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ESA 4 Rev > IUPA REV > Flashcards

IUPA REV Flashcards

1
Q

How does a fetal skull differ from an adults?

A

Large calvaria relative to face
No teeth
No mastoid or styloid process
Small nasal cavities

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2
Q

What form the borders between the cranial fossa?

A

Lesser wing sphenoid

Superior border petrous part of temporal bone

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3
Q

What are fontanelles?

A

Areas of unossified membranous gaps between flat bones of calvaria

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4
Q

When do the fontanelles close?

A

Anterior - 18 months to 2 years

Posterior - 1-3 months

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5
Q

Where is the bleeding in a cephalohaematoma, is the brain compressed?

A

between periosteum and bone.

No brain compression - outside skull.

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6
Q

Which vessels lie in the dense connective tissue layer of the scalp?

A

Vessels supplying scalp
Supraorbital + supratrochlear
Occipital, pre-auricular and superficial temporal

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7
Q

Which vessels lie in the loose connectivity tissue layer of scalp?

A

Emissery veins - connect vessels in dense ct layer with dural venous sinus.

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8
Q

How can scalp infections spread intracranially?

A

Emissery veins connecting vessels in deep ct layer to intracranial venous sinuses.

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9
Q

What space do bridging veins traverse?

A

Subdural space - drain cerebral veins in subarachnoid space into dural venous sinus

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10
Q

What does the MMA supply?

A

Bones of skull + dura

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11
Q

Where is the bleeding in an extradural haemorrhage?

A

Between skull and periosteal layer dura

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12
Q

Where is the bleeding in a subdural haemorrhage?

A

Subdural space - between dura and arachnoid mater

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13
Q

Which type of intracranial haemorrhage can be confirmed by lumbar puncture?

A

Subarachnoid -blood mix with CSF in subarachnoid space

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14
Q

Which artery has an important relationship with recurrent laryngeal nerve?

A

Inferior thyroid artery - from thyrocervical trunk

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15
Q

Which bone is the cavernous sinus in?

A

Sphenoid bone

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16
Q

What are 2 complications of infections spread intracranially from the face?

A

Cavernous sinus thrombosis

Meningitis

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17
Q

What is the significance of the ‘danger triangle’ of the face?

A 
Infections in this region can spread through venous system to dural venous sinuses and intracranially.
Pterygoid plexus (extracranial) via valveless emissary veins to cavernous sinus (intracranial).
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18
Q

Which skull hole does IJV pass through?

A

Jugular foramen

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19
Q

Branches from which arteries supply the nasal septum?

A

Ophthalmic - ant and post ethmoidal
Maxillary - sphenopalatine and greater palatine
Facial - superior labial

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20
Q

Which side is the thoracic duct? where does it drain into?

A

Left side

Subclavian vein

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21
Q

Which nodes may be enlarged in conjunctivitis, tonsillitis and mouth ulcer?

A

Pre-auricular
Jugulo-digastric (deep)
Submental

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22
Q

Where is the olfactory cortex?

A

Temporal lobe- uncus

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23
Q

What are 3 signs of CNIII nerve palsy?

A

Ptosis
Dilated pupil
Down and out position

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24
Q

Why does horners syndrome only cause partial ptosis?

A

LPS still functioning - supplied by CNIII

Sympathetics supplying superior tarsal affected.

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25
Q

Which cranial nerve emerges from the dorsal aspect of brainstem?

A

Trochlear

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26
Q

Which 2 cranial nerves emerge from midbrain?

A

CNIII - oculomotor

CNIV - trochlear

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27
Q

Which 4 cranial nerves emerge from pons?

A

V- trigeminal
VI- abducens
VII - facial
VIII - vestibulocochlear

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28
Q

Which cranial nerve is vulnerable if raised ICP, why?

A

Abducens - emerges at pontomedullary junction and courses close to bone into cavernous sinus.

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29
Q

What reflex tests the facial nerve?

