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Questions I get wrong Flashcards

1
Q

Where does the sartorius originate from?

A

Anterior Superior Iliac Crest

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2
Q

Which area of the brain is supplied by the middle cerebral arteries?

A

The parietal lobes

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3
Q

Which cells produce intrinsic factor? and what is intrinsic factor needed for?

A

Parietal cells in gastric mucosa produce intrinsic factor. Intrinsic factor is needed to absorb Vitamin B12 so body can produce red blood cells. In pernicious anaemia, immune system attacks the parietal cells.

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4
Q

Which structures pass through the cavernous sinus?

A
  • Internal Carotid Artery
  • Oculomotor nerve (CN III)
  • Trochlear nerve (CN IV)
  • Ophthalmic nerve (CN Va)
  • Maxillary nerve (CN Vb)
  • Abducens nerve (CN VI)
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5
Q

Which lymph nodes do nipple, areolar and breast TISSUE drain to?

A

Anterior and central axillary nodes

Parasternal (internal thoracic) nodes

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6
Q

What lymph nodes does the breast SKIN drain to?

A

Axillary, infraclavicular and deep cervical nodes

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7
Q

What are the 4 categories of congenital defect?

A

1) Malformation = an INTRINSICALLY abnormal developmental problem
2) Disruption = an EXTRINSIC breakdown of, or interference with and originally normal developmental process
3) Deformation = an abnormal form, shape or position of a part of the body caused by mechanical force
4) Dysplasia = an abnormal organisation of cells into tissues and its morphologic result - a process of dyshistogenesis.

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8
Q

What are the symptoms of foetal alcohol syndrome?

A 
Midline facial abnormalities (maxillary)​
​-Absent philtrum​
​-Thin top lip​
​-Thick/pronounced epicanthic folds ​
​
Flattened nose​
​
Short palpebral fissure​
​
Heart defects​
​
Neural issues: Behavioural and developmental
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9
Q

What are the 4 defects in Tetraology of Fallot?

A

1) Overiding aorta
2) Pulmonary stenosis
3) Right ventricular hypertrophy
4) Ventricular septal defect

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10
Q

What is the mnemonic for the mechanisms of labour?

A

Every Darn Fool in England Eats Raw Eggs

Engagement
Descent
Flexion
Internal rotation
Extension (crowning)
External rotation (restitution)
Expulsion (birth)
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11
Q

10-14 days after the start of menstruation, which hormone initially provides negative feedback to the anterior pituitary gland?

A

17β-Estradiol

Progesterone and inhibin do this AFTER ovulation

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12
Q

Which layer of myometrium is only present after menarche and until menopause?

A

The junctional zone

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13
Q

What are the three characteristics of the proliferative phase of the uterine cycle?

A

1) Thickening of endometrium
2) Growth of endometrial glands
3) Development of spiral arteries

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14
Q

Which hormone controls the proliferative phase of the uterine cycle?

A

Progesterone

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15
Q

Which is the most variable phase of the ovarian cycle?

A

Follicular

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16
Q

If a woman has a regular menstrual cycle lasting 32 days and her periods last 6 days; how long will her proliferative phase last?

A

12 days.
In a regular cycle, the luteal phase is 14 days, with 6 days of menstruation, this leaves 12 days in a 32 day cycle for proliferation.

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17
Q

How much variability in cycle length constitutes an irregular menstrual cycle?

A

Cycle lengths that vary between 8 days and up to and including 20 days are classed as irregular. Cycles that vary in duration by more than 20 days are classed as very irregular.

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18
Q

What is the normal range of blood loss per period?

A

An average of 30-72ml

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19
Q

Which genetic disorder is commonly associated with raised levels of hCG?

A

Down’s syndrome (trisomy 21) is typically associated with higher levels of hCG, but you can also see raised hCG with reproductive tumours, for example germ cell tumours/ovarian cancer and also in the presence of multiple embryos eg. twins.

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20
Q

Define sensitivity and how to calculate it

A

Sensitivity is the proportion of people who have the disease that the test correctly detects
Sensitivity = TP/(TP+FN)

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21
Q

Define specificity and how to calculate it

A

Specificity is the proportion of people who do not have the disease that the test correctly identifies as not having the disease
Specificity = TN/(TN+FP)

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22
Q

What is Positive Predictive Value and how do you calculate it?

A

Positive Predictive Value (PPV) is the probability that a person has the disease given that they have had a positive test result
PPV = TP/(TP+FP)

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23
Q

What is Negative Predictive Value and how do you calculate it?

