Exam Flashcards
Pudendal nerve
- Motor supply to: EAS + EUS in females + ischiocavernosus/bulbospongiosus/levator ani
- Sensory supply to anal canal below pectinate line (bottom 1/3)
- Sensory supply to perianal skin/labia minora, vestibule, posterior aspect labia majora.
Hormonal effects of prostaglandin
Paracrine
Origin of appendicular artery
Ileocolic artery
Estrogen produced in pre-menopausal/reproductive women
Estradiol (E2)
Estrogen produced in menopausal years
Estrone (E1)
Estrogen produced during pregnancy
Estriol (E3)
Type of atom released during MRI to generate image
Hydrogen
Risk of neonatal congenital CMV infection if mother contacts in pregnancy (2nd trimester)
30-40% in first/second trimester and 40-70% in third trimester. Affects 0.2-2.2% of all live births.
Step infection toxin type
Enterotoxin
Commonest fallopian tube malignancy
Serous (Papillary serous cystadenocarcinoma)
Adenocarcinoma if serous not option
Commonest feature of warfarin embryopathy
Nasal hypoplasia
Max score PUQE (Pregnancy Unique Quantification of Emesis)
Max score = 15
<=6 = mild
7-12 = moderate
13-15 = severe
Lung volumes decreased in pregnancy
Functional residual capacity by 20%
Total lung capacity by 5%
Expiratory reserve volume by 20%
PCO2 decreases
Lung volumes increased in pregnancy
Tidal volume by 50%
Minute ventilation by 50% during first trimester
PO2 increases
Oxygen consumption by 20%
Primary amenorrhea, normal secondary sexual characteristics, normal LH/FSH/E2/TSH, absent uterus and blind-ended vagina.
Karotype 46XX
MRKH syndrome (Müllerian agenesis)
LH half life
20 mins
Additional risk of miscarriage with amniocentesis
1%
Commonest tumor in newborn
Sacrococcygeal teratoma
2nd = neuroblastoma
Lithium associated with which anomalies:
Overriding right atrioventricular valve
Right ventricular obstruction outlet
Ebstein anomaly (The tricuspid valve is incorrectly formed and located lower than usual in the heart)
Ratio of T4:T3 in blood
14:1
Plasmodium species causing heaviest malaria burden
Falciparum
Frequency used in transvaginal ultrasound scans
5-10mHz (in TA 2-6 MHZ)
Often quoted as 7.5 mHz
Percentage of free T3 in circulation
1%
Chancroid causative agent
Haemophilus ducreyi
If one parent is a carrier for cystic fibrosis + other parent is unknown, what is the risk of child developing cystic fibrosis?
1%
Mode of inheritance for BRCA 1 & 2
Autosomal dominant
Psamomma bodies contain which ion?
Calcium
Origin of the appendix testis
Paramesonephric duct (Mullerian duct)
Where is the Ductus Arteriosus located?
Between pulmonary artery & aorta
How does clindamycin work?
inhibiting bacterial protein synthesis at the level of the 50S ribosome
How does Metronidazole work?
Binds covalently with DNA
Damage DNA and inhibit DNA synthesis
What is the recurrence rate of ectopic in a history of salpingectomy?
15-20%
What is the test for hemolytic anaemia in babies?
Direct coombs test
Which vitamin deficiency can cause homocysteine increase?
Folic acid or Vitamin B12
Most common benign ovarian tumor
Mature teratoma
Phase before mitosis
G2
RNA analysis is by
Northern blot
Heat stable enzyme used in PCR
Taq DNA polymeras
Largest cell in the body
Oocyte
BMI calculation
Weight (kg) / Height (m2)
Epidural anaesthesia given between which layers
Dura mater & vertebrae
Which enzyme in renal tubule cells is responsible for production of ammonia?
Glutamines
Brenner tumor consists of which kind of cell
Transitional + Squamous
Which layers do the sperm pass through during fertilization?
The sperm first burrow through the cells of the corona radiata. Then, upon contact with the zona pellucida, the sperm bind to receptors in the zona pellucida (acrosome reaction)
The urethral orifice is present in which space?
Superficial perineal pouch
What does methotrexate inhibit?
Dihydrofolate reductase
At term, fetus gets cholesterol from which source?
Fetal liver
which subtype of lichen planus causes the most symptoms?
Erosive
Chances of endometrial cancer with Lynch syndrome (HNPCC)?
60%
Vulval lesion on biopsy shows keratin pearls. What is likely diagnosis?
Squamous cell carcinoma
Most effective emergency contraception?
Copper IUD
During development of liver and biliary system, hepatic bud invaginates into which structure?
Septum transversum
Lung cancer + lethargy, fatigue and polyuria + depression. Most likely disturbance?
Hypercalcaemia
What vitamin supplement is given during hyperemesis/vomiting in pregnancy?
Vitamin B1 (thiamin)
Important cell of adaptive immunity
Lymphocytes
TSH mildly high but thyroid hormones normal, is which diagnosis?
Subclinical hypothyroidism
Previous pregnancy IGG negative for CMV. Now CMV IGG +ve, cytotoxic IGG value given, IGM -ve. What is the interpretation?
Previously infected, primary and secondary infection status can be assessed.
- Positive CMV IgG results indicate past or recent CMV infection.
- A negative cytomegalovirus (CMV) IgM result suggests that the patient is not experiencing acute or active infection. However, a negative result does not rule-out primary CMV infection.
NAAT (RNA) report for chlamydia takes how long?
21 days
Number of carbon atoms in estrogen, progesterone, aldosterone, cortisol and androgen?
18 21 21 21 19
Fluid filled area or black area on ultrasound scan
Anechoic
2,3 DPG in pregnancy, what happens to O2 dissociation curve?
Increase in 2,3 DPG shifts curve to the right
which organ will be affected by ACE inhibitors?
Kidney
Warfarin teratogenicity develops at which gestational age?
6-9 weeks
What is the level of dermatome for epidural at umbilical region?
T10
What ligament resists horizontal rotation of the pelvis?
Sacrospinous ligament
Cervical screening guidelines:
HR - HPV test
- if negative, routine recall 25-49 3 years + > 50 5 years (25-64)
- if positive –> cytology abornal at all, then for colposcopy.
- If positive –> cytology normal, then re-screen in 12 months. If HPV negaive, then routine recall. If HPV positive + cytology normaly, re-screen in 12 months. If third HPV positive + cytology normal, then return to routine re-call.
- Test for cure 6 months after treatment for any CIN.
- Women with high-grade dyskaryosis or worse are referred straight to colposcopy i.e without HR-HPV test
- For those with negative, borderline change (of squamous or endocervical type), or low-grade dyskaryosis a HR-HPV test is performed.
If HR HPV Negative test then 3 year recall
If HR HPV Positive referred back to colposcopy
Natural killer cells belong to?
Lymphocytes
Levonorgestrel IUS secretion in 24 hours?
20 ug
What is the term used for anti-cancer agent methotrexate?
Anti-metabolite
Hematopoietic function starts at which gestational age?
6 weeks
Cell lysis is by which complement?
C5
What is the risk of fetal loss for women who get parvovirus in first trimester?
10%
In girls, puberty is indicated by?
Thelarchae
Normal physiological changes in pregnancy?
Increase plasma volume
Decrease hematocrit
Decrease plasma protein
Increase in blood volume
Major contribution to amniotic fluid by fetal urine from?
18 weeks
Prostaglandins are synthesized from?
Unsaturated fatty acids
Which structure divides the paramedical and para-rectal pouches?
Uterine artery
Which anti-hypertensive should be avoided in pre-eclampsia and asthma?
Nifedipine
Which most accurately describes the mode of action of Letrozole?
Aromatase inhibitor
IUD in place with discharge
Don’t remove IUD, take vaginal swab and treat
Epithelium of fallopian tube
Columnar epithelium - ciliated
Hirshprung disease etiology
Abnormality in parasympathetic ganglia
Nature of heparin
Polysaccharide
Typical effective dose for CT chest
7mSv
The placenta is the lower anterior in
which it invades through the myometrium up to the uterine serosa’.
Placenta percreta
Placenta attachment definitions:
Accreta: chorionic villi attached to myometrium rather than decidua basalis
Increta: chorionic villi invade into the myometrium.
Percreta: chorionic villi invade through the myometrium
CT scan which shows
multiple circumscribed masses in the myometrium. Hysterectomy is performed and
histopathological examination shows spindles shaped cells in whorled bundles and the
mitotic figures are scarce. The most likely diagnosis is?
Leiomyoma
An 18-year-old woman has had pelvic discomfort for several months. On pelvic
examination, there is a right adnexal mass. Ultrasound picture of the right ovary shows cystic
lesion measuring 3.3x 2.5 cm with echogenic septae. What is the most likely finding?
Benign teratoma
What type of acid–base disturbance results in a case of Conn’s syndrome?
Metabolic alkalosis
Where does vulval cancer more commonly arise?
Labia majora
What percentage of T4 is free?
0.1%
Standard CXR is equivalent to what duration of natural radiation?
10 days
Which of the following drugs is used to suppress lactation postpartum in mothers who
suffers from stillbirth?
Cabergoline
The non-invasive, cell-free fetal DNA in maternal blood of prenatal diagnosis would best
be used on
Chorionic cells
What is used to calculate RMI score?
ultrasound score x ca-125 x menopause score
50 years old women with absent periods for 2years, has bilateral ovarian mass with
solid areas on scan and CA 125 of 100. What is her RMI score?
900
Which drug trial phase primarily assesses the safety of a drug?
Phase 1
Zika virus is
Ss RNA
Which substance is indicated by the letter ‘X’ in the diagram below?
