MEQ 2009 Flashcards
State and define the stages of labour (4 marks) - Parturition
- latent (dilatation) - 10cm head causes a breach, uterine contractions, water breaks due to sac of amniotic fluid
- active – Explusion (I,II,III)
i - - contractions - push baby down uterus to cervix and vagina/birth canal - contractions every 5 mins
ii - fetal explusions - crowning of head, rotation and devlier of anterior shoulder, then posterior
iii - body and umbilical cord - clamped - post-partum – after birth of placenta
What hormone is a marker for a positive pregnancy test? (1 mark)
beta-HCG
What examinations and investigations can be carried out to find out how far gone she is in the pregnancy?
12 week dating scan (Ultra Sound Scan), blood analysis for chemical markers
What is the normal concentration of sperm in an ejaculate?
> = 15 million/ml
What can the couple do to conceive? What technique?
Intracytoplasmic sperm injection (sperm is injected into egg, type of IVF) , intra-uterine insemination (IUI - when sperm is injected into uterus
(forms of IVF )
What does oligozoospermic mean?
Low sperm count
How can they tell if the embryo is okay?
Pre-implantation genetic analysis
What is the cause of his weight gain? (4 marks)
increased appetite due to damage to satiety centre in brain and hunger centres in the hypothalamus
Why is creatinine used as an estimate of the Glomerular Filtration Rate ( needed to state two features of creatinine which enables it to be used in the measurement of GFR)
Freely filtred, not secreted, not metabolised
Name the protein found in the glomerular basement membrane that is damaged in kidney disease?
Nephrin (?) - forms membrane
Name the type of gait in the following conditions; parkinsons, stroke, cerebellar disease? (1 mark for each)
- Hemiplegic Gait - unilateral weakness on the affected side, arm flexed, adducted and internally rotated. - stroke
- Diplegic Gait - both sides with spasticity in lower extremities worse than upper extremities. The patient walks with an abnormally narrow base, dragging both legs and scraping the toes. - bilateral lesions - cerebral palsy.
- Choreiform Gait - (Hyperkinetic Gait) - Huntington’s Disease and other forms of chorea, athetosis or dystonia. The patient will display irregular, jerky, involuntary movements in all extremities.
- Ataxic Gait - (Cerebellar) - clumsy, staggering movements with a wide-based gait. While standing still, the patient’s body may swagger back and forth and from side to side, known as titubation. ( appears like acute alcohol intoxication)
- Parkinsonian Gait- rigidity and bradykinesia. He or she will be stooped with the head and neck forward, with flexion at the knees. (walk of little steps). Patient may also have difficulty initiating steps.
- Sensory Gait -stomping gait - patients may lift their legs very high to hit the ground hard. This gait can be seen in disorders of the dorsal columns (B12 deficiency or tabes dorsalis) or in diseases affecting the peripheral nerves (uncontrolled diabetes). In its severe form, this gait can cause an ataxia that resembles the cerebellar ataxic gait.
State the signs of an UMN lesion (5 marks)
hyper-reflexia, spastic paresis, increased tone, lack of muscle atrophy, positive Babinski
Question about back pain and reflexes…state reflex lost and distribution of sensory loss and motor weakness
(know the main ones..L4, L5, S1)
Anatomy of the knee: which leminiscus is more likely to be ruptured?
(medial) - cutaneous leminiscus
How do you test to see if the cruciate ligaments are damaged? State the name of the test and describe how you would carry it out? ( “anterior draw test” – detects anterior cruciate ligament rupture)
Lachman’s Test
