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Transition Block > 18/04/18 > Flashcards

18/04/18 Flashcards

1
Q

What constitutes the corpus striatum?

A

lentiform nucleus (globus pallidu and putamen) and caudate nucleus

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2
Q

What isthe baseline HR in a CTG defined as?

A

average HR within a 10 minute window

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3
Q

What are hte causes of fetal tachycardia?

A

fetal hypoxia; chorioamnionitis; hyperthyroidism; anameia; tachyarrhythmia

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4
Q

What is mild bradycardia ?

A

100-120bpm

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5
Q

What are the causes of mild bradycardia?

A

postdate gestation; occiput posteiror or transverse presentation

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6
Q

What are the causes of severe prolonged bradycardia?

A

severe hypoxia- cord compression; cord prolpase; epidural and psianl anaesthesia; maternal seizures; rapid fetal descent

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7
Q

What is severe prolonged bradycardia defined as?

A

less than 80bpm for more than 3m inutes

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8
Q

What are the non-reassuring variabilities?

A

less than 5bpm for between 30-50 minutes; >25bpm for 15-25mins

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9
Q

What are the abnormal types of variablity?

A

<5bpm for >50 minutes; >25bpm >25 minutes or sinusoidal

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10
Q

What are hte causes of reduced variability?

A

fetal sleeping; fetal acidosis due to hypoxia; tachycardia; drugs; prematurity; heart abnormalities

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11
Q

What are the acclerations before and after a variable deceleration known as?

A

shoudlers of deceleration

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12
Q

What do shoulders of deceleration mean?

A

fetus is not yet hypoxic and is adapting to reduced blood flow

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13
Q

What is a prolonged deceleration?

A

> 2 minutes

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14
Q

What is a non-reassuring prolonged deceleration?

A

2-3 minutes

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15
Q

What is an abnormal prolonged decelration?

A

> 3 mins

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16
Q

When do late deceleraitons become abnormal?

A

if happens for 30minutes

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17
Q

What are concerning characteristics of variable decelerations?

A

> 60s; reduced baseline variability within decel; dailure to return to baseline; biphasic shape; no shoudlering

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18
Q

What are the causes of a sinusoidal pattern?

A

severe fetal hypoxia/anaemia; fetomaternal haemorrhage

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19
Q

What is an acceleration defined as?

A

abrupt >15bpm for >15s

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20
Q

What flow rate are nebulisers given at?

A

6-8L/min

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21
Q

What should be written down when prescribing oxygen/nebulisers?

A

drug name; flow rate; device used; target sats; indication; signature; date

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22
Q

What is the flow rate for non-rebreathers?

A

15L/min

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23
Q

What is the management of hypogylcaemia if concious; oriented and able to swallow?

A

15-20g of quick-acting carb snack eh orange juice and check blood glucose after 10-15 mins

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24
Q

How often can snack be repeated fro hypo?

A

upto 3 times

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25
Q

What is the treatment for hypo if conscious but uncooperative?

A

glucose gel between teeth and gums

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26
Q

What is the treatment for hypoglycaemia in an unconscious paitent?

A

glucose IV 10% at 200ml/hr or glucagon 1mg IV/IM

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27
Q

What is the management of hypo once blood gluocse is >4mmol/L?

A

long acting carb e.g slice of toast

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28
Q

What symptoms of SZ does dysregulation of mesolimbic system cause and why?

A

positive symptoms- dopmaine mediates the importance we place on obejects os excess mesolimbic dopmaine causes attaching salienece t oall osrtso fu nrealted phenomena

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29
Q

What is seen on MRI with SZ?

A

larger lateral ventricles, reduced frontal lobe, hippocampus and amygdala

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30
Q

What is the effect of dopamine on renal blood flow?

A

increases

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31
Q

What effect does phenytoin have on hair?

A

causes hirsutism

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32
Q

What xrays are needed for scaphoid fractures?

A

AP; lateral and oblique; PA

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33
Q

What is the most common cause of inherited unconjugated hyperbilirubinaemia?

A

gilbert syndroem

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34
Q

what drugs exacerbate psoriasis?

A

lithium; NSAIDs; beta-blockers; antimalarials; alcohol

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35
Q

Where is sensation lost in an UMN lesion?

A

sensation is lost to the level of the lesion

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36
Q

What is the function of alpha1 receptor stimulation?

A

SM of blood vessels; bronchi; uterus; bladder and iris to contract

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37
Q

Where are M3 receptors found?

A

glandular tissue and SM of lungs; GI tract and eye

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38
Q

What is the function of M2 receptors?

A

decreased heart contraction and SA node ratw

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39
Q

What is teh treatment for pain associated with smooth muscle spasm eg colicky abdo pain?

A

hyoscine butylbromide (buscopan)

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40
Q

What cancers are associated with von-Hippel Lindau disease?

A

phaeo; CNS haemangiomas; hypernephroma

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41
Q

What is glibenclamide?

A

SU

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42
Q

What are signs of significant ischaemia with non-proliferative diabetic retinopathy?