A

Negative Predictive Value (NPV) is the probability that a person does not have the disease given that they have a negative test result
NPV = TN/(TN+FN)

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24
Q

How does the PPV of a test differ from populations with high prevalence of the disease to populations with low prevalence of the disease?

A

In a population with a lower prevalence of a. disease, the PPV of the same test will be lower compared to a population with a higher prevalence.

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25
What is the innervation of the tongue?
Motor to all parts of tongue is by Hypoglossal nerve (CN XII) Anterior 2/3: General sensation - Trigeminal (CN Vc) Taste - Chorda Tympani (branch of facial nerve CN VII) Posterior 1/3: Both sensation and taste is by glossopharyngeal nerve (CN IX)
26
Where is the clavicle most likely to fracture?
junction between middle and lateral 1/3
27
What will a fracture of the surgical neck of the humerus damage?
Axillary nerve
28
What will a fracture of the mid-shaft of the humerus damage?
Radial nerve and profunda brachii artery
29
Name the rotator cuff muscles and what do they do?
3 at the back: Supraspinatus: Initial arm abduction to 15 - 20 degrees Infraspinatus and Teres Minor: External shoulder rotation 1 at the front: Subscapularis: Internal shoulder rotation
30
What does pec major do?
Adducts and medially rotates humerus
31
What does deltoid do and what is it's innervation?
Does all movements except adduction Axillary nerve
32
What does trapezius do and what is it's innervation?
Shrug your shoulders Accessory nerve (CN IX)
33
What does latissimus dorsi do?
Adducts and medially rotates humerus
34
Where is the triangle of auscultation and what are its borders?
Found medial to the inferior angle of the scapula Borders are: - Trapezius - Rhomboid major - Latissimus dorsi
35
Where would you put a chest drain?
- Between mid-axillary line and anterior axillary line - Ideally 4th ICS (but between ribs 3 and 5) - Posterior to ant. Axillary fold
36
What are the borders of the axilla?
``` Ant = Anterior axillary fold (Pec major and minor) & contents​ Post = Posterior axillary fold (latissimus dorsi and teres major) & contents​ Med = Serratus anterior and lateral thoracic wall​ Lat = Intertubercular groove ```
37
What are the radiological features in osteoarthritis?
``` Remember LOSS L = Loss of joint space O = Osteophytes S = Subchondral sclerosis S = Subchondral cysts ```
38
Define fertility window
The fertility window is the time when intercourse has a greater than 5% chance of pregnancy.
39
When does the fertility window occur?
4-5 days pre-ovulation and 1-2 days afterwards
40
Which brush border enzymes result in glucose + glucose?
Maltase
41
Which brush border enzymes result in glucose + fructose?
Sucrase
42
Which brush border enzymes result in glucose + galactose?
Lactase
43
When does the posterior fontanelle close?
3 months
44
When does the anterior fontanelle close?
18 months
45
What are the contents of the tarsal tunnel?
``` Tibialis posterior flexor Digitorum posterior tibial Artery Vein tibial Nerve flexor Hallucis longus ```
46
What would be the symptoms of an MCA infarct?
Sensory-motor loss to face and upper limb If dominant hemisphere --> Aphasia If non-dominant hemisphere --> Hemi-spatial neglect
47
What would be the symptoms with an ACA infarct?
Sensory-motor loss to lower limb and urinary incontinence
48
What would be the symptoms with a PCA infarct?
Hemianopsia with macular sparing | If dominant hemisphere, would get Alexia sans agraphie
49
What is the nerve supply of the medial aspect of the leg?
Saphenous nerve which arises from the femoral nerve
50
What is the nerve supply of the lateral foot?
Sural nerve which arises from the common fibular and tibial nerves
51
What is the nerve supply of the dorsum of the foot?
Majority from the superficial fibular nerve
52
What is the nerve supply of the web space between the first and second toes?
Deep fibular nerve
53
What is the nerve supply of the sole of the foot?
Majority from branches of the tibial nerve
54
What is the pharmacological treatment for focal and focal to generalised seizures?
1st line: - Carbamazepine - Lamotrigine - (sodium valproate) not in young women ``` 2nd line (adjuncts): - Clobazapam, gabapentin, topiramate ```
55
What is the pharmacological treatment for generalised tonic clonic seizures?
1st line: - Sodium valproate but not in young women - Lamotrigine - (Carbamazepine) ``` 2nd line (adjuncts): - Clobazapam, levetiracetam, topiramate ```
56
What is the pharmacological treatment for generalised absence typical seizures?
1st line: - Ethosuximide - Sodium valproate but not in young women 2nd line: - Lamotrigine
