Pregnancy and paediatrics Flashcards

1
Q

What is the blastogenesis stage?

A

fertilized ovum divides and implants itself in the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the embryonic stage?

A

all rudiments for the principle organs and membranes develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the foetal stage?

A

most rapid period of growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is normal weight gain like in pregnancy?

A

11-15kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are maternal obesity at risk for?

A

pre-eclampsia, gestational diabetes, infants develop anomalies and neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the risk when underweight?

A

low birth weight, prematurity, higher miscarriage rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How many extra calories a day do pregnant women need?

A

100-300 kcal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How much extra protein is needed for pregnant women?

A

6-10g a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some symptoms of pregnancy?

A

cramping, nausea, vomiting, increase in abdominal girth, changes to bowel, increased urinary freq, palpitations, heart murmurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is cramping concerning in pregnancy?

A

cramping is worsening or associated with vaginal bleeding as maybe a sign of ectopic pregnancy, threatened abortion or missed abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can we do to reduce the risk of food poisoning in pregnancy?

A

raw or partially cooked eggs, unpasteurised dairy products, do not drink contaminated water, wash hands after touching raw meat, take care with food left uncovered on a warm plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is toxoplasmosis?

A

infection caused by a parasite found in cat faeces or raw/uncooked meat or soil left on unwashed fruit and vege

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 5 things can be done to reduce toxoplasmosis?

A

unwashed raw fruit and vege, raw uncooked meat, cured meats (salami), unpasteurised goats milk/cheese, avoid contact with soil or faeces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is important with vitamin A and pregnancy?

A

Do not supplement as it can result in defects

But beta-carotene is not teratogenic (vit A precursor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is it important to supplement folate or folic acid in pregnancy?

A

folic acid is important for DNA synthesis and cell replication and deficiency is linked with neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is it important to supplement iron in pregnancy?

A

iron deficiency anaemia is the most common pregnancy complication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What advise is there on fish and pregnancy?

A

fish intake needs to limit to 2 oily fish a week (mercury levels)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What disease has fish oil reduced when the foetus became an adult?

A

asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain why DHA is important for pregnancy.

A

high in retinal and brain membrane phospholipids which is involved in neural function and neurotransmitter metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Explain what happens when there is vitamin D3 deficiency in pregnancy.

A

Vit D deficiency is linked to maternal skeletal preservation and foetal skeletal formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens when there is iodine/calcium deficiency in pregnancy?

A

low thyroid function due to low iodine intake increases the risk of infant lower IQ and calcium is a major part of the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does zinc deficiency affect pregnancy?

A

zinc deficiency impairs learning and memory by reducing NMDA receptor expression which is responsible for creating plasticity changes in brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does magnesium supplement help with pregnancy?

A

reduce risk of foetal growth retardation, pre-elampsia and increased birth weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What to do if the pregnant women is on a vegetarian and vegan diet?

A

possible deficiencies in vit D3, zinc, iron and B12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some lifestyle guidelines for pregnancy?

A

Moderate exercise, avoid contact sport, do not scuba dive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the guideline for caffeine and pregnancy?

A

caffeine should be lower than 100mg/d especially in early pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What else do you need to avoid in pregnancy?

A

chemical solvents and pesticide during pregnancy can increase risk of childhood cancer and primary exposure to radiographs, workplace radiation and environmental exposure so can also lead to cancer in childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Why does lead put a pregnant woman at risk?

A

high levels lead to stillbirths and abortion found in lead based paints, leaded petrol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Explain how mercury can affect pregnancy?

A

can affect CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Where is cadmium found?

A

graphic art material, paint, ceramics, solder, fish and cigarette smoke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Where is manganese found?

A

tea, cloves, and some grains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What can be done to help morning sickness?

A

frequent, smaller meals and snacks, B6 (25mg 3 times a day), ginger or peppermint tea, prevent blood sugar drops to reduce symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is hyperemesis?

A

severe nausea, vomiting, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Explain why pregnant women get heartburn.

A

increased progesterone and decreased motilin, decreased lower oesophageal sphincter tone leads to excess gastric acid in oesophagus

35
Q

What craving indicate iron deficiency?

A

dust, charcoal, dirt and ice

36
Q

What is pre-eclampsia?

A

new-onset hypertension and proteinuria

37
Q

What is done for pre-eclampsia?

A

delivery, reducing risk factors (maternal obesity and oxidative markers), magnesium sulcate to prevent seizures, diet rich in fruit and vege for antioxidants and magnesium

38
Q

What does gestational diabetes do to the baby?

A

increases risk of birth weight babies, complicates delivery and increases risk of caesarean section

39
Q

What are 5 risk factors of GD?

A

BMI of 30 or above, previous heavy baby (10lbs +), GD previously, family history of GD

40
Q

Whats the treatment for GD?

A

Diet and exercise, low GI/GL diet, regular meals, increased fruit and vege, avoid sugars and refined foods

41
Q

Explain what is meant by a birth plan?

A

document that states the mothers wishes, not fixed but a guideline. Things to think of include: who will be there, pain relief options, heart rate monitoring, different inductions

42
Q

How is lactation stimulated or inhibited?

A

prolactin and oxytocin stimulate lactation

dopamine inhibit lactation

43
Q

What induces oxytocin?

A

direct suckling

44
Q

What is the link between stress and lactation?

A

stress will down-regulate milk synthesis by increasing dopamine, nor epinephrin which inhibit PRL synthesis

45
Q

What does breast milk contain?

A

protein, carbohydrates, fats, enzymes, immunoglobulins especially secretory immunoglobulin (sLgA)

46
Q

What in breast milk can affect pathogenic bacteria?

