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MRCOG part 1 > Recalls 8 > Flashcards

Recalls 8 Flashcards

1
Q

What is the enzyme which Changes testosterone to estrogen?

Which changes progesterone (from mineralocorticoid pathway) to glucocorticoid pathway?

What changes the things from glucocorticoid pathway to sex hormone pathway?

What does the verticla changes?

A

Aromatase

17a hydroxylase

17 Lyase

3B HSD

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1
Q

treatment of chlamydia in pregnancy

A

1g single dose azithromycin

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2
Q

Cut off for referal to gyn-onc?

A

> 200 RMI

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3
Q

MOA of:

Dalteparin
Enoxaparin
Warfarin
Dabigatran
Apixaban
Rivaroxaban

A

Dalteparin - Factor Xa inhibitor

Enoxaparin - Factor Xa inhibitor via activating antithrombin

Warfarin - Vit K antagonist

Dabigatran - antithrombin

Apixaban/Rivaroxaban - Factor Xa inhibitor

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4
Q

What is lenoleic acid?

A

Essential fatty acid that is not produced in the body. NEed to consume in diet

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5
Q

What type of hypogonadism does chemotherapy tend to cause

A

Hypothalamic hypogonadism.

Tends to affect hypothalamus/pituitary and stop GNRH proudction

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6
Q

What is G-banding

A

A technique to identify chromosomes

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7
Q

What is Potter Syndrome?

What are the characteristics?

A

Abnormal kidney development. If complete renal agenesis then not compatible with life

Characteristics:
- Low set ears
- Flat node
- Flat chin

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8
Q

Where is the primary immunoglobulin prodution

A

Plasma cells which are a type of B lymphocytes

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9
Q

What cell is the main cell involved in combatting TB

A

Macrophages

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10
Q

When is the:

Blastocyst
Morula
Implantation

A

Morula 4
Blastocyst 6 (inner cell mass formed at this stage)
Implantation 8

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11
Q

Why is GNRH secreted in a pulsatile fashion

A

BEcause of the hypothalamus’s innate ability to do it pulsatile. This is from the arcuate nucleus. Specialised neurones regulate this.

Oestrogen feedback enhances this affect but does not CAUSE it

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12
Q

What are the functions of the following hormones during pregnancy:

Oestrogen
Progesterone
Inhibin A

Where are they secrete by?

A

All initially secreted by the CL in response to HCG from placenta. Then placenta takes this over.

Progesterone = inhibits contractions. Also inhibits lots of things throughout pregnancy and has effects on lungs/heart/GIT

Oestrogen = promotes vascularity and endometrial growth

Inhibin A = inhibits FSH secretion from the AP. To allow for the correct horonal balance. Production starts around 7 weeks but is much hgiher later in pregnancy

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13
Q

Is arachidonic acid a saturated or unsaturated fatty acid

A

Unsaturated

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14
Q

Incidence of facial nerve palsy in forceps

A

Approx 1:100

Most common!

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15
Q

Where is prolactin produced in pregnancy

A

AP
Placenta
Decidua basalis in early pregnancy

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16
Q

When do twins split?

A

Di-Di <4

Diamniotic Monochorionic - 4-8

Mono-mono - 8-12

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17
Q

How much T3 qnd T4

A

T4 is innnactive
Gets turned into T3 in the tissues

14:1 T4:T3

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18
Q

What level does the ureter cross the internal iliac arteries

A

At the birfurcation of common –> int and ext

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19
Q

what level does the aorta pass through the aperture

What about the IVC

What about the oesophagus

A

Aorta - T12. The lowest and the most posterior of the apertures

IVC - T8

Oesophagus - T10

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20
Q

What is the histology of the lower uterine segment

A

Columnar. Thinner endothelium than the UUS

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21
Q

Where is GNRH secreted other than the brain

A

Duodenum

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22
Q

Explain what type on incontinence this is

A

There is a leak with the cough so it is stress

But there is also a leak in the middle which is detrusor overactivity. Notmal urination at the end has a bell shaoed curve

