Recalls 8 Flashcards
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?
Aromatase
17a hydroxylase
17 Lyase
3B HSD
treatment of chlamydia in pregnancy
1g single dose azithromycin
Cut off for referal to gyn-onc?
> 200 RMI
MOA of:
Dalteparin
Enoxaparin
Warfarin
Dabigatran
Apixaban
Rivaroxaban
Dalteparin - Factor Xa inhibitor
Enoxaparin - Factor Xa inhibitor via activating antithrombin
Warfarin - Vit K antagonist
Dabigatran - antithrombin
Apixaban/Rivaroxaban - Factor Xa inhibitor
What is lenoleic acid?
Essential fatty acid that is not produced in the body. NEed to consume in diet
What type of hypogonadism does chemotherapy tend to cause
Hypothalamic hypogonadism.
Tends to affect hypothalamus/pituitary and stop GNRH proudction
What is G-banding
A technique to identify chromosomes
What is Potter Syndrome?
What are the characteristics?
Abnormal kidney development. If complete renal agenesis then not compatible with life
Characteristics:
- Low set ears
- Flat node
- Flat chin
Where is the primary immunoglobulin prodution
Plasma cells which are a type of B lymphocytes
What cell is the main cell involved in combatting TB
Macrophages
When is the:
Blastocyst
Morula
Implantation
Morula 4
Blastocyst 6 (inner cell mass formed at this stage)
Implantation 8
Why is GNRH secreted in a pulsatile fashion
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
What are the functions of the following hormones during pregnancy:
Oestrogen
Progesterone
Inhibin A
Where are they secrete by?
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
Is arachidonic acid a saturated or unsaturated fatty acid
Unsaturated
Incidence of facial nerve palsy in forceps
Approx 1:100
Most common!
Where is prolactin produced in pregnancy
AP
Placenta
Decidua basalis in early pregnancy
When do twins split?
Di-Di <4
Diamniotic Monochorionic - 4-8
Mono-mono - 8-12
How much T3 qnd T4
T4 is innnactive
Gets turned into T3 in the tissues
14:1 T4:T3
What level does the ureter cross the internal iliac arteries
At the birfurcation of common –> int and ext
what level does the aorta pass through the aperture
What about the IVC
What about the oesophagus
Aorta - T12. The lowest and the most posterior of the apertures
IVC - T8
Oesophagus - T10
What is the histology of the lower uterine segment
Columnar. Thinner endothelium than the UUS
Where is GNRH secreted other than the brain
Duodenum
Explain what type on incontinence this is
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
What does chamydia cause in the eyes
Ophthalmia Neonatorum
If a pregnant women develops goitre, which nerve can be damaged
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
Which vessel in the brain can bleed in eclampsia
MCA
Which bit of the HIV virus cannot enter the host cell
Glycoprotein
Which gynaecological cancer is most associated with MMR
Endometrial cancer - endometriod cancer
For ovarian it is alo endometroid then clear cell
What is Crispr
An exyme that detects DNA
Look at some pedigrees
What is the most common cause of dermatitis in pregnancy
Pregnancy specific - PUPPS
not pregnancy specific - atopic dermatiis
What does pellagra cause
What deficiency is it caused by
Dermatitis, dementia, diarrhoea, death
Niacin, vit B6
Inheritance pattern of achondroplasia
AD
Most common side effect of depo-provera
Irregular bleeding
Which is the most common HPV to cause high grade cervical changes
16 is more common than 18
MOA of aspirin
Irreveribly inhibits COX1
Reduces prostaglandins
Describe the anatomy of the hepatic vessels
Does pulmonary capillary wedge pressure change in pregnancy
Na not really
What is the shelf life of whole blood
7 weeks
In regional anaesthesia, where does the epidural or spinal go
Epidural - between vertebral column and dura mater
Spinal - In the subarachnoid space. Between the pia mater and arachnoid mater
Describe the boundaries of the superficial and perineal pouches
Colles fascia
Perineal fascia
What gestation doe haematopoetic function start in fetuses
Yolk sac makes RBCs 2-6 weeks
liver makes RBCs 6-22 weeks
Bone barrow tskes over at 22 weeks
which lab test used to amplify small amounts of DNA
PCR
How to work out type 1 error and type 2 error
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.