Dihydrotestosterone
Endometriod - USS picture and laparoscopic picture
Jan 2023 exam
Pedunculated fibroid
USS picture
Which gene is defect in 21 hydroxylase deficiency
Gene mutation 6p 21
Vulvar ca 3a latest figo calcification 2021
<=5mm
Metaplasia definition
replacement of one differentiated somatic cell type with another differentiated somatic cell type in the same tissue (epithelial cells changes into other epithelial cells)
Dysplasia
Pleomorphism
Phenylketonuria - where does it deposit in fetus?
Brain
GBS positive with a UTI?
Treat UTI and given intra-partum antibiotics
Congenital abnormalities and with their rate - Edward, Turner and Translocation
Edwards = 1/10,000
Turner = 1/3000
Translocation = 1/500
How much folic acid should a mother have if her previous baby had anencephaly?
Folic acid 5000 mcg
Down syndrome biochemical markers?
Increased B-HCG and Inhibit, rest reduced
Most common vulval cancer
squamous cell carcinoma
Most common hyperthyroidism in pregnancy
Grave’s disease
MRI not suitable to use at which gestation?
10-12 weeks
Carbimazole embryopathy causes:
Choanal atresia
Cochrane risk of thromboembolic events:
2/100,000-6-12/100,000
Mechanism of action of raltegravir:
Integrase inhibitor
Mother has Galactorrhea. TSh 15 Fsh 20 lh 20. Cause?
Hypothyroidism
Pheochromocytoma signs and symptoms?
Headache, tachycardia and sweating
Obturator artery arises from
Internal iliac
Hyperaldosteronism with feminisation drug
Spiroletone
Granulosa cells produce:
Estrogen
Gonorrhoea image on Google
Granules!
Hyperemesis gravidarum, which is the best fluid?
0.9% sodium chloride
Rate of expulsion of IUD?
1/20
Risk of fibroid to change to malignancy?
1/1000
Pelvic splenic nerve is what kind?
Pre-ganglionic parasympathetic
What is obliterated in the uterine cavity prevent developing pregnancy?
decidua capsularis merges with the decidua parietalis
Anti-D doses
- Anti-D i not required for spontaneous miscarriage before 12 gestation, unless there is instrumentation or medical evacuation of the uterus.
- In pregnancies <12 weeks , anti-D prophylaxis is only indicated following ectopic pregnancy, molar pregnancy, therapeutic termination of pregnancy and in cases of uterine bleeding where this is repeated, heavy or associated with abdominal pain.
- <20 weeks gestation = 250 IU within 72 hours
- > 20 weeks gestation = 500 IU within 72 hours
Muscles of scrotum?
dartos muscle and the cremasteric muscle
Half life of FSH
3-4 hours
Opsonization achieved by which compound of complement system?
C3b
Obturator artery arises from?
Anterior division of internal iliac artery
Pellagra occurs in deficiency of which vitamin?
Niacin (Vitamin B3)
Left uterine vein drains into:
Left internal iliac
Inferior rectal vein drains into:
Internal pudendal vein
HPV vaccine is:
Recombinant/ Subunit Vaccine
subunit (polysaccharide)
Vaccines to be avoided in pregnancy?
Live vaccines
Artery which is ligated to reduce PPH in cases of morbid adherent placenta (accreta)?
Internal iliac artery
Site of glycolysis?
Cytosol
Site of urea cycle?
Liver
Marfan’s syndrome (mother affected, father not)?
50% - autosomal dominant
X-ray image with pointer at SI joint - what structure passes anterior to it?
Ureter
Image question: Ilacus muscle marked. What is nerve supply?
Femoral nerve
Obturator nerve root values?
L2, L3, L4
Lateral wall of ischiorectal fossa formed by:
Obturator internus
Nd-YAG, type of laser:
Solid laser
Power sensitivity: 90%. What is value of B?
Power = 1-B
0.9 = 1 - B
B = 1 - 0.9
B = 0.1 or 1/10
Type of necrosis in brain?
Colliquative (Liquefactive)
E-coli urine infection in pregnancy but no symptoms?
Nitrofurantoin for 7 days
Which antibiotic should be avoided at term?
Nitrofurantoin
What is the site for filtration in kidneys?
Glomerulus
SI unit of magnetic field?
Tesla
MRI acts by:
- Aligning protons
History of old inferior MI on ECG?
Q wave in lead 2, 3, and AVF
ECG changes in N pregnancy?
T wave inversion Lead 3
What is blood supply to kidney in non-pregnant woman?
20-25%
Increase in cardiac output in second stage of pregnancy?
50%
Antigen presenting cells in cervix?
Langerhans cells
Secretions attack pathogens by? conjunctival secretions protect from bacteria by secreting?
Lysozymes
Standard error of mean calculation:
SD/square root of N (sample size)
What is a Type 1 error?
- False positive
- occurs if an investigator rejects a null hypothesis that is actually true in the population
What is Type 2 error?
- False negative
- investigator fails to reject a null hypothesis that is actually false in the population.
What occurs at gastrulation?
Formation of 3 germ layers
Cytotrophoblast forms on which day?
Day 8
Carbon atoms in estrogen?
18
Carbon atoms in testosterone?
19
Incidence of rhesus negative population in UK?
15%
When does hemolytic disease of newborn occur?
When father is homozygous Rhesus positive + mother is rhesus negative
What is the basis of the Kleihauer-Betke test?
Fetal RBCs are resistant to denaturation by acid as compared to maternal RBCs (acid elution test)
Brunner’s glands are located in?
Duodenum
What is the unit for electrosurgery?
300 Hz - 5 MHz
Which nerve passes below the inguinal ligament and medial to ASIS?
Lateral femoral cutaneous nerve/lateral cutaneous nerve of thigh
Incidence of which cancer is increased with endometriosis?
Clear cell carcinoma
Most common clinical feature of uterine fibroids?
Heavy menstrual bleeding
A girl with dysmenorrhea - which treatment is not effective to treat dysmenorrhea?
- Progesterone from Day 21 to Day 28 of cycle.
Treatments that work:
NSAIDs
COCP Pills
GnRH analogues
Progesterone from Day 5 to Day 28 of cycle.
Retinol causes teratogenicity during pregnancy due to:
Hypervitaminosis of Vitamin A
IgG passes through the placenta via:
Pinocytosis
Amino acids transferred across the placenta by which method?
Active transport
What is the co-factor for DNA synthesis?
Folic Acid
How long do you continue LMWH for patients with hyperemesis gravid arum?
Until patient discharge
What is the treatment for patient with hyperemesis and ketonuria +++ who cannot tolerate oral fluids and feeds?
Anti-emetics + 0.9% saline
What drug is used for the treatment of herpes simplex?
Aciclovir
zidovudine belongs to which class of drug?
Nucleotide reverse transcriptase inhibitor
Sexually active girl presents with dome shaped ulcers on her vulva and thighs. Likely diagnosis?
Molluscum contagiosum
Patient at booking visit tested for rubella antibodies. IgM -ve + IgG -ve. What is the next step?
Give her MMR vaccine after delivery.
Acute hemolytic reaction following blood transfusion occurs because of;
ABO incompatibility
Progesterone receptors are?
Nuclear transcription factor
Lacunae develops into which layer?
syncytiotrophoblast
What is the karyotype of complete mole?
46XX
What is the karotype of Turner’s syndrome?
45XO
Karotype of male Edward syndrome?
47XY (also written as 47,XY,+18)
What are the features of Turner’s Syndrome?
Short stature
Neck webbing
Decreased fertility
Dalteparin monitored using which test?
Anti-Xa levels
Additional features of Warfarin Embryopathy?
nasal hypoplasia
Slipped epiphysis
IUGR
What are the consequences of fetal anticonvulsant syndrome?
- Neural tube defects (spina bifida), particularly with sodium valproate & carbamazepine.
- Congenital heart defects, particularly with phenytoin.
- Orofacial clefts.
What is not associated: hyperplasia of corpus collosum.
What epithelium lines the endosalpinx?
Simple columnar
Methotrexate acts in what way?
Reversible DHFR inhibitor
Arias-Stella phenomenon occurs where?
Endometrium - benign change in the endometrium associated with the presence of chorionic tissue.
What change in the endometrium poses a high risk for endometrial carcinoma?
Atypical hyperplasia
What test denotes menopausal status?
FSH
What test is for ovarian reserve?
AMH
Drugs cross across the placenta via which method?
No-ionization
The size of the uterus in pregnancy increases due to?
Hypertrophy
Cystoscopy done for haematuria - papillary growth seen. What is the likely malignancy?
Transitional cell carcinoma
Sequence of events in wound healing
Hemostasis
Inflammation
Proliferation
Maturation
Remodelling
pneumocystis jirovecii pneumonia due to HIV. At what CD4 count is prophylaxis to be given?
CD4 < 200
What cells are affected by HIV?
CD4 + T-cells
Plasma cells originate from?
B lymphocytes
In which site are prostaglandins inhibited?
Lungs
Discoloration of teeth due to which antibiotic?
Tetracycline
Birth weight is which type of data?
Ratio variable
Patient complains of greenish discharge and cervix erythematous on examination. Cells under microscope show characteristic HALO around nucleus in shed cells. pH 6 What is the diagnosis?
Trichomonas Vaginalis
Patient has yellow discharge and gram negative cocci seen. Diagnosis?
N. Gonorrhoea
Fungal agent responsible for UTIs?
Candida
What drug causes kernicterus?
Sulfonamide
IUCD related infection with sulfur granules seen. Causative organism?
Actinomyces israelii
Mechanism of action of IUCD
Inhibits implantation/fertilization
Mechanism of action of Fluconazole?
Inhibits Lanosterol 14 alpha-demethylase enzyme and hence ergosterol synthesis.
interruption of the conversion of lanosterol to ergosterol via binding to fungal cytochrome P-450 and subsequent disruption of fungal membranes.
Patient develops rash and joint pain. USS shows fetal hydrops/fetal ascites. Likely diagnosis?
Parvovirus B19
Patient had infection during pregnancy, baby delivered normal. After 1 year, developed notching of incisors + deafness. Likely diagnosis?
