Week 5 Flashcards Preview

Mattias - Reproduction > Week 5 > Flashcards

Flashcards in Week 5 Deck (154)
Loading flashcards...
1
Q

What is the connection between the pulmonary artery and aorta in a fetus

A

Ductus arteriosum

2
Q

Where does the fetus get oxygen from

A

Placenta

Maternal circulation

3
Q

From placenta to fetal hearth, what is involved

A

Umbilical vein –> Ductus venosus –>

Inferior vena cava –> Right atrium

4
Q

What is the blood distribution from Right atrium in fetus

A

Some into Left atrium, some into Right ventricle

5
Q

How does the blood get from Right to Left Atrium in fetus

A

Oval foramen

6
Q

What is the distribution from Right ventricle in fetus

A

Pulmonary trunk –> Pulmonary arteries AND Ductus arteriosus to the descending aorta

7
Q

When does the foramen ovale functionally close

A

By 3 months of age

8
Q

When does Ductus arteriosus functionally close

A

10-15h post birth

9
Q

What closes ductus arteriosus

A

Oxygen and pressure

10
Q

What opens the ductus arteriosus

A

Prostaglandins

11
Q

What is presenting symptoms of failed adaptation of fetus

A

Feeding difficulties
Fast breathing rate
Cyanotic episodes

12
Q

What is atrial septal defect

A

The Oval foramen has not closed, leaking blood from Left to Right Atrium

13
Q

What can happen with Ventricular Septal defect

A

Pulmonary hypertension, fluid leakage in lungs

14
Q

What is aortic stenosis

A

Narrowing of the aortic valve

15
Q

What is pulmonary atresia

A

Non-functional pulmonary valve

16
Q

What is tetralogy of Fallot

A

Large ventricular septal defect
Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta

17
Q

What is it called when the aorta and pulmonary trunk are swapped

A

Transposition of the great arteries

18
Q

Definition of Extremely preterm

A

Week 27 or before

19
Q

Definition of Very Preterm

A

Week 31 or before

20
Q

Definition of Preterm

A

Week 36 or before

21
Q

Definition of Term baby

A

Week 37-41

22
Q

Definition of Post term

A

Week 42 or later

23
Q

Normal birth weight

A

2.5kg - 4kg

24
Q

Definition of Large for gestational age at birth

A

> 4kg

25
Q

Defintion of small for gestational age at birth

A
26
Q

What enhances baby adaption after birth

A

Cortisol and Adrenaline

27
Q

What is hemolytic disease of the newborn

A

Alloimmune disease that breaks down RBC in the fetus

28
Q

Why is Vitamin K given to newborns

A

To stop Hemorrhagic disease of the newborn casued by Vitamin K deficiency

29
Q

What infections are screened for in infants

A

Hep B and C, HIV, TB, Group B Strep, Syphilis, Gonococcus

30
Q

What vaccination is given at birth

A

Hep B

31
Q

What vaccination is given first month of life if riskfactors are there

A

BCG vaccine

TB vaccine

32
Q

When is routine vaccinations given

A

8 weeks

33
Q

What Screening tests are done on infants

A

Universal hearing screen
Hip screen
Metabolic (Blood test)

34
Q

Newborn examination: Head

A
OFC
Moulding
Overlapping sutures
Fontanelles
Cephalohematoma
Caput succedaneum
Ventouse/forceps marks
35
Q

What is hemorrhage between skull and periosteum in a newborn called

A

Cephalhematoma

36
Q

What is swelling of infants scalp called

A

Caput succedaneum

37
Q

Newborn examination: Eyes

A

Size
Red reflex
Conjunctival hemorrhage
Squints

38
Q

Newborn examination: Ears

A

Position
External auditory canal
FH of hearing loss
Tags/pits

39
Q

Newborn examination: Mouth

A

Shape – Philtrum – Tongue tie – Palate – Neonatal teeth – Ebsteins pearls – Sucking/rooting reflex

40
Q

What are Epstein pearls

A

Whitish-yellow cysts that form on the gums and roof of mouth.
Harmless

41
Q

Newborn examination: Face

A

Facial palsy

Dysmorphism

42
Q

Newborn examination: Respiratory

A
Chest shape
Nasal flaring
Grunting
Tachypnea
In-drawing
Breath sounds
43
Q

Newborn examination: Cardiovascular

A

Color – Saturation – Femoral pulse – Apex/thrills – Heart sounds

44
Q

Newborn examination: Abdominal

A
Moves with respiration
Distention
Bile stained vomiting
Passage of meconium
Anus
45
Q

