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Flashcards in revision questions Deck (194):
1

what enzyme is involved in oestrogen production

aromatase

2

what is the appendix epididymis a remnant of

proximal end of the mesonephric duct

3

which part of the male duct empties into the prostatic urethra

the ejaculatory duct

4

what conditions may result from a patent tunica vaginalis

cytocele, hydrocele, indirect inguinal hernia

5

what constituent of ejaculate is used as a source of choline

glycerylphosphorylcholine formed in the epididymis

6

which ligament forms the inferior border of the greater sciatic foramen

sacrospinous

7

what is the subpubic angle of the female pelvis

80-85

8

which area of the prostate is most likely to be affected by prostate cancer

peripheral zone

9

what endometrial condition is most often associated with a p53 mutation

endometrial adenocarcinoma non endometroid

10

at what positions are anal cushions present

3, 7, 11 o'clock

11

what veins in the rectum contribute to the systemic part of the portosystemic anastomosis

internal pudendal

12

what are the features of stage 3 male puberty

penal enlargement, pubic hair and testicular enlargement

13

what conditions can be detected during the combined first trimester screening test which is aimed at the whole population

anencephaly
patau's
down's
edward's

14

what are the features of WPW dysrhythmia

short PR interval with early QRS upstroke

15

what is the peak incidence of teratomas in men

20-30 years
alpha fetoprotein is a useful marker

16

what age do yolk sac tumours occur

children
AFP is a marker

17

what age do seminomas occur

30-50
no protein marker

18

what is rigler's sign

double wall sign
usually pneumoperitoneum due to bowel perforation

19

what is the leading cause of traveller's diarrhoea

enterotoxigenic e. coli ETEC

20

what are the features of proliferative glomerulonephritis

post strep infection
deposition of immune complexes
Type 3
nephritic syndrome
blood in urine
sub epithelial

21

what are the features of GI carcinoid tumours

large intramural masses with polypoid excavations
occur mostly in the appendix

22

what are the features of adenocarcinomas in the GI tract

napkin ring encircling and exophytic growth

23

large bulky intramural mass that may ulcerate

leiomyosarcoma

24

clearly pedunculated with a lobar growth on the end of a stalk

tubular adenoma

25

3 cm velvety mass

villous adenoma

26

what cells are responsible for producing fluid that flushes sperm from the tubule to the epididymis

sertoli cells

27

describe the stepped care model

level one is self management
level 2 is multiple chronic conditions treated by a MDT
level 3 is unplanned visits to secondary care

28

what nerves might be damaged in overflow incontinence

S2-4

posterior 2/3rds of the scrotum are supplied by pudendal nerve S2,3 so would be affected

29

who is renal cell carcinoma most common in

smokers and obese people

30

what are the symptoms of renal cell carcinoma

back pain
blood in urine
pyrexia due to paraneoplastic syndrome

31

what is the five year survival rate of renal cell carcinoma

50%

32

what is the effect of phenothiazines on prolactin

phenothiazines are D2 antagonists which increase prolactin

33

what does hemizygous mean

only on chromosome is present e.g. for men with an X linked disease

34

how might a seminoma present

hard lump in young man

35

what structures secrete inhibin

CL and leydig cells

36

what substance can be used to detect neural tube defects

raised alpha fetoprotein

37

what are the features of the trophoblast

the cells of the cytotrophoblast can divide to form synciotiotrophoblast
synciotrophoblast cells are multinucleated and produces hCG. it is in contact with maternal sinusoids

38

what is trisomy 13

patau's syndrome

cleft palate, heart defects
associated with high maternal age
majority die as neonates

39

in what condition would barr bodies be absent

45 X

40

what is cyproterone acetate used to treat

prostate carcinoma and BPH and male hypersexuality
acne and PCOS

41

What effect does psychological stress have on prolactin

increases prolactin

42

what effect does hyperthyroidism have on prolactin

decreases

43

what is the function of oestrodiol

stimulates hyperplasia and hypertrophy of columnar epithelium and stroma in the endometrium and fallopian tubes
also secretion