Treponema pallidum
Patient comes in with heavy painless vaginal bleeding at 34 weeks pregnant. What should not be done immediately?
Vaginal examination PV
Sequence of vessels from left to right: aorta, pulmonary artery, SVC?
SVC, aorta, pulmonary artery
What is the screening test fr iron deficiency anaemia?
Hb
Patient presents with irregular periods + Normal FSH/TSH + raised Prolactin (1500) + low serum progesterone. Diagnosis?
Pituitary microadenoma
Patient post-op with output post-surgery 300 mld. mildly raised urea + creatinine. Diagnosis?
Dehydration
Most common cause of hyperthyroidism?
Grave’s disease
HPV 16 + 18 responsible for what percent of cervical cancers?
70%
Which HPV strains cause genital warts?
HPV strains 6 + 8 + 11
Patient presents at 8 weeks pregnant with hyperemesis. Decreased TSH + normal free T4. Diagnosis?
Normal fr 8 weeks pregnancy + repeat later
The anterior pituitary develops at:
6-7 weeks
What enzyme is used for androgen synthesis in ovary?
3β-Hydroxysteroid dehydrogenase
Most common degranulation in a fibroid?
Hyaline
What is the steroid synthesis pathway?
DHEA (Dehydroepiandrosterone)–> Androstenedione –> Testosterone
The vestibule is between?
Vagina + labia minora/ between two labia minora
Patient with amenorrhea + increased FSH/LH + TSH. Diagnosis?
Premature ovarian failure
Which is a second generation progesterone?
Levonorgestrel
Drospirenone has what special property compared to other synthetic progesterones?
Much higher antiandrogenic potency .
Surfactant synthesis in pneumocytes, due to which organelle?
lamellar bodies
Technique of bonding for conventional chromosomal analysis?
G-banding
GnRH chemical structure
decapeptide
Ondansetron acts as antagonist to which receptor?
5HT
What is the male equivalent of round ligament in females?
gubernaculum
The lower border (lower 2/3) of the vagina develops from:
Urogenital sinus
What is the source of fetal cholesterol in late pregnancy?
Fetal liver
Mutations in 21-hydroxylase (Congenital adrenal hyperplasia) involves which chromosome?
6p21
In Cushing’s disease, what happens to the level of ACTH, cortisol and growth hormone?
Low ACTH, high cortisol, low growth hormone
What is down-regulated in cases of recurrent pregnancy losses?
HLA-G
Detrusor muscle receptor type?
M3
Which muscle doesn’t attach to the perineal body?
Ischiocavernosus
The hepatic phase of hematopoiesis begins at what gestational age?
6 weeks
Atropine exerts its antagonist action on which receptors?
Acetylcholine
striae gravidarum in pregnancy occur due to which hormone?
Cortisol
The Kolmogorov–Smirnov is used for?
Non-parametric test used for indifferent data that is unrelated; compare two distributions to determine if they are pulling from the same underlying distribution
What is used for delivery of head at pelvic floor?
Outlet instrumental delivery
Complications associated with retroverted uterus in pregnancy:
Incarceration of the gravid uterus
What term is used for endometrium which is thin?
Atrophic
Hyperprolactinemia in PCOS occurs due to:
Unopposed oestrogen
During fertilization, sperm penetrates which layer?
Zona Pellucida
Caput medusa due to dilation of which embryonic structure?
Umbilical vein
Itching in pregnancy at 37 weeks affecting palm + sole + raised AST + bile acids. Diagnosis?
Obstetric cholestasis
UTI scenario: drug to be given at 8 weeks. Which to avoid in first trimester?
Trimethorpim
UTI scenario: patient given Cephalexin and not responded. Which drug to be given? 37 weeks pregnant.
Trimethoprim
What is the mechanism of action of oxytocin?
Activation of phospholipase C and increase in intracellular calcium
Most common cause of delayed puberty in males?
Constitutional
Pregnant patient at 18 weeks with HIV. Increased AST + low platelets + peripheral smear of fragmented RBCs. Diagnosis?
Thrombotic Thrombocytopenia Purpura
Which electrocautery system attaches to a ground plate?
Monopolar diathermy
HIV transmission to the baby from other is maximum during:
Delivery
what is the most common cause of secondary hyperparathyroidism?
Chronic renal failure
What releases calcitonin?
Thyroid
LDH is increased in which ovarian tumor?
Dysgerminoma
Condyloma lata seen in which stage of syphilis?
Secondary syphilis
1 = chancre
2 = condyloma lata
3 = gumma
What is the haldane effect on facilitating exchange at placenta?
Carbon dioxide transfer from the fetus to the mother is facilitated by the Haldane effect (the increased capacity of deoxygenated blood to carry carbon dioxide compared with oxygenated blood).
Previous delivery > 4kg baby. Now patient develops prolapse. Which ligament likely to be involved?
Uterosacral/cardinal ligaments
Atosiban is:
Oxytocin antagonist
The antibacterial action of BenzylPenicillin is due to its effect on?
Cell wall synthesis
Warfarin acts where in the clotting cascade?
Vitamin K antagonist
Grade B recommendation of RCOG means?
well controlled studies but non randomized
RCOG recommendations of evidence.
A = At least one randomized controlled trial
B = well controlled studies but non randomized
C = requires evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities.
What is the most common cause of the female urethral caruncle?
Hypoestrogenism
What type of variable is ABO Blood Group ?
Nominal
Which is a precursor of Serotonin?
Tryptophan
Wernicke-Korsakoff syndrome Deficiency disease of vitamin?
Vitamin B1
Incidence of “RARE” disease when translated into mathematics is?
1:1000- 1:10,000
Which protein is coiled in DNA?
Histones
A 65-year-old nulliparous women presents with vaginal spotting. A hysterectomy is
performed, and pathologic examination of the removed uterus reveals heterologous
components of a malignant tumor of the endometrial glands and metaplastic cartilage. Which
of the following is the most likely diagnosis?
Carcinosarcoma
Which is the single
mechanism of action for Mirabegron?
Selective Beta-3 antagonist
Side effect of Terbutaline:
Maternal tachycardia
In ECG which lead reflects the inferior wall of heart?
II, III, aVF
What is the embryological origin of Gartners duct cyst?
Mesonephric duct
What is the SI unit for the activity of radioactive decay?
Becquerel
What is the contrast dye used in MRI scans?
Gadolinium
Which hormone increases the excretion of calcium in Kidney?
Calcitonin
When Choriocarcinoma metastasizes, it has a predominantly spread by which route ?
Hematogenous
What drug can be given in methotrexate toxicity?
Folinic acid
40-year-old woman had bilateral silicone breast implants placed two years ago. Since that
time, she has noted increased firmness with slight deformity of the breast on the left. The
implants are removed, and there is evidence for leakage of the implant contents on the left.
Which of the following cell types is most likely to be most characteristic of the inflammatory
response in this situation?
Giant cells
Which of the following is contraindication of the use of oxybutynin?
Narrow angle glaucoma
A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother was
treated with diethylstilbestrol during the pregnancy is likely to be a:
Clear cell carcinoma of vagina
Active form of Vit-D is produced in which organ?
Kidney
Patau syndrome karotype:
Trisomy 13
Lancefield grouping of streptococci is based on the presence of ?
Carbohydrate antigen on cell wall
Antihypertensive which causes postnatal depression, when used in permpartum period?
Methyl dopa
Clomifene citrate mechanism of action ?
Selective estrogen receptor modulator
Which Antineoplastic drug causes hemorrhagic cystitis?
Cyclophosphamide
Luteinizing hormone (LH) is structurally related to what other glycoprotein hormones?
HCG, FSH and TSH
Mechanism of action of ulipristal acetate ?
Selective progesterone receptor modulator
Which one of the following is the termination of round ligament?
Labia majora
Ductus venosus is completely obliterated after birth to form what adult
structure?
Ligamentum venosum
A 60-year-old with erythematous erosive lichen planus on the vulva. What type of cancer is linked to lichen planus?
Squamous cell carcinoma
Which of the following organisms Colonize copper IUD?
Actinomyces species
Bacterial vaginosis is diagnosed with depletion in numbers of which
organism?
Lactobacillus
The most common in Utero infection causing fetal anemia in the UK is
Parvovirus B19
Sheehan syndrome affects?
Anterior pituitary
A 25-year-old woman presents with right-sided pelvic pain for more than one year. An
ultrasound scan is arranged which shows a 5 cm well-defined cystic lesion in the right adnexa
with mixed echoes. There is no fluid in the cul-de-sac
Benign cystic teratoma
Cori cycle
metabolic pathway in which lactate, produced by anaerobic glycolysis in muscles, is transported to the liver and converted to glucose, which then returns to the muscles and is cyclically metabolized back to lactate
BMI classes:
Healthy weight — BMI of 18.5-24.9 kg/m2.
Overweight — BMI of 25-29.9 kg/m2.
Obesity class 1 — BMI of 30-34.9 kg/m2.
Obesity class 2 — BMI of 35-39.9 kg/m2.
Obesity class 3 — BMI of 40 kg/m2 or more.
A 33-year-old woman is admitted with surgical wound infection after emergency
caesarean section for suspected fetal compromise. Culture of the wound demonstrates
methicillin-resistant Staphylococcus aureus (MRSA). She has no known allergies. Which is
the most appropriate treatment?
Clindamycin and vancomycin
APGAR Score:
Activity Absent (0) Flexed limbs (1) Active (2)
Pulse Absent (0) <100 (1) >100 (2)
Grimace Floppy (0) Minimal response to stimuli (1) Prompt response to stimuli (2)
Appearance Pale/blue (0) Pink body + blue extremities (1) Pink (2)
Respiration Absent (0) Slow and irregular (1) Vigorous Cry (2)
Max score = 10
What is affected in Horner syndrome?
Loss of Sympathetic supply
What is the most common cause of cushing’s syndrome?
