Recalls 6 Flashcards
During laparoscopy which vessel injured during right lateral port insertion?
Where does this branch from?
Inferior epigastric artery
Branch of external iliac artery
What are the branches of the internal and external iliac arteries
Internal
ANTERIOR
- Obturator
- Umbilical (superior vesicle branches)
- Uterine
- Vaginal
- Middle rectal
- Internal pudendal
- Inferior gluteal artery
POSTERIOR
- Iliolumbar
- Superior gluteal
- Lateral sacral
External
- Deep circumflex
- Inferior epigastric
- Femoral is terminal branch (superficial circumflex branches from this)
What relation of VAN
VEIN IS MEDIAL
What is the dermatome of the suprapubic incision aka joel-cohen
What about pfannenstiel?
T12
Pfannenstiel L1
During sacrospinous fixation whicha artery can be injured
Inferior gluteal
Branch of anterior divison of IIA
In a kidney transplant, which artery and vein it is anastomosed to?
EIA
EIV
What are the layers surrounding the zona pellucida
Corona radiata then cumulus oophorus
Describe the layers of the placenta and what happens to them throughout pregnancy
Syncytiotrophoblast - OUTER part of placenta. early pregnancy secrete HCG. Remains throughout pregnancy
Cytotrophoblast - role in early pregnancy. Inner layer of placenta. Not present by the end of pregnancy.
The decidua basalis is the aprt of the endometrium that forms the maternal part of the placenta. It protects the underlying myometrium from syncytiotrophoblast invasion
What is the embryoligcal origin of the bottom 2/3 of vagina
Urogenital sinus - Endoderm.
The cloaca separates to form the urogenital sinus and the anus.
Which hernia will result from a small defect in the lateral umbilical region due to regression of umbilical vein
Gastroschisis
What is the cause of gastrochisis and omphalocele and congeital umbilical hernia
Gastrochisis - herniation through abdominal wall defect due to lateral umbilical vein regression
Omphalocele - herniation through the umbilical cord. Failure of midgut to return to the umbilical cavity
Congenital umbilical hernia - weakening in abdominal wall
What is the embryological course of the GnRH neurones
Primary olfactory placode
Secondary source is neural crest
Brain and CNS is from neuroal tube
How much estradiol is bound to albumin and SHBG
38% SHBG
60% albumin
What percentage of T4 is free
0.03%
How many hours after the LH surge does ovulation occur
36h after the surge
16h after the peak
What is order of potency:
Testosterone
DHEA
DHT
A2
MOST POTENT TO LEAST
DHT
Testosterone
Androstanedione
DHEA
What leads do V1 and AVr represent on an ECG
LV and RA
What is a normal bicarb in pregnancy
18 is lower limit of normal
When is eGFR at the maximum in pregnancy
- massive rise to 13th week
I think peak at 32 weeks
Where does vaginal lubrication come from when aroused
Vaginal transudate
What is cloasma due to in pregnancy
Melanocyte stimulating hormone
Same as melasma
Which amino acid is nitrogen oxide
L-arginine
In brow presentation what is the line called
What are the other presentations called and what are the diameters
mentovertical - brow - 13
suboccipitobregmatic - vertex - 9.5
occipito frontal - OP - 11
Submentobregmatic - face - 9.5
What type of drug is drosperinone
3rd generation progesterone
Antiandrogen
Antimineralocorticoid
How much progesterone does the mirena secrete in 24h
20 mcg
What type of drug is trimethoprim
Antimetabolite
Dihydrofolate reductase inhibitor
What contraception to be used with carbamazepine
mirena, copper coil OR depo
ENZYME INDUCER
What are the uses of ulipristal acetate
Emergency contraception
- If vomits can be taken again if vomited within 3h
- Selective progesterone receptor modulator
- Up to 5 days (120h) after UPSI
- 30mg
Also can be used to treat fibroids. If using for this needs barrier protection. This is because it is a progesterone receptor modulator and can make other forms of contraception less effective
Which drug to give as GBS prophylaxis if allergic to penicillin
Clindamycin
How does mifepristone work
Blocks progesterone
What is the ratio of uterine corpus to cervix in PM women at level of cervical os
Newborn 1:2
Nullip 2:1
Multip 3:1
Postmenopausal 1:1
How to manage thyrotoxicosis in early pregnancy
IF looks like a try hyperthyroidism
- Biochemical evidence + SYMPTOMS of graves etc thenc an start propylthiouracil
IF it is a thyrotoxicosis which is transient from excessive HCG then you repeat in 1 week and treat the hyperemesis
What si the threshold for something to be considered ultrasound
20 khz
Effect on bloods with steroid use
Low FSH
High testosterone
Increase WCC
What type of cardiomyopathy does peripartum resemble
Dilated
How does the kleihauer work
HBF is resistant to breakdown by acids, unlike maternal RBCs. So the RBCs and broken downt hen the HBF counted
In PET, what are the effects on the kidneys
Vascular endothelial dysfunction
What is the pathology of secretory endometrium
Simple columnar with subnuclear vacuolation
What type of endometrium does simple hyperplasia most accurately represent
proliferative
Type of cancer most common in urethra of females
SCC
IUCD and positive gonorrhoea or chamydia swab but patient asymptomatic, management?
Treat infection. Dont remove IUCD.
May remove if symptomatic or if has PID
which APCs are mainly present in the cervix
Langerhan cells which are a type of dendritic cells
