SPOPs Pathophysiology Flashcards

Question

Prolactin Function During Pregnancy

Answer 1

inhibits lactation during pregnancy enlarges mammary glands and prepares them for milk production produces breast milk

Answer 2

inhibits uterus contraction to prevent premature birth relaxes blood vessles, increasing blood flow to placenta and kidneys relaxes joints of the pelvis softens and lengthens cervix during birth

Answer 3

stimulates contraction of uterus muscles during labour triggers production of prostaglandins to increase contractions can be used to induce labour

Answer 4

uterus leaves the pelvis and ascends into the abdominal cavity uterus can grow up to 5 times its normal size abdominal contents become displaced fundus increases in size until 38 weeks and then descends in preparation for delivery Uterus blood flow increases from 50mL/min at 10 weeks to 500mL/min at term

Answer 5

mucous glands secrete operculum (mucous plug) which seals the uterus and protects from infection

Answer 6

blood supply increases due to uterus and embryo demands blood causes colour changes in the vulva leading to a bluish discoloration feeling of fullness and heaviness increased discharge

Answer 7

equilibrium of the spine and pelvis centre of gravity no longer falls over the feet need to lean backwards to gain equilibrium resulting in disorganisation of spinal curves

Answer 8

alterations in collagen metabolism due to altered levels of relaxin, oestrogen and progesterone connective tissue more pliable and laxative reduced joint stability especially in symphysis pubis and sacroiliac joints elongation of abdominal muscles can cause pelvic girdle pain and linea alba (abdominal separation)

Answer 9

major alteration to blood composition to protect against: normal blood loss during delivery (round 500ml) maintain cardiac output despite widespread vasodilation promote rapid haemostasis during placental separation bacterial infection

Answer 10

blood volume increase by 30-40% (approx. 1500mL) between 7 and 34 weeks plasma increases at a faster rate than other cellular components plasma increase begins around 7 weeks, rapidly during second trimester, reaching 40-50% by 32 weeks RBC volume increases slower, reaching 2-30% increase RBC increase is less than the total plasma increase = physiological aneamia blood viscosity reduced by 20% which decreases heart's workload haemoglobin concentration falls due to haemodilution - can be concern due to increased iron requirements WBC (neutrophil) increases to protect against bacterial infections hypercoagulability due to increase in clotting factors incl fibrinogen

Answer 11

progesterone decreases BP causing decreased systemic vascular resistance cardiac output increases by 30 – 50% peaking in 3rd trimester due to increased blood volume HR increases 15% and stroke volume 30% IVC compression at later stages (25-30% drop in CO lying supine) can all lead to dizziness, light headedness, palpitations, decreased exercise tolerance.

Answer 12

changes in ventilation due to: BMR increase causes increased oxygen consumption (20%) progesterone increases sensitivity of chemoreceptors to CO2 and leads to 40% ventilation increase 40% increase in tidal volume by end of first trimester (from 500ml – 700ml) 35-45% decrease in chest wall compliance, decreasing functional residual capacity (FRC) and residual volume (RV) Progesterone production enhances response to hypercapnia and water retention

Answer 13

progesterone relaxes muscles decreasing GI motility and lower oesophageal sphincter tone causing: reflux nausea and vomiting constipation

Answer 14

Systemic vasodilation early in pregnancy increases renal plasma volume and GFR dilation of the kidney's collecting system causes retention of electrolytes necessary for foetal growth limiting proteins, glucose and amino acids in urine increase in total body sodium increases plasma volume progesterone dilates kidneys and potentially kinks the ureters from 10 weeks and can cause urinary stasis and increased risk of infection

Answer 15

Melanocyte stimulating hormone increases and causes deeper pigmentation of the skin leading to: patchy mask on the face (chloasma) pigmented line on the abdomen from the pubis to the umbilicus (linea niagra) Areola darken and toughen up Stretch marks in the collagen layer of the skin causing red stripes (stria gravidarum)

Answer 16

Onset 6 – 8 weeks and in some settles around 21 weeks, others until full term causes chronic dehydration and malnutrition and can lead to excessive weight loss if Pts don’t receive aggressive and consistent management they are at extreme risk of: loss of \> 5-10% of pre-pregnancy body weight dehydration and production of ketones nutritional deficiencies metabolic imbalances severe fatigue and debility depression/anxiety and trauma premature labour/delivery

Answer 17

usually begin at 6 – 8 weeks, peaking at 9 weeks and settles at 14 weeks lose little if any, weight don’t impact ability to eat/drink normally vomit infrequently and the nausea is episodic but not severe or constant diet or lifestyle changes are enough most of the time typically improve after first trimester, but may have brief period of it later in pregnancy still able to work most days and fulfill normal life duties

Answer 18

love hormone causes feelings of euphoria helps uterine contractions helps bonding with baby responsible for milk ejection

