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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
Furguson reflex?
Pressure effect on cervix
26
Which interleukin causes cervical ripening?
IL 8
27
What is the cause of inc in oxytocin receptors in myometrium in the 3rd trimester?
Estrogen
28
COP increase in pregnancy
40% increase from 4.5 to 6 l/min.
29
HR increase in pregnancy
10% from 80 to 90 bpm
30
Peripheral resistance in pregnancy increased or decreased?
Decreased. (d.t. relaxant effect of progesterone in arterial smooth muscles)
31
Range of normal fetal heart rate ?
110-160 bpm
32
In pregnancy, alkaline phosphatase ⬆️ or ⬇️
Increases three times its normal levels because it’s also produced by the placenta
33
What size is a follicle ready to ovulate
>20 mm
34
What size is a resting follicle?
> 0.02 mm
35
Which testicular cells are located outside the blood/testis barrier?
Leydig cells
36
What is the average haemoglobin concentration in a newborn at term
17 g/dl
37
Regarding plasma calcium, what proportion is carried in an ionized form
45%
38
At what gestation does fetal urine become the major contributor to amniotic fluid volume
> 18 weeks
39
The required daily intake of which vitamins and minerals is not increased in pregnancy or lactation
VIT D and K
40
At what gestational age does the formation of the definitive alveoli take place
> 36 weeks The alveolar stage starts at 36 week and may take up to 2 years postnatal to complete
41
Which test is used to diagnose haemolytic anaemia in a newborn
Direct Coomb Test
42
RBCs life span
> 120 days
43
Platelets life span
> 5 - 10 days
44
Increase of Oxygen consumption in pregnancy
> 50 ml/min
45
Mendelson syndrome
known as peptic pneumonia, refers to acute chemical pneumonitis caused by the aspiration of stomach contents in patients under general anesthesia.
46
Kidneys percent of COP
25% = 1.2L
47
Renal Plasma Flow normally equals
660 ml/min
48
Creatinine clearance
120 ml/min
49
GFR normally equals
120 ml/min (less 10% in females)
50
Bladder is stimulated at what volume
300 ml
51
Gestational age of Luteo-placental shift
6 weeks
52
Start of fetal erythropoesis
6 weeks gestations
53
Number of primordial follicles at 6 months gestation
5-7 millions
54
Number of primordial follicles at birth
1-2 million
55
Number of primordial follicles at puberty
400.000 follicles
56
What percentage of hemoglobin is HbF in the newborn?
50-90%
57
Cardiac output is calculated by
Stroke Volume X Heart Rate
58
What is the average lifespan of a basophil (white blood cell)?
3-4 days
59
Where in the kidney is the majority of Bicarbonate reabsorbed
Proximal Convoluted tubules
60
What is the typical volume increase from a non-pregnant to term uterus?
10-5000 ml
61
Following parturition uterine contractions called After-pains may typically continue for how long?
2 - 3 days
62
At what gestational age does the luteo-placental shift occur?
6 -8 weeks
63
During pregnancy which hormone(s) inhibit lactogenesis?
Estrogen and Progesteron
64
During pregnancy the GFR changes as
GFR increases by 40%
65
Which structure is the primary mechanism for shunting blood away from the fetal pulmonary circulation?
Foramen Oval
66
Which test is most appropriate in diagnosing the thyroid dysfunction in pregnancy?
Free thyroxine (T4) levels
67
Which mechanism of transfer do oxygen and carbon dioxide cross the placenta?
Simple diffusion
68
Which part of the nephron has receptors for antidiuretic hormone (ADH) (vasopressin)?
Collecting Duct
69
What structure carries the electrical impulse from the sino-atrial node to the atrio-ventricular node?
Cardiac smooth muscle
70
What is the blood flow to the uterus in a term pregnancy?
700 ml/min
71
Minute ventilation in pregnancy increases due to
Increased Progesterone
72
Which cells are responsible for the production of surfactant?
Type II pneumocytes
73
What is the percentage change in minute ventilation during the first trimester of pregnancy?
40% increase
74
Ootidogenesis refers to
1st and 2nd Meiotic Divisions
75
At what gestational age does the formation of the definitive alveoli take place?
36 weeks
76
During lactation the 'let-down' reflex is stimulated by the action of which hormone?
Oxytocin
77
Urea is transferred from fetal circulation to maternal circulation via which transport mechanism?
Passive diffusion
78
Ammonia is transported from fetal to maternal circulation by
Active transport
79
How many days does it take from the resting follicle stage to ovulation?
375 days
80
LH peak precedes ovulaQon by?
