Test 4 - GI, Neuro, immunology, endocrine

Question 1

When does the Gi tract start to develop? and it progresses from Cranial-to-caudal

Answer 1

4th week

Question 2

By the 4th week, what is present?

Answer 2

Intestine and liver

Question 3

By what week does the urorectal septum fuse with the cloacal membrane which separates the rectum from the bladder

Answer 3

Week 7

Question 4

What anchors the liver to the anterior abdominal wall?

Answer 4

falciform ligament

Question 5

When is the diaphragm complete and the intestinal vili developes?

Answer 5

Week 8

Question 6

When do the intestines re-enter the abdominal cavity?

Answer 6

Week 9-10

Question 7

When do the pancreatic islet cells appear?

Answer 7

Week 12

Question 8

When do the nerve cells start to innervate the bowel - neural crest cell colonize gut? This is where hirschsprung’s disease may form.

Answer 8

Week 13

Question 9

When is meconium present and swallowing present?

Answer 9

Week 16

Question 10

What are four major functions of the Enteric Nervous System?

Answer 10

Motility
Microcirculation
Secretions
Immune Respones

Question 11

When is the sucking/swallowing coordinated?

Answer 11

34-36weeks

Question 12

What is when the ventral bud of the pancreas encircles the duodenum which causes occlusion?

Answer 12

Annular Pancreas

Question 13

At what week can esophageal atresia or stenosis form d/t failure of the lumen to recanalize?

Answer 13

Week 8

Question 14

By what week does the midgut herniate into the umbilical cord and when does it return to abd cavity?

Answer 14

6 weeks - 10 weeks

Question 15

When does omphalocele and gastroschisis usually appear?

Answer 15

Week 8-11weeks

Question 16

When the rectum ends above the puborectails muscle?

Answer 16

anorectal agenesis

Question 17

When the rectum ends below the puborectails muscle?

Answer 17

anal agenesis

Question 18

The failure of the neural crest cells to migrate to the distal colon (lack of ganglion cells in the sigmoid colon and rectum)

Answer 18

Hirschsprung’s disease

Question 19

What are infants more at a risk for if they have Hirschprung’s disease?

Answer 19

Hearing loss and decreased peripheral nerve function?

Question 20

What is when the colon, urinary, and genital systems all empty via one common channel.

Answer 20

Cloacal Extrophy

Question 21

When is the anatomy of the GI tract developed?

Answer 21

20weeks

Question 22

When is bile metabolism start and when does it start to be secreted?

Answer 22

11 week and 22 weeks

Question 23

The gut is initially sterile but gut colonization is needed for…

Answer 23

vit K

Question 24

NB have limited digestion and absorption of what three main things?

Answer 24

CHO, fats, proteins

Question 25

What is the main site of hematopoiesis by type II cells?

Answer 25

Liver

Question 26

By the 3rd month, the liver must start to synthesis ____ and ____ so help keep the infant's Bld glucose stable.

Answer 26

Cholesterol and glycogen

Question 27

What are the three sources the liver receives blood from?

Answer 27

hepatic portal vein, hepatic artery, and UVC through Ductus Venosus

Question 28

What organ metabolises CHO to glucose (galactose->fructose->glucose)

Answer 28

Liver

Question 29

What is bilirubin comprised of?

Answer 29

the end product of heme degredation and hemoglobin from dead RBCs

Question 30

What are the three components when Hgb is brokendown?

Answer 30

Iron - stored in the body CO - exhaled Biliverdin - bkdn into unconjugated bilirubin

Question 31

What type of bilirubin binds to albumin -> goes to liver (water soluble form) ->to intestines -> excreted in stool

Answer 31

Conjugated bilirubin

Question 32

What is when congugated bilirubin is converted back to unconjugated bilirubin which is reabsorped back into the liver

Answer 32

enterohepatic re-circulation

Question 33

What are three main causes of poor binding of bilirubin to get excreted?

