Thursday, 15 December 2016

Tutorial 15th. December 2016

Contact us.
Don’t answer the Abortion Act question. The answer became very long so I thought I would be clever and make some of the option lists do for more than one question. But I was not as clever as I thought and ended up with some questions and answers that did not relate to each other. I’ll sort this out and put the topic on for the next tutorial.
 15 December 2016.

41
SBA. Appendicitis & pregnancy
42
EMQ. Abortion Act
43
EMQ. Anatomy of fetal skull and maternal pelvis
44
EMQ. Drugs in O&G 1
45
EMQ. Clue cells, koilocytes etc.

41.         Appendicitis in pregnancy
Abbreviations.
AIP
Appendicitis in pregnancy
CRP
C reactive protein
CT
computed tomography, also known as computerised tomography
RLQP
right lower quadrant pain
RUQP
right upper quadrant pain
Question 1
Lead-in
What is the approximate incidence of appendicitis in pregnancy?
Option List
A.       
1 in 500
B.       
1 in 1,000
C.       
1 in 2,000
D.       
1 in 5,000
E.        
1 in 10,000
Question 2
Lead-in
When is appendicitis in pregnancy most common?
Option List
A.       
first trimester
B.       
second trimester
C.       
trimester
D.       
1st. and 2nd. stages of labour
E.        
in the hours after the 3rd. stage of labour
F.        
during the puerperium
Question 3
Lead-in
What eponymous title is given to the surface marker for the appendix?
Option List
A.       
McBarney’s point
B.       
MacBurney’s point
C.       
McBurney’s point
D.       
MacBorney’s point
E.        
McBorney’s point
Question 4
Lead-in
Where is the point referred to in the above question?
Option List
A.       
1/3 of the way along the line joining the anterior superior iliac spine and umbilicus
B.       
1/2 of the way along the line joining the anterior superior iliac spine and umbilicus
C.       
2/3 of the way along the line joining the anterior superior iliac spine and umbilicus
D.       
1/3 of the way along the line joining the left and right anterior superior iliac spines
E.        
1/2 of the way along the line joining the left and right anterior superior iliac spines
Question 5
Lead-in
Which, if any, of the following statements are true about the person after whom the point in the above questions is named?
Statements
A.       
he spent 2 years as a postgraduate working in Berlin, London, Paris and Vienna
B.       
he was Professor of surgery at the Roosevelt hospital, New York from 1889 to 1894
C.       
he presented his classical paper on appendicitis to the NY Surgical Society in 1889
D.       
he was a transvestite
E.        
he died of a heart attack while on a hunting trip
Question 6
Lead-in.
Pick the best option from the list below in relation to right lower quadrant pain in AIP in the pregnant and non-pregnant.
Option List
A
comparative figures for the pregnant and non-pregnant are unknown due to the rarity of appendicitis in pregnancy
B
RLQP is as common in the pregnant as in the non-pregnant
C
RLQP is less common in the pregnant
D
RLQP is more common in the pregnant
E
RLQP is rare in pregnancy
Question 7
Lead-in.
Pick the best option from the list below in relation to right upper quadrant pain in AIP in the pregnant and non-pregnant.
Option List
A
comparative figures for the pregnant and non-pregnant are unknown due to the rarity of appendicitis in pregnancy
B
RUQP is ½ as common in the pregnant as in the non-pregnant
C
RUQP is as common in the pregnant as in the non-pregnant
D
RUQP is twice as common in the pregnant as in the non-pregnant
E
RUQP is four times as common in the pregnant as in the non-pregnant
Question 8
Lead-in.
Pick the best option from the list below in relation to nausea in AIP in the pregnant and non-pregnant.
Option List
A
comparative figures for the pregnant and non-pregnant are unknown due to the rarity of appendicitis in pregnancy
B
nausea is as common in the pregnant as in the non-pregnant
C
nausea is less common in the pregnant
D
nausea is more common in the pregnant
E
nausea is rare in pregnancy
Question 9
Lead-in.
Which condition did CMACE say should be excluded in women presenting acutely with gastrointestinal symptoms?
Option List
A
aortic dissection
B
appendicitis
C
Caesarean section scar pregnancy
D
ectopic pregnancy
E
pancreatitis
F
ovarian torsion
Question 10
Lead-in.
Pick the best option from the list below in relation to abdominal guarding in AIP in the pregnant and non-pregnant.
Option List
A
comparative figures for the pregnant and non-pregnant are unknown due to the rarity of appendicitis in pregnancy
B
abdominal guarding is as common in the pregnant as in the non-pregnant
C
abdominal guarding is less common in the pregnant
D
abdominal guarding is more common in the pregnant
E
abdominal guarding is rare in pregnancy
Question 11
Lead-in.
Pick the best option from the list below in relation to rebound tenderness in AIP in the pregnant and non-pregnant.
Option List
A
comparative figures for the pregnant and non-pregnant are unknown due to the rarity of appendicitis in pregnancy
B
rebound tenderness is as common in the pregnant as in the non-pregnant
C
rebound tenderness is less common in the pregnant
D
rebound tenderness is more common in the pregnant
E
rebound tenderness is rare in pregnancy
Question 12
Lead-in.
Pick the best option from the list below in relation to fever in AIP in the pregnant and non-pregnant.
Option List
A
comparative figures for the pregnant and non-pregnant are unknown due to the rarity of appendicitis in pregnancy
B
fever is as common in the pregnant as in the non-pregnant
C
fever is less common in the pregnant
D
fever is more common in the pregnant
E
fever is rare in pregnancy
Question 13
Lead-in
How useful is the finding of leucocytosis in making the diagnosis of AIP?
Option List
A.       
sine qua non
B.       
very useful
C.       
not very useful
D.       
I don’t know
Question 14
How useful is the finding of a raised CRP level in the diagnosis of AIP?
Option List
A.       
sine qua non
B.       
very useful
C.       
not very useful
D.       
I don’t know
Question 15
Lead-in
What are the ultrasound features of appendicitis?
Option List
A
appendix with diameter > 0.6 mm.
B
appendix with diameter > 1 cm.
C
blind-ending tubular structure
D
non-compressible tubular structure
E
none of the above
Question 16
Lead-in
What figures do W&M give for sensitivity & specificity for US diagnosis of appendicitis?
Option List

