Mixture Flashcards
- A: True
- B: False Schema activation
- C: False Complex procedure hierarchy
- D: True There is snowballing in this, but the teacher is not there, only a moderator who may not know about the topic. Students are teaching themselves.
- E: True Because if they get it wrong, the response is the refined answer
About surrogacy:
a) agreements are legally binding
b) the surrogate is the sole parent of the child, even if married, until birth
c) after birth, consent to a parental order needs to be given by the surrogate after six weeks
d) the surrogate will have custody of the child until the parental order is finalised
e) the child may be conceived through both donor egg and sperm
a) false
b) incorrect. if married, the partner/husband is the legal father unless explicitly expressed that does not consent to the surrogacy
c) correct. the child can live with th eintended parents, and must be living at the time of parental order application. but the surrogate can only give free consent after the child is 6 weeks old
d) false see above
e) at least one intended parent must be biologically related to the child
C
1) Beneficence –> we do not know here if the young woman has capacity. Mother was also involved in the decision, so it was done in the young woman’s best interest.
2) Autonomy
1) Beneficence –> the neonatalogist makes decision to treat in the best interest of the baby, now that the baby is born
2) 2) bolam test –> followed all the necessary steps
3) Veracity
1) Direct death (K)
2) Indirect death (L)
3) Direct death (K)
4) Not a maternal death (P) - more than one year since pregnancy, so not even late death
5) Coincidental death (N)
Which of these statements are correct:
a) Cardiac catheterisation should be avoided in pregnancy due to the high risk of fetal ionising radioation exposure
b) A CXR exposes the fetus to 2.2mGy of radiation, the same as the background radiation level in the UK
c) A CTPA conveys higher risk of childhood cancers to the fetus, but lower risk of breast cancer to the mother
d) A V/W scan conveys a higher risk of childhood cancer to the fetus, but lower risk of breast cancer to the mother
e) Esxposue to >250mGy converys a 2% risk of fetal malformations
a) It is safe. If involves 1.5mGy of radiation, only 20% of which reaches the fetus
b) it exposes the fetus to <0.01mGy, The backgroud in the UK is indeed 2.2 mGy
c) False –> CTPA has a slightly lower risk to fetus and higher risk to breast
d) Correct –> V/Q has a slightly higher risk to fetus, although this is still very small. It has a lower risk to breast
e) exposure to this level conveys a 0.1% risk
** “safe” levels in pregnancy is <50mGy
What nerves can be injured by deep retractor blades? What is the difference in presentation between them?
Femoral and lateal cutaneous
- Femoral: Anterior and medial thigh. Poor hi flexion, adduction and knee extension
- Lateral cutaneous: Anterior + posterolateral thigh
What is the nerve most likely to be injured during surgery for endometriosis resection?
Obturator
- Presentation: sensory loss on medial upper thigh. Impaired adduction
- more likely to be damaged in retroperitoneal surgery
What nerve can be damaged in SSLF? What are the features?
Pudendal.
Buttock, perineal and vulval pain. Worse on sitting.
What is the incidence of ilioinguinal/iliohypogastric nerve injury in a Pfannestiel incision?
~4%
- Features: paresthesia from incision to mons pubis and labia
- 7% of women have chronic pain after Pfannestiel
What proportion of women develop chronic nerve pain after Pfannestiel incision?
7%
What is the most commonly injured nerve during open hysterectomy?
Femoral nerve.
After that, lateral cutaneous.
Both because of the retractors.
11% of women will have femoral nerve injury after open hysterectomy.
What is the most common cause of genitofemoral nerve injury? What are the features?
Pelvic side wall surgery/ External iliac nodes
Fetaures: most pubis/labia majora/femoral triangle
What is the nerve most likely to be injured during external iliac node removal? What are the features?
Genitofemoral nerve. Paresthesia on mons/labia/femoral triangle
What nerves can lithotomy injure and how? What are the features?
Sciatic and common peroneal.
This is through hyperflexion of hips or compression of fibular neck.
For sicatica, it is reduced sensation below knee, weakness on knee flexion and hip extension
For common peroneal it is foot drop and paresthesia on calf and dorsum of foot