A

Lactoferrin - binds to iron making it unavailable to pathogen bacteria.
Lysozyme - enhances sIgA bactericidal activity
Oligosaccharides - intercept bacteria
Milk lipids - damage membranes of viruses
Mucins - adhere to bacteria/viruses and eliminates them
Interferon/fibronectin - antiviral activity

47
Q

What are some common breastfeeding problems?

A

mammary vascular engorgement (frequent breastfeeding around the clock), sore nipples, cracked nipples, mastitis (emptying breast helps recovery), yeast infection of breast (can be passed to infant as oral thrush)

48
Q

What are galactagogues?

A

herbs that increase milk production

49
Q

What is the best example of a galactagogue?

A

fennel seeds brewed as a tea or fenugreek

50
Q

What is important about vitamin D?

A

If mother is deficient then baby can be deficient as well so supplement in a multi if necessary

51
Q

What is postpartum depression?

A

rapidly fluctuating mood, tearfulness, irritability and anxiety after 4/5 days after delivery

52
Q

What is some self-care tips for the mother?

A

mobilise a community, try to get lots of sleep, integrate baby into everyday life, take a shower and get dressed everyday, do some gentle exercise with baby

53
Q

What are some supplements for after birth?

A

multivit with iron, omega 3, folate, B12, calcium, selenium, zinc

54
Q

What is the main tip with children and nutritional therapy?

A

Do not cut out any food groups. If you do then have justification for it and make sure they are getting adequate nutrition

55
Q

What do you need to consider with children and supplements?

A

Go for powders, liquids and easily ingested supplements not pills

56
Q

What affects microbial colonisation?

A

Babies are sterile and it becomes colonised by the mothers bacterial balance, mothers use of probiotics, type of birth, gestational age, primary source of nutrition, stress levels

57
Q

What bacteria do breastfed babies have more of?

A

bifidobacteri in their stool and a higher proportion of lactobacillus to e.coli

58
Q

When is important to introduce solid food?

A

not before 4 months but later than 6 months of age

59
Q

What can protect against allergies and intolerance?

A

Breast feeding and not introducing solid food to early. Avoid allergenic food until later (6-7 months when baby is still breastfed) e.g. eggs, wheat, peanuts, milk, soy fish

60
Q

What can be done to support children immunity?

A

zinc, lactobacillus rhamnosus, vit A, echinacea, propolis

61
Q

What are some common childhood illness?

A

common cold, scabies, chicken pox, tonsillitis, GIT infections

62
Q

What is otitis media?

A

infection between area between tympanic membrane and inner ear including Eustachian tube

63
Q

What are symptoms of otitis media?

A

earache, irritability, fever, red bulging eardrum, typically after cold/bacterial infection. Can lead to chronic infection (hearing loss)

64
Q

What are some orthodox treatments of otits media?

A

antibiotics, analgesics, anti-histamines; vertical procedure to drain fluid

65
Q

What are some common risk factors for glue ear?

A

cigarette smoke, food allergies, day care, lack of breast feeding

66
Q

What can be done for otitis media?

A

remove food allergies, vitamin C, probiotics

67
Q

What is colic?

A

uncontrollable crying in a baby that seems to have no cause.

68
Q

What is the cause of colic?

A

bloating, gas, cramping and babies cry because of not being able to release gas

69
Q

What are some nutritional treatments of colic?

A

remove gassy food from mother diet, remove food sensitivities for mothers diet, remove cow protein from babies diet, digestive aid teas (chamomile), probiotics

70
Q

What is ADHD?

A

behavioural disorder that begins in early childhood and common in boys

71
Q

whats the orthodox treatments for ADHD?

A

ritalin, therapy, behavioural interventions

72
Q

What are 5 signs and symptoms of ADHD?

A

hyperactivity, short attention span, poor memory and thinking, listening problems, specific learning disabilities

73
Q

What are some contributing factors of ADHD?

A

glucose control, nutrient deficiencies (Omega 3, zinc, iron, magnesium, vitamin D), exposure to heavy metals, food additives sensitivities

74
Q

What is the opioid theory?

A

peptides from gluten and casein react with opiate receptors in the brain thus mimicking effects of opiate drugs

75
Q

How can you spot an opioid reaction?

A

child develops a picky appetite and addicted to gluten and dairy, silly or spacey behaviour, hyperactive or aggressive behaviour, sensory issues, lack of attention, mood swings

76
Q

How can you test for an opioid reaction?

A

urinary peptides to ascertain if casein or gluten is in urine

77
Q

What is the nutritional care of ADHD?

A

nutrients deficiencies - address them, high levels of oxidative stress, omega 3 are beneficial, support gut heating, calming supplements

78
Q

What is the pathophysiology of autism?

A

genetic factors involved, abnormalities in the brain (enlarged amygdala)

79
Q

What are some symptoms of ASD?

A

seizures, cognitive defects, sensorimotor abnormalities, immune impairments, disordered sleep and Gi distress

80
Q

What do 70% of children with autism have?

A

Low faecal chymotrysin - indicators for low pancreatic enzyme release

81
Q

What are some common GIT problems with autism children?

A

diarrhoea, constipation, abdominal pain, gas and bloating, oesophageal reflux, low carb digesting enzymes

82
Q

What problems do children with autism have in terms of toxicity and detox?

A

impaired sulfation, decreased activity of phenylsulfotransferase, impaired methylation, efflux disorder

83
Q

What is the GAPs diet?

A

SCD removes all carbohydrates that require digestion to ease pressure on intestines. Only monoaccharides are allowed because they are easy to digest.