Sensitivity
Specificity
A
≥65%
≥80%
B
≥75%
≥85%
C
≥86%
≥97%
D
≥91%
≥98%
E
≥95%
≥95%
Question 17
Lead-in
Which, if any, of the following statements are true about CT scanning for the diagnosis of AIP?
Option List
A
CT scanning has sensitivity > 85% and specificity >95%
B
CT scanning exposes mother and fetus to radiation doses of little concern
C
CT scanning has replaced ultrasound scanning for AIP
D
CT scanning is not of proven value after inconclusive ultrasound scanning
E
CT scanning is of proven value and most useful  after inconclusive ultrasound scanning
Question 18
Lead-in
Which, if any, of the following statements are true about MRI scanning for the diagnosis of AIP?
Option List
A
MRI scanning has sensitivity > 90% and specificity >97%
B
MRI scanning exposes mother and fetus to radiation doses of little concern
C
MRI scanning has replaced ultrasound scanning for AIP
D
MRI scanning is not of proven value after inconclusive ultrasound scanning
E
MRI scanning is of proven value and most useful  after inconclusive ultrasound scanning
Question 19
Lead-in
Which, if any, of the following statements are true about the complications of AIP?
Option List
A
fetal loss rate in uncomplicated AIP is about 1.5%
B
fetal loss rate in AIP complicated by peritonitis is about 6%
C
fetal loss rate in AIP complicated by perforation of the appendix is up to 36%
D
pre-term delivery rates increase in AIP complicated by perforation of the appendix
E
a low level of suspicion should apply to the diagnosis of AIP in relation to surgical intervention
Question 20
Lead-in
Which, if any, of the following statements are true about surgery for AIP?
Option List
A
laparotomy should be done through a grid-iron incision with the mid-point the surface marker for the appendix in the right iliac fossa
B
laparotomy should be done through a right paramedian incision starting at the level of the umbilicus
C
about 35% of laparotomies show no evidence of appendicitis
D
the appendix should be removed even if it looks normal
E
antibiotic therapy is an alternative to surgery in early cases of AIP
Question 21
Lead-in
Which, if any, of the following statements are true about surgery for AIP?
Option List
A
laparotomy should be done through a grid-iron incision with the mid-point the surface marker for the appendix in the right iliac fossa
B
laparotomy should be done through a right paramedian incision starting at the level of the umbilicus
C
about 35% of laparotomies show no evidence of appendicitis
D
the appendix should be removed even if it looks normal
E
antibiotic therapy is an alternative to surgery in early cases of acute AIP
Question 22
Lead-in
Which, if any, of the following statements are true about surgery for AIP?
Option List
A
laparoscopic appendicectomy is an acceptable alternative to laparotomy, but only in the 1st. trimester
B
laparoscopic appendicectomy is an acceptable alternative to laparotomy, but only in the 1st. & 2nd. trimesters
C
laparoscopic appendicectomy is an acceptable alternative to laparotomy, at all gestations
D
there is evidence that laparoscopic appendicectomy is associated with doubling of the rate of fetal loss

