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High Yield > Human Development > Flashcards

Human Development Flashcards

1
Q

When is further growth assessment needed in babies?

A

Drop of 2 weight centiles

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2
Q

When is further growth assessment needed in kids and teens?

A

Weight, height or BMI below 0.4 centile

Height more than 3 centiles below mid-parental height

Drop in height centile more than 2 centiles

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3
Q

How can we classify BMI on growth charts?

A

BMI above 91st centile –> overweight

BMI above 98th centile –> obese

BMI below 2nd centile –> underweight

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4
Q

What is failure to grow in utero caused by?

A 
Poor nutrition
Poor O2 supply
Diabetes
Drugs, alcohol, smoking
Long term maternal conditions 
Pre-eclampsia 
Chromosomal abnormalities
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5
Q

How is small for gestational age defined?

A

Weight, length or head circumference below 10th centile

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6
Q

What are causes of SGA?

A 
Small parents
Genetic abnormalities
Infection
Placental problems
Maternal factors
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7
Q

How is large for gestational age defined?

A

Weight, length or head circumference above 90th centile

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8
Q

What is macrosomia?

A

Birth weight > 4.5kg

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9
Q

What are causes for LGA?

A

Maternal diabetes and obesity

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10
Q

What are the developmental domains?

A
  1. Gross motor
  2. Fine motor and vision
  3. Language and speech
  4. Social
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11
Q

What are key parts in gross motor development?

A

Sits without support by 9 months

Walks by 18 months

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12
Q

What are key parts in fine motor and vision development?

A

Follows objectts by turning head by 3 months

Mature pincer grip by 12 months

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13
Q

What are key parts in speech and language development?

A

Babbles at 7 months

A few words by 12 months

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14
Q

What are key parts in social development?

A

Social smile by 8 weeks

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15
Q

What is abnormally early puberty for girls?

A

< 8 years (often benign)

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16
Q

What is abnormally early puberty for boys?

A

< 9 years (often concerning)

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17
Q

What are causes of precocious puberty?

A
  1. Gonadotrophin-dependent (central) - activation of HPG axis; normally benign
  2. Gonadotrophin-independent - due to increased sex hormone production without maturation of axis; congenital adrenal hyperplasia, tumours
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18
Q

What is abnormally late puberty for girls?

A

No breasts by 13 or primary amenorrhoea at 15

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19
Q

What is abnormally late puberty for boys?

A

No testicular development by 14

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20
Q

What are causes for delayed puberty?

A
  1. Constitutional delay
  2. Chronic illness or malnutrition
  3. Excessive exercise
  4. Tumours
  5. Congenital abnormalities
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21
Q

What is the genetic profile for Turner?

A

45 X

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22
Q

What does Klinefelter cause?

A

Infertility

Small, poorly functioning testicles

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23
Q

What is Klinefelter?

A

47 XXY

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24
Q

What does Turner cause?

A

Short stature
Premature ovarian failure
Neck webbing

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25
Q

When are the breasts ready to produce milk?

A

Month 5-6

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26
Q

What triggers milk production?

A

High levels of progesterone prevent milk production

Delivery of placenta causes progesterone drop and the high prolactin means milk production

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27
Q

What is the first milk?

A

Colostrum (high IgA to help develop GI system)

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28
Q

What happens in the follicular phase?

A

FSH stimulates 10-20 follicles to grow, as they grow they produce more oestrogen

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29
Q

What happens in the ovulatory phase?

A

one follicle will continue to grow, and produce more oestrogen, at particular level of oestrogen pituitary gland signalled to release LH, LH signals for egg to rupture and enter uterine tubes, oocyte propelled by cilia and uterine tube contractions

30
Q

What happens in the luteal phase?

A

haemorrhage into remains of follicle, corpus luteum formed and persists if fertilsiation occurs and acts to secrete progesterone

31
Q

When is primordial follicle arrested?

A

Prophase I meoisis I

32
Q

When is the secondary oocyte arrested?

A

Matephase II of meisosis II

33
Q

What is menopause?

A

One year of amenorrhoea (typically late 40s, early 50s)

34
Q

What are symptoms of menopause?

A

Hot flushes, palpitations, night sweats, vaginal atrophy and prolapse

35
Q

How is menopause diagnosed?

A

> 45years–no tests and based on symptoms alone

< 45 years – high FSH levels with low oestrogen

36
Q

What are the consequences of menopause?

A

CVD
Osteoporosis
Vaginal dryness
Atrophy

37
Q

Why does menopause occur?

A

Menopause occurs due to a limited pool of oocytes, that decrease over time, reduced number of granulosa cells therefore reduced oestrogen and lack of ovulation, FSH increases due to lack of negative feedback leading to anovulatory cycles and physiological + physical changes

38
Q

What is the underlying mechanism of menopause osteoporosis?

