sept.2005 part 1

Discussion in 'MRCOG Forum' started by pradhuym, Jul 9, 2006.

  1. pradhuym

    pradhuym Guest

    sept.2005 part 1

    Sigmoid colon
    Attached to pelvic wall
    Lies lateral to psoas major
    Ends at S3

    Rectum
    Starts at S3
    No appendices epiploae
    Middle rectal artery is the major artery suuplying it
    12 cm long

    T pallidum
    Spiral shape
    Causes yaws in children
    Stained with silver impregnation

    HIV seroconversion
    Illness occurs witin 1-4 wks
    After illness infectivity decreases
    The best available diagnostic test is HIV viral load assay
    Without any intervention during pregnancy the mother to child transmission rate is 80%
    Mode of delivery by LSCS decreases the transmission to baby
    Short course of anti viral Rx during labor decreases transmission to baby
    BF is safe

    Percutaneous mode of infection
    H simplex
    Rabies
    Hepatitis B
    Epstein barr virus

    Hep A mode of infection is through
    Blood transfusion
    Shared needles
    Faeco oral route
    Insect bites
    Air borne

    Match the disease with their respective causative org
    Bone marrow suppression – myco bacterium avium
    Red cell aplasia – parvovirus


    The foll are pre malignant
    CIN 3
    Vulval lichen sclerosis
    Endometrioses
    Fibro epithelial polyp
    Atypical endometrial hyperplasia

    Bacterial vaginosis
    Microscopic finding “clue cells”
    pH less than 4.5
    best Rx with ampicillin
    sensitive to clindamycin
    may be due to gardnerella vaginalis

    vaginal infecton
    incidence of n gonorrhoea resistance to penicillin is 1%
    incidence of n gonorrhoea resistance to 3 rd gen ceph 5%
    azithromycin DOC for trichomoniasis
    crytococcus neoformans causes meningitis

    C trachomatis
    Strains L123 cause LGV
    Reticulate body is the infectious form

    Transferrin
    Increased in pregnancy
    One third saturated with Fe
    Binds to 10 mg of iron per gm
    Levels in neonate are low

    Antibodies
    Are soluble proteins
    Formed before 12 wks in fetus
    ABO antigens are present in fetus

    Foll Hb chains are present in intrauterine life
    Alpha 2 beta2
    Alpha 2 gamma 2
    Gamma 4
    Alpha 2 epsilon 2
    Zeta 2 epsilon2

    Pulm embolism
    Spiral CT scan is indicated in suspected cases
    DVT always causes pulm embolism
    X ray angiography is diagnostic
    Spiral CT involves dignoses based on the perfusion copared to air in lungs
    ECG is reliable for diagnosis

    MRI
    Involves administerind of radio contrast agents
    Protons give better imaging
    Damage to fetus is due to tissue heating

    Xray
    Contraindicated in pregnancy
    Low rays are used for breast imaging

    Conventional USG
    Increased freq gives higher resolution
    Increased freq gives better attenuation
    TVS uses higher freq compared to conventional USG
    Doppler USG measures movement
    Gives accurate measurement of bld flow in fetal vessels
    Doppler effect based on blood flow within vessels


    Calcification occurs in
    Renal calculi
    Hyaline degeneration of fibroid
    Parathyroid adenomas
    Secondary bone deposits in prostratic CA

    Foll originate from endothelial cells
    Nitric oxide
    Protein C
    Fibronectin
    Plasminogen activator

    Thyroid
    100-200 micro gms are trapped daily
    increases in size in pregnancy
    trapsinorganic iodine
    colloid is stored outside epithelial cells
    TBG is increased n pregnancy
    5% is bound to CBG

    ketone bodies
    formed from acetone
    formed from acetyl CoA
    not formed during starvation
    not utilised by brain

    Mgso4
    Potentiates action of non depolarising agents
    Check respiratory status
    Causes brisk patellar reflexes
    In toxicity Rx IV calcium sulphate


    CIN
    CIN 3 does not involve breach in basement epithelial layer
    Arias stella reaction mimicks clear cell CA
    Tissue biopsy is required for diagnosis
    Incidence is decreased in renal transplant patients

