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Pathophysiology (L3) > REPRODUCTION > Flashcards

REPRODUCTION Flashcards

1
Q

When does the sex of the embryo differ, and what protein’s presence is the determing factor?

A

Differentiation occurs around 7th week of gestation

SRY protein on Y chromosome determines sex. W/o exposure = females, w/ exposure = males

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2
Q

Where are primary and secondary oocytes formed?

A

At birth ovaries contain all primary oocyte

Secondary oocytes are formed after puberty at ovulation

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3
Q

What controls an increase secretion of FSH and LH and where is it secreted from?

A

FSH and LH are stimulated by gonadotropin releasing hormone (GnRH)
Which causes FSH and LH to be secreted from the anterior pituitary cells

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4
Q

What is the main function of FSH?

A

Stims the growth of follicles of the ovaries to produce estrogen, progesterone and inhibin (Stimulates growth of eggs in the ovaries)

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5
Q

What is the main function of LSH?

A

It is responsible for stimulating ovulation (Triggers the release of egg from the ovary). Basically it helps control the menstrual cycle

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6
Q

What is the function of estrogen?

A

Responsible for the development and maintenance of female reproductive structures and secondary female characteristics (Adipose tissue deposition, voice pitch, broad pelvis and pattern of hair growth)

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7
Q

What is the function of progesterone?

A

Works with estrogen to prepare and maintain the endometrium and to prepare the mammary glands for lactation

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8
Q

What is the function of relaxin?

A

Role in relaxation of uterine smooth muscle

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9
Q

What is the function of inhibin?

A

Works with estrogen and progesterone to provide feedback for HPO axis
Main function is in stimulating or inhibiting release of FSH and LH

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10
Q

What is occurring during day 1-5 of the female cycle? (Menstrual phase) (3)

A

Uterus sheds most layers of endometrium
Discharge due to dec amt of progesterone and estrogen
Ovarian hormones are low, causes a stim in secretion of GnRH which leads to stim of FSH and LH

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11
Q

What is occurring during day 6-14 of the female cycle? (Variable pre-ovulatory phase) (4)

A

FSH causes maturation of dominant follicle
Estrogen promotes endometrial growth
Ovulation occurs when secondary oocyte are released into pelvic cavity
LH causes leftover cells to become corpus luteum and secrete estrogen, progesterone, inhibin and relaxin

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12
Q

What is occurring during day 15-28 of the female cycle? (Post-ovulatory phase) (3)

A

Progesterone and estrogen cause further growth of endometrial glands
Thickening of endometrium for fertilized ovum
W/o fertilized ovum, corpus luteum degens, causing dec amt of progesterone which causes menstruation

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13
Q

What is term of the fertilized ovum at two weeks, from 2-8 weeks and from 8 weeks to birth?

A

2 weeks: Blastocyst
2-8 weeks: Embryo
8 weeks: Fetus

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14
Q

What is the marker used to detecting pregnancy and how is it produced?

A

Beta human growth hormone

After implantation trophoblast will produce this hormone

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15
Q

What is the function of beta human growth hormone?

A

Produce during pregnancy

Maintains corpus luteum by producing inc amts of progesterone which is needed to support and thicken the uterine lining

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16
Q

Why is the first trimester of pregnancy the most important?

A

All major strucutres and pathways are formed before the 13th gestational week
It is important for the maternal to ensure proper health and care of body and nutrients to ensure healthy growth of baby

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17
Q

What contributes to the development of the placenta?

A

The chorion membrane is responsible for dividing and forming the placenta

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18
Q

What is the function of the placenta?

A

Production of progesterone and hCG

Filters nutrients, oxygen, fetal waste products, and facilitate gas and nutrient exchange

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19
Q

The arteries and veins in the placental and pulmonary vessels are unique, why?

A

Arteries remove deoxygenated blood

Vein carries oxygenated blood to fetus

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20
Q

What is responsible for the stimulation of maternal thyroid hormone?

A

hCG with TSH

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21
Q

What is the main function of maternal thyroxin?

A

Crosses placenta to facilitate fetal development

22
Q

What is the proposed role of placental CRH? (2)

A

Plays a role in timing of parturition (birth)
High levels of CRH near end of pregnancy causes smooth muscles to relaxes and inc formation of prostaglandins
Responsible for fetal lung maturation and development of fetal surfactant

23
Q

What is the function of placental progesterone?

A

Maintain pregnancy specifically the uterine linings

24
Q

What can be palpated at 12 weeks of gestation?

A

Begin to palpate the uterus above pelvic bone

25
Q

What is occurring with the fundus at 16 weeks of gestation?

A

Fundus of uterus will be about halfway between pubic bone and umbilicus

26
Q

Where is the fundus located at 20 weeks?

