week 4

Question 1

daily potassium req

Answer 1

60-80 mmol/day or about 1mmol/kg

Question 2

unsafe prescribing of KCl

Answer 2

20mmol /hour
40mmol/litre of fluid
140mmol/day

Question 3

why is upper gut almost sterile?

Answer 3

gastric acidity, propulsive motility, pancreatic enzymes

Question 4

pH of colon

Answer 4

5.5-7, so slightly acidic but is buffered by bicarbonate

Question 5

beneficial metabolic activites of the gut

Answer 5

produces vitamins, bioactive molecule production, short chain fatty acid production. These help drive water absorption, can act as a fuel for colonic cells, promote healing and inhibit growth of pathogenic bacteria

Question 6

pronephros

Answer 6

formed in the cervical region. regresses by week 4. is rudimentary and non-functioning. Formed of 7-10 solid cell groups. Appears at third week (day 20)

Question 7

mesonephros

Answer 7

Unsegmented. Forms from week 4 and see appearance of the excretory tubules. Mesonephric duct is only structure which will remain. Contributes cells to the genital ridge

Question 8

metanephros

Answer 8

the definitive kidney, forms from week 5 and is functional by week 11. Excretory units develop from the metanephric mesoderm
Two parts: ureteric bud - outgrowth of the metanephric duct which will form the collecting duct
metanephric cap - spherical shape, will go onto form each kidney’s excretory units

Question 9

allantois

Answer 9

vessels contained in this will go onto form important parts of the umbilical cord. Important in nutrition and secretion. The urachus will from from this in weeks 5-7. Duct between the bladder and yolk sac

Question 10

division of cloaca into urogenital and anal/rectal sinus happens?

Answer 10

weeks 4-7. The urorectal septum fuses with the cloaca membrane

Question 11

where does the trigone form from?

Answer 11

the mesonephric ducts

Question 12

when do the genital ducts develop?

Answer 12

weeks 5-6

Question 13

gonads, when does initial development begin

Answer 13

week 5

Question 14

what do leydig cells secrete?

Answer 14

testosterone

Question 15

what do sertoli cells secrete ?

Answer 15

AMH

Question 16

when do external genitalia begin to form?

Answer 16

week 3

Question 17

klinefelter’s syndrome

Answer 17

genetic disorder which affects 1 in 5000 males.
Boys who are born with one or more extra X chromosomes
1/5000 males affected
Causes - infertility, gynaecomastia, impaired sexual maturation.
Low sperm production as leydig cells do not produce enough

Question 18

testicular feminising syndrome

Answer 18

genetic males with female external phenotype. Can produce testosterone, just have mutation on their X chromosome which means they cannot respond to it (deficient in receptors)
uterus and vagina are absent

Question 19

Turner’s syndrome

Answer 19

Only have an X chromosome. Partly or completely missing one X chromosome.
Primordial germ cells degenerate shortly after they arrive at the gonadal ridge- failure of gonadal development.
Infantile genitalia

Question 20

location of production of steroid hormones

Answer 20

adrenal gland, gonads, and placenta

Question 21

examples of conditions with hormone excess

Answer 21

PCS, granulosa cell tumour, teratoma

Question 22

examples of conditions with hormone deficiency

Answer 22

hypogoinadism
turner’s
klinefelter’s
hypopituitarism

Question 23

hormone resistance

Answer 23

testicular feminisation syndrome

5 alpha-reductase type 2 deficiency

Question 24

endocrine disruptor

Answer 24

exogenous chemicals which disrupt normal endocrine function. Have a similar structure to endogenous hormones and either block or mimic the effect of the normal hormone

Question 25

primary follicle

Answer 25

the primary oocyte and the granulosa cells surrounding it

Question 26

Granulosa cells produce

Answer 26

aromotase

Question 27

Theca cells produce

Answer 27

androgens

Question 28

what develops from the urethral folds

Answer 28

labia minora in females, lateral walls of the urethral groove on the penis - will form the penile urethra etc.

Question 29

what develops from the genital swellings

Answer 29

(located on lateral side of the urethral folds) form scrotal swellings in male, labia majora in females

Question 30

what are the three types of gallstone?

Answer 30

cholesterol stone - usually solitary, large and oval bile pigment stone - multiple, irregular and hard. Are associated with chronic haemolysis mixed stone - most common. They are multiple and multi-faceted. Have a laminated surface with layers of cholesterol, bile pigment and calcium salts

Question 31

biliary colic

Answer 31

stone impacted in the gallbladder, usually in the neck (hartmann's pouch). Pain in the epigastrium/right quadrant. This is provoked by eating, with vomiting being common. Usually no jaundice, fever or abnormal LFTS. Often the stone will move back to the base of the gallbladder settling the condition.

Question 32

acute cholecystitis

Answer 32

impacte stone in gall bladder leading to inflammation and oedema of the gall bladder wall, with development of a bacterial infection. Occurs within hours and leads to vomiting, nausea, fever and abdominal tenderness. Give antibiotics and analgaesia.

Question 33

choledocholithiasis

Answer 33

migration of one or more stones from the gall bladder to the bile duct, usually settle just above the ampulla of vater. Patients presents with obstructive jaundice, cholangitis, acute pancreatitis, or a combination of the above.

Question 34

average number of insensible losses per day

Answer 34

800ml | Would be increased in a ventilated patient

Question 35

minimum daily potassium loss

Answer 35

60-80 mmol/day

Question 36

reasons the upper gut is almost sterile

Answer 36

gastric acidity, propulsive motility and the pancreatic enzymes

Question 37

therapeutic range

Answer 37

difference between concentration that achieves therapeutic response and the concentration that has adverse effects