PBL Flashcards
Explain the terms thelarche, menarche, pubarche and andrenarche.
Give the name of the hormone whose pulsatile secretion is essential for puberty.
Name a non-biochemical method for detection and confirmation of pregnancy.
Thelarche: onset of breast growth. Menarche: onset of mensturation. Pubarche: onset of pubic hair growth. Andrenarche: onset of androgen secretion by adrenal glands.
Gonadotrophin releasing hormone.
Ultrasound - transvaginal (TVS) or transabdominal (TAS)
Describe 3 symptoms of early pregnancy.
Describe 3 signs of early pregnancy.
Amenorrhoea, nausea, vomiting, breast enlargement, breast tenderness, increase in frequency of micturition, tiredness
Breasts swollen and warm, breasts show prominent superficial veins, breasts show darkening of areolae, uterus soft and enlarged, cervix soft and enlarged, cervix appears bluish rather than pink
Mary has regular 28 day menstural cycles and the date of her last mestural peroid was 21/7/16. What is her estimated date of delivery?
Name 3 tests carried out to assess foetal well being in pregnancy.
Name 3 tests carried out to assess maternal wellbeing.
List 3 signs of onset of labour.
28/4/17 (+ 1 yr - 3m + 1week)
Ultrasound, blood tests, test for Downs, neural tube defects, abdo exam. Not routine but also amniocentesis and chorionic villus.
BP, BG, blood, urine, ketones, Hb, height, weight, ABO and Rh group, hep B and rubella test
Cervix dilation, irregular painful contractions, rupture of membrane - waters break.
Describe the NHS screening timeline.
Where does amniotic fluid come from origionally? What fluids supplement it later on in foetal development?
List 4 changes that take place in the cardiorespiratory systems at birth.
Give 2 substances which are actively transported across the placeta from the maternal to foetal circulation.
Initially secreted by amnion. Supplemented by urine from foetal kidneys and secretion from foetal lungs.
Pulmonary vascular resistance decreses. Umbilical arteries close. Umbilical veins and ductus venosus closes. Ductus arteriosus closes.
AAs, FAs, IgG, calcium phosphate, Fe
What is the main metabolic energy source for the baby in utero and post delivery?
How long after birth will it take the ductus arteriosus to close?
Name 3 conditions which the heel prick tests screens for and what is being detected in the blood sample for each condition.
In utero: glucose. Post delivery: fats.
12-15hrs
Hypothryroidism - TSH. Phenylketourea - phenylalanine. Thalassaemia and sickle cell - level of Hbs. CF - immuno reactive trypsinogen.
Also galactosemia (galactose-1 phosphate in RBC and galactose in blood), maple syrup urine disease, medium-chain acyl-coenzyme A dehydrogenase deficiency (MCADD)
Name 2 components that are present in breast milk in higher concentration than formula milk. What advantages do these components confer?
Give 2 reasons why a woman may choose not to breast feed.
A comibination of hormonal changes and external stimuli and required to initiate and maintain lactation. Name 2 factors which acheive this.
Define the term weaning and at what age is it recommended to begin?
IgA - defense against infection. Long chain FA - very important for brain development. Proteins, easier to digest.
Negative experience from previous baby. Don’t like idea, embarassed. Medical conditions may impede breastfeeding. Woman going back to work earlier.
Drop in progesterone and oestrogen. Rise in prolactin and oxytocin.
Introducing solid food. 6m.
What are the 4 developmental subdivisions of the Denver Developmental sreening test?
To which age range does a child belong who can take off his clothes, run and string words together?
Briefly describe herd immunity.
Gross motor, fine motor, language and personal social.
15-20m
High percentage of population protected by vaccination against viruses/bacteria so it’sdifficult for a disease to spread b/c so few susceptible people.
In addition to irregular periods, name 4 additional signs or symptoms of perimenopause.
When is a woman considered to have reached the menopause?
What is the average age for a woman to reach the menopause in the UK?
What treatment is available to alleviate the symptoms of the menopause?
Hot flush/night sweats, worse PMS, sleep problems, breast tenderness, lower sex drive, fatigue, vaginal dryness, urinary incontinence.
1 year since LMP.
51.5
HRT
Define subfertility.
Name 3 methods for testing ovulation.
When taking a history from the male partner which 2 infections would you be particularly interested in?
What does ICSI stand for?
Inability to conceive for 12m after commencing regular unprotected intercourse.
Basal body temperature chart, LH peak (blood or urine), progesterone at day 21 in blood, cervical mucus change.
Chlamydia, orchitis (mumps).
Intracytoplasmic sperm injection.
Describe the changing levels of progesterone, oestrogen, LH and FSH throughout a normal 28 day menstrual cycle.
Define what is meant by a small-for-gestational-age baby.
Name 3 possible causes of IUGR.
What is the most reliable method for assessing foetal growth and name one drawback of this method.
Baby’s birthweight it below the 10th centile
Maternal factors (smoking, substance abuse, malnutrition), placenta problems, pre-eclampsia, congenital abnormalities, infection, heart/kidney disease
Ultrasound. Viewing angles.
There are several other methods for assessing foetal wellbeing when growth restriction is suspected. Name one.
Name 2 foetal measurements from which the foetal weight in utero can be estimated.
What is the main course of measurement for IUGR?
Name 1 implication for IUGR babies in their later adult life.
Amniotic fluid volume. Foetal movement. Ultrasound doppler (venous).
Head circumference. Femur length. Transabdominal circumference.
Appropriately timed delivery and if possible early if needed.
Increased risk of CHD, hypertension, hyperlipidaemia, diabetes.
Define hypoxia.
What acute neurological condition arises as a consquence of perinatal asphyxia?
Give three long term neurodevelopmental problems that may occur following perinatal asphyxia.
Inadequate supply of O2 to tissues.
Hypoxic ischemic encaphalopathy.
Cerebral palsy, epilepsy, cortical blindness, deafness, leaning difficulties,
Below are 2 CTG traces. Name and breifly describe the condition the foetal heart trace is showing.
Trace A: tachycardia - foetal HR consistantly above the normal 120-160bpm.
Trace B: type II dips - foetal HR returns to baseline only after contraction ends.
