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MRCOG - PART 1 > Physiology > Flashcards

Physiology Flashcards

1
Q

Where in the body is angiotensin I converted to angiotensin II under the influence of angiontensin-converting enzyme?

A

Lungs

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2
Q

The amniotic fluid volume peaks at around 900ml. At what gestation does the amniotic fluid reach its maximum volume?

A

35 Weeks

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3
Q

What is the typical time taken for wounds closed by primary intention to reach full tensile strength?

A

12 Weeks

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4
Q

Where in the kidney is the majority of Bicarbonate reabsorbed??

A

Proximal Convoluted Tubules

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5
Q

What is the primary form of haemoglobin in a 6 week old foetus?

A

Hb Gower 1

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6
Q

Placental production of hPL, hCG, Oestrogen and Progesterone are examples of which type of mechanism?

A

Endocrine

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7
Q

What is the typical volume
increase from a non-pregnant to term
uterus?

A

10 ml to 5000 ml

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8
Q

What is the typical weight of a non-pregnant premenopausal uterus?

A

40 gm

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9
Q

Which of the following is a primary site of Prostaglandin E2 (PGE2) production?

A

Placenta

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10
Q

During pregnancy which hormone(s) inhibit lactogenesis?

A

Oestrogen and Progesterone

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11
Q

In the 3rd trimester anemia is defined by?

A

Haemoglobin < 10.5 g/l

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12
Q

GERD is common in pregnancy, esophageal sphincter relaxes due to what hormone?

A

Progesterone

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13
Q

PR interval in Wolff Parkinson White syndrome

A

Rapid interval <0.1 sec

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14
Q

Stroke Volume

A

SV= End diastolic Volume - End sysolic volume

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15
Q

Ejection Fraction

A

EF= SV/EDV

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16
Q

Location of Carotid Sinus

A

Bifurcation of common carotids

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17
Q

ACE converts

A

Angiotensin I to Angiotensin II

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18
Q

The main Stimulus to respiratory centers

A

Chemoreceptors

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19
Q

The main chemical mediator responsible for the closure of patent ductus arteriosus

A

Bradykinin (from the lungs)

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20
Q

Administration of Prostaglandin antagonist soon after birth used to therapeutically close what patent structure?

A

Ductus Arteriosus

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21
Q

During Lactation, “let down” reflex is stimulated by which hormone?

A

Oxytocin

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22
Q

Role of fetus in initiation of labor?

A

gives CRH

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23
Q

Before labor starts, which factors stop the uterus from contracting?

A

Progesterone
Catecholamines
Relaxin

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24
Q

Which type of prostaglandins are involved in the ripening of the cervix?

A

rapid rise in the activity of COX-2 and other inflammatory cytokines at the onset of
labour, leading some to compare labour to an inflammatory process. Increased COX-2 activity leads to an
increase in prostaglandin synthesis; the amnion and chorion secrete primarily prostaglandin-E2, while the
decidua favours prostaglandin-F2α

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25
Q

Furguson reflex?

A

Pressure effect on cervix

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26
Q

Which interleukin causes cervical ripening?

A

IL 8

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27
Q

What is the cause of inc in oxytocin receptors in myometrium in the 3rd trimester?

A

Estrogen

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28
Q

COP increase in pregnancy

A

40% increase from 4.5 to 6 l/min.

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29
Q

HR increase in pregnancy

A

10% from 80 to 90 bpm

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30
Q

Peripheral resistance in pregnancy increased or decreased?

A

Decreased. (d.t. relaxant effect of progesterone in arterial smooth muscles)

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31
Q

Range of normal fetal heart rate ?

A

110-160 bpm

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32
Q

In pregnancy, alkaline phosphatase ⬆️ or ⬇️

A

Increases three times its normal levels because it’s also produced by the placenta

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33
Q

What size is a follicle ready to ovulate

A

> 20 mm

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34
Q

What size is a resting follicle?

A

> 0.02 mm

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35
Q

Which testicular cells are located outside the blood/testis barrier?

