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PPE > Repro > Flashcards

Repro Flashcards

1
Q

briefly what occurs in the fetal period early and late

A

early - protein deposition. Late is adipose development of embryonic structures throughout

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2
Q

how does the last menstrual period relate to weeks of fertilisation

A

+2 weeks after fertilisation

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3
Q

what would you use to meaasure a babys progress in t1, 2, and 3?

A

t1 - crown rump length t2 - biparietal diameter t3 - head circumference

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4
Q

how assess antenatal wellbeing

A

mother and fetal movements, USS, uterine exapnsion (symphysis fundal height). Glucose tests, blood checked for rghesus, Hb, infection, urinalysis for preeclampsia

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5
Q

what is terms for too much or too little amniotic fluid

A

oligo and polyhydroamniosis

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6
Q

why is a scan done at weeks 7-13?

A

estimate delivery date and CRL

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7
Q

what is good and bad weights for child and why does it happen

A

>4500g - macrosomia, gestational diabetes

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8
Q

name the 3 stages of lung development and weeks involved and what happens

A

pseudoglandular - 8-14 wks, ducts + bronchioles develop from bronchiopulmonary trunk canalicular - 16-26 wks, resp bronchioles form terminal sac - 26+, terminal sacs form and type 1 and 2 (surfactant) pneumocytes differentiate

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9
Q

what aids lung development

A

amniotic fluid and breathing movements

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10
Q

what is the threshold for viability for baby

A

24 wks +

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11
Q

when does kidneys begin to function and what happens if they dont

A

10 wks oligohydroamnios if not

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12
Q

when does nervous system myelinate and when do voluntary coordinated movements occur

A

myelination at 9 mths and after birth voluntary coordinated movements - 4 mths +

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13
Q

when is fetus first movements

A

8 wks +

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14
Q

what and when is quickening of fetus

A

increased awareness of fetus at 17 wks

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15
Q

state fetal circulation

A

ductus venosus - bypass liver ductus arteriorus and FO - bypass lungs

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16
Q

how does the last menstrual period relate to weeks of fertilisation

A

+2 weeks after fertilisation

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17
Q

what is the metabolic funcitons of the placenta

A

synthesis glycogen, FAs, cholesterol

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18
Q

what does umbilical vein and artery carry

A

vein - blood to fetus artery - blood from fetus

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19
Q

what is amniotic fluid purpose`

A

swallowed to make urine and meconium protects against trauma aids development of urinary and GI

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20
Q

how much fetal urine produced at 25 weeks?

A

100-500 ml

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21
Q

why does fetal jaundice occur

A

fetus cant conjugate bilirubin

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22
Q

what is haemomonochorial mean

A

placenta has direct contact with blood, placental barrier at thinnest

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23
Q

explain formation of placenta after blastocyst has invaginated endometrium

A

1) trophoblast differentiates to cytotrophoblast and syncytiotrophoblast 2) SCT forms villi and lacunae. lacunae fill with blood 3) CT villi grow into SCT - primary villi, 2nd week 4) extraembryonic mesoderm grows into villi - 2nd villi, 3rd week. Soon after, embryonic blood vessels form in villi, 3rd villi 5) maternal blood in intervillous spaces

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24
Q

what happens to the SCT and CT in placenta

A

gets thinner and thinner allowing increased exchnage

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25
Q

how is endometrium prepped for implantation

A

spiral arteries which are high flow and low resistance

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26
Q

what is decidualisation

A

pre decidual cells of mother balance invasive force of trophoblast

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27
Q

explain the placental and amniotic situation of dizygotic twins

A

2 placenta + 2 separate amniotic sacs

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28
Q

what is maternal aspect of placenta and what is it made of? what is fetal aspect made of

A

maternal - decidua basalis, made of cotyledons fetal - umbilicus

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29
Q

what substances diffuse into placenta and how

A

simple diffusion - gases, electrolytes, water, urea facilitated - glucose active transport - AAs, fe, folate RME - IgG

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30
Q

name the teratogenic drugs

A

TERATOWgenic thalidomide, epilepsy drugs, retinoid, ACEi, third element: lithium, OCP, warfarin

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31
Q

thyroid changes in pregnancy

A

increased T3/4 due to hCG stimulation

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32
Q

what is the endocrine functions of placenta

A

hCG, hPL, prog, oest, hCS, hCT (thyrotrophin)

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33
Q

what can increased hCG indicate in female

A

pregnancy, hydratiform mole, coriocarcinoma

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34
Q

what does hPL do

A

increase glucose available from mother

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35
Q

what does progesterone do

A

increase appetite

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36
Q

what are possible pregnancy complications

A

pre-eclampsia, placental insufficiency

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37
Q

what is preeclampsia and what can it lead to if untreated

A

high BP (>140/90) and proteinuria. Can lead to seizures (eclampsia)

