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MRCOG part 1 > Recalls > Flashcards

Recalls Flashcards

1
Q

**

Frequency of current used in electrosurgery?

A

Needs to be over 100khz

100khz to 5 mhz

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2
Q

What is the most abundant carbohydrate in breast milk

A

Lactose

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3
Q

What causes caput medusa?

A

This is when the veis around the umbilicus become swollen.

Caused by dilation of paraumbilical veins from portal hypertension

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4
Q

why does suxamethonium not cross the placental barrier?

A

Because it is highly ionized. Non-ionized drugs more readily cross the placenta.

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5
Q

In a forest plot, what do the horizontal lines represent

A

conficence intervals

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6
Q

Green frothy discharge with PH of 6

A

trichomonas

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7
Q

What is a normal vaginal ph

Which infections affect the ph

A

3.8-5.0

Trichomonas, chlamydia, gonorrhoea, BV all higher PH

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8
Q

Why can vitamin A cause birth defects

A

Hypervitaminosis A

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9
Q

What is the primary way that choriocarcinoma is spread

A

Haematogenous

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10
Q

Which drug can be given to reverse myelotoxicity with methotrexate

A

Folinic acid

AKA Calcium folinate

NOT FOLIC ACID

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11
Q

At what stage of syphilis does condyloma lata present?

A

It is the wart like lesions that present i secondary syphilis

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12
Q

What type of epithelium lines the mons pubis

A

Staratified squamous ketatinized

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13
Q

What do plasma cells come from?

A

B lymphocytes

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14
Q

What is the embryological origin of the trigone of the bladder

What about the bladder?

A

mesonephric duct from the mesoderm

Bladder is from the urogenital sinus from the endoderm

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15
Q

What condition can oxybutynin aggrevate and why?

A

Closed angle glaucoma

All anticholinergics are contraindicated in glaucoma

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16
Q

Which nerve passes through the psoas muscle

A

The obturator nerve

The femoral nerve

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17
Q

Which of the following eicosanoids are high for menstruation:

Leucotriene LT
Thromboxane A2
Prostaglandin F2a
Prostaglandin D2
Prostaglandin E2

A

Prostaglandin F2a and E2

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18
Q

Which enzyme in the renal tubular cells is responsible for producing ammonia

A

Glutaminase

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19
Q

Which is the most common cause of secondary hyperparathyroidism

A

Chronic renal failure

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20
Q

Which nucleus in the hypothalamus produces ADH and oxytocin

A

Supraoptic AND paraventricular

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21
Q

What is the route of the piriformis muscle

A

Sacrum –> greater sciatic foramen –> greater trochanter femur

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22
Q

What is the function of DNA polymerase

A

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

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23
Q

How many points does postmenopausal give you in RMI

A

x3 of total score

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24
Q

What level do the common iliacs bifurcate

A

L4

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25
Q

What are the tumour markers for:

Dysgermioma
Teratoma
Theca cell tumour
Granulosa cell tumour
Endodermal sinus tumour
Brenner cell tumour

A

Dysgermioma - high LDH
Teratoma - rarely but sometimes AFP
Theca cell tumour - no markers
Granulosa cell tumour - inhibin and AMH
Endodermal sinus tumour - AFP
Brenner cell tumour - no marker

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26
Q

Which are the muscles most likely to be cut in a ML episiotomy

A

Bulbospongiosus and superficial transverse muscles

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27
Q

Which imunoglobulin primarily secreted in general and more specifically from cervix?

A

IgA

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28
Q

Most common subtype of cancer associated with endometriosis

A

Endometrioid adenocarcinoma… followed by clear cell carcinoma

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29
Q

Clue cells in discharge

A

BV, gardenella vaginosis

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30
Q

What is the embryological origin of a lateral wall vaginal cystic structure

A

It is a gartners duct. This is the mesonephric duct

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31
Q

What is the function of the mesonephric duct/where does it come from?

Males vs females?

A

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

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

Also from the mesoderm

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32
Q

What percentage of T4 is free

A

0.1%

Mostly bound to thyroxine binding globulin

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33
Q

what is the commonest and second most common cause of CAH?

A

FIRST - 21-hydroxylase deficiency

SECOND - 11-beta hydroxylase deficiency

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34
Q

What is the anatomical location of the bartholins gland

A

superficial perineal pouch

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35
Q

Most common cause of PMB?

