Recalls 8 Flashcards by Hamish Reed-Embleton

What is the enzyme which Changes testosterone to estrogen?

Which changes progesterone (from mineralocorticoid pathway) to glucocorticoid pathway?

What changes the things from glucocorticoid pathway to sex hormone pathway?

What does the verticla changes?

Aromatase

17a hydroxylase

17 Lyase

3B HSD

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treatment of chlamydia in pregnancy

1g single dose azithromycin

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Cut off for referal to gyn-onc?

> 200 RMI

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MOA of:

Dalteparin
Enoxaparin
Warfarin
Dabigatran
Apixaban
Rivaroxaban

Dalteparin - Factor Xa inhibitor

Enoxaparin - Factor Xa inhibitor via activating antithrombin

Warfarin - Vit K antagonist

Dabigatran - antithrombin

Apixaban/Rivaroxaban - Factor Xa inhibitor

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What is lenoleic acid?

Essential fatty acid that is not produced in the body. NEed to consume in diet

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What type of hypogonadism does chemotherapy tend to cause

Hypothalamic hypogonadism.

Tends to affect hypothalamus/pituitary and stop GNRH proudction

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What is G-banding

A technique to identify chromosomes

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What is Potter Syndrome?

What are the characteristics?

Abnormal kidney development. If complete renal agenesis then not compatible with life

Characteristics:
- Low set ears
- Flat node
- Flat chin

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Where is the primary immunoglobulin prodution

Plasma cells which are a type of B lymphocytes

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What cell is the main cell involved in combatting TB

Macrophages

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When is the:

Blastocyst
Morula
Implantation

Morula 4
Blastocyst 6 (inner cell mass formed at this stage)
Implantation 8

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Why is GNRH secreted in a pulsatile fashion

BEcause of the hypothalamus’s innate ability to do it pulsatile. This is from the arcuate nucleus. Specialised neurones regulate this.

Oestrogen feedback enhances this affect but does not CAUSE it

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What are the functions of the following hormones during pregnancy:

Oestrogen
Progesterone
Inhibin A

Where are they secrete by?

All initially secreted by the CL in response to HCG from placenta. Then placenta takes this over.

Progesterone = inhibits contractions. Also inhibits lots of things throughout pregnancy and has effects on lungs/heart/GIT

Oestrogen = promotes vascularity and endometrial growth

Inhibin A = inhibits FSH secretion from the AP. To allow for the correct horonal balance. Production starts around 7 weeks but is much hgiher later in pregnancy

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Is arachidonic acid a saturated or unsaturated fatty acid

Unsaturated

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Incidence of facial nerve palsy in forceps

Approx 1:100

Most common!

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Where is prolactin produced in pregnancy

AP
Placenta
Decidua basalis in early pregnancy

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When do twins split?

Di-Di <4

Diamniotic Monochorionic - 4-8

Mono-mono - 8-12

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How much T3 qnd T4

T4 is innnactive
Gets turned into T3 in the tissues

14:1 T4:T3

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What level does the ureter cross the internal iliac arteries

At the birfurcation of common –> int and ext

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what level does the aorta pass through the aperture

What about the IVC

What about the oesophagus

Aorta - T12. The lowest and the most posterior of the apertures

IVC - T8

Oesophagus - T10

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What is the histology of the lower uterine segment

Columnar. Thinner endothelium than the UUS

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Where is GNRH secreted other than the brain

Duodenum

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Explain what type on incontinence this is

There is a leak with the cough so it is stress

But there is also a leak in the middle which is detrusor overactivity. Notmal urination at the end has a bell shaoed curve

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What does chamydia cause in the eyes

Ophthalmia Neonatorum

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If a pregnant women develops goitre, which nerve can be damaged

The recurrent laryngeal nerve from he vagus nerve The route on the left is looped under the ductus arteriosus The route on the right is under the subclavian

Which vessel in the brain can bleed in eclampsia

MCA

Which bit of the HIV virus cannot enter the host cell

Glycoprotein

Which gynaecological cancer is most associated with MMR

Endometrial cancer - endometriod cancer For ovarian it is alo endometroid then clear cell

What is Crispr

An exyme that detects DNA

Look at some pedigrees

What is the most common cause of dermatitis in pregnancy

Pregnancy specific - PUPPS not pregnancy specific - atopic dermatiis

What does pellagra cause What deficiency is it caused by

Dermatitis, dementia, diarrhoea, death Niacin, vit B6

Inheritance pattern of achondroplasia

Most common side effect of depo-provera

Irregular bleeding

Which is the most common HPV to cause high grade cervical changes

16 is more common than 18

MOA of aspirin

Irreveribly inhibits COX1 Reduces prostaglandins

Describe the anatomy of the hepatic vessels

Does pulmonary capillary wedge pressure change in pregnancy

Na not really

What is the shelf life of whole blood

7 weeks

In regional anaesthesia, where does the epidural or spinal go

Epidural - between vertebral column and dura mater Spinal - In the subarachnoid space. Between the pia mater and arachnoid mater

Describe the boundaries of the superficial and perineal pouches

Colles fascia Perineal fascia

What gestation doe haematopoetic function start in fetuses

Yolk sac makes RBCs 2-6 weeks liver makes RBCs 6-22 weeks Bone barrow tskes over at 22 weeks

which lab test used to amplify small amounts of DNA

PCR

How to work out type 1 error and type 2 error

Type 1 error = p value. So p value 0.05 = 5% chance of type 1 error Type 2 error is 1-power Power is the probability that you have correctly rejected the null hypothesis. Therefore the probability of incorrectly accepting the null hypothesis (T2 error) is 1-power.