Answer 19

the 'mothering' hormone major hormone of breastfeeding may play a role in helping baby adjust to life outside the womb peaks at the start of labour

Answer 20

causes feelings of euphoria natural pain relief increased with feelings of love works on same area of our brain as morphine and heroin

Answer 21

fight or flight response initially slows labour, natural reaction to birth gives sudden rush of energy before delivery

Answer 22

improves and initates oxytoxin function to work more effectively makesg contractions longer and labour quicker higher levels at night - why more labour at night

Answer 23

surfactant deficiency, especially in immature lungs which increases the surface tension in small airways and alveoli, reducing the lungs compliance

Answer 24

Decreased flow rates and reduced gas exchange Air gets into lungs due to decreased intrapulmonary pressure on inspiration, but struggles to get out on expiration due to the increased pressures and further narrowing Lung stretch receptors sense hyperinflation and trigger hyperventilation More air is trapped and CO2 builds up Decrease in alveoli perfusion Intrathoracic pressure impedes venous return

Answer 25

rare 3 major contributing factors of severity, management and psychological factors

Answer 26

Stage 1 - Sensorimotor Period Stage 2 - Preoperational Period Stage 3 - Concrete Operational Period Stage 4 - Formal Operational Period

Answer 27

Birth to 2 years coordination of sensory input and motor responses development of object permanence

Answer 28

2 to 7 years development of symbolic thought marked by irreversibility, centration, and egocentrism

Answer 29

7 - 11 years Mental operations applied to concrete events mastery of conservation, hierarchical classification

Answer 30

11 through to adulthood Mental operations applied to abstract ideas; logical, systematic thinking

Answer 31

Undeveloped temperature regulation Large head in relation to body size (More susceptible to head injuries) Incomplete motor development (Increased risk of falls) Thinner cranial bones (increased risk of head trauma) Presence of fontanelles at birth (Anterior fontanelle closes 12-18months, Posterior closes 2-3 months) | (Neonates and infants increased risk of hypothermia)

Answer 32

Narrower airways Large tongue with smaller mouth| (Greater risk of obstructions) Soft cricoid cartiledge (External pressures can obstruct airway) Larynx is higher and more anterior (More difficult airway management) Trachea is soft and compressible and smaller in diameter (Hyperextension or hyperflexion of neck can fully compress airway and difficult airway management) | (Greater risk of obstructions -Swelling (inhalation burns, croup etc), -Foreign bodies, -Nasal mucous (RSV))

Answer 33

Higher basal metabolic rate Smaller and fewer alveoli (Smaller area for gas exchange and increased dead space - must breathe faster to achieve adequate minute ventilation) Infants are obligatory nasal breathers (partially blocked results in increased resistance, laboured breathing and difficult feeding) Infants use abdominal muscles for breathing (Any distention of injury can quickly lead to respiratory distress) | (Naturally higher respiratory rates and oxygen consumption resulting in greater loss of water from lungs)

Answer 34

Large body surface area Decreased contractile efficiency of heart (Difficulting manipulating their cardiac stroke volume - increased HR to increase stroke volume.) Smaller volumes of circulating blood (Small amounts of blood loss constitute a large percentage of their volume.) Cardiac output, oxygen consumption and delivery are higher (Anything that causes an increase in oxygen consumption and a decrease in delivery can cause decompensation) Smaller veins and more subcutaneous tissue (Difficult cannulation) Higher metabolic rate (Increased cardiac workload and HR) | (Greater fluid losses through evaporation. Require greater fluid requirements to maintain adequate circulating volume.)

Answer 35

Increased glucose requirements with poor glycogen stores Reliance on others for fluid and nutrition (Hard for caregivers to meet the childs needs, especially when sick) Higher metabolic rate (ncreased waste production and increased nutrition and fluid requirements) ``` Cylindrical abdomen (Poor protection of vital organs) ``` Proportionally longer intestinal length (Greater fluid losses) Immature lower oesophageal sphincter tone (up to 12 months) (Regurgitation) | (Can rapidly develop hypoglycemia and muscular fatigue)

Answer 36

Lack of tone, muscle and power Bones are soft until puberty (Bones will break and bend more easily) Bones are more flexible (Serious internal injuries can result without fractures present) Growth plates are still active (Fractures to these long bones can have significant impacts on growth) Babies born with more bones than adults (Many of these will fuse together as they grow) | (Rely on others to keep stable and safe, Large head held by weak neck so more prone to head and spinal injuries, cannot initiate shivering with poor muscle tone)

Answer 37

Immature tubular function Decreased ability to concentrate urine (loss of water) Age related changes in pharmokinetics and pharmodynamics (slower excretion of some drugs) | (sodium wasting)

Answer 38

body to surface area ratio is 4 times that of adults and heat production is only 1 and a half times as high nerve endings in the retinas are not fully developed (Blurred images and shapes seen in the first few weeks - will start to smile at you when clearly sees you smiling) | (More prone to accidental hypothermia)