2nd deck Flashcards by Philippa S

Post-operatively, the nurse notices an area of burn near the diathermy plate. What is the mechanism of injury?

High frequency current focused on small area

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Which immunoglobulin is a dimer?

IgA

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What is a Type 2 error?

The erroneous acceptance of the null hypothesis

Type 2 - false negative

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Definition specificity

Ability to identify a true positive.

Specificity=true negatives/(true negative + false positives)

If a person does not have the disease how often will the test be negative (true negative rate)?

In other terms, if the test result for a highly specific test is positive you can be nearly certain that they actually have the disease.

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Th-1 cytokines include

Interferon gamma and TNF alpha.

Th-1 is suppressed during pregnancy

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Statistical heterogenicity means

Differences in the intervention effects in different studies

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When undertaking a meta-analysis, which tests can be used to estimate heterogenicity

I-squared or Cochrane Q tests

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The ultrasound frequency range typically used for transabdominal gynaecology scanning

2-5Mhz

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Calculate PPV

PPV = true positives / all positives = 9/12 = 0.75

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Diagnostic studies frequently use a receiver operating characteristic curve. What do the two axes of the curve represent?

True positive rate (y) and false positive rate (x)

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What is given by the formula (1 – sensitivity) / (specificity) ?

Negative likihood ratio

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an objective of a Phase 3 Clinical trial?

compare drug to others

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an objective of a Phase 2 Clinical trial?

test effectiveness of drug

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Calculate maternal mortality

The number of women who die while pregnant or during the first 42 days following termination of the pregnancy per 100,000 maternities (UK = women giving birth at or after 24 weeks) from any cause related to or aggravated by pregnancy, but not from accidental or incidental causes.

Need to minus twins and multiples from number of births the calculate the number of women who delivered.

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The Kolmogorov Smirnov (K-S) test is

Used to compare a sample distribution to a reference distribution

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What do the bottom and top of the rectangle represent on the box-and-whisker plot?

First and third quartile

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Which cytokines are secreted by virally infected host cells and Stimulates uninfected neighbouring cells to synthesize antiviral proteins?

interferon gamma

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Product of bilirubin metabolism responsible for the brown colour of faeces

Stercobilin

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Movement of the bis-acromial diameter from the transverse to the antero-posterior diameter of the maternal pelvis

External rotation

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internal rotation is what movement

Occurs at the level of the ischial spines as a result of the combined effect of uterine contractions and the tone & shape of the pelvic floor.
Typically, the head rotates 45° from the occipito-transverse to the occipito-anterior position.
This brings the suboccipito-bregmatic diameter in line with the wider diameter of the pelvic outlet – the antero-posterior diameter

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The change in maternal cardiac out-put during labour

+ 40%

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The change in maternal cardiac out-put associated with breast feeding

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The presenting diameter in a brow presentation

13.5cm

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Suboccipito-bregmatic diameter

9.5cm

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Submento-bregmatic diameter

9.5 cm From the junction of the chin and neck (sub-mentum) to the centre of the bregma The presenting diameter in face presentation when the head is completely extended

Mento-vertical diameter

13.5 cm From the tip of the chin to the centre of the vertex The presenting diameter in brow presentation The mento-vertical diameter is longer than any diameter of the pelvis so a bow presentation cannot be delivered vaginally

Occipito-frontal diameter

11.5 cm Form the occipital protuberance to the root of the nose The presenting diameter in the occipito-posterior position This diameter is different from the diameter that presents in the occipito-anterior position because of the tendency of the head to be de-flexed in the occipito-posterior position

Renal excretion of which solute is decreased during normal pregnancy?

Sodium

The change in extracellular fluid volume by 24 weeks in normal pregnancy

+3L

Immediately following delivery, maternal cardiac output

Increases by 10 to 20%

The baby weighs 3500 g with delayed cord clamping. What is the neonatal blood volume?

450mL At the moment of birth the neonate has a blood volume of 78 ml/kg (about 280 ml for a 3.5 kg baby). When the cord-clamping was delayed for 5 minutes the blood volume increased by 61 % to 126 ml/kg. This placental transfusion amounted to 166 ml for a 3500 g infant, one-quarter of which occurred in the first 15 seconds, and one-half within 60 seconds of birth

Main hydrogen ion buffer found in urine

phosphate

What percentage of total body water is intracellular?

