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Transition Block > 19/04/18 > Flashcards

19/04/18 Flashcards

1
Q

What type of scan should be done in stroke?

A

unenhanced CT

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2
Q

How does McArdle’s disease present?

A

painful muscle cramps after exercise in adulthood

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3
Q

What is the inheritacne of McArdle’s disease?

A

AR

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4
Q

What is a disadvantage of breast feeding?

A

breast milk has inadequate levels of vit K and nutrients

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5
Q

What is the 10% rule in phaeo?

A

10% are familial; bilateral; mlaignant and extra-adrenal

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6
Q

What conditions are associated with phaeochromocytoma?

A

MEN2; NF and von-Hippel Lindau syndrome

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7
Q

What is the characteristic pattern of clotting in liver failure?

A

all are low except for VIII

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8
Q

Why is VIII high in liver disease?

A

synthesised in endothelial cells thourghout the body

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9
Q

What artery supplies the lateral aspect of the heart?

A

left circumflex

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10
Q

What does lactase break sugar into?

A

glucose and galactose

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11
Q

Where is Gerotas fascia found?

A

surrounding the the kidney

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12
Q

What forms the trigone of the bladder?

A

two ureteric orificies and internal urethral orifice

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13
Q

How is relative risk reductino/increase calculated?

A

dividing the absolute risk change by the control event rate

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14
Q

Where is the majority of water absorbed in the GI tract?

A

jejunum

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15
Q

What is the only reason for aspiring in under 16?

A

Kawasaki disease

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16
Q

What is Reye’s syndrome?

A

encephalopathy and liver damage

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17
Q

what blood group is associatied wtih gastric cancer?

A

blood gorup A

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18
Q

What is the most common type of gastric cancer?

A

adenocarcinoma

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19
Q

What are the 4 collateral venous systems with superior vena caval obstruction?

A

azygous; internal mammary venous pathway; long thoracic venous system with connections to the femoral and vertebral veins

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20
Q

Where does the long head of biceps orginitae?

A

supraglenoid process

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21
Q

What does prompt antibiotic treatment prevent the devleopment of in suspected strep throat?

A

rheumatic fever- not GN

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22
Q

What WBC is found in granulomas?

A

macrophages

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23
Q

What stastic is used in case-control?

A

odds ratio

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24
Q

What statistic is used in a cohort study?

A

relative risk

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25
Q

When is a left sided murmur loudest?

A

on expiration

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26
Q

When is a right sided murmur loudest?

A

on inspiration

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27
Q

What innervates quadratus lumborum?

A

subcostal nerve

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28
Q

What are the actionso f quadratus lumborum?

A

pulls rib cage inferiorly and lateral flexion

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29
Q

Why is there a mixed pattern of neuro signs in MND?

A

damages motor cortex adn anterior horn celsl

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30
Q

What cancer is associated with BCL-2 oncogene?

A

follicular lymphoma

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31
Q

Whhich area of the prostate is associated with BPH?

A

transitional zone

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32
Q

How much bile enters the small bowel in 24 hours?

A

500-1.5L

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33
Q

What is the MOA of amiloride?

A

potassium sparing diuretic which inhibits epithelial sodium channels in the collecting ducts

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34
Q

Why are proximal ulnar injuries less severe than more distal ones?

A

causes denervation of medial half of FDP which causes decreased flexion of fingers which reduces claw like appearance

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35
Q

What class of hormone is insulin?

A

protein

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36
Q

What is MOA of ondansteron?

A

5-HT3 receptor antagonist

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37
Q

What ish te MOA of SUs?

A

block potassium ATP channels on beta cells to cause memrbaen depolarisation

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38
Q

Which structure of the IV disc usually herniates in dic prolapse?

A

nucleus pulposus

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39
Q

What is seen in tabes dorsalis?

A

degeneration of the dorsal columns

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40
Q

What is gravidity?

A

number of times a woman has been pregnnat

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41
Q

What is Down’s screening between 11 and 14 weeks?

A

combined test- US and blod test

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42
Q

what is the screening for Down’s between 15 and 20 weeks?

