Growth

Question 1

How is the mother monitored during labour?

Answer 1

Contractions
Dilatation
Vital signs 
Drugs/fluids
Urine output
PV loss
Pain
Emotional state

Question 2

How is the fetus monitored during labour?

Answer 2

Fetal heart activity
Fetal position
Descent

Question 3

What are the three types of pain relief during labour?

Answer 3

Non-pharmacological (breathing and massage)
Pharmacological (Entonox, opioids)
Regional (epidural)

Question 4

What are the 3 stages of labour?

Answer 4

Stage 1 = dilatation of the cervix
Stage 2 = delivery of the baby
Stage 3 = delivery of placenta

Question 5

What happens in the passive part of Stage 1?

Answer 5

Painful irregular contractions

Cervical effacement and dilatation

Question 6

What happens in the active part of Stage 1?

Answer 6

Regular painful contractions

Progressive cervical dilatation

Question 7

What happens in the transition into the second stage?

Answer 7

Uncontrollable urge to push
Sweating
Mood changes
Genitals/anus bulging
Baby's head moves into vagina
Purple line between buttocks

Question 8

What is the passive stage of stage 2?

Answer 8

Full dilatation of the cervix (rest and be thankful)

Question 9

What is the active stage of stage 2?

Answer 9

Expulsive contractions (baby visible)

Question 10

How can stage 3 of labour be managed?

Answer 10

Active management (uterotonic drugs)
Physiological (no drugs)

Question 11

What are examples of serious postpartum complications?

Answer 11

Post partum haemorrhage
Infection
Pre-eclampsia/eclampsia
Thromboembolism

Question 12

What are three components of child growth?

Answer 12

Physical growth
Emotional growth
Child development

Question 13

What is auxology?

Answer 13

The study of measuring growth

Question 14

How are children measured differently before and after 2 years of age?

Answer 14

Up to 2 years - length of baby

After 2 years - height of child

Question 15

When is head circumference measured and why?

Answer 15

Up to 2 years

Monitor brain development

Question 16

For how long is there lots of ‘normal’ fluctuation in growth?

Answer 16

First 6 months of life

Question 17

At what age do girls usually overtake boys on the growth curve?

Answer 17

Around 12 years

Question 18

What are the 3 phases of child growth?

Answer 18

Infancy
Mid-childhood
Puberty

Question 19

What hormones are involved in infancy growth?

Answer 19

Insulin

But NO growth hormone

Question 20

What hormones are involved in mid childhood growth?

Answer 20

Growth hormone

Thyroxine

Question 21

What hormones are involved in puberty?

Answer 21

Growth hormone

Sex hormones

Question 22

How is faltering growth defined?

Answer 22

Dropping more than 2 centile lines on a growth chart over 12 months

Question 23

How is coeliac disease characterised?

Answer 23

Tiredness
Anaemia
Positive antibodies
Positive jejunal biopsy
Response to diet

Question 24

What are the 3 stages of sex determination?

Answer 24

Gonad formation
Gonad determination
Sex differentiation

Question 25

What occurs during gonad formation?

Answer 25

Intermediate mesoderm forms the urogenital ridge, which develops into the nephrogenic ridge and gonadal ridge. Bipotential gonad forms

Question 26

What occurs during gonad determination?

Answer 26

Formation of ovary or testis from bipotential gonad

Question 27

Which two transcription factors are important in testes formation?

Answer 27

SRY | Sox9

Question 28

Which gene on the X chromosome is important for repressing testes development?

Answer 28

DAX1 | 2 copies

Question 29

What is needed for ovary formation?

Answer 29

Germ cells | 2 X chromosomes

Question 30

What occurs during sex differentiation?

Answer 30

Gonads secrete hormones - creates external genitalia etc

Question 31

At what age of the embryo do the external genitalia begin to look different?

Answer 31

8 weeks

Question 32

How does the male gonad form?

Answer 32

Wolffian duct stabilised | AMH prevents Mullerian ducts developing

Question 33

How does the female gonad form?

Answer 33

Wollfian structure regresses | Mullerian ducts stabilised (no AMH/testosterone)

Question 34

What are the 3 classes of disorders of sexual development?

Answer 34

1. Whole chromosome 2. Region of a chromosome 3. Change within a single gene

Question 35

Give an example of a whole chromosome sexual development disorder

Answer 35

``` Klinefelter syndrome (XXY) (2 copies of DAX1 so testes do not form properly) ```

Question 36

Give an example of a region of a chromosome sexual development disorder?

Answer 36

SRY translocation (in father, between X and Y)

Question 37

Give an example of a change within a single gene that causes a sexual development disorder?

Answer 37

5 alpha reductase deficiency | testosterone not converted to DHT properly so external genitalia do not form