Iatrogenic Steroid Administration
Glucocorticoids are secreted from which region of the adrenal gland?
Zona fasciculata
Which cells produce mullerian-inhibiting substance in fetal testis?
Sertoli cells
Which enzyme found in red blood cells which buffers blood CO2?
Carbonic anhydrase
Urogram interpretation:
Detrusor muscle overactivity
Calculation of maternal mortality ratio:
(Number of maternal deaths / Number of live births) X 100,000
Calculation of perinatal mortality:
number of stillbirths (from 22 weeks) + deaths in the first week of life per 1,000 total births
Calculation: (stillbirths + neonatal deaths) / (live births + still births)
A 67-year-old woman attends for a preoperative assessment. She has been taking
bendroflumethiazide for several years for hypertension. Her ECG shows:
Hypokalaemia
A Couple with primary subfertility , who have been trying to conceive for over 12 months
, attends a reproductive medicine clinic , the male partner has already give a semen sample
for analysis which return back showing : 32 million spermatozoa , morphology >5 , vitality
>5% , live spermatozoa 63% , PH 7.2 , What is the correct interpretation of this result ?
Normal semen analysis
Regarding Insulin, it gets activated by removing ?
C-peptide
What represent the 2 axis of ROC curve ?
Sensitivity Vs 1-Specificity
What hormone secreted by placenta leading to fetal diuresis ?
Vasopressinase.
A 55 year old presents to clinic due to vulval itch and discolouration. examination reveals
pale white discoloured areas to the vulva. A biopsy shows epidermal atrophy with
subepidermal hyalinization and deeper inflammatory infiltrate. What is this characteristic of?
Lichen Sclerosus
What is the Action of mRNA?
Transcription
From Which structure inhibin is produced ?
Granulosa cells
At what level ovarian artery arise?
L2
Which of the muscles leaves the lesser pelvis through the greater sciatic foramen?
Piriformis
To reduce postoperative pain after caesarean section, an obstetrician performs ilioinginaliliohypogastric
nerve block (IINB) on his 25-year-old patient. What is the nerve root of
ilioinguinal and iliohypogastric nerve?
L1
What is the anatomical location of Bartholin’s gland?
Superficial perineal pouch
What do the bottom and top represent on the box-and-whisker plot?
Lower and upper quartile
Which hormone prevent regression of corpus luteum?
HCG
A 14-year-old girl is treated with radiotherapy. Which of following tissues is most
radioresistant?
Cerebral nuerons
Which pattern of endometrium do simple endometrial hyperplasia most likely resemble?
Proliferative endometrium
Which class I major histocompatibility complex human leucocyte antigen (HLA) is
expressed only in extravillous trophoblast?
HLA-G
Botulinum toxin is now used to treat neurogenic bladder because of its ability to
Inhibit the release of acetylcholine
What is the embryonic origin of the trigone of urinary bladder?
Mesonephric duct
In the development of the oocyte, when does the second meiotic division occur?
When sperm penetrates the zone pellucida
A 28-year-old woman has undergone emergency hysterectomy due to obstetric
haemorrhage during her 3rd pregnancy. The previous pregnancies were both term C-section
deliveries. Examination of the uterus shows the placenta has not invaded the myometrium.
What is the most likely diagnosis?
Placenta accreta
The rate of growth hormone secretion follows a circardian rhythm. When is the highest
peak of growth hormone release?
Deep sleep
The most biologically active form of vitamin D is
1, 25-Dihydroxycholecalciferol
Which muscles form the pelvic diaphragm?
Levator ani and coccygeus
A 23-year-old woman who is six weeks by dates is referred to EPU with vaginal
spotting, which continuous today. Ultrasound shows a fetal pole with a CRL of 4 mm. There
is no fetal heart action noted. The ovaries and adnexa appear normal. What is the most likely
diagnosis?
Could be a viable pregnancy
A 23-year-old woman attends the antenatal clinic in her first pregnancy. Booking bloods
reveal her Blood group O and her rhesus status to be cde/cde; her long-standing partner is
also tested at her request and his blood group A with rhesus status CDe/CDe. What is the
expected blood group of her fetus?
A positive or O positive
The probability of sarcomatous change occurring in fibroid is
0.1%
What part of the embryo is the origin of primordial germ cells?
Yolk sac endothelium
The greater omentum is derived from which of the following embryonic structures?
Dorsal mesogastrium
What electrolyte imbalance can cause paralytic ileus?
Hypokalemia
Vasopressin act on increasing water re-absorption at
collecting duct
Placement of cup during ventose delivery when the neck is flexed
Sagittal
Schiller Duval Bodies is found in
endodermal sinus tumor
Second line drugs in hyperemesis:
Metoclopramide, Ondansetron, Prochlorpromazine
Most common endocrine disorder in reproductive age group
Polycystic Ovarian Syndrome
Structural diagram to which carbon number base will attach? Check photo
1
How much in the UK population has RH negative blood group?
15%
In Horseshoe Kidney what is the structure preventing the kidney to ascend from pelvis
to abdomen?
inferior mesenteric a.
Angle of the vagina with the horizontal while standing
60%
Joint which resist horizontal rotation of the pelvis
Ileolumbar
Two Most common dermatitis in pregnancy
Polymorphic (PUPP) + Obstetric Cholestasis
Most common protozoan causes zoonotic infection(cerebral calcification, retinitis)
Toxoplasma
Paroxetine is teratogenic to which organ
Cardiovascular system
Which electrolyte is involved in central pontine mylenosis due to fluid overload?
Sodium
Vitamin E toxicity
hemorrhage
Origin of obturator artery
Internal Iliac
At Term G2 wearing seat belt has car accident she has abdominal pain and consults you
for anti D
anti D 500iu
Congenital conjunctivitis organism. Purulent discharge 36 hours after birth
Chlamydia trachomatis
Piezoelectric used in
USS
Transformation Zone
Squamous to glandular metaplasia
Change is: glandular epithelium replaced by squamous epithelium.
Alternate complement pathway initiation
C3b
Infertility case, Male 190 cm wt 60 kg, testicular volume 5 ml. What is the possible
karyotype
47xxy
Target Hgb with oral and IV iron
0.8g/dl/ml
18 y/o non penetrative intercourse, + painful ulcers in the vagina
Behchet’s disease
Incomplete early miscarriage, bleeding PV, refuse surgical intervention.
Ergometrine
HSG is done on what day of cycle
6-12
In ECG, T wave represents
Ventricular repolarization
Herpes simplex is what type of virus
DsDNA
Abnormal LFTs, HbsAg -ve, HbeAg -ve, HbeAb +ve, HbsAb 3miu/hr,HbcAb +ve
Chronic infection ( low infectivity)
HBeAb reactive indicates your body has a high level of antibodies against the hepatitis B virus.
HbeAg It is an indicator of active viral replication; this means the person infected with Hepatitis B can likely transmit the virus on to another person.
25 y/o first papsmear , low grade dyskaryosis, next step?
Repeat after 6 months
Cauterization of large area with appearance of smoke
Fulguration
Pregnancy rate with COCP if perfectly compliant and non perfectly compliant
0.1 perfectly compliant to 5-6 non-compliant
INH (Isoniazid) Metabolism is by
Acetylation
Risk of VTE with COCP?
3–9 per 10,000 people/ yr
Muscles of internal sphincter derived from?
Circular Muscle
Cardiac output after delivery
60-80%
Where does the inferior rectal vein drain?
Internal pudendal vein
IUD+ Pregnancy. What is the risk of Ectopic Pregnancy
1/20
Cannon bell mets associated with which tumor marker?
HCG
cannonball metastases is classically seen in germ cell tumor, choriocarcinoma and endometrial cancer.
Rate of miscarriage in couples with balanced translocation?
2-5%
Lifelong immunity
Adaptive
AMENORRHEA with raised TSH, FSH, LH - what is the cause?
Premature ovarian failure
Which screening test has high negative predictive value for detection of pre-term pre-labour rupture of membranes?
Fetal fibronectin test
The epithelial lining of cervix exterior to transformation zone is whcih tissue time?
stratified squamous non-keratinized
Level of the gonadal artery
L2
During the inflammatory phase of wound healing what is the predominant cell type
found in the wound during the first 48 hours?
PMNs
Glucose transported across the placenta via?
Facilitated Diffusion
Gonads are derived from which embryonic layer?
Intermediate Mesoderm
Which of the following is true for a patient whose pre-transfusion blood type is group
O?
- AB antigen +ve Anti A and Anti B antibodies
Which immunoglobulin is a key to passive neonatal immunity?
IgG
What is the normal rate of urine output per hour?
0.5ml/kg/hr
Tetanus toxoid vaccine
Toxoided protein
Which clotting factors are unchanged in pregnancy?
Factors 11 + 13
Which kind of cells secrete calcitonin hormone?
Parafollicular cells
What type of cell is a natural killer cell?
Lymphocyte
80 y/o no subjective complaints came in for pessary change then with profuse vaginal
discharge. Culture result moderate beta hemolytic streptococcus with coliform and anaerobic
bacteria .
Metronidazole + Clindamycin p.o. X 7 days
Why ramifentanyl used in patient controlled analgesia?
Short acting easily metabolized by serum esterase
191.
Patient Hypertensive, Gravida 2 in labor 4cm dilated, membranes ruptured
spontaneously clear liquor, CTG showed Baseline FHR 120-130 bpm, good beat to beat
variability, no acceleration, no deceleration. She was on Oxytocin. After 2 hours, Baseline
FBS
Diagonal conjugate is the only diameter that can be measured clinically. How is it
measured ?
From Lower border of Symphsis pubis to sacral promontory.
During which phase DNA synthesis and chromosome duplication take place
S phase
Endometrial tissue found within the myometrium is
Adenomyosis
Which of the following depression screening questionnaire are frequently used during
pregnancy?
Edinburgh Postnatal Depression Scale
Pain due to ovarian irritation is felt through which spinal segment ?