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23
Q

What does chamydia cause in the eyes

A

Ophthalmia Neonatorum

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24
Q

If a pregnant women develops goitre, which nerve can be damaged

A

The recurrent laryngeal nerve from he vagus nerve

The route on the left is looped under the ductus arteriosus

The route on the right is under the subclavian

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25
Q

Which vessel in the brain can bleed in eclampsia

A

MCA

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26
Q

Which bit of the HIV virus cannot enter the host cell

A

Glycoprotein

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27
Q

Which gynaecological cancer is most associated with MMR

A

Endometrial cancer - endometriod cancer

For ovarian it is alo endometroid then clear cell

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28
Q

What is Crispr

A

An exyme that detects DNA

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29
Q

Look at some pedigrees

A
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30
Q

What is the most common cause of dermatitis in pregnancy

A

Pregnancy specific - PUPPS

not pregnancy specific - atopic dermatiis

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31
Q

What does pellagra cause

What deficiency is it caused by

A

Dermatitis, dementia, diarrhoea, death

Niacin, vit B6

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32
Q

Inheritance pattern of achondroplasia

A

AD

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33
Q

Most common side effect of depo-provera

A

Irregular bleeding

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34
Q

Which is the most common HPV to cause high grade cervical changes

A

16 is more common than 18

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35
Q

MOA of aspirin

A

Irreveribly inhibits COX1
Reduces prostaglandins

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36
Q

Describe the anatomy of the hepatic vessels

A
37
Q

Does pulmonary capillary wedge pressure change in pregnancy

A

Na not really

38
Q

What is the shelf life of whole blood

A

7 weeks

39
Q

In regional anaesthesia, where does the epidural or spinal go

A

Epidural - between vertebral column and dura mater

Spinal - In the subarachnoid space. Between the pia mater and arachnoid mater

40
Q

Describe the boundaries of the superficial and perineal pouches

A

Colles fascia
Perineal fascia

41
Q

What gestation doe haematopoetic function start in fetuses

A

Yolk sac makes RBCs 2-6 weeks

liver makes RBCs 6-22 weeks

Bone barrow tskes over at 22 weeks

42
Q

which lab test used to amplify small amounts of DNA

A

PCR

43
Q

How to work out type 1 error and type 2 error

A

Type 1 error = p value. So p value 0.05 = 5% chance of type 1 error

Type 2 error is 1-power

Power is the probability that you have correctly rejected the null hypothesis. Therefore the probability of incorrectly accepting the null hypothesis (T2 error) is 1-power.

44
Q

What are the hormones doing in PCOS

A

Oestrogen is down

Leptin is down (think overweight so hunger is no longer inhibited)

SHBG is down

Insulin is up

45
Q

What do the results of the odds ratio tell you

A

> 1 - association between the exposure and disease

1 - no association

<1 - protective

46
Q

Incidence of turners

A

1:2500 females

47
Q

Which receptor does nicotine bind to in the fetus that is harmful

A

acetylcholine

48
Q

What is the function of the BRCA gene

A

tumour suppressor gene

When it is mutated it can cause cancer

49
Q

What lies medial and lateral to the internal iliac vein

A

Medial - the internal iliac artery
Lateral - the ureter

50
Q

Describe the embryology of the ovary and gametes

A

The ovary develops from the pramesonephric duct.

The primordial germ cells originate in the yolk sac at 4 weeks.
They then migrate between 4-5 weeks to through the primitive streak then hind gut and dorsal mesentary. By end of week 6 they are in the gonads.

51
Q

What does cleft palate result from

A

Failure of development of the 1st pharyngeal arch

52
Q

Describe what comes from all the pharyngeal arches

1
2
3
4
5

A

1 - muscles of mastication, CN 5, maxillary artery
2 - facial muscles, CN 7, stapedius artery
3 - Stylopharyngeus, CN 9, carotid arteries
4 - Cricothyroid and epiglottis, CN 10, aortic arch and subclavian artery
5 - All other laryngeal muscles other than cricothyroid, CN 10, pulmonary artery, ductus arteriosus

53
Q

A

Are nitric oxide and prostaglandins upregulated or downregulated in pregnancy in sepsis

A

Both upregulated to promote inflammation

54
Q

Why are both cortisol and prolactin increased in pregnancy

A

Unopposed oestrogen

Oestrogen increases ACTH (from AP) production and CRH production (from placenta)

55
Q

How much does prolactin increase during pregnancy

A

5-10 fold

56
Q

Attachments of the cardinal ligament

A

lateral cervix and endopelvic fascia (fascia of obturator internus)

