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JL Reproduction and Sexual Health > Week 5 part 1 > Flashcards

Week 5 part 1 Flashcards

1
Q

What does the avergae male weigh at term?

A

3550g, 15% fat

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2
Q

Normal weght of baby born?

A

2.5kg - 4kg

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3
Q

What is a normal apgar score?

A

Greater than 8/10

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4
Q

5 aspects of apgar score?

A
  1. HR
  2. Resp
  3. Responsiveness
  4. Tone
  5. Colour
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5
Q

What is important for establishing breast feeding?

A

Skin to skin contact

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6
Q

What are the three shunts present in the foetus prior to borth?

A

`1. Ductus Venosus

  1. Foramen Ovale
  2. Ductus Arteriosis
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7
Q

What shunt in foetal circulation: crosses through the liver to the IVC?

A

Ductus venosus

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8
Q

What shunt in foetal circulation: is kept open by pressure being higher in right atrium, allowing blood to cross to left side of heart and supply brain?

A

Foramen Ovale

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9
Q

What shunt in foetal circulation: has blood pass through it to go out of right side of heart to systemic circulation?

A

Ductus arteriosis

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10
Q

How does the baby prepare for labour in 3rd trimester?

A

Stores oxygen in liver, muscle, and heart to withstand hypoxic phase of labour.

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11
Q

During delivery of baby what occurs in lung aeration?

A

Pulls lung fluid from alveolar to interstitial tissue back into lymphatics as babies take deep breath

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12
Q

When baby takes deep breath, lungs open up, vessels have no more room to expand and P02 increases. 100% of CO now goes to lungs. As pulmonary vascular resistancen decreases, systemic vascular resistance increases to allow left side pressure to be greater than right - thus closing off …

A

Foramen ovale

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13
Q

What becomes ligamentum arteriosis?

A

Ductus arteriosus

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14
Q

What does ductus venosis become?

A

Ligamentum teres

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15
Q

Main cause of sepsis in neborn?

A

Group B strep

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16
Q

How is PPHN treated in newborn?qN

A

NO gas, inotropes, keep warm

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17
Q

How do babies keep warm in first few hours if they cannot shiver?

A

Breakdown of adipose tissue in response to catecholamines

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18
Q

Labetalol is used to treat pregnancy in hypertension - what might it induce?

A

Neonatal hypoglycaemia

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19
Q

Is losing 10% of birth weight during first 5 days normal for baby?

A

Yes due to high proportion of fluid in body - if more than 10% then admit for hyponatraemia

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20
Q

Why is it normal for babies to be a bit anaemic at 8-10 weeks?

A

Lack of time between foetal and adult HB synthesis - babies have higher haematocrit in utero

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21
Q

Name a physiological cause of neonatal jaundice?

A

Rhesus or ABO incompatibility

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22
Q

Is jaundice in newborn less than 24 hours bad?

A

Always pathalogical

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23
Q

Is conjugated hyperbilirubinaemia normal in newborn?

A

Always abnormal - hepatitis, biliary atresia

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24
Q

What is meconium ileus a sign of?

A

probably been born with CF

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25
Q

ABDOMINAL distension and bile stained vomit?

A

Malrotation until proven otherwise

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26
Q

Biggest bacterial infection affecting neonates?

A

Strep Group B

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27
Q

Name two pregnancy/birth related respiratory problems?

A
  1. Transient tachypnoea of the newborn (TTN)

2. Pneumothorax

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28
Q

In baby: swollen liver, severe abdominal swelling?

A

Hydrops fetalis

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29
Q

Tetralogy of Fallot?

A
  1. Pulmonary stenosis
  2. Right ventricular hypertrophy
  3. Over-riding aorta
  4. Ventricular septal defect
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30
Q

Name two congenital respiratory disease of sick term infant?

A
  1. Tracheooesophageal fistula

2. Diohragmatic hernia

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31
Q

What is normal resp rate of newborn?

A

40-60 - periodic breathing normal

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32
Q

What is normal newborn heart rate?