44

what metabolic disturbance causes hyperkalaemia

acidosis

45

why does burns cause hyperkalaemia

cellular injury causing potassium release

46

how much protein is lost per day in nephrotic syndrome

3. 5 g

47

a man comes in with raised red plaque on his penis. what's the diagnosis

Bowen's disease
Squamous cell carcinoma in situ
very slow growing cancer

48

what causes invasive squamous cell carcinoma on the penis

HPV

Nodule of plaque
mets to inguinal lymph node

49

what occupation used to be at risk of carcinoma of the scrotum

chimney sweeps and arsenic workes

50

a man comes in with a nodular ulcerated mass on his scrotum. what's the diagnosis

squamous carcinoma

51

what is the most common testicular tumour

seminoma

52

a man has testicular cancer which has spread to the para aortic lymph nodes, what stage is this

2
(involves testes and paraaortic lymph nodes)

3- mediastinum/ supraclavicular region

53

what week in pregnancy do hCG levels peak

8-10

54

when is maternal circulation functional

week 10 -12

55

at what week are all steroids required for pregnancy secreted by the placenta

week 4-5

56

a woman presents with uterine bleeding in week 7 of her pregnancy. what drug do you prescribe to stop the bleeding

ergometrine
causes the uterus to contract
alpha receptor antagonist

57

what is stage 1 of male pubertal maturation

no pubic hair, no enlargement of penis or testes

58

a boy has testicular enlargement and start of pubic hair, what stage is this

2

59

a boy has penal enlargement, testicular enlargement and pubic hair, what stage is this

3

60

a boys pubic hair darkens what stage is this

4

61

what is stage 5

adult genital appearance

62

what is the venous drainage of the ovary

pampiniform plexus to the uterine plexus to the left renal vein or aorta

63

what surrounds each ovary

tunica albuginea (pressure) mesotheliun which is analogous to peritoneum

medulla consists of connective tissue and blood vessels

64

which antenatal test is usually carried out at 11-12 weeks gestation

chorionic villus sampling

65

which antenatal scan would be most appropriate to diagnose down's syndrome at 15 weeks

amniocentesis

66

what is the energy intake increase needed at the end of pregnancy

1200 kJ per day

67

why might pregnant women experience heartburn, constipation and increased transit time

reduced GI tone and motility due to relaxation of smooth muscle by progesterone

68

what causes morning sickness

ovarian steriods

69

how much does the maternal pituritary increase by

40 %

70

how much does pulmonary ventilation increase by

40%
raised tidal volume

71

where does the inguinal ligament go to

pubic tubercle to asis

inwardly rolled inferior edge of external oblique

72

abdo pain worse after eating, weight loss, constipation, malaise, smoking, watery diarrhoea

crohns

73

where is the thorocolumbar fascia

iliac crest to 12th rib

74

cerebral calcifications, cerebral palsy
treated with spiramycin

toxoplasmosis

75

eye defects and limb hypoplasia
treated with iv aclivor or immunoglobulin

VZV

76

heart defect, microcephaly

rubella

77

ductal carcinoma in situ

unilateral

78

lobular carcinoma in situ

bilateral

79

mucoid diarhoea

UC

80

watery diarrhoea

crohns

81

peripheral zone

prostate cancer

82

p53

non endometroid endometrial adenocarcionoma

83

inferior rectal veins

internal pudendal veins

84

hyperparathyroidism

increased calcium levels which can lead to the production of renal calculi leading to haematurian and pain- loin and groin

85

renal tuberculosis

weight loss, night sweats, haematuria, loin pain

86

kidney disease, hearing loss, eye abnormalities

alport syndrome

87

nephrotoxic mechanism of aminoglycosides

accumulates in the lysosomes of the PCTs

88

early distal tubules to block the sodium chloride co transporter

thiazide

89

decreases active reabsorption in the TAL by blocking the sodium chloride potassium co transporter

loop diuretric
e.g. furosemide

90

directly inhibits entry of sodium and secretion of potassium in the collecting ducts

soidum channel blocker
e.g. amiloride

91

competes with aldosterone for receptors in the cortical collecting ducts leading to retention of potassium

potassium sparing diuretic
e.g. spironolactone

92

inhibits water and solute reabsorption by increasing the osmolarity of tubular fluid

osmotic diuretc e.g. mannitol

93

inhibits H+ secretion and bicarbonate reabsorption which reduces sodium reabsorption in the PCT

