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MRCOG part 1 > Recalls 7 > Flashcards

Recalls 7 Flashcards

1
Q
A
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2
Q

What is the blood supply to the:
- Ovary
- Uterus
- Cervix
- Upper 1/3 vagina
- Lower 2/3 vagina

A

Ovary = ovarian artery
Tubes = ovarian artery
Uterus = uterine artery
Cervix =
Upper 1/3 vagina = mainly from uterine
Lower 2/3 vagina = mainly from vaginal artery and internal pudendal

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3
Q

What is the protective layer for the graffian follicle

A

The zona pellucida.

The coronaratiata provides nutrient support

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4
Q

Which ligaments are commonly used for colposuspension in vaginal vault prolapse?

A

Cardinal and uterosacral - fixed to the sacrum

Then I think sacrospinous is used for anterior or posterior wall prolapse

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5
Q

what level does the aorta bifurcate? And the common iliacs?

A

Both L4

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6
Q

What is the dimpling of the buttocks formed by

A

Posterior superior iliac spine

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7
Q

What gestation can umbilical hernias be diagnosed?

A

12-14 weeks

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8
Q

What is the pubocervical fascia

A

Connects pubis to cervix but gigves structural support for the bladder.

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9
Q

Which enzyme converts testosterone to DHT

A

5a reductase

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10
Q

Which hormone is responsible for glucose metabolism in the fetus

A

HPL

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11
Q

Percentage of worldwide congeital uterine abnormalities

A

3-6%

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12
Q

Iliacus muscle

Describe the route?

Function?

Innervation?

A

THE GREEN ONE

Attches to the ileum and lesser trochanter of the femur

Flexes the hip

Femoral nerve

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13
Q

What is the main mechanism by which glucagon increases glucose in blood

A

Increase in hepatic glycogenolysis

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14
Q

What is the precursor for vitamin K

A

K3

Menadione

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15
Q

Blood test for haemolytic anaemia in pregnancy

A

FBC

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16
Q

How does DMPA aka Depo work

A

Inhibits ovulation

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17
Q

Which cancers increase risk or decrease risk with breast feeding?

What about with taking the COCP?

A

Increase:
- Cervical

Decrease:
- Ovarian
- Endometrial
- Breast

With COCP:

Increase:
- cervical
- breast

Decrease:
- Ovarian
- Endometrial
- Colorectal

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18
Q

What colours do alpha haemolytic and beta haemolytic strep appear on an agar plate

A

Alpha - Green with haemolysis

Beta - Clear with complete haemolysis

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19
Q

Which neurotransmitted is inhibited by atropine

A

Acetylcholine

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20
Q

Where are Brunners glands located

A

Duodenum

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21
Q

Metabilic process making ATP for uterine contractions

A

Oxidative phosphorylation

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22
Q

From what compound are eicosanoids derived from?

What are eicosanoids?

What is the pathway for creation of prostaglandins

A

Arachidonic acid

They are stuff like ILs, thromboxane and prostaglandins

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23
Q

How many carbon atoms are in oestrogen, progesterone, testosterone

A

O - 18

T - 19

P - 21

OTP - 181921

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24
Q

What is the make up of entonox

A

50:50

O2 and NO

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25
Q

Which antiemetics can lead to high prolactin

A

Metoclopramide
Domperidone

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26
Q

What is the teratogenic effect of paroxetine

A

heart defects

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27
Q

What is the action of botox

A

Inhibit acetylcholine release

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28
Q

What is the mechanism of action of TXA

A

Antifibrinolytic

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29
Q

How does azathioprine work

A

Inhibits RNA synthesis

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30
Q

Which cancer has keratin pearls

A

SCC

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31
Q

How do you work out the number needed to treat

A

1/absolute risk ratio

ARR = risk in control - risk in treatment group

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32
Q

What is this and what do the corners represent

A
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33
Q

What transducer is required for obese patient vs non obese patients

A

2.5 mHz rather than 5 Mhz in normal

LOW FREQUENCY TRAVELS FURTHER

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34
Q

How much oestrogen binds to SHBG

How much testosterone binds to SHBG

A

Oestrogen:
20-40% (say 20% in exam) to SHBG
60% to Albumin
<1% free

Testosterone
60% to SHBG
30% to Albumin
1% free

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35
Q

Which vitamin is required for DNA synthesis

A

Folic acid - vitamin B9

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36
Q

Which vitamin causes homocysteine deficiency

A

Folic acid

But also B12 and B6

37
Q

When is peak plasma volumne in pregnancy

A

32 weeks and plateau until delivery

38
Q

Pre-eclampsia in first pregnancy - what is risk with second pregnancy

A

20%

39
Q

With GDM. what is risk of T2DM

A

10x risk

?approx 20%

40
Q

Treatment gonnorhoea with:

No PID
PID
Pregnancy no PID
Pregnancy PID

A

No PID - 1g IM cef
PID - 1g IM cef + doxy + met
Pregnancy no PID - 1g IM cef
Pregnancy PID - 1g IM cef with azithromycin + metronidazole

41
Q

How do the following drugs work:
- Metronidazole
- Clindamycin
- Fluconazole

A
  • Metronidazole - damages DNA and inhibits DNA synthesis
  • Clindamycin - 50s subunit ribosomes
  • Fluconazole - cell membrane disruption
42
Q

