10/04/18 Flashcards

1
Q

What is the relation of the pudendal nerve to the internal pudendal artery as it pases the ischial spine?

A

medial

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2
Q

What nerve is the anterior labial nerve a division of?

A

ilioinguinal nerve

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3
Q

What are the 2 terminal branches of the pudendal nerve?

A

dorsal nerve of penis/clitoris and perineal nerve

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4
Q

Where does the internal pudendal vein drain?

A

internal iliac vein

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5
Q

What lines the upper 2/3rds of the anal canal?

A

cuboidal epithelium

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6
Q

What lines the lower 1/3rd of hte anal canal?

A

non-keratinisedsquamous epithelium

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7
Q

What is Hilton’s line?

A

junction of the keratinised and non-keratinised epithelium

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8
Q

What is the pectinate line?

A

junction of the upper 2/3rds and lower 1/3rd

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9
Q

What muscle of the pelvic floor blends with the internal anal sphincter?

A

pubococcygeus

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10
Q

Where does pyramidalis lie?

A

anterior to rectus abdominus within the rectus sheath

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11
Q

What is found in the pudendal canal?

A

pudendal nerve, artery and vein

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12
Q

How does the pudendal nerve pass the ischial spine?

A

just lateral to

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13
Q

Where is the lylmphatic drainage of hte bladder?

A

internal iliac nodes

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14
Q

What is found below the tunica vaginalis?

A

fibrous layer-tunica albuginea

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15
Q

What does the tunica albuginea form?

A

septa that divide the testis to form lobules where the seminifierous tubules are located

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16
Q

What is the hydatid of morgani?

A

remnant of the mullerian ducts

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17
Q

What is the relation of the ureters to the peritoneum?

A

retroperitoneal

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18
Q

What do the ureters derive from embryogically?

A

ureteric buds

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19
Q

Waht provides lubrication to the vagina?

A

Bartholin’s glands

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20
Q

What is the emrbyological origin of the vagina?

A

mesoderm- paramesonephric duct and urogential sinus

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21
Q

What is the lymphatic drainage of the superior part of hte vagina?

A

internal iliac nodes

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22
Q

What is the lymphatic drainage of the lwoer part of the vagina?

A

superficial inguinal nodes

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23
Q

What are the 3 muscular layers of the uterus?

A

endometrium; myometrium and epimetrium

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24
Q

What is the blood supply to the bladder?

A

superior and inferior vesical arteries derived from teh pudendal artery

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25
Q

What pelvic organ is found intraperitoneallu?

A

uterine tubes

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26
Q

Where does lymph from the superior part of hte bladder travel?

A

external iliac

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27
Q

Where does lymph from inferior bladder drain?

A

internal iliac

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28
Q

Where does the clitoris drain?

A

deep inguinal nodes

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29
Q

What antivonculsant can cause hyperammonaemia?

A

valproate- encephalopathy

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30
Q

What muscle is classically wasted in diabetic amyotrophy?

A

quadriceps

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31
Q

What types of leuakaemia might have raised RBCs and platelets?

A

myeloid leuakemia

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32
Q

What are cells going to stain positive for in ALL?

A

TdT

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33
Q

What are cells going to stain for in CML?

A

philidelphia chromosome (9;22)

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34
Q

What are cells going to stain for in AML?

A

myeloperoxide; auer rods

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35
Q

What is a drug that is an tyrosine kinase inhibitor?

A

imatinib

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36
Q

What is the treatment for the M3 variant of AML?

A

all-trans retinoic acid (vitamin A)

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37
Q

What will the M3 variant of AML stain for?

A

myeloperoxidase and auer rods

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38
Q

When do you treat CLL?

A

only if symptomatic

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39
Q

In order of age what are the leukaemias?

A

ALL–CML–AML–CLL

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40
Q

How do auer rods look?

A

flat crystals in the cytoplasm

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41
Q

What can CML progress to?

A

AML- blast crisis

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42
Q

Waht is a blast crisis?

A

> 20% blast cells in smear

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43
Q

What is the baby able to do at 6 months?

A

six= S’s- sit; switches (transfers between hands); shmooze (babbles); stranger anxiety

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44
Q

What is the baby able to do at 12 months?

