apgar score lactation menopause Flashcards

(33 cards)

1
Q

Apgar score - use

A

assessment of newborn vital sign following labor vua a 10 point scale evaluated at 1 minute and 5 minutes

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2
Q

Apgar score is based on

A
Appearance
Pulse
Grimace 
Activity 
Respiration
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3
Q

Apgar score - score for appearance

A

pink –> 2
extremities blue –> 1
pale or blue –> 0

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4
Q

Apgar score - score for Pulse

A

more than 100 –> 2
less than 100 –> 1
no pulse –> 0

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5
Q

Apgar score - score for Grimace

A

cries and pulls away –> 2
Grimaces or weak cry –> 1
no response to stimulation –> 0

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6
Q

Apgar score - score for Activity

A

active movement –> 2
arms, legs flexed –> 1
no movement –> 0

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7
Q

Apgar score - score for Respiration

A

strong cry –> 2
slow irregular –> 1
no breathing –> 0

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8
Q

Apgar score - management/evaluation/meaning

A

if less than 7 –> further evaluation

if remains low at later time points –> increased risk to develop long-term neurological damage

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9
Q

Low birth weight definition

A

less than 2500 g

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10
Q

mechanism of low birth weight

A

preamaturity or intrauterine growth restriction (IUGR)

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11
Q

2 causes of low birth weight

A
  1. cocaine

2. smoking

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12
Q

Leading cause of low birth weight in developed countries

A

smoking

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13
Q

Complications of low birth weight

A
  1. high risk of sudden infant death (SIDS)
  2. impaired thermoregulation
  3. impaired immune function
  4. hypoglycemia
  5. polycythemia
  6. impaired neurocognitive/emotional development
  7. infections
  8. respiratory distress syndrome
  9. necrotizing enetrocolitis
  10. intraventricular haemorrhage
  11. persistent fetal circulation
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14
Q

breast/lactation during pregnancy

A
  • Estrogens + progesterone stimulate growth and development of breasts during pregnancy
  • prolactin levels increase during prengncy because estrogen stimulate anterior pituitary
  • lactation does not occut because estrogne and progesterone blocks prolactin’s action on the breast
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15
Q

lactation after the labor

A

the low levels of pregnancy and estrogen disinhibit lactation

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16
Q

hormones of lactation - regulation of production and action

A

suckling is required to maintain milk production, since high nerve stimulation –> increased oxytokin+prolactin:

a. prolactin –> induce+maintains lactation and decreases reproductive function
b. oxytokin –> assists milk letdown (also uterine contraction)

17
Q

prolactin inhibits reproductive function via

A

inhibition of GnRH

18
Q

breast milk is the ideal nutrition for infants …(age)

A

younger than 6 months

19
Q

breast milk contains

A
  1. maternal immunoglobulins conferring passive immunity, mostly IgA)
  2. macrophages
  3. lymphocytes
20
Q

breast milk effects on infants

A
  1. reduce infant infections

2. associated with low risk for child develop 3. asthma, 4. allergies, 5. DM, 6. obesity

21
Q

Exclusively breastfed infants require ….

A

vitamin D supplementation

22
Q

breastfeeding effects on mother

A
  1. decreases maternal risk of breast and ovarian cancer

2. facilitates mother-child bonding

23
Q

Menopause is diagnosed by (clinically)

A

amenorrhea for 12 months

24
Q

amenorrhea

A

an abnormal absence of menstruation.

25
average age of menopause
51 (earlier in smokers)
26
menopause associated hirsutism - mechanism
decreased estrogen production due to age-linked decline in number of ovarian follicles
27
menopause usually preceded by
4-5 years of abnormal menstrual cycles
28
source of estrogen after menopause
peripheral conversion of androgens --> estrone
29
menopause - mechanism
Ovarian estrogen secretion declines rapidly, whereas ovarian androgen production continues for a few years after menopause. Androgen production after menopause is gonadotropin dependent and, when excessive, can lead to hirsutism
30
hormonal changes in menopause
1. low estrogen 2. high LH (no surge) 3. VERY high FSH 4. high GNRH 5. high androgens
31
specific lab finding for menopause (and mechanism)
very high FSH (loss of negative feedback on FSH due to low estrogen)
32
menopause - presentation
1. hot flashes 2. atrophy of vagina 3. Osteoporosis 4. Coronary artery disease 5. Sleep disturbances 6. Hirsuitism
33
Menopause before 40 suggests
1ry ovarian insuficiency (premature ovarian failure)