A

Corneal reflex - orbicularis oculi

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30
Q

Which component of CNVIII do acoustic neuromas arise from?

A

Schwann cells of vestibular nerve

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31
Q

What are the symptoms of an acoustic neuroma?

A 
Unilateral hearing loss
Tinnitus 
Vertigo
Numbness
Weakness in half of face - compress facial n.
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32
Q

Which nerves pass through the jugular foramen?

A

Glossopharyngeal
Vagus
Spinal accessory

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33
Q

Explain 3 signs of horner’s syndrome.

A

Partial ptosis - superior tarsal muscle
Miosis - dilator pupillae
Anhydrosis - no sweat gland stimulation

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34
Q

Which structures are formed from the pouches of pharyngeal arches?

A

Eustacian tube and middle ear cavity
Palatine tonsils
Thymus and parathyroid glands

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35
Q

What is ramsey-hunt syndrome?

A

Reactivation of varicella zoster virus from geniculate nucleus

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36
Q

What ear pathology causes painless, smelly otorrhea?

A

Cholesteatoma

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37
Q

What are 4 causes of sensorineural hearing loss?

A

Acoustic neuroma
Meniere’s disease
Presbyacusis
Ototoxic medication

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38
Q

What are 4 causes of conductive hearing loss?

A

Wax
Otitis media
Glue ear
Otosclerosis

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39
Q

Where are the anterior chamber and posterior chamber of eye?

A

Anterior - between iris and cornea

Posterior - between iris and lens

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40
Q

How might closed-angle glaucoma present?

A

Sudden onset of painful red eye
Irregular oval-shaped pupil
Nausea and vomiting
Eye hard and tender to palpate through eyelid

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41
Q

What is the main refractor of the eye?

A

Cornea

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42
Q

What complication can arise from ethmoid sinusitis?

A

Orbital cellulitis

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43
Q

Head and neck cancers are usually ___________.

A

squamous cell carcinoma

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44
Q

What investigation can be done if thyroid cancer suspected?

A

FNAC - fine needle aspiration for cytology

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45
Q

What is the most common type of thyroid cancer?

A

Papillary - adenocarcinoma

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46
Q

Give 4 differentials for scrotal swelling.

A

Testicular torsion
Hydrocele
Testicular cancer
Scrotal hernia

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47
Q

What does the cremasteric reflex test?

A

Genitofemoral nerve - L1

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48
Q

Where is the most common site of ectopic pregnancy?

A

Ampulla

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49
Q

What is the lymph drainage of the fundus of uterus?

A

Para-aortic

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50
Q

What is the lymph drainage of the body of the uterus?

A

Upper - external iliac

Lower - internal iliac

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51
Q

What is the lymph drainage of the cervix?

A

Internal iliac

Sacral

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52
Q

What is the lymph drainage of the thirds of the vagina?

A

External iliac
Internal iliac
Superficial inguinal

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53
Q

Give an example of a condition which causes hypergonadophic hypogonadism.

A

Turners syndrome - 45 XO = primary ovarian failure

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54
Q

What are GnRH agonists used to treat?

A

Endometriosis

Uterine fibroids

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55
Q

What do theca cells secrete?

A

Androgens -> Oestrogens

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56
Q

What do granulosa cells secrete?

A

Oestrogen

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57
Q

What happens during LH surge?

A

Granulosa cells become sensitive to LH and secretes progesterone

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58
Q

At which stage is the endometrium at max thickness?

A

Early secretory

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59
Q

Variations in menstrual cycle are due to which phase?

A

Follicular phase

Luteal phase strictly 14 days +-2

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60
Q

What effects do oestrogen and progesterone have on the myometrium?

A

Oestrogen - thickens and increases motility

Prog - thickens and decreases motility

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61
Q

How is secondary amenorrhoea defined?

A

No menstrual period for 6 months

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62
Q

What are causes of primary amenorrhoea?

A

Structural - agenesis, imperforate hymen
Chromosomal - Turner’s
Hormonal - HPA axis

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63
Q

What are causes of secondary amenorrhoea?