Answer 33

low albumin drugs - compete for binding sites pH

Question 34

What is indirect bilirubin? physiologically rises slowly in the NB

Answer 34

Unconjugated bilirubin

Question 35

What is direct bilirubin? freely removed. levels increase when bile flow is obstructed.

Answer 35

Conjugated bilirubin

Question 36

When a small amt of unconjugated bilirubin is not bound to albumin and could cross the BBB leading to neuronal damage?

Answer 36

Free bilirubin

Question 37

Elevated levels of AST and ALT may indicate ____ ____.

Answer 37

hepatocyte damage

Question 38

What is the most abundant plasma protein? the level is decreased in a damaged liver = puffy

Answer 38

Albumin

Question 39

What enzymes catalyze oxidation-reduction reactions and also assess hepatic injury in the neonate?

Answer 39

dehydrogenase

Question 40

What are the 4 coagulation proteins that are produced in the liver?

Answer 40

prothrombin, factor 7 and 10, and vit K

Question 41

What are two key liver enzymes that metabolize drugs. expressed gradually making drug metabolism sluggish in neonates.

Answer 41

CYP450 and glucoronyl transferase

Question 42

What organ produces >25 digestive proteins and is immature at birth.

Answer 42

Pancreas - dorsal is much larger than the ventral segment

Question 43

When overstimulation of the islet cells from a diabetic mother leading to hypoglycemia.

Answer 43

Hyperinsulinemia

Question 44

What cell type has glucogon? insulin? and somatostatin (islet cells of the pancrease)

Answer 44

Alpha Beta Gamma

Question 45

When is the primary Neurulation of the fetal brain? | the Dorsal induction.

Answer 45

3-4weeks gest

Question 46

Myelination usually occurs when and continues for years postnatally?

Answer 46

Birth

Question 47

When is the Gyri formed? so you must wait if you are uncomfortable at 35 weeks.

Answer 47

38weeks

Question 48

How do the neural folds fuse? a zipper

Answer 48

From cephalic to caudal direction; from the center to the head and butt

Question 49

When does the neural tube close?

Answer 49

By the 4th week

Question 50

What is seen when there is a possible open neural tube defect? Levels peak at 10-14 wks and decrease with increaaing GA

Answer 50

Alpha-fetoprotein

Question 51

What NTD in the crainial area fails at 24-25days. The exposed brain tissue become necrotic from the A.F

Answer 51

Anencephaly

Question 52

The failure of the Caudal part to close. a bony defect with the herniation of meninges and brain tissue thru the skull.

Answer 52

Encephalocele

Question 53

When failure of the Neural tube to fold over but the back is still closed. Could have a tethered cord.

Answer 53

SpinaBifida Occulta

Question 54

NTD with a sac full of meninges, spinal cord, or both. Three different types of NTD is in this group.

Answer 54

Spina bifida cyctica

Question 55

S.B cyctica that has a sac with nerve roots, meninges, and CSF. Neurologic defect below the level of the sac

Answer 55

Meningomyelocele

Question 56

S.B. Cyctica with a sac of just CSF and meninges. Better prognosis.

Answer 56

Meningocele

Question 57

The most sever form of SB cyctica. Can be entire length of spinal cord.

Answer 57

Myeloschisis

Question 58

The downward displacement of the cerebellar which can cause a blockage of CSF leading to Hydrocephalus. Cerebellat tonsils are pulled through the foramen magnum.

Answer 58

Arnold-Chiari malformation

Question 59

What stage is between 5-6weeks when the brain divides into the forebrain and midbrain

Answer 59

Prosencephalic development

Question 60

When does neuronal proliferation begin and it peaks at _____ wks?

Answer 60

begins at 8 week and peaks - 12wks

Question 61

What are the two last areas for neuronal growth?