A

Atrophic vaginitis

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36
Q

What is the neonatal effect of lithium in first trimester

A

Ebstein’s anomaly. Abnormal tricuspid valve and right heart

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37
Q

What is the mechanism of action of atosiban

A

Oxytocin antagonist

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38
Q

What is the commonest cause of a femal urethral caruncle

A

It is a fleshy growth at the urethral meatus

Caused by low oestrogen in postmenopusal women

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39
Q

Which type of vaccine as absolutely contrindicated during pregnancy

A

live attenuated

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40
Q

Which receptors does terbutaline stimualte

A

Beta 2 adrenergic.

Relaxes uterus and also bronchodilates

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41
Q

What type of bacteria is neisseria gonorrheoa

A

Gram negative aerobic cocci

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42
Q

Which nerve enters the leg by passing under the inguinal ligament just medial to the ASIS?

A

Lateral femoral cutaneous nerve

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43
Q

Normal endometrial glands within the myometrium and and enlarged uterus. Diagnosis?

A

Adenomyosis

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44
Q

Which of the following lab techniques is used for RNA analysis?

Northern
Southern
Western
Eastern

A

SNOW DROP

northern - RNA

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45
Q

What type of necrosis is seen i the heart after an acute MI?

Liquifactive necrosis
Coagulative necrosis
Caesiating necrosis
Gangrenous necrosis
Fibroid necrosis

A

coagulative necrosis

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46
Q

Which of the following Igs has a dimeric structure?

Which has a pentad structure?

A

IgA

IgM is pentad

The rest are monomers

47
Q

Which of the following is the major buffer in urine:

Bicarbonate
Phosphate
Calcium carbonate

A

PHOSPHATE

48
Q

How many carbon atoms does oestrogen contain

A

18

24 hydrogen
2 oxygen

49
Q

What is the most common cause of a transfusion reaction

A

ABO incompatability

50
Q

How much cervical cancer is HPV 16/18 responsible for

A

70%

51
Q

Where are the renal tubules developed from

A

the mesonephric duct aka wolffian duct

52
Q

What is riak of breast ca and ovarian Ca with BRCA 1 vs BRCA 2

A

BRCA 1

B 75%
O 35%

BRCA 2

45%
15%

53
Q

What is the narrowest part of the fallopian tube

A

The intitstitial aprt aka intramural part.

54
Q

Which abx contraindicated in pregnancy

A

Qunolones
Tetracyclines

55
Q

Which cells produce parathyroid hormone

A

Chief cells

56
Q

Which hormone decreases appetite

A

Leptin

57
Q

How is magnesium excreted

A

Kidneys. Doesnt need to bec onjugated or metabolised

58
Q

How does IgG transfer across the placenta

A

receptor mediated endocytosis which is a type of PINOCYTOSIS

59
Q

What type of structure does GNRH have

A

decapeptide - made from 10 amino acids

60
Q

What type of drug is drosperinone

A

It is a progesterone

BOTH antiandrogenic and antimineralocorticoid

61
Q

Most common type of fbroid degeneration NOT pregnant vs pregnant

A

NOT pregnant = hyaine

Pregnant = red

62
Q

What type of data is blood group

A

nominal

63
Q

Formation of iron in the gut requires which vitamins

A

Vitamin C

64
Q

How to calculate SEM

A

Standard deviation / Square root of sample size

65
Q

Mechanism of action of hydralazine

A

Smooth muscle relaxant

66
Q

What type of compound is renin

A

PROTEIN

glycoprotein enzyme

67
Q

What is the most common complication of asymptomatic bacteruria in pregnancy

A

Pyelo

followed by PTL

68
Q

What are the proteins that coil in DNA

A

Histones

69
Q

Hyphae in vaginal discharge

A

candida!

70
Q

When is the peak plasma volume in pregnancy

A

24-32 weeks

71
Q

What is the mechanism of action of Ulipristal Acetate

A

progesterone receptors so prevents ovulation. Also inhibits Lh.

It is a selective progesterone receptor modulator NOT a progesterone analogue

72
Q

How does botox treat OAB

A

Inhibits acetylcholine release

73
Q

Which muscles form the pelvic diaphragm

A

Levator ani (puborectalis, iliococcygeus, pubococcygeus)

Coccygeus

74
Q

What is the probability that a fibroid will undergo a sarcomatous change

A

0.1% VERY LOW

75
Q

During which phase does chromosome replication take place

A

S phase.

G1, S, G2, M (cell division)

76
Q

What does the dexa scan report results in

A

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

77
Q

Can you breast feed if you have HepC

A

Yes unless you get a nipple injury. BBV

78
Q

Describe what each bit represents on a box and whisker plot

A
79
Q

Label these

A
80
Q

Itchy hands and abdomen
Rash around linea nigra
Normal LFTs
Raised bile salts
Normal ALP

A

Polymoprhic eruption of pregnancy

81
Q

What is jarsich-herxheimer reaction caused by?