A

120-140

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33
Q

a birth that occurs after 42 completed weeks of gestation?

A

post term

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34
Q

extremely preterm weeks?

A

Less than 27

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35
Q

Very preterm weeks?

A

Less than 31 weeks

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36
Q

What is the biggest cuase of preterm birth?

A

Spontaneous preterm labour

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37
Q

Greater than how many preterm deliveries increase the risk of another preterm baby by 70%?

A

2

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38
Q

By how muich does an abnormally shaped uterus increase risk of giving birth early?

A

19%

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39
Q

wHAT MAKES women 9 times more likely to give birth early?

A

If have multiple pregnancy

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40
Q

An interval of less than how many motnsh between pregnancies increases preterm risk?

A

6 months

41
Q

Is preterm risk increased with conceiving throgh in vitro fertilisation?

A

Yes

42
Q

In relation to preterm babies and cord clamping: if baby is ok and can be kept warm what should you do?

A

Pause for at least one montie to allow placental transfusion

43
Q

What might damage from overinflation of preterm lungs predispose to?

A

Inflammatory cascade leading to bronchiopulmonary dysplasia

44
Q

What four systemic immaturities/dysfunctions are common concerns in preterm infants?

A
  1. Respiratory discress syndrome
  2. Patent ductus arteriosus
  3. Intraventricular haemorrhage
  4. Necrotsiing enterocolitis
45
Q

give four reasons thermal regulastion is ineffective in preterm infants?

A
  1. Low BMR
  2. Minimal muscular activity
  3. Subcut fat insulation negligible
  4. High ratio of surface area to body mass
46
Q

Name organisms likely to cause late onset neonatal sepsis?

A

Gram positive - staph auireus, stpah epidermidis, strep pneumoniae, strep pyogenes

47
Q

Name organisms likely to cause early onset neonatal sepsis?

A

Group B strep

gram neg - klebsiellam, e.coli, pseudomonas,

48
Q

What increases infection which is used for preterm infants?

A

Incubators

49
Q

Name three respiratory complicatoins of prematurity?

A
  1. Resp distress syndrome
  2. Apnoea of prematurity
  3. Bronchopulmonary dysplasia
50
Q

What si the primary pathology of respiratory distress syndrome?

A
  1. Surfactant deficiency

2. Structural immaturity

51
Q 
Tachypnoea
Grunting
Intercostal recessions
Nasal flaring
Cyanosis?
A

Respiratory distress syndrome of newborn

52
Q

Management of respiratory distress of newborn?

A
  1. Maternal steroid
  2. Surfactant
  3. Ventilation
53
Q

Name a complication of respiratory disress syndrome of newborn?

A

tension penumothorax

54
Q

Why are premature infants at risk of patnet ductus arteriosus?

A

Duct not responding to close signals that occur in labour

55
Q

What does intraventricular haemorrhage begin with bleeding into?

A

Germinal matrix

56
Q

What are the two major risk factors for intraventricular haemorrhage in newbonr?

A

Prematuriry

Resp distress syndrome

57
Q

When do most intraventricular haemorrhages of newbirn occur?

A

In first day of life - usually present within 72 hours

58
Q

How do you prevent intraventricular haemorrhage?

A

Antenatal steroids

Prompt and appropriate resuscitation

59
Q

Inrelation to intraventricular haemorrhage: what is grade 1 and 2 classification and outcome?

A

Neurodevelopmental delay up to 20%

Mortality 10%

60
Q

In relation to intraventricular haemorrhage: what is grade 3 and 4 classification and outcome?

A

Neurodevelopmental delay up to 80%

Mortality 50%

61
Q

wHAT is the most common neonatal surgical emergency?

A

Necrotising enterocolitis NEC

62
Q

Usually after RDS recovery
Early signs: lethargy and gastric residuals
Blood stool, temp instability, apnoea and bradycardia?

A

NEC

63
Q

Name a large molecular weight drug which doesnt cross placenta?