A

Pregnancy
Weight loss
Stress
PCOS - raised LH:FSH ratio

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64
Q

What is the MOA of sildenafil?

A

Inhibits phosphodiesterase, increased cGMP, increased NO.

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65
Q

What are 4 causes of erectile dysfunction?

A

Drugs - anti-depressants
Vascular - atheroma
Tears in tunica albuginea
Psychological inhibition

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66
Q

How does high dose progesterone act as contraception?

A

Inhibits positive feedback of oestrogen - No LH surge, inhibiting ovulation.

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67
Q

What are possible SE of taking COCP?

A

MI, stroke, thromboembolism

Increased risk of breast cancer + cervical cancer (no STI protection)

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68
Q

What is the commonest female cause of infertility?

A

Anovulation

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69
Q

What is the commonest cause of irregular, upper tract bleeding in females?

A

Anovulation

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70
Q

Which intrauterine device is used for patients with heavy bleeding?

A

IUS - progesterone secreting

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71
Q

What is the primary and secondary action of IUD?

A

Primary - Cu toxic to sperm and ovary

Secondary - endometrial inflammatory reaction inhibits implantation, thickens cervical mucus.

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72
Q

What are the disadvantages for intrauterine contraception?

A

No STI protection
Insertion unpleasant
Risk of uterine perforation
Displacement/expulsion possible

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73
Q

Which oral contraception has a risk of ectopic pregnancy?

A

Low dose progesterone (POP) - doesn’t inhibit ovulation.

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74
Q

What is the decidua?

A

Thickened endometrium

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75
Q

What are 2 examples of implantation defects?

A

Ectopic - ampulla

Placenta praevia - lower uterine segment blocking cervix, haemorrhage risk.

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76
Q

Where would you inject an epidural?

A

L4/5

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77
Q

What is used to assess fetal head position in birth canal?

A

Anterior fontanelle

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78
Q

What happens to vaginal pH after menopause?

A

increases - less glycogen, less lactic acid produced lactobacilli.

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79
Q

What are risk factors for prolapse?

A 
Age
Vaginal delivery
Post-menopause
Obesity - raised pressure
Ct disorders
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80
Q

How is chlamydia trachomitis diagnosed?

A

Men - first catch urine

Women - vaginal swab

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81
Q

How is neisseria gonorrhoea diagnosed?

A

Swab and gram stain - gram -ve diplococcus (pink)

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82
Q

Which STI is protozoa?

A

Trichomonas vaginalis

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83
Q

How are genital ulcers treated?

A

Aciclovir - herpes simplex

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84
Q

What is the commonest cause of ectopic pregnancy?

A

Previous salpingitis - scarring of tube epithelium.

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85
Q

What is PID?

A

Infection of upper reproductive tract - travelled through cervix into uterus.

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86
Q

What is the treatment for PID?

A

Antibiotics for 14 days

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87
Q

Other than gonorrhoea and chlamydia, what can cause PID?

A

IUD - copper coil

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88
Q

How does PID present?

A

Fever
Lower abdominal pain and tenderness
Pain during intercourse
Vaginal discharge

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89
Q

What are 3 complications of PID?

A

Ectopic pregnancy - cilia damage
Infertility
Fitz- hugh- curtis syndrome - per-hepatitis after chlamydial PID.

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90
Q

What are risk factors for endometrial carcinoma?

A

Overweight - adipose tissue secrete oestrogen
Anovulation
Exogenous - HRT
Post-menopause

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91
Q

COCP is protective against which cancer?

A

Ovarian epithelial

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92
Q

What are risk factors for ovarian epithelial cancers?

A

Nulliparity or low parity
Heritable mutations - BRCA1/2
Smoking

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93
Q

What are signs of hepatocellular carcinoma?

A

Hepatomegaly - hard, irregular border

Ascites

94
Q

What are virulence factors of H.Pylori?