    GH
    Stmulated by glucose infusion
    Increased in sleep
    Opposes insulin action
    Causes positive nitrogen balance
    Decreased in pregnancy

    Foll form boundaries of ovarian fossa
    Ureter
    Ext iliac vn
    Int iliac art
    Int pudendal art
    Obliterated umb art

    Penem antibiotics
    Active in beta lactam ring
    Drug of choice for ps aeroginoa

    Vagina
    Derived from mullerian ducts
    Seperated from anal canal by anal body

    Bladder
    Pelvic splanchnic stimulation contracts the trigone
    Ext urethral sphincter innervated by pudendal nv
    Mucosa of urethra is innervated by pudendal nv
    Transaction of spinal cord above S2 causes autonomous bladder
    Afferent innervation of glans of clitoris is by ilioinguinal nv

    Hypo k+ is found in
    Prolonged vomiting
    In diabetis ketoacidosis
    Addison’s disease

    Foll are below inguinal ligament
    Ilio inguinal nv
    Lateral branch of genito femoral nv
    Subcostal nv
    Femoral art

    Inf hypogastric (pelvic) plexus
    Supplies pain fibres to body of ut
    Continues as vesical plexus
    Lies at base of braod lig

    Sciatic nv
    S3&4 contribute towards it
    Lies behind quadratus femoris
    Tibial branch supplies short head of biceps femoris
    Injection on the outer & upper quadrant of the buttock may cause damage to the nv

    Undescended testis
    More common in premature than term infants
    Commonly assoc with gonadal neoplasia
    Asoc with 1% of absent testis
    More common on left side

    Embryo
    Parameso duct lies medial to mesonephros
    Mesonephros forms urine
    TVS detects fetal heart beat 21 days after implantation
    Erthropoiesis is entirely medullary


    UG sinus
    Divides the cloaca coronally
    Urachus connects bladder to umbilicus

    Corpus luteum
    Is major source of relaxin
    Contains endothelial cells
    Hysterectomy prolonges the life period
    17 hydroxy prog is the main prog secreted
    steroids prevent recruitment of new follicles

    fertilisation
    acrosome fuses with zona pellucida
    polar body has same karyotype as ovum
    fetilised egg moves slower than unfertilised egg in fallopian tube
    inner ell mass lysis deciduas during implantation

    histo pathologic examination of tissue of conception can diagnose
    CIN 3
    Cx incompetence
    Ectopic preg
    Gest Trophblastic Di

    Ring inversion of Y chromosome found the foll will be done
    Maternal chromosome is tested
    Paternal chromosome is tested
    Scan to look for male genitalia
    Anomaly scan and amniocentesis done for fetus
    Do karyotype of all previous children of couple

    Right ureter
    Below sigmoid coon
    Supplied by vaginal art
    Lined throughout by urothelium
    Contain glands

    Oral absorption of drug depends
    More availablibility in ionised form than non ionised
    Increased lipid solubility increases penetration in CNS
    Enters intestinal cells by simle diffusion
    Protein binding increases excretion
    Lipid form increases uptake

    Fetal circulation
    Portal vn drains in IVC
    Ductus arteriosus takes blood to pulm art
    R atria and L atria communicate thro’ Foramen Ovale

    Voiding in females
    Occurs above rate of 20 ml/sec
    When vesical press is more than 45 mm H2O
    Initial contraction of trigone

    Enzyme activity is modified by
    Dephosphorylation
    Allosteric esters
    Binding to plasma prot
    Proteolytic cleaving of inactive precursors
    Gene transcription

    Functional cyst occurs in
    Stein levinthal synd
    PID
    Multiple sclerosis
    Gest tropho di
    Rx with clomiphene

    Amniotic fluid
    Hypotonic compared to fetal plasma
    Absored in lungs
    Unrelated to swallowing
    Increased until term in fetus
    Contains more HCO3 compared to fetal blood

    Action of complement
    Increase in permeability
    Migration of polymorphs

    Genetics
    South blot detects DNA
    DNA is exact copy of RNA
    DNA is transcribed by RNA polymerase
    Ribosomes contain RNA
    Transcription occurs at any direction along the chain
    DNA replication is called transformation
    DNA has transcription restriction enzyme
    Histones do not contain DNA