What are the hormones doing in PCOS

Oestrogen is down Leptin is down (think overweight so hunger is no longer inhibited) SHBG is down Insulin is up

What do the results of the odds ratio tell you

>1 - association between the exposure and disease 1 - no association <1 - protective

Incidence of turners

1:2500 females

Which receptor does nicotine bind to in the fetus that is harmful

acetylcholine

What is the function of the BRCA gene

tumour suppressor gene When it is mutated it can cause cancer

What lies medial and lateral to the internal iliac vein

Medial - the internal iliac artery Lateral - the ureter

Describe the embryology of the ovary and gametes

The ovary develops from the pramesonephric duct. The primordial germ cells originate in the yolk sac at 4 weeks. They then migrate between 4-5 weeks to through the primitive streak then hind gut and dorsal mesentary. By end of week 6 they are in the gonads.

What does cleft palate result from

Failure of development of the 1st pharyngeal arch

Describe what comes from all the pharyngeal arches 1 2 3 4 5

1 - muscles of mastication, CN 5, maxillary artery 2 - facial muscles, CN 7, stapedius artery 3 - Stylopharyngeus, CN 9, carotid arteries 4 - Cricothyroid and epiglottis, CN 10, aortic arch and subclavian artery 5 - All other laryngeal muscles other than cricothyroid, CN 10, pulmonary artery, ductus arteriosus

# A Are nitric oxide and prostaglandins upregulated or downregulated in pregnancy in sepsis

Both upregulated to promote inflammation

Why are both cortisol and prolactin increased in pregnancy

Unopposed oestrogen Oestrogen increases ACTH (from AP) production and CRH production (from placenta)

How much does prolactin increase during pregnancy

5-10 fold

Attachments of the cardinal ligament

lateral cervix and endopelvic fascia (fascia of obturator internus)

What level does the SMA branch What about the IMA

L1 L3

Diameters of the pelvis

If a fetus is born without a mastoid process, what structure is most at risk during delivery

CN 7

How much does HRT increase your risk of breast Ca

Probably by 3 but actually by 50% so more like 1.5 ??depends on Q

What is the toxin released by strep

Exotoxin

Roughly HCG values for 4,5,6 weeks

4 weeks <500 5 weeks anywhere from 20-7000 6 weeks anywhere from 1000-56000

What is ebsteins anomaly

Caused by lithium abnormality with tricuspid valve

What is the cut off for 250 vs 500 IU anti-D

20 weeks

What is thee frequency of TVUSS vs abdo USS

tvuss - 5-10 abdo - 2-5

What is the percentge of free T3 and T4 in circulation

BOTH BELOW 0 T3 is more - 0.3% T4 is less - 0.03%

Which of the branches of the IIA is sometimes absent

Obturator

BRENNER tumours Where are they found What type of cells are in them

1-2% of ovarian tumours Transitional cells. Not to be confused with Brunner's glands which are glands in the duodenum that secrete alkaline fluid to neutralise acid

Where does the fetus get cholesterol in first second and third trimester

First - maternal liver Second - placenta Third - fetal liver.

Which type of lichen planus causes maximum symptoms

erosive

Explain primary and secondary infection status with CMV in pregnancy

IgG positive - current or pt infection IgM positive - current or recent infection (in this pregnancy) Primary infection refers to a new and first infection in this pregnancy Secondary infection refers to a current but repeated infection in this pregnancy (we care less)

When is most of the teratogenic risk with warfarin

6-12 weeks

Describe the roles of C3 and C5 in the complement pathway

C3 - roel in initiating the complement pathway C5 - more of a role in cell LYSIS and activating MAC

What indictes puberty in girls

Thelarche - breast development

Does haematocrit increase or decrease in pregnancy

Decrease

What is amniotic fluid before urine When does the baby start to pee? When does pee become the main part of amniotic fluid?

Maternal plasma via the chorion 8-12 weeks starts to produce urine By 16 weeks urine is main part of amniotic fluid

Is arachidonic acid saturated or unsaturated

Unsaturated

What is the typical radiation dose for a chest CT

7mSv

What type of virus is Zika

SS RNA

Which gene mutation is 21 hydroxylase deficiency

Chromosome 6 short arm Short arm = p so 6p CYP21A2

What size is vulval Ca in FIGO classification 3a

<5mm

When is MRI not typically used in pregnancy

First trimester

What is the teratogenic effect of carbimazole

Choanal atresia

How does Raltegravir work

HIV integrase inhibitor

What is the treatment of hyperaldosteronism? What can it cause?

Spironolactone Can cause feminisation due to anti-androgenic properties. If not wanting deminisation can use eplerenone.

What is the rate of IUD explusion

1/20 or 5%

How much does tidal volumne increase in pregnancy

30-50%

re the pelvic sphlanchnic nerves pre-ganglionic or postnanglionic

They are pre-ganglionic. The vast majority of parasympathetic nerves have their ganglia close to the target organ. In contrast with sympathetic nerves, they mostly are postganglioic as they have synapsed in the sympathetic chain.

Describe the electrophoresis results for normal and beta thalassaemia major and minor

Which carbon atom is phosphate attached to What about the nitrogenous base

The sugar is the 5 carbon ring. The nitrogenous base is attached to carbon 1 The phosphate is attached to carbon 5

Who regulates non-ionizing radiation machines

International commission for Non-ionizing Radiation Protection