A 
Urease - converts urea to ammonium
Ammonium toxic to epithelia
Degrades mucus layer
Flagella - adhere
Cytotoxins - epithelial injury
95
Q

What surface landmark can be used to locate the deep inguinal ring?

A

Midpoint of inguinal ligament - ASIS to pubic tubercle.

96
Q

What is a complication of UC?

A

Toxic megacolon

97
Q

How does smoking affect crohns and UC?

A

Crohns - worsens

UC - protective

98
Q

What is the treatment for Crohns?

A

Sulphasalazine
Corticosteroids
Immunosuppressants - azathioprine

99
Q

What are complications of CKD?

A 
Fluid retention
Hyperkalaemia 
Metabolic acidosis
Uraemia
Anaemia
Mineral bone disease
100
Q

List differentials of haematuria.

A 
Cancer - RCC, TCC, prostate
BPH
Stones
Infection
Glomerular
101
Q

What does RCC look like microscopically?

A

Clear cells

102
Q

What can be used to treat prostate cancer?

A

GnRH agonists - desensitise to androgens which increase growth.

103
Q

What are the types of urinary tract cancer?

A

TCC - transitional cell carcinoma

RCC - renal cell carcinoma

104
Q

Which areas of the nephron are first to be damaged in ischaemia?

A

PCT and TAL - outer medulla

105
Q

Name 3 endogenous nephrotoxins.

A

Myoglobin
Bilirubin
Urate

106
Q

What host factors can increase risk of UTI?

A 
Women - shorter urethra
Obstruction - stasis
Neurological - incomplete emptying
Structural - duplex ureter, pelvic kidney
Catheter
Pregnancy
107
Q

Give 3 reasons you might find sterile pyria.

A

Antibiotics already started
TB
Urethritis - chlamydia

108
Q

What infections can cause immune-mediated glomerulonephritis?

A

Post-streptococcal
Endocarditis
Hep B + C
HIV

109
Q

What drugs can be used to treat urge incontinence?

A

Anti-muscarinics

B3 agonist

110
Q

Which AQP is inserted into the apical membrane by ADH?

A

AQP2

111
Q

What produces the concentration gradient in the nephron?

A

Loop of henle acting as counter current multiplier

112
Q

What maintains the concentration gradient in the nephron?

A

Vasa recta acting as counter current exchanger.

113
Q

What is the aldosterone paradox during volume depletion?

A

Angiotensin II will also be raised - inhibits ROMK to limit K+ excretion while still increasing NaCl reabsorption to raise blood pressure.

114
Q

What is the aldosterone paradox during hyperkalaemia?

A

Low AngII as blood volume fine - Inhibits NaCl absorption.

Aldosterone increases K+ secretion.

115
Q

Where do PTH and Vit D act on kidney?

A

DCT

116
Q

What acid-base balance does diarrhoea cause?

A

Metabolic acidosis - HCO3- and K+ loss

117
Q

What acid-base disturbance does vomiting cause?

A

Metabolic alkalosis - H+ lost

118
Q

What 2 buffers are used in PCT and DT?

A

PCT - ammonia

DT- phosphate

119
Q

What is the main action of adenosine in auto regulation?

A

Dilate EA

120
Q

What are the actions of ANP?

A

Inhibit Na reabsorption - natruresis

Vasodilation - AA increases GFR

121
Q

What are 2 causes of renal artery stenosis?

A

Atheroma

Fibromuscular dysplasia

122
Q

How might symptoms differ in unilateral renal artery stenosis compared to bilateral renal artery stenosis?

A

Unilateral - hypertension but no fluid overload as healthy kidney corrects.
Bilateral - hypertension and fluid overload as no volume correction.

123
Q

How might you diagnose primary hyperaldosteronism/Conn’s syndrome?

A

Low renin:angiotension ratio

Hypertension refractory to treatment

124
Q

What is the embryological kidney?

A

Mesonephros

125
Q

Where does the ureteric bud sprout from?

