HD 2 Flashcards

1
Q

what CV changes occur in pregnant women? [4]

what does this means occurs in pregnant women with regards to daily life? [3]

A

changes in blood volume;
changes in heart rate;
changes in blood pressure;
changes in cardiac output;

what does this means occurs in pregnant women with regards to daily life? [3]

  • dyspnoea (difficulty breathing)
  • tachycardia
  • reduced exercise tolerance
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2
Q

how does CO change with each uterine contraction? [1]

A

how does CO change with each uterine contraction? [1]
15-20% increase in CO

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3
Q

how does BP change during pregnancy? (systolic / diastolic?) [2]

A
  • systolic BP does not change during pregnancy
  • diastolic BP is reduced in trimester 1 & 2, retunrs to non-pregnant levels at trimester 3
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4
Q

what happens to peripheral resistance of pregnant women [2]
explain why this occurs [2]

A
  • reduced peripheral resistance
  • bc increased CO & decreased diastolic BP
  • placenta acts as an arteriovenous shunt [1]
  • peripheral vasodilating factors: oestrogen and progesterone [1]
  • increased endothelial synthesis of prostaglandin E2 and prostacyclins [1]
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5
Q

why can pregnant women feel dizzy when lying on right hand side? [2]
what can be done to correct for this? [1]

A

why can pregnant women feel dizzy when lying on left hand side? [1]

  • *venacaval compression from the gravid uterus which sig. reduces CO.**
  • *so less blood to head and neck area**

what can be done to correct for this? [1]
turn her on to left side

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6
Q

where does venous pressure change during pregrancy? [1]
where does it not change? [1]
explain why these changes occur [1]

A

where does venous pressure change during pregrancy? [1]
changes in legs

where does it not change? [1]
arms

explain why these changes occur [1]
mech. obstruction of the uterus and contents

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7
Q

why would a fetus not come to harm if mother falls over? [1]

A

fetus is well cushioned by uterus and amniotic fluid

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8
Q

what is the ferguson reflex? [1]
what is it triggered by? [1]
what does it cause the release of? [1]

A

what is the ferguson reflex? [1]
when a woman’s body expels her baby without actively pushing. The reflex is involuntary

what is it triggered by? [1]
fetal presenting part impinging ripened cervix

what does it cause the release of? [1]

  • *release of oxytocin from post pit.**
  • *oxytocin binds to oxy receptors in the myometrium –> muslce contractions**
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9
Q

what is the rate of cervical dilation plotted on? [1]

what is the size of cervix for latent phase? [1]

A

what is the rate of cervical dilation plotted on? [1]
partogram

what is the size of cervix for latent phase? [1]
0-3 cm

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10
Q

what is a primiparae? [1]

A

what is a primiparae? [1]
women giving birth for first time

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11
Q

at what rate does cervix dilate for primiparae between 1-5cm [1] and 5-10 cm [1]?

A

at what rate does cervix dilate for primiparae between 1-5cm [1] and 5-10 cm [1]?

  • *1-2 cm / hr (**between 1-5)
  • *2-3 cm / hr** (between 5-10 cm)
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12
Q

which factors do we use to assess labour? [2]

what is labour not assessed on? [3]

A
  • dilation of cervix
  • descent of presenting part in relation ot ishial spines.

not on the frequency, duration or intensity of contractions

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13
Q

when is the first, second and third stage of labour? [3]

A

1st: -10cm dilation
2nd: full cervical dilation until delivery of fetus
3rd: expulsion of placenta

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14
Q
A
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15
Q

is the placenta a maternal or fetal organ? [1]

what is the function of the placenta? [6]

A

is the placenta a maternal or fetal organ? [1]
fetal

what is the function of the placenta? [6]
acts as lungs: gaseous exchange
provides nutrients for fetus
acts as kidney (excrete waste)

detoxifies drugs and metabolites
metabolically active (produces molecules like hCG)
makes long chain fatty acids for brain development

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16
Q

what is placental circulation like? [2]

A

two umbilical arteries: deoxygenated blood
one umbilical vein; oxygenated blood

17
Q

how does amniotic fluid circulate through placenta? [1]

role of amniotic fluid? [4]

A

swallows it; excretes through urine

function: move in the womb, lungs to develop, keep constant temp, cushion from blows [4]

18
Q

explain what happens during first couple of breaths of baby and why

A
  • lungs previously filled with fluid need to fill with air
  • first gasp: creates negative intra-thoracic pressure and air fills lungs
  • 2nd & 3rd breathes much of the fetal lung fluid is expelled (rest is absorbed in the lymph)
19
Q

how does PaO2 change during the first few breathes? [1]

what structure does this cause to close? [1]

A

how does PaO2 change during the first few breathes? [1]
2-3.5 kPa –> 9-13 kPa
causes ductus arteriosus to close

20
Q

what happens to pulmonary vascular resistance after birth? what does this cause to occur? [1]

what happens to pressure on right side of heart? what does this cause to occur? [1]

what happens to pressure in IVC? what does this cause to occur? [1]

A

fall in pulmonary vascular pressure: causes pulmonary blood flow to increase

drop in presure on right side - no longer shunting from left to right atrium across the foramen ovale

drop in pressure in IVC; causes ductus venosus to closes

21
Q

how does metabolism change in uterus to when the baby is born? [2]

why does a baby rely on fat stores during the first week of life? [1]

A

in utero: glucose
after birth: lipid based - have high free fatty acid levels

why does a baby rely on fat stores during the first week of life? [1]
until feeding is fully established

22
Q

which organs of the baby utilise glucose and which utilise fats duirng early life?

A

brain: glucose
all other organse: fats

23
Q

jaundice????

A
24
Q

name 4 diseases that heel prick test screens [4]

A

name 4 diseases that heel prick test screens [4]

PKU
CF
SCA
Hypothyrdoism - TSH

25
Q

name a non-blood screening test all babies undergo [1]

A

hearing: oto acoustic emission technique