T10
In which phase of oocyte development does zona pellucida apear around ovum ?
primary oocyte
Which adverse reaction is common and usually dose related in patients taking misoprostol?
Diarrhea
Terbutaline has the following mechanism of action
Beta 2 agonist
The ureteric buds is derived from which of the following structures ?
Mesonephric duct
Allantois embryonic origin
Endoderm
Which of the following antibodies is found as a dimer?
IgA
Magnesium excretion
Excreted Unchanged in urine
Vitamin A has 2 diet sources. Plant source is carotene and the animal source is…
vitamin A is found as retinol, the ‘active’ form of vitamin A. Liver, including fish liver, is a very good source.
Klinefelter’s Syndrome karotype
47,XXY
Case of a male with azoospermia and loss of smell(anosmia) diagnosis?
Kallman’s Syndrome
A 30 year old women comes to see you and advises she has felt a little unwell with
diarrhoea and flu like symptoms. She is 28 weeks pregnant. A blood culture confirms listeria
infection. What is the appropriate treatment (she has no known dug allergies)?
Amoxicillin
CNS is the most affected during teratogenesis. What is the first sensation developed in the
fetus?
Touch
What is the mechanism of action of Dibagatran?
Thrombin inhibitor
Warfarin acts where in the clotting cascade
factor V precursor
Pyramidalis is supplied by which nerve?
Subcostal nerve
The pathway of piriformis muscle??
Pelvic surface of sacrum,greater sciatic notch,greater trochanter
Which hormone has a structure similar to Prolactin?
Growth Hormone
Reciprocal translocation
occur when part of one chromosome is exchanged with another.
Robertsonian translocation
one in which, effectively, the whole of a chromosome is joined end to end with another. This type of translocation involves only chromosomes 13, 14, 15, 21 and 22
Coronal suture is located in?
between frontal and parietal
A pregnant woman desires screening test for down’s syndrome and the following report is
obtained :
Age related risk; 1:1000MoM
AFP; 1.05MoM
β-hCG; 0.85
Test risk; 1:10000
What will you counsel this woman?
It is low risk for down’s syndrome
LDH elevates in which type of ovarian ca ?
Dysgerminoma
Infection with which one of the following human papillomaviruses (HPVs) is associated with
an increased risk of cervical cancer?
HPV 33
Which group of viruses cause molluscum contagiosum?
Pox virus
Which enzyme is present in granulosa cells but not in theca cells?
Aromatase
Where in body is androgen produced?
Zona reticularis
Mother has sickle cell disease married to sickle cell trait husband chance of baby to
having disease?
50%
Aspirin and ibuprofen what is the difference in action?
Aspirin Irreversibly inhibit COX 1 and is more selective towards COX 1 than ibuprofen
Grade A recommendation of RCOG means
at least one randomized controlled trial
Sigmoid Colon - arterial supply + lymph drainage
Inf Mesenteric AND pre aortic LN
Drugs readily cross the placenta because of which quality?
High lipid solubility
HIV positive patient came with ruptured membranes 38 weeks. Already on HAART. Viral
copies 1450. Management?
Category 3 CS with IV Zidovudine
Macrophages are derived from what type of cell?
Monocytes
From which organ / system does the Krukenberg tumor of the ovaries originate from?
GIT
What type of variable is BMI ?
Continuous
Categorical variable
Categorical variable
Categorical variables contain a finite number of categories or distinct groups. Categorical data might not have a logical order. For example, categorical predictors include gender, material type, and payment method.
Discrete variable
Discrete variables are numeric variables that have a countable number of values between any two values. A discrete variable is always numeric. For example, the number of customer complaints or the number of flaws or defects.
Continuous variables
Continuous variables are numeric variables that have an infinite number of values between any two values. A continuous variable can be numeric or date/time. For example, the length of a part or BMI.
Half life of Mifepristone?
25 to 30 hours
In pregnancy, what is the total percentage increase in plasma volume by term compared to
a non-pregnant woman?
30 to 50%
Motor fibers to detrusor muscle of the urinary bladder are derived from which of the
following nerves?
Pelvic splanchnic
During laparoscopy, the remnant of theumbilical artery could be identified sometimes the
it is patent. In the adult the patent segment supplies which vessel?
superior vesical
Which is the most common cause of the premature ovarian failure?
idiopathic
A male came for infertility check up who was taking Finasteride for treatment of his male
pattern baldness. Finasteride exert its action by inhibition of which enzyme?
5-alpha reductase
The enzyme involve in the final oxidation of uric acid?
xanthine oxidase
Most enzymes that take part in Kreb’s cycle are located in?
mitochondria
Which is precursor of dopamine/catecholamines? .
Tyrosine.
What is the most common cause of postmenopausal bleeding?
Atrophic vaginitis and endometritis
What is the function of DNA polymerase?
DNA repair
Which of the following ovarian Cysts most prone to undergo Torsion ?
Dermoid cyst
Patient came in with abdominal pain with history of heavy and painful periods. Exlap was
done which revealed the following:
Ovarian Endometrioma
Telogen Effluvium (hair loss) is more pronounced in what stage of pregnancy?
after delivery
Natural Killer Cells(NK) is increased significantly at which stage of menstrual cycle?
late secretory
Sympathetic supply of bladder largely comes from which nerve?
Hypogastric +Inferior gluteal nerve
Which structure in female is homologus to male prostate?
Skenes gland
Rate limiting step in the synthesis of catecholamines?
tyrosine hydroxyla
The anesthesiologist wanted to anesthesize the anterior andomen using TAP block. In this
procedure where are the nerves mostly located?
between internal oblique and transversus abdominis
What is the chemical structure of Renin?
Protein
The difference between the peak and the throughs of ultrasound wave is called?
Amplitude
There are 3 components of interaction of ultrasound with the tissue medium: absorption,
scattering, and the third one is…
reflection
Blood supply to the medial part of the anterior abdominal wall below the umbilicus?
Inferior epigastric artery
A primigravida at 22 weeks is scared to have vaginal delivery. On examination she had
absent clitoris and normal labia majora. What type of genital mutilation is it?
Type 1 = (clitoridectomy) – removing part or all of the clitoris
Type 2 = (excision) – removing part or all of the clitoris and the inner labia (the lips that surround the vagina), with or without removal of the labia majora (the larger outer lips)
Type 3 = (infibulation) – narrowing the vaginal opening by creating a seal, formed by cutting and repositioning the labia
Type IV – Other
.All other harmful procedures to the female genitalia for non-medical purposes, eg, pricking, piercing, incising, scraping and cauterising (burning) the genital area..
Ovarian CA associated with mutation of mismatch repair genes
endometriod CA
What type of necrosis is seen in the heart after an acute myocardial infarction?
Coagulative necrosis
Physiological variation in menstrual cycle between 21 to 35 days due to
estrogen fails to produce positive feedback on pituitary
A 60-year-old woman with stage IIB cervical cancer is currently undergoing radiotherapy
by impact of gamma-emitting isotopes containing Casieum 137 on her vagina. This type of
therapy is best described by which of the following terms?
Brachytherapy
Where is prolactin produced that is not under dopaminergic control?
maternal decidua
You see a patient who is 35 weeks pregnant in your day assessment unit. She presents
with itching… more on the area of the abdominal striae. Lab results given which showed
normal ALP, normal bilirubin levels. Diagnosis?
Polymorphic Eruption of Pregnancy
27-year-old woman after normal vaginal birth develops shortness of birth and seizures.
Despite resuscitation she died. At autopsy squamous cells and fetal hair are found in lungs.
What is the most likely cause of death?
Amniotic fluid embolism
Which one of the following bacteria produces an exotoxin causing ‘toxic shock
syndrome’?
Staphylococcus aureus
Which organism is the most common cause of sepsis in pregnancy?
Group A Streptococcus
A lady was injured while walking in the garden barefoot. After that she developed
cellulitis.. What’s the possible cause?
Stap aureus
There is difficulty in extracting blood in the upper arm, the intern decided to extract
from the femoral vein. What is the relation of the femoral vein to the artery and nerve from
lateral to medial?
Lateral - NAVY - medial
Most important complement in opsonization
C3b
23-year-old woman presents with fishy foul smelling vaginal odour. ‘Clue cells’ are found
in the smear. Which of the following cell types is belong to ‘Clue cells’?
Epithelial cells
A 28-year-old woman with complete hydatidiform mole is found to have
bilateral multiple tiny ovarian cysts along with an enlarged uterus at 12 weeks’ gestational
age. The quantitative β-hCG level of 300,000 mIU/mL.What is the most likely type of these
ovarian cysts?
Theca lutein cyst
What is the most common cause of acromegaly?
Pituitary adenoma
Labetalol is:
Non selective beta blocker
What is the mechanism of action of hydralazine?
Direct acting smooth muscle relaxant
A woman experiences a postpartum hemorrhage after delivery and is administrated
carboprost to promote uterine contraction. What type of drug is carboprost?
prostaglandin F2
Patient has heavy menstrual bleeding. She desires an endometrial ablation to stop
bleeding after failure of medical treatment. Which part of the uterus is destructed to stop
bleeding?
Basal layer of endometrium
A 28-year-old woman has undergone emergency hysterectomy due to obstetric
haemorrhage during her 3rd pregnancy. The previous pregnancies were both term Csection
deliveries. Examination of the uterus shows the placenta had invaded through
the full thickness of the myometrium. What is the most likely diagnosis?
Placenta increta
What is the new non invasive prenatal diagnostic test of cell-free fetal DNA of maternal
blood derived from?
Placental Trophoblast
Which of the option correctly identified the embryological origin beginning and ending of
the round ligament of the uterus?
Gubernaculum ovarii , ant surface of uterine cornua, labia majus
The most common site of endometriosis is?
ovary
Which neoplasm is characteristically associated with paraneoplastic syndrome of
inappropriate antidiuretic hormone (SIADH)?