A

Mesonephric duct

126
Q

What is the kidney collecting duct system derived from?

A

Ureteric bud itself

127
Q

What causes a pelvic kidney?

A

Ascent of kidney blocked by abdominal vessels - IMA at L3

128
Q

What causes a horseshoe kidney?

A

Kidney hooked on IMA (lowest branch of aorta), inferior poles fuse.

129
Q

What does the urachus form in an adult?

A

Median umbilical ligament.

130
Q

Where is the main site for calcium reabsorption in the nephron?

A

DCT

131
Q

What are the 3 sites of ureter constriction?

A

Pelviuretic junction
Bifurcation of common iliac artery
Entering bladder (vesicoureteric junction)

132
Q

What is the level of the kidneys?

A

Left - T11-L2/3

Right - T12-L3/4

133
Q

What is the lymphatic drainage of the kidney?

A

Lateral aortic nodes

134
Q

What are the layers surrounding the kidney?

A

Capsule
Perirenal fat
Renal fascia
Pararenal fat

135
Q

What epithelium is present in the nephron?

A

Simple squamous - bowman’s capsule + desc LH
Cuboidal - CD
Cuboidal + many microvilli - PCT
Cuboidal + few microvilli - DCT

136
Q

Give differentials for haematuria.

A

Infection
Obstruction - renal calculi
Cancer - RCC, bladder TCC, upper tract TCC
BPH

137
Q

What bony feature do the ureters descend anteriorly to.

A

Tips of transverse processes of lumbar vertebrae.

138
Q

What artery supplies the superior surface of the bladder?

A

Umbilical artery

139
Q

What passes anteriorly to the vas deferent in men and women?

A

Vas deferens - men

Uterine artery- women

140
Q

Which part of the urinary tract can develop adenocarcinoma?

A

Apex of bladder - due to origin of tissue

141
Q

What ligaments help secure the bladder neck in males and females?

A

Males - puboprostatic

Female - pubovesical

142
Q

Which kidney is used in transplants?

A

Left - longer vein makes it easier

143
Q

What complication can occur in patients with a horseshoe kidney?

A

Urinary stones - increased risk.

144
Q

What is the significance of the trigone?

A

Part of bladder most strongly tethered in position.

145
Q

What is the sternal angle?

A

Junction between manubrium and body of sternum

146
Q

What is the conducting portion of the resp tract?

A

Nostrils to terminal bronchioles

147
Q

What is the respiratory portion of the resp tract?

A

Resp bronchioles to alveoli

148
Q

Where are clara cells found, what is there function?

A

Bronchioles
Secrete surfactant lipoprotein - prevent bronchiole walls sticking together
Produce protein - protects against toxins

149
Q

Which lung cancer can secrete ACTH and ADH?

A

Small cell carcinoma

150
Q

Which lung cancer can secrete PTH?

A

Squamous cell

151
Q

Where in the bronchial tree is the main site of airway resistance?

A

Trachea - upper resp tract

152
Q

What are accessory muscles of inspiration?

A

SCM, scalene, pec major and minor, trapezius

153
Q

What are accessory muscles of expiration?

A

Internal intercostal, abdo wall

154
Q

How does FRC change with age?

A

increases - lose elastic fibres with age

155
Q

Give an example of a disease causing increased compliance.

A

Emphysema - can still stretch but loss of recoil

156
Q

What forces favour inward lung movement?

A

Elastic recoil

Surface tension

157
Q

What is compliance?

A

Volume change per unit pressure change.

158
Q

What are the functions of surfactant?

A

Increase compliance

Stabilise lungs - prevent small alveoli collapsing into large

159
Q

How would pneumothorax affect dead space?

A

Decrease anatomical dead space - bronchioles narrow

160
Q

What physical signs might you see in a patient with a PE?

A

Pleural rub

Raised JVP

161
Q

What investigation could you do if you suspected PE?

A

CT pulmonary angiography

Blood - d-dimer

162
Q

What is the most common cause of chronic type 2 resp failure/hypoventilation?