    Insulin
    Binding to tyrosine receptor kinase increases activity
    Causes glucose transporter movement to plasma membrane
    Increases glycogen synthetase activity
    Increases fat deposition
    Increase glucose utilisation by CNS

    Heparin
    T ½ is 1.5 hrs
    LMW heparin is administered 4 hrly
    Given in pregnancy causes intracranial haemorrhage in fetus
    Longer duration of action in S/C compared to IV administration

    Foll have imp natural reservoir other than human
    Listeria
    Saolmonella typhimurium
    Brucella

    Crohn’s disease
    Non caseous granulomatous infection
    Forms deep fissures
    Forms crypt abscesses
    Assoc with mucosal polyps
    Recognised to occur in vulva
    Assoc with intestinal wall thickening

    Absorption in kdny
    Glucose occurs in loop of henle
    Water is actively absorbed in proximal conv tubules

    Estrogen
    17 beta estradiol is formed by aromatisation of testos
    increases LH receptors
    secreted by theca cells
    granulosa cells secrete inhibin
    humoral immunity is depressed in pregnancy
    T & B cells are derived from bone marrow

    teratoma
    usually benign
    can occur is assoc with germ cell tumors
    secretes hormones


    during menstruation
    platelet and fibrin plug is formed after 1st 20 hrs of bleeding
    hemostasis is thro’ estr mediated vaso constriction
    hemostasis is thro PG mediated spiral vessel constriction

    During ovulation
    Basal vacuoles occur in mid secretory phase
    Gland stromal mitosis maximum in mid secretory phase
    PG in follicle fluid during ovulation
    Increase of estr and prog receptors in proliferaive phase
    LDL receptors are increased in proliferative phase
    Indomethacin inhibits ovulation
    Matrixmetalloproteinases(MMC) is inhibited by progestrones
    Cloiphene can cause deficient secretory phase

    Glycogen
    Synthesis occurs in muscle
    Is stored along with water

    Carbohydrates
    Yield energy ?17 J/Kg
    Major source of energy for brain
    Major component of diet
    Higher energy compared with fats

    Foll decrease the efficacy of OCP’s
    Isoniazid
    Carbamaepine
    Phenytoin
    Rifampicin

    Female pelvis compared to male
    Sacrum more curved
    Greater sc notch is larger
    Sub pubic angle is more
    Distance betw pubic sym to acetabulum is less than the diam of acetabulum

    Vascular derived epithelial growth factor
    Causes vasodilatation of placental vessels
    Causes angiogenesis in placenta
    Is an angigogenic factor
    Increases permeability of endothelial cells

    And always save the best for last ……STATISTICS

    Definition
    LBW – less than 1,500 gms
    PMR – deaths in first 1 week per 1,000 births
    Perinatal mortality – deaths after 22wks ( more than 154 days) until 1 wk after birth
    Maternal mortality rate

    Tests used
    ANOVA
    Std error of mean means diffce betw sample mean from population mean
    Probablity of 1 means 1 in 10 chance for event to occur

    Examples of ?continuous variables are
    Bld glucose
    Haemoglobin
    Gender
    Height
    Blood pressure



    Sigmoid colon
    Attached to pelvic wall......T
    Lies lateral to psoas major ........F
    Ends at S3 .........T

    SIGMOID COLON...STARTS AT PELVIC BRIM.....ENDS AT S3.......IS 45 CMS LONG.....LIES ON THE PERITONEAL SURFACE OF BLADDER AND UTERUS.....SO THE PSOAS IS A DEEPER STRUCTURE.....





    Rectum
    Starts at S3 ........T
    No appendices epiploae.......T
    Middle rectal artery is the major artery suuplying it........F......ITS THE SUPERIOR RECTAL ARTERY
    12 cm long .............T





    T pallidum
    Spiral shape........T
    Causes yaws in children..........T
    Stained with silver impregnation.........F.......
    THE ONLY TESTS FOR MICROSCOPY ARE DARK GROUND IMMUNOFLOURSCENCE................OTHERWISE SEROLOGY IS THE OTHER DIAGNOSTIC AID....