What are the hormones doing in PCOS
Oestrogen is down
Leptin is down (think overweight so hunger is no longer inhibited)
SHBG is down
Insulin is up
What do the results of the odds ratio tell you
> 1 - association between the exposure and disease
1 - no association
<1 - protective
Incidence of turners
1:2500 females
Which receptor does nicotine bind to in the fetus that is harmful
acetylcholine
What is the function of the BRCA gene
tumour suppressor gene
When it is mutated it can cause cancer
What lies medial and lateral to the internal iliac vein
Medial - the internal iliac artery
Lateral - the ureter
Describe the embryology of the ovary and gametes
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.
What does cleft palate result from
Failure of development of the 1st pharyngeal arch
Describe what comes from all the pharyngeal arches
1
2
3
4
5
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
A
Are nitric oxide and prostaglandins upregulated or downregulated in pregnancy in sepsis
Both upregulated to promote inflammation
Why are both cortisol and prolactin increased in pregnancy
Unopposed oestrogen
Oestrogen increases ACTH (from AP) production and CRH production (from placenta)
How much does prolactin increase during pregnancy
5-10 fold
Attachments of the cardinal ligament
lateral cervix and endopelvic fascia (fascia of obturator internus)
What level does the SMA branch
What about the IMA
L1
L3
Diameters of the pelvis
If a fetus is born without a mastoid process, what structure is most at risk during delivery
CN 7
How much does HRT increase your risk of breast Ca
Probably by 3 but actually by 50% so more like 1.5 ??depends on Q
What is the toxin released by strep
Exotoxin
Roughly HCG values for 4,5,6 weeks
4 weeks <500
5 weeks anywhere from 20-7000
6 weeks anywhere from 1000-56000
What is ebsteins anomaly
Caused by lithium
abnormality with tricuspid valve
What is the cut off for 250 vs 500 IU anti-D
20 weeks
What is thee frequency of TVUSS vs abdo USS
tvuss - 5-10
abdo - 2-5
What is the percentge of free T3 and T4 in circulation
BOTH BELOW 0
T3 is more - 0.3%
T4 is less - 0.03%
Which of the branches of the IIA is sometimes absent
Obturator
BRENNER tumours
Where are they found
What type of cells are in them
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
Where does the fetus get cholesterol in first second and third trimester
First - maternal liver
Second - placenta
Third - fetal liver.
Which type of lichen planus causes maximum symptoms
erosive
Explain primary and secondary infection status with CMV in pregnancy
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)
When is most of the teratogenic risk with warfarin
6-12 weeks
Describe the roles of C3 and C5 in the complement pathway
C3 - roel in initiating the complement pathway
C5 - more of a role in cell LYSIS and activating MAC
What indictes puberty in girls
Thelarche - breast development
Does haematocrit increase or decrease in pregnancy
Decrease
What is amniotic fluid before urine
When does the baby start to pee?
When does pee become the main part of amniotic fluid?
Maternal plasma via the chorion
8-12 weeks starts to produce urine
By 16 weeks urine is main part of amniotic fluid
Is arachidonic acid saturated or unsaturated
Unsaturated
What is the typical radiation dose for a chest CT
7mSv
What type of virus is Zika
SS RNA
Which gene mutation is 21 hydroxylase deficiency
Chromosome 6 short arm
Short arm = p so 6p
CYP21A2
What size is vulval Ca in FIGO classification 3a
<5mm
When is MRI not typically used in pregnancy
First trimester
What is the teratogenic effect of carbimazole
Choanal atresia
How does Raltegravir work
HIV integrase inhibitor
What is the treatment of hyperaldosteronism?
What can it cause?
Spironolactone
Can cause feminisation due to anti-androgenic properties.
If not wanting deminisation can use eplerenone.
What is the rate of IUD explusion
1/20 or 5%
How much does tidal volumne increase in pregnancy
30-50%
re the pelvic sphlanchnic nerves pre-ganglionic or postnanglionic
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.
Describe the electrophoresis results for normal and beta thalassaemia major and minor
Which carbon atom is phosphate attached to
What about the nitrogenous base
The sugar is the 5 carbon ring.
The nitrogenous base is attached to carbon 1
The phosphate is attached to carbon 5
Who regulates non-ionizing radiation machines
International commission for Non-ionizing Radiation Protection