57
What is the pharmacological treatment for status epileptics generalised tonic clonic?
- Commence i.v. Lorazepam (repeated after 10 mins) (can use buccal Midazolam/i.v. diazepam)​ - Buccal Midazolam/Rectal diazepam (if resusc facilities not available)​ - After 25 mins: phenytoin sodium or phenobarbital sodium*​ - After 45 mins: Anaesthetize with thiopental, midazolam or non-barbiturate anaesthetic (propofol)
58
What does tiagabine do?
Inhibits GABA transporter (Anti-epileptic drug)
59
What does vigabatrin do?
Acts to inhibit GABA transaminase (Anti-epileptic drug)
60
What is the main site of production of 5HT (serotonin)?
Raphe nuclei in brainstem
61
What are the main sites of production of noradrenaline?
Locus coerulus and lateral tegmental area
62
Do interactions between 5HT and NA neurons in the brainstem speed up activity or slow down activity?
Interactions in the brainstem speed up activity
63
Do interactions between 5HT and NA neurons in the cortex speed up activity or slow down activity?
Interactions in the cortex slow down activity
64
What is the role of inflammation in depression?
Inflammatory mediators lead to:​ Microglia activation​ Cell dysfunction​ Cell death​ Leads to spectrums of disorders
65
What is the role of neurogenesis in depression?
Depression is associated with decreased dendritic arborisation​ ​ Also with decreased number of synapses​ ​ And overproduction of receptors (probably why there is a delay in antidepressants (to reset number of receptors))​ ​ This deficit can be reversed by neuronal growth factors (e.g. BDNF) and also​ antidepressants.
66
In Transcranial Magnetic Stimulation (TMS) where are the magnetic pulses targeted?
- Prefrontal cortex | - Limbic system
67
What muscle does the glossopharyngeal nerve innervate?
Stylopharyngeus
68
What nerve innervates the parotid gland?
Glossopharyngeal (CN IX)
69
What salivary glands does the facial nerve innervate?
Sublingual and submandibular | Passes through parotid gland but does not innervate it
70
What does the accessory nerve innervate?
Sternocleidomastoid and trapezius
71
What does the hypoglossal nerve innervate?
All tongue muscles (except palatoglossus, this is CN X)
72
What effect do high levels of oestrogen alone have on the levels of luteinising hormone (LH)?
LH surge, positive feedback
73
When does the subclavian artery become the axillary artery?
After the lateral border of 1st rib
74
When does the axillary artery become the brachial artery?
After lower border of teres major
75
What muscles allow pronation?
Pronator teres (median nerve) and pronator quadratus (median nerve)
76
What muscles allow supination?
Biceps brachii (musculocutaneous nerve) and supinator (radial nerve)
77
In the hand, what runs in compartment 1 and how can it be damaged?
Extensor pollicis brevis and abductor pollicis longus Affected by painful ​De-Quervains tenosynovitis (result of overuse) (Mommy's thumb)
78
In the hand, what runs in compartment 3 and how can it be damaged?
Extensor Pollicis longus | EPL can wear on the dorsal radial tubercle and rupture​
79
In the hand, what runs in compartment 6 and how can it be damaged?
Extensor carpi ulnaris | ECU can wear on the ulnar styloid process and rupture
80
What are the borders of the anatomical snuffbox?
Lateral border: Extensor pollicis brevis and abductor pollicis longus Medial border: Extensor pollicis longus Proximal border: Styloid process of radius
81
What is Froment sign?
A loss of functioning of adductor pollicis (eg. in ulnar nerve lesion) leads to excess thumb flexion whilst pinching (pinching normally requires thumb adduction)
82
What are the components of Virchow's triad?
- Endothelial dysfunction - Haemodynamic changes - Hypercoagulability
83
What do principal cells (collecting duct) reabsorb and secrete?
Reabsorb sodium | Secrete potassium
84
What do intercalated cells (collecting duct) reabsorb and secrete?
Reabsorb potassium | Secrete hydrogen ions
85
Where is ADH produced?
In supraoptic and paraventricular nuclei of hypothalamus
86
What is the main stimulus for ADH release?
Raised plasma osmolarity
87
What receptor does ADH bind to?
V2 (vasopressin 2 receptor)
88
What are the factors that shift K+ into cells (decrease extracellular [K+]?
- Insulin (used as part of emergency treatment of hyperkalaemia) - Aldosterone - Beta-adrenergic stimulation - Alkalosis
89
What are the factors that shift K+ out of cells (increase extracellular [K+])?
- Insulin deficiency (diabetes mellitus) - Aldosterone deficiency (Addison's disease) - Beta-adrenergic blockade - Acidosis - Cell lysis - Strenuous exercise - Increased extracellular fluid osmolarity

Andrea (10 decks)

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