by Expert
in the ovary, where does LH act on - Correct Answer theca cells
Granulose cells
in the ovary, where does FSH act on - Correct Answer granulose cells
what does theca cells produce - Correct Answer androgens - that also go to Granulose
progestins
what do granolas cells do - Correct Answer produce progestin’s
estrogens
inhabit
What is the proliferative (follicular) phase? - Correct Answer period 1-7 days
increase in oestrogen - oestrogen phase
rising LH levels
repair and regeneration of the endometrium stimulated by estrogen from the ovarian
follicles
What is the secretory (luteal) phase? - Correct Answer 2nd phase of the endometrial
cycle
- Begins after ovulation & ends w/ onset of menstruation
- Endometrium continues to thicken - primary hormone is progesterone
What does the corpus lutein secrete? - Correct Answer progesterone
What is Early Pregnancy? - Correct Answer the 1st 10 weeks of 1st Trimester
For how long does the Corpus Latium produce βhCG? - Correct Answer C.L produces
βhCG for the first 8 weeks
Why does the C.L. produce progesterone? - Correct Answer to prevent autolysis
When does implantation occur? - Correct Answer 6-7 days after fertilization
what is HCG an analogue of? - Correct Answer βhCG is an analogue of Luteinizing
Hormone and binds to its receptor
,where is βhCG produced? - Correct Answer it is produced by the syncytriotrophoblast
of the placenta
at what rate does βhCG level increase - Correct Answer increases by >63% in 48
hours
peaks at 12 weeks
How much folic acid is recommended for women of childbearing age?
a. 1.0 mg
b. 0.4 mg
c. 1.5 mg
d. 2.0 mg - Correct Answer b. 0.4mg (400mcg) for 12 weeks for normal pregnancy
how much folic acid is recommended for women with a BMI >30 in early pregnancy -
Correct Answer 5mg, 1 month before the pregnancy and up to 12 weeks
how much folic acid is recommended for women with epilepsy in early pregnancy -
Correct Answer 5mg folic acid till 12 weeks
how much vitamin D is recommended for women in early pregnancy - Correct Answer
10 IU/daily
What should pregnant women avoid? - Correct Answer vitamin A - harms foetus
prevent listeriosis - pasteurised milk, soft cheese, brie, camembert pate, uncooked food
prevent salmonella - raw offs, poultry, deli, avoid alcohol and smoking
what are the haematological disorders screened for in pregnancy - Correct Answer
anaemia
blood group, Rhesus D, sickle cell anaemia
thalassemia
normal levels: 11g/ ld.
28 weeks: 10.5 g/ld.
when are haematological disorders screened for in pregnancy - Correct Answer at
booking appointment (10 weeks) and 28 weeks
what do we not screen for in pregnancy - Correct Answer asymptomatic bacterial
vaginosis
How many antenatal appointments should a woman have:
a. null parity
b/ porous - Correct Answer a. 10 appointments
b. 7 appointments
,when in the 1st antenatal appointment and what is checked - Correct Answer booking
appointment - ideally 10 weeks
determine gestational age (CRL)
anaemia, blood group and rhesus status
HIV, Hepatitis B
syphilis
urine test for asymptomatic bacteria
measure BMI
check for risk factors for Gestational diabetes
when is the 2nd antenatal appointment and what is checked - Correct Answer ideally
16 weeks
- Down's syndrome
> combined test - 11-14 wks
> serum screening 15-20 wk.
measure maternal height, weight and BMI
measure BP
test urine
what is the 3rd antenatal appointment and what is checked - Correct Answer 18-20
weeks
USS for fetal anomalies
at 20 weeks - check for pre-eclampsia
when is the 4th antenatal appointment and what is checked - Correct Answer 28
weeks
2nd blood/ haematological disorder check
offer anti-D prophylaxis
when is the 5th antenatal appointment and what is checked - Correct Answer 34
weeks
2nd dose of ant-D prophylaxis
when is the 6th antenatal appointment - Correct Answer 36 weeks
if breech offer Cephalic version
when is the 7th antenatal appointment - Correct Answer 38 weeks
last appointment if porous
what are the additional ANC appointments that occur in nulliparous pregnancy - Correct
Answer 25 weeks - measure syphilis-fundal
31 weeks
40 weeks
, Define miscarriage - Correct Answer spontaneous loss of pregnancy <24 weeks
early = <13 weeks
late = 13-24 weeks
what is the most common cause of miscarriage - Correct Answer chromosomal
abnormalities
>50% is due to genetics 9trisomy, monopsony)
2nd to this is maternal age >35 yrs.
what percentage of pregnancies lead to miscarriage? - Correct Answer 1 in 5 of
pregnancies lead to miscarriage
what are the endocrine causes of miscarriage? - Correct Answer Diabetes
Hypothyroidism
where the uterine causes of miscarriage? - Correct Answer - IUCD
- cervical (weakness) incompetence
- submucosal fibroids
- congenital septum
- adhesions (Sherman’s syndrome)
where the immunological causes of miscarriage> - Correct Answer - Antiphospholipid
syndrome (cause 2nd trimester loss)
- Thrombophilia
what are the infectious causes of miscarriage? - Correct Answer Toxoplasma
Rubella CMV
TB
Listeria
Salmonella
Chlamydia
BV
malaria
list the 5 types of miscarriage - Correct Answer 1. complete
2. incomplete
3. missed
4. threatened
5. inevitable
what is a complete miscarriage? - Correct Answer all products of conception has been
expelled
bleeding stopped