HD

Question 1

Thelarche

Answer 1

Onset of breast growth

Question 2

Menarche

Answer 2

Onset of menstruation

Question 3

Pubarche

Answer 3

Onset of pubic hair growth

Question 4

Adrenarche

Answer 4

onset of androgen secretion from the adrenal glands

Question 5

Average age for menarche

Answer 5

12.5

Question 6

Average age for puberty

Answer 6

11 in girls

12 in boys

Question 7

Symptoms of early pregnancy

Answer 7

Amenorrhoea
Nausea
Vomiting 
Breast enlargement 
Breast tenderness
Increased urinary frequency 
Tiredness

Question 8

Tests for pregnancy

Answer 8

Monoclonal antibody test for presence of beta subunit of hCG

Ultrasound

Question 9

Methods of assisted conception

Answer 9

IVF
ICSI
IUI
Ovulation induction 
Donor sperm treatment 
Sperm washing 
Surrogacy 
Donor egg

Question 10

Causes of primary amenorrhoea

Answer 10

Mullerian agenesis 
Turner's syndrome 
Imperforate hymen 
Kallman syndrome
Hypogonadism

Question 11

Causes of secondary amenorrhoea

Answer 11

Pregnancy 
Breastfeeding 
Menopause
Asherman's syndrome
Sheehan's syndrome 
Polycystic ovary disease
Chronic illness
Weight loss 
Stress

Question 12

Antenatal screening for maternal health

Answer 12

Weight and height
Blood pressure
Urine test for glucose, proteins
Blood test for infections, antibodies, haemoglobin

Question 13

Antenatal screening for foetal health

Answer 13

Ultrasound for structural abnormalities
Blood tests for sickle cell anaemia, thalassaemia, chromosomal abnoramlities
Cardiotocography for heart beat
Nuchal test for Downs syndrome

Question 14

Signs of onset of labour

Answer 14

Rupture of membranes
Regular painful contractions
Cervical dilatation
Passage of bloodstain mucous plug

Question 15

Protection of foetus in utero

Answer 15

Thickened myometrium 
Abdominal muscles 
Cushioning from amniotic fluid 
Mucous plug for infections 
Pubic bones 
Placenta

Question 16

Ferguson’s reflex

Answer 16

Baby applies pressure to the top of the cervix 
Causes oxytocin release 
Causes myometrial contractions 
Pushes baby further into cervix 
Increased oxytocin release 
More contractions

Question 17

Function of relaxin

Answer 17

Aids cervical dilatation and vagina

Aids relaxation of pelvic floor muscles

Question 18

Functions of the placenta

Answer 18

Nutrient supply 
Waste removal 
Gaseous exchange 
Detoxification of drugs and metabolites 
Synthesis of hormones 
Long chain fatty acid production

Question 19

Which substances cannot cross the placenta?

Answer 19

Insulin, heparin

Question 20

Amniotic fluid formation

Answer 20

By the amnion
Ultrafiltrate of blood
Supplemented by secretions from the baby’s lungs and kidneys as urine

Question 21

Function of amniotic fluid

Answer 21

Cushioning 
Development of lungs and GI system 
Formation of meconium
Allows movement
Temperature regulation

Question 22

Foetal metabolic adaptations at birth

Answer 22

560g of fat
34g of glycogen
Rely on FFAs initially and ketones in for the brain

Question 23

Respiratory changes at birth

Answer 23

Inflation of the lungs
Clearance of lung fluid
Decrease in pulmonary vascular resistance
Secretion of pulmonary surfactant

Question 24

What does the heel prick test look for?

Answer 24

Sickle cell disease - haemoglobinopathies
CHT - TSH
Cystic fibrosis - immune reactive trypsinogen
PKU - phenylalanine
MCADD - octanoylcarnitine

Question 25

Advantages of breast feeding

Answer 25

``` Free Always available Right temperature Correct balance of nutrients Reduces foetal risk of infection, SCIDS and allergies Helps baby develop immune system Reduced maternal risk of breast and ovarian cancer and osteoporosis Helps mother with weight loss Promotes bonding ```

Question 26

Problems with breastfeeding

Answer 26

``` Sore nipples Can't tell amount Father can't help Have to be with baby Inadequate milk supply Social stigma Embarrassment Can't return to work ```

Question 27

Why can't cow's milk not be used?

Answer 27

Excessive protein, sodium and phosphate leading to dehydration

Question 28

Why can't soy based products be used?

Answer 28

Contains phyto-oestrogens | Can harm fertility

Question 29

What does breast milk provide that infant formula does not?

Answer 29

IgA Long chain fatty acids Lysozyme Whey protein

Question 30

Hormones involved in breastfeeding

Answer 30

Human placental lactogen, oxytocin, prolactin, oestrogen and progesterone in breast development Oestrogen and progesterone block lactogenic effects of prolactin Prolactin stimulates milk secretion Oxytocin stimulates milk ejection when suckling

Question 31

5 mesenchymal swellings leading to facial development

Answer 31

Frontonasal prominence Maxillary prominence Mandibular prominence

Question 32

What causes cleft lip?

Answer 32

Failure of maxillary and medial nasal prominences to fuse correctly

Question 33

What causes cleft palate?

Answer 33

Failure of palatine shelves to fuse correctly

Question 34

Short term menopause symptoms

Answer 34

``` Hot flushes and night sweats Palpitations Breast tenderness Urge incontinence Vaginal dryness Fatigue Mood swings Lowered libido Worsening PMS ```

Question 35

Average age for menopause

Answer 35

52

Question 36

Routes of HRT administration

Answer 36

``` Patches Gels Implants Pessaries Creams Nasal sprays ```

Question 37

Side effects of HRT

Answer 37

``` Heavy cyclical bleeding Bloating Fluid retention Weight gain Mastalgia Headaches Muscle pain Depression ```

Question 38

Complications of HRT

Answer 38

Thrombo-embolic events | Increased breast and ovarian cancer risk

Question 39

Physiology of menopause

Answer 39

Reduction of oestradiol secretion from ovaries Loss of feedback inhibition on pituitary Increased FSH and LH levels