A

triple or quadruple test (blood tests)

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43
Q

When should anaemia be checked in pregnancy?

A

booking appointment and at 28 weeks

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44
Q

What is considered a positive result with down’s screening?

A

risk higher than 1 in 150

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45
Q

What are the indications of fetal echocardiography?

A

mothers with congenital heart disease; type 1 diabetes or epilepsy; high risk NT result or abnormal heart on anomaly scan

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46
Q

What does an increased NT but normal chromosomes suggest?

A

multiple structural abnormalities

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47
Q

What is secondary dysmenorrhea associated with?

A

endometriosis; PID; IUD; cervical stenosis after large loop exicions

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48
Q

How is baseline variablity calculated?

A

distance between the highest peak andl owest trough in a 1 minute segment

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49
Q

What suggests an abonrmal features with late decels?>

A

if present in over 50% of contractions for over 30 minutes

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50
Q

Aside from the classic triad; what else in associated with Reiter’s syndrome?

A

circinate balanitis(red lesions on penis); keratoderma blenorrhagicum (hard nodules on soles)

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51
Q

What is molluscum contagiosum caused by?

A

DNA poxvirus

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52
Q

What serovars of chlamydia cause infection in the eye?

A

A,B, C

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53
Q

Is jaundice seen in cholecystitis?

A

no

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54
Q

How is acute fatty liver of pregnancy differentiated from HELLP syndrome ?

A

acute fatty liver- hypoglycaemia and high uric acid

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55
Q

What is pain and discmofort in the pelvic area which can radiate to the upper thighs and perineum, worse on walking?

A

symphysis pubis dysfunction

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56
Q

What is the shape of the anteiror fontanelle?

A

diamond dhaped

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57
Q

What is the shape of hte posteiror fontanelle?

A

Y-shaped/triagnular

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58
Q

What are teh indicators of breech presentation?

A

ballotable head at fundus and fetal heart heard above the umbilicsu

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59
Q

What are the 3 types of breech?

A

extended; felxed and footling

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60
Q

what is extended breech?

A

feet extended near the head

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61
Q

What is flexed breech?

A

feet next to bottom

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62
Q

What is footling breech?

A

foot presents at cervix

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63
Q

what is the most common type of breech?

A

extended breech

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64
Q

What are the CI to exterenal cephalic version?

A

previous C/S; hx of APH; multiple pregnnacy; oligo/polyhydramnios and placenta praevia

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65
Q

What is the least common presentation?

A

brow- extended neck with largest diameter of fetal head presenting (chin to occiput)

66
Q

How is brow nad face presentation differentiated?

A

can palpate the sagittal suture and anterior fontanelle in brow presentation

67
Q

why is there a higher risk of cord prolapse in footling breech?

A

feet do not fill the pelvis like a head or buttock would- more space for cord to come down

68
Q

When should cyclical combined HRT be given?

A

patients with a uterus and bled within the las tyear

69
Q

What is prematuirty defined as?

A

delivery before 37 weeks

70
Q

When are steroids give in preterm labour?

A

from 24 to 35 weeks

71
Q

What is the antibiotic give for PROM?

A

erythromycin

72
Q

What antibiotic is associated with increased incidence of fetal necrotising colitis?

A

co-amoxiclav

73
Q

What are the features of uterine rupture?

A

pain; maternal shock; sudden termination of contractions and CTG abnormalities

74
Q

What happens in placental abruption?

A

placental bed bleeds and a haematoma forms behind it lifting hte placenta away from the uterus

75
Q

When is hysteroscopic resection possible for fibroids?

A

small, submucosal fibroids

76
Q

What happens to respiratory rate in pregnnacy?

A

unchanged

77
Q

What are the medical treatments for uterine fibroids?

A

GnRH analogues or low dose ulipristal acetate

78
Q

What are the treatments for cervical ectropion?

A

diathermy or cryocautery

79
Q

What do cerivcal polyps usually arise from?

A

endocervical mucosa

80
Q

Which cancers are reduced with pill use?

