Recalls Flashcards
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Frequency of current used in electrosurgery?
Needs to be over 100khz
100khz to 5 mhz
What is the most abundant carbohydrate in breast milk
Lactose
What causes caput medusa?
This is when the veis around the umbilicus become swollen.
Caused by dilation of paraumbilical veins from portal hypertension
why does suxamethonium not cross the placental barrier?
Because it is highly ionized. Non-ionized drugs more readily cross the placenta.
In a forest plot, what do the horizontal lines represent
conficence intervals
Green frothy discharge with PH of 6
trichomonas
What is a normal vaginal ph
Which infections affect the ph
3.8-5.0
Trichomonas, chlamydia, gonorrhoea, BV all higher PH
Why can vitamin A cause birth defects
Hypervitaminosis A
What is the primary way that choriocarcinoma is spread
Haematogenous
Which drug can be given to reverse myelotoxicity with methotrexate
Folinic acid
AKA Calcium folinate
NOT FOLIC ACID
At what stage of syphilis does condyloma lata present?
It is the wart like lesions that present i secondary syphilis
What type of epithelium lines the mons pubis
Staratified squamous ketatinized
What do plasma cells come from?
B lymphocytes
What is the embryological origin of the trigone of the bladder
What about the bladder?
mesonephric duct from the mesoderm
Bladder is from the urogenital sinus from the endoderm
What condition can oxybutynin aggrevate and why?
Closed angle glaucoma
All anticholinergics are contraindicated in glaucoma
How do the following nerves relate to the psoas muscle:
Obturator
Femoral
Genitofemoral
Lateral femoral cutaneous nerve
The obturator nerve L2/4 - descends through the psoas muscle and appears on the medial border
The femoral nerve L2/4 - descends through the psoas muscle
Genitofemoral L1/2 - travels anteriorly to the psoas muscle
LFCN L2/3 - emerges from the lateral border of psoas
Which of the following eicosanoids are high for menstruation:
Leucotriene LT
Thromboxane A2
Prostaglandin F2a
Prostaglandin D2
Prostaglandin E2
Prostaglandin F2a and E2
Which enzyme in the renal tubular cells is responsible for producing ammonia
Glutaminase
Which is the most common cause of secondary hyperparathyroidism
Chronic renal failure
Which nucleus in the hypothalamus produces ADH and oxytocin
Supraoptic AND paraventricular
What is the route of the piriformis muscle
Sacrum –> greater sciatic foramen –> greater trochanter femur
What is the function of DNA polymerase
Acurately replicate DNA before cell division. It does this by reading existing DNA and creating two replicate strands. It does this by adding nucleotides to the growing strand
How many points does postmenopausal give you in RMI
x3 of total score
What level do the common iliacs bifurcate
L4
What are the tumour markers for:
Dysgermioma
Teratoma
Theca cell tumour
Granulosa cell tumour
Endodermal sinus tumour
Brenner cell tumour
Dysgermioma - high LDH
Teratoma - rarely but sometimes AFP
Theca cell tumour - no markers
Granulosa cell tumour - inhibin and AMH
Endodermal sinus tumour/yolk sac tumour - AFP
Brenner cell tumour - no marker
Which are the muscles most likely to be cut in a ML episiotomy
Bulbospongiosus and superficial transverse muscles
Which imunoglobulin primarily secreted in general and more specifically from cervix?
IgA
Most common subtype of cancer associated with endometriosis
Endometrioid adenocarcinoma… followed by clear cell carcinoma
Clue cells in discharge
BV, gardenella vaginosis
What is the embryological origin of a lateral wall vaginal cystic structure
It is a gartners duct. This is the mesonephric duct
What is the function of the mesonephric duct/where does it come from?
Males vs females?
it comes from the mesoderm.
Mesoderm makes the ureteric bud
- ureters
- trigone of the bladder
- renal tubules
- renal pelvis
In males:
- vas deferens
- Epididymas
- Seminal vesicles
- Ejaculatory duct
The sertoli cells secrete AMH which causes regression of the paramesonephric duct - formes the testes appendix.
Leydig cells secrete testosterone which causes the development of the mesonephric duct into the male bits.
The testes develop from the gonadal ridge which is part of the mesonephros.
