Obs and Gyne Flashcards
What is the source of phospholipids in breastfed babies?
Membrane fragments
Mention folic acid antagonists and their effects
Trimethoprim and triamterene Neural tube defects Cardiovascular defects Oral clefts Urinary tract defects
Mention complications of oral isoretinoin?
Hydrocephalus + cerebellar abnormalities + cns malformations+neuronal brain migration+severe intellectual disability + seizures+
Microtia with or without atresia of ear canal
Dysmorphic features
Phenytoin causes ??
Dysmorphic features
Nail hypoplasia
Heart defects
Ebstein anomaly caused by?
Lithium
Cmv rubella and toxo all cause?
Microcephaly and Intellectual disability
Misoprostol causes
Fetal death and vascular disruption (terminal transverse limb defects)
How to stage puberty in girls
Breast rather than publc hair
Stage puberty in males ?
Penile length and testicular volume by palpating
McCune Albright syndrome is؟
Polypstoic fibrous dysplasia
Cafe au lait spots
Precocious puberty
Mention inhibitory peptides
Progesterone Relaxin Calcitonin gene related peptide Parathyroid hormone related peptide Nitric oxide Adrenomedullin Vasoactive intestinal peptide Prostacyclin (PGI-2)
Phase one of labour characteristic by?
When term approaches- uterotropins like estrogen activate uterus
Increased of Contraction-associate- protein like
Oxytocin and prostaglandins
Activating ion channels
Increase in connexin 43(gap junction) = electrical synchrony
Stimulatory phase is by
Uterotonic agonists like
Prostaglandins F2 alpha and E2 and oxytocin
Involution of uterus mediated primarily by?
Oxytocin
Why humans for sure differ than sheeps in initiating labour?
Because human placenta lacks glocucorticoid inducible 17 alpha hydroxylase 17, 20 lyase enzyme essential for the process
Why does availability of free intracellular calcium is a key modulator of myometrial contractility?
Because phosphorylation of myosin light chain by kinase depends on calcium/calmodulin enzyme
Activation of beta adrenergic / pgE2 receptors is via
Gas adenyl cyclise/cAMp transduction pathway
Oxytocin receptors couple to?
Gaq/Gai/phospholipase C
Causing increase in inositol- 1,4,5 triphosphate which releases Ca from sarcoplasmic reticulum
And 1,2 diacylglycerol that activates protein kinase
How is it known that labour is caused by downregulation of pathways?
Gas levels gets low before labour
Is myometrial cells contracting neural?
No! Have sparse innervation regulation of contraction is humoral and on intrinsic factor
What is the effect of indomethacin on labour?
Stop contractility
Prolong gestation
What causes cervical repenning?
Cervical softening by degradation of collagen by prostaglandin F2 alpha
Phases of sexual response cycle
Excitement
Plateau
Orgasm
Resolution
Do men and women experience same sexuality cycle?
Same phases but different timing it is highly unlikely that reach orgasm at same time
And intensity and response varies from one person to another
Characteristics of excitement
Clitoris and labia minora swells and penis erect Scrotum tightens as testis enlarges Women breast become fuller Nipples harden and erect Heart rate increase and flushing Vaginal lubrication
Characteristics of plateau phase?
Vaginal wala becomes dark purple as blood flow continues to increase
Clitoris highly sensitive and retracts under the clitoral hood to avoid direct stimulation by penis
Muscle spasm reach face hand and feet
Muscle tension increases
Orgasm characteristics
Sudden release of sexual tension
Involuntary muscle contraction
Vagina and uterus goes under rhythmic contractions
Sex flush all over the body
Rhythmic contracts in men at base of penis ejaculate semen
Rapid intake of oxygen
Difference in orgasm of males and female
Females multiple and can have rapid return while men need recovery time called refaractory period can’t reach orgasm in it
Refractory period increases with?
Age
Decrease estrogen in perimenopausal women caused
Reduced vulvovaginal lubricant
And vasocongestion
Also vaginal atrophy
And pain in sex
Decreasing libido
What does high doses of exogenous androgens do to females
Positive effect on female sexuality
Erection is first triggered by?
Neurological signals then it’s hormonal
Thoracolumbar erection center located at ?
T-11 to L-2
Difference between psychogenic election and reflex erecting?
Psycho trigger by neural impulse like visual auditory stimuli unlike reflex is by tactile stimulating to penis or genital area
Reflex arc activates?
Sacral erecting center from S2-S4
Mans early sexual life erecting is more of
Psychogenic
How amino acids and vitamins pas
Active transportation
How glucose pass?
Facilitated diffusion
Immunoglobulin pass through?
Pincytosis
Why does insulin and parathormone does not pass?
High MW
Exposure to teratogens in days 10-14 may result in?
Cell death!
Blocking of metabolic processes is the mechanism of action of?
Thioureas and iodides
Congenital anomalies that comes with IDDM?
Spina bifida
Congenital heart disease
Focal femoral hypoplasia
Caudal regression
Maternal PKU causes
ID
Congenital heart disease
Microcephaly
List maternal autoimmune diseases and effect on baby?
SLE ,,, heart block
Myasthenia Gracie ,,, transient neonatal myasthenia
Graves’ disease ,, neonatal thyrotoxicosis
ITP ,,, neonatal thrombocytopenia
Increased maternal core temperature by 2,5 in the first trimester fro 24 hours causes
Neural tube defects?
Other findings of high maternal temperature
Microcephalic
ID
Hypo/hyper tonia
Seizures
What increase the risk of neural tube defects?
Folic antagonists like trimethoprium and triametrene
Why statins are contraindicated?
Congenital heart disease
CNS malformations
LIMB MALFORMATIONS!!!
Ace inhibitors causes
Renal and skull defects
Diethylstillbesterol causes
Cervical cancer in female progeny