    HIV seroconversion
    Illness occurs witin 1-4 wks......T...........SEROCONVERSION OCCURS IN FIRST FEW WEEKS......FOLLOWED BY SIGNS OF ILLNESS
    After illness infectivity decreases ..........F.........I THINK SO BECAUSE THOUGH ITS A LATENT PHASE AND NO OVERT SYMPTOMS OCCUR WHILE THE VIRUS MULTIPLIES, I THINK INFECTIVITY REMAINS JUST THE SAME.........
    The best available diagnostic test is HIV viral load assay........T.........FROM AN OBSTETRIC POINT OF VIEW.....VIRAL LOAD IS THE ONLY USEFUL WAY OF PREDICTING DISEASE......BECAUSE SEROLOGY IS UNRELIABLE IN ITS RESULTS DUE TO MATERNAL ANTIBODIES......WHICH MIGHT TAKE UPTO 18MONTHS TO DIE DOWN...
    Without any intervention during pregnancy the mother to child transmission rate is 80% .........F.....ITS 15-45%......LATTER IN UNTREATED CASES......
    Mode of delivery by LSCS decreases the transmission to baby......T.....CAN BRING THE TRANSMISS DOWN TO 2%
    Short course of anti viral Rx during labor decreases transmission to baby.........T
    BF is safe ........F.......MOST IMP METHOD OF TRASMISS IF OTHER PREVENTIVE MEASURES HAVE BEEN UNDERTAKEN....




    Percutaneous mode of infection
    H simplex........T
    Rabies .......F.....BITE WITH SALIVA
    Hepatitis B ........F......
    Epstein barr virus .......T I THINK.......ECAUSE IT SAYS YOU CAN GET IT FROM PATIENTS THROUGH "CASUAL CONTACT"......




    Hep A mode of infection is through
    Blood transfusion.....F
    Shared needles .....F
    Faeco oral route ......T
    Insect bites ......F
    Air borne ......F

    Match the disease with their respective causative org
    Bone marrow suppression – myco bacterium avium
    Red cell aplasia – parvovirus




    The foll are pre malignant
    CIN 3 ........T
    Vulval lichen sclerosis.......F BUT NOT SURE...
    Endometrioses .......F
    Fibro epithelial polyp ............T I THINK...
    Atypical endometrial hyperplasia ??T





    Bacterial vaginosis
    Microscopic finding “clue cells”.........T
    pH less than 4.5 .......F........HAS TO BE MORE THAN 5 FOR BV TO OCCUR
    best Rx with ampicillin ............F
    sensitive to clindamycin ...........F.......I DIDNT FIND IT ANYWHERE.....SO I WILL GO FOR F
    may be due to gardnerella vaginalis........T.....




    vaginal infecton
    incidence of n gonorrhoea resistance to penicillin is 1% ......T BUT NOT SURE 100%
    incidence of n gonorrhoea resistance to 3 rd gen ceph 5% .....? FALSE
    azithromycin DOC for trichomoniasis ,.......F....METRO...
    crytococcus neoformans causes meningitis .........T.....ESP IN AIDS PTS



    C trachomatis
    Strains L123 cause LGV.........T
    Reticulate body is the infectious form .......F.....RETICULATE I THE VEGETATIVE NON INF INTRACELL. FORM....

    Transferrin
    Increased in pregnancy ........T
    One third saturated with Fe .........T
    Binds to 10 mg of iron per gm ???.....DUNNO....DIDNT FIND THIS KIND OF DATA ANYWHERE....
    Levels in neonate are low........FALSE.....





    Antibodies
    Are soluble proteins........I THINK ITS TRUE....THEY HAVE TO BE.....BUT NO BOOK CONFIRMATION YET.....
    Formed before 12 wks in fetus .........TRUE.....IGM FORMS AT 11 WEEKS....
    ABO antigens are present in fetus........TRUE

    Foll Hb chains are present in intrauterine life
    Alpha 2 beta2 .......TRUE......HB A......PRESENT 8TH MONTH ONWARS
    Alpha 2 gamma 2 ........T......HB F......ALL THROUGH PREG AND LATER TOO...
    Gamma 4 ......F
    Alpha 2 epsilon 2........F
    Zeta 2 epsilon2 ........T.....HBGOWER 1.......PRESENT I THE FIRST FEW WEEKS.....
    ALSO THERE IS HBA2....ALPHA2 AND DELTA 2 UNITS...



