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Medicine Phase One > Keeping Peolpe Healthy: Week Three > Flashcards

Keeping Peolpe Healthy: Week Three Flashcards

1
Q

What is the main sugar in breast milk?

A

Lactose

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2
Q

What is the first milk made by the breast called?

A

Colostrum

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3
Q

What antibody is in breast milk?

A

IgA

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4
Q

What is the function of alpha-lactalbumin, located in breast milk?

A

Antibacterial and Immunostimulatory properties

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5
Q

What is the function of lactoferrin, located in breast milk?

A

Binds iron in competition with bacteria products, preventing iron overdoes

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6
Q

What is the function of Oligosaccrahries, located in breast milk?

A

Encourage the growth of beneficial probiotic organisms in the gut

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7
Q

What is the function of epidermal growth factor, located in breast milk?

A

Promotes healing

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8
Q

What is the function of neural growth factor, located in breast milk?

A

Promotes peristalsis development

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9
Q

What can long chain polyunsaturated fatty acids help with?

A

Brain development

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10
Q

What is Necrotising enterocolitis ?

A

Necrotising enterocolitis (NEC) is a serious illness in which tissues in the intestine (gut) become inflamed and start to die. This can lead to a perforation (hole) developing, which allows the contents of the intestine to leak into the abdomen (tummy). Formula fed babies are 6-10 times more likely to get this.

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11
Q

When and where is prolactin produced?

A

This is stimulated from the anterior pituitary gland when the nipple is stimulated.

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12
Q

What is the function of prolactin?

A

Cause lactocytes to make milk

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13
Q

When and where is oxytocin produced?

A

This is made in posterior pituitary and stimulated when there is nipple stimulation

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14
Q

What is the function of feedback inhibitor of lactation?

A

This will build up in the milk and cause lactation to stop.

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15
Q

What are some advantages of bottle feeding?

A
  • longer nights
  • separation
  • large volumes always available
  • same micronutrients
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16
Q

What intercostal spaces does the breast expand to and from?

A

2nd-6th

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17
Q

What is the pigmented area around the nipple called?

A

Areolar

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18
Q

What muscle cells surround the alveoli of the breast and help contraction?

A

Myoepithelial

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19
Q

What is the function of Cooper’s ligaments?

A

Hold breasts against chest wall

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20
Q

What is the function of the Montgomery glands?

A

Secrete a lipid fluid that helps lubricate the areolar and protect the nipple

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21
Q

What type of gland is the breast?

A

Apocrine

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22
Q

What is the epithelium of the nipple?

A

Keratinized stratified squamous epithelium

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23
Q

What is the breast vascular supply?

A

Internal thoracic artery

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24
Q

What are the three lymphatic nodes of the breast?

A

Axillary, Parasternal, Posterior intercostal

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25
Q

What is the passage way of breast milk out of the breast?

A

Alveoli (contained in the lobule) - lactiferous duct -lactiferous sinus - nipple

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26
Q

What three hormones prepare the alveolar cells to prepare for milk production during pregnancy?

A

Human placental lactogen, progesterone from the placenta.

Prolactin from the anterior pituitary.

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27
Q

Why is there no milk let-down during pregnancy?

A

Although there is prolactin stimulating let-down, it is inhibit by the placental progesterone.

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28
Q

What is the difference in the alveolar cells compared to pregnancy and lactation?

A

Pregnancy: columnar

Milk production: squamous and have microvilli

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29
Q

When is mature milk secreted?

30
Q

What is the composition of colostrum?

A

This is low in fats, lactose and B vitamins, but high in protein and vitamins A,D,E and K and minerals, There are also IgAs.

31
Q

What is the composition of mature milk?

A

Higher concentration of fats and sugars

32
Q

What are the three main proteins of breast milk?

A

Casein, Alpha-lactalbumin, Lactoglobulin

33
Q

What does Oligosaccharides help within the baby?

A

Lactose promotes growth of intestinal flora.

Galactose is essential in myelin production.

34
Q

What should the proper attachment of the baby’s mouth to the nipple be?

A

Nipple against roof, mouth wide open covering alveolar, tongue against bottom of areolae

35
Q

Explain the process of milk production stimulation

A

Suckling initiates the neuroendocrine reflex, where mechanoreceptors are activated. This causes signals up to the hypothalamus via intercostal nerves and dorsal root ganglion. There is a decrease in prolactin inhibitory hormone (dopamine) and an increase in prolactin.

36
Q

Explain the process of milk let-down stimulation

A

Oxytocin is responsible for this. This is made in the hypothalamus and secreted by the posterior pituitary. There will also be contraction of the Myoepithelial cells.

37
Q

When will lactation cease if not stimulated?

A

2-3 weeks. Complete involution will take 3 months.

38
Q

What are some conditions that the baby is more likely to get is they are formula fed?

A
  • Otitis media
  • Asthma
  • Obesity
  • Diabetes
  • Lower respiratory infections
  • Eczema
  • Sudden infant death syndrome
39
Q

What are some benefits for the mother when she breast feeds?