A

Immunilogical phenomenon after abx treatment for syphilis

Patient generally unwell and exaceration of cutaneous lesions

82
Q

What is the main site of filtration in the kidney

A

glomerulus

83
Q

What are the names of the passageways that are in the placenta which enable passage of small molecules

A

Gap junctions

84
Q

Which are the cells which kill other cells infected with viruses

A

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

85
Q

Does a long loop in electrosurgery use a low or high density current

A

Uses low, larger surface area to perform the LLETZ so needs lower density current.

86
Q

When can an umbilical hernia be detected on USS

A

18-22 weeks

87
Q

Which is the most commonly injured artery during an appenicectomy?

A

The iliocolic artery

The answer might be the deep circumflex iliac artery but this is much less commonly affected

88
Q

What does a high protein meal trigger with insulin and glucagon

A

Increase in both

89
Q

What is the frequency of TVUSS vs abdo USS

What about an obese patient with a large pelvic mass? Why?

A

TVUSS - 5-10

Abdo USS - 2-5

Obese with large mass - 2-3 because lower frequency waves have better penetration but WORSE resolution

90
Q

What is the cause of dimpling in the mid gluteal region

A

PSLS ????

91
Q

Which of the following are caused by a robertsonian translocation:

Downs sydnrome
Edwards
Pataus
Turners

A

Downs syndrome

Rarely Pataus

92
Q

How much of down syndrome is caused by:

Robertsonian
Nondisjunction

A

95% nondisjunction - error in cell copying
4-5% Robertsonian - bit of chromosome attached to another
Mosaicism 1% - two cell populations

93
Q

Pathology: microfollicular pattern with call-exner body?

A

granulosa cell tumour

94
Q

What is the percentage of women that have a uterine anomaly

A

3-5%

95
Q

Where does the appendix of the testis arise from

A

The paramesonephric ducts

96
Q

what is the main thing contributing to cystocele

A

Pubocervical fascia weakening

In addition to this the iliopectinial ligament provides support

97
Q

What causes the conversion of testosterone to DHT

A

5 alpha reductase

98
Q

What is the primary action of DMPA

A

Depo - inhibits ovulation

99
Q

Main action of POPs

A

thickens cervical mucus

100
Q

What is the main cause of toxic shock syndrome

A

staph aureus enterotoxin

101
Q

What does thromboxane have to do with PET?

A

Thromboxane a2 plays important role in causing vasoconstriction and high BP

102
Q

Descibe the course of the pudendal nerve

A

S2-4 –> GSF –> across obturator internus medial border –> LSF (back into pelvis)–> alcock canal (gives off the 3 branches)

Alcock canal contains: pudendal nerve, internal pudendal artery and vein

103
Q

What hormone is responsible for making more glucose available for the fetus?

A

Human placental lactogen. This decreases insulin sensitivity in mum, therefore increasing blood glucose levels –> more to transfer to the fetus

104
Q

What are the phases of lung development in the fetus?

A

Pseudoglandular - 5-17 weeks
- basic lung structure
- bronchus etc

Canalicular 17-25 weeks
- ducts start to form
- Surfactant production begins

Saccular phase 25-38 weeks
- Alveolar sacs form (will become alveoli)
- - Type 2 pneumocytes become more

Alveolar phase 36 weeks onwards
- Alveoli form

105
Q

what is breast feeding protective of

A

ovarian Ca
Breast Ca
osteoporosos
postpartum depression

Child:
- Diabetes
- obestity
- leukaemia

106
Q

What is the haldane effect

A

Dcrease in O2 carrying by haemoglobi means it can carry CO2

107
Q

Which neurotransmitter is inhibited by atropine

A

acetylcholine

108
Q

What is ziduvidane

A

A HIV drug

Nucleoside reverse transcriptase inhibitor

109
Q

What is entonox made from

A

50% O2 50% NO

110
Q

Most common ovarian cyst to tort

A

dermoid

111
Q

What is the definition of perimortality rate

A

Death of fetus from 22 weeks to 7 days PN per 1000 births

112
Q

during a hysterectomy for accreta, which artery is ligated

A

IIA

113
Q

BRCA mode of inheritance

A

AD

114
Q

How much of oestrogen is bound to SHBG

A

40-50%

MRCOG part 1 (20 decks)

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