Growth Flashcards
How is the mother monitored during labour?
Contractions Dilatation Vital signs Drugs/fluids Urine output PV loss Pain Emotional state
How is the fetus monitored during labour?
Fetal heart activity
Fetal position
Descent
What are the three types of pain relief during labour?
Non-pharmacological (breathing and massage)
Pharmacological (Entonox, opioids)
Regional (epidural)
What are the 3 stages of labour?
Stage 1 = dilatation of the cervix
Stage 2 = delivery of the baby
Stage 3 = delivery of placenta
What happens in the passive part of Stage 1?
Painful irregular contractions
Cervical effacement and dilatation
What happens in the active part of Stage 1?
Regular painful contractions
Progressive cervical dilatation
What happens in the transition into the second stage?
Uncontrollable urge to push Sweating Mood changes Genitals/anus bulging Baby's head moves into vagina Purple line between buttocks
What is the passive stage of stage 2?
Full dilatation of the cervix (rest and be thankful)
What is the active stage of stage 2?
Expulsive contractions (baby visible)
How can stage 3 of labour be managed?
Active management (uterotonic drugs) Physiological (no drugs)
What are examples of serious postpartum complications?
Post partum haemorrhage
Infection
Pre-eclampsia/eclampsia
Thromboembolism
What are three components of child growth?
Physical growth
Emotional growth
Child development
What is auxology?
The study of measuring growth
How are children measured differently before and after 2 years of age?
Up to 2 years - length of baby
After 2 years - height of child
When is head circumference measured and why?
Up to 2 years
Monitor brain development
For how long is there lots of ‘normal’ fluctuation in growth?
First 6 months of life
At what age do girls usually overtake boys on the growth curve?
Around 12 years
What are the 3 phases of child growth?
Infancy
Mid-childhood
Puberty
What hormones are involved in infancy growth?
Insulin
But NO growth hormone
What hormones are involved in mid childhood growth?
Growth hormone
Thyroxine
What hormones are involved in puberty?
Growth hormone
Sex hormones
How is faltering growth defined?
Dropping more than 2 centile lines on a growth chart over 12 months
How is coeliac disease characterised?
Tiredness Anaemia Positive antibodies Positive jejunal biopsy Response to diet
What are the 3 stages of sex determination?
Gonad formation
Gonad determination
Sex differentiation
What occurs during gonad formation?
Intermediate mesoderm forms the urogenital ridge, which develops into the nephrogenic ridge and gonadal ridge.
Bipotential gonad forms
What occurs during gonad determination?
Formation of ovary or testis from bipotential gonad
Which two transcription factors are important in testes formation?
SRY
Sox9
Which gene on the X chromosome is important for repressing testes development?
DAX1
2 copies
What is needed for ovary formation?
Germ cells
2 X chromosomes
What occurs during sex differentiation?
Gonads secrete hormones - creates external genitalia etc
At what age of the embryo do the external genitalia begin to look different?
8 weeks
How does the male gonad form?
Wolffian duct stabilised
AMH prevents Mullerian ducts developing
How does the female gonad form?
Wollfian structure regresses
Mullerian ducts stabilised (no AMH/testosterone)
What are the 3 classes of disorders of sexual development?
- Whole chromosome
- Region of a chromosome
- Change within a single gene
Give an example of a whole chromosome sexual development disorder
Klinefelter syndrome (XXY) (2 copies of DAX1 so testes do not form properly)
Give an example of a region of a chromosome sexual development disorder?
SRY translocation (in father, between X and Y)
Give an example of a change within a single gene that causes a sexual development disorder?
5 alpha reductase deficiency
testosterone not converted to DHT properly so external genitalia do not form