A

colon; ovarian and endometrial

81
Q

what cancers are increased with pill use?

A

breast

82
Q

When is the COCP CI in diabetics?

A

only if neuropathy; nephropathy or retinopathy or other vascular disease is present

83
Q

After what gestation is the Kleihauer test used?

A

after 20 weeks gestation

84
Q

When is anti-D needed with threatened or complete miscarriage?

A

only afte r12 weeks unless uterine evacuation is performed

85
Q

When should anti-D be given with terminations of ectopic pregnnacy?

A

always

86
Q

What is the minimum dose of anti-D after 20 weeks gestation?

A

500 IU

87
Q

What is the geenral meaning of stage 2 ovarian cancer?

A

beyond ovaries but confined to pelvis

88
Q

what is the general meaning of stage 3 ovarian cnacer?

A

beyond pelvis but confined to abdomen

89
Q

What is the general meaning of stage 4 ovarian cancer?

A

disease is beyond abdomen

90
Q

What metastatic tumour of the ovaries has signet ring morphology?

A

Krukenberg tumours

91
Q

How can stage 1a1 cervical cancer be treated?

A

cone biopsy or simple hysterectomy

92
Q

What is stage 1a1 cervical cancer defiend as?

A

less than 3mm and width less 7mm

93
Q

What is stage Ib1 cervical cacner?

A

tumour <4cm

94
Q

what is stage 1b2 cervical cacner?

A

tumour >4cm

95
Q

What is stage 2a cervical cancer?

A

invasion of upper 2/3rds of vagina

96
Q

What is stage 2b cervical cancer?

A

invasion of parametrium

97
Q

What do all other cervical cancers of stage 1 and 2 except 1a1 require fro treatment?

A

radical abdo hysterectoym

98
Q

What is a radical abdo hysterectomy?

A

hysterectomy with removal of upper 1/3rd of vagina, parametrium and pelvic lymph nodes

99
Q

What is the alternative for radial hysterectomy for women who wish to stay fertile?

A

radical trachelectomy

100
Q

What is the main RF fro uterine sarcoma?

A

pelvic irradiation

101
Q

What is the type of endometrial cancer in 90%?

A

adenocarcinoma

102
Q

What is the management of post-dates woman who doesn’t want induced?

A

twice weekly CTG and US of liqour volume

103
Q

What is first line in failure to progress?

A

amniotomy

104
Q

What is uterine hyperstimulation defined as?

A

> 7 contractions in 15 minutes

105
Q

What are the features of fetal varicella syndrome?

A

dermatomal skin scarring; neuro defects; limb hypoplasia; eye defects

106
Q

What is the treatment for toxoplasmosis?

A

spiramycin

107
Q

What virus causes roseola infantum?

A

HHV6

108
Q

What is made up of mesovarium?

A

broad ligament

109
Q

What is the suspensory ligament of the ovary?

A

part of hte broad ligament- lateral mesovarium

110
Q

What is the anatomy of the ligament of the ovary?

A

atttaches to the medial aspect of the ovary and passes to the lateral edge of the uterus- medial mesovarium

111
Q

What is a fundal placenta a risk for?

A

uterine inversion

112
Q

What in the mx of the third stage of labout can cause uterine inversion?

A

excessive cord traction or rapid decompression of the uterus

113
Q

What does large for gestational age mean?

A

> 90th centile

114
Q

What is macrosomia?

A

fetuses with a weight >4.5kg

115
Q

How is the diagnosis of cord prolapse made?

A

signs of fetal distress and cord can be palpated in the vagin

116
Q

Which emergency contraception cannot be used alongisde hormonal contraception?

A

ulipristal acetate- will affect progesterone-containing contraceptives for the rest of hte cycle

117
Q

What information should be given to patients with EC?

A

return if vomit within 2 hours of taking hte pill; next period may be early or late; barrier protection should be used for 7 days and to seek medical attention if she gets symptoms suggesting pregnancy

118
Q

Waht is the most common cause of secondary PPH?

