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MD3002 post MSA > revision questions > Flashcards

revision questions Flashcards

1
Q

what enzyme is involved in oestrogen production

A

aromatase

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2
Q

what is the appendix epididymis a remnant of

A

proximal end of the mesonephric duct

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3
Q

which part of the male duct empties into the prostatic urethra

A

the ejaculatory duct

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4
Q

what conditions may result from a patent tunica vaginalis

A

cytocele, hydrocele, indirect inguinal hernia

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5
Q

what constituent of ejaculate is used as a source of choline

A

glycerylphosphorylcholine formed in the epididymis

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6
Q

which ligament forms the inferior border of the greater sciatic foramen

A

sacrospinous

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7
Q

what is the subpubic angle of the female pelvis

A

80-85

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8
Q

which area of the prostate is most likely to be affected by prostate cancer

A

peripheral zone

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9
Q

what endometrial condition is most often associated with a p53 mutation

A

endometrial adenocarcinoma non endometroid

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10
Q

at what positions are anal cushions present

A

3, 7, 11 o’clock

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11
Q

what veins in the rectum contribute to the systemic part of the portosystemic anastomosis

A

internal pudendal

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12
Q

what are the features of stage 3 male puberty

A

penal enlargement, pubic hair and testicular enlargement

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13
Q

what conditions can be detected during the combined first trimester screening test which is aimed at the whole population

A

anencephaly
patau’s
down’s
edward’s

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14
Q

what are the features of WPW dysrhythmia

A

short PR interval with early QRS upstroke

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15
Q

what is the peak incidence of teratomas in men

A

20-30 years

alpha fetoprotein is a useful marker

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16
Q

what age do yolk sac tumours occur

A

children

AFP is a marker

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17
Q

what age do seminomas occur

A

30-50

no protein marker

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18
Q

what is rigler’s sign

A

double wall sign

usually pneumoperitoneum due to bowel perforation

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19
Q

what is the leading cause of traveller’s diarrhoea

A

enterotoxigenic e. coli ETEC

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20
Q

what are the features of proliferative glomerulonephritis

A 
post strep infection 
deposition of immune complexes
Type 3 
nephritic syndrome
blood in urine 
sub epithelial
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21
Q

what are the features of GI carcinoid tumours

A

large intramural masses with polypoid excavations

occur mostly in the appendix

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22
Q

what are the features of adenocarcinomas in the GI tract

A

napkin ring encircling and exophytic growth

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23
Q

large bulky intramural mass that may ulcerate

A

leiomyosarcoma

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24
Q

clearly pedunculated with a lobar growth on the end of a stalk

A

tubular adenoma

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25
Q

3 cm velvety mass

A

villous adenoma

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26
Q

what cells are responsible for producing fluid that flushes sperm from the tubule to the epididymis

A

sertoli cells

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27
Q

describe the stepped care model

A

level one is self management
level 2 is multiple chronic conditions treated by a MDT
level 3 is unplanned visits to secondary care

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28
Q

what nerves might be damaged in overflow incontinence

A

S2-4

posterior 2/3rds of the scrotum are supplied by pudendal nerve S2,3 so would be affected

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29
Q

who is renal cell carcinoma most common in

A

smokers and obese people

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30
Q

what are the symptoms of renal cell carcinoma

A

back pain
blood in urine
pyrexia due to paraneoplastic syndrome

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31
Q

what is the five year survival rate of renal cell carcinoma

A

50%

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32
Q

what is the effect of phenothiazines on prolactin

A

phenothiazines are D2 antagonists which increase prolactin

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33
Q

what does hemizygous mean

A

only on chromosome is present e.g. for men with an X linked disease

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34
Q

how might a seminoma present

A

hard lump in young man

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35
Q

what structures secrete inhibin

A

CL and leydig cells

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36
Q

what substance can be used to detect neural tube defects

A

raised alpha fetoprotein

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37
Q

what are the features of the trophoblast

A

the cells of the cytotrophoblast can divide to form synciotiotrophoblast
synciotrophoblast cells are multinucleated and produces hCG. it is in contact with maternal sinusoids

