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MRCOG
| Question | Answer |
|---|---|
| What is the % change of plasma volume during pregnancy, and when does it reach maximum? | 50%, Max at 32 weeks |
| Total blood volume increase during pregnancy (%) | 40% |
| Red blood cell volume increase during pregnancy (% and figures in ml) | 30% Red cell mass increases from 1400ml to 1700-800ml |
| Cardiac output increase in pregnancy (% and L/min) and when does it plateau? | 40% from 4.5L/min to around 6L/min, plateau at 24-30 weeks |
| Stroke volume increase at term (%) | 30% |
| Heart rate increase at term (% + bpm) | 25%, 15bpm |
| Oxygen consumption increase in pregnancy in ml/min | +30-50mL/min |
| Which increase is greater in pregnancy, ventilation or oxygen consumption? What is significance? | Increase in ventilation is greater therefore the arterio-venous gradient is reduced |
| ECG changes in pregnancy (5) | 1. HR increased 2. Left axis deviation by 15degrees, 3. Inverted T wave in lead III 4. Q wave in lead III and AVF, 5. non-specific ST changes |
| ECG changes in pregnancy are secondary to... (4) | 1. Left ventricular hypertrophy and dilatation 2. No change in contractility 3. Upward displacement of the diaphragm 4. apex is shifted anterior and left |
| What happens to ventilation in pregnancy? (%) | Increases by 40% |
| Is progesterone a bronchodilator or bronchoconstrictor? | Bronchodilator |
| Does airway resistance increase or decrease in pregnancy? | Decrease |
| Does respiratory rate change during pregnancy? | No |
| Is there any change in vital capacity during pregnancy? | No |
| Is there any change to residual volume during pregnancy? | Yes, decrease by 200ml |
| What happens to expiratory reserve volume during pregnancy? | Decreases |
| Is there ay change to FEV1 or peak flow during pregnancy? | No |
| What happens to tidal volume in pregnancy? | Increases |
| How much iron do pregnant women need? And how much extra is it? | 6.6mg/day at term (this is 700-1400mg total extra) |
| Which coagulation factors DON'T rise in pregnancy? | XI, XIII |
| Most significant prolactin inhibitory factor? | Dopamine |
| What keeps the ductus arteriosus patent during pregnancy? | PEG2 |
| How does USS work? Is it ionising? | Non ionising, apply charges across piezoelective crystals |
| 5 facts about rubella | 1. Togavirus, 2. Single stranded RNA 3. Incubation 12-23 days 4. Vaccination is live attenuation 5. Congenital rubella poor prognosis |
| Which area of hypothalamus produces TRH SRH and oxytocin | Paraventricular nucleus |
| 3 facts about leydig cells | 1. produces testosterone 2. testicular cells 3. Have LH receptors |
| Formula for positive likelyhood ratio | sensitivity/(1-specificity) |
| Formula for sensitivity | TP/(TP+FN) |
| Formula for specificity | TN/(TN+FP) |
| Which hormones are required for alveolar morphogenesis? | Progesterone, prolactin and hPL |
| Which strains of HPV are covered by gardasil? | 6, 11, 16, 18 |
| What is the prevalence of HIV in the UK obstetric population? | 2/1000 live births |
| Abdominal CT radiation dose is equivalent to... | 400 x-rays or 2.7 years background radiation |
| What initiates the extrinsic pathway? | Tissue damage/tissue factor |
| What are spearman and pearson and how are they different? | correlation coefficients, pearson is parametric and spearman is non-parametric |
| Incidence of placenta accreta all inclusive | 1.7/10000 |
| Typical oxygen consumption in non pregnant 75kg woman | 250ml/min |
| Group 1 ovulation disorders | Hypothalamic failure ie stress, underweight etc |
| Incidence of molar pregnancy in UK | 1 in 1000 |
| Vasopressin is also known as? and is released from? | Anti-diuretic hormone, posterior pituitary |
| 4 phases of wound healing | 1. haemostasis 2. inflammatory 3. proliferation 4. remodelling |
| Lifespan of RBCs | 120 days |
| Main site of reabsorption of all ions? | Proximal collecting tubule |
| Lifespan of platelets? | 5-9 days |
| What is a type 1 error? | Incorrectly rejecting the null hypothesis, aka false positive |
| Hindgut is innervated by? (nerve roots) | T12/L1 |
| Prolactin is similar to... | hPL + GH |
| Type 2 error | Incorrectly accepting null hypothesis |
| Addisons - what is it and how do you test for it? | Chronic Primary adrenal insufficiency. Test: 9am cortisol and synacthen test |
