Midwifery Exam Practice Questions and Answers

Midwifery Exam Practice Questions and Answers What is the first stage of the menstrual cycle (that lasts 4-7 days) known as? Menstrual Cycle What is the second stage of the menstrual cycle (lasting 8-13 days) known as? Follicular Phase What is the third stage of the menstrual cycle, occurring at day 14, known as? Ovulatory Phase What is the final stage of the menstrual cycle known as? Luteal Phase What occurs during the follicular phase of the menstrual cycle? FSH causes follicle maturation in the ovary. Increased oestrogen causes the endometrium to thicken and become a nourishing environment for a potential pregnancy. Define Ovulation A period of heightened hormones where a dominant follicle releases an egg into a Fallopian tube. Which hormone is responsible for ovulation? LH (Luteinizing Hormone) What happens during the luteal phase of the menstrual cycle? Oestrogen decreases, progesterone increases due to the corpus luteum. What happens during the menstrual phase of the menstrual cycle? Oestrogen and progesterone decrease and the endometrial lining is shed. How long is an egg viable for following ovulation? 1 day What happens if an egg is not fertilised? Progesterone decreases, corpus luteum is reabsorbed and FSH causes new follicles to start maturing. Define capacitation The protective covering of the acrosome of the sperm is removed. What sort of reaction begins when a sperm comes into contact with an egg? Cortical reaction - cortical granules block any other sperm from entering the egg How many chromosomes does a zygote contain? 46, in 23 homologous pairs How many cells does the merula have? 8 to 16 How many cells does the blastocyst have? 16 to 32 How many days after ovulation can implantation occur? 6 to 10 days Define decidualisation Progesterone increases, creating a hospitable environment for the developing fetus. What are trophoblasts? Cells on the outer layer of the blastocyst What are integrins? Cell adhesion molecules that work in implantation. What is the chorion? Fetal part of placenta made out of trophoblast cells Which hormone causes skin pigmentation in pregnancy? Pituitary melanin-stimulating hormone What is the linea nigra? Abdominal midline What is striae gravidarum? Stretch marks What is choloasma? 'Mask of pregnancy' which is a tan or dark skin discoloration. What hormones cause SPD? Increased relaxin and progesterone What causes backache in pregnancy? Increased progesterone and relaxin that relaxes the sacroiliac joint. How does the vagina change in pregnancy? Increased vascularity resulting in purple/red discoloration What is Jacquemier's sign of pregnancy? Vagina and cervix may appear purple/blue due to increased blood supply What is Osiander's sign of pregnancy? Pulse located in the lateral vaginal fornix which indicates pregnancy What is the function of the cervical mucus plug? Protect the fetus from any ascending infections What is an ectropion? Purple/red discoloration of the cervix What causes vaginal discharge in pregnancy? Shedding of mucosal cells from the cervix or uterus What is candida albicans? Thrush or a yeast infection How does the mouth change in pregnancy? Increased gum vascularity, increased salivation resulting in bleeding gums or gingivitis. How does the stomach change in pregnancy? Cardiac sphincter relaxes caused by progesterone or heartburn How does the thyroid gland change in pregnancy? Increased TSH or thyroxine resulting in enlargement, or a goitre, thought to be related to nausea and vomiting. Which gland produces prolactin? Anterior pituitary gland What gland produces oxytocin? Posterior pituitary or hypothalamus Define puerperium Starts after the delivery of the placenta and membranes and continues for 6 weeks Define involution Process by which the uterus returns to its normal size, tone and position Define ischaemia Inadequate blood supply to an organ or part of the body Define autolysis Destruction of cells, tissues, muscle fibres by enzymes. What 3 processes contribute to involution? Ischaemia, autolysis, phagocytosis What is the role of phagocytosis in involution? It removes any debris left by autolysis What is the role of coagulation in involution? Takes place due to platelet aggregation and the release of thromboplastin and fibrin What is the role of vasoconstriction in