Recalls 9 Flashcards
Most common branch missing from IIA
Middle rectal
I actually think it might be the obturator - originates elsewhere in 25% of cases
Where is the aortic bifurcation in relation to the bony landmarks
Tip of iliac crests. Think epidural
When do the external genitalia start to differentiate
Week 7, this is when the Y chromosome is expressed.
Where do lacunae form in the placenta
In the syncytiotrophoblast.
The lacunae end up being the space where amteral-fetal exxchnage occurs. They will with maternal blood. The cells around the lacunae penetrate into the uterus and will make the villous trees
What gestation does the anterior pituitary develop?
Develops from rathke’s pouch by 5th week
OVERVIEW OF BRAIN DEVELOPMENT
The notocord sits under the ectoderm and releases growth factors. This causes the ectoderm to form a plate which has ectoderm on the peripheries and a neural plate in the middle.
This continues to expand and bends upwards. This creates the neural folds, the neural crest and ultimately the neural tube.
The top portion of the neural tube forms the brain
The bottom portion of the neurla tube forms the spinal cord
Brain vesicles
Prosencephalon - forebrain
Mesencephalon - midbrain
Rhombencephalon - hindbrain
What do each of the brain vesicles give rise to
Prosencephalon - forebrain - telencephalon (cerebral hemispheres), diencephalon (thalamus/hypothalamus)
Mesencephalon - midbrain - midbrain
Rhombencephalon - hindbrain - metencephlon (pons/cerebellum) myelincephalon (medulla)
Which enzyme catalyses the rate limiting stage of the urea cycle
Where does the urea cycle take place
What is the purpose of the urea cycle
Carbonyl Phosphate Synthetase
Liver
When our bodies break down amino acids they produce ammonia which is TOXIC. Therefore the liver enzymes turn this into urea and excrete it via urine
How does fibronectin work
Binds to integrin and helps cells stick together
Where do prostaglandins get deactivated
Lungs mainly
also liver and kidney
Describe the production and storage of surfactant
Made in type 2 pneumocytes in the lungs.
Produced by endoplasmic reticulum.
Processed by golgi
Sorted in lamellar bodies
Which cells are responsible for wound remodelling
Myofibroblasts
When do HCG levels peak in pregnancy
10-12 weeks
When does HPL plateau during pregnancy
36 weeks
When does production of HbA start????
Really hard to find the answer on this - final answer going for 38-40 weeks
Increase in minute ventilation in pregnancy
20-40%
What do the syphilis results mean
VDRL
TPPA
EIA
VDRL - antibodies.
TPPA - the bacteria. Means you have CURRENT infection
EIA - antibodies. Likely positive for life.
Testo fo cure for gonnorhoea/chalydia
Gonorrhoea - 2 weeks
Chalydia - 3 weeks
What si the structure of IgG
4 peptide chains. 2 heavy chains and 2 light chains
Same as IgE and IgD
IgA dimer, IgM pentamer
Where is HPL produced in the placenta
Syncytiotrophoblast
What is the cause of striae gravidarum
Cortisol
But also oestrogen and relaxin
Risk of miscarriage with amnio and cvs
Amnio is lower - 0.5%
CVS 1%
What su the cause of type 1 and type 2 error and how do you fix each
Most common side effect of oxybutinin
Dry mouth
MOA of copper IUD
Kills sperm
AND protects endometrium - if already fertilised
What is the mechanism of action of fluconazole
Inhibits conversion to ergosterol.
Has to do with cell membrane
APGARS
Appearance (colour) -1 if blue peripheries
Pulse -1 if <100
Grimace -1 if weak cry or grimace
Activity (tone) -1 if some flexion
Respiration -1 slow irregular breathing
Is rhesus dominant
yes
What type of cancer with DES exposure
clear cell carcinoma of vagina
IUD/ectopic facts
What is the chance of ectopic if you get pregnant with an IUD?
Chance of ectopic recurrence ?
Risk of IUD expulsion?
16%
Recurrence if has salpingecttomy 20%
Risk of expulsion of IUD 1/20
THINK 20s!!!
Describe the structure of a prostaglandin
20 carbon structure
Alcohol attached to carbon 15
Features of neonatal herpes
Doesnt cause congeital malformation which akes sense as baby is formed by the time it comes into contact with the herpes.