A

Heparin

64
Q

What pharmacokinetics might be disrupted by morning sickness?

A

Volume of distribution increases - increased plasma volume and fat stores
Increased free drug (decreased protein binding)
Increased liver metabolism e.g. phenytoin

65
Q

What abnormality does lithium cause in pregnancy?

A

Ebsteins anomaly

66
Q

In what stage of pregnancy might hypertensive patients be more susceptible to drugs?

A

2nd trimester - BP naturally falls

67
Q

Pre-conception, what should women take?

A

Folic acid 400mg daily for 3 months prior and into

68
Q

In pregnancy when is greatest teratogenic risk?

A

4th to 11th weeks

69
Q

Teratogenic effects of: ACE/ARBs?

A

Renal hypoplasia

70
Q

Teratogenic effects of: androgens

A

virulisation of female foetus

71
Q

Teratogenic effects of: antiepileptics

A

Cardiac, faical, limb, neural tube defects

72
Q

Teratogenic effects of: cytotoxics

A

multiple defects, abortion

73
Q

Teratogenic effects of: lithium

A

Cardiovascular defects

74
Q

Teratogenic effects of: methotrexate?

A

Skeletal defects

75
Q

Teratogenic effects of: retinoids

A

ear, cardiovascular, skeletal defects

76
Q

Teratogenic effects of: warfarin

A

Limb and facial defects

77
Q

wHAT CAuses finger hypoplasia?

A

Carbamazepine in pregnancy

78
Q

What can cause abnormal closure of ductus arteriosus ?

A

NSAIDs taken by mother in opregnancy

79
Q

What drugs in pregnancy can cause respiratory depression in newborns?

A

Opiates

80
Q

What drug can lead to vaginal adenocarcinoma in female children aged 15-20 years ?

A

Diethylstilbestrol

81
Q

What are frequent seizurse during pregnancy associated with?

A

Lower verbal IQ in child, hypoxia, bradycardia, antenatal death, maternal death

82
Q

What two antiepileptic drugs should be carefully AVOIDED in pregnancy?

A

Phenytoin and valproate

83
Q

What diabetic drugs are not safe in pregnancy?

A

Sulfonylureas

84
Q

Significant side effect of methyldopa?

A

Depression

85
Q

Is cylizine fine to take in pregnancy if mother has nausea and vomiting?

A

Yes

86
Q

Pregnant women with significant risk factors for VTE shpuld receive what?

A

Thromboprophylaxis with LMWH

87
Q

Name some risk factors for VTE?

A 
Obesity
Over 35
Smoking
para more than 3
Previous DVT
cs delivery
88
Q

What is foremilk rich in?

A

Protein

89
Q

What is hindmilk rich in?

A

Higher fat content

90
Q

Name a drug that is actively concentrated in breast milk and leads to suckling difficulties?

A

Phenobarbitone

91
Q

When breastfeeding, what can occur if taking amiodarone?

A

Neonatal hypothyroidism

92
Q

When breastfeeding, what can occur if taking cytotoxics

A

bone marrow suppression

93
Q

When breastfeeding, what can occur if taking benzodiazepines

A

drowsiness

94
Q

When breastfeeding, what can occur if taking bromocroptine

A

suppresses lactation

95
Q

Which antibiotic given during pregnancy or in early childhood can cause this appearance of staining bones and teeth?

A

Tetracycline

96
Q

Which drug taken in excess in early pregnancy causes short palpable fissures, flat mid face, short nose, idistinct philtrum, thin upper lip, low nasal bridge and a small chin?

A

Alcohol

97
Q

Which antiepileptic drug is particularly associated with cleft lip and palate?

A

Phenytoin

98
Q

Which drug taken during pregnancy can cause this problem in female offspring - adenocarcinoma vaginal?

A

Stilbestrol

99
Q

Which antiepiletpic drug is particulalry associated with spina bifida and anencephaly?

A

Valproate

JL Reproduction and Sexual Health (18 decks)

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