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38
Q

what is trisomy 13

A

patau’s syndrome

cleft palate, heart defects
associated with high maternal age
majority die as neonates

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39
Q

in what condition would barr bodies be absent

A

45 X

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40
Q

what is cyproterone acetate used to treat

A

prostate carcinoma and BPH and male hypersexuality

acne and PCOS

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41
Q

What effect does psychological stress have on prolactin

A

increases prolactin

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42
Q

what effect does hyperthyroidism have on prolactin

A

decreases

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43
Q

what is the function of oestrodiol

A

stimulates hyperplasia and hypertrophy of columnar epithelium and stroma in the endometrium and fallopian tubes
also secretion

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44
Q

what metabolic disturbance causes hyperkalaemia

A

acidosis

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45
Q

why does burns cause hyperkalaemia

A

cellular injury causing potassium release

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46
Q

how much protein is lost per day in nephrotic syndrome

A
  1. 5 g
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47
Q

a man comes in with raised red plaque on his penis. what’s the diagnosis

A

Bowen’s disease
Squamous cell carcinoma in situ
very slow growing cancer

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48
Q

what causes invasive squamous cell carcinoma on the penis

A

HPV

Nodule of plaque
mets to inguinal lymph node

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49
Q

what occupation used to be at risk of carcinoma of the scrotum

A

chimney sweeps and arsenic workes

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50
Q

a man comes in with a nodular ulcerated mass on his scrotum. what’s the diagnosis

A

squamous carcinoma

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51
Q

what is the most common testicular tumour

A

seminoma

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52
Q

a man has testicular cancer which has spread to the para aortic lymph nodes, what stage is this

A

2
(involves testes and paraaortic lymph nodes)

3- mediastinum/ supraclavicular region

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53
Q

what week in pregnancy do hCG levels peak

A

8-10

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54
Q

when is maternal circulation functional

A

week 10 -12

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55
Q

at what week are all steroids required for pregnancy secreted by the placenta

A

week 4-5

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56
Q

a woman presents with uterine bleeding in week 7 of her pregnancy. what drug do you prescribe to stop the bleeding

A

ergometrine
causes the uterus to contract
alpha receptor antagonist

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57
Q

what is stage 1 of male pubertal maturation

A

no pubic hair, no enlargement of penis or testes

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58
Q

a boy has testicular enlargement and start of pubic hair, what stage is this

A

2

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59
Q

a boy has penal enlargement, testicular enlargement and pubic hair, what stage is this

A

3

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60
Q

a boys pubic hair darkens what stage is this

A

4

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61
Q

what is stage 5

A

adult genital appearance

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62
Q

what is the venous drainage of the ovary

A

pampiniform plexus to the uterine plexus to the left renal vein or aorta

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63
Q

what surrounds each ovary

A

tunica albuginea (pressure) mesotheliun which is analogous to peritoneum

medulla consists of connective tissue and blood vessels

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64
Q

which antenatal test is usually carried out at 11-12 weeks gestation

A

chorionic villus sampling

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65
Q

which antenatal scan would be most appropriate to diagnose down’s syndrome at 15 weeks

A

amniocentesis

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66
Q

what is the energy intake increase needed at the end of pregnancy

A

1200 kJ per day

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67
Q

why might pregnant women experience heartburn, constipation and increased transit time

A

reduced GI tone and motility due to relaxation of smooth muscle by progesterone

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68
Q

what causes morning sickness

A

ovarian steriods

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69
Q

how much does the maternal pituritary increase by

A

40 %

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70
Q

how much does pulmonary ventilation increase by

A

40%

raised tidal volume

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71
Q

where does the inguinal ligament go to

A

pubic tubercle to asis

inwardly rolled inferior edge of external oblique

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72
Q

abdo pain worse after eating, weight loss, constipation, malaise, smoking, watery diarrhoea