A

infection

119
Q

What is the initial management of an atonic uterus?

A

emptying the bladder and rubbing up uterine contractions

120
Q

What is first line medical mx of atonic uterus?

A

ergometrine adn oxytocin

121
Q

What is 2nd line medical mx of atonic uterus?

A

carboprost IM thigh or the myometrium

122
Q

What is the surgical mx of atonic uterus?

A

B-lynch suture; insertion of a uterine balloonm over-sewing of the placental bed

123
Q

What is the cervical screening for HIV positive patietns?

A

yearly

124
Q

When does the active stage of labour start ?

A

4cm dilated

125
Q

How can tearing of perineum as the head is delivered by reduced?

A

shorter, smaller, active pushes and applying support to the perineum with a pad or swab

126
Q

What is Mendelson’s syndrome?

A

aspiration pneumonitis - acute lung injury after sterile gadtric contents are inglated into the lung

127
Q

What other name is Mayer-Rokitansky-Kuster-Hauser syndrome known as?

A

mullerian agenesis

128
Q

What is seen in mullerian agenesis?

A

congential absence of the uterus; cervix adn upper 2/3rds of the vagina

129
Q

What is hte maximum number of contractions with instrumental deliveries?

A

3

130
Q

What is 3c perineal tear?

A

both external and internal anal sphincters are torn

131
Q

How long should PT for UI be carried out?

A

3 months

132
Q

What is the MOA of mirabegron?

A

beta-3 agonist

133
Q

When is PTU preferred in pregnnacy?

A

early pregnnacy and in breastfeeding

134
Q

When is carbimazole used in pregnnacy? why?

A

in latter stages due to lvier toxicity with PTU

135
Q

What is first line anti-emetic in pregnnacy?

A

promethazine

136
Q

how do primordial germ cells divide?

A

mitosis

137
Q

How do spermatogonia divide?

A

mitosis into primary spermatocytes

138
Q

How many chromosomes do primary spermatocytes contain?

A

46

139
Q

What are primary spermatocytes which have undergone meiosis 1 called?

A

secondary spermatocytes

140
Q

What are secondary spermatocytes called once they have undergone meiosis 2?

A

spermatids

141
Q

How do spermatids become spermatozoa?

A

undergo spermiogenesis

142
Q

What organism causes chancroid?

A

haemophilus ducreyi

143
Q

What type of twins result if division ovccurs between days 4 and 8?

A

monozygotic monochorionic diamniotic twins

144
Q

What is the best reliable indicator of gestational age after 14 weeks?

A

head circumference

145
Q

What is the most sensitive parameter to assess fetal grwoth and detect IUGR

A

abdo circumference

146
Q

Where are Pick’s bodies typically found in Pick’s disease?

A

substantia nigra

147
Q

What is somatic passivity?

A

patient feels that they are receiving bodily sensations from an outside agency

148
Q

What is mild depression?

A

4 symptoms in total

149
Q

What is moderate depression?

A

5 or 6 symptoms in total

150
Q

what is severe depression?

A

7 symptoms in total including all 3 core symptoms

151
Q

What are the 3 core symptoms?

A

low mood; anhedonia and anergia

152
Q

What is atypical depression?

A

hyperphagia; weight gain adn hypersomnia

153
Q

what is somatic syndrome?

A

at least 4/8 biological symptoms of depression

154
Q

What is perseveration?

A

mental operations are continued beyond when they are relevant- e.g repeating a whole word or last syllable of a word

155
Q

What is dysprosody?

A

loss of hte normal melody of speech

156
Q

What does perseveration suggest?

A

organic brain disease

157
Q

What is Knight’s move thinking?

A

speech jumps from one subject ot another with no link

158
Q

What is flight of ideas?

A

accelerated thorughts with abrupt incidental changes of subject and no central direction

159
Q

What is hypnagogic?

A

wake to sleep

160
Q

what is hypnopompic ?

A

sleep to wake

161
Q

What is pseudocyesis?

A

development of symptoms and many of hte signs of pregnancy in a woma nwho is not pregnant.

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