Reproduction and the Growing Child - (General)

Question 1

What happens at 4 weeks of mammogenesis?

Answer 1

Two milk lines (Streaks) form from the axilla to the groin.

Question 2

What happens by 8 weeks of mammogenesis?

Answer 2

‘Milk hills’

Thickening and inward growth- invagination into chest wall

Question 3

What happens from 12-16 weeks of mammogenesis?

Answer 3

Differentiation

Epithelial cells -> mammary buds in an alveolar pattern.

Question 4

What happens from 28-32 weeks of mammogenesis?

Answer 4

Canalization (formation of channels) of branched epithelial tissue
Primary milk ducts

Question 5

What happens by 40 weeks of mammogenesis?

Answer 5

Lobular-alveolar structures containing colostrum develop
Ducts open into nipple
Nipple and areola develop and become pigmented

Question 6

What hormones are responsible for breast growth at puberty?

Answer 6

Oestrogen

Human growth hormone

Question 7

With reproductive cycles, is the proliferation and active growth reversible?

Answer 7

No

Question 8

What hormone is responsible for areolar growth during pregnancy?

Answer 8

Serum placental lactose

Question 9

What is oestrogen’s effect on the breast during pregnancy?

Answer 9

Stimulates ductal system proliferation and differentiation

Question 10

What cells line each alveolus of the breast?

Answer 10

Lactocytes- secretory epithelial cells

Question 11

What is the role of myoepithelial cells in the breast?

Answer 11

Contract around the alveoli to eject milk into the ductules

Question 12

Where is milk produced in the breast?

Answer 12

Alveolar glandular tissue

Question 13

What stops liquid from dripping out of the breast?

Answer 13

Surface tension

Closure of tight junctions between lactocytes

Question 14

When do changes to the nipple and areola occur in pregnancy?

Answer 14

Around 12 weeks

Question 15

When does colostrum begin to be secreted in pregnancy?

Answer 15

12-16 weeks

Question 16

When does involution occur?

Answer 16

40 days after last breastfeed

Question 17

What is lactogenesis?

Answer 17

The transition from pregnancy to lactation

Question 18

What causes the drop in progesterone, oestrogen and human placental lactogen during labour?

Answer 18

Delivery of the placenta

Question 19

What hormones cause milk production?

Answer 19

Low progesterone
Low oestrogen
High prolactin

Question 20

What stimulus drives milk production?

Answer 20

Feeding - milk removal suggests increased demand for milk

Question 21

What is the milk ejection/ let-down reflex?

Answer 21

Oxytocin release stimulates myoepithelial cells to squeeze milk out of acini and into the ducts.

Question 22

What are the causes of breastfeeding related pathology?

Answer 22

Poor positioning/ attachment
Nipple/ tissue trauma
Breastfeeding management problems

Question 23

What is the difference between symmetrical and asymmetrical developmental insults?

Answer 23

Symmetrical- early insult- smaller throughout body

Asymmetrical- late insult- fat deposited depleted but not everywhere

Question 24

What are the four factors causing foetal growth restriction?

Answer 24

Maternal
Foetal- (TORCH infections)
Placental
Uterine

Question 25

What is the pathophysiology of pre-eclampsia?

Answer 25

Decreased uterine blood flow -> atherosclerosis of uterine spiral arteries

Question 26

What is important when measuring foetal growth?

Answer 26

You need at least 2 measurements to check for change.

Question 27

When considering IUGR in a foetus, what is the most important thing to measure by ultrasound?

Answer 27

Abdominal circumference

Question 28

What is the Barker hypothesis?

Answer 28

Fetal programming arising from impaired growth in pregnancy and infancy

Question 29

What is cosanguinuity?

Answer 29

People reproducing from within the same gene pool

Question 30

What is talipes

Answer 30

A single primary defect where feet bend inwards. More common in twins.

Question 31

What is the difference between a malformation and a disruption?

Answer 31

Malformation- problem with a formation process | Disruption - destruction of structures after their formation

Question 32

What is Holt-Oram syndrome dysplasia?

Answer 32

Radius missing | Cardiac defects

Question 33

What are the causes of congenial defects?

Answer 33

``` 50% unknown Genetic Infectious Nutritional Environmental teratogens ```

Question 34

Where is the defect in congenital duodenal atresia?

Answer 34

Recanalisation of the duodenum before 7-8 weeks development

Question 35

Where is the defect in congenital exstrophy of the bladder?

Answer 35

Migration of infraumbilical mesenchyme before 30 days development

Question 36

In clinical testing, what does the dynamic range refer to?

Answer 36

Anything outside of normal

Question 37

What are the broad categories of biochemical tests?

Answer 37

Selective requesting | Screening tests

Question 38

What is the difference between core and specialised selective requesting?

Answer 38

Core- Most senior clinicians are qualified to perform the test Specialised- Sample sent to a specific specialty for testing

Question 39

What are types of biochemical tests?

Answer 39

One-off (Dipstix) Biochemical profiles - analysis of multiple constituents in the sample Dynamic function tests- measuring body's response to external stimulus

Question 40

What are the purposes of selective testing?

Answer 40

``` To confirm a diagnosis Aiding differentials To assess disease severity Monitoring progress/ therapy Detection of complications/ side effects ```

Question 41

What are the two major types of variation that can affect clinical testing?

Answer 41

Analytical- precision, accuracy, sensitivity, specificity of test Biological- patient physiological factors affecting results

Question 42

What would you do if your test comes back and is not consistent with clinical findings?

Answer 42

Check procedure: lab sample, test accuracy etc. | Repeat the test

Question 43

What is type I hyperlipidaemia?

Answer 43

Increased chylomicrons in blood; suggests poor diet