A

crohns

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73
Q

where is the thorocolumbar fascia

A

iliac crest to 12th rib

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74
Q

cerebral calcifications, cerebral palsy

treated with spiramycin

A

toxoplasmosis

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75
Q

eye defects and limb hypoplasia

treated with iv aclivor or immunoglobulin

A

VZV

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76
Q

heart defect, microcephaly

A

rubella

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77
Q

ductal carcinoma in situ

A

unilateral

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78
Q

lobular carcinoma in situ

A

bilateral

79
Q

mucoid diarhoea

A

UC

80
Q

watery diarrhoea

A

crohns

81
Q

peripheral zone

A

prostate cancer

82
Q

p53

A

non endometroid endometrial adenocarcionoma

83
Q

inferior rectal veins

A

internal pudendal veins

84
Q

hyperparathyroidism

A

increased calcium levels which can lead to the production of renal calculi leading to haematurian and pain- loin and groin

85
Q

renal tuberculosis

A

weight loss, night sweats, haematuria, loin pain

86
Q

kidney disease, hearing loss, eye abnormalities

A

alport syndrome

87
Q

nephrotoxic mechanism of aminoglycosides

A

accumulates in the lysosomes of the PCTs

88
Q

early distal tubules to block the sodium chloride co transporter

A

thiazide

89
Q

decreases active reabsorption in the TAL by blocking the sodium chloride potassium co transporter

A

loop diuretric

e.g. furosemide

90
Q

directly inhibits entry of sodium and secretion of potassium in the collecting ducts

A

soidum channel blocker

e.g. amiloride

91
Q

competes with aldosterone for receptors in the cortical collecting ducts leading to retention of potassium

A

potassium sparing diuretic

e.g. spironolactone

92
Q

inhibits water and solute reabsorption by increasing the osmolarity of tubular fluid

A

osmotic diuretc e.g. mannitol

93
Q

inhibits H+ secretion and bicarbonate reabsorption which reduces sodium reabsorption in the PCT

A

Carbonic anhydrase inhibitors

94
Q

secreted by parietal cells

A

intrinisic factor and hydrochloric acid

95
Q

released by p’symp stimulation it excites peptic cells, parietal cells and mucous cells

A

acetyl choline

96
Q

stimulates ECL cells and acid secretion

A

gastrin

97
Q

intestino intestinal reflex

A

inhibition of contractions in the adjacent regions of the small intestine

98
Q

left iliac fossa is palpated causing pain in the right iliac fossa due to movement of inflammed parietal peritoneum

A

rovsing’s sign - appendicitis

99
Q

cannot be made directly

A

vitamins

100
Q

copper deposition

A

wilson’s disease

101
Q

acute hepatitis

A

toxoplasmosis

102
Q

histamine 2 and muscarinic 3 and prostaglandins and gastrin receptors

A

increases gastric acid secretion from parietal cells

103
Q

normal temp

A

36-37.5

104
Q

anterior fibres of temporalis

A

elevation of the mandible

105
Q

posterior fibres of temporalis

A

retraction of the mandible

106
Q

ranitidine

A

targets h2 receptors in order to reduce gastric acid secretion

107
Q

chemoreceptor trigger zone

A

D2 receptors

e.g. metoclopramide and domperidone

108
Q

ondansetron

A

serotonin antagonist 5HT3

109
Q

what are the different types of antiemetic

A

antimuscarinics
histamine 1 antagonists
serotonic antagonists
dopamine 2 antagonists

110
Q

what is the surface marker for the femoral pulse

A

midway between the asis and the pubic symphysis

111
Q

villous atrophy, increased lymphocytes, increased crypt cell

A

coeliac disease

112
Q

non bloody diarhoea

A

crohns

113
Q

inflammation always starts at rectum and never spreads beyond ileocaecal valve, no inflammation beyond submucosa