A

COPD

163
Q

What is the most important factor in COPD treatment?

A

Stop smoking

164
Q

What test can be used to differentiate between COPD and asthma?

A

DLCO (diffusion capacity of lungs for CO) is reduced in COPD but normal in asthma.

165
Q

What 3 ways can you measure eosinophilic inflammation in asthmatic patients?

A
  • FBC
  • Induced sputum
  • FeNO
166
Q

What is the 2 phase response in asthma?

A
  1. Immediate response- type 1: IgE + allergen

2. Late phase response - type 4: inflammatory cells

167
Q

How can you diagnose CF?

A

Chloride sweat test - high levels as can’t reabsorb

168
Q

Give an example of an URT commensal.

A

Viridans streptococci.

169
Q

How will a CXR appear in acute bronchitis?

A

Normal - airways not parenchyma affected

170
Q

What does haemophilus influenza look like on gram stain?

A

Pink rods - gram negative

171
Q

What signs might you find on examination of a patient with pneumonia?

A

Dullness on percussion - exudate
Bronchial breathing
Crackles

172
Q

What are complications of pneumonia?

A

Sepsis
Lung abscess
Empyema
Pleural effusion

173
Q

Where is it normal to hear bronchial breath sounds?

A

Trachea

174
Q

What is the difference between transudate and exudate?

A

Transudate - low protein, increased pressure

Exudate - high protein, increased vascular permeability

175
Q

What would you expect to hear on percussion of pleural effusion?

A

Stony dull

176
Q

When might you see a mediastinal shift on CXR?

A

Tension pneumothorax - one way valve

177
Q

What does the presence of crackles on lung auscultation suggest?

A

Consolidation

178
Q

When might there be mediastinal shift towards the side of abnormality?

A

Lobar collapse

179
Q

Where does lung cancer metastasise to?

A 
Brain
Pleura
Liver
Pericardium
Bone
180
Q

Where is the bronchus located in the hilum?

A

Posteriorly (bronchus = back)

181
Q

What is the lymph drainage of the lungs?

A

Hilar nodes (bronchopulmonary) which run to tracheobronchial nodes.

182
Q

Where is the upper respiratory tract?

A

Nostrils to lower border cricoid cartilage.

183
Q

When are the vocal cords closed?

A

Cough

Phonation

184
Q

What is a bronchopulmonary segment

A

Area of lung supplied by a segmental bronchus and accompanying segmental artery. Drained by segmental pulmonary vein.
Surgery - segments removed without bleeding or interference.

185
Q

What is the blood supply to the alveoli?

A

Pulmonary artery

186
Q

What is the nerve supply of the lung?

A

Parasympathetic - vagus nerve to bronchial SM and mucous glands
Sympathetic trunk - vasoconstrictor and bronchodilator.

187
Q

What are the effects of hypercapnia?

A

Acidosis
Impaired CNS function - drowsy, confusion, coma,flap
Vasodilation - warm hands, bounding pulse
Cerebral vasodilation - headache

188
Q

What are the effects of hypoxia?

A

Impaired CNS
Central cyanosis
Cardiac arrhythmia
Hypoxic vasoconstriction

189
Q

What are the 3 main causes of bronchiectasis?

A

Post-infective
Immune deficiency
Mucociliary clearance defects - CF

190
Q

What are complications of COPD?

A

Recurrent pneumonia
Pneumothorax - bulla formation and rupture
Resp failure
Cor pulmonale

191
Q

What must be given alongside isoniazid, why?

A

Vit B6 - prevent nerve damage

192
Q

How can you differentiate between latent and active TB?

A

CXR

Sputum smear

193
Q

Why can bronchial breath sounds be heard over consolidation?

A

Exudate fluid present - sound travels better through fluid than air.

194
Q

What are features of pleuritic pain?

A

Worse on inspiration
Sharp
Well localised

195
Q

How can you tell between acute and chronic subdural haemorrhage on CT?

