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Transition Block > 20/04/18 > Flashcards

20/04/18 Flashcards

1
Q

What are the sources of vitamin A in the diet?

A

cheese; eggs and yoghurt

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2
Q

What are the srouces of vit C in the diet?

A

oranges; blackcurrants and potatoes

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3
Q

What supplements should all children above 6 months who are consuming <500mls/day of infant formula be taking?

A

vitamin A, C and D

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4
Q

What supplement should all breastfeeding mothers tkae?

A

vit D

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5
Q

When should the transition from exclusive milk feeding to family foods b/e

A

6 months; not before 4

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6
Q

When can fullt fat cows milk be used as a drink?

A

12 months

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7
Q

When should semi-skimmed milk not be given before?

A

2 years

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8
Q

when should skimmed milk not be given before?

A

5 years

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9
Q

When should whole nuts and seeds be avoided before?

A

5 years

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10
Q

When should drinking from cups or beakers be introduced?

A

6 months

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11
Q

What is primary haemostasis?

A

formation of platelet plug

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12
Q

what is secondary haemostasis?

A

formation of fibrin clot

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13
Q

What causes the formation of prothrombin to thrombin?

A

V/Xa

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14
Q

What factor binds to tissue factor?

A

VII

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15
Q

What is the effect of plasmin?

A

converts fibrin to FDPs

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16
Q

What muscle does the sacral plexus overlie?

A

piriformis

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17
Q

What muscles make up the lateral pelvic wall?

A

obturator internus; coccygues; piriformis; levator ani

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18
Q

What is the origin of the superior rectal artery?

A

IMA

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19
Q

What 2 arteries of hte pelvis do not arise from the itnernal iliac artery?

A

gonadal artery and superior rectal

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20
Q

What arteries arise form the posteiror division of the internal iliac?

A

gluteal arteries

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21
Q

What is the inferior vesical artery in females?

A

vaginal artery

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22
Q

What is the foudn in the lateral umbilical fold?

A

inferior epigastric vessels

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23
Q

What is the medial umbilical fold?

A

remnant of umbilical artery

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24
Q

What is the median umbilical fold?

A

urachus

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25
Q

What is the termination of the perineal artery?

A

posterior scrotal artery

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26
Q

what is the origin of the anterior scrotal artery?

A

external iliac

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27
Q

What is the uterine artery a homolog of in the male?

A

artery to vas defenes

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28
Q

What artery is the middle rectal artery a branch of?

A

internal pudendal artery

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29
Q

What is hte vaginal artery a branch of?

A

uterine artery

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30
Q

What supplies the inferior part of hte vagina ?

A

itnernal pudendal artery

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31
Q

Where do the lateral sacral veins drain?

A

internal vertebral venous plexus

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32
Q

Where does the right ureter normally cross?

A

external iliac

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33
Q

Where does the left usually corss?

A

more medial- common iliac

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34
Q

Which ureter is more commonly damaged in surgery?

A

left ( right is more constant and lateral)

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35
Q

Where does uperior pelvic viscera generally drain?

A

external iliac

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36
Q

Where does inferior vagina drain?

A

sacral nodes

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37
Q

Where does the inferior vesical artery in females branch from?

A

vaginal artery

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38
Q

Where should your fingers be when palpating hte uterus bimanually?

A

posterior fornix

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39
Q

Where is the round ligament contained proximally?

A

broad ligament

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40
Q

What is anteverted?

A

uterus tipped anteiror realtive to axis of Vagina (anteVerted= Vagina)

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41
Q

What line divides the pernieum into the urogenital and anal trigagles?

A

line bweteen the ischial tuberosities

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42
Q

What is the nerve to levator ani roots?

A

S3, 4 ,5

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43
Q

What is level I axillary nod clearance?

A

inferior and lateral to pec minor

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44
Q

what is level II axilalry node clearnace?

A

deep to pec minor

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45
Q

What is level III axillary clearance?

