3rd deck Flashcards
1
Q
Consumption of a large protein meal causes what
A
Increased insulin secretion, Increased glucagon secretion
2
Q
Is secreted by granulosa cells
A
Oestradiol
3
Q
what does not function via a trans-membrane G-protein receptor?
A
Thyroxine (thyroid hormone receptor)
4
Q
Maternal serum HCG levels at the time of the first missed period
A
100 IU/L
5
Q
Human chorionic gonadotrophin is a
A
Is a glycoprotein
6
Q
What is the main source for premenopausal oestrogen secretion?
A
granulosa cells
7
Q
The cellular effects of cortisol are mediated by
A
DNA transcription
8
Q
Aldosterone secretion is stimulated by
A
A fall in extracellular fluid volume
9
Q
the metabolic effects of insulin.what enzyme activity is increased in the liver
A
The activity of glucokinase is increased
10
Q
Which hormones have identical alpha sub-units?
A
TSH, LH and FSH
11
Q
Thyrotropin releasing hormone is produced as a polypeptide precursor. How many molecules of TRH are produced from one molecule of the precursor?
A
6
12
Q
Pendrin protein is essential for thyroid hormone synthesis and exchanges iodide for which ion?
A
Cl-
13
Q
the ratio of T4 to T3 secreted by the thyroid gland is
A
13:1
14
Q
Prostaglandins are degraded in
A
local tissues
15
Q
Blood gas analysis in primary aldosteronism (Conns syndrome) typically show
A
Metabolic alkalosis
Spontaneous hypokalemia, especially if the patient is also hypertensive
Severe hypokalemia in the setting of low to moderate doses of potassium-wasting diuretics
Treatment-resistant hypertension
Hypertension
Weakness
Abdominal distention
Ileus from hypokalemia
16
Q
The % of circulating oestrogen that is bound to albumin
A
58%
17
Q
Serum electrolyte abnormalities in primary hyperparathyroidism include
A
Increased calcium, decreased phosphate
Characterized by the quartet stones, bones, groans, and psychiatric overtones referring to the presence of kidney stones, hypercalcemia, constipation and peptic ulcers, as well as depression
18
Q
Leuteinizing hormone (LH) is structurally related to which other glycoprotein hormones?
A
HCG, FSH and TSH
19
Q
Effects of calcitonin on phosphate excretion
A
increased phosphate excretion
20
Q
What percentage tetra-iodothyronin (T4) is free?
A
0.03
21
Q
Plasma concentration of estrogen increases throughout pregnancy. By 40 weeks, the concentration of estriol increased relative to estradiol by how many times?
A
15
22
Q
What is the most common cause of Cushings syndrome?
A
Iatrogenic corticosteroids
23
Q
Which condition is diagnosed by the dexamethasone suppression test?
A
Cushings syndrome
24
Q
test for addisons
A
ACTH
25
The progesterone receptor is an example of a
Nuclear receptor
26
Iodine accumulation in thyroid cells involves symport with
sodium
27
If fertilization is day 0, the vertebral column is completely formed by
27
28
what muscle Supports the upper third of the vagina
Levator ani muscle
29
The embryological origin of the dome of the bladder
yolk sac. (urogenital sinus)
As the bladder develops from the urogenital sinus, it absorbs the caudal parts of the mesonephric ducts (also known as the Wolffian ducts), becoming the trigone of the bladder
30
embryological origin on trigone of bladder
trigone of the bladder is derived from the caudal end of mesonephric ducts, which is of mesodermal origin
31
the pericaridum is lined by what epithelium
Is lined by simple squamous epithelium
32
The insertion of the iliacus muscle
lesser trochanter
33
Blood supply to the superior-medial aspects of the parietal lobes of the brain
Anterior cerbral artery
34
The antero-posterior diameter of pelvic INLET in the female
12
35
In which anatomical space is the external uretheral sphincter located?
Deep perineal pouch
contents
1) The sphincter urethrae and the deep transverse perineal muscle
2) Part of the vagina
3) Part of the urethra
4) Internal pudendal vessels
5) Dorsal nerve of the clitoris
36
37
Which of the following is homologous to the female epoophoron?
epididymis
38
The course of the Piriformis muscle
Lateral mass of sacrum, greater sciatic foramen, greater trochanter
39
During the 4th week of development, germ cells are located in the
yolk sac
The gonads do not develop male / female differentiation until the end of the 6th week
Primordial germ cells develop from the yolk sac endoderm and migrate via the dorsal mesentery of the hindgut to reach the gonadal ridge in the 6th week
40
Lymphatic drainage of the distal part of the rectum
Internal iliac nodes
41
The narrowest segment of fallopian tube
isthmus
42
Which artery is most likely to be injured during sacro-spinous fixation?