involution? Overall blood supply to the uterus reduces, resulting in a further reduction in blood loss. What is lochia rubra? Blood, decidua, lanugo, vernix, shreds of chorion and amnion, meconium What is lochia serosa? Decidua, altered blood and serum, mucous, leukocytes What is lochia alba? Mucous, leukocytes and other microorganisms What are the signs of a perineal infection? Abnormal discoloration, excessive pain, offensive smell Define diuresis Excessive urination Define dysuria Painful urination What are the symptoms of a UTI? Passing small amounts, burning/stinging, abdominal or loin pain What are haemorrhoids? a.k.a. piles, Painful swelling of a vein in the rectum, which are very common after birth and worsened by pushing or straining Why may ovulation be delayed in breastfeeders? Prolactin inhibits ovulation. What is the aim of the UNICEF Baby Friendly Initiative? Address poor hospital practices and aggressive marketing techniques by formula companies which contribute to a decrease in breastfeeding rates from the 50s onwards. When were the university standards introduced in the Baby Friendly Initiative? 2005 What is the first stage of the baby friendly initiative? Building a firm foundation What is the 'gold' standard of the baby friendly initiative? Provide leadership, monitoring and culture needed to maintain and progress the standards over time. How many mothers initiate breastfeeding in the UK? 80% How many mothers continue breastfeeding until beyond 4 months old in the UK? 40% How many mothers stop breastfeeding before they want to in the UK? Around 8 in 10 How much have breastfeeding rates increased since the introduction of the baby friendly initiative? 20% What kind of protein is present in human milk? Whey-based protein (60-80%) which is easiest to digest What is alpha lactalbumin? Found in human milk, associated with the destruction of over 40 types of cancer cells. What kind of protein is present in formula milk? Cows' milk protein, associated with an increased risk of babies developing juvenile onset diabetes What kind of fats are seen in breast milk? Long-Chain Polyunsaturated Fatty Acids What kind of fats are seen in formula milk? Mainly vegetable, such as coconut or rapeseed What kind of growth factors are present in breast milk? Epidermal growth factor What are transfer factors? Enable effective absorption of certain nutrients in the milk What is lactoferrin? Transfer factor found in breast milk that assists in iron absorption and is bactericidal. What immunoglobin is found in breast milk? IgA, which provides a protective coating on the baby's gut What are leukocytes? White blood cells that destroy harmful bacteria What kind of leukocytes are found in breast milk? Macrophages, which produce lysozyme that disrupt bacterial cell walls, destroying them What are oligosaccharides? Simple, short-chain carbohydrates What is the role of oligosaccharides in breast milk? Help develop microflora by increasing beneficial bacteria in the baby's gut What is the role of milk lipids in breast milk? Damage the outer surface of some viruses What is the role of IL-7 in breast milk? Stronger immune system, reduces risk of childhood leukaemia What is the role of cytokines in breast milk? Helps to boost the immune system Why does colostrum have a laxative effect? Reduces risk of jaundice by assisting the passage of meconium, which contains bilirubin Breastfeeding reduces the mothers' risk of ... Breast/ovarian cancer, hip fractures, heart disease When does lactogenesis begin? In utero, when breast tissue develops What is the colostrum that a newborn baby may produce known as? Witches milk What occurs during Lactogenesis I? Initiation of milk secretion, breast development at 16-20 weeks, differentiates alveolar epithelial cells into lactocytes that secrete colostrum What occurs during Lactogenesis II? Production of colostrum and transitional milk, begins day 2-4, prolactin increase and pregnancy hormone decrease What occurs during Lactogenesis III? Galactopoiesis, maintenance of lactation, begins 8-9 days, milk production controlled by the autocrine system. What is feedback inhibitor of lactation? Whey protein produced by acini cells that inhibits milk production at each breast independently, controls the amount of milk produced What hormone is responsible for milk production? Prolactin