Harvluck B11 W2

Question 1

Supplies blood to medial aspect of breast

Answer 1

Internal thoracic artery- branch of subclavian artery

Question 2

Functions of the pelvis?

Answer 2

Locomotion, thermoregulation, labour

Question 3

Android pelvis

Answer 3

Heart shaped inlet which is more common in taller and Afro-Carribean women. Increases risk of failure of rotation and deep transverse arrest.

Question 4

Platypelloid pelvis

Answer 4

Wide inlet which makes it difficult for the head to engage.

Question 5

Anthropoid pelvis

Answer 5

AP diameter is wider than transverse diameter. Increased risk of breech position

Question 6

Epithelia lining breast ducts

Answer 6

Stratified squamous epithelia

Question 7

Liver analytes in jaundice

Answer 7

Bilirubin, alkaline phosphatase, aspartate. Normal prothrombin time.

Question 8

What is the shortest stage of labour?

Answer 8

3rd stage which is 20 minutes.

Question 9

Complications of prolonged labour?

Answer 9

Incontinence, sepsis and prolapse

Question 10

How does feedback inhibitor of prolactin work?

Answer 10

Distorts shape of mammary alveoli and suppresses secretion of prolactin.

Question 11

Effect of oestrogen on mammogenesis

Answer 11

Stimulates mammary duct development and collection of fat in the collective tissue

Question 12

Effect of progesterone on mammogenesis

Answer 12

In the second trimester, increases the volume of breast tissue. It causes the lobes and alveoli to grow and widening of the ducts.

Question 13

Effect of oestrogen and progesterone on mammogenesis

Answer 13

Proliferation of the lactocytes/secretory tissues

Question 14

Hormones for mammary gland growth and differentiation

Answer 14

LH, somatomammatrophin, oestrogen, progesterone, prolactin

Question 15

What promotes mammary growth in pregnancy?

Answer 15

Growth hormone and adrenocorticotropic hormone.

Question 16

Changes to the breast in pregnancy?

Answer 16

Alveolar cell differentiation, lobule formation, hypertrophy of ductar-lobular-alveolar system

Question 17

Hormones important for breast development in puberty?

Answer 17

Oestrogen
Growth hormone

Question 18

How are the alveoli formed?

Answer 18

From the epithelia of the milk hills.

Question 19

What is the impact of epidurals?

Answer 19

Loss of motility such as bladder control, low blood pressure and slower breathing.

Question 20

Source of progesterone production in pregnancy?

Answer 20

Placenta, myometrium and placental membranes.

Question 21

Let-down reflex

Answer 21

Milk at ph7.0 is ejected first due to stimulation of mechanoreceptors which induces oxytocin release before prolactin, releasing milk already present.

Question 22

What inhibits the let-down reflex?

Answer 22

Oestorgen, relaxin and prostaglandins.
Pain, embarassment and alcohol intake inhibits this.

Question 23

What stimulates prolactin release?

Answer 23

Vasoactive intestinal protein and oxytocin which inhibit dopamine release.

Question 24

Where is prolactin released?

Answer 24

Decidual cells
Anterior pituitary gland

Question 25

What is important in cervical effacement?

Answer 25

Oestrogen, relaxin and prostaglandins.

Question 26

Which hormone is only present in the serum during pregnancy?

Answer 26

Human placental lactogen/somatomammatropin which is involved in areola growth.

Question 27

Composition of colostrum

Answer 27

Contains more immunogoblins and fat soluble vitamins than normal breast milk but less water soluble vitamins, fat and sugar.

Question 28

Treatment of infective mastitis

Answer 28

Analgesia, increased fluid, frequent breast feeding and antibiotics

Question 29

Treatment of non-infective mastitis

Answer 29

Massaging breasts, analgesics, bra fitting

Question 30

Normal foetal heart rate

Answer 30

100-160bpm

Question 31

What determines the size of the birth canal?

Answer 31

Size of pelvic inlet

Question 32

Conditions screened for in newborn neonatal screening?

Answer 32

Sickle cell disease Cystic fibrosis Hypothyrodisim Phenylketonuria Acyl coA dehydrogenase Maple syrup urine disease Isovaleric acidaemia Glutaric aciduria type 1 Homocystinuria

Question 33

Location of oxytocin production

Answer 33

Posterior pituitary gland

Question 34

Latent labour

Answer 34

Slow cervical dilatation until it reaches 4cm

Question 35

How does oxytocin cause uterine contractions?

Answer 35

Lowers threshold for action potentials to increase the frequency of contractions via the Ferguson reflex. Afferent impulses from the cervix and vagina creates positive feedback loop for release.

Question 36

Role of oestrogen in labour

Answer 36

Increases expression of oxytocin receptors and excitability of smooth muscle

Question 37

What is a major component of breast milk?

Answer 37

Water

Question 38

Major cause of infective mastitis?

Answer 38

Staphylcoccus aureus -poor management of mastitis leads to breast abscess

Question 39

Passenger in labour

Answer 39

Portion of the skull which first descends into pelvis, where foetal bones can be overlapped to reduce diameter

Question 40

What increases myometrial excitability in labour?

Answer 40

CRH + Oestrogen (which increases oxytocin receptor expression) Prostaglandin; increases muscle contractiliy

Question 41

Hormones which induce labour

Answer 41

Cortisol, vasopressin, oxytocin, prostaglandin, uterine distention

Question 42

Hormones which prevent labour

Answer 42

Adrenaline, relaxi, progesterone Cervical ripening: reduced collagen and glcosaminoglycans that causes thinning

Question 43

Analgesics in labour

Answer 43

Simple oral Transcutaneous electrical stimulation Systemic opiates Epidural

Question 44

Effect of systemic opiates in labour

Answer 44

Pain relief and slows breathing however it can lead to foetal respiratory distress

Question 45

Preventable causes of labour death

Answer 45

Severe bleeding, infection, pre-eclampsia

Question 46

Delivery of foetus in labour

Answer 46

Foetus reaches perineum and extends the head. It rotates to assist with shoulder delivery that comes out from under the pubic symphysis.

Question 47

Which position does the foetus engage with the pelvis?

Answer 47

Occipital-transverse.

Question 48

Cardinal movements of labour

Answer 48

Movements of the foetus to fit the pelvis -engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion

Question 49

Partogram

Answer 49

Chart which measures cervical dilation

Question 50

Contractility

Answer 50

Ability for uterus to contract in co-ordination.

Question 51

Entonox

Answer 51

Mixture of NO2 and O2 which is a fast acting pain relief in labour that can cause nausea