon to rectum, pupils capable of reacting to light, active production of surfactant begins
Milestones 26-28 weeks
the eyes open, lung alveoli
begin to mature, blood vessels in retina very thin and fragile
Milestones 32 weeks
skin appears less wrinkled &
red—since subcutaneous fat has been laid down—fingernails reach the ends of the fingers, active Moro reflex, fetus responds by movement to sounds/activities outside of mom, birth position assumed
Milestones 36 weeks
weight 5-6 pounds—lanugo
begins to disappear—most babies turn into a head-down presentation (vertex), additional subcutaneous fat deposited
milestones 40 weeks
vernix caseosa is apparent only
in the creases & folds of skin—lanugo remains on upper arms & shoulders only, active fetal kicking, creases on the sole of feet cover @ least two thirds of surface, fingernails extend over fingertips
