10/04/18 Flashcards
What is the relation of the pudendal nerve to the internal pudendal artery as it pases the ischial spine?
medial
What nerve is the anterior labial nerve a division of?
ilioinguinal nerve
What are the 2 terminal branches of the pudendal nerve?
dorsal nerve of penis/clitoris and perineal nerve
Where does the internal pudendal vein drain?
internal iliac vein
What lines the upper 2/3rds of the anal canal?
cuboidal epithelium
What lines the lower 1/3rd of hte anal canal?
non-keratinisedsquamous epithelium
What is Hilton’s line?
junction of the keratinised and non-keratinised epithelium
What is the pectinate line?
junction of the upper 2/3rds and lower 1/3rd
What muscle of the pelvic floor blends with the internal anal sphincter?
pubococcygeus
Where does pyramidalis lie?
anterior to rectus abdominus within the rectus sheath
What is found in the pudendal canal?
pudendal nerve, artery and vein
How does the pudendal nerve pass the ischial spine?
just lateral to
Where is the lylmphatic drainage of hte bladder?
internal iliac nodes
What is found below the tunica vaginalis?
fibrous layer-tunica albuginea
What does the tunica albuginea form?
septa that divide the testis to form lobules where the seminifierous tubules are located
What is the hydatid of morgani?
remnant of the mullerian ducts
What is the relation of the ureters to the peritoneum?
retroperitoneal
What do the ureters derive from embryogically?
ureteric buds
Waht provides lubrication to the vagina?
Bartholin’s glands
What is the emrbyological origin of the vagina?
mesoderm- paramesonephric duct and urogential sinus
What is the lymphatic drainage of the superior part of hte vagina?
internal iliac nodes
What is the lymphatic drainage of the lwoer part of the vagina?
superficial inguinal nodes
What are the 3 muscular layers of the uterus?
endometrium; myometrium and epimetrium
What is the blood supply to the bladder?
superior and inferior vesical arteries derived from teh pudendal artery
What pelvic organ is found intraperitoneallu?
uterine tubes
Where does lymph from the superior part of hte bladder travel?
external iliac
Where does lymph from inferior bladder drain?
internal iliac
Where does the clitoris drain?
deep inguinal nodes
What antivonculsant can cause hyperammonaemia?
valproate- encephalopathy
What muscle is classically wasted in diabetic amyotrophy?
quadriceps
What types of leuakaemia might have raised RBCs and platelets?
myeloid leuakemia
What are cells going to stain positive for in ALL?
TdT
What are cells going to stain for in CML?
philidelphia chromosome (9;22)
What are cells going to stain for in AML?
myeloperoxide; auer rods
What is a drug that is an tyrosine kinase inhibitor?
imatinib
What is the treatment for the M3 variant of AML?
all-trans retinoic acid (vitamin A)
What will the M3 variant of AML stain for?
myeloperoxidase and auer rods
When do you treat CLL?
only if symptomatic
In order of age what are the leukaemias?
ALL–CML–AML–CLL
How do auer rods look?
flat crystals in the cytoplasm
What can CML progress to?
AML- blast crisis
Waht is a blast crisis?
> 20% blast cells in smear
What is the baby able to do at 6 months?
six= S’s- sit; switches (transfers between hands); shmooze (babbles); stranger anxiety
What is the baby able to do at 12 months?
Twelve = T’s : two-legs; track (object permanence); two-words; two-of us( separation and anxiety)
What is the baby able to do at 9 months?
9 = P’s (9 inch penis) : pull (to stand); pincer grasp ; papa (and mamma) ; play
Waht is the baby able to do at 3 months?
before everything else- roll; laugh; smile
What does a cohort study give you?
relative risk: relatives are the same (two O’s in cohort)
What is the direction of study in cohort?
prospective: two O’s are eyes- looking forward
What statistic does a case control study give you?
odds ratio (a and an o- at odds with one another)
What is the direction of study in a case control study?
backwards- A forms a backwards arrow
What are the most common bacterial groups to cause cerebral abscesses?
staphylococcus; streptococcus; bacteroides; enterbacteria
What are hte side effects of carbimazole/PTU?
agranulocytosis; rash; pruritis; nausea; alopecia; headache
What is the treatment for agrnulocytosis with carbimazole?
stop thioamide therpay and treat with radioactive iodein
Which DMARDs can cause pancytopenia?
methotrexate; sulfasalzein; penicillamine; gold
What is a common cause of cervical stenosis?
cone biosy
What is faceal soiling in children most commonly caused by?
constipation with secondary overflow
What bone do the cavernous sinuses lie on either side of?
sella turcica
What is the spleen derived from embryologically
mesoderm
Where do the ureters open into the bladder?
fundus
What are the most common causes of basophilic stippling?
alpha or bet a thalassaemia
What are Howell-Jolly bodies?
residual nuclear fragments
What are pappenheimer bodies?
violet staining granules in the periphery of RBCs
When are pappenheimer bodies found?
sideroblastic anaemia; lead posioning; thalassaemias; asplenic patietns
When are schistocytes seen?