    Pulm embolism
    Spiral CT scan is indicated in suspected cases.........F
    DVT always causes pulm embolism ............F
    X ray angiography is diagnostic ...............T
    Spiral CT involves dignoses based on the perfusion copared to air in lungs ...............F
    ECG is reliable for diagnosis............F
    IS SPIRAL CT AND VQ SCAN THE SAME THING????SORRY FOR ASKING SUCH A BASICALLY DUMB QUESTION....





    MRI
    Involves administerind of radio contrast agents........T I THINK....
    Protons give better imaging ?????T I THINK.........BECAUSE IT DEENDS ON THE OSCILLATION OF CHARGED PARTICLES......EPS THE HYDROGEN ATOM....
    Damage to fetus is due to tissue heating.......F I THINK.....BECAUSE MRI IS NOT AN IONISING RADIATION.....SO I DONT THINK THERE IS ANY HEATING.....



    Xray
    Contraindicated in pregnancy...............F
    Low rays are used for breast imaging ............????......LOW COMPARED TO WHAT??7 TO 10 MRADS ARE USED..........WHICH IS MORE THAN EG THE 2-3 MRADS FOR CHEST X RAY...........I DONT THINK THATS LOW.......I WOULD SAY FALSE.....






    Conventional USG
    Increased freq gives higher resolution
    Increased freq gives better attenuation
    TVS uses higher freq compared to conventional USG
    Doppler USG measures movement ........T
    Gives accurate measurement of bld flow in fetal vessels........T
    Doppler effect based on blood flow within vessels ...........T......THE SOUND OF BLOOD FLOW WITHIN VESSELS....TO BE EXACT....
    FOR THE FIRST THREE STEMS......I COULDNT FIND THE ANSWER......BUT IT WAS SOMEWHERE IN THIS FORUM.........I WILL POST IT AS SOON AS I COME ACROSS IT AGAIN.......


    Calcification occurs in
    Renal calculi ...........T
    Hyaline degeneration of fibroid.........T.....CALCIFICATION OCURS IN FIBROID........I DONT WHAT THE SIGNIFICANCE OF HYALINE DEGENERATION IS IN TH QUESTION
    Parathyroid adenomas ............T
    Secondary bone deposits in prostratic CA ..........T




    Foll originate from endothelial cells
    Nitric oxide......T
    Protein C ............F
    Fibronectin ........T
    Plasminogen activator................T





    Thyroid
    100-200 micro gms are trapped daily.......T
    increases in size in pregnancy .........T I THINK.....ACTOVITY INCREASES........SO DOES THE SIZE......BUT IM NOT SURE....
    trapsinorganic iodine .......T
    colloid is stored outside epithelial cells.........T
    TBG is increased n pregnancy ...........T.
    5% is bound to CBG ...........................TO TBG I THINK WAS MEANT....F......T3 AND T4 ARE BOUND 75 AND 85 %





    ketone bodies
    formed from acetone..............T
    formed from acetyl CoA ..........T
    ormed during starvation .....T
    not utilised by brain T




    Mgso4
    Potentiates action of non depolarising agents T I THINK
    Check respiratory status T......PARALYSIS OF RESP MUSCLE IS THE FIRST SIGN OF OVERDOSE
    Causes brisk patellar reflexes T.........ANOTHER SIGN OF MG EXCESS....
    In toxicity Rx IV calcium sulphate .....F.....CA GLUCONATE...





    CIN
    CIN 3 does not involve breach in basement epithelial layer F....THATS EXACTLY TH DISTINCTION
    Arias stella reaction mimicks clear cell CA..........THIS ONE IS JUT SOMEWHERE IN MY brain CELLS......DONT KNOW NOW....
    Tissue biopsy is required for diagnosis ......FALSE....SMEAR CAN ALSO SHOW CIN III CHNGES.......
    Incidence is decreased in renal transplant patients?????......F I THINK.....COULDNT FIND INFO ANYWHERE.......BUT MY GUESS IS THAT IMMUNOSUPRESSION DURING RENAL TRANSPLANT WOULD EXACERBATE MALIGNANCY RATHER THAN SUPPRESS IT.....