16 h
81
Which one of the following best describes the histological type of endometrium soon after ovulation?
Secretory endometrium
82
The use of hormone replacement therapy (HRT) will decreases the risk of which cancer?
colorectal cancer HRT benefits : • ↓ Vasomotor symptoms. • ↓ urogenital symptoms and improved sexuality. • ↓ Risk of osteoporosis . • ↓ Risk of colorectal cancer.
83
Wernicke-Korsakoff syndrome Deeiciency disease of vitamin?
Vit. B1
84
For overactive bladder a new drug called Mirabegron is used. Which is the single mechanism of action for this drug?
Selective Beta-3 antagonist
85
Primary stimulator of uterine involution after delivery is
Oxytocin
86
Physiological anemia occurs in what gestational age
32 weeks
87
WHAT IS THE TOTAL BLOOD VOLUME IN A TERM NEWBORN?
85 ml/kg
88
Peak maternal hCG concentration at week
10 weeks
89
Which organisms do type II PNEUMOCYTES utilifor surfactant release
Lamillar bodies
90
Q34. Antibodies present in a patient of O positive blood group
Anti A,Anti B & Anti-D
91
How many sperms produced in 24 hours
30 million
92
What happens to both intrathoracic volume and pressure on inspiration
Volume increases pressure decreases
93
What is the motor nerve root supply to the diaphragm
C3,4,5
94
What metabolite is produced when vitamin D is metabolized by liver
25 Dihydroxycholecalciferol
95
Which substance gives the most accurate measurement of the glomerular filtration rate
Insulin
96
During labor what is the minimum intrauterine pressure achieved by contractions to progressively dilate the cervix
25mmhg
97
What happens to the systolic and diastolic blood pressure in the first trimester
Systolic doesn’t change diastolic decreases
98
Which vitamin is the only one that is water soluble
Vit B
99
At what stage of pregnancy is there an increase in serum alkaline phosphatase concentration
Third trimester
100
What is the concentration of potassium cations in extracellular and intracellular fluid
ECF: 4 meq/L ICF: 140 meg/L
101
At what gestational age does the fetus typically start swallowing
12 weeks
102
First fetal urine produced at
8 to 11 weeks
103
Typical O2 consumption in non pregnant women
250 ml/min In pregnancy increases 50ml to be 300 ml/min
104
What is the primary form of hemoglobin in a 18 week old fetus
HbF Before 10-12 weeks: embryonic Hb After 10-12 weeks: fetal Hb
105
Aldosterone promotes water retention via which mechanism
Regulation of sodium potassium pumps in distal tubule and collecting ducts
106
What percentage of hemoglobin is HbF by six months of age
<2%
107
Upregulation of urea movement through urea transport proteins in the collecting ducts is effect of 
Vasopressin
108
What is the maximum normal menstrual blood loss
85 ml Average blood loss= 35-40 ml
109
What is average volume of blood loss during the Menstrual cycle
35 - 40 ml
110
Following partiurition how long does involution of the uterus take
4-6 weeks
111
Mature breast milk composition
Fat 4% Protein 1% Sugar 7%
112
Causes of prolonged prothrombin time (and also INR)
- Factor V deficiency - Warfarin Therapy - Liver Failure - DIC
113
Primary stimulus of ADH release is
High serum osmolality
114
mean arterial pressur (MAP) is equal to
DBP + 1/3 (pulse pressure)
115
Blood flow through cerebral circulation is directly proportion to:
pCO2
116
By how much does the overall size of the kidney increase during pregnancy ?
1 cm
117
What is the relative concentration of follicle-stimulating hormone (FSH) and oestradiol in the late menopausal transition?
High FSH level and low oestradiol level
118
Renal site where aldosterone mainly exerts its action?
Distal convoluted tubules
119
99% of body calcium is in what form?
Calcium phosphate
120
During pregnancy what changes of the upper respiratory mucosa would you expect to see?
Increased phagocytic activity and increased mucopolysacchride content
121
Commonest cause of hypercalcemia in UK, (30 / 100000)
Primary Hypepararthyroidism
122
The Haldane effect refers to
The increased capacity for deoxygenated blood to carry CO2
123
The softening of the cervical isthmus that occurs early in gestation is called:
Hegar's sign
124
Insensible loss of water from sweat and lungs in 70 years old healthy woman is?
850 ml/kg
125
T- score to asses bone density
+1 to >-1 Normal -1 to -2.25 Osteopenia <-2.25 Osteoprosis (+fractures = severe)

MRCOG - PART 1 (15 decks)

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