Keeping People Healthy: Week One Flashcards
Name the determinates of health
- Income and social status
- Education
- Physical environment
- Social support channels
- Genetic
- Personal behaviour
- Health services
- Gender
What are the factors that contribute to the Bradford Hill Criteria?
- Strength
- Constituency
- Specificity
- Temporality
- Biological gradient
- Plausibility
- Coherence
- Experiment
- Analogy
What does Noggin inactivate?
BMP-4
Name four threats to validity of a study’s findings
- lack of generalising
- chance
- confounding
- bias
What part of the cytotrophoblast ensures remodelling of the spiral arteries?
Extravilllous
How are amino acids transported across the placenta?
Active transport
What wave was the agent-vector model of disease most prominent?
Second
What system has the longest critical period of development?
Nervous system
What system does the drug tetracycline affect?
Teeth enamel
What system does the drug sodium valproate effect?
Neural tube development. This drug is more epilepsy
What system does the drug thalidomide effect?
Limb development
What system does Rubella affect?
Ear development
Which weeks is the pre-embryonic period?
Weeks 1-2
Which weeks is the embryonic period?
Weeks 3-8
Which weeks is the fetal period?
Weeks 9- Term
Which germ layer forms the notochord?
Mesoderm
What forms the nucleus fibrosis?
Notochord
What germ layer gives the neural tube?
Ectoderm
How many cervical somite pairs are there?
8
How many thoracic somite pairs are there?
12
How many lumbar somite pairs are there?
5
How many sacral somite pairs are there?
5
How many coccygeal somite pairs are there?
8-10
What separates the somatic (dorsal layer) and the splanchnic (ventral layer) mesoderm layer?
Coelem
What two structures form the chorion?
The trophoblast and the extra-embryonic mesoderm.
What shape is the placenta?
Discoidal
When and how do primary villi form?
Day 14: stalks of cytotrophoblast emerge
When and how to secondary villi form?
Extra-embryonic mesoderm invades the core of the primary villi
How do tertiary villi form?
Blood vessels develop in the mesenchyme and these will eventually connect with the umbilical vessels.
How are amino acids and glucose transported across placenta?
Facilitated diffusion: against concentration gradient
What vitamins cross the placenta?
B,C,D
How do antibodies cross the placenta?
Pinocytosis
Name two viruses that can cross the placenta
HIV, Rubella
What layer of the trophoblast produces hormones, including oestradiol and progesterone
Syncytiotrophoblasts
What are the features of the early placental barrier?
There is both the syncytiotrophoblasts layer and the cytotrophoblast layer which some blood vessels
What are the features of the late placental barrier?
There is no cytotrophoblast. The mesenchyme becomes more dense and the mass of villi and blood vessels increase
What are Hafobauer cells?
Placenta macrophages
What are placental macrophages called?
Hafobauer cells
What does the central nasal prominence become?
Forehead, nose, middle portion of upper lip and primary palate
What does the left and right maxillary prominences become?
Lower face regions lower lip, jaw and secondary palate
Why is folate essential during pregnancy?
RNA and DNA synthesis
Which arteries does maternal blood flow through to reach the intervillus space?
Spiral arteries
What is the rate of blood flow during full pregnancy?
500ml/min
What are the four extra-embryonic membranes and what is the innermost one?
The amnion, chorion, yolk sac and allantois
The amnion is the inner one
What is the meaning of malformation?
This is a structural defect of part or the whole organ caused by an abnormal process intrinsic to its development. An example is spina bifida
What is the meaning of disruption?
This is a defect in an organ or body part caused by a process that interferes with an originally normal developmental process. An example is thalidomide induced Phocomelia.
What is the meaning of deformation?
Structural abnormality caused by mechanic fore. An example is amniotic band constriction.
What is a sequence?
This is a pattern of multiple malformations stemming form a disturbance of developmental process/mechanical factor. An example is Potter sequence.