57
Q

What level does the SMA branch

What about the IMA

A

L1

L3

58
Q

Diameters of the pelvis

A
59
Q

If a fetus is born without a mastoid process, what structure is most at risk during delivery

A

CN 7

60
Q

How much does HRT increase your risk of breast Ca

A

Probably by 3 but actually by 50% so more like 1.5 ??depends on Q

61
Q

What is the toxin released by strep

A

Exotoxin

62
Q

Roughly HCG values for 4,5,6 weeks

A

4 weeks <500
5 weeks anywhere from 20-7000
6 weeks anywhere from 1000-56000

63
Q

What is ebsteins anomaly

A

Caused by lithium
abnormality with tricuspid valve

64
Q

What is the cut off for 250 vs 500 IU anti-D

A

20 weeks

65
Q

What is thee frequency of TVUSS vs abdo USS

A

tvuss - 5-10
abdo - 2-5

66
Q

What is the percentge of free T3 and T4 in circulation

A

BOTH BELOW 0

T3 is more - 0.3%
T4 is less - 0.03%

67
Q

Which of the branches of the IIA is sometimes absent

A

Obturator

68
Q

BRENNER tumours

Where are they found

What type of cells are in them

A

1-2% of ovarian tumours

Transitional cells.

Not to be confused with Brunner’s glands which are glands in the duodenum that secrete alkaline fluid to neutralise acid

69
Q

Where does the fetus get cholesterol in first second and third trimester

A

First - maternal liver
Second - placenta
Third - fetal liver.

70
Q

Which type of lichen planus causes maximum symptoms

A

erosive

71
Q

Explain primary and secondary infection status with CMV in pregnancy

A

IgG positive - current or pt infection
IgM positive - current or recent infection (in this pregnancy)

Primary infection refers to a new and first infection in this pregnancy

Secondary infection refers to a current but repeated infection in this pregnancy (we care less)

72
Q

When is most of the teratogenic risk with warfarin

A

6-12 weeks

73
Q

Describe the roles of C3 and C5 in the complement pathway

A

C3 - roel in initiating the complement pathway
C5 - more of a role in cell LYSIS and activating MAC

74
Q

What indictes puberty in girls

A

Thelarche - breast development

75
Q

Does haematocrit increase or decrease in pregnancy

A

Decrease

76
Q

What is amniotic fluid before urine

When does the baby start to pee?

When does pee become the main part of amniotic fluid?

A

Maternal plasma via the chorion

8-12 weeks starts to produce urine

By 16 weeks urine is main part of amniotic fluid

77
Q

Is arachidonic acid saturated or unsaturated

A

Unsaturated

78
Q

What is the typical radiation dose for a chest CT

A

7mSv

79
Q

What type of virus is Zika

A

SS RNA

80
Q

Which gene mutation is 21 hydroxylase deficiency

A

Chromosome 6 short arm

Short arm = p so 6p
CYP21A2

81
Q

What size is vulval Ca in FIGO classification 3a

A

<5mm

82
Q

When is MRI not typically used in pregnancy

A

First trimester

83
Q

What is the teratogenic effect of carbimazole

A

Choanal atresia

84
Q

How does Raltegravir work

A

HIV integrase inhibitor

85
Q

What is the treatment of hyperaldosteronism?

What can it cause?

A

Spironolactone

Can cause feminisation due to anti-androgenic properties.

If not wanting deminisation can use eplerenone.

86
Q

What is the rate of IUD explusion

A

1/20 or 5%

87
Q

How much does tidal volumne increase in pregnancy

A

30-50%

88
Q

re the pelvic sphlanchnic nerves pre-ganglionic or postnanglionic

A

They are pre-ganglionic. The vast majority of parasympathetic nerves have their ganglia close to the target organ.

In contrast with sympathetic nerves, they mostly are postganglioic as they have synapsed in the sympathetic chain.

89
Q

Describe the electrophoresis results for normal and beta thalassaemia major and minor

A
90
Q

Which carbon atom is phosphate attached to

What about the nitrogenous base

A

The sugar is the 5 carbon ring.

The nitrogenous base is attached to carbon 1

The phosphate is attached to carbon 5

91
Q

Who regulates non-ionizing radiation machines

A

International commission for Non-ionizing Radiation Protection

MRCOG part 1 (28 decks)

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