Newborn examination: Genitourinary

A

Normal passage of urine
Normal genitalia
Undescended testes
Hypospadius

46
Q

Newborn examination: MSK

A
Limbs and digits
Movement
Contractures
Spine
Sacral dimples
Hip examination
47
Q

What are the two Hip examinations called in newborns

A

Ortolani/Barlow

48
Q

Newborn examination: Neurological

A

Posture
Tone
Movement
Reflexes

49
Q

What is the reflex that newborns have when they fall backwards called

A

Moro

50
Q

Newborn examination: Skin

A

Dryness/cracking
Milia
Birth marks
Erythema toxicum

51
Q

Causes of preterm birth

A
Spontaneous
Multiple pregnancy
Preterm prelabor rupture of membranes
Cervical incompetence
And more
52
Q

Risk factors of preterm labor

A

Multiple pregnancy (x9)
Smoking, alcohol and drugs
In vitro fertilisation

53
Q

What is a good tool to assess preterm babies

A

Pulse oximetry

Lungs are immature

54
Q

When should umbilical cord be clamped

A

If the baby is ok and can be kept warm, pause for a minute before clamping

55
Q

How is a preterm baby kept warm

A

Keep baby in plastic bag under a radiant heater

56
Q

Consideration with preterm lungs

A

Lungs are fragile and susceptible to over-inflation

57
Q

When should growth charts be used with Gestational correction

A

Preterm babies

58
Q

How long should Gestational correction be used

A

1 year for infants born week 32-36

2years for infants born before 32 weeks

59
Q

Most commong Organism of neonatal sepsis

A

Group B strep

60
Q

What is Respiratory distress syndrome

A

Syndrome that happens when newborn lungs can’t sufficiently provide enough oxygen

61
Q

Signs and symptoms of Respiratory distress syndrome

A
Tachypnoea
Grunting
Intercostal recessions
Nasal flaring
Cyanosis
62
Q

How is Respiratory distress syndrome managed

A

Maternal steroids
Surfactants
Ventilation (invasive or non invasive)

63
Q

What are cardiovascular concerns in preterm infants

A

Patent ductus arteriosus

Systemic hypotension

64
Q

What is intraventricular hemorrhage

A

A form of intracranial hemorrhage that occurs in preterm infants, which begins with bleeding into the germinal matrix

65
Q

What are the risk factors for Intraventricular hemorrhage

A

Prematurity

Respiratory distress syndrome

66
Q

What are the grades of Intraventricular hemorrhage

A

Grade 1-4

1 being best outcome

67
Q

What is Necrotizing enterocolitis

A

Widespread necrosis in the small and large intestine

68
Q

Most common Bacterial infections in neonates

A
Group B strep
E. Coli
Listeria myogenes
Staphylococcus aureus
Staphylococcus epidermidis
69
Q

Common Viral infections in neonates

A

Cytomegalovirus
Parovirus
Herpes virus
Enteroviruses

70
Q

What is Transient tachypnoea of the newborn (TTN)

A

Self-limited disease caused by problems of fluid clearance of the lungs. Presents at first few hours of life.

71
Q

Tetralogy of Fallot is

A
  • Pulmonary valve stenosis
  • Overriding aorta
  • Ventricular Septal Defect
  • Right ventricular hypertrophy
72
Q

What is Total Anomalous Pulmonary Venous Drainage (TAPVD)

A

Congenital cyanotic malformation where all pulmonary vessels are malformed and return blood to venous system rather than the left atrium.

73
Q

What is hypoplastic heart

A

Congenital disease where part of the heart does not form properly causing cyanotic condition

74
Q

What is Potter’s syndrome

A

Congenital disease where the kidneys are not developed properly causing lack of amniotic fluid and kidney failure.

75
Q

What is Spina bifida

A

Congenital neural tube defect. The spine is not formed properly and the spinal canal is exposed. Severity depends if the skin close over or not.

