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MRCOG part 1 > Recalls 6 > Flashcards

Recalls 6 Flashcards

1
Q

During laparoscopy which vessel injured during right lateral port insertion?

Where does this branch from?

A

Inferior epigastric artery

Branch of external iliac artery

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2
Q

What are the branches of the internal and external iliac arteries

A

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)

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3
Q

What relation of VAN

A

VEIN IS MEDIAL

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4
Q

What is the dermatome of the suprapubic incision aka joel-cohen

What about pfannenstiel?

A

T12

Pfannenstiel L1

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5
Q

During sacrospinous fixation whicha artery can be injured

A

Inferior gluteal

Branch of anterior divison of IIA

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6
Q

In a kidney transplant, which artery and vein it is anastomosed to?

A

EIA

EIV

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7
Q

What are the layers surrounding the zona pellucida

A

Corona radiata then cumulus oophorus

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8
Q

Describe the layers of the placenta and what happens to them throughout pregnancy

A

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

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9
Q

What is the embryoligcal origin of the bottom 2/3 of vagina

A

Urogenital sinus - Endoderm.

The cloaca separates to form the urogenital sinus and the anus.

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10
Q

Which hernia will result from a small defect in the lateral umbilical region due to regression of umbilical vein

A

Gastroschisis

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11
Q

What is the cause of gastrochisis and omphalocele and congeital umbilical hernia

A

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

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12
Q

What is the embryological course of the GnRH neurones

A

Primary olfactory placode

Secondary source is neural crest

Brain and CNS is from neuroal tube

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13
Q

How much estradiol is bound to albumin and SHBG

A

38% SHBG

60% albumin

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14
Q

What percentage of T4 is free

A

0.03%

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15
Q

How many hours after the LH surge does ovulation occur

A

36h after the surge

16h after the peak

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16
Q

What is order of potency:
Testosterone
DHEA
DHT
A2

A

MOST POTENT TO LEAST

DHT
Testosterone
Androstanedione
DHEA

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17
Q

What leads do V1 and AVr represent on an ECG

A

LV and RA

18
Q

What is a normal bicarb in pregnancy

A

18 is lower limit of normal

19
Q

When is eGFR at the maximum in pregnancy

A
  • massive rise to 13th week

I think peak at 32 weeks

20
Q

Where does vaginal lubrication come from when aroused

A

Vaginal transudate

21
Q

What is cloasma due to in pregnancy

A

Melanocyte stimulating hormone

Same as melasma

22
Q

Which amino acid is nitrogen oxide

A

L-arginine

23
Q

In brow presentation what is the line called

What are the other presentations called and what are the diameters

A

mentovertical - brow - 13
suboccipitobregmatic - vertex - 9.5
occipito frontal - OP - 11
Submentobregmatic - face - 9.5

24
Q

What type of drug is drosperinone

A

3rd generation progesterone

Antiandrogen
Antimineralocorticoid

25
Q

How much progesterone does the mirena secrete in 24h

A

20 mcg

26
Q

What type of drug is trimethoprim

A

Antimetabolite

Dihydrofolate reductase inhibitor

27
Q

What contraception to be used with carbamazepine

A

mirena, copper coil OR depo

ENZYME INDUCER

28
Q

What are the uses of ulipristal acetate

A

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

29
Q

Which drug to give as GBS prophylaxis if allergic to penicillin

A

Clindamycin

30
Q

How does mifepristone work

A

Blocks progesterone

31
Q

What is the ratio of uterine corpus to cervix in PM women at level of cervical os

A

Newborn 1:2

Nullip 2:1

Multip 3:1

Postmenopausal 1:1

32
Q

How to manage thyrotoxicosis in early pregnancy

A

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

33
Q

What si the threshold for something to be considered ultrasound

A

20 khz

34
Q

Effect on bloods with steroid use

A

Low FSH
High testosterone

Increase WCC

35
Q

What type of cardiomyopathy does peripartum resemble

A

Dilated

36
Q

How does the kleihauer work

A

HBF is resistant to breakdown by acids, unlike maternal RBCs. So the RBCs and broken downt hen the HBF counted

37
Q

In PET, what are the effects on the kidneys

A

Vascular endothelial dysfunction

38
Q

What is the pathology of secretory endometrium

A

Simple columnar with subnuclear vacuolation

39
Q

What type of endometrium does simple hyperplasia most accurately represent

A

proliferative

40
Q

Type of cancer most common in urethra of females

A

SCC

41
Q

IUCD and positive gonorrhoea or chamydia swab but patient asymptomatic, management?

A

Treat infection. Dont remove IUCD.

May remove if symptomatic or if has PID

42
Q

which APCs are mainly present in the cervix

A

Langerhan cells which are a type of dendritic cells

MRCOG part 1 (28 decks)

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