Small cell lung carcinoma
Which types of cells are phagocytic for residual bodies left over from the process of
spermiogenesis?
Sertoli cells
Insensible loss of water from sweat and lungs in 70 yr old healthy woman is
450ml/kg
Which kind of cell produce parathyroid hormone?
chief cells
Which chromosomes are capable of robertsonian translocations?
13, 14, 15, 21, 22
Which signaling molecule that stimulate the renin-angiotensin system to regulate the
sodium concentration?
Aldosterone
Woman climbed up the hill with her friends suddenly felt breathless plus parasthesia in
her hands. What is the acid-base imbalance ?
Respiratory alkalosis
What type of acid–base disturbance result in a case of Conn’s syndrome?
Metabolic alkalosis
Trichomonas Vaginalis is what kind of protozoa?
flagelated protozoan
174.25 y/o had lscs at term for breech presentation with spinal anesthesia After what time
you start low dose molecular heparin(LMWH)
No need for treatment only hydration and mobilization
VIN3 is caused by which organism ?
HPV 16
Zika virus is
Ss RNA
Thrombosis in protein C deficiency is due to
Factor 5 and 8a
Transport of iodide in the cells is associated with
Sodium
Renal Calculus referred pain
Lumbar region
CAH is caused by 21 hydroxylase the remaining is due to?
11b- hydroxylase
Embryonic origin of oocytes
primordial germ cell
Definition of Tidal Volume
amount of air that goes in and out of the lungs during normal respiration
What type of compound is Histones?
Protein
Most important function of Vitamin C
collagen formation
Indirect Inguinal Hernia is lateral to which arteries?
inferior epigastric arteries
Cells in the body produce hormones among them how many are lactotrophs?
10-15%
What is the most common cause of endogenous Cushing’s syndrome?
Pituitary adenoma
Trophoblast cells that invade the lumen of spiral arteries
endovascular trophoblast
HPV proliferate in?
Basal Cell of endometrium
Regarding Influenza vaccine , what type of vaccine?
Organism Subunit vaccine + inactivated
Which drug antagonises the action of oxytocin?
Atosiban
Misoprostol is analogue of which?
PGE1
Urea transfer from fetal circulation to maternal circulation?
Passive diffusion
Which class of immunoglobulin is primarily secreted in breast milk and protects the infant’s intestinal mucosa from infection?
IgA
which Immunoglobin is a pentamer?
IgM
What day of a regular 25-day menstrual cycle is a woman likely to ovulate?
11
A 32-year-old woman 7 weeks pregnant. Her Chlamydia swab is positive. Which is the single most appropriate treatment?
Erythromycin 500 QDS
Which anti-emetic drug has extrapyramidal side effect?
Metoclopramide
Pregnant women with Nausea and vomiting. Which fluid should not be given?
5% dextrose
Mechanism of action of ondansetrone?
Seretonin HT3
A Doctor is making a discharge summary for a women who underwent a laparoscopic saplingo-oophorectomy for Ectopic pregnancy after 4days. You realise that her blood group is O-. What is the best course of action?
Check Partner Blood group & Rh
A 19-year-old woman gives birth to her first child. She begins breast feeding the infant. She continues breast feeding for almost a year with no difficulties and no complications. Which of the following cellular processes that occurred in the breast during pregnancy allowed her to nurse the infant for this period of time?
Lobular hyperplasia
What is the mode of inheritance of Duchenne muscular dystrophy (DMD)?
X-linked Recessive
When should the prophylactic dose of low molecular weight heparin (LMWH) be given post-c-section?
12 hours
Remifentanil is an ideal controlled analgesia during labour because
It is rapidly metabolized by tissue estrases
Lancefield grouping of streptococci is based on the presence of ?
Carbohydrate antigen on cell wall
Mechanism of action of Neostigmine is
Anticholinesterase
Coumarin drug antagonise which vitamin?
Vitamin K
Which structures passes through the lesser sciatic foramen?
Tendon of obturator internus muscle
Which Antineoplastic drugs causing hemorrhagic cystitis?
Cyclophosphamide
Mechanism of action of ulipristal acetate ?
Selective progesterone receptor modulator
A girl presented to your clinic requesting emergency contraception. LMP 20days ago. h/o unprotected intercourse 7days ago for which she took levonorgestrel. The couple had regular intercourse since then and last night the condom had breeched. What is the best course for action?
No need for additional contraception as levonorgestrel already inhibited ovulation this cycle
The following image from ICSI procedure .
First polar body.
Side effect of Aminoglycosides is mainly by affection of which of the following nerves?
Vestibulocochlear nerve ( 8th)
Regarding Breech presentation, What is the Bi-trochanteric diameter?
10 cm
The most common in Utero infection causing fetal anemia in the UK is
Parvovirus B19
A 20 week GA women with h/o recent travel to India, presents with fever, chills. Blood test falciparum Vivax +VE. Best treatment?
Choloroquine
The Lowest acceptable Hb in second trimester?
10.5 g/dl
Pregnant women when exposed to sun, get pigmentation on cheeks & face?
Melasma
Mechanism of Action of Indomethacin?
Cyclo-oxygenase Inhibitor
Which of the following regions is represented by the arrows ?
Amniotic cavity
What is Evidence based medicine?
Using current guidelines for treating individual patients.
During laparoscopy you visualize medial umbilical folds. what structure it contains?
Medial Umbilical ligament
What is the source for premenopausal Oestrogen secretion?
Granulosa cells
41 years old women presents to clinic Complaining of galactorrhea. Labs show: FSH, LH and TSH raised.
Hypothyroidism
80 years old women presents to clinic with dysuria, on Examination you notice a growth at urethral orifice exophytic with well circumscribed edges?
Uretheral caruncle
which clotting factor does not rise in pregnancy?
XI & XIII
You see a patient in antenatal clinic who is 14 week pregnant and is worried. Her 3 year old son has chicken pox. she does not remember if she had chicken pox in past? her lab reports are as follows: Varicella IgG negative Varicella IgM negative
She is not immune to Chicken pox
Which cells secrete histamine and serotonin?
Basophils
Which Type of Ovarian cancer occurs which BRCA 1 mutation ?
papillary serous cystadenocarinoma.
Regarding Varicella Zoster , What its infectivity period?
2 days before rash until the crust appear.
Gestation age is which type of data?
Interval
Which type of electrosurgical circuits is safest in theatres?
Patient is Attached to pad
The deep circumflex iliac artery is a branch of which artery?
External iliac artery
Glucocorticoids are secreted from which region of the adrenal gland?
Zona fasciculate
Which of the following essential amino acids not found in OMEGA 3 and should be taken from dietry intake ?
α-Linoliec acid
Cervical cancer incidence in UK ?
1/3000
What is the mechanism of action of Trimethoprim ?
Inhibit dihydrofolate reductase enzyme
Acts on nucleic acid
Post-operatively , the nurse noticed an area of burn near attached diathermy plate , what is the mechanism of injury ?
High frequency current focused on small area.
What is the measurement of Anteroposterior diameter of pelvic inlet in Engagement ?
11cm
What is the site of production of Thromboxane A2 ?
Platelets.
What is the site where Urea cycle occurs ?
Liver.
What is the Nerve that most commonly injured during Gynecological laparotomy ?
Obturator nerve.
The Umbilical artery is branch of ?
Anterior division of internal iliac artery.
What is the best investigation to detect receptor status in breast cancer?
Immuno-histochemistry
Regarding OOCYTE , when the second meiotic division is completed ?
fertilization
Regarding Wound healing process , what is the first stage ?
Hemostasis.
Regarding inferior vesical artery , where does it come from ?
Anterior division of internal iliac artery.
A 22-year-old primiparous woman books her pregnancy at 11 weeks’ gestation. Her booking blood tests reveal a haemoglobin level of 10.1 g/dL. Electrophoresis reveals haemoglobin karyotype HbAS.
Sickle cell trait
A study design is made with a Power sensitivity 90% and P = 0.05 .
What is the chance of type 2 error ?
10%
describe Tidal volume ?
The normal volume of air displaced between normal inhalation and exhalation(in and out ) when extra effort is not applied
A 28 years old women undergoing a D&C for a missed abortion , develop pain on cervical dilatation , what is the nerve supply of cervix ?
Pelvic splanchnic nerve.
A condition where the uterus is bulky and endometrial glands are in myometrium is called ?
Adenomyosis
From what structure does ligamentum Arteriosus come from?
Ductus arteriosus
What is the incidence of pregnancies complicating by cancer ?
1/1000
Which enzymes used in Transcription ?
RNA Polymerase.
What is the Direct arterial blood supply of decidua ?
Spiral arteries.
What is the component of Placental barrier at term pregnancy?
Syncitiotrophoblast and Endothelium
Regarding sex differentiation , at what gestational age does the External genitalia of male and female is Identical/ remain undifferentiated?
6 weeks
Which of the following is male homologous of bartholin gland ?
Bulbouretheral gland ( Cowper’s gland )
What hormone secreted by placenta leading to fetal diuresis ?
Vasopressinase.
Which of the following neurotransmitters secreted onto adrenal medulla?
Acetylcholine
A Multiparous women with prolapse , which muscle is most likely to be injured ?
Pubococcygeus.
What is the site of production of Ammonia ?
Kidneys
55 year old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva.
A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate.
What is this characteristic of?
Lichen Sclerosus
What is the most common solid benign tumour of ovary ?
Benign teratoma
A Patient come complaining of a groin pain , a ureteric stone is suspected and Xray is requested , at what level you would expect to see the stone ?
Pelvic brim
What is the Action of mRNA ?
Transcription
From Which structure inhibin is produced ?
Granulosa cells
Which of the following cells is considered the basis for the adaptive immune system?
Lymphocytes
Which Immunoglobulin is a Dimer ?
IgA
Diagram order of structures - inferior epigastric/medial umbilical/ median umbilical
See picture!