What is a syndrome?
Group of malformations of differ structures due to a single primary cause, but acting through multiple pathways. An example is Down syndrome
What is an association?
Group of anomalies seen in more than one individual that cant be attributed to definitive cause.
What is teratology?
Study of abnormal development of congenital defects
What is a teratogen?
An agent that disturbs the development of embryo
What period is the more susceptible to teratogens?
Weeks 3-8 (embryonic stage)
What are the outcomes of a teratogen in weeks 1-2?
Death or embryo can compensate
What is the critical period for the Heart?
Weeks 3-6
What is the critical period for the CNS?
Weeks 2-7
What teratogen can caused hydantoin syndrome and what are some features?
Fetal hydantoin syndrome, also called fetal dilantin syndrome is a group of defects caused to the developing fetus by exposure to teratogenic effects of phenytoin or carbamazepine. Dilantin is the brand name of the drug phenytoin sodium in the United States, commonly used in the treatment of epilepsy.
Effects include prominent eye and increase space between eyes
What are the consequences of methotrexate during pregnancy?
Craniofacial abnormalites
What affect does alcohol have on pregnancy?
Foetal alcohol syndrome
Why is alcohol bad during pregnancy?
The liver cant metabolize the alcohol ad hence the blood becomes highly concetrated
What does Rubella cause on the 6th week of development?
Cataracts.
What does Rubella cause on the 9th week of development?
Deafness
What is raised body temperature during pregnancy associated with?
Anencephaly
Explain the Manchester triage system
RED: urgent and patient is seen straight away
ORANGE: this is very urgent and patient is seen in 10 minutes
YELLOW: this is urgent and patient is seen in 60 minutes
GREEN: this is standard and patient is seen in 120 minutes
BLUE: this is non-urgent and patient is seen in 240 minutes
Explain the diffusion of oxygen and carbon dioxide in the placenta
This will diffuse due to partial pressure
What is the difference with fetal haemoglobin?
The fetal blood have 50% more haemoglobin and this has a higher oxygen affinity.
How is glucose transported across the placenta?
Through hexose transporters via facilitated transport that aren’t dependent on insulin.
How is glucose used in embryo for energy?
Glucose oxidised to lactate and this is used as energy.
How doe amino acids cross the placenta?
Active transport
What is the only antibody that crosses the placenta?
IgG
What is bilirubin?
A waste product of haemoglobin. This is usually conjugated in liver to be water-soluble and then is secreted in bile.
What happens to bilirubin in the featus?
Conjugated Bilirubin crosses the placenta poorly. There is therefore only a small portion of conjugated bilirubin produced, most is unconjugated.
When does the Morula form?
Day 4
When does the blastocoel form?
Day 5
What affect does warfarin have during pregnancy?
Bone abnormalities
What affect does aspirin have during pregnancy?
Heart abnormalities
What affect does sodium valproate have on folate levels?
Decreases it
What does the amniotic cavity consist of?
The inner ectoderm layer and outer mesoderm layer.
What three parts does a receptor have?
Extracellular part, transmembrane part, intracellular part
Where is sonic hedgehog secreted?
Notochord
Where does the notochord form and what is it formed of?
This is from the mesoderm and is ventral to ectoderm
The signals noggin and chordin, are from the notochord. What are their functions?
These induce neural tube development. These signals will inactivate BMP4. The absence of BMP4 will cause NT patterning and somite formation
What does the appearance on the notochord cause the overlying ectoderm to do?
The ectoderm thickens and forms the neural plate. Cells of the plate make up the neuroectoderm. Once the plate is induced, the growing begins. The structure lengthens and the lateral edges elevates, forming the neural folds. The depressed region forms the neural groove. The folds will eventually fuse and form the neural tube.
When do anterior pores fuse?
Day 25
When do posterior pores fuse?
Day 27
What affect does SHH have on the neural tube?
Causes the formation of the neural plate