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revision > 3rd deck > Flashcards

3rd deck Flashcards

1
Q

Consumption of a large protein meal causes what

A

Increased insulin secretion, Increased glucagon secretion

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2
Q

Is secreted by granulosa cells

A

Oestradiol

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3
Q

what does not function via a trans-membrane G-protein receptor?

A

Thyroxine (thyroid hormone receptor)

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4
Q

Maternal serum HCG levels at the time of the first missed period

A

100 IU/L

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5
Q

Human chorionic gonadotrophin is a

A

Is a glycoprotein

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6
Q

What is the main source for premenopausal oestrogen secretion?

A

granulosa cells

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7
Q

The cellular effects of cortisol are mediated by

A

DNA transcription

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8
Q

Aldosterone secretion is stimulated by

A

A fall in extracellular fluid volume

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9
Q

the metabolic effects of insulin.what enzyme activity is increased in the liver

A

The activity of glucokinase is increased

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10
Q

Which hormones have identical alpha sub-units?

A

TSH, LH and FSH

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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

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12
Q

Pendrin protein is essential for thyroid hormone synthesis and exchanges iodide for which ion?

A

Cl-

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13
Q

the ratio of T4 to T3 secreted by the thyroid gland is

A

13:1

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14
Q

Prostaglandins are degraded in

A

local tissues

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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

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16
Q

The % of circulating oestrogen that is bound to albumin

A

58%

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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

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18
Q

Leuteinizing hormone (LH) is structurally related to which other glycoprotein hormones?

A

HCG, FSH and TSH

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19
Q

Effects of calcitonin on phosphate excretion

A

increased phosphate excretion

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20
Q

What percentage tetra-iodothyronin (T4) is free?

A

0.03

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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

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22
Q

What is the most common cause of Cushings syndrome?

A

Iatrogenic corticosteroids

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23
Q

Which condition is diagnosed by the dexamethasone suppression test?

A

Cushings syndrome

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24
Q

test for addisons

A

ACTH

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25
Q

The progesterone receptor is an example of a

A

Nuclear receptor

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26
Q

Iodine accumulation in thyroid cells involves symport with

A

sodium

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27
Q

If fertilization is day 0, the vertebral column is completely formed by

A

27

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28
Q

what muscle Supports the upper third of the vagina

A

Levator ani muscle

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29
Q

The embryological origin of the dome of the bladder

A

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

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30
Q

embryological origin on trigone of bladder

A

trigone of the bladder is derived from the caudal end of mesonephric ducts, which is of mesodermal origin

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31
Q

the pericaridum is lined by what epithelium

A

Is lined by simple squamous epithelium

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32
Q

The insertion of the iliacus muscle

A

lesser trochanter

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33
Q

Blood supply to the superior-medial aspects of the parietal lobes of the brain

A

Anterior cerbral artery

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34
Q

The antero-posterior diameter of pelvic INLET in the female

A

12

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35
Q

In which anatomical space is the external uretheral sphincter located?

A

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

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36
Q
A
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37
Q

Which of the following is homologous to the female epoophoron?

A

epididymis

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38
Q

The course of the Piriformis muscle

A

Lateral mass of sacrum, greater sciatic foramen, greater trochanter

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39
Q

During the 4th week of development, germ cells are located in the

A

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

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40
Q

Lymphatic drainage of the distal part of the rectum

A

Internal iliac nodes

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41
Q

The narrowest segment of fallopian tube

A

isthmus

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42
Q

Which artery is most likely to be injured during sacro-spinous fixation?

A

Inferior gluteal artery

43
Q

The liver and biliary tree develop from the

A

Distal foregut endoderm

44
Q

The lower 1/3 of the vagina develops from

A

The urogenital sinus

45
Q

Post-ganglionic sympathetic fibres supplying the urinary bladder originate from

A

The inferior mesenteric ganglion

46
Q

Voluntary control of the external urethral sphincter is via

A

Alpha motor neurons

47
Q

Which structure can be used to reliably distinguish between direct and indirect inguinal hernias?

A

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
Q

the endocervix is lined by that epithelium

A

Is lined by columnar epithelium

49
Q

The level at which the ovarian artery arises from the abdominal aorta is

A

L2

50
Q

Meckels diverticulum is an adult remnant of the vitelline duct. Which of the following embryonic structures are joined by the vitelline duct?

A

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
Q

The ureteric bud is derived from which of the following embryonic structure

A

The mesonephric duct

52
Q

Spermatozoa acquire motility in the

A

Epididymis

53
Q

labetolol

A

COMPETITIVE B blocker

54
Q

Which anti-hypertensive drug is contraindicated in women with SLE?