Answer 61

Cerebellum and cerebrum

Question 62

What is when there is a decrease in the size OR number of neuronal-glial cell units? assoc. with ETOH, cocaint, PKU, and radiation

Answer 62

Microencephaly

Question 63

When do the neurons reach thier permanent loaction. Differentiation is still occurring.

Answer 63

28 wks

Question 64

When dose myleinization begin and peaks? Peripheral NS: Central NS:

Answer 64

Begins at 20wks and peaks at 6-1year old PNS - motor ->sensory CNS - Sensory -> motor

Question 65

What can malnutrition lead to?

Answer 65

hyoplasia of cerebral white matter and decreased myelinization

Question 66

What brain part has rapid growth from 24-40 weeeks. Injury to this decreases language, behavioral and cognitive function

Answer 66

Cerebellar development

Question 67

VISION: myelinization of optic nerve? visual attention?

Answer 67

optic nerve - 25 weeks | attention - 30-32 weeks

Question 68

How does motor tone develop? and they increase with gest age

Answer 68

Develops from tail to head | and from distal-proximal

Question 69

What are four major categories an infant must have for autonomic regulation? CNS system is intact

Answer 69

sustaining respiration, stable HR, stable temp, and food feeding techniques

Question 70

Where is the most common source of IVH? and usually caused by asphyixa with reperfusion and birth trauma.

Answer 70

Subependymal germinal matrix

Question 71

MAP -ICP = ____ and it increases with G.A.

Answer 71

Cerebral perfusion pressure

Question 72

At what age do infants respond to taste and smell? - auditory processing - pupillary responses - awake visual attention

Answer 72

taste - 36 auditory - 30 pupillary - 29 visual - 30

Question 73

What refers to the brain changes in response to external experiences, ex: repeated/inappropriate stimulation

Answer 73

brain plasticity

Question 74

``` Reflex: appears: 28-32 weeks disappears:6 months asymmetry = brachial plexia injury nonhabituation = cerebral injury ```

Answer 74

Moro

Question 75

Reflex: appears: 28 wks disappears: 2 months nonhabituation = cerebral injury

Answer 75

Palmar grasp

Question 76

Reflex: appears: 35 wks disappears: 7 months nonhabituation = cerebral abnormalities

Answer 76

Tonic neck

Question 77

What is under developed and is not consistant with the demands of the environment? Sensory overload.

Answer 77

CNS development

Question 78

What is when the necrotic changes in white matter that follows an ischemic episode? ongoing hypoxic episodes.

Answer 78

Periventricular Leukomalacia

Question 79

When necrosis of neurons in the cortices of cerebrum and cerebellum occurs. Free radicals are formed from re-perfusion

Answer 79

HIE - hypoxic-ischemic encephalopathy

Question 80

What involves massive discharge of neurons and intense energy consumption. Hypoxia, hypoglycemia, and other metabolic changes occure in the CNS

Answer 80

Seizures

Question 81

When does the WBC production shift to the bone marrow?

Answer 81

12th week

Question 82

When does the thymus development begin and when d the lymphocytes appear in the thymus?

Answer 82

4th week and then the 8th week

Question 83

What is the main mission of the immune system?

Answer 83

Detect, destroy, and eliminate foreign materals.

Question 84

What is the response of the immune system when the body is exposed to a foreign antigen?

Answer 84

Active immunity

Question 85

What is the acquired immunity that results from active immunity? Memory cells are established.

Answer 85

Adaptive immunity

Question 86

What are the cell-mediated factors that includes helper cells, cytotoxic cells, and suppressor cells?

Answer 86

T lymphocytes

Question 87

What are the humoral factors that includes all the immunoglobulins (IgG, IgD, IgM, IgE, IgA)

Answer 87

B Lymphocytes

Question 88

Which immunity has memory? The body remembers the particular invader so the response is higher the 2nd go round.

Answer 88

Adaptive immunity

Question 89

What are proteins that react with specific antigens. They bind to invading pathogens to be reecognized as a foreign

Answer 89

Antibodies