    GH
    Stmulated by glucose infusion.........FALSE....
    Increased in sleep ......T
    Opposes insulin action F
    Causes positive nitrogen balance F
    Decreased in pregnancy F
    GH STIM BY
    LOW ENERGY CONDN
    HYPOGLYCaenia
    EXCERCISE
    FASTING
    HIGH AMINO ACIDS
    HIGH PROT MEAL
    ARGININE INFUSION
    STRESS STIM
    GLUCAGO
    SLEEP

    GH INHIB BY
    GLUCOSE
    CORTISOL
    FFA
    MEDROXYPROGEST
    GH

    ANABOLIC HORMONE......WANTS TO BULD AND CONSTRUCT.....SO I THINK N2 BALANCE WOULD BE NEGATIVE......
    AND SHOULD BE HIGH IN PREG I THINK......








    Foll form boundaries of ovarian fossa
    Ureter T LATERAL TO OF
    Ext iliac vn T ABOVE OF
    Int iliac art T ABOVE THEN POST TO OF
    Int pudendal art F.....WAY OFF BELOW THE LEVATOR ANI....NOWHERE CLOSE...
    Obliterated umb art..T LAT TO OVARY..




    Penem antibiotics
    Active in beta lactam ring T
    Drug of choice for ps aeroginoa T




    Vagina
    Derived from mullerian ducts T
    Seperated from anal canal by anal body....PINEAL BODY-T

    Bladder
    Pelvic splanchnic stimulation contracts the trigone F......ALL TRUE....BUT NOTHING CONTRACTS THE TRIGONE!
    Ext urethral sphincter innervated by pudendal nv....F....NO PUDENDAL INVLVMT IN URETHERA......SUPP BY SOMATIC FIBS FROM S2-4
    Mucosa of urethra is innervated by pudendal nv F
    Transaction of spinal cord above S2 causes autonomous bladder T I THINK........BECAUSE IT WOULD STILL WORK AUTONOMOUSLY THROUGH REFLEX.......BUT NO SOMATIC ACTION BECAUSE CEREBRAL CONTROL IS LOST....
    Afferent innervation of glans of clitoris is by ilioinguinal nv ........F AFFERRENT OF GLANS CLIT IS THROUGH PELVIC SPLANCH......EFF IS THRU PUDENDAL N......AND BLOOD SUPPLY IS THROUGH INT PUD ARE
    PUD N ALSO SUPPS INF RECTAL NERVE AND A PERINEAL NERVE....




    Hypo k+ is found in
    Prolonged vomiting T
    In diabetis ketoacidosis T
    Addison’s disease F HYPERKALEMIA HERE........CORTISOL IS HYPOKALEMIC.......AND NO CORTISOL IN ADDISONS....




    Foll are below inguinal ligament
    Ilio inguinal nv T
    Lateral branch of genito femoral nv T
    Subcostal nv F
    Femoral art T






    Inf hypogastric (pelvic) plexus
    Supplies pain fibres to body of ut T
    Continues as vesical plexus T
    Lies at base of braod lig T





    Sciatic nv
    S3&4 contribute towards it F L4 TO S3
    Lies behind quadratus femoris F......IT LIES ON IRIFORMIS.....WIT NO MORE USCLES ON TOP....QF IS A VERY DEEP MUSCLE
    Tibial branch supplies short head of biceps femoris ......FASE......SHORT HEAD IS BY COMMON PERONEAL.....LONG HEAD ISBY TIBIAL.....
    Injection on the outer & upper quadrant of the buttock may cause damage to the nv ....FLASE........THIS IS THE SAFEST AREA





    Undescended testis
    More common in premature than term infants T
    Commonly assoc with gonadal neoplasia T
    Asoc with 1% of absent testis
    More common on left side