A

The fundus should be around the umbilicus and should be able to measure the symphysis-fundal height

27
Q

The term GTPALS is used to denote client’s obstetrical history. What does the term mean?

A

Gravida: Amount of pregnancies regardless of outcomes
Term: How many babies have been to full term (36 weeks)
Preterm: How many babies have been to preterm (20 weeks to 36 weeks)
Abortus: Anything less than preterm (Less than 19 weeks)
Live: How many children are currently alive
Stillbirths: How many children were NOT born post 20 weeks

28
Q

How are breasts affected in a full term pregnancy?

A

Nipple enlargement and pigmentation occurs
There is an increase in blood supply
*Lactation is prevented during pregnancy due to high levels of estrogen

29
Q

How is the cardiovascular system affected in pregnancy?

A

Heart becomes displaced to the left
Heart size increases
Mothers cardiac output and blood volume increase

30
Q

How is the respiratory system affected in pregnancy?

A

Tidal volume and resting ventilation increase

Functional residual capacity and residual volume are decreased as uterus elevates diaphragm

31
Q

How is the GI system affected in pregnancy?

A

Dec stomach and intestinal motility allow for greater absorption of nutrients
Enlarged gallbladder contracts slower

32
Q

How is the renal system affected in pregnancy?

A

Ureters can dilate and inc the urine volume

Kidneys can increase in length and weight

33
Q

What is the definition of infertility?

A

Failure of couple to conceive after one year of unprotected intercourse

34
Q

When ovarian hormone secretion is normal what can be the cause of amenorrhea?

A

Think about uterine function

Is uterus present or has there been a surgery which affected the uterus

35
Q

When there as an increased ovarian hormone secretion what can be the cause of amenorrhea?

A

Why is there an inc amt
Are ovaries enlarged due to tumours
Is it PCOS?

36
Q

When there is a decrease in ovarian hormone secretion what can be the cause of amenorrhea?

A

Look at HPO axis
Is gonadotropin lvls high due to overactive hypothalamus
If low gonado lvls think what is happening to hypo and pit glands

37
Q

What is the clinical manifestation of PCOS?

A

Oligomenorrhea (lack of menstruation), hirsutism and acne

Inc number of follices

38
Q

What effect does insulin have on PCOS?

A

Insulin reduces sex hormone-binding globulin
SHBG resp for making testosterone and estradiol inactive
Causes more biologically active steroids available

39
Q

What is the pathophysiology of PCOS?

A

Primarily hyperandrogenemia

40
Q

How does PCOS affect pregnancy?

A

Blunted FSH/LH feedback leads to stim for new follicles but not to full maturation or ovulation

41
Q

What is the treatment for PCOS?

A

Re-establish normal hormonal lvls using oral birth control pill
Metformin to dec ovarian steroidogenesis

42
Q

What is endometriosis?

A

Appearance of plaques of endometrial tissue on other structures in the body
Endometrial tissue appears in random places, swell and slough with no exit point and cause pain

43
Q

What are two strategies for treating infertility?

A

Intrauterine Insemination: Directly inject semen into uterus

In Vitro Fertilization: Ova and sperm combined outside body and zygotes are transferred into woman’s uterus

44
Q

What is the difference and similarities between pre-existing HTN and gestational HTN?

A

Both: Systolic above 140 mmHg or diastolic above 80
Pre-HTN: Before 20 weeks gestational age
Ges: Post 20 weeks gestation

45
Q

What is pre-eclampsia?

A

Condition of hypertension and inc proteinuria

46
Q

What is eclampsia?

A

Eclampsia all features of pre-e WITH addition of seizure activity
Important to deliver baby because if mother is seizing so is uterus

47
Q

What is the treatment of eclampsia?

A

Magnesium sulphate to stop seizure

Delivery of baby

48
Q

What is the treatment of pre-eclampsia?

A

Delivery of fetus

Control BP through use of beta-blockers and/or methyldopa

49
Q

What is the HELLP syndrome?

A

Further progression of hypertensive state WITH hemolysis, elevated liver enzymes, and low platelets

50
Q

What is disseminated intravascular coagulation and what causes it?

A

Imbalance between coagulation
Coagulation over activated , body consumes clotting factors and platelets leading to abnormal bleeding
Caused by overexpression of tissue factors

51
Q

What is PPH?

A

Post-partum hemorrhage is excessive bleeding that occurs in first 24 hours post delivery
Blood loss above1000ml

52
Q

Prevention and treatment of PPH

A

Admin a dose of oxytocin with delivery of anterior shoulder

Treatment: Start resus quickly to ensure adequate perfusion of oxygen to tissues

Pathophysiology (L3) (8 decks)

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