Reproduction and the Growing Child - (General) Flashcards
What happens at 4 weeks of mammogenesis?
Two milk lines (Streaks) form from the axilla to the groin.
What happens by 8 weeks of mammogenesis?
‘Milk hills’
Thickening and inward growth- invagination into chest wall
What happens from 12-16 weeks of mammogenesis?
Differentiation
Epithelial cells -> mammary buds in an alveolar pattern.
What happens from 28-32 weeks of mammogenesis?
Canalization (formation of channels) of branched epithelial tissue
Primary milk ducts
What happens by 40 weeks of mammogenesis?
Lobular-alveolar structures containing colostrum develop
Ducts open into nipple
Nipple and areola develop and become pigmented
What hormones are responsible for breast growth at puberty?
Oestrogen
Human growth hormone
With reproductive cycles, is the proliferation and active growth reversible?
No
What hormone is responsible for areolar growth during pregnancy?
Serum placental lactose
What is oestrogen’s effect on the breast during pregnancy?
Stimulates ductal system proliferation and differentiation
What cells line each alveolus of the breast?
Lactocytes- secretory epithelial cells
What is the role of myoepithelial cells in the breast?
Contract around the alveoli to eject milk into the ductules
Where is milk produced in the breast?
Alveolar glandular tissue
What stops liquid from dripping out of the breast?
Surface tension
Closure of tight junctions between lactocytes
When do changes to the nipple and areola occur in pregnancy?
Around 12 weeks
When does colostrum begin to be secreted in pregnancy?
12-16 weeks
When does involution occur?
40 days after last breastfeed
What is lactogenesis?
The transition from pregnancy to lactation
What causes the drop in progesterone, oestrogen and human placental lactogen during labour?
Delivery of the placenta
What hormones cause milk production?
Low progesterone
Low oestrogen
High prolactin
What stimulus drives milk production?
Feeding - milk removal suggests increased demand for milk
What is the milk ejection/ let-down reflex?
Oxytocin release stimulates myoepithelial cells to squeeze milk out of acini and into the ducts.
What are the causes of breastfeeding related pathology?
Poor positioning/ attachment
Nipple/ tissue trauma
Breastfeeding management problems
What is the difference between symmetrical and asymmetrical developmental insults?
Symmetrical- early insult- smaller throughout body
Asymmetrical- late insult- fat deposited depleted but not everywhere
What are the four factors causing foetal growth restriction?
Maternal
Foetal- (TORCH infections)
Placental
Uterine
What is the pathophysiology of pre-eclampsia?
Decreased uterine blood flow -> atherosclerosis of uterine spiral arteries
What is important when measuring foetal growth?
You need at least 2 measurements to check for change.
When considering IUGR in a foetus, what is the most important thing to measure by ultrasound?
Abdominal circumference
What is the Barker hypothesis?
Fetal programming arising from impaired growth in pregnancy and infancy
What is cosanguinuity?
People reproducing from within the same gene pool
What is talipes
A single primary defect where feet bend inwards. More common in twins.
What is the difference between a malformation and a disruption?
Malformation- problem with a formation process
Disruption - destruction of structures after their formation
What is Holt-Oram syndrome dysplasia?
Radius missing
Cardiac defects
What are the causes of congenial defects?
50% unknown Genetic Infectious Nutritional Environmental teratogens
Where is the defect in congenital duodenal atresia?
Recanalisation of the duodenum before 7-8 weeks development
Where is the defect in congenital exstrophy of the bladder?
Migration of infraumbilical mesenchyme before 30 days development
In clinical testing, what does the dynamic range refer to?
Anything outside of normal
What are the broad categories of biochemical tests?
Selective requesting
Screening tests
What is the difference between core and specialised selective requesting?
Core- Most senior clinicians are qualified to perform the test
Specialised- Sample sent to a specific specialty for testing
What are types of biochemical tests?
One-off (Dipstix)
Biochemical profiles - analysis of multiple constituents in the sample
Dynamic function tests- measuring body’s response to external stimulus
What are the purposes of selective testing?
To confirm a diagnosis Aiding differentials To assess disease severity Monitoring progress/ therapy Detection of complications/ side effects
What are the two major types of variation that can affect clinical testing?
Analytical- precision, accuracy, sensitivity, specificity of test
Biological- patient physiological factors affecting results
What would you do if your test comes back and is not consistent with clinical findings?
Check procedure: lab sample, test accuracy etc.
Repeat the test
What is type I hyperlipidaemia?
Increased chylomicrons in blood; suggests poor diet
