28 May 2015.
1
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How to prepare
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2
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SBA. RCOG sample obstetric.
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3
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SBA.
RCOG sample gynaecological
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4
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Basic communication skills.
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5
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SBA. Placenta accrete, increta &
percreta
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6
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EMQ. MBRRACE.
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2 & 3 - the RCOG's sample questions can be downloaded from the website.
go to the tab "courses, exams and events" then select "about the part 2
exam".
exam".
5. Placenta “creta”: accreta increta & percreta
This topic has been chosen to remind you of
the existence of UKOSS and the various Reports it has produced as they would
make perfect EMQs or SBAs.
Abbreviations.
Creta: term
to describe accreta, increta or percreta.
PET: pre-eclampsia
PIH: pregnancy-induced
hypertension
Question
1.
Lead-in
Choose the best option from the option list
for the definition of placenta accreta.
Option
List
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Placenta which is difficult to remove, but can be separated digitally
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Placental villi invade the
decidua, but not the myometrium
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Placental villi invade the
decidua and myometrium but not the serosa
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Placental villi invade the
decidua, myometrium and serosa
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Placental villi invade
adjacent organs, e.g. the bladder
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Question
2.
Lead-in
Choose the best option from the option list
for the definition of placenta increta.
Option
List
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Placenta is difficult to remove, but can be separated digitally
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Placental villi invade the
decidua, but not the myometrium
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Placental villi invade the decidua
and myometrium but not the serosa
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Placental villi invade the
decidua, myometrium and serosa
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Placental villi invade
adjacent organs, e.g. the bladder
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Question
3.
Lead-in
Choose the best option from the option list
for the definition of placenta percreta.
Option
List
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Placenta is difficult to remove, but can be separated digitally
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Placental villi invade the
decidua, but not the myometrium
|
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Placental villi invade the decidua
and myometrium but not the serosa
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Placental villi invade the
decidua, myometrium and serosa
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Placental villi invade
adjacent organs, e.g. the bladder
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Question
4.
Lead-in
What is the approximate incidence of placenta
creta in the UK?
Option
List
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1-2 per 1,000 deliveries
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1-2 per 1,000 maternities
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1-2 per 5,000 deliveries
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1-2 per 5,000 maternities
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1-2 per 10,000 deliveries
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1-2 per 10,000 maternities
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Question
5.
You need to be able to define “maternity” and
know why it is important.
Lead-in
What is a “maternity”?
Option
List
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Any pregnancy, including ectopic pregnancy
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Any pregnancy, excluding ectopic pregnancy
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Any pregnancy resulting in a live birth
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Any pregnancy resulting in live birth or stillbirth
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Any pregnancy ending from 24 completed weeks plus any pregnancy
resulting in a live birth.
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Question
6.
Lead-in
Why is the term “maternity” important.
Option
List
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We should take best possible care of our pregnant patients
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It is used as the denominator in calculations of the maternal
mortality rate
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It is used as the numerator in calculations of the maternal mortality
rate
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It is used as the denominator in calculations of the maternal
mortality ratio
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It is used as the numerator in calculations of the maternal mortality
ratio
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Question
7.
This question relates to risk factors for
placenta accreta
Lead-in
Match each of the risk factors listed below with an adjusted odds ratio from
the Option List. Each option can be used once, more than once or not at all.
Note that some of the adjusted odds ratios
show a reduced risk.
Risk factors and adjusted odds ratio.
Risk factor
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Adjusted odds ratio
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BMI > 30
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Cigarette smoking in pregnancy
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Ethnic group non-white
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IVF pregnancy
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Maternal age > 35
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Parity ≥ 2
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PIH or PET
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Placenta previa diagnosed pre-delivery
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Previous Caesarean section > 1
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Previous Caesarean section x 1
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Previous uterine surgery – not C. section
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Option
List
Adjusted odds ratio
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0.53
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0.57
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0.66
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0.9
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1.0
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2.0
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3.06
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3.4
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3.48
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10
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14
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16.31
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32.13
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65.02
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102
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Question
8.
Lead-in
This question relates to estimated incidence
of placenta creta for various risk factors.
Match the risk factors with the estimated
incidence in the option list. Each option can be used once, more than once or
not at all.
Risk factors and estimated incidence per
10,000 maternities.
Risk factor
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Estimated incidence
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No previous C section
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≥ 1 C section
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Placenta previa not diagnosed pre-delivery
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Placenta previa diagnosed pre-delivery
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Previous C section but placenta previa not diagnosed pre-delivery
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Previous C section + placenta previa diagnosed pre-delivery
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Option
List
0.3
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0.6
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1
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3
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5
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9
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108
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577
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1,000
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6. EMQ. MBRRACE.
Lead-in.
The following scenarios relate to MBRRACE.
Pick one option from the option list.
Each option can be used once, more than once or not at
all.
Abbreviations.
CMACE: Centre
for Maternal and Child Enquiries (now deceased).
MMR: Maternal
mortality rate.
Option list.
Scenario
1.
What is the
meaning of the acronym MBRRACE-UK”?
Scenario
2.
Which organisation
does it replace?
Scenario
3.
How does it differ
structurally from its predecessor?
Scenario
4.
How will its
reports differ from those of its predecessor?
Scenario
5.
When was its first
Report published?
Scenario
6.
What geographical
innovation was included in its first Report?
Scenario
7.
What was the
latest MMR reported in its first Report?
Scenario
8.
How did this
compare with the final MMR reported by CMACE?
Scenario
9.
Which topics were
reviewed in detail in the first Report?
Scenario
10. What was the leading direct cause of death in the first
Report?
Scenario
11. What was the leading indirect cause of death in the first
Report?
Scenario
12. What is the definition of a maternal death?
Scenario
13. What is the definition of a direct maternal death?
Scenario
14. What is the definition on indirect maternal death?
Scenario
15. What observation was made in the first Report about deaths
due to hypertensive diseases.
Scenario
16. Which condition was linked to 1 in 11 maternal deaths?
Scenario
17. What were the 5 top causes of direct maternal death in the
years 2009 – 2011?
Scenario
18. What key messages were singled out in the first Report?
