1
Q
what is the weight of term uterus
A
1200gm (1100-1200gm)
Average volume 5L
Non term- 40gm(10ml volume)
2
Q
what happens to the renal blood flow in pregnancy
A
Increases by 50%
3
Q
average lifespan of a RBC
A
120 Days
4
Q
Where in the kidney is the majority of Potassium and Phosphate reabsorbed
A
PCT
5
Q
During wound healing the clotting cascade is activated. Which of the following activates the extrinsic pathway?
A
Tissue factor
6
Q
what is the average life span of basophills
A
2-5 days
Blood Cell Lifespans
Red Blood Cells 120 days
Platelets 5-9 days
White blood cells 2-5 days
Neutrophils (up to 5 days)
Basophils (2 to 3 days)
Eosinophls (2 to 5 days)
Monocytes (1 to 5 days)
Lymphocytes (variable
7
Q
most common cause of hypercalcaemia
A
primary hyperparathyroidism
8
Q
In pregnancy how much does the oxygen concentration increases by
A
20%-
the typical Oxygen Consumption (VO2) is 250ml/min.
In pregnancy this increases by around 20% (or 50ml/min) to 300ml/min
9
Q
99% of body calcium is in what form?
A
calcium phosphate
10
Q
wound healing collagen alignment along tension lines is part of which phase?
A
remodelling
Maximum tensile wound strength is typically achieved by week 12.
11
Q
A
12
Q
What is the mode of transfer of amino acid via Placenta
A
Secondary active transport
13
Q
The mode of transfer of co2via placenta
A
Simple diffusion
Glucose- facilitated diffusion
14
Q
How much cardiac output increases in the first trimester
A
1.5l/min
15
Q
What keeps the DA OPEN
A
Pgye2
16
Q
What produces the surfactant
A
Type 2 pneumocytes
17
Q
Which substance provides the most accurate measurement of gfr
A
Inulin
18
Q
By how much does the kidney invreases in size
A
1cm- hypertrophy
19
Q
A
20
Q
By how much does the renal blood flow increases
A
25%pre pregnanxy is 1.2l/min
To pregnancy 1.5 L/min
21
Q
A
22
Q
What happens to the diaphragm and the thoracic diameter in pregnancy
A
Diaphragm is elevated and the thoracic diameter
23
Q
What is the test used for cross matching
A
Indirect coombs and for ABO incompatibility direct coombs is used
24
Q
metaboli aciosis with a normal anion gap occurs in
A
Diarrhoea, renal tubular acidosis including vitamin d intoxication, PTH high
25
where are the bicarbonates reabsorbed
In PCT majority of it
26
what is the water content in neonates
75%
iN WOEMN- 50%
In males 60%
27
Plasma volume in females
3L
28
Thirst is stimulated when the serum osmolarity is
rises by more than 4mOsmol/kg
29
what is a recognised cause of salte defiecient hyponatremia
Excessive vomiting of diarrohea
30
what is the time limt of third stage of labour in physiological management
60 mins
31
what are the three stages of active management of third stage
use of uterotonics
Early clamping and cutting of clamp
controlled cord traction
32
the proportion of the pre term infants that have jaundice
80%
About 10% of breast fed babies have jaundice till 1 months of age
Prolonged jaundice is more than 14 days i term adn 21 days in pre term
33
enzyme that catalyses the rate limiting step in bilirubin synthesis
Haem oxygenase
34
what is the typical length of the cervix and what is it made of-
3-3.5cm and made of type 1/3 long collagen
35
where does the cell production starts in week 2-8
yolk sac
then the progenitor cells migrate to the liver then supported by spleen(liver is the leader then supported by spleen)
36
where does the red cells gets produced in bones?
12 weeks - the medullary cavity of the cavicles, then medulary cavity of long bones from 20 weeks till term
37
what is the trigger for the red cell production ?
Erythropoetin from the foetal liver
At birth the kidney takes over the production of the EPE
38
Surfactant is produced at the age of
24-28 weeks, and it is detectanble in the amniotic fluid by 28 to 32 weeks
39
With respect to coagulation in pregnancy ---- What changes
Factor7 to 10 and fibrogen increases
protein s concentration decreases
40
the change in the serum creatinine ratio in pregnancy at 24 weeks
decreases by 25%
41
the storage temperature for cryoprecipitate ?
-30 centrigatre
All blood is tested for HIV, hep b c and Syphylis
42
what temperature are clotting factors stored at
4c- shelf life 5 weeks
Platelets are stored at 22c - shelf life 5 days
43
what is the commonest cause of death in transfusion related patients
Bacterial contamination
44
ESR increased with
Age
45
where are the alpha genes for Hb production present
Chromoson 16- (4 genes in total)
🧠 Memory tip: “Two gone, trait shown.”