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38
Q

risk factors of preeclampsia

A

DM, obesity, hypertension,

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39
Q

treatment of preeclampsia

A

CCB, beta blocker

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40
Q

what is placental insufficiency

A

not enough blood flow to placenta > reduced HR of fetus

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41
Q

why does gestational diabetes occur. Risk factors

A

hPL increases insulin resistance and decreases fasting blood glucose RF - PCOS, smoking

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42
Q

what is acrosome process

A

sperm penetrates ZP. cortical reaction blocks polyspermy

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43
Q

urinary changes in pregnancy

A

increase GFR and risk of UTI decrease urea and creatinine by 50% urinary stasis due to prog ureteral dilation

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44
Q

resp changes in pregnancy

A

increase AP and transverse diameter, tidal volume, RR (hyperventilation) decrease FRV

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45
Q

How does lipid metabolism change in pregnancy

A

increased lipolysis T2+

46
Q

thyroid changes in pregnancy

A

increased T3/4 due to hCG stimulation

47
Q

GI changes in pregnancy

A

appendix in RUQ increased risk biliary stasis, pancreatitis due to progesteron

48
Q

blood changes in pregnancy

A

prothrombotic therefore increase risk of thrombus anemia - dilution of blood and fe and folate deficiency

49
Q

symptoms of PCOS, diagnose, treat

A

diagnose USS increase LH and FSH and androgen, hirsutism, insulin resistance, infertile treat - weight loss, metformin

50
Q

female sex response

A

blood engorgement of clit, vagina, breast and nips no refractory period

51
Q

components of semen and origins

A

60% seminal vesicles - fructose, clotting factors, alkaline 30% prostate - proteolytic enzymes 10% bulbourethral - lubricate urethra

52
Q

stats of sperm

A

2-4 ml, 20-200 million per ml >50% morphology and movement

53
Q

explain how erections happen

A

NO release in corpora cavernosa and corpora spongiosum, arteries dialte and release blood.

54
Q

how does viagra work

A

inhibits cGMP breakdown (cGMP inhibits MLCK) which allows vasodilation of arteries of dick

55
Q

ED causes

A

tears in corpora cavernosa, alcohol, psychological

56
Q

what is sperm capacitation

A

in uterus, membrane changes to allow oocyte fusion and tail starts to whip

57
Q

what is acrosome process

A

sperm penetrates ZP. cortical reaction blocks polyspermy

58
Q

what happens after sperm + egg meet

A

meiosis 2 > nuclei fuse > mitosis

59
Q

what is vasectomy

A

severing of vas deferens

60
Q

what muscles make up levator ani

A

puborectalis, pubococcygeus, iliococcygeus

61
Q

how does morning after pill work

A

high dose oestrogen and progesterone blocks implantation and luteal functions

62
Q

what is in deep perineal space

A

deep transverse perineal muscle males - membranous urethra females - proximal urethra

63
Q

casues of infertility. define infertility

A

anovulation (stress, PCOS, menopause), tubal occlusion, sperm problem cannot conceieve after 1 yr of trying

64
Q

symptoms of PCOS, diagnose, treat

A

diagnose USS symptoms - increased LH and fsh and androgens, hirsutism, insulin resistance, infertile metformin treat and weight loss

65
Q

how induce ovulation

A

antioestrogen

66
Q

give arteries, veins and innervation and lymphatics of scrotum

A

anterior - lumbar plexus, ant scrotal art + vein posterior - sacral plexus, post scrotal art + vein lymph - superficial inguinal

67
Q

what are spermatic cord contents

A

3x3+1 arteries - vas deferens, cremasteric, testicular nerves - genitofemoral, testicular, ilioinguinal others - pampiniform plexus, lymph, tunica vaginalis, vas deferns

68
Q

give coverings of spermatic cord and what derived from

A

external - external spermatic fascia (external oblique) middle - cremasteric muscle and fascia (internal oblique)( internal - internal spermatic fascia (transversalis abdominis)

69
Q

describe course of vas deferens

A

passes anterior to pubic bone then post to bladder and enters ejaculatory duct

70
Q

waht are zones of prostate

A

central, transitional, peripheral

71
Q

give lymph drainage of ovary, and uterus

A

ovary - paraaortic fundus - aortic + inguinal cervix and body - ext iliac

72
Q

symptoms of BPH and carcinoma

A

dysuria, frequency, urgency

73
Q

treatment for pelvic floor dysfunction

A

exercises and surgery

74
Q

what is in superficial perinal space and function

A

ischiocavernosus - increase pressure to maintain erection bulbospongiosus - expel urine, maintain erection levator ani superficial transverse perineal exteernal anal sphincter cremaster muscle