A

engorged tortuous veins; cotton wool spots and large bloot haemorrhages

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43
Q

What is Lowenstein-Jensen medium used for ?

A

culture of mycobacteria

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44
Q

give na example of a gram positive alpha haemolytic diplocci ?

A

strep. pneumoniae

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45
Q

How are streptococci differentiated?

A

haemolysis

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46
Q

How are staphylococci differentiated?

A

coagulase positive or negative

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47
Q

What is a coag negative staph?

A

staph epi

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48
Q

What is an alpha haemolytic strep?

A

strep pneumoniae and strep viridans

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49
Q

What are the beta haemolytic streps?

A

group a and b strep

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50
Q

What is a group A strep?

A

strep. pyogenes

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51
Q

What is non-haemolytic strep?

A

entercoccus

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52
Q

When are attacks with cluster HA more common?

A

at night

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53
Q

Why would cirrhosis cause hyponatraemia?

A

hypervolaemia

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54
Q

What contraceptive shouldn’t be used in a IDDM with microalbuminuria or hypertension?

A

COCP

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55
Q

What does a high stepping or stamping gait indicate?

A

dorsal column loss

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56
Q

what are the causes of dorsal column loss?

A

tabes dorsalis or subacute combined degeneration of the cord

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57
Q

What is the appearnce of acute leukaemia in the retina similar to?

A

Roth spots in infective endocarditive

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58
Q

How do roth spots appear?

A

circular retinal haemorrhages with a central pale core

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59
Q

What are dot haemorrhages on teh retina pathognomic of?

A

DM

60
Q

Why would a thiazide precipitate digoxin toxicity?

A

cause hypokalaemia which increases the risk of digoxin toxicity

61
Q

When should a patietn be referred for not being able to sit unsupported?

A

10 months

62
Q

when should a patietn be referred for not being reliably dry at night?

A

6 years

63
Q

When should a patient be referred for not being able to speak in intelligible short sentences?

A

3 years

64
Q

How are X and Y chromosomes paired in speramtogeneiss?

A

end to end

65
Q

What does a base deficit mean?

A

acidosis

66
Q

What is seen on ECG with hypokalaemia?

A

ST segment depression; U waves; inverted T wabes; prolonged PR interval

67
Q

What is the inheritance of acute intermitten phorphytia?

A

AD

68
Q

What artery origintes from the left posterior aortic sinus?

A

LCA

69
Q

Who gets pseudomonas osteomyleitis ?

A

haemodialysis and IV drug addicts

70
Q

What is the enzyme deficiency in prophyria cutanea tarda?

A

uroporphinogen decarboxylase

71
Q

What are the factors contributing to PCT?

A

alcohol; excess iron and excess oestrogens

72
Q

What happens when sulphonamides and methotreaxate are combined?

A

sulphonamide displaces methotrexate from its plasma protein binding site

73
Q

What is the most atherogenic lipid particle?

A

small dense LDL

74
Q

What enzyme is carried on LDL?

A

Lp-PLA2

75
Q

What is Lp-PLA2 associated iwth?

A

development of necrotic core

76
Q

What blood vessels ahve the biggest impact on BP?

A

arterioles

77
Q

What is Charcot’s triad?

A

RUQ pain; jaundice; fever with rigors

78
Q

What is the pain in cholecysitis?

A

constant

79
Q

What is the most common site of pancreatic cancer?

A

head of the pancreaas

80
Q

What artery supplies the body and tail of pancreas?

A

SMA- mid gut

81
Q

What is a positive correlation mean?

A

direction of relationship

82
Q

What is the best assay to determine if there is PROM in vaginal fluid?

A

AFP

83
Q

What type of renal stone are seen with hypercalciuria?

A

calcium phosphate

84
Q

How many feeds would a 2 month old infant be expected eachday?

A

3/4 stools a day

85
Q

How many wet nappies should an infant produce a day?

A

5/6

86
Q

How many stools should an infant have per day?

A

3/4

87
Q

What is seen histoloigcally in Sjogren’s syndrome?

A

lymphocytic infiltration and fibrosis of exocrine galnds esp lacrimal and salivary

88
Q

What does the SMA supply?

A

second half of the duodenum to the first 2/3rds of the transverse colon

89
Q

What is aphse 1 study?

A

conducted in healthy volunteers

90
Q

What is a phase 2 study?

A

conducted in patietns across a ragne of doses

91
Q

What is the cause of characteristic watermelon appearance on endoscopy?

A

gastric angiodysplasia

92
Q

What is the cause of achalasia?

A

degeneration of Auerbach’s myenteric plexus

93
Q

Aside from Hodgkins lymphoma when else are owls eye inclusions seen?

A

CMV

94
Q

What is a true aneurysm?

A

involves all three layers of aortic wall

95
Q

What is the effect of St Johns wort on heptic enzymes?

A

inducer

96
Q

Where should labour at 42 weeks gestation take place and why?

A

consultant unit as increased perinatal mortliaity and morbidity

97
Q

What happens to the amniotic fluid at 42 weeks gestation?

