Past paper questions Flashcards
Pudendal nerve roots
S2,S3,S4
What muscle does the pudendal nerve innervate
Levator ani (PPI - Puborectalis, pubococcygeous, iliococcygeous), bulbospongiousus, ischiocaernosis, external anal sphincter, female external uerthral sphincter
Path of pudendal nerve
S2-S4 -> leaves greater sciatic foramen through ischial spine and sacrospinous ligament -> lesser foramen -> pudendal canal here it splits into dorsal nerve of clitoris, perineal nerve, inferior rectal nerve
Pudendal nerve accompanies the internal pudendal vessels along the lateral wall of the ischiorectal fossa, contained in the sheath of the obturator fascia - called pudendal canal
Medial to pudendal artery
Sensory areas of pudendal nerve
Inferior rectal nerve -> anal skin
Perineal nerve -> scrotum/labia majora, urethra/labia minora
Dorsal nerve -> penis/clitoris
Does PCO2 decrease or increase in pregnancy
Decreases
Does PCO2 increase or decrease in high altitudes
Decreases
Does reduced pco2 increase cerebral blood flow
False
Does reduced pco2 increase or decrease blood ph
false
Do B lymphocytes produce IgE
They differentiate into plasma cells which produce IgE
B lymphocytes present antigens to which type of cells?
T cells
Which are the 3 types of MHC Class 2 APCS
Dendiritc cells
Macrophages
B cells
What to B cell produce
antibodies
Do B cells produce complemtsn
No
Mode of delivery for women on cART for HIV?
Check viral load at 36 weeks:
- If <50 RNA copies - vaginal
- If 50-399 RNA copies- consider PLCS
- If >/ 400 RNA copies - PLCS
Mode of delivery for women on zidovudine therapy?
PLCS regardless of viral load
What are the indications for zidovudine infusion?
- If viral load >1000, and presenting for elective cs, ruptured membranes or in active labour
- If unknown viral load
- If on zidovudine mono therapy
When do you give antiretroviral therapy for babies born to HIV positive mothers?
VERY LOW RISK
- If mum has 2x HIV load <50 taken 4 weeks apart
AND
- HIV load <50 at 36 weeks
AND
- Mum has taken cART for >10 weeks
—- 2 weeks zidovudine mono therapy for infant
LOW RISK
- If mum has HIV load <50 at 36 weeks
—– 4 weeks zidovudine monoterahpy
HIGH RISK
- does not meet low risk category
—— combination PEP
HIV testing in formula fed infants
At 48hr and prior to discharge
If high risk - at 2 weeks
6 weeks
12 weeks
HIV antibody seroconversion at 18 and 24 months
HIV testing in breast fed infants
At 48hrs and prior to discharge
2 weeks
6 weeks
12 weeks
Monthly for the duration of breast feeding
4 and 8 weeks after breast feeding
What are the indications for fetal blood sampling?
CTG abnormal in labour
Suspected fetal acidosis in labour
Contraindiations to FBS
-Maternal infection - HIV, ETC
- PREMATURE 34 WEEKS
- FETAL COAGULOPATHY
- ACUTE FETAL COMPROMISE
What is a normal FBS Ph and what is the action
> 7.25
Repeat FBS in 1 hr if CTG remains abnormal
What is borderline FBS pH and what is the action
7.21 - 7.24
Repeat in 30 mins
What is abnormal FBS pH and what is the action
<7.2
consider delivery