intravascular haemolysis
What cardiac abnormalitiy is see n in ADPKD
mitral valve prolapse
What is relative risk?
measure of how much a particular ris kfactor influences the risk of a specified outcome
Why should elderly patients with hypothermia be gradually rewardmed?
rapid rewarming may precipiatate heart failure/organ failure
What does lymphcyte reciruclation refer to?
cells leaving the blood; crossing tissues and returning back to the blood via efferent lymph
What type of enzyme is alph-1 antitrypsin?
serine protease inhibitor
What is the function of alpha-1 antitrypsin?
prevents breakdown of elastin by elastase
What happens in renal osteodystrpohy?
reduced 1 hydroxylation of vitamin D
What other name is Wilson’s disease known as?
hepatolenticular degeneration
What part of the brain is affected first in Huntington;s?
striatum- caudate nucleus and putamen
Whcih sulcus separates the parietal and frontal lobes?
central sulcus
Where is Broca’s area?
inferiorfrontal gyrus
What part of the brain is affected in asterognosis?
superiorparietal lobule
Where is Wernicke’s area?
superior temporal gyrus
The middle cranial fossa contains which lobe?
temporal lobe
What leuakemia has smear cells on blood film?
CLL
Which antipsychotic is the most potent dopamine antagonist?
haloperidol
How long should blood counts be monitored weekly after starting clozapine?
18 weeks
Which drug is the most common cause of NMS?
haloperidol
What interleukin causes B cells to differentitae?
IL4
What is the function of reverse transcriptase?
enzyme producing cDNA
What is reverse transcripatse assocaited with ?
retroviruses
What is HbA2?
alpha globin chains and delta chains
How does sarcoid affect T cells?
low CD4+ and peripheral blood T cell coutn
What happens in XLA?
failure of proliferation of pre-B cells in the marrow
How do the anterior vertebral ascend in the neck in relation to the anterior rami of the cervical nerves?
anteiror
How do the vertebral arteries pass behind the materal mass of atlas?
medially
What is prominent abnormal dilatation of bronchi filled with mucous and neutrophils?
bronchiectasis
What is hyperplasia of bronchial submucosal glands. An increased ratio of the thickenss of hte gland layer to that of the bronchial wall?
chronic bronchitis
What is infiltration of smaller bronchioles and alveolar walls with neutrophils, lymphocytes and macrophages with deposition of immune complexes?
hypersensitivity penumonitis
Where does the femoral vein become the external iliac vein ?
inguinal lig
What layer of fascia are the great and small saphenous vein found in?
superficial fascia
Waht is the difference between the functions of gluteus maximus and medius/minimus?
gluteus maximus extends the hip and laterally rotates whereas medius/minimus abduct and medially rotates
What is Hunter’s syndrome?
mucopolysaccharidosis - accumulation
What are the symptosm of Hunter’s syndrome?
progressive heraing loss; hepatomeglay; CVS involvemetn and death in early childhood
What is restitution?
rotation of the head into line with the fetal shoulders
When does restitution occur?
once the head has been delivered
What is the best policy to eradicate MRSA spread?
swab all elective patients pre-admission to detect MRSA carraige
What is the most important investigation for CLL?
flow cytomtery showing a specific pattern of monoclonal B cell prolieration
What is a side effect of quinolones?
achilles tendon rupture
Where is the level of the carina?
T4/5
Which bronchus is more likely to have foreign bodies?
right main bronchus
why is the right main bronchus ofte n the site of foreign bodies?
wider, shorter and more vertical
Waht is the most likely cause of projectile vomiting in an infant?
pyloric stenosis
What is the function of the carotid body?
partial pressure of oxygen and CO2; pH and temp
What is engagmenet ?
biparietal diameter has entered the pelvic brim
What happens to iron in pregnnacy?
reduction in iron conc. and increase in iron binding capacity
When should the body be delivered after delivery of the head?
3 minutes
How does cholesterol enter the HDL?
scavenger receptor
What is VLDL digested into?
LDL and free fatty acids
What does widespread ST elevation suggest?
not an MI- pericarditis or something else
What is the mechanism of cyclophosphamide?
causes DNA cross-linking
What is the most common biochemical abnormality with co-trimoxazole?
hyperkalaemia
What monoclonal antibody causes autoimmune thyroid disease?
alemtuzumab
What is the risk of recurring pre-eclampsia if it has been severe or had complications?
1 in 4 if delivery before 34 weeks ; 1 in 2 if delivery before 28 weeks
Why are many patients with CAH diagnosed at puberty?
girls experience virilisation as androgens are made while cortisol is defieicnt
What gender is more likely to get renal artery stenosis?
females
What is the function of citrate in the urine?
inhibits the formation of renal stones esp. calcium oxalate stones
What is the most common cause of low urinary citrate?
high dietary intake of animal protein
Where does the most growth occur during the growth spurt of puberty?
spine
What is the function of ACE?
converts angiotensin 1 to angiotensin 2
What converts angiotensinogen to angiotensin1?
renin
What else converts angiotensin 1 -2?
lung
What is the disability score used in MS?
Kurtzke scale
Where is the primary visual cortex?
calcarine sulcus