A

decreased

98
Q

What translocation commonly causes Down’s?

A

21 and 14

99
Q

What is a sub-viral satellite?

A

virus that can exist only alongisde another

100
Q

What drugs can be given for PROM?

A

oxytocin receptor antagonist or nifedipine

101
Q

What drugs should not be used for tocolysis?

A

betamimetics

102
Q

What anticonvulsant can cause a PCOS syndrome in women?

A

valproate

103
Q

What type of renal stone is only caused by inherited condition?

A

cystine

104
Q

In which condition are Perls’ Prussian blue positive deposits found in the liver?

A

haemochromatosis

105
Q

What clearance equal to?

A

urine conc. x urine volume/ plasma conc.

106
Q

When is choriocarcinoma more common?

A

extremes of reproductive age

107
Q

What is seen on pathology with choriocarcinoma?

A

sheets of syncytiotrophoblasts and cytotrophoblasts with evidence of necoris; haemorrhage and intravascualr grwoth

108
Q

What cytokines act on bone marrow to increase the production of leucocytes?

A

colony stimulating factor

109
Q

What cancer are aflatoxins assocaited with?

A

hepatocellular carcinoma

110
Q

What is vaginal clear cell carcinoma associated with?

A

exposure to diethylstilbestrol in-utero

111
Q

What cancer is actinic keratosis assocaited with?

A

SCC

112
Q

What is the commonest form of sarcoma?

A

GI stromal trumours

113
Q

Which chromosome has a point mutation in beta thal?

A

11

114
Q

What chromsome has a deletion in alpha thal?

A

16

115
Q

How are the BRCA genes inherited?

A

AR

116
Q

What is karyorrheixis?

A

fragmentation of the nuclei

117
Q

What are apoptotic bodies?

A

cytoplasmic blebs

118
Q

Is there release of inflammatory mediators in apoptosis?

A

no

119
Q

What is karyolysis?

A

complete dissolution of the nucleus secondary to the action on DNAase

120
Q

Why might mycoplasm penumonia cause a positive DAT?

A

cold AIHA

121
Q

What antibiotic can cause a positive DAT?

A

cephalosporins

122
Q

Is dysplasia irreversible?

A

no

123
Q

What is heteroplasia?

A

replacement of normal tissue by abnormal tissue or malpositioned normal tissue (growing in the wrong place)

124
Q

What is a bicornuate uterus assocaited with?

A

recurrent miscarriage; breech presentation; preterm delivery

125
Q

Waht is the typical genotype of complete molar pregnnacy?

A

diploid 46 XX ( single sperm combining with an egg devoid of DNA and undergoing mitosis)

126
Q

What is the typical genotype of a partial molar pregnancy?

A

69 XXy or quadrapolid XXXY- two sperm or one which duplicates

127
Q

When are neutrophils typically replaced by macrophages in cutenaoue wound healing?

A

48-92 horus

128
Q

What happens to the kidneys in pre-eclampsia?

A

hypertrophy of the glomerulus as a result of hypertrophy of intracapillary cells- reduced pergusion—-glomerular capillary endotheliosis

129
Q

What is the most common cause of acute renal failure?

A

acute tubular necrosis

130
Q

What type of GN is seen in DM?

A

nodular glomerulosclerosis

131
Q

What is seen in affected vessels with PAN?

A

necrotising transmural inflammation

132
Q

What virus is assocaited iwth PAN?

A

chronic hep B

133
Q

What cancers is CA-125 assocaited with?

A

ovarian and priamry peritoneal

134
Q

What cancers is raised CA19-9 associated with?

A

colorectal cancer and pancreatic cancer

135
Q

What cancer is CA15-3 assocaited with?

A

breast

136
Q

What other name as endotoxins?

A

bacterial wall lipopolysaccharides

137
Q

What is clomiphene citrate used for in IVF?

A

ovarian hyperstimulation

138
Q

How does clomiphene citrate work

A

blocks oestrogen receptors in the hypothalamus and pituitary , inhibiting the oestorgen levels

139
Q

What is the mechanism of cyproterone acetate?

A

antiandrogen

140
Q

What are hte SE of cyproterone acetate?

A

hepatotoxicity; gynaecomastia; low cortisol; low aldosterone and osteoporosis

141
Q

What is the MOA of mifeprositone?

A

competitive progesterone receptor antagonist

142
Q

What is danazol?

A

synthetic testosterone

143
Q

Why should sulphonaemides and trimethoprim be avoided in the third trimester?

A

cause neonatal haemolysis and methaemoglobinaemia

144
Q

Why should trimethorpim be avoided in the first trimester?

A

folate antagonist

145
Q

What antibiotics should be used for UTIs in pregnnacy>

A

nitrofurantoin

146
Q

What is first line treatment for ovarian cancer?

A

total abdominal hysterectomy with bilateral salpingo-oophorectomy

147
Q

What is an important complication of femal sterilisation?

A

ecoptic pregnnacy

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