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Flashcards in Repro Deck (111):
1

briefly what occurs in the fetal period early and late

early - protein deposition. Late is adipose development of embryonic structures throughout

2

how does the last menstrual period relate to weeks of fertilisation

+2 weeks after fertilisation

3

what would you use to meaasure a babys progress in t1, 2, and 3?

t1 - crown rump length t2 - biparietal diameter t3 - head circumference

4

how assess antenatal wellbeing

mother and fetal movements, USS, uterine exapnsion (symphysis fundal height). Glucose tests, blood checked for rghesus, Hb, infection, urinalysis for preeclampsia

5

what is terms for too much or too little amniotic fluid

oligo and polyhydroamniosis

6

why is a scan done at weeks 7-13?

estimate delivery date and CRL

7

what is good and bad weights for child and why does it happen

>4500g - macrosomia, gestational diabetes

8

name the 3 stages of lung development and weeks involved and what happens

pseudoglandular - 8-14 wks, ducts + bronchioles develop from bronchiopulmonary trunk canalicular - 16-26 wks, resp bronchioles form terminal sac - 26+, terminal sacs form and type 1 and 2 (surfactant) pneumocytes differentiate

9

what aids lung development

amniotic fluid and breathing movements

10

what is the threshold for viability for baby

24 wks +

11

when does kidneys begin to function and what happens if they dont

10 wks oligohydroamnios if not

12

when does nervous system myelinate and when do voluntary coordinated movements occur

myelination at 9 mths and after birth voluntary coordinated movements - 4 mths +

13

when is fetus first movements

8 wks +

14

what and when is quickening of fetus

increased awareness of fetus at 17 wks

15

state fetal circulation

ductus venosus - bypass liver ductus arteriorus and FO - bypass lungs

16

how does the last menstrual period relate to weeks of fertilisation

+2 weeks after fertilisation

17

what is the metabolic funcitons of the placenta

synthesis glycogen, FAs, cholesterol

18

what does umbilical vein and artery carry

vein - blood to fetus artery - blood from fetus

19

what is amniotic fluid purpose`

swallowed to make urine and meconium protects against trauma aids development of urinary and GI

20

how much fetal urine produced at 25 weeks?

100-500 ml

21

why does fetal jaundice occur

fetus cant conjugate bilirubin

22

what is haemomonochorial mean

placenta has direct contact with blood, placental barrier at thinnest

23

explain formation of placenta after blastocyst has invaginated endometrium

1) trophoblast differentiates to cytotrophoblast and syncytiotrophoblast 2) SCT forms villi and lacunae. lacunae fill with blood 3) CT villi grow into SCT - primary villi, 2nd week 4) extraembryonic mesoderm grows into villi - 2nd villi, 3rd week. Soon after, embryonic blood vessels form in villi, 3rd villi 5) maternal blood in intervillous spaces

24

what happens to the SCT and CT in placenta

gets thinner and thinner allowing increased exchnage

25

how is endometrium prepped for implantation

spiral arteries which are high flow and low resistance

26

what is decidualisation

pre decidual cells of mother balance invasive force of trophoblast

27

explain the placental and amniotic situation of dizygotic twins

2 placenta + 2 separate amniotic sacs

28

what is maternal aspect of placenta and what is it made of? what is fetal aspect made of

maternal - decidua basalis, made of cotyledons fetal - umbilicus

29

what substances diffuse into placenta and how

simple diffusion - gases, electrolytes, water, urea facilitated - glucose active transport - AAs, fe, folate RME - IgG

30

name the teratogenic drugs

TERATOWgenic thalidomide, epilepsy drugs, retinoid, ACEi, third element: lithium, OCP, warfarin

31

thyroid changes in pregnancy

increased T3/4 due to hCG stimulation

32

what is the endocrine functions of placenta

hCG, hPL, prog, oest, hCS, hCT (thyrotrophin)

33

what can increased hCG indicate in female

pregnancy, hydratiform mole, coriocarcinoma

34

what does hPL do

increase glucose available from mother

35

what does progesterone do

increase appetite

36

what are possible pregnancy complications

pre-eclampsia, placental insufficiency

37

what is preeclampsia and what can it lead to if untreated

high BP (>140/90) and proteinuria. Can lead to seizures (eclampsia)