A

Leydig cells

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36
Q

What is the average haemoglobin concentration in a newborn at term

A

17 g/dl

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37
Q

Regarding plasma calcium, what proportion is carried in an ionized form

A

45%

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38
Q

At what gestation does fetal urine become the major contributor to amniotic fluid volume

A

> 18 weeks

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39
Q

The required daily intake of which vitamins and minerals is not increased in pregnancy or lactation

A

VIT D and K

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40
Q

At what gestational age does the formation of the definitive alveoli take place

A

> 36 weeks

The alveolar stage starts at 36 week and may take up to 2 years postnatal to complete

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41
Q

Which test is used to diagnose haemolytic anaemia in a newborn

A

Direct Coomb Test

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42
Q

RBCs life span

A

> 120 days

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43
Q

Platelets life span

A

> 5 - 10 days

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44
Q

Increase of Oxygen consumption in pregnancy

A

> 50 ml/min

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45
Q

Mendelson syndrome

A

known as peptic pneumonia, refers to acute chemical pneumonitis caused by the aspiration of stomach contents in patients under general anesthesia.

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46
Q

Kidneys percent of COP

A

25% = 1.2L

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47
Q

Renal Plasma Flow normally equals

A

660 ml/min

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48
Q

Creatinine clearance

A

120 ml/min

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49
Q

GFR normally equals

A

120 ml/min (less 10% in females)

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50
Q

Bladder is stimulated at what volume

A

300 ml

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51
Q

Gestational age of Luteo-placental shift

A

6 weeks

52
Q

Start of fetal erythropoesis

A

6 weeks gestations

53
Q

Number of primordial follicles at 6 months gestation

A

5-7 millions

54
Q

Number of primordial follicles at birth

A

1-2 million

55
Q

Number of primordial follicles at puberty

A

400.000 follicles

56
Q

What percentage of hemoglobin is HbF in the newborn?

A

50-90%

57
Q

Cardiac output is calculated by

A

Stroke Volume X Heart Rate

58
Q

What is the average lifespan of a basophil (white blood cell)?

A

3-4 days

59
Q

Where in the kidney is the majority of Bicarbonate reabsorbed

A

Proximal Convoluted tubules

60
Q

What is the typical volume increase from a non-pregnant to term uterus?

A

10-5000 ml

61
Q

Following parturition uterine contractions called After-pains may typically continue for how long?

A

2 - 3 days

62
Q

At what gestational age does the luteo-placental shift occur?

A

6 -8 weeks

63
Q

During pregnancy which hormone(s) inhibit lactogenesis?

A

Estrogen and Progesteron

64
Q

During pregnancy the GFR changes as

A

GFR increases by 40%

65
Q

Which structure is the primary mechanism for shunting blood away from the fetal pulmonary circulation?

A

Foramen Oval

66
Q

Which test is most appropriate in diagnosing the thyroid dysfunction in pregnancy?

A

Free thyroxine (T4) levels

67
Q

Which mechanism of transfer do oxygen and carbon dioxide cross the placenta?

A

Simple diffusion

68
Q

Which part of the nephron has receptors for antidiuretic hormone (ADH) (vasopressin)?

A

Collecting Duct

69
Q

What structure carries the electrical impulse from the sino-atrial node to the atrio-ventricular node?

A

Cardiac smooth muscle

70
Q

What is the blood flow to the uterus in a term pregnancy?

A

700 ml/min

71
Q

Minute ventilation in pregnancy increases due to

A

Increased Progesterone

72
Q

Which cells are responsible for the production of surfactant?

A

Type II pneumocytes

73
Q

What is the percentage change in minute ventilation during the first trimester of pregnancy?

A

40% increase

74
Q

Ootidogenesis refers to

A

1st and 2nd Meiotic Divisions

75
Q

At what gestational age does the formation of the definitive alveoli take place?

A

36 weeks

76
Q

During lactation the ‘let-down’ reflex is stimulated by the action of which hormone?

A

Oxytocin

77
Q

Urea is transferred from fetal circulation to maternal circulation via which transport mechanism?

A

Passive diffusion

78
Q

Ammonia is transported from fetal to maternal circulation by

A

Active transport

79
Q

How many days does it take from the resting follicle stage to ovulation?

A

375 days

80
Q

LH peak precedes ovulaQon by?

A

16 h

81
Q

Which one of the following best describes the histological type of endometrium
soon after ovulation?

A

Secretory endometrium

82
Q

The use of hormone replacement therapy (HRT) will decreases the risk of which cancer?

A

colorectal cancer

HRT benefits :
• ↓ Vasomotor symptoms.
• ↓ urogenital symptoms and improved sexuality.
• ↓ Risk of osteoporosis .
• ↓ Risk of colorectal cancer.

83
Q

Wernicke-Korsakoff syndrome Deeiciency disease of vitamin?

A

Vit. B1

84
Q

For overactive bladder a new drug called Mirabegron is used. Which is the single mechanism of action for this drug?