| 3 points on Sertoli cells | 1. FSH receptors, 2. secrete inhibin, 3. Forms blood-testis barrier. |
| Average lifespan of a basophil? | 3-4 days |
| 4 Facts about THeca cells | 1. ovarian cells, 2. Produce androgens 3. produce progesterone 4. LH receptors |
| 4. facts about granulosa cells | 1. ovarian cells, 2. FSH receptors 3. Convert androgens to aromatase (then into estradiol) 4. Produce progesterone |
| Plasma accounts for what % of body weight? | 4% |
| Diagnose gestational diabetes if a woman has either... | Fasting blood sugar >5.6 or 2 hour glucose >7. |
| Oxytocin | 1. initiates letdown of milk 2. induces contraction of uterine muscle via activation of phospholipase c 3. can stimulate uterine prostaglandin synthesis |
| Embryonic haemoglobin | 1. primary form of haemoglobin until 10-12 weeks 2. produced from the yolk sac 3. tetramer 4. primary form is Gower 1 |
| How much radiation is a chest x-ray equivalent to? | 2.5 days background radiation |
| Edwards syndrome | 1. Trisomy 18, 2. 1 in 5000, 3. all serum markers are reduced 4. 90% detected on anomaly scan 5. lifespan 5-15 days |
| Endometrial carninoma, FIGO stage 1 def + 5yr survival | Confined to uterus, 1a <1/2 myometrial invasion, 1b >1/2 myometrial invasion. 85-90% 5yr survival |
| Endometrial cancer FIGO stage 2 def + 5yr survival | Cervical stromal invasion but not beyond uterus, 65% 5yr survival |
| Endometrial cancer FIGO stage 3, def + 5yr survival | Beyond uterus: 3a serosa or adnexa, 3b vaginal and/or parametrial, 3c1 pelvic nodal involvement, 3c2 para-aortic nodal involvement. 5yr survival 45-60% |
| Endometrial carcinoma FIGO stage 4, def + 5yr survival | Distant metastasis: 4a tumour invasion bladder/bowel mucosa 4b distant mets inc abdominal mets/inguinal lymph nodes. 5yr survival 15% |
| lifetime risk of breast cancer in general population | 12% |
| 4 facts on internal anal sphincter | 1. involuntary 2. sympathetic contraction 3. parasympathetic relaxation 4. pelvic splanchnic nerve (S4) |
| Contents of superficial perineal pouch (6) | 1. bulbospongiosus muscle 2. ischiocavernosus muscle 3. superficial transverse perineal muscle 4. crura of clitoris 5. vestibular bulbs 6. greater vestibular glands |
| Contents of deep perineal pouch (5) | 1. Deep transverse perineal muscle 2.external sphinchter muscle of urethra 3. compressor urethrae muscle 4. urethrae vaginal sphincter 5. proximal portion of urethra |
| Calcitonin | 1. released by parafollicular cells in response to hypercalceamia, 2. reduced osteoclast activity 3.increased osteoblast activity 4. inhibits calcium absorption in intestines 5. inhibits renal tubule reabsorption of calcium |
| max dose of lidocaine | 3mg/kg |
| define oligohydramnios | AFI <5cm or deepest pool <2cm |
| define polyhydramnios | AFI >25cm, deepest pool >8cm |
| Tranexamic acid | plasminogen-activator inhibitor. It inhibits the dissolution of thrombosis (and fibrin) that leads to menstrual flow. It can reduce flow by up to 50% |
| 3 facts on VTE in pregnancy | 1) 10-20% of VTEs are PE's. The majority are DVT 2) Inherited Thrombophilia is present in approximately 40% of women with pregnancy associated VTE 3) Obesity (BMI >30) increases DVT risk by 4 to 5 times |
| WHO classification of bone denisties | Normal: T-score greater than or equal to -1 Osteopenia: T-score less than -1 but greater than -2.5 Osteoporosis: T-score less than or equal to -2.5 Severe osteoporosis: T-score less than or equal to -2.5 + fragility fracture |
| Components, arterial supply and innervation of Levator Ani | Innervation: Pudendal, Perineal and Inferior Rectal nerves S3 and S4 spinal nerves Arterial Supply: Inferior gluteal artery 3 Muscle Componenets: puborectalis, pubococcygeus muscle (puborectalis is part of) and iliococcygeal muscle. |
| Cytomegalovirus 5 points | 1. >50% women sero +ve 2. Vertical transmission approx 40% 3.10% of infected infants will be symptomatic 4.Transmission also via breastmilk 5. Incubation period 3-12 weeks |
| 4 increased risks associated with VBAC | 1. 2-3/10,000 additional risk of birth-related perinatal death 2. 8/10,000 infant hypoxic ischaemic encephalopathy 3.22-74/10,000 Risk of uterine rupture (previous lower segment c-section) 4. 1% additional risk of either blood transfusion or endometritis |
| UK incidence of OASIS | Primiparous 6.1% Multiparous 1.7% Overall 2.9% |
Created by:
ejcapay