Carbonic anhydrase inhibitors

94

secreted by parietal cells

intrinisic factor and hydrochloric acid

95

released by p'symp stimulation it excites peptic cells, parietal cells and mucous cells

acetyl choline

96

stimulates ECL cells and acid secretion

gastrin

97

intestino intestinal reflex

inhibition of contractions in the adjacent regions of the small intestine

98

left iliac fossa is palpated causing pain in the right iliac fossa due to movement of inflammed parietal peritoneum

rovsing's sign - appendicitis

99

cannot be made directly

vitamins

100

copper deposition

wilson's disease

101

acute hepatitis

toxoplasmosis

102

histamine 2 and muscarinic 3 and prostaglandins and gastrin receptors

increases gastric acid secretion from parietal cells

103

normal temp

36-37.5

104

anterior fibres of temporalis

elevation of the mandible

105

posterior fibres of temporalis

retraction of the mandible

106

ranitidine

targets h2 receptors in order to reduce gastric acid secretion

107

chemoreceptor trigger zone

D2 receptors

e.g. metoclopramide and domperidone

108

ondansetron

serotonin antagonist 5HT3

109

what are the different types of antiemetic

antimuscarinics
histamine 1 antagonists
serotonic antagonists
dopamine 2 antagonists

110

what is the surface marker for the femoral pulse

midway between the asis and the pubic symphysis

111

villous atrophy, increased lymphocytes, increased crypt cell

coeliac disease

112

non bloody diarhoea

crohns

113

inflammation always starts at rectum and never spreads beyond ileocaecal valve, no inflammation beyond submucosa

uc

114

increases the volume and alkalinity of pancreatic juice

secretin

115

increases peristalsis

substance p

116

osmotically active substance is secreted into the tubules which retains water causes diuresis

mannitol

117

what hormone is involved in the milk let down reflex

oxytocin

118

what hormone leads to a rise in HDL cholesterol levels

oestrogen

119

what hormone is involved in galactorrhoea

prolactin

120

level of the coeliac trunk, superior mesenteric and inferior mesenteric

t12, L1 and L3

121

which unpaired artery arises just above the aortic bifurcation at L4, posteriorly

median sacral

122

what vitamin deficiency may alcoholism cause

B1- thiamine

(amino acid and energy production and muscle action potentials)
found in wheat, oats and yeast products

may lead to beriberi / Korsakoffs syndrome

123

what is the most serious consequence of hypomagnesium

arrythmias and cardiac arrest

124

where is aldosterone (mineralocorticoid) produced

zona glomerulosa (outer layer)

125

what is the function of aldosterone

Aldosterone promotes sodium retention and loss of potassium and hydrogen ions. regulates blood pressure

126

where is cortisol made, and other glucocorticoids

zona fasciculata (middle)

127

what is the function of cortisol

increased blood sugar levels, helps to stabilise membranes, stimulates appetite and suppresses the immune/ hypersensitivity response.

128

where are adrenal androgens made

zona reticularis (inner layer)

129

where is renin made

juxtaglomerular apparatus
also regulates the glomerular filtration rate to control sodium excretion.

130

where are catecholamines made

adrenal medulla

131

at what level is the head of the pancreas

L2

132

what structures does the head of the pancreas overlie

IVC, renal veins and common bile duct

133

what is the lymph drainage of the testes

para aortic

134

what is the lymph drainage of the upper third of the rectum

inferior mesenteric

135

what is the lymph drainage of the vulva

superficial inguinal

136

what is the lymph drainage of the scrotum

superficial inguinal

137

what is the lymph drainage of the cervix

internal iliac

138

what is the lymph drainage of the upper anal canal

inferior mesenteric

139

what is the lymph drainage of the lower anal canal

inguinal nodes

140

what nerves are inferior/posterior to the left kidney

ilioinguinal nerve, iliohypogastric and subcostal

141

what is the vertebral level of the left kidney

t12 to L3

142

what are the anterior relations of the left kidney

stomach, spleen, pancreas, jejunum and descending colon

143

what hormone enhances insulin release, reduces glucagon and promotes satiety

glucagon like peptide
GLP1

144

what hormone is raised in patients with chronic renal failure

parathyroid hormone
due to the body attempting to conserve calcium

145

metabolic acidosis is associated with decreased levels of bicarbonate

respiratory acidosis is increased levels of CO2

146

why does SIADH cause decreased sodium

results in fluid overload and dilutional hyponatraemia

147

what structure is responsible for absorbing 60 % of all solute

PCT

148

Which limb is impermeable to water

ascending

149

what might be a symptom of B6 deficiency

sensory neuropathy

150

what is the function of PTH

promotes loss of phosphate in the urine and and prevents the loss of calcium in the urine