A

Selective Beta-3 antagonist

85
Q

Primary stimulator of uterine involution after delivery is

A

Oxytocin

86
Q

Physiological anemia occurs in what gestational age

A

32 weeks

87
Q

WHAT IS THE TOTAL BLOOD VOLUME IN A TERM NEWBORN?

A

85 ml/kg

88
Q

Peak maternal hCG concentration at week

A

10 weeks

89
Q

Which organisms do type II PNEUMOCYTES utilifor surfactant release

A

Lamillar bodies

90
Q

Q34. Antibodies present in a patient of O positive blood group

A

Anti A,Anti B & Anti-D

91
Q

How many sperms produced in 24 hours

A

30 million

92
Q

What happens to both intrathoracic volume and pressure on inspiration

A

Volume increases
pressure decreases

93
Q

What is the motor nerve root supply to the diaphragm

A

C3,4,5

94
Q

What metabolite is produced when vitamin D is metabolized by liver

A

25 Dihydroxycholecalciferol

95
Q

Which substance gives the most accurate measurement of the glomerular filtration rate

A

Insulin

96
Q

During labor what is the minimum intrauterine pressure achieved by contractions to progressively dilate the cervix

A

25mmhg

97
Q

What happens to the systolic and diastolic blood pressure in the first trimester

A

Systolic doesn’t change
diastolic decreases

98
Q

Which vitamin is the only one that is water soluble

A

Vit B

99
Q

At what stage of pregnancy is there an increase in serum alkaline phosphatase concentration

A

Third trimester

100
Q

What is the concentration of potassium cations in extracellular and intracellular fluid

A

ECF: 4 meq/L
ICF: 140 meg/L

101
Q

At what gestational age does the fetus typically start swallowing

A

12 weeks

102
Q

First fetal urine produced at

A

8 to 11 weeks

103
Q

Typical O2 consumption in non pregnant women

A

250 ml/min

In pregnancy increases 50ml to be 300 ml/min

104
Q

What is the primary form of hemoglobin in a 18 week old fetus

A

HbF

Before 10-12 weeks: embryonic Hb
After 10-12 weeks: fetal Hb

105
Q

Aldosterone promotes water retention via which mechanism

A

Regulation of sodium potassium pumps in distal tubule and collecting ducts

106
Q

What percentage of hemoglobin is HbF by six months of age

A

<2%

107
Q

Upregulation of urea movement through urea transport proteins in the collecting ducts is effect of 

A

Vasopressin

108
Q

What is the maximum normal menstrual blood loss

A

85 ml

Average blood loss= 35-40 ml

109
Q

What is average volume of blood loss during the Menstrual cycle

A

35 - 40 ml

110
Q

Following partiurition how long does involution of the uterus take

A

4-6 weeks

111
Q

Mature breast milk composition

A

Fat 4%
Protein 1%
Sugar 7%

112
Q

Causes of prolonged prothrombin time (and also INR)

A
  • Factor V deficiency
  • Warfarin Therapy
  • Liver Failure
  • DIC
113
Q

Primary stimulus of ADH release is

A

High serum osmolality

114
Q

mean arterial pressur (MAP) is equal to

A

DBP + 1/3 (pulse pressure)

115
Q

Blood flow through cerebral circulation is directly proportion to:

A

pCO2

116
Q

By how much does the overall size of the kidney increase during pregnancy ?

A

1 cm

117
Q

What is the relative concentration of follicle-stimulating hormone (FSH) and oestradiol in the late menopausal transition?

A

High FSH level and low oestradiol level

118
Q

Renal site where aldosterone mainly exerts its action?

A

Distal convoluted tubules

119
Q

99% of body calcium is in what form?

A

Calcium phosphate

120
Q

During pregnancy what changes of the upper respiratory mucosa would you expect to see?

A

Increased phagocytic activity and increased mucopolysacchride content

121
Q

Commonest cause of hypercalcemia in UK, (30 / 100000)

A

Primary Hypepararthyroidism

122
Q

The Haldane effect refers to

A

The increased capacity for deoxygenated blood to carry CO2

123
Q

The softening of the cervical isthmus that occurs early in gestation is called:

A

Hegar’s sign

124
Q

Insensible loss of water from sweat and lungs in 70 years old healthy woman is?

A

850 ml/kg

125
Q

T- score to asses bone density

A

+1 to >-1 Normal
-1 to -2.25 Osteopenia
<-2.25 Osteoprosis (+fractures = severe)

MRCOG - PART 1 (15 decks)

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