A

superior and medial to pectoralis minor

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46
Q

What muscle forms the internal urethral spinchter ?

A

detrusor muscle

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47
Q

What aspect of hte bladder are the ureteric orificies?

A

base

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48
Q

Where is the internal urethral orifice in the bladder?

A

floor

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49
Q

What is the conjoint tendon?

A

medial end of the combined aponeuroses of IO and TA

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50
Q

What type of muscle is the dartos muscle?

A

SM

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51
Q

What is the root of hte penis attached to?

A

ischium of pelvis

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52
Q

Where is the corpus cavernosum located in the penis?

A

psoteriorly

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53
Q

What forms the glans penis ?

A

corpus spongiosum

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54
Q

Where does most of the lymph from the scrotum and most of penis drain?

A

superficial inguinal nodes

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55
Q

Where does lymph from glans penis drain?

A

deep inguinal nodes

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56
Q

What forms the pelvic inlet?

A

sacral promontory; ilium; superior pubic ramus and pubic symphysis

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57
Q

What forms the pelvic outlet?

A

pubic symphysis; ischiopubic ramus; ischial tuberosities; sacrotuberous ligaments; coccyx

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58
Q

Where does the pelvic cavity lie?

A

between the pelvic inlet and pelvic floor

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59
Q

What is the longest diameter in the fetal head?

A

occipitofrontal diameter

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60
Q

What is the difference between a night terror and a nightmare?

A

nightmare, patietn can remember the dream

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61
Q

What causes narcolepsy?

A

inhibition of REM sleep

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62
Q

What are the 4 main features of narcolepsy?

A

irresisteible attacks of sleep at inappropriate times; cataplexy; hypnogogic/hypnopompic hallucinations and sleep paralysis

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63
Q

What is cataplexy?

A

sudden loss of muscle tone when intense emotion occurs leading to collapse

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64
Q

What is the annual risk of suicide in the general population?

A

1 in 10,000

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65
Q

What is the risk of completed suicide in the year following self harm?

A

1%

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66
Q

How many patients who have completed suicide have seen a GP in the last month?

A

66.6%

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67
Q

How many patients who self-harm have a psychiatric illness?

A

90%

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68
Q

What is the annual incidence of self-harm?

A

3 in 1000

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69
Q

What is Couvade syndrome?

A

male experiences symptoms similar to pregnancy

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70
Q

What is puerperium defined as?

A

first 6 weeks following childbirth

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71
Q

What are the effects of cannabis use?

A

dry cough; increased appetitie; conjunctival infection and fatigue

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72
Q

What is formication?

A

tactile hallucination- insects crwloing over the skin

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73
Q

What drug is formication asociated with?

A

cocaine

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74
Q

What is the size of pupils with cocaine use?

A

mydriasis

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75
Q

What are Lilliputian hallucinations?

A

hallucinations seeing little people

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76
Q

What are lilliputian hallucinations characteristic of?

A

alcohol withdrawal

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77
Q

How many grams of alcohol is one unit equal to?

A

10g

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78
Q

What is Ekbom syndrome?

A

delusional psychosis that one is infested with parasites

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79
Q

What is Cotard syndrome?

A

delusion that one is dea, lost all possessions and is decaying

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80
Q

What is Rett’s syndrome?

A

neurodevelopmental disorder- developmental decline after 1-2 years, similar to autism

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81
Q

What is Pickwickian syndrome?

A

associated of obesity with sleep apnoea and hypersomnia

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82
Q

What is de Clerambault’s syndrome?

A

delusional belief that soeone of higher social status is in love with them

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83
Q

What is Ganser’s syndrome?

A

factitious disorder in which people give approximate answers to simple questions that show that they understand the underlying theem of the questions asked

84
Q

What is Fregoli’s syndrome?

A

persecutor is able to change into many forms and disguise themselves to look like different people

85
Q

What is othello syndrome?