75
Q

what muscles make up levator ani

A

pubococcygeus, iliococcygeus, puborectalis

76
Q

name the uterine ligaments

A

suspensory, mesovarium, round (keeps uterus anteflexed), broad, ovarian

77
Q

draw out ischiocavernosus, bulbospongiosus, superficial transverse perineal, and perineal body

A

see book

78
Q

function of perineal body

A

anchors muscles, rectum and aids in pelvic support

79
Q

how can perineal body be damaged and what happens

A

childbirth - damage to pudendal nerves and ligaments of muscles damage results in prolapse of vagina and uterus and urinary incontinence

80
Q

what can cause pelvic floor dysfunction

A

age, menopause, obesity

81
Q

give ovarian blood supply

A

ovarian artery from AA. right vein from IVC left vein from left renal vein

82
Q

give fallopian tubes anatomy

A

uterus > isthemus > ampulla > infundibulum > ovary

83
Q

give cervix anatomy

A

vagina > external os > endocervical canal > internal os

84
Q

cervical blood supply

A

uterone + internal pudendal both from ant int iliac

85
Q

give lymph drainage of ovary, and uterus

A

ovary - paraaortic fundus - aortic + inguinal cervix and body - ext iliac

86
Q

where are bartholin glands found and their function

A

found left and right of vagina. secrete mucus

87
Q

what causes bartholinitis

A

gonorrhoea or chlamydia

88
Q

innervation of vagina and perineum

A

perineum - pudendal lower 1/5 vagina - pudendal upper 4/5 - uterovaginal plexus

89
Q

differentials of PID

A

IBS, ectopic pregnancy, UTI, endometriosis

90
Q

organism of chlamydia

A

chlamydia trachomatis

91
Q

symptoms, diagnosis and treatment of chlamydia

A

symptoms - urethritis, conjunctivits diagnose - NAAT urine, urethral swab treat - doxycycline

92
Q

organism, symptoms, diagnosis and treatment of gonorrhoea

A

organism - neiserria gonorrhoea symptoms - urethritis, pharyngitis, PID, bacteremia (severe) diagnosis - NAAT urine, pharyngeal swab treat - ceftriaxone + azithromycin

93
Q

organism, symptoms, diagnosis and treatment of herpes

A

symptoms - primary = painful genital ulcers, dysuria, fever, recurrent (stays in DRG) treat - aciclovir

94
Q

which herpes type does cold sores

A

typ1

95
Q

organism, symptoms, diagnosis and treatment of genital warts. which types oncogenic

A

organism HPV. 16 + 18 oncogenic symptoms - painless warts treat - vaccine. self limiting diagnosis - colposcopy + acetowhite screening. cervical swab. visual diagnosis

96
Q

organism, symptoms, diagnosis and treatment of syphilis

A

organism - treponema pallidum (spirochete) primary - hard painless ulcers. secondary - fever, rash, lymphadenopathy. third - tabes dorsalis, neurosyphalis diagnosis - serology treat - penicillin

97
Q

diagnosis, symptoms, treatment trichomonas vaginalis

A

diagnosis - vaginal wet mount symptoms - frothy, greeny discharge. musty smell. dyrsuria treat - metronidazole

98
Q

diagnosis, symptoms, treatment vulvovaginal candidiasis

A

symptom - curd like discharge. itchy vag diagnosis - vaginal wet mount treat - nystatin or flucanozole

99
Q

diagnosis, symptoms, treatment bacterial vaginosis

A

symptom - fish odour discharge diagnosis - cervical smear treat - metronidazole

100
Q

what is PID

A

infection of upper female repro

101
Q

risk factors of PID

A

alcohol, drugs, smoking, IUCD COCP reduces risk

102
Q

symptoms of PID

A

fever, lower abdo pain, adnexal tenderness, abnormal discharge +/- blood adhesions and fibrosis

103
Q

differentials of PID

A

IBS, ectopic pregnancy, UTI, endometriosis

104
Q

diagnosis and treatment of PID

A

diagnosis - triple smear treat - analgesia, doxycycline + ceftriaxone + metronidazole

105
Q

what is fitz hugh curtis syndrome

A

post PID complication causes adhesion on liver and RUQ pain

106
Q

explain fetal co2 levels and why

A

lower than in mother. progesterone stimulates hyperventilation in mother

107
Q

name infectious agents that cross placental barrier

A

TORCH toxoplasma gondii, others, rubella, CMV, HSV2

108
Q

cvs changes in pregnancy

A

increase - CO, SV (40%), HR (20%), BV decrease - TPR (30%), BP due to progesterone and uterine compressing IVC and aorta (normal in T3)

109
Q

coitus phases

A

excitement > plateau > orgasm > resolution

110
Q

what zones are enlarged in BPH and carcinoma

A

BPH - transitional zone carcinoma - peripheral zone

111
Q

what are the parts of the male urethra

A

preprostatic, prostatic, membranous, spongy

PPE (18 decks)

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