What vein arises from the femoral vein and can get injured in subcutaneous tissue during suprapubic insertion?
superficial epigastric vein
Superior vesical artery is a direct branch from:
Umbilical artery (branch from anterior division internal iliac)
Which artery is most commonly absent?
Middle rectal artery
At what point is the aortic bifurcation?
Highest point on iliac crests
Ventouse is applied to which suture?
Sagittal suture
What is the post-menopausal uterine body:cervical ratio?
1:1
What is the embryological origin of the bladder trigone?
mesoderm derived wolffian ducts
At 4 weeks, germ cells are present where?
Yolk sac
Which cells invade spiral arteries?
Extravillous trophoblasts
What is PCR used for?
DNA amplification
What is northern blot used for?
Identify RNA sequences
What is southern blot used for?
Identify DNA sequences
Acute hyperventilation of the mother can cause what sort of fetal acid-base disturbance?
may lead to the development of fetal metabolic acidosis because it induces uterine vasoconstriction
Where does paracrine action occur?
Adjacent cells : Paracrine signaling in which cells communicate over relatively short distances by the release (secretion) of small signaling molecules onto nearby cells
Which protein forms gap junctions?
Connexins
What causes pellagra (dermatitis, diarrhoea, and mental disturbance/dementia)?
Niacin (B3) deficiency?
Which enzyme works in the urea cycle?
Carbamoyl phosphate synthetase
What is the mechanism of action behind oxytocin causes uterine contractions?
Increase in intracellular calcium
Which cells are involved in wound remodeling?
Myofibroblasts
postmenopausal woman with ovarian cyst of 5cm - what tumor markers?
None needed - Women with simple ovarian cysts of 50-70 mm in diameter should have yearly ultrasound follow-up and those with larger simple cysts should be considered for either further imaging (MRI) or surgical intervention’
What kind of damage does pre-eclampsia cause?
Vascular endothelial damage
What is the epithelium outside of the cervical transformation zone?
Stratified squamous epithelium
When is the peak GFR in pregnancy?
13 weeks (Renal plasma flow increases by 50-70% in pregnancy), urea + creatinine levels are decreased
When does HCG peak?
12 weeks
When does HPL plateau?
35 weeks (3rd trimester)
What is the major Hb at 32 weeks?
HbF
When does adult Hb production start?
28 weeks
What is the increase in total/minute ventilation during pregnancy?
40-50%
What are the causative agents of bacterial vaginosis?
Gardenella Vaginalis, Mycoplasma genitalium, (third one except trichomonalis)
Syphilis patient with positive EIA + TPPA and VDRL test with titre 1:2 (initial titre 1:120). What does this mean?
VDRL used to monitor for re-infection of syphilis or inadequate treatment, but patients might have low levels and not have condition. VDRL do not detect antibodies specific for
syphilis. This is likely past infection that was well treated.
When is the test for cure in gonorrhea?
14 days
Flu like symptoms in the mother and then baby has rash, hepatosplenomegaly and jaundice. condition?
Listerosis
Trichomonas in pregnancy should be treated with what?
Metronidazole
What type of bacteria is chlamydia?
gram-negative, anaerobic, intracellular obligates that replicate within eukaryotic cells
HBsAG -ve
HbsAB +ve
HBcAB +ve
HbeAB +ve
Diagnosis?
Previous infection
HbsAG = current infection acute or chronic
HbsAB (anti HBS) = immunity due to infection/vaccination
HBcAB (anti HBC) = indicates current or past infection
HBeAB = indicates your body has a high level of antibodies against the hepatitis B virus.
Peptide chains in IGG?
2, 4
Antigen-antibody complexes are formed in which pathway?
classical pathway
Image of direct coombs test
Antibodies are on RBCs
What is the function of parathyroid hormone?
Decrease excretion of calcium
What is the immediate pre-cursor of testosterone?
Androstenedione (+ Cholesterol)
how many sequences do the TRH precursors have?
6
Where is HPL produced?
Synctiotrophoblast
What has direct action on aldosterone?
Angiotensin 2
What is the main regulator of sodium?
Aldosterone
Where is ADH + oxytocin synthesized?
Supraoptic + paraventricular nucleus of hypothalamus
Main tumor causing hyperprolactinemia?
Adenoma
Where is prolactin produced?
Maternal decidua
Other than breast and ovary, what cancer is associated with the BRCA gene?
Pancreas
What is a low risk screening for down’s syndrome?
1:10,000
Oxybutynin side effects include:
Dry mouth, dry eyes, hypohidrosis
Nature of Mifepristone:
Anti-progesterone
Patient came 8 days after UPSI on Day 16 of her cycle. Which emergency contraception can she use?
No contraception effective
Missed single dose COCP - advice?
Take missed pill + continue rest of pack
Method of action of the POP?
Thickens cervical mucus
Method of action of the IUD/copper IUD?
Inhibits implantation by altering endometrium + inhibition of sperm entry/ inhibits fertilization
What is dinoprostone?
PGE2 analogue
What is the method of action of botox?
Inhibits release of acetylcholine at neuromuscular junction.
Therapeutic dose of LMWH - after how many hours is anesthesia safe?
24 hours
Recreational drug use causing placental abruption?
Cocaine
Tocolytic which prevents calcium influx?
Nifedipine
Hepatitis C advice for breastfeeding
Can breastfeed but pump if nipples cracked/bleeding
Diagnosis of diabetes in pregnancy?
FBS = 5.6 or above
2-hour post prandial sugar = 7.8 or above
Chicken pox + rash management
STAT Aciclovir
Oral aciclovir should be prescribed for pregnant women with chickenpox if they present within 24 hours of the onset of the rash and if they are 20+0 weeks of gestation or beyond. Use of aciclovir before 20+0 weeks should also be considered
VZIG has no therapeutic benefit once chickenpox has developed and should therefore not be used in pregnant women who have developed a chickenpox rash.
If varicella IgG negative and IgM positive, what does this mean?
Acquired varicella infection
LMP 1st march with 35 day cycle. what is EDD?
15 december
Calculate due date: first day of LMP then subtract 3 months + add 1 year and 7 days + add difference from 28 day cycle (35- 28 = additional 7 days)
Intraoperative cell salvage during CS blood loss?
20% blood loss
Patient on anti-epileptics and contraception of choice?
IUS
Ductus venosus connects:
umbilical vein + inferior vena cava
PCOS biochemistry includes:
Insulin increases
Estradiol decreases
SHBG decreases
Leptin decreases
Incidence of 45XO + its mosaicism?
1:3000
Mode of inheritance for blood groups?
Co-dominant
Which receptor does nicotine bind to that affects neurotransmitter in foetus
Acetylcholine
Function of BRCA
Tumour suppressor gene
Coagulation factors that increase during pregnancy
Factor VII, VIII, IX, X, plasminogen
Structure lateral to internal iliac artery
Ureter
Ovary originates from:
Mesoderm
Cleft palate results from:
Failure of development of 1st pharyngeal arch
Derivatives of 2nd pharyngeal arch:
stapedial artery, epiglottis, facial nerve
Proximal internal carotid artery derived from :
3rd pharyngeal arch
Phosphate excreted by:
Kidneys
Site where active form of Vit D produced :
Kidney
Nerve supply to structure below umbilicus :
Inferior hypogastric nerve
You intend to prescribe COCP to 4 wks postpartum woman, not breastfeeding. How long should additional contraception be used:
7 days
Source of Vit K1 :
Leafy green vegetables
Pt came with fever, abdominal pain, hypotension, tachycardia. Worsening of sepsis and inflammation in pregnancy due to :
Up regulation of nitric oxide and PG
Screening test for iron deficiency anaemia :
Serum iron
40% of pt with PCOS have hyperprolactinemia because?
Estradiol excess leading to hyperprolactinemia
Pregnancy 3 fold increase cortisol. Mechanism :
Cortisol increased by increased unopposed oestrogens
Prolactin levels in pregnancy compared to pre-pregnancy :
50 fold increase (20-50 folds)
Structure passing through deep inguinal ring visualised easily on laparoscopy :
Round ligament
Ligament arising from lateral border of cervix and attached to endopelvic fascia :
Cardinal ligament
Structure supplying majority of midgut branches from aorta at which level?
L1
Structure supplying majority of hindgut branches from aorta at which level?
L3
Main blood supply of transverse colon :
Middle colic artery
Sutures enclosing largest fontanelle :
Frontal, coronal, saggital
Diameter(s) widest in mid pelvis :
AP, oblique, transverse
Foetus born with absence of mastoid process. Which structure is at increased risk of damage during delivery :
CN VII
Alcohol group attached to which carbon atom of prostaglandin structure :
C 20/ C15 (best answer)
Name the structure (picture)
Colle’s fascia
Term for condition in which statistical difference occurs purely by chance :
Type I error
Major estrogen produced by placenta :
Estriol
Healthy normal adult, what is the response to a fall in blood glucose :
Decreased insulin, increased glucagon
Type of treatment where a device is inserted into vagina to deliver radioactive substance :
Brachytherapy
Type of electrosurgery used in laparoscopy where a pad is placed on patient :
Monopolar diathermy
USG phase with best resolution :
Axial
USG process causing lysis of cell and damage :
Heating/cavitation
Pt with underlying Chron’s disease presented with had numbness. Had hx of bowel resection. Hb 10.5, MCV 122. Likely cause of symptoms :
Vit B12 deficiency
Pt complained of perioral numbness and spasm over upper limbs. *Diagram showed pic of ECG : Prolonged QT interval. Likely electrolyte abnormality :
Hypocalcemia
Hepadnavirus containing DNA, can be transmitted via needle sharing, blood transfusion :
Hepatitis B
Lady with generalised fatigue. Non-pregnant. Done LFT
ALP 230 ( raised ). ALT, GGT, Alb, Bili within normal range. Possible dx :
Vitamin D deficiency
Best sample for dx of chlamydia :
Endocervical swab
Features of neonatal herpes :
pneumonitis + mucous membrane vesicles
Dx criteria in Amsel’s criteria :
clue cells on wet mount, vaginal pH >4.5, amine odor when vaginal fluid is exposed to 10% potassium hydroxide, and abnormal vaginal discharge.