    Corpus luteum
    Is major source of relaxin T RELAXIN, INHIBIN AND ACTIVIN
    Contains endothelial cells T I THINK, IT HAS RICH BLOOD SUPPLY.......SO ENDOTHELIAL CELLS TOO I SUPPOSE...
    Hysterectomy prolonges the life period F I THINK.....HYSTERECTOMY WOULD HAVE NO EFFECT.......OR IT WOULD DECREASE THE LIFE......NO BOOK CONFIRMATION....
    17 hydroxy prog is the main prog secreted F I THINK.......PROGESTERONE IS THE MAIN
    steroids prevent recruitment of new follicles T STEROIDS LOWER THE LEVEL OF ESTROGEN RECEPTORS..





    fertilisation
    acrosome fuses with zona pellucida T
    polar body has same karyotype as ovum T
    fetilised egg moves slower than unfertilised egg in fallopian tube F UNSURE.....BUT WHY SHOULD IT?
    inner ell mass lysis deciduas during implantation F INNER CELL MASS DOES NOTHING OUTSIDE.....IT BECOMES THE FETUS.....





    histo pathologic examination of tissue of conception can diagnose
    CIN 3 T
    Cx incompetence F
    Ectopic preg T
    Gest Trophblastic Di T





    Ring inversion of Y chromosome found the foll will be done
    Maternal chromosome is tested F
    Paternal chromosome is tested T
    Scan to look for male genitalia T
    Anomaly scan and amniocentesis done for fetus ?T
    Do karyotype of all previous children of couple F
    ALL ARE DEDUCTIONS......BECAUSE Y IS RELATED WITH PATERNAL.....AND ASSOCIATED WITH EXPRESSION OF MALE PHENOTYPE.......PLEASE DISCUSS




    Right ureter
    Below sigmoid coon F LEFT URETER
    Supplied by vaginal art T
    Lined throughout by urothelium T IF UROTHELIUM IS ANOTHER NAME FOR TRANSITIONAL EPITH
    Contain glands F.......BLADDER EPITH IS DEVOID OF GLANDS......I THINK URETERS' IS ALSO THE SAME....





    Oral absorption of drug depends
    More availablibility in ionised form than non ionised F.....BECAUSE I DIDNT FIND IT ANYWHERE THAT IONISED FORM INFLUENCED ORAL ABS.....
    Increased lipid solubility increases penetration in CNS T
    Enters intestinal cells by simle diffusion T
    Protein binding increases excretion F
    Lipid form increases uptake T





    Fetal circulation
    Portal vn drains in IVC T
    Ductus arteriosus takes blood to pulm art F AWAY FROM IT
    R atria and L atria communicate thro’ Foramen Ovale T





    Voiding in females
    Occurs above rate of 20 ml/sec T MAX URINE FLOW RATE =20-40 ML/SEC
    When vesical press is more than 45 mm H2O T VOID PRESS=45-70 MM
    Initial contraction of trigone F........TRIGONE DOES NOTHING!!!






    Enzyme activity is modified by
    Dephosphorylation T
    Allosteric esters T
    Binding to plasma prot T
    Proteolytic cleaving of inactive precursors T
    Gene transcription ?F
    ALL GUESSES......ANYONE KNOWS THE ANSWERS??





    Functional cyst occurs in
    Stein levinthal synd T
    PID F
    Multiple sclerosis F
    Gest tropho di F
    Rx with clomiphene T





    Amniotic fluid
    Hypotonic compared to fetal plasma ?T
    Absored in lungs ?T
    Unrelated to swallowing F
    Increased until term in fetus F DECS TO TERM
    Contains more HCO3 compared to fetal blood ?T





    Action of complement
    Increase in permeability T
    Migration of polymorphs T






    Genetics
    South blot detects DNA F ITS ONLE SEROLOGICAL TEST
    DNA is exact copy of RNA F
    DNA is transcribed by RNA polymerase T
    Ribosomes contain RNA T
    Transcription occurs at any direction along the chain F ONLY 5' TO 3'
    DNA replication is called transformation F
    DNA has transcription restriction enzyme ?F DIDNT FIND ANYTHING LIKE THAT ANYWHERE
    Histones do not contain DNA T





    Insulin
    Binding to tyrosine receptor kinase increases activity T
    Causes glucose transporter movement to plasma membrane T
    Increases glycogen synthetase activity T
    Increases fat deposition T
    Increase glucose utilisation by CNS ?T




