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MRCOG Part 1 > Physiology > Flashcards

Physiology Flashcards

1
Q

What change occurs to arterial pCO2 in pregnancy?

A

Reduced

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2
Q

What reduces arterial pCO2 geographically?

A

Altitude > 2500m

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3
Q

Effect of arterial pCO2 on cerebral blood flow?

A

Increased pCO2 increases cerebral blood flow

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4
Q

What is the effect of reduced arterial pCO2 on urine?

A

Reduced pCO2 —> increased blood pH —> more alkaline urine

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5
Q

How does pH affect calcium?

A

Acidosis favors release of ionized Ca
Alkalosis favors binding of Ca and Dec ionized Ca
Total Ca level unchanged

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6
Q

Where is somatostatin produced?

A

Delta cells of pancreas and hypothalamus (growth hormone inhibiting hormone)

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7
Q

What do pancreatic beta cells produce?

A

Insulin and amylin

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8
Q

What are the contractant molecules of the myometrium?

A

Oxytocin (produced by uterus)
Prostaglandins (F2alpha)

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9
Q

How do the contractant molecules of the myometrium stimulate contractility?

A

Oxytocin and prostaglandins act via G protein coupled receptors to activate phospholipase C which increases intracellular Ca2+ concentration and activation of myosin light chain kinase, and Ca2+/calmodulin dependent protein kinase

Positive feedback loop - oxytocin stimulates uterine prostaglandin synthesis and prostaglandins up regulate oxytocin receptor expression

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10
Q

What are the relaxant molecules of the myometrium?

A

NO, relaxin, progesterone, (prostacyclin)

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11
Q

What is the action of myometrium relaxants?

A

Via cAMP and cGMP, activate dependent protein kinases which dephosphorylate myosin light chain and limit contraction force

Progesterone also inhibits synthesis and action of oxytocin and prostaglandins and inhibits gap junctions

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12
Q

Causes of hypokalaemia

A
  1. Transcellular shifts - alkalosis, insulin, beta-agonists
  2. Renal losses - diuresis, DKA after therapy, Conn’s
  3. Extrarenal losses - diarrhoea, NG suction
  4. Decreased intake - malnutrition, alcoholism
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13
Q

How is insulin made?

A

Cleavage of C-peptide from peptide chain

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14
Q

What change in electrolytes is acidosis associated with?

A

Potassium retention and rise in chloride with maintenance of anion gap

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15
Q

Vertical transmission rate of Hep B?

A

?20

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16
Q

Cancer type associated with endometrioma?

A

Clear cell carcinoma

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17
Q

Changes to insulin and glucagon after protein rich meal?

A

Both increase

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18
Q

What can occur with silicone implant rupture?

A

Silicone granuloma with giant cells

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19
Q

When should amniocentesis be performed?

A

After 15+0/40

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20
Q

When should CVS be performed?

A

After 11+0/40 (and not before 10+0/40)

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21
Q

What is the newborn screening test for CF?

A

Immunoreactive trypsinogen in Guthrie

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22
Q

Which hormone is similar to oxytocin?

A

Vasopressin

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23
Q

What type of oestrogen predominates in menopause?

A

Estrone E1

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24
Q

What type of oestrogen predominates in fertile non-pregnant women?

A

Estradiol E2

25
Q

What type of oestrogen is produced by placenta?

A

Estriol E3

26
Q

What type of oestrogen is produced by fetal liver?

A

E4 estetrol

27
Q

Where are oestrogens produced?

A

Ovary
Liver
Adrenal glands
Adipose tissue
Breast tissue
Placenta

28
Q

What is progesterone a precursor for?

A

Aldosterone, cortisol, androstenedione, testosterone

29
Q

Where is progesterone produced?

A

Corpus luteum, tested, adrenals, placenta

30
Q

Daily calcium requirement of fetus in third trimester?

31
Q

Most frequent cause of pathological hyperprolactinaemia?

32
Q

Which cell type congegrates in cervix to release collagenase?

A

Neutrophils

33
Q

At what gestation is physiological dilution anaemia the greatest?

34
Q

Hb concentration of newborn?

A

165-175 g/L

35
Q

Most important buffer in interstitial space?

A

Bicarbonate

36
Q

Normal adult dietary requirement of calcium?

37
Q

Ratio of plasma testosterone in pregnancy?

A

1% free, 19% albumin bound, 80% SHBG bound

38
Q

Placental mechanism for uptake of glucose?

A

Facilitated diffusion

39
Q

Fetal Ca requirement in third trimester?

40
Q

What is the distance between z-lines in muscle?

41
Q

What is the length of myosin in muscle?

42
Q

Beta-hCG peaks at?

A

8-12 weeks

43
Q

Which 3 hormones are structurally similar?

A

Prolactin, GH, hPL

44
Q

Which 4 hormones are structurally similar?

A

FSH, LH, hCG, TSH

45
Q

Which hormones stimulate breast ductal morphogenesis in pregnancy?

A

Oestrogen and GH

46
Q

Which hormones stimulate breast alveolar morphogenesis in pregnancy?

A

Progesterone, prolactin, hPL

47
Q

Most important anion in urine?

48
Q

Cytokine involved in OHSS?

49
Q

Hormone predictor of fertility and androgenic?

50
Q

Main difference between transudate and exudate?

A

High specific gravity

51
Q

Genetic variants of LH reported in individuals with PCOS?

A

Variants of LH beta subunit

52
Q

Structure of progesterone?

53
Q

Oliguria definition

A

<400mL urine in 24h (but >100mL)

54
Q

Anuria definition

A

<100mL urine/24h

55
Q

Number of carbons of androgens?

56
Q

Number of carbons of estrogens?

57
Q

Time to produce sperm?

58
Q

Time for follicular maturation up to ovulation?

MRCOG Part 1 (13 decks)

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