Inferior gluteal artery
43
The liver and biliary tree develop from the
Distal foregut endoderm
44
The lower 1/3 of the vagina develops from
The urogenital sinus
45
Post-ganglionic sympathetic fibres supplying the urinary bladder originate from
The inferior mesenteric ganglion
46
Voluntary control of the external urethral sphincter is via
Alpha motor neurons
47
Which structure can be used to reliably distinguish between direct and indirect inguinal hernias?
two types of inguinal hernia can only be reliably differentiated at the time of surgery by identifying the inferior epigastric vessels – indirect hernias will be lateral to the vessels whilst direct hernias will be medial to the vessels
48
the endocervix is lined by that epithelium
Is lined by columnar epithelium
49
The level at which the ovarian artery arises from the abdominal aorta is
L2
50
Meckels diverticulum is an adult remnant of the vitelline duct. Which of the following embryonic structures are joined by the vitelline duct?
The apex of the intestinal loop remains in open connection with the yolk sac through the vitelline duct, remnants of which form the Meckel's diverticulum
51
The ureteric bud is derived from which of the following embryonic structure
The mesonephric duct
52
Spermatozoa acquire motility in the
Epididymis
53
labetolol
COMPETITIVE B blocker
54
Which anti-hypertensive drug is contraindicated in women with SLE?
Hydralazine
55
what drug Blocks beta-1 receptors in the myocardium
labetolol
56
A 34 year old woman is administered an intravenous bolus of oxytocin during caesarean section. Stimulation of uterine contractility would be maintained for
1 hour
57
Drug associated with water intoxication
oxytocin
58
Exposure to warfarin in-utero is associated with
diaphargmatic hernia
59
A 68 year old woman is on the waiting list for vaginal hysterectomy because of prolapse symptoms. She attends the pre-operative clinic 1 week before planned surgery. It is noted that she is treated with apixaban. How would you advise her regarding apixaban therapy?
3 days
60
Drug transport across cell membranes is due to
non ionisation
61
Acidic drugs tend to
Higher protein binding
62
The mechanism of action of doxazosin
Alpha 1 adrenergic antagonist
63
Mechanism of action of hydralazine
Direct smooth muscle relaxant
64
Coumarin drug antagonise which vitamin?
vit k
65
Renal excretion of methotrexate is reduced by
aspirin
66
Which drug is known to increase the haematological toxicity of methotrexate?
corticosteroids
67
Which drug is associated with an increased risk of polycystic ovary syndrome?
sodium valporate
68
The mechanism of action of atosiban
Competitive oxytocin antagonist
69
mode of action of letrozole?
Aromatase inhibitor
Inhibits peripheral conversion of androgens to oestrogens
70
Administration of letrozole to pre-menopausal women results in
Increased gonadotropin secretion
Non-steroidal inhibitors, such as anastrozole and letrozole inhibit the synthesis of oestrogen via reversible competition for the aromatase enzyme
71
Which non-ergot dopamine agonist used to treat hyperprolactinemia?
Quinagolide
72
Terbutaline has a preference for stimulation of which of the following receptors?
Beta-2 adrenergic
73
She is treated for detrusor overactivity with Mirabegron. Which one is the single mechanism of action for this drug?
Beta-3 adrenergic agonist
74
A 42-year-old mother of 3 children complains of urinary leakage on coughing and straining. Her symptoms have not improved with pelvic floor physiotherapy and she is listed for surgery. In the meantime, she is treated with duloxetine. Which one is the single mechanism of action for this drug?
Serotonin and noradrenaline re-uptake inhibitor
75
Which of the following diseases are aggravated by use of oxybutynin?
Prostatic hypertrophy and congestive cardiac failure
76
What is the mechanism of action of labetalol?
Non-selective beta blocker and selective alpha-1 blocker
Competitive beta and alpha-1 blocker
77
A 62 year old woman is due to be admitted for laparotomy because of an ovarian mass. She has a history of atrial fibrillation and is treated with dabigatran. Her renal function is normal. Dabigatran is re-started after surgery. How many hours after administration is the peak effect of dabigatran achieved?