causes bone release of calcium
activates vitamin D

151

what can be used to treat pre eclampsia

magnesium

152

what are the features of hypermagnesemia

neuromuscular depression
depressed respiratory function
nausea and vomiting
hypotension
cardiac arrest

153

give an example of a paraneoplastic syndrome

pyrexia due to kidney cancer

154

what mediates the efferent limb of the gastrocolic reflex

gastrin and CCK

155

what mediates the efferent limb of the vagovagal reflex

VIP

156

what structures does the sigmoid mesocolon cross in the left iliac fossa

birfurcation of the common iliac
ureter

157

where does the base of the mesentery begin

Left of L2

158

which artery enters the rectus sheath between the sternal and costal ends of the diaphragm

superior epigastric

159

what drug has its absorption slowed by ingesting food

paracetamol

160

how do ductal cells modify saliva

absorb sodium and chloride
secrete potassium and bicarb

161

what embryonic tissue gives rise to the liver

endoderm

162

how much is life expectancy reduced in obesity

7

163

which antiemetic causes sedation

haloperidol

164

which drug increases permeability to calcium ions and is used to treat schistomes

praziquantel

165

what substance is a risk factor for adenocarcinoma

smoking

166

what part of the duodenum does the SMA start at

second part

167

what nerves are carried with the IMA

least splanchnic and p'symp from S2-4

168

what is omphalocele

physiological herniation fails to return to normal

169

what two structures does the ventral mesentery form

falciform ligament and lesser omentum

170

what structures form the stomach bed

central tendon
left colic flexure
spleen

171

how much rotatation of the bowel around the SMA occurs

270 anticlockwise

172

where is the swallowing centre

medulla and lower pons

173

what factors decrease action potential frequency

gastrin
GIP
sympathetic NS
secretin

174

what is the location of the second part of the duodenum

anterior to the hilum of the right kidney, right of L2-3 vert

175

what is the best marker of acute hepatocellular injury

ALT

176

What is a metabolic consequence of acute pancreatitis

low serum calcium

177

how does CCK affect the pancreas

reduces exocrine secretions

178

what are the features of the exocrine pancreas secretion

high bicarbonate
isotonic

179

what is the blood supply to the lower pharynx

inferior thyroid

180

what does the falciform do in the developing embryon

connects the liver to the anterior abdo wall

181

what embryonic tissues form the anus

endoderm and ectoderm marked by the pectinate line

182

what does the cloaca develop into

anteriorly the urogenital system
posteriorly the anorectum

183

what congenital abnormalities of the GI system can arise

abnormal rotation
Meckel's diverticulum
vitelline cyst
patent vitelline fistula
gastroschisis
umbilical hernia
omphalocele
failure of recanalisation

184

where does the caecum and appendix migrate

from the right hypochondrium to the left iliac fossa

185

how much rotation happens in the physiological hernia

90 degrees
then another 180 as it drops back into the abdomen and 10 weeks

186

what does the midgut form from

the primary intestinal loop on a mesentery

187

what connects the midgut to the yolk sac

vitelline duct

188

what causes herniation of the intestine into the umbilical cord

rapid growth

189

what are the boundaries of the lesser sac

caudate lobe of liver
lesser omentum
stomach
pancreas
left kidney
adrenal gland
epiploic foramen

190

what is pringles manouver

compressing the hepatic artery and portal vein between the fingers to control bleeding

191

what are the borders of the epiploic foramen

free border of lesser omentum
inferior vena cava
caudate process of the caudate lobe
first part of the duodenum

192

where is the umbilical vein

free edge of the falciform ligament

193

what forms the pancreas

dorsal and ventral endodermal buds from the duodenum. rotation of the duodenum causes them to fuse

194

when does CVS happen

10 weeks