A

Twelve = T’s : two-legs; track (object permanence); two-words; two-of us( separation and anxiety)

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45
Q

What is the baby able to do at 9 months?

A

9 = P’s (9 inch penis) : pull (to stand); pincer grasp ; papa (and mamma) ; play

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46
Q

Waht is the baby able to do at 3 months?

A

before everything else- roll; laugh; smile

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47
Q

What does a cohort study give you?

A

relative risk: relatives are the same (two O’s in cohort)

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48
Q

What is the direction of study in cohort?

A

prospective: two O’s are eyes- looking forward

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49
Q

What statistic does a case control study give you?

A

odds ratio (a and an o- at odds with one another)

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50
Q

What is the direction of study in a case control study?

A

backwards- A forms a backwards arrow

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51
Q

What are the most common bacterial groups to cause cerebral abscesses?

A

staphylococcus; streptococcus; bacteroides; enterbacteria

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52
Q

What are hte side effects of carbimazole/PTU?

A

agranulocytosis; rash; pruritis; nausea; alopecia; headache

53
Q

What is the treatment for agrnulocytosis with carbimazole?

A

stop thioamide therpay and treat with radioactive iodein

54
Q

Which DMARDs can cause pancytopenia?

A

methotrexate; sulfasalzein; penicillamine; gold

55
Q

What is a common cause of cervical stenosis?

A

cone biosy

56
Q

What is faceal soiling in children most commonly caused by?

A

constipation with secondary overflow

57
Q

What bone do the cavernous sinuses lie on either side of?

A

sella turcica

58
Q

What is the spleen derived from embryologically

A

mesoderm

59
Q

Where do the ureters open into the bladder?

A

fundus

60
Q

What are the most common causes of basophilic stippling?

A

alpha or bet a thalassaemia

61
Q

What are Howell-Jolly bodies?

A

residual nuclear fragments

62
Q

What are pappenheimer bodies?

A

violet staining granules in the periphery of RBCs

63
Q

When are pappenheimer bodies found?

A

sideroblastic anaemia; lead posioning; thalassaemias; asplenic patietns

64
Q

When are schistocytes seen?

A

intravascular haemolysis

65
Q

What cardiac abnormalitiy is see n in ADPKD

A

mitral valve prolapse

66
Q

What is relative risk?

A

measure of how much a particular ris kfactor influences the risk of a specified outcome

67
Q

Why should elderly patients with hypothermia be gradually rewardmed?

A

rapid rewarming may precipiatate heart failure/organ failure

68
Q

What does lymphcyte reciruclation refer to?

A

cells leaving the blood; crossing tissues and returning back to the blood via efferent lymph

69
Q

What type of enzyme is alph-1 antitrypsin?

A

serine protease inhibitor

70
Q

What is the function of alpha-1 antitrypsin?

A

prevents breakdown of elastin by elastase

71
Q

What happens in renal osteodystrpohy?

A

reduced 1 hydroxylation of vitamin D

72
Q

What other name is Wilson’s disease known as?

A

hepatolenticular degeneration

73
Q

What part of the brain is affected first in Huntington;s?

A

striatum- caudate nucleus and putamen

74
Q

Whcih sulcus separates the parietal and frontal lobes?

A

central sulcus

75
Q

Where is Broca’s area?

A

inferiorfrontal gyrus

76
Q

What part of the brain is affected in asterognosis?

A

superiorparietal lobule

77
Q

Where is Wernicke’s area?

A

superior temporal gyrus

78
Q

The middle cranial fossa contains which lobe?

A

temporal lobe

79
Q

What leuakemia has smear cells on blood film?

A

CLL

80
Q

Which antipsychotic is the most potent dopamine antagonist?

A

haloperidol

81
Q

How long should blood counts be monitored weekly after starting clozapine?

A

18 weeks

82
Q

Which drug is the most common cause of NMS?

A

haloperidol

83
Q

What interleukin causes B cells to differentitae?

A

IL4

84
Q

What is the function of reverse transcriptase?

A

enzyme producing cDNA

85
Q

What is reverse transcripatse assocaited with ?

A

retroviruses

86
Q

What is HbA2?

A

alpha globin chains and delta chains

87
Q

How does sarcoid affect T cells?