65% Intracellular fluid 40% of body weight Extracellular fluid 20% of body weight ECF comprises plasma and interstitial fluid Plasma volume typically around 3 litres (5% of body weight Total body water accounts for 60% of body weight. 40% of body weight is ICF 20% is ECF (with 4-5% plasma).

Cells in the proximal duodenum that secrete alkaline-rich mucus

Brunner cells

Protein absorption by the proximal convoluted tubule is by

Pinocytosis

Which molecules are typically secreted into the lumen of the proximal convoluted tubule?

bile salts, penicillin

In the coagulation cascade, factor VIII is produced by

endothelial cells

The transport of peptides across cell membranes by

secondary active transport

describes the Bohr effect?

Shift of the oxygen-haemoglobin dissociation curve to the right as CO2 concentration increases Hemoglobin's oxygen binding affinity is inversely related both to acidity and to the concentration of CO2 The Bohr effect refers to the shift in the oxygen dissociation curve (to the right) caused by changes (increase) in the concentration of CO2 or the pH (decrease) of the environment

Regarding Breech presentation, What is the Bi-trochanteric diameter?

10cm

Bi-acromial diameter between the acromial processes of the scapula

11cm

The most important anion in urine

chloride

Which clotting factors are remain unchanged in normal pregnancy?

Anti-thrombin III

What does oestrogen cause in. the myometrium in late pregnancy

Estrogen is a 'pro-labour' hormone and is responsible for stimulating the production of gap junctions between myometrial smooth muscle cells

In normal pregnancy at term what percentage of women will rupture membranes before onset of contractions

the fetal membranes will rupture in 10% of women before the onset of contractions

During normal labour at term, the cervix should dilate at a rate of at least

0.5cm/hour

This is the widest diameter of the maternal pelvic outlet, measuring on average 12.5 cm

Anteroposterior

During labour complicated by a deflexed occipito-posterior position, the presenting diameter, measuring on average 11.5 cm.what is this measurement called on fetal skull

Occipito-frontal

During vaginal examination in labour, palpation of the coronal, frontal and sagittal sutures allow identification of this structure

Anterior fontanelle

With a brow, the presenting diameter measures 13.5 cm.

Mento-vertical

During labour complicated by a face presentation, the presenting diameter measures on average are 9.5 cm.

Suboccipito-bregmatic

This term describes the measurement from the sacral promontory to under the border of the pubic symphysis:

Diagonal conjugate diameter of brim

This is the area bounded by the anterior and posterior fontanelles and the parietal eminences:

Vertex

Moulding is classified as following:

0 Bones are separated and the sutures can be felt easily. +1 Bones are just touching each other. +2 Bones are overlapping but can be separated easily with pressure by your finger. +3 Bones are overlapping but cannot be separated easily with pressure by your finger.

The uterus receives sympathetic nerve supply from

the hypogastric nerve. This causes contractions of uterine smooth muscle when acting via alpha adrenoreceptors and relaxation of uterine smooth muscle when acting via beta adrenoreceptors

what receptors inhibit contractions.

β adreno-receptors

Inflammatory mediators (e.g. interleukins) impact on contractions

Hide question 10 feedback Inflammatory mediators (e.g. interleukins) stimulate contractions.

a normal rate of dilatation is:

cervical dilatation of at least 2 cm in 4 hours for first labours cervical dilatation of at least 2 cm in 4 hours.

wcc of up to what can be normal post partum

White cell counts of up to 25 x 109/l are normal in the immediate postpartum period

most important mechanism for maintaining patent DA during pregnancy

prostaglandin E2 (and 1)

ovarian cancer risk brca 2

15%

hormonal markers of PCOS - LH - LH:FSH ratio - FSH - Testosterone, oestrogen, prolactin - SHBG

elevated LH LH:FSH 3:1 FSH low or normal T O P - normal or elevated SHBG - normal or low

MOA mefanamic acid

inhibits prostaglandin synthesis