Memory tip: “Three gone, HbH on.”
🧠 Memory tip: “Four gone, baby’s gone.”
Alpha thalassemia = caused by gene deletions
Beta thalassemia = caused by gene mutations (not deletions
46
what about in the beta thallesemia which chromosome is affected
11- and there are only 2 genes
47
what is the hereditary patter for transfer of haemohpilia
X-linked recessive
48
when the concentration of HCO3- and co2 is equal- what is the Ph
6.1
49
Angiotensinogen in produced by
Liver------upregulated by estrogen--- chopped to angiotensin 1 by renin- then ACE - enzyme produced by lungs convert it to Angiotensin 2
50
Three function of Angiotensin 2
* Vasoconstriction (↑BP)
* Aldosterone release (↑Na+/H2O reabsorption)
* Thirst & ADH (↑fluid retention)
51
half life of angiotensin 2
90Seconds
52
minute volume is
tidal volume x RR
53
WHAT HAPPENs to P02 and PC01 in pregnancy
There is no change to arterial PO2 however there is decrease in PC2 thats why there is a complimentary HCO3 reductions
54
what two factors causes haemodilution in pregnancy
Increase in the plasma volume by 40-50% and increase in the red cell mass
55
What happens to the platelet count at term
falls at term
56
protein S concentration---- in pregancy
Decreases
57
Immidetaly affer delivery what happens to the cardiac output
Increases by 10-20% AS THE BLOOD FROM THE UTERUSCOMES BACK IN CIRCULATION
58
In a preganct patient the apex beat is at
4ht Intercoastal space. the axis is left by 15%to
59
total protein concentration----
Increases however the albumin reduces by 20%
60
At 24 weeks getsation the GFR
rises to 50% -Peaks from 16 to 24 weeks then decreaes
renal blood flow increases by 75%
Creatining reduces by 25%
61
change in colloid osmotic pressure at 24 weeks
reduces by 10%
62
total body water increases by
6-8 L
63
when does the cardiac output return to pre labour value
1 Hrs post partum
Basal bp increases during labour and increases with each contraction
64
maternal requirement increases
by 6-10 gm per day
65
serum fructosamine concentration in pregnancy
falls in second and third trimester
66
fetal umblical venous pressure ---- with increasing gestation age
increases
67
when is the foetal heart rate recognised in transvaginal scan
28 days from conception. it increases from 90 beats/min to 145 beats/min at 7 weeks conception
68
umblical arstery ph ----- with increasing gestational age
decreases
69
bregma or anterior fontanelle is clinically palpable till the age of
18 months
70
suboccipito bregmatic diameter is
9.5cm- shrotest in the fully flexed head
Incomplete flexion bole to isuboccipito frontal- 10+cm
71
what is brow presentation
mento vertical - 13.5 CM
72
in an OP baby what is he diameter
11.5 as the head is deflexed
73
if the PT time is increased what is affected
extrinsic and common pathway--- by warfrin
PTT is intinsic and common pathway is affected- by Heparin
74
What are the clotting factors involved in the intrinsic pathway
TENET
75
ESR is the rate of fall of red cells in a colum in
blood. raised in tissue injury
76
what happens to the bdy after protein rich food
insulin increases and glucagon increases
77
which circulatory cells in capable of differetiation to plasma cells
b lymphocytes
78
bleeding time increased meaning
platelet dysfuction
79
surfactant is produced by
Lamellar bodies of the type 2 pneumocytes
80
T score of -2.2
Osteopaenia
0- -1---NORMAL
-1TO -2.5--- Osteopaenia
-2.5 or less- Osteoporosis
81
platetes are removed from the the circulation via
Spleenic microphages
Half life is 8-9 days
Count falls during preganancy
contains actin and myosin fibrils
2-4 Microns in size
82
blood is stored at a temperature of
2-6 degrees
83
beta thallesemia minor is
HBA2 and Hb F`
84
peptides cross the placenta by
active transport
85
complication of blood transfusion, which is caused by leucocytes antibody
Non haemolytic fibrile reaction
86
The main enzyme responsible for ammonia (NH₃) production in the renal tubules is:
Glutaminase
87
type of bile acids?