A

uc

114
Q

increases the volume and alkalinity of pancreatic juice

A

secretin

115
Q

increases peristalsis

A

substance p

116
Q

osmotically active substance is secreted into the tubules which retains water causes diuresis

A

mannitol

117
Q

what hormone is involved in the milk let down reflex

A

oxytocin

118
Q

what hormone leads to a rise in HDL cholesterol levels

A

oestrogen

119
Q

what hormone is involved in galactorrhoea

A

prolactin

120
Q

level of the coeliac trunk, superior mesenteric and inferior mesenteric

A

t12, L1 and L3

121
Q

which unpaired artery arises just above the aortic bifurcation at L4, posteriorly

A

median sacral

122
Q

what vitamin deficiency may alcoholism cause

A

B1- thiamine

(amino acid and energy production and muscle action potentials)
found in wheat, oats and yeast products

may lead to beriberi / Korsakoffs syndrome

123
Q

what is the most serious consequence of hypomagnesium

A

arrythmias and cardiac arrest

124
Q

where is aldosterone (mineralocorticoid) produced

A

zona glomerulosa (outer layer)

125
Q

what is the function of aldosterone

A

Aldosterone promotes sodium retention and loss of potassium and hydrogen ions. regulates blood pressure

126
Q

where is cortisol made, and other glucocorticoids

A

zona fasciculata (middle)

127
Q

what is the function of cortisol

A

increased blood sugar levels, helps to stabilise membranes, stimulates appetite and suppresses the immune/ hypersensitivity response.

128
Q

where are adrenal androgens made

A

zona reticularis (inner layer)

129
Q

where is renin made

A

juxtaglomerular apparatus

also regulates the glomerular filtration rate to control sodium excretion.

130
Q

where are catecholamines made

A

adrenal medulla

131
Q

at what level is the head of the pancreas

A

L2

132
Q

what structures does the head of the pancreas overlie

A

IVC, renal veins and common bile duct

133
Q

what is the lymph drainage of the testes

A

para aortic

134
Q

what is the lymph drainage of the upper third of the rectum

A

inferior mesenteric

135
Q

what is the lymph drainage of the vulva

A

superficial inguinal

136
Q

what is the lymph drainage of the scrotum

A

superficial inguinal

137
Q

what is the lymph drainage of the cervix

A

internal iliac

138
Q

what is the lymph drainage of the upper anal canal

A

inferior mesenteric

139
Q

what is the lymph drainage of the lower anal canal

A

inguinal nodes

140
Q

what nerves are inferior/posterior to the left kidney

A

ilioinguinal nerve, iliohypogastric and subcostal

141
Q

what is the vertebral level of the left kidney

A

t12 to L3

142
Q

what are the anterior relations of the left kidney

A

stomach, spleen, pancreas, jejunum and descending colon

143
Q

what hormone enhances insulin release, reduces glucagon and promotes satiety

A

glucagon like peptide

GLP1

144
Q

what hormone is raised in patients with chronic renal failure

A

parathyroid hormone

due to the body attempting to conserve calcium

145
Q

metabolic acidosis is associated with decreased levels of bicarbonate

A

respiratory acidosis is increased levels of CO2

146
Q

why does SIADH cause decreased sodium

A

results in fluid overload and dilutional hyponatraemia

147
Q

what structure is responsible for absorbing 60 % of all solute

A

PCT

148
Q

Which limb is impermeable to water

A

ascending

149
Q

what might be a symptom of B6 deficiency

A

sensory neuropathy

150
Q

what is the function of PTH

A

promotes loss of phosphate in the urine and and prevents the loss of calcium in the urine

causes bone release of calcium
activates vitamin D

151
Q

what can be used to treat pre eclampsia

A

magnesium

152
Q

what are the features of hypermagnesemia

A 
neuromuscular depression 
depressed respiratory function 
nausea and vomiting 
hypotension 
cardiac arrest
153
Q

give an example of a paraneoplastic syndrome

A

pyrexia due to kidney cancer

154
Q

what mediates the efferent limb of the gastrocolic reflex

A

gastrin and CCK

155
Q

what mediates the efferent limb of the vagovagal reflex

A

VIP

156
Q

what structures does the sigmoid mesocolon cross in the left iliac fossa

A

birfurcation of the common iliac

ureter

157
Q

where does the base of the mesentery begin

A

Left of L2

158
Q

which artery enters the rectus sheath between the sternal and costal ends of the diaphragm