38

risk factors of preeclampsia

DM, obesity, hypertension,

39

treatment of preeclampsia

CCB, beta blocker

40

what is placental insufficiency

not enough blood flow to placenta > reduced HR of fetus

41

why does gestational diabetes occur. Risk factors

hPL increases insulin resistance and decreases fasting blood glucose RF - PCOS, smoking

42

what is acrosome process

sperm penetrates ZP. cortical reaction blocks polyspermy

43

urinary changes in pregnancy

increase GFR and risk of UTI decrease urea and creatinine by 50% urinary stasis due to prog ureteral dilation

44

resp changes in pregnancy

increase AP and transverse diameter, tidal volume, RR (hyperventilation) decrease FRV

45

How does lipid metabolism change in pregnancy

increased lipolysis T2+

46

thyroid changes in pregnancy

increased T3/4 due to hCG stimulation

47

GI changes in pregnancy

appendix in RUQ increased risk biliary stasis, pancreatitis due to progesteron

48

blood changes in pregnancy

prothrombotic therefore increase risk of thrombus anemia - dilution of blood and fe and folate deficiency

49

symptoms of PCOS, diagnose, treat

diagnose USS increase LH and FSH and androgen, hirsutism, insulin resistance, infertile treat - weight loss, metformin

50

female sex response

blood engorgement of clit, vagina, breast and nips no refractory period

51

components of semen and origins

60% seminal vesicles - fructose, clotting factors, alkaline 30% prostate - proteolytic enzymes 10% bulbourethral - lubricate urethra

52

stats of sperm

2-4 ml, 20-200 million per ml >50% morphology and movement

53

explain how erections happen

NO release in corpora cavernosa and corpora spongiosum, arteries dialte and release blood.

54

how does viagra work

inhibits cGMP breakdown (cGMP inhibits MLCK) which allows vasodilation of arteries of dick

55

ED causes

tears in corpora cavernosa, alcohol, psychological

56

what is sperm capacitation

in uterus, membrane changes to allow oocyte fusion and tail starts to whip

57

what is acrosome process

sperm penetrates ZP. cortical reaction blocks polyspermy

58

what happens after sperm + egg meet

meiosis 2 > nuclei fuse > mitosis

59

what is vasectomy

severing of vas deferens

60

what muscles make up levator ani

puborectalis, pubococcygeus, iliococcygeus

61

how does morning after pill work

high dose oestrogen and progesterone blocks implantation and luteal functions

62

what is in deep perineal space

deep transverse perineal muscle males - membranous urethra females - proximal urethra

63

casues of infertility. define infertility

anovulation (stress, PCOS, menopause), tubal occlusion, sperm problem cannot conceieve after 1 yr of trying

64

symptoms of PCOS, diagnose, treat

diagnose USS symptoms - increased LH and fsh and androgens, hirsutism, insulin resistance, infertile metformin treat and weight loss

65

how induce ovulation

antioestrogen

66

give arteries, veins and innervation and lymphatics of scrotum

anterior - lumbar plexus, ant scrotal art + vein posterior - sacral plexus, post scrotal art + vein lymph - superficial inguinal

67

what are spermatic cord contents

3x3+1 arteries - vas deferens, cremasteric, testicular nerves - genitofemoral, testicular, ilioinguinal others - pampiniform plexus, lymph, tunica vaginalis, vas deferns

68

give coverings of spermatic cord and what derived from

external - external spermatic fascia (external oblique) middle - cremasteric muscle and fascia (internal oblique)( internal - internal spermatic fascia (transversalis abdominis)

69

describe course of vas deferens

passes anterior to pubic bone then post to bladder and enters ejaculatory duct

70

waht are zones of prostate

central, transitional, peripheral

71

give lymph drainage of ovary, and uterus

ovary - paraaortic fundus - aortic + inguinal cervix and body - ext iliac

72

symptoms of BPH and carcinoma

dysuria, frequency, urgency

73

treatment for pelvic floor dysfunction

exercises and surgery

74

what is in superficial perinal space and function

ischiocavernosus - increase pressure to maintain erection bulbospongiosus - expel urine, maintain erection levator ani superficial transverse perineal exteernal anal sphincter cremaster muscle