A

Hydralazine

55
Q

what drug Blocks beta-1 receptors in the myocardium

A

labetolol

56
Q

A 34 year old woman is administered an intravenous bolus of oxytocin during caesarean section. Stimulation of uterine contractility would be maintained for

A

1 hour

57
Q

Drug associated with water intoxication

A

oxytocin

58
Q

Exposure to warfarin in-utero is associated with

A

diaphargmatic hernia

59
Q

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?

A

3 days

60
Q

Drug transport across cell membranes is due to

A

non ionisation

61
Q

Acidic drugs tend to

A

Higher protein binding

62
Q

The mechanism of action of doxazosin

A

Alpha 1 adrenergic antagonist

63
Q

Mechanism of action of hydralazine

A

Direct smooth muscle relaxant

64
Q

Coumarin drug antagonise which vitamin?

A

vit k

65
Q

Renal excretion of methotrexate is reduced by

A

aspirin

66
Q

Which drug is known to increase the haematological toxicity of methotrexate?

A

corticosteroids

67
Q

Which drug is associated with an increased risk of polycystic ovary syndrome?

A

sodium valporate

68
Q

The mechanism of action of atosiban

A

Competitive oxytocin antagonist

69
Q

mode of action of letrozole?

A

Aromatase inhibitor

Inhibits peripheral conversion of androgens to oestrogens

70
Q

Administration of letrozole to pre-menopausal women results in

A

Increased gonadotropin secretion

Non-steroidal inhibitors, such as anastrozole and letrozole inhibit the synthesis of oestrogen via reversible competition for the aromatase enzyme

71
Q

Which non-ergot dopamine agonist used to treat hyperprolactinemia?

A

Quinagolide

72
Q

Terbutaline has a preference for stimulation of which of the following receptors?

A

Beta-2 adrenergic

73
Q

She is treated for detrusor overactivity with Mirabegron. Which one is the single mechanism of action for this drug?

A

Beta-3 adrenergic agonist

74
Q

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?

A

Serotonin and noradrenaline re-uptake inhibitor

75
Q

Which of the following diseases are aggravated by use of oxybutynin?

A

Prostatic hypertrophy and congestive cardiac failure

76
Q

What is the mechanism of action of labetalol?

A

Non-selective beta blocker and selective alpha-1 blocker

Competitive beta and alpha-1 blocker

77
Q

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?

A

2 – 3 hour

78
Q

Which one of the above descriptions of placental abruption is correct?

A

Bleeding from a normally sited placenta

79
Q

When performing a pudendal block, the needle is inserted into the vaginal wall to a depth of

A

1cm

80
Q

How long does it take for a pudendal block to become effective for vaginal operative delivery?

A

5-10 min

81
Q

Carriers of the BRCA 1 or 2 mutation are at increased risk of

A

pancreatic cancer

82
Q

The most common chromosomal abnormality found in first trimester miscarriages

A

AUTOSOMAL TRISOMY

83
Q

On average, for how many days after the onset of symptoms, does the PCR test for SARS-CoV-2 infection remain positive?

A

17 days

84
Q

The levels of which inflammatory marker are raised in women with PCOS?

A

CRP

85
Q

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

A

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
Q

he most common symptom of Neisseria gonorrhoea infection in females

A

discharge

87
Q

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?

A

vulvovaginal

88
Q

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

A

10%

89
Q

kleinfelters endocrine panel

A

Low testosterone levels
High sex hormone binding globulin (SHBG) and raised gonadotrophins (FSH and LH

90
Q

Nerves effected klumpke palsy

A

C8 T1

91
Q

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

A

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
Q

Fetal exposure to radiation during V/Q scan

A

0.1 mgrey

93
Q

During major postpartum haemorrhage, fibrinogen levels should be maintained above

A

2g/L

94
Q

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?

A

Oral acyclovir and refer to fetal medicine

95
Q

Following Ectopic pregnancy a woman is treated with single dose regimen of methotrexate. Serum HCG levels should be measured

A

day 4 and 7

96
Q

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?

A

44%

97
Q

Which one is not typically associated with ovarian theca-lutein cysts?

A

BMI <17q

98
Q

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)?

A

150

RMI = U × M × CA125.

m= 1 pre menopausal, 3 post menopausal
u = concerning features

99
Q

Question 44 Which of the following is typically used to screen for anxiety disorders during pregnancy?

A

GAD 2

100
Q

site of ectopic

A

Commonest site is the fallopian tube – ampulla (55%), isthmus (25%), fimbrial end (17%) and cornua (2%)
Ovarian – 0.5%
Intra-abdominal – 0.1%

101
Q

The incubation period of measles

A

10-14

102
Q

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?

A

7 days

103
Q

The life-time risk of ovarian cancer in women with mutations in the DNA mismatch repair genes

A

10-12%

104
Q

Trans-cervical chorionic villus sampling is associated with an excess rate of miscarriage of

A

3%

revision (14 decks)

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