Difficult MCQs Flashcards
Infection with genital herpes
Has seen a large increase in YA between 2005 and 2006.
Is not self-limiting, or preventible by vaccination.
Is a co-factor for HIV infection and is infectious even when asymptomatic
HFEA (2008)
Makes it possible for gay couples to obtain a parental order following a surrogate birth.
Bans sex selection.
Removed requirement for a father.
Dominant hormone in proliferative stage of endometrium
oestrogen
Placental 11-hydroxysteroid dehydrogenase type 2
converts cortisol to cortisone
Seminal fluid pH
alkaline to buffer acidity of female genital tract
Progesterone feedback
hypothalamus; reduces GnRH pulse frequency. Pituitary; reduces prolactin production.
Chromosomal abnormalities in spontaneously aborted fetuses are predominantly …
Trisomies.
Oestrogen
Low oestrogen levels inhibit GnRH release, high oestrogen levels stimulate GnRH release, sertoli cells release inhibin in response to FSH, LH increases androgen synthesis in the ovary
fluid in the fetal lung
about 30 ml/kg of body weight
A patient in a persistent veg. state can have feeding withdrawn if…
There is a clearly established indication that the patient previously wanted feeding withdrawal in such circumstances.
Valid consent requires
The consent to be voluntary, competent and informed.
Between the ages of 11 and 16 a child can consent…
If they can adequately understand, retain and weigh information given.
NICE determines
Which treatments are effective and good value.
If a mistake is made at a fertility clinic and a woman’s egg is fertilised with sperm of
someone other than the partner mentioned on her consent form then:
The child is legally her partner’s because they were treated together.
Amends the law regarding abortion.
Who can be put on the police DNA database?
All those suspected of commiting a serious crime.
DNA paternity testing…
Can be bought on the web.
All births in England and Wales have to be registered within
42 days.
Aging population in the West is mostly due to …
A declining birth rate.
Social inequalities in risk of premature death were greatest…
At the start of the 21st century. Mostly due to CVD.
Offences against the person act, 1861
Illegal to procure own miscarriage.
Utilitarianism is associated with…
Peter Singer, Jeremy Bentham, Henry Sedgwick, John Stuart Mill
In calculating life expectancy for a national population of interest:
A hypothetical birth cohort is created and exposed to the age specific mortality risks
of the population of interest
Pre-eclampsia
Increased risk if over 40, associated with proteinurea. Develops in 20th week normally.
The morning after pill
Not legally distinct from other contraception. Does not count as abortion (doesn’t need to satisfy abortion act conditions). Can be dispensed by pharmacists?
Female gametes remain arrested in…
prophase of first meiosis; dictyate stage of diplotene.
Spermatozoa in seminal fluid
50-150 million per ml
seminal fluid production controlled by…
symp nervous system.
Progesterone only pill acts mainly by preventing
sperm penetration
Hofbauer cells
Macrophages in placenta.
Feedback loop from cortisol to hypothalamus
Indirect, long.
Amniocentesis; risk of miscarriage.
associated with 1% chance of miscarriage
TSH signalling pathway
Binds GPCR, release of Ga(s), increase in cAMP, activation of PKA, activation of CREB, increased transcription of proteins.
Mechanism of thyroid hormone production.
Iodine trapping, iodination of tyrosine residues, endocytosis of thyroglobulin, degradation to aa, DIT, MIT and thyroid hormones.
Control of thyroid hormone production by TSH
Increases transcription of proteins for…
Sodium iodine cotransporter, thyroperoxidase (iodination), formation of pseudopodia
Control of thyroid hormone production
TRH –> TSH –> thyroid hormones. Negative feedback of thyroid hormones on production.
T4 effect
deiodinated to T3 in peripheral tissues. Binds thyroid hormone receptor in cells. Binds thyroid response elements –> activation or suppression.
Effects of thyroid hormones
Skeletal system, CNS, ANS, cardio, metabolic
Maturation effects of thyroid hormones
Perinatal development of CNS (hypo –> irreversible mental retardation), activity of CNS (slowed speech, lack of energy, hyper excitability, emotional instability etc)
Stimulates skeletal growth (hypo –> retardation of growth)
ANS effects of thyroid
Upregulation of B receptors in heart; tachycardia and increased CO in hyper.
CVS effects of thyroid
Upregulates SERCA and ryanodine receptors; change in CO and TPR.
Metabolic effects of thyroid
Activity of Na+/K+ ATPase, O2 consumption, thermogenesis via uncoupling, carb metabolism and lipogenesis.
Uptake of HIV testing in antenatal clinics
95%
RIA ELISA
Immobilised antibody; competitive binding of patient sample and of radioactive antigen.
Sperm or egg donors can withdraw consent
At any time until embryo implantation
Is there a need for supportive parenting in IVF?
Yes, the clinic must consider it.
What percentage of HIV diagnoses are late stage?
50%
Thyroid hormone thermogenesis
Involves uncoupling proteins UCP1 and 3.
Can be central or peripheral.
Involves AMPK inhibition to increase symp stimulation to brown fat.
Is impaired by deiodinator inhibitors.