A

Acute - hyperdense = white

Chronic - hypodense = darker

196
Q

What attaches to the superficial temporal line?

A

Temporalis

197
Q

Why is dietary history important in neurology?

A

Vegan diet predisposes to B12 deficiency - demyelination of large neurones.

198
Q

Which muscles move the eye directly up?

A

Superior rectus and Inferior Oblique

199
Q

Which muscles move the eye directly down?

A

Inferior rectus and superior oblique

200
Q

When is diplopia worst with trochlear nerve palsy?

A

Looking down and medially

201
Q

When is diplopia worst with abducens nerve palsy?

A

Horizontal gaze

202
Q

Which pharyngeal muscle is not innervated by the vagus nerve?

A

Stylopharyngeus - glossopharyngeal

203
Q

Where is the pterygoid venous plexus?

A

Infratemporal fossa

204
Q

What is used to treat gonorrhoea?

A

Ceftriaxone

205
Q

What is used to treat trichomoniasis and bacterial vaginosis?

A

Metronidazole

206
Q

What are the nerve roots of the pudendal nerve?

A

S2,3,4

207
Q

What type of hemolysis does strep pneumonia produce?

A

alpha - incomplete, green

208
Q

What is a cause of viral pneumonia?

A

Influenzae

209
Q

How is aspiration pneumonia treated?

A

Co-amoxiclav

210
Q

What are the causative organisms in aspiration pneumonia?

A

Mixed - anaerobes + viridans streptococci.

211
Q

Where is a cannula inserted to treat tension pneumothorax?

A

2nd intercostal space in mid clavicular line

212
Q

What spirometry parameter is likely to be increased in asthmatic patients?

A

Residual volume

213
Q

What might cause pleural effusion with high protein content (exudate)?

A

Cancer
Infection - pneumonia
PE

214
Q

By what gestational age is surfactant production sufficient?

A

30 weeks

Production starts at 26 weeks

215
Q

Why is pregnancy associated with increased urinary incontinence?

A

Uterus presses on bladder as it grows

216
Q

How does smoking in pregnancy affect oxygen delivery to fetus?

A

Increased CO in women who smoke, reduces O2 circulating and released to fetus.

217
Q

What are signs and symptoms of pre-eclampsia?

A

Severe headache
Visual disturbances
Hyper-reflexia

218
Q

What might you ask a mother at a 20 week scan?

A

Has she felt any movements?

219
Q

Why is oligohydramnios associated with asymmetrical growth restriction?

A

Placental insuffiency is the most common cause

220
Q

What is asymmetrical growth restriction?

A

Normal size head

Small abdomen

221
Q

At what stage in fetal development is urine first produced?

A

10

222
Q

What maternal condition might cause a high fetal abdominal circumference compared to head could indicate what?

A

Gestational diabetes - macrosomia.

223
Q

What spinal levels are blocked in epidural?

A

Given L4/5 sitting up as want to diffuse to S2-S4 region where pelvic nerves orginate.

224
Q

What effect can stress have on oxytocin release?

A

Increase

225
Q

Why is sigmoid volvulus most common?

A

Mesentery more mobile - twists easily.

226
Q

In relation to the inguinal ligament, how do femoral hernias differ from inguinal hernias?

A

Femoral - leave posterior to inguinal ligament

Inguinal - leave anterior to inguinal ligament

227
Q

What lies anteriorly and posteriorly to the lesser momentum?

A

Anterior- stomach

Posterior- transverse mesocolon

228
Q

Where does the portal vein form?

A

Behind the neck of the pancreas

229
Q

Which nerves are vulnerable in anterior dislocation of temporomandibular joint?

A

Facial n.

Auriculotemporal n.

230
Q

Which muscles are responsible for elevation of TMJ?

A

Masseter
Temporalis
Medial pterygoid

231
Q

Which muscle is responsible for depression of TMJ?

A

Lateral pterygoid

ESA 4 Rev (16 decks)

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