76
Q

What are the sections of the Apgar Score

A

Heart Rate – Resp.effort – Tone – Color – Response

77
Q

What is the highest APGAR score

A

10

78
Q

What is normal Resp rate of newborn

A

40-60/minute

79
Q

What is normal heart rate of newborn

A

120-140/minute

80
Q

What was the anti-emetic drug that caused severe birth defects and is now banned

A

Thalidomide

81
Q

Green puke in infants mean

A

Malrotation with volvus until proven otherwise. Medical emergency

82
Q

Does Heparin cross the placenta

A

No, it is a large molecular weight drug

83
Q

Pharmokinetics during pregnancy, what happens to Absorption

A

May be affected by morning sickness

84
Q

Pharmokinetics during pregnancy, what happens to Distribution

A

Increased plasma volume, decreased protein binding and fat stores alters the distribution.

85
Q

Pharmokinetics during pregnancy, what happens to Metabolism

A

Increased liver metabolism of some drugs

86
Q

Pharmokinetics during pregnancy, what happens to Elimination

A

Renally excreted drug elimination increases due to increased GFR

87
Q

What teratogenic effect does ACE inhibitors/ARB have

A

Renal hypoplasia

88
Q

What teratogenic effect does Lithium have

A

Cardiovascular defects

89
Q

What teratogenic effect does Warfarin have

A

Limb and fascial defects

90
Q

What teratogenic effect does Methotrexate have

A

Skeletal defects

91
Q

Which Epileptic drugs should be avoided in pregnancy

A

Valproate and Phenytoin

92
Q

Which diabetes drugs should be avoided in pregnancy

A

Sulfonylureas

93
Q

Which anti-hypertensive drugs should be used in pregnancy

A

Labetalol
Methyldopa
Nifedipine

94
Q

Which anti-hypertensive drugs should be avoided in pregnancy

A

ACE inhibitors
ARB
Most betablockers in late prgnancy

95
Q

Which anti emetic is safe in pregnancy

A

Cyclizine

96
Q

Which drugs are used in UTI in pregnancy

A

Amoxicillin or Cefalexin

97
Q

Which pain reliever is used in pregnancy

A

Paracetamol

Avoid NSAIDs

98
Q

Which drugs especially enters breast milk

A

Small molecules

Fat soluble

99
Q

26y women, 28week pregnany, presents with swollen right leg. Differential diagnosis.

A

DVT

100
Q

26y women, 28 week pregnancy, presents with swollen right leg. DVT confirmed on USS. Treatment?

A

LMWH- Low molecular weight Heparin

101
Q

Which antibiotic during pregnancy or in early childhood may cause darkening of teeth

A

Tetracycline - Casue staining of bones and teeth

102
Q

Which antiepileptic drug is associated with Cleft palate

A

Phenytoin

103
Q

Discriminating facial features of Fetal alcohol syndrome

A

Flat midline – Short nose – Indistinct philtrum – Thin upper lip

104
Q

Which antiepileptic drug is associated with neural tube defects

A

Valporate

105
Q

What is population attributable risk

A

What proportion of this disease is attributable to this risk factor?

106
Q

What is the BMI requirements for IVF

A

> 18.5

107
Q

What is the smoking requirement for IVF

A

Non smoker for >3 months

Both partners

108
Q

What is the methadone requirement for IVF

A

Methadone free for at least one year prior to treatment

109
Q

What is the alcohol requirement for IVF

A

Neither partner should drink alcohol

110
Q

Can a couple receive IVF if they have undergone voluntary sterilization

A

No

Even if they reversed it, (self funded)

111
Q

What causes breast engorgement

A
Delay in first feed
Ineffective positioning and attachment
Restricted feeding
Ineffective emptying
Supplmentation
112
Q

Appareance of breast in breast engorgement

A

Stretched shiny skin, edma.

May be red

113
Q

Management of Engorgement

A

Warm baths or warm compress prior to feed –
Cold compress after feed to reduce edema –
Mild analgesia (paracetamol or Ibruprofen) –
Express milk if feed is not sufficient to reduce pressure

114
Q

Poor management of engorgement may lead to

A

Mastitis

115
Q

What causes Mastitis

A

Plugged milk duct – breast infection – poor position and attachment – infrequent feeds – consistent breast pressure – Dummies – Supplementation – Trauma

116
Q

Signs and Symptoms of Mastitis (blocked duct)

A

Tender spot, redness, sore lump without fever

117
Q

Signs and Symptoms of Mastitis (breast infection)