A

Oestrogens crucial for maintaining bone mass by acting to suppress bone resorption by osteoclasts and to promote bone formation by osteoblasts- management; weight bearing exercise, vitamin D + oestrogen

39
Q

What is the management of menopause?

A

HRT; replacing oestrogen, progesterone given to protect endometrium if uterus present (protection against endometrial hyperplasia), testosterone given to increase overall energy + sexual drive.

Risks; increased breast and endometrial cancer risk

40
Q

What do Sertoli cells do?

A

Facilitate spermatogenesis and spermiogenesis

Provide nutrition

Secrete inhibin which regulates FSH through negative feedback

Secretes ABP required for sperm cells maturation

41
Q

What do Leydig cells do?

A

Drives spermatogenesis via testosterone secretion which acts on Sertoli cells to create a suitable environment allowing progression of germ cells into mature sperm

42
Q

What is secondary infertility?

A

Someone has already been pregnant before

43
Q

What are causes for subfertility?

A 
Male factor
Anovulation
Tubal factor 
Age over 35
History of STD
Smoking
Excessive alcohol 
Low BMI
44
Q

What is premature ovarian insufficiency?

A

Cessation of menses for more than 1 year < 40 yo

45
Q

What are risk factors for premature ovarian insufficiency?

A

Family history
Exposure to chemotherapy or radiation
Autoimmune disease

46
Q

What investigations are needed for premature ovarian insufficiency?

A

LH and FSH levels (usually FSH > 30 on 2 occasions)
Serum estradiol
AMH level

47
Q

What is a treatment for for premature ovarian insufficiency?

A

HRT

48
Q

What are diagnostic factors for for premature ovarian insufficiency?

A 
Hot flushes 
Sleep disturbances
Irritability 
Vaginal dryness
Infertility 
Vaginal atrophy 
Small uterus with non-palpable ovaries
49
Q

What are signs and symptoms of PCOS?

A

Irregular menstruation
Infertility
Hirsutism
Acne

50
Q

What are risk factors for POCS?

A

Family history
Obesity
Premature or early adrenache

51
Q

What are investigations for PCOS?

A 
Serum 17-hydroxyprogesterone
Serum prolactin
Serum TSH
Oral glucose tolerance 
Serum LH
Serum FSH
52
Q

What is treattment for PCOS?

A
  1. Weight loss
  2. Non-steroidal anti-oestrogen
  3. Oral contraceptive + weight loss
53
Q

What is the folic acid recommendation?

A

400 micrograms per day

54
Q

When are women offered a scan for chromosomal abnormalities?

A

11+0 weeks

13+6 weeks

55
Q

When is the first antenatal visit?

A

10-12 weeks

56
Q

What is done during the first antenatal visit?

A 
FBC
Blood type, Rh
Rubella screen
STD screen
Hep B
Dating ultrasound
57
Q

When is the first ultrasound?

A

11-13 weeks

58
Q

When is the fetal anatomy ultrasound?

A

18-20 weeks

59
Q

When is the quadruple marker serum screening and amniocentesis for chromosomal abnormalities?

A

15-22 weeks

60
Q

What are cardiovascular changes that occur during pregnancy?

A

Increase blood volume
Increase RBC and WBC
Increased stroke volume
BP falls in first 2 trimesters but increases in 3rd

61
Q

What are respiratory changes that occur during pregnancy?

A

Increase in RR
Reduction in functional residual capacity
Respiratory alkalosis

62
Q

What are urinary and digestive changes that occur during pregnancy?

A

Increase in kidney size and renal blood flow

63
Q

What are risk factors for ectopic pregnancies?

A

History of one
IUD
Smoking
Multiple sexual partners

64
Q

What are signs and symptoms of an ectopic pregnancy?

A

Abdominal pain
Vaginal bleeding
Abdominal tenderness
Amonerrhoea

65
Q

How would you investigate an ectopic pregnancy?

A

Urine/serum pregnancy test

Transvaginal ultrasound

66
Q

What are risk factors for pre-eclampsia?

A 
Multiple gestations
Age > 35
DM
Obesity
Family history
67
Q

What are the key factors in pre-eclampsia?

A

New onset hypertension

Proteinuria

68
Q

What is the prevalence of gestational diabetes?

A

5-10%

69
Q

What are risk factors for gestational diabetes?

A 
Previous GDM
Previous macrosomia babies
Increased BMI
>40 yo
PCOS
Family history of DM
70
Q

How would you test for GDM?

A

7/11 rule

> 7mmol/L fasting plasma glucose
11mmol/L random blood glucose level

71
Q

What is considered premature?

A

<37 weeks

72
Q

What are the three stages of labour?

A
  1. Dilation up to 4 cm –> active phase up to 10cm
  2. Full cervical dilation up to birth of the baby (less than 3 hours)
  3. Placental delivery

High Yield (3 decks)

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