Absolute contratindication in pt with hx of pulmonary embolism :
COCP
20 y/o, had large complex ovarian cyst 30cm. Suggested tumour markers :
Ca-125
LDH
AFP
HCG
Origin of Ca 125 :
Coelomic epithelial structures
Ig that crosses placenta from mother to foetus :
IgG
Likely test to give biological false +ve for syphilis :
VDRL
Pt 22 y/o presented with prolonged heavy menses. Had heavy menses since menarche. Pt is otherwise well. Took CBC. Additional investigations :
Coagulation
Rheumatoid arthritis less frequently flare up in pregnancy. Which mechanism contributes to this?
Suppression of T helper 1
MoA nifedipine :
Decrease PVR
E. coli belongs to :
Enterobacteriaceae
Action of antibiotics that renders bacteria inactive, but does not kill bacteria :
Bacteriostatic
Group of abx treatment for syphilis infection :
Penicillin
Foetal head at level of pelvic floor, requires operative delivery. Type of delivery :
Outlet delivery
% or Brenner tumour with malignant change :
5%
Pt no known medical illness, not on meds. Has red papules over bilateral labia majora 20mm, 10mm until natal area. + lesions at umbilicus. Speculum examination normal. Hair, skin, nails normal. Likely dx :
Eczema
Pt day 1 post hysterectomy. Na 123. K, Urea, Creat normal range. Possible cause :
Excessive IV dextrose
Pt amenorrhea 5 wks. UPT strongly +ve. USG sac-like structure 2mm, eccentric location, ectopic pregnancy cannot be ruled out. Likely BHCG levels that correspond to the findings :
1200
Anterior pelvic compartment prolapse. Pt underwent op, done sling via transabdominal route. Most important ligament for the procedure :
Iliopectineal
HLA types that down-regulated in pregnancy
HLA-A + HLA-B
PG with highest level pre-menstruation :
PGE2
Advantage of PGE 2 vs PGE 1 analogue :
More effective at cervical ripening
Defective structure in thalassemia :
Globin
Baby with extra chromosome 18 with limb abnormalities :
Edward syndrome
Rett syndrome associated with profound neurological impairment. Mode of inheritance :
X-linked dominant
In males, FSH secreted by :
Sertoli cells
Enzyme for androgen synthesis in ovary :
Aromatase
Pt with primary amenorrhoea, scant pubic and axillary hair. Hx of bilateral inguinal hernia in her childhood. Dx :
Androgen insensitivity syndrome
Treatment for central precocious puberty :
GnRH analogue
Class of drugs associated with hyperprolactinemia :
Antiemetics
Types of bile acid :
Cholic and chenodeoxycholic acid
Methods that reduce risk of SSI during C-sec according to RCOG :
Antibiotics before skin incision
Pt presents with hyperemesis, 8 wks amenorrhoea. T4 0.04 (↓), TSH 18 (N). Interpretation :
Normal findings for 8 wks pregnancy
Pt experiencing PPH. Given oxytocin. Onset of action of oxytocin :
5 mins
Pt presents with amenorrhoea, diagnosed with anorexia nervosa. BMI 18 dropped to
16. Likely cause of amenorrhoea :
Hypogonadism
Structure on HIV allowing it to enter cells :
Glycoprotein
What is the best way to perform intermittent auscultation during 1st stage of labour :
Immediately after contraction, for at least 1 minute, every 30 mins
Minimum amount of sperm concentration per mL of ejaculate :
15 000 000
Agent that cannot be used as tocolytic :
Prostacyclin
Pain score is what type of variable :
Ordinal
Measured blood loss type of variable :
Ordinal
Adverse effect of COCP
Irregular bleeding
In what active disease is COC contraindicated
SLE
Rotterdam criteria requires biochemical evidence of :
Hyperandrogenism
Rotterdam criteria for PCOS:
oligo‐anovulation, hyperandrogenism and polycystic ovaries (≥ 12 follicles measuring 2‐9 mm in diameter and/or an ovarian volume > 10 mL in at least one ovary).
Gestation at which differentiation of external genitalia occurs :
9-11 wks
What substance is secreted by granulosa cells :
Oestrogen
Erythrocytes formed from :
Pluripotent haematopoetic stem cells
Percentage of non-epithelial ovarian Ca :
10%
βHCG is a tumour marker for :
Choriocarcinoma
Identify structure: umbilical artery/vein
Umbilical vein
True statement regarding inheritance of achondroplasia :
Roughly equal number of males and females affected
Non-ergot agent used to supress lactation postpartum :
Quinagolide
Enzyme for conversion of testosterone to DHT :
5 alpha-reductase
Histamine released from :
Mast cell, eosinophil, basophil
Oxytocin cannot be given orally because :
Destroyed by gastric juice
15 y/o British came to see you for contraceptive advice, does not wish to let parents know. Which guideline will you follow?
Fraser guideline
Pt underwent surgery for ovarian mass. Histology showed benign spindle shaped cells. Dx :
Fibroma
From what arch does the ligamentum arteriosum come?
6th arch
What amount of hormone released from Mirena/24 hours?
20mcg/24 hours
Patient has increased FSH, LH + TSH =
premature ovarian failure
Patient complaining of cold intolerance + increase TSH
Hashimoto’s
Type of ovarian cancer with association of mismatch repair?
Endometroid Ca
Likelihood of pneumonitis with chicken pox?
1/400 = .25%
HIV Pregnancy guidelines
- Viral load should be checked at 36 weeks then delivery planned as follows:
- < 50 HIV RNA copies/mL = vaginal delivery
- 50–399 = PLCS considered
- ≥400 HIV = PLCS
Zidovudine Infusion
- Indicated for women with a viral load of >1000 HIV RNA copies/mL who present in labour or with ruptured membranes or who are admitted for planned CS
- Indicated for women presenting in labour or with ruptured membranes in whom the current viral load is not known
- Women taking zidovudine monotherapy
nfant Antiretroviral therapy(ART)
Very low risk =
Mother has been on cART for longer than 10 weeks and
Two documented maternal HIV viral loads <50 HIV RNA copies/mL during pregnancy
at least 4 weeks apart and
Maternal HIV viral load <50 HIV RNA copies/mL at or after 36 weeks
2 weeks zidovudine monotherapy
Low risk
maternal viral load <50 HIV RNA copies/mL at 36 weeks or
maternal viral load <50 HIV RNA at time of delivery if born prematurely
4 weeks zidovudine monotherapy
High risk = Combination PEP
Post-menopausal woman had one episode of vaginal bleeding. ET 1.2mm
No further action + return if bleeding continues
Post CS, absorbable sutures, nodule at stitch line, cells for inflammation
Neutrophils
HIV patient with viral load > 16000, when should anti-viral HAART be started?
ASAP after 16 weeks
Anti-epileptic affected by increased renal flow?
Lamotrigine
Magnesium excreted by?
Excreted unchanged by kidneys
Chlamydia transmittion from mother to her foetus via :
Direct contact
Pseudomonas appear on macconey agar :
colourless
Prophlaxis of malaria during pregnancy :
Mefloquin in 2nd and 3rd trimester
Exotoxins:
Heat labile
Secreted by gram positive
Susceptible to antibodies
Higher toxicity
Endotoxins = gram negative
Preg. With flu like symptoms & backache ,baby Delivered with resp. depression,jaundice & hepatosplenomegaly :
Listeria
Treatment of vulvovaginal atrophy includes :
estriol and phytoestrogens
Most common non-epithelial vaginal cancer:
Rhabdomyosarcoma
SI unit of diathermy power
Watt
Cutoff of fibronectin level in screen of preterm labour
50ng
Rate of recurrence of pre eclampsia
16%-20%
Rate of CMV to be symptomatic for the baby:
10-15%
Pendrin protein used in thyroid synthesis , which ion is exchanged for iodine:
Cl−/HCO3−
Definition of minor PPH:
500-1000 loss without shock
70 kg ptn,Maximum safest dose of lidocaine:
49 with adrenaline
Doxazosin MOA
Alpha-1 antagonist
Complement system , initial cascade that end by cell lysis
C3 complement
Six differentiation is due to gene on:
Short am of y chromosome
False and true data variable:
Nominal (binary)
In sexual arousal engorgement of bulb of vestibule is dt:
Dorsal nerve of clitoris OR labial branch of perineal nerve.
In male most of ejaculate come from:
Seminal vesicles
Nerve supply of area over femoral triangle?
Genitofemoral nerve
Percentage of DM type 2 after GDM
40-60%
Dose of radiation to breast tissue used in CTPA
20
Oncogenes in Lynch Syndrome:
MSH2/methylation MLH1/MSH6
N.s of internal anal sphincter?
Sympathetic L5, parasympathetic S2, 3, 4
USS has the best resolution in which plane?
Axial
Semen analysis all normal except morphology 3%
Morphology > 4% = normal but morphology very unreliable measurement
Normal
Which numbers should we focus on?
Sperm concentration should be >20million <5: difficult to conceive naturally
Total motility should be >40%
< 20: difficult to conceive naturally
What kind of junctions in the uterus?
Gap junctions
GNRH secreted where other than hypothalamus?
Liver
Painless ulcer & enlarged LN & diagnosed by serology
treponema pallidum
Lower 2/3 of vagina developed from:
sinovaginal bulbs (derived from the pelvic part of the urogenital sinus)
Non penetrative intercourse , shallow painful genital ulcer
Behçet disease
Fetal hemolysis detected by:
direct Coombs’ test is the test usually used to identify hemolytic anemia. [The indirect Coombs’ test is used only in prenatal testing of pregnant women and in testing blood prior to a transfusion.]