It causes:
- vesicles
- Pneumonitis
- Conjuctivitis (might not agve this in exma)
What is featured in Amsel’s criteria
It is criteria for BV
Dsicharge colour
PH >4.5
Clue cells >20%
+ve whiff test with KOH
What would the suggested tumour markers be for a 20 year old with a large complex ovarian cyst
Ca125
LDH - dysgermioma
AFP - yolk sac/germ cell tumours
BHCG - choriocarcinoa/mixed germ cell
Inhibin A and B - Sex cord (granulosa cells are type of sex cord tumour)
Do a breakdown of the types of ovarian tumour - benign and malignant
Epithelial
**Benign:
**
- Serous cystadenoma
- Mucinous cystadenoma
- Endometrioma
- Brenner tumour
Malignant
- Serous adenocarinoma (MOST COMMON) Ca 125
- Mucinous adenocarcinoma
- Endometrioid
- Clear cell
- Transitional
GERM CELL
Benign
- Mature teratoma (dermoid)
Malignant
- Dysgerminoma (LDH)
- Choriocarcinoma (HCG)
- Immature teratoma
- Yolk sac tumour (AFP)
- Mixed germ cell
SEX CORD
Benign
- Fibroma (part of Meig’s syndrome)
- Thecoma
Malignant
- Granulosa (inhibin A or B)
- Leydig cell
What is the origin of Ca125
Coelomic epithelian structures
Which is the tet likely to give a false biological positive for syphilis
VDRL
What is the parametriv version of:
Krustall wallis
MWU
Krustall wallis - ANOVA
MWU - t-test
How does nifedipine work to lower BP
Decreasing peripheral vascular resistance
What type of toxins do staph and strep produce
Staph - enterotoxin
Strep - exotoxin
What is the term to describe an antibiotic that renders bacteria inactive or stable rather than killing them
Bacteriostatic
What are the typical rsults on U&E for:
SIADH
Diabetes insipidus
Dextrose excess
SIADH - low Na
DI - normal or high Na
Dextrose excess - low Na
What happens to protein C and protein S in pregnancy
Protein C stays the same
Protein S can be markedly reduced.
Therefore if blood tests show this it is likely jut pregnancy
Most common features of warfarin teratogenicity
Nasal hypoplasia
Stipple vertebrae
Bony epiphyses
Most important ligament for trans-abdominal sling for anterior prolapse repair
??ilioectinial or uterosacral
Contrast misoprostol vs dinoprostone
???
cervical ripening
Hyperstimultion
What is the defective structure in thalassaemia
Globin chain
1.
Amenorrhoea, scant pubic hair and bilateral inguinal hernias
Complete androgen insensitivity syndrome
What are the types of bile acid
Cholic acid
Chenodeoxycholic acid
Deoxycholic acid
Lithocholic acidy
What is normal sperm count per ml of ejaulate
15 million minimum
What are erythrocytes delivates of
Myeloid progenitor cells
How many ovarian cancers are no-epithelioid
Only 10%
What is the difference between Gillick competence and Fraser guidelines
Gillick competence - can a child consent to anything?
Fraser guideline - specifically about supplying contraception for underage kids
How would an endometrioma be described on uss
Low level echos or ground glass appearance. Round. Well defined.
Could potentially have some solid components but not necessarily
What is the treatment of gonorrhoea in and out with pregnancy
What about with PID?
Not pregnant: 1g cef
Pregnant: 1g cef
With PID:
Non-pregnant: cef, doxy, metronidazole
Pregnant: cef, azithromycin, metronidazole
What is the treatment of Chamydia in and out with pregnancy
What about with PID?
Not pregnant: 1g azithromycin, or 7/7 doxycycline
Pregnant: 1g azithromycin then 500mg daily for 2/79
With PID:
Non-pregnant: cef, doxy, metronidazole
Pregnant: cef, azithromycin, metronidazole
When can the COCP be restarted following GTD
When the HCG is negative again
When does LMWH get stopped prior to delivery
IOL or PCB - >24h before
Natural labour - stop as soon as signs of labour
> 12h prior to epidural
>24h if treatment dose9
Label everything
Which of the following does not contain paracrine glands:
labia minora
labia majora
mons pubis
??? dont know as rach
Contrast the jejunum and ileum
Jejunum - shorter, longer and fewer arcades. Thick walled.
Ileum - longers, shorter and more arcades. Thin walled
Where is the dentate line
Marks the division of the top 2/3 of the anal canal (end of the hindgut) and the rectum.
Above - columnar epithelium
Below - stratified squamous
Also known as the pectinate line
Which muscle is the sacral plexus situated on top of?
What is in front?
Piriformis
In front - IIA, IIV, ureter and sigmoid colon
Describe the route of the ureter
Exits kidney,
Passes down psoas muscle
Passes anteriorly to the bifurcation of CI vessels which is at the level of the sacroiliac joint
What are the functions of the sacrospinous and sacrotuberous ligaments
Preventing anterior tipping of sacrum and also preventing too much rotation at SI joint
Sacrospinous ligament prevents too much rotation of the ileum past the sacrum
What percentage of blood does the ovary get from the uterina rteries
About 5-10%
Contrast inguinal and femoral hernias
Inguinal = superior and medial to PT
What is the rate limiting step of the urea cycle
Carbamoyl phosphate synthetase reation
What is the structure called at the stage of splitting for twins:
Di-Di
Mono-Di
Mono-Mono
Di-Di - <4 days - BEFORE the morula stage
Mono-Di - 4-8 days before blastocyst hatching
Mono-Mono - 8-12 days after blastocyst hatching
Conjoined - after 12 days
When do the anterior and posteiror fontanelle close
Posterior - first. 2-3 months
Anterior - much later - 7-18 months
When does the odds ratio approximate the risk ratio
If the disease is RARE
What type of variable does a histogram show
Continuous
Results for LH, FSH and SHBG in kleinfelters
All increased
Which hormone leads to nutrient transfer from mum to fetus
HPL
How long from resting folicle stage to ovulation
20 days
What are the layers that the sperm must penetrate when fertilising
Corona radiata
Zona pellucida
Perivitelline space
Plasma membrane
Which hormone withdrawal is thought to be responsible for miscarriage
Progesterone. Think progesterone pessaries and also that progesterone inhibits contraction of the uterus