A

delusional intensity belief that partner is being disloyal

86
Q

What is Capgras’ syndrome?

A

delusional belief that a close acquantiance has been replaced by an identical double

87
Q

What type of disorder is agoraphobia?

A

phobic anxiety disorder

88
Q

What is social phobia?

A

fear of scrutiny and criticism from others

89
Q

What is generalised anxiety disorder defined as?

A

generalised, excessive worry for more than 6 months

90
Q

How long do symptoms need to last for a diagnosis of somatization disorder?

A

2 years

91
Q

What is first line managemetn of panic disorder?

A

CBT

92
Q

What does the term conversion mean in psychiatry?

A

unconscious change of intrapsychic anxiety into physical symptoms of symbolic significance

93
Q

What pathway in the brain is involved in positive symptoms ?

A

mesolimbic pathway

94
Q

what pathway in the brain is involved in negative symptoms?

A

mesocortical pathway

95
Q

What are teh 4 dopamine pathways in the brain?

A

mesolimbic; mesocortical; tuberoinfundibular and nigrostriatal

96
Q

What can be used to treat akathisia?

A

beta blockers and BZDs

97
Q

What are the specific SE of chlorpromazine?

A

greying of the skin in response to sunlight and reduced seizure threshold

98
Q

What type of dopamine receptor do typical antipsychotics work on?

A

D2 receptors

99
Q

What dopamine receptors do clozapine and olanzapine work on?

A

D1 and D4

100
Q

What is the combination of St Johns wort and fluoxetine assocaited with?

A

serotonin syndrome

101
Q

Waht are the signs of serotonin syndrome?

A

severe HT; tachycardia; high pyrexia; myoclonus, sweating and hyper-reflexia

102
Q

What is hypermnesia?

A

exaggerated retnetion of detail about past experiences

103
Q

what is paramnesia?

A

distorted recall of events, such that falsification of memory occurs

104
Q

What is confabulation?

A

verbal evidence of unconscious filling of gaps in memory with false memories

105
Q

What is stupor?

A

state of being unresponsive, akinetic and mute but fully conscious

106
Q

How long do symptoms need to present for a diagnosis of SZ?

A

1 month

107
Q

What is waxy flexibility?

A

patient remains motionless but allow their limbs to be moved be someone els

108
Q

What is a schizoid personality?

A

preference for theri own company over other , lack emotional expression

109
Q

what is a paraphilia?

A

disorder of sexual preference

110
Q

What is first line treatment for mild depression?

A

CBT

111
Q

What is the absolute CI to ECT?

A

raised ICP

112
Q

what is SSRI withdrawal syndrome?

A

transient dizziness; lethargy; nausea and HA

113
Q

What is the problem thing in MAOs?

A

tyramine

114
Q

Why should there be a washout period before starting an MAO?

A

risk of serotonin syndrome- highest when MAOI is combined with otehr antidepressants

115
Q

What is anankastic PD?

A

inflexible preoccupation with rules; order adn attention to detail

116
Q

What are cluster A personality disorders?

A

paranoid; schizoid; schizotypal : odd/eccentric

117
Q

what are cluster B personality disorders?

A

emotional or dramatic- antisocial; borderline; histrionic; narcisstic

118
Q

What are cluster C personality disorders?

A

anxious/fearful- avoidant; dependent; anankastic

119
Q

What are Brodmann’s areas 1,2 and 3?

A

primary somatosensory cortex

120
Q

What is Brodmann’s area 4?

A

primary motor cortex

121
Q

What is Brodmann’s area 5?

A

somatosensory association cortex- superior parietal lobe

122
Q

What is Brodmann’s area 6?

A

premotor cortex and supplementary motor cortex

123
Q

what is the treatment for paroxysmal hemicrania?

A

indomethacin

124
Q

What tumour is a dural tail associated iwth?