    Heparin
    T ½ is 1.5 hrs T
    LMW heparin is administered 4 hrly F 8 TO 12
    Given in pregnancy causes intracranial haemorrhage in fetus F DOESNT CROSS PLAC COS ITS TOO BIG
    Longer duration of action in S/C compared to IV administration T






    Foll have imp natural reservoir other than human
    Listeria F
    Saolmonella typhimurium F
    Brucella T FROM DAIRY AIMALS




    Crohn’s disease
    Non caseous granulomatous infection T
    Forms deep fissures T
    Forms crypt abscesses T
    Assoc with mucosal polyps F......PSEUDOPOLYPS
    Recognised to occur in vulva F......AT THE MOST....A FISTULA MIGHT OPEN I THE VULVA......BUT THATS NOT CROHNS OCCURING IN THE VULVA I THINK....
    Assoc with intestinal wall thickening ? T......NOT A PROPER STATEMENT......THERE IS INFLAMMATION.....THICKENING IS A VERY LAYMAN TERM I THINK....





    Absorption in kdny
    Glucose occurs in loop of henle F ACTIVE ABSPN IN PCT WITH AA
    Water is actively absorbed in proximal conv tubules F OPASSIVE DIFFSN IN PCT WITH NA AND CL






    Estrogen
    17 beta estradiol is formed by aromatisation of testos T
    increases LH receptors T
    secreted by theca cells F GRANULOSA CELLS
    granulosa cells secrete inhibin F CORP LUT DOES
    humoral immunity is depressed in pregnancy F I THINK.....IF IT WERE TRUE, RHESUS CONFLICT WOULDNT BE AN ISSUE
    T & B cells are derived from bone marrow T





    teratoma
    usually benign T
    can occur is assoc with germ cell tumors T
    secretes hormones F....NOT USUALLY I THINK





    during menstruation
    platelet and fibrin plug is formed after 1st 20 hrs of bleeding F I THINK.....PLATELET PLUG FORMN TAKES PLACE VERY QUICK AND IN VERY SMALL TRAUMAS.....
    hemostasis is thro’ estr mediated vaso constriction F
    hemostasis is thro PG mediated spiral vessel constriction F PG ARE CONSIDERED TO BE THE CAUSE.....BUT I DONT KNOW IF ITS AT THE SPIRAL ARTS OR BELOW THEM.......BECAUSE THE APIRAL ARTS ARE ACTUALLY SHED....ISNT IT...





    During ovulation
    Basal vacuoles occur in mid secretory phase T
    Gland stromal mitosis maximum in mid secretory phase T
    PG in follicle fluid during ovulation F DIDNT FIND THAT ANYWHERE
    Increase of estr and prog receptors in proliferaive phase T I THINK
    LDL receptors are increased in proliferative phase ?F
    Indomethacin inhibits ovulation F
    Matrixmetalloproteinases(MMC) is inhibited by progestrones ???!!! WOW NO CLUE
    Cloiphene can cause deficient secretory phase F ITS ANTI ESTROGEN......SO IT MAY SHORTEN PROLIF PHASE....





    Glycogen
    Synthesis occurs in muscle T
    Is stored along with water F ITS POLYMERISED......AND TURNS TO CRYSTALS ON STORING.....THIS IS THE REASON THERE IS NO OSMOTIC HAVOC IN CELLS WITH IT






    Carbohydrates
    Yield energy ?17 J/Kg T
    Major source of energy q=brain &s=0">brain </a> F I THINK ITS GLUCOSE ACTULLY.....
    Major component of diet T
    Higher energy compared with fats F FATS HAVE MAX ENERGY




    Foll decrease the efficacy of OCP’s
    Isoniazid F
    Carbamaepine T
    Phenytoin T
    Rifampicin T
    ALSO PHENOBARB




    Female pelvis compared to male
    Sacrum more curved F LESS CURVED AND MORE MORE BACK TILT
    Greater sc notch is larger T
    Sub pubic angle is more T
    Distance betw pubic sym to acetabulum is less than the diam of acetabulum F......ACETABULUM IS VERY SMALL...AND THE DISTANCE IS GREATER



    I
  2. pls reply

    pls reply Guest

    few questions

    paper1 consist of 50 or 60 mcq
  3. Guest

    Guest Guest

    Thanx man for your effort

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