A

low CD4+ and peripheral blood T cell coutn

88
Q

What happens in XLA?

A

failure of proliferation of pre-B cells in the marrow

89
Q

How do the anterior vertebral ascend in the neck in relation to the anterior rami of the cervical nerves?

A

anteiror

90
Q

How do the vertebral arteries pass behind the materal mass of atlas?

A

medially

91
Q

What is prominent abnormal dilatation of bronchi filled with mucous and neutrophils?

A

bronchiectasis

92
Q

What is hyperplasia of bronchial submucosal glands. An increased ratio of the thickenss of hte gland layer to that of the bronchial wall?

A

chronic bronchitis

93
Q

What is infiltration of smaller bronchioles and alveolar walls with neutrophils, lymphocytes and macrophages with deposition of immune complexes?

A

hypersensitivity penumonitis

94
Q

Where does the femoral vein become the external iliac vein ?

A

inguinal lig

95
Q

What layer of fascia are the great and small saphenous vein found in?

A

superficial fascia

96
Q

Waht is the difference between the functions of gluteus maximus and medius/minimus?

A

gluteus maximus extends the hip and laterally rotates whereas medius/minimus abduct and medially rotates

97
Q

What is Hunter’s syndrome?

A

mucopolysaccharidosis - accumulation

98
Q

What are the symptosm of Hunter’s syndrome?

A

progressive heraing loss; hepatomeglay; CVS involvemetn and death in early childhood

99
Q

What is restitution?

A

rotation of the head into line with the fetal shoulders

100
Q

When does restitution occur?

A

once the head has been delivered

101
Q

What is the best policy to eradicate MRSA spread?

A

swab all elective patients pre-admission to detect MRSA carraige

102
Q

What is the most important investigation for CLL?

A

flow cytomtery showing a specific pattern of monoclonal B cell prolieration

103
Q

What is a side effect of quinolones?

A

achilles tendon rupture

104
Q

Where is the level of the carina?

A

T4/5

105
Q

Which bronchus is more likely to have foreign bodies?

A

right main bronchus

106
Q

why is the right main bronchus ofte n the site of foreign bodies?

A

wider, shorter and more vertical

107
Q

Waht is the most likely cause of projectile vomiting in an infant?

A

pyloric stenosis

108
Q

What is the function of the carotid body?

A

partial pressure of oxygen and CO2; pH and temp

109
Q

What is engagmenet ?

A

biparietal diameter has entered the pelvic brim

110
Q

What happens to iron in pregnnacy?

A

reduction in iron conc. and increase in iron binding capacity

111
Q

When should the body be delivered after delivery of the head?

A

3 minutes

112
Q

How does cholesterol enter the HDL?

A

scavenger receptor

113
Q

What is VLDL digested into?

A

LDL and free fatty acids

114
Q

What does widespread ST elevation suggest?

A

not an MI- pericarditis or something else

115
Q

What is the mechanism of cyclophosphamide?

A

causes DNA cross-linking

116
Q

What is the most common biochemical abnormality with co-trimoxazole?

A

hyperkalaemia

117
Q

What monoclonal antibody causes autoimmune thyroid disease?

A

alemtuzumab

118
Q

What is the risk of recurring pre-eclampsia if it has been severe or had complications?

A

1 in 4 if delivery before 34 weeks ; 1 in 2 if delivery before 28 weeks

119
Q

Why are many patients with CAH diagnosed at puberty?

A

girls experience virilisation as androgens are made while cortisol is defieicnt

120
Q

What gender is more likely to get renal artery stenosis?

A

females

121
Q

What is the function of citrate in the urine?

A

inhibits the formation of renal stones esp. calcium oxalate stones

122
Q

What is the most common cause of low urinary citrate?

A

high dietary intake of animal protein

123
Q

Where does the most growth occur during the growth spurt of puberty?

A

spine

124
Q

What is the function of ACE?

A

converts angiotensin 1 to angiotensin 2

125
Q

What converts angiotensinogen to angiotensin1?

A

renin

126
Q

What else converts angiotensin 1 -2?

A

lung

127
Q

What is the disability score used in MS?

A

Kurtzke scale

128
Q

Where is the primary visual cortex?

A

calcarine sulcus