Good morning and welcome to your Wednesday dose of Your Daily Meds.
Bonus Review: What is bile?
Answer: It is the stuff that is secreted by the liver into the hepatic ducts and then subsequently undergoes further changes in the gallbladder.
Bile contains:
* Water (the main constituent)
* Bile salts
* Bile pigments
* Electrolytes
Somewhat Anatomical:
Which of the following correctly describes the layers of the heart wall from outermost to innermost?
* Fibrous pericardium; parietal layer of serous pericardium; myocardium; epicardium; endocardium
* Parietal layer of serous pericardium; fibrous pericardium; epicardium; myocardium; endocardium
* Fibrous pericardium; epicardium; parietal layer of serous pericardium; endocardium; myocardium
* Parietal layer of serous pericardium; fibrous pericardium; myocardium; epicardium; endocardium
* Fibrous pericardium; parietal layer of serous pericardium; epicardium; myocardium; endocardium
Have a think.
Scroll for the chat.
The PPH:
Which of the following is consistent with primary postpartum haemorrhage?
* Bleeding of 500 mL or more from the birth canal in the first 24 hours after delivery of the baby
* Bleeding of 1000 mL or more from the birth canal in the first 24 hours after delivery of the baby
* Bleeding of 500 mL or more from the birth canal in the first 7 days after delivery of the baby
* Bleeding of 1000 mL or more from the birth canal in the first 6 weeks after delivery of the baby
* Intra-abdominal bleeding of 500 mL or more from uterine incision after caesarean section
Have a think.
More scroll for more chat.
Layers, Like Onions:
The layers of the heart wall from outermost to innermost are as follows:
* Fibrous pericardium
* Parietal layer of serous pericardium
* Visceral layer of serous pericardium, also known as the epicardium
* Myocardium
* Endocardium
The endocardium is loose connective tissue and simple squamous epithelium.
The subendocardial layer joins the endocardium to the myocardium and contains the Purkinje fibres.
The myocardium comprises cardiac muscle and is involuntary striated muscle.
The epicardium is composed of connective tissue and fat. The connective tissue secretes a small amount of lubricating fluid into the pericardial space, between the parietal and visceral layers of the serous pericardium.
See the pretty picture:
TTTThe Bleed:
Postpartum haemorrhage occurs in approximately 4% of pregnancies and accounts for approximately 10% of maternal deaths.
Primary postpartum haemorrhage is defined as bleeding of 500 mL or more from the birth canal in the first 24 hours after delivery of the baby.
Postpartum haemorrhage occurring from 24 hours to 6 weeks after delivery is known as secondary, delayed or late postpartum haemorrhage.
The common causes of postpartum haemorrhage are categorised by those involving ‘tone’ (such as uterine atony), ‘tissue’ (as in retained placental tissue), ‘trauma’ (such as birth canal laceration) and ‘thrombin’ (to signify coagulopathy).
Active management of the third stage of labour with oxytocics reduces the risk of uterine atony as a cause of postpartum haemorrhage.
Bonus: Alrighty then, here’s a big one. What are the functions of the liver? Is the liver essential for life?
Answer in tomorrow’s dose.
Closing:
Thank you for taking your Meds and we will see you tomorrow for your MANE dose. As always, please contact us with any questions, concerns, tips or suggestions. Have a great day!
Luke.
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