A 
Weight loss
Reduces cancer risk
Reduces uterine bleeding
Reduces risk of heart disease, osteoporosis, type II diabetes, arthritis
Skin-to-Skin contact
40
Q

What is the breast feeding bill of 2005?

A

This allows women to breast feed in a public place, as long as child is allowed to be there

41
Q

How much colostrum will a baby require during each feed?

42
Q

What are some complications of breast feeding?

A
  • cracked nipples
  • breast enlargement
  • blocked milk duct
43
Q

When should weaning occur?

44
Q

When should babies start being given vitamin D supplements?

A

From birth

A and C given from 6 months

45
Q

What is the distance between each centile on a growth chart?

A

2/3 of a standard deviation

46
Q

What are the two centiles that are two standard deviations above or below median?

A

2nd and 98th

47
Q

What are the findings on a growth chart of an overweight and obese child?

A

Overweight: 91st
Obese: 98th

48
Q

What are some signs that there may be undernutrition?

A

Weight: 2nd or 9th
Height: 25th

49
Q

What is the liquid and calories intake recommended for infants?

A

Liquid: 150ml/kg/day
Calories: 110kcal/kg/day

50
Q

What are some macronutrients found in breast milk?

A
  • phosphorus
  • calcium
  • magnesium
  • copper
  • iron
  • zinc
51
Q

What is a short stature defined as?

A

2 standard deviations blow median

52
Q

Name some common uses of hormonal contraception

A
  • Oestrogen and Progesterone: pill, patch and vaginal ring

- Progesterone: pill, injectable, implant, mirena coil

53
Q

Name some common contraceptives

A
  • hormonal
  • condom
  • diaphragm
  • cervical caps
  • natural methods: temperature, rhythm, persona, withdrawal
  • sterilisation: tibiual ligation in women ( 1:300 failures) and vasectomy in males (1:2000 failures)
54
Q

Name and describe the difference between the two types of oral emergency contraception

A
  • Levonella: this has levonorgesterol (progesterone) and this is used within 72 hours
  • EllaOne: this is ullipristal and is used within 120 hours
55
Q

Describe the intrauterine emergent contraception

A

This is a copper coil. This is 99% effect (the oral has 95%) and can be used within 120 hours.
This is invasive and painful.

56
Q

Give some examples of STIs

A
  • Genital warts
  • HIV
  • Chlamydia
  • Genital Herpes
  • Gonorrhoea
  • Hep B
  • Trichomonas Vaginitis
  • Syphilis
57
Q

Describe Genital warts

A

This is caused by HPV 6 and 11. There will be warts around the genital area and they might by asymptomatic.

58
Q

Describe Chlamydia

A

This is mainly asymptomatic. However, it may cause dysuria, discharge, cervicitis, pelvis inflammatory disease and female infertility. This is causes by bacteria

59
Q

What is Dysuria?

A

Painful urination

60
Q

Describe Genital herpes

A

This is caused by Herpes simplex virus (cold sore). There will be painful ulcers that will heal but may recur.

61
Q

Describe Hep B

A

This is from the Hepadnavirus. This can also be spread through blood and vertical transfer.
This can case cirrhosis, liver failure and cancer.

62
Q

Describe Trichomonas Vaginitis

A

This is caused by Flagellated bacteria. This is mainly asymptomatic.
Women may have discharge and an odour
Men may have discharge and dysuria

63
Q

Describe Gonorrhoea

A

This is caused by Neisseria Gonorrhoea (negative diplococci). This is mainly asymptomatic but may cause men to have purulent urethral discharge and dysuria, Women may also have discharge.
Complications include: PID, Conjunctivitis, Disseminated gonococcal infection

64
Q

Describe Syphilis

A

This is caused by bacteria and can result in an ulcer or rash. If left untreated, it can cause neuropathy, aneurysm,
It is usually treated with long acting penicillin.

65
Q

Describe HIV

A

This is an STI more common in developing countries. Effective treatment has meant that, in many cases, the life expectancy is normal.

66
Q

What thee STIs are males more likely to get if they have intercourse with other males?

A

HIV, Syphilis, Gonorrhoea

67
Q

What kind of urine sample do men give for STI testing?

A

First void urine sample: Chlamydia and Gonorrhoea

68
Q

What are the two types of tests for female STIs?

A

Self Swab: Chlamydia and Gonorrhoea

Blood: HIV and Syphilis

69
Q

What do the Fraser Guidelines say in relation to a Doctor giving advice about sexual health to under 16s

A

Doctor can continue giving advice in the patient meets following criteria:

  • young person understands
  • young person won’t tell parents
  • young person will continue having sex
70
Q

What are the stages of the audit process?

A
  • select the topic
  • define the standards
  • define the methods
  • pilot and data collection
  • analyses and report the data
  • make recommendations
  • implement change
  • re audit

Medicine Phase One (44 decks)

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