A

A tender spot or lump and a low grade fever

118
Q

Signs and symptoms of Infective mastitis

A

Cracked nipple
Pus and blood in milk
Red streaks from site back into breast

119
Q

Treatment of mastitis

A

Continue breastfeeding
Express milk if needed
Anti-inflammatory medication
Antibiotics if no improvement

120
Q

What is the order of events in mastitis

A

Blocked duct –> Localized inflammation –> systemic response

121
Q

Mastitis can lead to what if untreated

A

Abscess

122
Q

Antibiotic treatment for Mastitis

A

Flucloxacillin

Clindamycin if Penicillin allergy

123
Q

When is the prevalence of breast thrush low and other causes of breast pain should be considered

A

First 6 weeks after birth

124
Q

Sign and symptoms of Breast thrush

A
Agonsing pain in BOTH breasts
Pain is equal in BOTH breasts
Pain AFTER feed
Position and attachement is normal. No change in nipple color or shape after feed. 
\+ve oral swab for Candida albicans
125
Q

What is Frenotomy

A

When the linguinal frenulum is cut. Done when baby has tounge-tie

126
Q

What causes Breast Thrush

A

Candida Albicans

127
Q

Signs of Thrush in infant

A

Nappy rash
Oral thrush
Baby pulling of breast while feeding
Baby windy, fretful or difficult to settle

128
Q

Management of Breast Thrush

A

Observe breast and breastfeed –
Boil dummies and teats 20min/day
Wash towels and bras in hot water
CONTINUE FEEDING

129
Q

Treatment of Superficial breast thrush

A

Miconazole cream

130
Q

Treatment of Deep breast thrush

A

Fluconazole

300mg loading dose + 150mg daily for at least 10days

131
Q

Treatment of Thrush in infant

A

Nyastin oral suspension

132
Q

Treatment of Thrush in infant >4months

A

Miconazole oral gel

133
Q

Bound anteriorally by the symphysis pubis, laterally by the iliopectineal lines, and posteriorly by the sacral promiotry

A

Pelvic inlet

134
Q

Bound anteriorally by the pubic arch, laterally by the ischial tuberosities and posteriorly by the coccyx

A

Pelvic outlet

135
Q

Woman presenting with multiple small painful ulcers on her genitalia and a flu-like illness. She is unable to urinate due to discomfort. Diagnosis

A

Herpes Simplex

136
Q

Non-sexually active woman presents with a frothy brownish vaginal discharge, which has an offensive smell

A

Bacterial vaginosis

137
Q

Woman presents with vulval irritation and a white discharge

A

Candida albicans

138
Q

At what stage of development is embryo transfer most successful

A

Blastocyst

139
Q

LH surge occurs at what duration prior to ovulation

A

24-36h

140
Q

Changes in the Endometrium in the luteal phase are direct effect of which hormone

A

Progesterone

141
Q

What is Clomifene

A

Non-steroidal infertility medication

Used to induce ovulation in polycystic ovarian syndrome.

142
Q

Oligoasthenospermia menas

A

Low count and low motility

143
Q

Teratoasthenospermia means

A

Abnormal form and low motility

144
Q

Where does spermatogenesis occur in the testicle

A

Seminiferous tubules

145
Q

Where is testosterone secreted from in a male

A

Leydig cells

146
Q

7 week gestation, heavy vaginal bleed and abdominal pain. Cervix is slightly open with tissue visible. USS shows fetal heart beat. Diagnosis

A

Inevitable miscarriage

147
Q

Most lymph (>75%) from the breast initially drains to the

A

Axillary lymph nodes

148
Q

32y old lady has been seen in the unplanned pregnancy assessment clinic. Report shows an intrauterine sac measuring 40x32x25mm. Most likely diagnosis is

A

Delayed miscarriage

149
Q

Antibiotic treatment for Chlamydia

A

Arithromycin

150
Q

Preferred test for Chlamydia in an asymptomatic female is

A

First void urine NAAT

151
Q

Main artery to the anterior abdominal wall

A

Inferior epigastric

152
Q

In Down’s syndrome screening, nuchal thickness is measured by ultrasound at what time

A

11-14weeks

153
Q

When can the fundus first be palpable in singelton pregnancy

A

12week

154
Q

Week 5 lecture done

A

yes