A

meningiomas

125
Q

How do visceral afferents of pelvic organs touching the peritoneum reach the spinal cord?

A

run alongside sympathetics

126
Q

what spinal levels do visceral afferents from the pelvis accompanying sympathetics enter?

A

T11-L2

127
Q

Where do visceral afferents from organs not touching the peritoneum enter the spinal cord?

A

alongside parasympathetics

128
Q

Where does spinal cord become cauda equina?

A

L2

129
Q

Where does the subarachnoid sapce end?

A

S2

130
Q

what space is anaesthetic injected into in a spinal?

A

subarachnoid

131
Q

What is the direction of incision in episiotomy?

A

posterolateral/mediolateral

132
Q

Which abdominal mucles attach into the thoracolumbar fascia?

A

internal oblique and transverse abdominus

133
Q

What plane does the nerve supply to the anterolateral abdo wall travel in?

A

between IO and TA

134
Q

Where do the epigastric arteries lie?

A

psoterior to rectus abdominus

135
Q

What is the blood supply to the lateral abdominal wall continuations of?

A

psoterior intercostal arteries

136
Q

What should be avoided in a lateral port ?

A

inferior epigastric artery

137
Q

Where does the inferior epigastric artery emerge?

A

medial to the deep inguinal ring

138
Q

where is the deep inguinal ring located?

A

half way between ASIS and pubic trubercle

139
Q

What are the 3 layers of the pelvic floor?

A

pelvic diaphragm; muscles of perineal pouches and perineal membrane

140
Q

Where does the deep perineal pouch lie?

A

below the pelvic diaphragm and above the perineal membrane

141
Q

What muscles are found in the deep perineal pouch?

A

external urethral sphincter; compressor urethrae and deep transverse perineal muscle

142
Q

What does the perineal membraen atttach to laterally?

A

sides of the pubic arch

143
Q

What muscles are found in the superficial perineal muscle of the male?

A

bulbospongiosus; ischiocavernous; superifical transverse perineal muscle

144
Q

what is the difference between the bulb in males and females?

A

paired in females; single structure in males

145
Q

what muscle is most invovled in maintaining faecal continence?

A

puborectalis

146
Q

What do the 4 rectal muscles and superior oblique originate from?

A

common tendinous ring

147
Q

What is the lacunar ligament?

A

joins the inguinal ligament to the pectineal ligament

148
Q

What is the pectineal ligament?

A

extension of hte lacunar ligament which runs along the pectineal line

149
Q

What forms the anterior wall of the inguinal canal?

A

aponeuroses- EO and IO

150
Q

What forms the roof of the inguinal canal?

A

muscles- TA and IO

151
Q

What forms the lower wall (floor) of hte inguinal canal?

A

Ligaments- lacunar and inguinal

152
Q

what forms the posterior wall of the inguinal canal?

A

conjoint tendon; transversalis fascia

153
Q

Where do direct inguinal hernias occur?

A

medial to inferior epigastric vessels

154
Q

What arteries make up the coeliac trunk?

A

common hepatic; left gastric and splenic arteries

155
Q

What is the function of the ciliary muscle?

A

accomodates the lens

156
Q

What side of hte thorax is the azygous vein?

A

Right side

157
Q

What is the version of hte azygous vein on the left side of hte thorax?

A

hemi-azygous vein

158
Q

Where does the hemi-azgyous vein drain?

A

left brachiocephalic vein

159
Q

Where does the azygous vein drain?

A

SVC

160
Q

How many bronchopulmonary segments does each lung have?`

A

10

161
Q

How many subunits are there in Hb?

A

4

162
Q

What is ferritin?

A

storage form of iron

163
Q

What other name is transferrin known as?

A

total iron binding capacity

164
Q

What is the triad of plummer-vinson syndrome?

A

WID- webs; IDA and dysphagia

165
Q

What is sideroblastic anaemia?

A

abnormality of heme production in the porphyrin pathway

166
Q

What are the causes of siderblastic anaemia?

