13/07 Flashcards

(51 cards)

1
Q

What level does spinal cord become cauda equina?

A

L2

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2
Q

What level is spinal/epidural anaesthetic injected?

A

L3-L4

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3
Q

What level does sympathetic outflow exit spinal cord?

A

T1-L2

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4
Q

Which nerve supplies somatic motor and sensory to the perinuem?

A

Pudendal nerve

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5
Q

What are the nerve roots of pudendal nerve?

A

S2,3,4

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6
Q

What arteries supply anterior abdo wall?

A
Superior epigastric (continuation of interal thoracic) 
Inferior epigastric (branch of ext iliac)
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7
Q

What is relationship of ureter and uterine artery?

A

Ureter inferior to uterine artery = “water under the bridge”

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8
Q

What structures are at risk of injury in sacrospinous fixation? Why?

A

Pudendal NVB
Sciatic nerve
(Runs around sacrospinous ligament)

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9
Q

What does the placenta do if implantation occurs?

A

Secrete HCG - prevents deterioration of corpus luteum

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10
Q

What is the most reliable test to assess ovulation?

A

Day 21 progesterone

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11
Q

What hormone should be tested to confirm menopause?

A

FSH

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12
Q

How does BP fluctuate in a normal pregnancy?

A

BP falls in 1st trimester (particularly diastolic) till 20-24 weeks - then gradually increases till term

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13
Q

High risk groups for preclampsia

A

CKD
Previous HTN in pregnancy
Autoimmune disorders
Diabetes

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14
Q

How long can pregnancy test remain positive after TOP?

A

4 weeks

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15
Q

How is cryptorchidism treated if < 14 y/o?

A

Orchidoplexy (to minimise cancer risk)

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16
Q

What does FSH act on in males?

A

Sertoli cells

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17
Q

What does LH act on in males?

A

Leydig cells

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18
Q

What do the seminal vesicle secrete?

A

Prostaglandins (stimulate motility)

Fibrinogen (clot precursor)

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19
Q

In a normal menstrual cycle what inhibits FSH?

A

Inhibin

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20
Q

What effect does oestrogen have on LH?

A

At low conc - inhibits LH

At high conc - stimulates LH

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21
Q

What does the corpus luteum produce?

A

Oestrogen
Progesterone (Inhibits GNRH - stimulates endometrial growth)
Inhibin (inhibits FSH)

22
Q

Causes of cervical excitation

A

PID

Ecoptic pregnancy

23
Q

When is LH surge?

A

midpoint of cycle (24-48 hours before ovulation)

24
Q

When do entrometiral polyps commonly occcur?

A

Around and after menopause

25
Most common organism that causes endometritis
Neisseria
26
What is a molar pregnancy?
Non-viable fertilized egg that implants in uterus (or tube)
27
Describe complete mole
1 or 2 sperm combine with egg without DNA | Complete 46 chromo set
28
Describe partial mole
Egg is fertilized by 2 sperm or one sperm that replicates itself (69XXY)
29
Drug to reverse respiratory depression caused by magnesium sulphate
Calcium gluconate
30
Drug used in benzo overdose
Flumazenil
31
ABC symptoms of IBS
Abdo pain Bloating Change in bowel habit
32
What type of pain is caused by ovarian torsion?
Deep seated colicky pain
33
4 T's of PPH
Tone Tissue Trauma Thrombin
34
Causes of secondary PPH
Retained placenta | Endometritis
35
What happens to Hb in normal pregnancy?
Decreases
36
Effect of normal pregnancy on platelets, WCC and ESR?
Platelets decrease WCC increase ESR icrease
37
Effect of pregnancy on GFR
Increases
38
Effect of pregnancy on calcium
``` Demands increase (serum calcium and phosphate levels decrease) Gut absorption of calcium increases ```
39
Effect of pregnancy on LFTs
ALP increases | Albumin decreases
40
Why is folic acid given during pregnancy?
Reduce the risk of neural tube defects
41
Causes of folic acid deficiency
Pregnancy Alcohol excess Methotrexate Phenytoin
42
Folic acid regime for normal pregnancy
400mg up till 12 weeks
43
Reasons for high folic acid dose
BMI >30 Partner or prev pregnancy with NTD Taking antieplileptics Has diabetes, coeliac or thalasseamia trait
44
Most common type of ovarian cancer
Serous carcinoma
45
First line in menorrhagia if not wanting to concieve
Mirena IUS
46
Management of menorrhagia if not wanting contraception
Mefanamic acid (good for dysmenorrhoea) or tranxaemic acid
47
Used to short term stop heavy bleeding
Northesterone 5mg tds
48
What is used for a medical termination of pregnancy?
Mifepristone then prostagaldnins
49
Mechanism of action of metformin increasing fertility in PCOS
Increases peripheral insulin sensitivity
50
List of drugs contraindicated in breast feeding
``` Antibiotics Antipsychotics (lithium, benzos) Aspirin Methotrexate Suphonylureas Cytotoxic drugs Amiodarone ```
51
Complications of PCOS
``` Endometrial ca Diabetes Stroke Obstructive sleep apnoea Coronary artery disease Subfertility ```