Cholic and chenodeoxycholic acid
88
what buffers co2 In blood
Carbonic anhydrase
89
plasma contains
Albumin, globuli and fibrinogens
90
what are the main cellular origin of clotting factor 8
Vascular
91
what is the volume for total blood volume that rises in normal pregnancy
25ml/kg
92
Platelet aggregration is inhibited by
prostacyclin
cyclo-oxygenase- like aspirin
93
what is the urine output
0.5ml/kg/hr
94
which area of the kidney is magnesium secreated
distal tubule
95
which neurotransmitter is adrenal medulla
Acetycholine
96
cardiac output after delivery
60-80%
97
what sided deviation is common in pregnant ladies
left axis deviation and systolic murmur s are also common
98
iodine accumulation can in thyroid is supported by
sodium
99
renin concentration concentration in pregnancy
increases in first half of the pregnancy
Renin is also produced by ovary, decidua, adn chorion
100
histamine and serotonin are released by
basophils
101
what is the total blood volume of new born
85 ml/kg
102
hypotension post spinal
Pre-ganglionic autonomic block
103
the daily production of H+ion from co2 is primarily buffered by
red blood cell Hb
104
opening of the chloride channel leads to
hyperpolarisation of the memrbane
105
In a nerve the magnitude of action potential overshoot is normally a function of
na permeability
106
brunner's gland is situated in
Duodenal submucosa
107
magnesium excreation
Is excreated unchanged in the kidney
108
renal correction of hyperkalemia will result in
metabolic acidosis
109
what is the bnest index of afterload
peripheral resistance
110
Which segment of the nephron is primarily responsible for establishing the medullary concentration gradient?
thick ascending loop of henle as it is responsible for the majority of resorption of k, na and cl
111
Which of the following hormones acts through a nuclear receptor to exert its effect?
thyroxine
112
What is the major stimulus for aldosterone secretion?
angiotensin 2
hyperkalemia
113
what is the normal concentration of sperm per ejacul;ation
15million/ ml(15,000,000)
114
which ion is responsible for the cardiac ventricular repolarisation
Na - through voltage gated sodium channel
Repolarizatoin is on k+ permeabilibuty and the resting membrane potention is also responsible for the same
Calcium influx is responsible for the plateu phase in repolarisation
115
three roles of glucocorticoid in carbohydrate metabolism
increases live gluconeogenesis
Decreases glucose consumption and increases insulin insensitivity
116
By how much does pulmonary capillary wedge pressure decrease during pregnancy?
10%
117
which hormone affects glucogenolysis
glucagon
118
Which part of the nephron is primarily responsible for generating the hyperosmotic renal medulla?
hyperosmotic medullary gradient
Ascending loop of henle
119
isovolumetric ventricular contaction in the cardiac cycle is described when
all the valves are closed adn the ventricles are preparing for the contraction
120
What occur during exercise to maintain mean arterial pressure?
increased sympathetic discharge
elevating heart rate, contractility, and causing vasoconstriction in non-essential vascular beds.
121
excessive iv dextrose can cause
hyponatremia
122
Which brain structure regulates circadian rhythm via melatonin secretion?
pineal gland -
123
what increases the venous return to the heart
INCREASED INSPIRATION- REDUCES thoracic pressure
124
major determinant of systemic vascular resistance?
arteriolar radius
125
which part of the nephron is impermeable to water
ascending loop of henle
126
Which of the following mechanisms is responsible for glucose reabsorption in the proximal tubule?
secondary active transport via SLT2
127
Which hormone increases intestinal calcium absorption?
calcitriol- Vitamin d
128
Which of the following is the most accurate indicator of alveolar ventilation?
PaCO₂
129
Which ion is primarily responsible for initiating the depolarization phase of the pacemaker action potential in the sinoatrial (SA) node?
Calcium
Unlike the ventriculr myocyte- SA Node lacks voltage gated sodium channel.
Phase 0 depolarization is driven by inward Ca²⁺ current (L-type channels)
Followed by Phase 3 repolarization via K⁺ efflux
Phase 4 (pacemaker potential) is due to slow Na⁺ influx (funny current, Iₓf) and gradual Ca²⁺ entry
130
Which part of the gastrointestinal tract has the highest rate of basal electrical slow waves?
duodenum
131
how aldosterone increases sodium reabsorption in the distal nephron?
ENAC channel stimulation
132
which cell produces EPO
peritubular interstitial cells in the cortex
In the fetus, EPO is mainly produced in the liver
133
The symporter involved in iodide uptake in the thyroid gland is coupled with which ion?
Sodium iodide symporter
134
what percentage does the glomerular-filtration rate (GFR) rise above the non-pregnant baseline?
50-60%
135
How many carbon atoms are present in testosterone?
19
136
Where are prostaglandins primarily destroyed in the body?
lungs
137
what percentage of Pituitary is composed of lactotrophs?
10-15%
138
Surfactant synthesis in pneumocytes is primarily associated with which organelle?
lamellar bodies
139
What is the primary form of haemoglobin in a 18 week old foetus?
hbf
Prior to 12 weeks Embryonic Haemoglobin (mainly Hb Gower 1) is the primary form