A

ALA synthetase deficiency; isoniazid; lead poisoning

167
Q

Why does isoniazid cause sideroblastic anaemia?

A

inhibits B6 which is a cofactor for ALA synthetase

168
Q

How does lead poisoning cause sideroblastic anaemia?

A

inhibits ferrochetalase- can’t prudce haem

169
Q

What is prussian blue stain for?

A

iron

170
Q

Waht does deletion of 2 alpha genes result in?

A

mild anaemia

171
Q

what does deletion of 4 alpha genes result in?

A

hydrops fetalis

172
Q

What are the 2 types of deletion in alpha thalassaemia?

A

cis and trans

173
Q

Which type of alpha deletion do asian people get?

A

cis deletion

174
Q

Which type of alpha deletion do african pateitns get

A

trans deletion

175
Q

What does one deletion of beta gene?

A

beta thal trait

176
Q

What is seen with beta thalassaemia?

A

high Hb A2

177
Q

What is the typical facial appearance of patietns with beta thal major?

A

chipmunk facies

178
Q

What is the cause of mutation in beta thal?

A

point mutation

179
Q

What inflammatory product is implicated in anaemia of chronic disease?

A

hepcidin

180
Q

What is the function of hepcidin?

A

hides iron (infection uses iron to multiply)- reduce iron absorption and increase ferritin

181
Q

What happens to transferrin in anaemia of chronic disease?

A

decreased

182
Q

What gene is defected in paroxysmal nocturnal haemoglobinuria?

A

PIGA

183
Q

What does PIGA gene procue?

A

CD55 (decay accelerating factor )and CD59

184
Q

What is seen in PNH?

A

Pancytopenia; Negative direct coombs and Hibernating( occurs when sleep)

185
Q

What are the function of CD55 and CD59?

A

inhibits C3 convertase- stops complement breakdown of RBC

186
Q

What mediates glutathione being reduced?

A

NADPH

187
Q

What is the function of reduced glutathione?

A

inhibits free radicals

188
Q

what is the function of G6PD?

A

changes NADP to NADPH

189
Q

What shunt is the G6PD enzyme involved in?

A

hexone monophosphate shunt

190
Q

What are the causes of oxidative stress?

A

D-dapsone
six-sulfa drugs
Primaquine
(fava beans) (G6P= D6P)

191
Q

What is seen on blood film with G6PD deficiency?

A

Heinz bodies and bite cells

192
Q

What is hereditary spherocytosis caused by?

A

dysfunctional RBC skeleton proteins- spectrin; ankyrin; bands

193
Q

What type of haemolysis is seen in hereditary spherocytosis?

A

extravascular haemolysis

194
Q

What is seen on blood film with hereditary spherocytosis?

A

howell-jolly bodies

195
Q

What are Howell-Jolly bodies?

A

DNA nuclear remnants usually removed by the spleen

196
Q

Where is B12 absorbed?

A

terminal ileum

197
Q

What is seen on labs with B12 deficiency?

A

increased homocysteine and increased MMA (methylmalonic acid)

198
Q

What happens to neutrophils in B12 or folate deficiency?

A

hypersegmented neutrophils

199
Q

Where is the thymus usually found?

A

posterior to the manubrium

200
Q

What is found in the anterior chamber of hte eye?

A

aqueous humour

201
Q

What canal does aqueous humour drain from the eye?

A

trabecular meshwork and then through the canal of Schlemm

202
Q

What is the area of the eye bounded anteriorly by the iris and posteirorly by the zonular fibres?

A

posteiror chamber

203
Q

What nerves are found in the side wall of the cavernous sinus?

A

III; IV; V1; V2

204
Q

What nerve traverses the cavernous sinus?

A

VI

205
Q

What is the relation of the ascending and descending colons to the peritoneum?

A

secondarily retroperitoneal

Transition Block (35 decks)

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