Where are germ cells found at 4 weeks

A

?YS

43
Q

What is the oncogene for Lynch syndrome aka HNPCC

A

MLH1
or
MSH2

44
Q

Give examples of 2nd and 3rd generation progesterones

A

2nd: levonorgestrel

3rd: Desogestrel
Dinoprostone

45
Q

In PCOS why is prolactin high

What is high in PCOS

A

Due to high oestrogen

High testosterone
Also high oestrogen, this is why there is increase risk of endometrial Ca and ovarian cancer

46
Q

How does pseudomonas appear on macconey agar

A

Colourless

47
Q

What is prophylaxis of malaria in 2nd and 3rd trimester

A

Mefloquin

48
Q

What is the most common non-epithelial vaginal cancer

A

Rhabomyosarcoma.

Most often in children or teens

49
Q

What is the structure between the paravesicle and pararectal spaces

A

Cardinal ligament

50
Q

What atom is used in MRI

A

Hydrogen nucleus

51
Q

What is the unit of diathermy power

A

Watt

52
Q

what is the cut off level for fibronectin in screening from preterm labour

A

50ng

53
Q

What is the rate of recurrence of ectopic pregnancy

A

18%

54
Q

Which ions are used for iodine transport

A

Na

If NA not available, then iodine is also exchanged for Cl-

55
Q

What are the maximum doses of lidocaine or L+adrenaline

A

Lidocaine 3mg/kg

Lidocaine + adrenaline 7mg/kg

56
Q

Method of action of doxazocin

A

Alpha blocker

57
Q

What is the method of action of trimethoprim

A

Dihydrofolatereductase inhibitor

Inhibits nucleic acid synthesis

58
Q

Where is the locaiton which determines sex

A

SRY gene on the SHORT arm of chromosome Y

59
Q

Where does most of the ejaculate come from in males

A

70% seminal vesicles
30% prostate
1% bulbourethral glands

60
Q

What is the dose from a CTPA to breast tissue

A

20mGy

61
Q

Where does the appendix of the testes come from

A

Paramesonephric ducts

62
Q

What is it called if >95% of sperm in sample have abnormal shape

A

Teratospermia

63
Q

What is recurrent implantation failure due to an increase in?

HLA A
HLA B
HLA C
HLA E
HLA G

A

HLA G

64
Q

Where are the germs cells located at:

4
5
6

weeks

A

4 - move from the yolk sac to hindgut epithelium
5 - in the primative streak
6 - in the gonads

65
Q

What are the half lives of:

LH
FSH
HCG

A

LH - 20 minutes
FSH - 3 hours
HCG - 24 hours

66
Q

Which test to check for fetal haemolysis

A

INDIRECT - MUM’s blood during pregnancy - checks for rh type of ABO incompatability

DIRECT - BABY’s blood with cord bloods - detects for antibodies attached to RBCs and signs of haemolysis

67
Q

What does the lower 2/3 of the vagina develop from

A

Endoderm -> urogenital sinus –> sinovaginal bulb –> vagina

68
Q

How can USS cause damage

A

Cavitation - creating small bubbles. More at risk with lower frequencies

69
Q

lymph node drainage of cervix and upper vagina 1/3

A

Internal/external iliac nodes

70
Q

What is it called when there is a benign change in the endometrium in response to hormones that can sometimes be confused for clear call carcinoma

A

Aria Stella

71
Q

What effect do granulosa cell tumours have on the endmetrium

what are the tumour markers

A

They increse the oestrogen so cause a proliferative endometrium,

Tumour marker - inhibin, aMH, oestradiol

72
Q

In pregnancy when is the maximum level of progesterone

A

Term

73
Q

Primary stimulator of Aldosterone in RAAS

A

Angiotensin 2

74
Q

Percentage of T3 and T4 unbound in the blood

A

T3 - 0.3%

T4 - 0.03%

75
Q

What is transcription?

What enzyme does it require

A

turning DNA into RNA

RNA polymerase

76
Q

If a man has congenital absence of the vas deferens, what is the likelihood that he will have CF

A

80%

77
Q

Heat stabiliser in PCR

A

Taq polymerase

78
Q

How many sperm are produced per day

A

300 million

79
Q

Biochemistry for kleinfelters

A

Low testosterone

High FSH, high LH, high SHBG

80
Q

Which ovarian cancers are associated with MMR/lynch/HNPCC

A

CCC or endometroid

81
Q

What si the function of G6Phosphatase

A

Production of NADHP in RBCs

82
Q

What is the most common uterine sarcoma

A

Uterine leiomyosarcoma

83
Q

How do peptides get transported across the placenta

A

Active transpot

84
Q

Where does complement get made

A

liver

85
Q

Risk of atypical hyperplasia becoming malignant in 10 and 20 years

A

10 –> 15%
20 –> 30%

86
Q

Which cell carries out phagocytosis and is 2-5% of WBC

A

eiosinophil

87
Q

Which hormone is responsible for epiphysial fusion

A

Oestrogen

88
Q

Closure of the neural groove occurs when?

A

Week 3-4

So day 25

MRCOG part 1 (30 decks)

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