A

superior epigastric

159
Q

what drug has its absorption slowed by ingesting food

A

paracetamol

160
Q

how do ductal cells modify saliva

A

absorb sodium and chloride

secrete potassium and bicarb

161
Q

what embryonic tissue gives rise to the liver

A

endoderm

162
Q

how much is life expectancy reduced in obesity

A

7

163
Q

which antiemetic causes sedation

A

haloperidol

164
Q

which drug increases permeability to calcium ions and is used to treat schistomes

A

praziquantel

165
Q

what substance is a risk factor for adenocarcinoma

A

smoking

166
Q

what part of the duodenum does the SMA start at

A

second part

167
Q

what nerves are carried with the IMA

A

least splanchnic and p’symp from S2-4

168
Q

what is omphalocele

A

physiological herniation fails to return to normal

169
Q

what two structures does the ventral mesentery form

A

falciform ligament and lesser omentum

170
Q

what structures form the stomach bed

A

central tendon
left colic flexure
spleen

171
Q

how much rotatation of the bowel around the SMA occurs

A

270 anticlockwise

172
Q

where is the swallowing centre

A

medulla and lower pons

173
Q

what factors decrease action potential frequency

A

gastrin
GIP
sympathetic NS
secretin

174
Q

what is the location of the second part of the duodenum

A

anterior to the hilum of the right kidney, right of L2-3 vert

175
Q

what is the best marker of acute hepatocellular injury

A

ALT

176
Q

What is a metabolic consequence of acute pancreatitis

A

low serum calcium

177
Q

how does CCK affect the pancreas

A

reduces exocrine secretions

178
Q

what are the features of the exocrine pancreas secretion

A

high bicarbonate

isotonic

179
Q

what is the blood supply to the lower pharynx

A

inferior thyroid

180
Q

what does the falciform do in the developing embryon

A

connects the liver to the anterior abdo wall

181
Q

what embryonic tissues form the anus

A

endoderm and ectoderm marked by the pectinate line

182
Q

what does the cloaca develop into

A

anteriorly the urogenital system

posteriorly the anorectum

183
Q

what congenital abnormalities of the GI system can arise

A 
abnormal rotation 
Meckel's diverticulum
vitelline cyst
patent vitelline fistula 
gastroschisis
umbilical hernia
omphalocele
failure of recanalisation
184
Q

where does the caecum and appendix migrate

A

from the right hypochondrium to the left iliac fossa

185
Q

how much rotation happens in the physiological hernia

A

90 degrees

then another 180 as it drops back into the abdomen and 10 weeks

186
Q

what does the midgut form from

A

the primary intestinal loop on a mesentery

187
Q

what connects the midgut to the yolk sac

A

vitelline duct

188
Q

what causes herniation of the intestine into the umbilical cord

A

rapid growth

189
Q

what are the boundaries of the lesser sac

A 
caudate lobe of liver
lesser omentum 
stomach 
pancreas
left kidney
adrenal gland 
epiploic foramen
190
Q

what is pringles manouver

A

compressing the hepatic artery and portal vein between the fingers to control bleeding

191
Q

what are the borders of the epiploic foramen

A

free border of lesser omentum
inferior vena cava
caudate process of the caudate lobe
first part of the duodenum

192
Q

where is the umbilical vein

A

free edge of the falciform ligament

193
Q

what forms the pancreas

A

dorsal and ventral endodermal buds from the duodenum. rotation of the duodenum causes them to fuse

194
Q

when does CVS happen

A

10 weeks

MD3002 post MSA (66 decks)

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