In females:
- Regresses but can stay and form gartner’s duct which is a cystic structure in the vaginal wall
In females the more important one is the paramesonephric duct which forms:
- Uterus
- Top 1/3 vagina
- Fallopian tubes
Similarly the ovaries are from the gonadal ridge which is part of the mesonephros
Also from the mesoderm
What percentage of T4 is free
0.03%
Mostly bound to thyroxine binding globulin
0.3% T3 unbound
what is the commonest and second most common cause of CAH?
FIRST - 21-hydroxylase deficiency
SECOND - 11-beta hydroxylase deficiency
What is the anatomical location of the bartholins gland
superficial perineal pouch
Most common cause of PMB?
Atrophic vaginitis
What is the neonatal effect of lithium in first trimester
Ebstein’s anomaly. Abnormal tricuspid valve and right heart
What is the mechanism of action of atosiban
Oxytocin antagonist
What is the commonest cause of a femal urethral caruncle
It is a fleshy growth at the urethral meatus
Caused by low oestrogen in postmenopusal women
Which type of vaccine as absolutely contrindicated during pregnancy
live attenuated
Which receptors does terbutaline stimualte
Beta 2 adrenergic.
Relaxes uterus and also bronchodilates
What type of bacteria is neisseria gonorrheoa
Gram negative aerobic cocci
Which nerve enters the leg by passing under the inguinal ligament just medial to the ASIS?
Lateral femoral cutaneous nerve
Normal endometrial glands within the myometrium and and enlarged uterus. Diagnosis?
Adenomyosis
Which of the following lab techniques is used for RNA analysis?
Northern
Southern
Western
Eastern
SNOW DROP
northern - RNA
What type of necrosis is seen i the heart after an acute MI?
Liquifactive necrosis
Coagulative necrosis
Caesiating necrosis
Gangrenous necrosis
Fibroid necrosis
coagulative necrosis
Which of the following Igs has a dimeric structure?
Which has a pentad structure?
IgA
IgM is pentad
The rest are monomers
Which of the following is the major buffer in urine:
Bicarbonate
Phosphate
Calcium carbonate
PHOSPHATE
How many carbon atoms does oestrogen contain
18
24 hydrogen
2 oxygen
What is the most common cause of a transfusion reaction
ABO incompatability
How much cervical cancer is HPV 16/18 responsible for
70%
Where are the renal tubules developed from
the mesonephric duct aka wolffian duct
What is riak of breast ca and ovarian Ca with BRCA 1 vs BRCA 2
BRCA 1
B 75%
O 35%
BRCA 2
45%
15%
What is the narrowest part of the fallopian tube
The intitstitial aprt aka intramural part.
Which abx contraindicated in pregnancy
Qunolones
Tetracyclines
Which cells produce parathyroid hormone
Chief cells
Which hormone decreases appetite
Leptin
How is magnesium excreted
Kidneys. Doesnt need to bec onjugated or metabolised
How does IgG transfer across the placenta
receptor mediated endocytosis which is a type of PINOCYTOSIS
What type of structure does GNRH have
decapeptide - made from 10 amino acids
What type of drug is drosperinone
It is a progesterone
BOTH antiandrogenic and antimineralocorticoid
Most common type of fbroid degeneration NOT pregnant vs pregnant
NOT pregnant = hyaine
Pregnant = red
What type of data is blood group
nominal
Formation of iron in the gut requires which vitamins
Vitamin C
How to calculate SEM
Standard deviation / Square root of sample size
Mechanism of action of hydralazine
Smooth muscle relaxant
What type of compound is renin
PROTEIN
glycoprotein enzyme
What is the most common complication of asymptomatic bacteruria in pregnancy
Pyelo
followed by PTL
What are the proteins that coil in DNA
Histones
Hyphae in vaginal discharge
candida!
When is the peak plasma volume in pregnancy
24-32 weeks
What is the mechanism of action of Ulipristal Acetate
progesterone receptors so prevents ovulation. Also inhibits Lh.
It is a selective progesterone receptor modulator NOT a progesterone analogue
How does botox treat OAB
Inhibits acetylcholine release
Which muscles form the pelvic diaphragm
Levator ani (puborectalis, iliococcygeus, pubococcygeus)
Coccygeus
What is the probability that a fibroid will undergo a sarcomatous change
0.1% VERY LOW
During which phase does chromosome replication take place
S phase.
