Year 3 Flashcards
Mild learning disability
50-69
Moderate learning disability
35-49
Non-epileptic fit movements
Side to side, thrusting of pelvis
Unipolar depression and dexamethasone
Dexamethasone will fail to suppress cortisol production
Mixed affective disorder
Manically depressed (high energy depression)
MSE has what
Appearance + behaviour, speech, affect, mood, thoughts, perception, cognitive function, insight
Aversive/defensive
Serotonin / NA
Depression and mania are problems with aversive/appetitive
Appetitive
Where is bipolar thought to affect?
Anterior cingulate nucleus (broadmann 24)
NA precursor
Tyrosine
5-HT precursor
Tryptophan
What metabolite is only increased in heroin?
6-monoacetylmorphine (6 hours)
Acute PTSD vs chronic
4 weeks
3 months
Hebenephric schizophrenia features
Babbles nonsense, laughs uncontrollably
Most common schizophrenia
Paranoid
Most worrying personality disorder and treatment
Group B
DBT
Schizophrenia affects white/grey matter
Grey
Schiz <1 month
Schizophreniform or acute and transient psychosis
How long to continue meds after single episode of schizophrenia?
18 m if no relapses
Schizotypal disorder
Overvalued ideas but no delusions or real hallucinations
Egodystonic
Thoughts aren’t own
Most common mental illness
Anxiety
Diagnostic tool for autism
ADOS
Disulifram does what?
Inhibits acetaldeyde dehydrogenase
What is the predict score?
Predict score = effectiveness of chemo and radiotherapy in breast caner
Where are subcutaneous glands in non-lactating breasts?
In front of deep fascia
Histology of non-lactating breast
Connective tissue and glandular epithelium
How many lobes in a breast?
15-25
What separates lobules?
Suspensory ligaments
Basic functional unit of breast
TDLU
Lactiferous sinus =
Bulge in lactiferous duct where milk concentrates
Lobules of non-lactating breast are filled with
Acinar cells, secretory epithelium (columnar and cuboidal), myoepithelial cells surround acinus
Histology of large ducts
Both stratified shamus and cuboidal
What can happen to breast during luteal?
Small secretions?
What is in lactate ?
88% water 7% carbs 3.5% lipid 1.5% protein IgA
Protein is secreted into ducts via
Eccrine transport
Lipids are secreted via
Apocrine
How deep does breast conservation surgery go?
Full thickness to chest wall
If you can’t see cancer with your eyes, how do you excise?
Wire guided wide excision
Why do you give under 35 an US?
Breast too dense for mammogram
Sterotaxis
Mammography guided biopsy
Most common breast cancer
Ductal
How is DCIS found?
Non-palpable, found on screening (pleomorphic, casting calficiations)
Invasive lobular carcinoma histology
Indian file pattern
Modified radial mastectomy preserves what?
Pec major
Fibroadenoma confirmation via
FNA and US
Phyllodes tumour looks like a ________ and is due to _______ _______
Sarcoma
Stromal overgrowth
Fat necrosis histology
Foamy macrophages
LCIS tumour markers
ER+
E-cadherin-
CDH1+ (chromosome 16)
BRCA and breast cancer risk
50%
Survival if ER positive ?
30% better
HER2+ cancer has ______ prognosis
Worse
FNA or needle core biopsy?
Needly core biopsy is more often now
Fertility treatment for poor swimmers
ICSI
First line fertility treatment
IUI
Mullerian tract makes what?
Fallopian tubes, mullein inhibiting factor in males makes them disappear
Obstructive male infertility blood
Normal
Non-obstructive male infertility blood
High LH/FSH
Low testosterone
Chlamydia treat
Doxy 7 days
What is implantation bleeding?
10 days post ovulation egg implants into uterus
What does vomiting occur in pregnancy?
First trimester
Treat hyperemesis
Cyclizine
What has a large fluid filled antrum?
Ovarian follicles
What is at the centre of the ovaries?
Hilum and medulla
Where are follicles in ovaries?
Cortex
Uterine and Fallopian tube histology
Simple columnar
Stratum of uterus endometrium undergoes monthly growth and degeneration
Functionalists
Should there be clots in normal menstruation?
No, clots are abnormal
Proliferative phase of menstruation
Oestrogen
Luteal phase of menstruation
Progesterone
Complete mole
2 sperm DNA
46 chromosomes
STI needing a proof of cure
Gonorrhea
What infections are people with AIDS at increased risk of?
Fungal, viral, parasitic, MYCObacterial
Toxoplasmosis signs
CN palsy, confusion
CMV signs
Floaters, abdo pain, PR bleed
How long after sex do you test HIV
4 weeks
How long do ovum survive?
17-24 hours
Listeria and pregnancy avoid what?
Soft cheese, shellfish, pate
Round ligament is remnant of what?
Gru vernaculum
Ribs below pec major?
2-6
Preeclampsia risk –> take
75 mg aspirin from week 12
T sign placenta with twins
Monochorionic
Lamba sign
Dichorionic
Asymmetrical IUGR suggests
Placental insufficiency
Prenatal appointment screen
Hep, HIV, syphilis, blood group, anaemia
Placenta is made of
Trophoblasts and decide
_____ stimulation releases oxytocin
Nipple
Urogenital system arises from the
Intermediate mesoderm
What helps testes descend
Gubernaculum
Are contractions under hormonal or neuro control?
Hormonal
APH
50-1000ml but no shock
1st phase of labour latent vs active
0-4cm
4-10cm
How many women experience baby blues?
Up to 50%
Treatment of overactive bladder?
Oxybutinyn and tolterodine
Demopressin
Mirabegron
What makes up levator ani?
PPI
Feeding of pre-term baby?
Supplements, give small drops of milk to encourage gut maturation
RDS is common before ____ weeks
37
XRAY in RDS
Ground glass
Normal weight of baby
2.5-4kg
c. number means
Where mutation is in mRNA
p. number mean
Which amino acid is affected
c.(number, letter>letter) meaning
Position of codon and what it has switched to
Liver in neonates is smaller/larger
Larger
Bowel loops should be _______ than vertebral column otherwise _______
Smaller
Dilated
Why does NEC happen?
Unprepared GI tract springs a leak and leads to shock
Brown fat
Produced in 3rd trimester, provides warmth after birth, between scapula and internal organs
How long can a newborn be blue and not be worrying?
5 mins
Initial rhesus of newborn
In air up to 10 mins then wrong so use oxygen
Physiological jaundice of newborn?
Fetal haemoglobin is breaking down, normal 24h-2weeks
Endometrial polyps are common when?
Around menopause
Endometroid endometrial cancer precursor
Atypia
Brachytherapy?
Intrauterine tube under GA, gets radiotherapy closer to cancer
Ovarian cancer risks
> 50, no kids, FMHx, BRCA
What divides obturator foramen?
Piriformis