2 – 3 hour
78
Which one of the above descriptions of placental abruption is correct?
Bleeding from a normally sited placenta
79
When performing a pudendal block, the needle is inserted into the vaginal wall to a depth of
1cm
80
How long does it take for a pudendal block to become effective for vaginal operative delivery?
5-10 min
81
Carriers of the BRCA 1 or 2 mutation are at increased risk of
pancreatic cancer
82
The most common chromosomal abnormality found in first trimester miscarriages
AUTOSOMAL TRISOMY
83
On average, for how many days after the onset of symptoms, does the PCR test for SARS-CoV-2 infection remain positive?
17 days
84
The levels of which inflammatory marker are raised in women with PCOS?
CRP
85
A 24 year old woman with gestational thrombocytopaenia attends the antenatal clinic at 37 weeks gestation. She will like to know the platelet count above which it would be safe for her to have a caesarean section
50
A count should be performed 6 weeks postnatally
Anaesthetic review if moderate or severe thrombocytopenia to discuss analgesic options, since most units will not consider epidural anaesthesia with platelet counts below 80
Platelet count of at least 50 is safe for vaginal or operative delivery
Platelet count of at least 80 needed for regional anaesthesia
86
he most common symptom of Neisseria gonorrhoea infection in females
discharge
87
A 23 year old woman presents with a 5 days history of lower abdominal pain, increased greenish vaginal discharge and inter-menstrual bleeding. Which one is the most appropriate specimen to test for gonorrhoea using nucleic acid amplification tests?
vulvovaginal
88
healthy 32 year old woman is found to have an anterior low-lying placenta at the 20 weeks scan. What is the probability that the placenta will no longer be low-lying by term
10%
89
kleinfelters endocrine panel
Low testosterone levels
High sex hormone binding globulin (SHBG) and raised gonadotrophins (FSH and LH
90
Nerves effected klumpke palsy
C8 T1
91
A healthy 23 year old woman developed pre-eclampsia in her first pregnancy. She attends the antenatal clinic at 10 weeks of gestation. What is her risk of developing hypertensive disease in this pregnancy
1 in 6
If birth was at 28–34 weeks 1 in 3
If birth was at 34–37 weeks 1 in 4
\
Any hypertension in preggo = pre eclampsia risk 1/7
92
Fetal exposure to radiation during V/Q scan
0.1 mgrey
93
During major postpartum haemorrhage, fibrinogen levels should be maintained above
2g/L
94
A 26-year-old woman who is work in a nursery school attends the GP surgery as she noticed vesicular rash on her back and abdomen. She is 25 weeks pregnant. Her GP confirms the diagnosis of chickenpox. What is the most appropriate action?
Oral acyclovir and refer to fetal medicine
95
Following Ectopic pregnancy a woman is treated with single dose regimen of methotrexate. Serum HCG levels should be measured
day 4 and 7
96
Following a water birth, a woman elects not to have oxytocics for the management of the third stage of labour. Thirty minutes later, she is brought to the consultant unit with a postpartum haemorrhage owing to an atonic uterus. She is treated with oxytocin, ergometrin and prostaglandins. If she had received standard oxytocic management for the third stage of labour, by what amount would she have reduced her risk of requiring therapeutic oxytocic drugs?
44%
97
Which one is not typically associated with ovarian theca-lutein cysts?
BMI <17q
98
A 70-year-old post-menopausal woman had an ultrasound because she was feeling bloated. This showed a 7 cm unilocular right sided ovarian cyst with no solid areas and no ascites. There are no other abnormalities. Her CA-125 is 50 U/ml. What is her risk of malignancy index score (RMI)?
150
RMI = U × M × CA125.
m= 1 pre menopausal, 3 post menopausal
u = concerning features
99
Question 44 Which of the following is typically used to screen for anxiety disorders during pregnancy?
GAD 2
100
site of ectopic
Commonest site is the fallopian tube – ampulla (55%), isthmus (25%), fimbrial end (17%) and cornua (2%)
Ovarian – 0.5%
Intra-abdominal – 0.1%
101
The incubation period of measles
10-14
102
A 23 year old woman with an itchy vaginal discharge is found to have trichomonas vaginalis. Treatment has been commenced with contact tracing. For how long should she abstain from sexual intercourse?
7 days
103
The life-time risk of ovarian cancer in women with mutations in the DNA mismatch repair genes
10-12%
104
Trans-cervical chorionic villus sampling is associated with an excess rate of miscarriage of
3%