G1, S, G2, M (cell division)
What does the dexa scan report results in
T score - compares the BMD to individuals to the younger version of them
Z score - compares the BMD to individuals to the equivalent people in sex, age, ethnicity
Can you breast feed if you have HepC
Yes unless you get a nipple injury. BBV
Describe what each bit represents on a box and whisker plot
Label these
Itchy hands and abdomen
Rash around linea nigra
Normal LFTs
Raised bile salts
Normal ALP
Polymoprhic eruption of pregnancy
What is jarsich-herxheimer reaction caused by?
Immunilogical phenomenon after abx treatment for syphilis
Patient generally unwell and exaceration of cutaneous lesions
What is the main site of filtration in the kidney
glomerulus
What are the names of the passageways that are in the placenta which enable passage of small molecules
Gap junctions
Which are the cells which kill other cells infected with viruses
CD8 killer cells. They are the adaptive immune system
CD4 cells are helper cells
Natural killer cells also kill ccells with viruses in them but they are part of the innate immune system
Does a long loop in electrosurgery use a low or high density current
Uses a higher density current because the wire is thin and needs to cut well and coagulate blood vessels well
When can an umbilical hernia be detected on USS
The earliest diagnosis can be 12 weeks because the gut should have internalised again by this time. ?? check this one
Which is the most commonly injured artery during an appenicectomy?
The iliocolic artery
The answer might be the deep circumflex iliac artery but this is much less commonly affected
What does a high protein meal trigger with insulin and glucagon
Increase in both
What is the frequency of TVUSS vs abdo USS
What about an obese patient with a large pelvic mass? Why?
TVUSS - 5-10
Abdo USS - 2-5
Obese with large mass - 2-3 because lower frequency waves have better penetration but WORSE resolution
What is the cause of dimpling in the mid gluteal region
Posterior superior iliac spine
Which of the following are caused by a robertsonian translocation:
Downs sydnrome
Edwards
Pataus
Turners
Downs syndrome
Rarely Pataus
How much of down syndrome is caused by:
Robertsonian
Nondisjunction
95% nondisjunction - error in cell copying
4-5% Robertsonian - bit of chromosome attached to another
Mosaicism 1% - two cell populations
Pathology: microfollicular pattern with call-exner body?
granulosa cell tumour
Also associated with tumour markers inhibin A and B
What is the percentage of women that have a uterine anomaly
3-5%
Where does the appendix of the testis arise from
The paramesonephric ducts
what is the main thing contributing to cystocele
Pubocervical fascia weakening
In addition to this the iliopectinial ligament provides support
What causes the conversion of testosterone to DHT
5 alpha reductase
What is the primary action of DMPA
Depo - inhibits ovulation
Main action of POPs
thickens cervical mucus
What is the main cause of toxic shock syndrome
staph aureus enterotoxin
What does thromboxane have to do with PET?
Thromboxane a2 plays important role in causing vasoconstriction and high BP
Descibe the course of the pudendal nerve
S2-4 –> GSF –> Crosses sacrospinous ligament –> LSF (back into pelvis)–> alcock canal (gives off the 3 branches)
Alcock canal contains (made from obturator internus fascia): pudendal nerve, internal pudendal artery and vein
What hormone is responsible for making more glucose available for the fetus?
Human placental lactogen. This decreases insulin sensitivity in mum, therefore increasing blood glucose levels –> more to transfer to the fetus
What are the phases of lung development in the fetus?
Pseudoglandular - 5-17 weeks
- basic lung structure
- bronchus etc
Canalicular 17-25 weeks
- ducts start to form
- T2 pneumocytes begin to differentiate and surfactant production begins
Saccular phase 25-38 weeks
- Alveolar sacs form (will become alveoli)
- Type 2 pneumocytes become +++
Alveolar phase 36 weeks onwards
- Alveoli form
what is breast feeding protective of
ovarian Ca
Breast Ca
osteoporosos
postpartum depression
Child:
- Diabetes
- obestity
- leukaemia
What is the haldane effect
Dcrease in O2 carrying by haemoglobi means it can carry CO2
Which neurotransmitter is inhibited by atropine
acetylcholine
What is ziduvidane
A HIV drug
Nucleoside reverse transcriptase inhibitor
What is entonox made from
50% O2 50% NO
Most common ovarian cyst to tort
dermoid
What is the definition of perimortality rate
Death of fetus from 22 weeks to 7 days PN per 1000 births
during a hysterectomy for accreta, which artery is ligated
IIA
BRCA mode of inheritance
AD
How much of oestrogen is bound to SHBG
40-50%