75

what muscles make up levator ani

pubococcygeus, iliococcygeus, puborectalis

76

name the uterine ligaments

suspensory, mesovarium, round (keeps uterus anteflexed), broad, ovarian

77

draw out ischiocavernosus, bulbospongiosus, superficial transverse perineal, and perineal body

see book

78

function of perineal body

anchors muscles, rectum and aids in pelvic support

79

how can perineal body be damaged and what happens

childbirth - damage to pudendal nerves and ligaments of muscles damage results in prolapse of vagina and uterus and urinary incontinence

80

what can cause pelvic floor dysfunction

age, menopause, obesity

81

give ovarian blood supply

ovarian artery from AA. right vein from IVC left vein from left renal vein

82

give fallopian tubes anatomy

uterus > isthemus > ampulla > infundibulum > ovary

83

give cervix anatomy

vagina > external os > endocervical canal > internal os

84

cervical blood supply

uterone + internal pudendal both from ant int iliac

85

give lymph drainage of ovary, and uterus

ovary - paraaortic fundus - aortic + inguinal cervix and body - ext iliac

86

where are bartholin glands found and their function

found left and right of vagina. secrete mucus

87

what causes bartholinitis

gonorrhoea or chlamydia

88

innervation of vagina and perineum

perineum - pudendal lower 1/5 vagina - pudendal upper 4/5 - uterovaginal plexus

89

differentials of PID

IBS, ectopic pregnancy, UTI, endometriosis

90

organism of chlamydia

chlamydia trachomatis

91

symptoms, diagnosis and treatment of chlamydia

symptoms - urethritis, conjunctivits diagnose - NAAT urine, urethral swab treat - doxycycline

92

organism, symptoms, diagnosis and treatment of gonorrhoea

organism - neiserria gonorrhoea symptoms - urethritis, pharyngitis, PID, bacteremia (severe) diagnosis - NAAT urine, pharyngeal swab treat - ceftriaxone + azithromycin

93

organism, symptoms, diagnosis and treatment of herpes

symptoms - primary = painful genital ulcers, dysuria, fever, recurrent (stays in DRG) treat - aciclovir

94

which herpes type does cold sores

typ1

95

organism, symptoms, diagnosis and treatment of genital warts. which types oncogenic

organism HPV. 16 + 18 oncogenic symptoms - painless warts treat - vaccine. self limiting diagnosis - colposcopy + acetowhite screening. cervical swab. visual diagnosis

96

organism, symptoms, diagnosis and treatment of syphilis

organism - treponema pallidum (spirochete) primary - hard painless ulcers. secondary - fever, rash, lymphadenopathy. third - tabes dorsalis, neurosyphalis diagnosis - serology treat - penicillin

97

diagnosis, symptoms, treatment trichomonas vaginalis

diagnosis - vaginal wet mount symptoms - frothy, greeny discharge. musty smell. dyrsuria treat - metronidazole

98

diagnosis, symptoms, treatment vulvovaginal candidiasis

symptom - curd like discharge. itchy vag diagnosis - vaginal wet mount treat - nystatin or flucanozole

99

diagnosis, symptoms, treatment bacterial vaginosis

symptom - fish odour discharge diagnosis - cervical smear treat - metronidazole

100

what is PID

infection of upper female repro

101

risk factors of PID

alcohol, drugs, smoking, IUCD COCP reduces risk

102

symptoms of PID

fever, lower abdo pain, adnexal tenderness, abnormal discharge +/- blood adhesions and fibrosis

103

differentials of PID

IBS, ectopic pregnancy, UTI, endometriosis

104

diagnosis and treatment of PID

diagnosis - triple smear treat - analgesia, doxycycline + ceftriaxone + metronidazole

105

what is fitz hugh curtis syndrome

post PID complication causes adhesion on liver and RUQ pain

106

explain fetal co2 levels and why

lower than in mother. progesterone stimulates hyperventilation in mother

107

name infectious agents that cross placental barrier

TORCH toxoplasma gondii, others, rubella, CMV, HSV2

108

cvs changes in pregnancy

increase - CO, SV (40%), HR (20%), BV decrease - TPR (30%), BP due to progesterone and uterine compressing IVC and aorta (normal in T3)

109

coitus phases

excitement > plateau > orgasm > resolution

110

what zones are enlarged in BPH and carcinoma

BPH - transitional zone carcinoma - peripheral zone

111

what are the parts of the male urethra

preprostatic, prostatic, membranous, spongy