42.         EMQ. Abortion Act.
Lead-in.
TOP and the Abortion Act are likely to feature in every written exam.
The following scenarios relate to the Abortion Act.
Scenario 1
Lead in.
What was the approximate rate of abortion in the UK in 2014?
Option list
A
1 per 1,000 resident women aged 15-44
B
10 per 1,000 resident women aged 15-44
C
15 per 1,000 resident women aged 15-44
D
20 per 1,000 resident women aged 15-44
E
50 per 1,000 resident women aged 15-44
F
100 per 1,000 resident women aged 15-44
Scenario 2
Lead in.
The rate of abortion has declined by > 20% in the UK in the past ten years.
Pick the answer from the option list that best matches the above statement.
Option list
A
False
B
Haven’t a clue
C
Maybe
D
No data exist
E
True
Scenario 3
Lead in.
What proportion of TOPs were performed at gestations < 10 weeks in 2014?
Option list
A
50%
B
60%
C
70%
D
80%
E
90%
Scenario 4
Lead in.
There has been a significant improvement in the proportion of TOPs performed early in the past decade.
Option list
A
False
B
Haven’t a clue
C
Maybe
D
No data exist
E
True
Scenario 5
Lead in.
What proportion of TOPs were performed using medical, not surgical techniques?
Option list
A
20%
B
30%
C
40%
D
50%
E
60%
F
70%
G
80%
Scenario 6
Lead in.
Which age had the highest rate of TOP?
Option list
A
18
B
19
C
20
D
21
E
22
F
23
G
24
H
25
Option list for scenarios 7 – 9.
Option list
A
the rate was much lower
B
the rate was slightly lower
C
the rate was much higher
D
the rate was slightly higher
E
the rate was unchanged
Scenario 7
Lead in.
What happened to the rate of TOP in 2014 for girls < 18 years compared with 2013?
Scenario 8
Lead in.
What happened to the rate of TOP in 2014 for girls < 16 years compared with 2013?
Scenario 9
Lead in.
What happened to the rate of TOP in 2014 for girls < 16 years compared with 2004?
Scenario 10
Lead in
Approximately what proportion of women having TOP in 2014 had previously had one or more TOPs?
Option list
A
1%
B
5%
C
10%
D
20%
E
30%
F
40%
G
50%
Scenario 11
Lead in
There were 190,092 TOPs in 2014. How many deaths occurred?
Option list
A
0
B
10
C
22
D
40
E
56
Scenario 12
Lead in
There were 190,092 TOPs in 2014. What was the rate of significant complications?
Option list
A
<1%
B
1%
C
3%
D
5%
E
10%
Option list for scenarios 13-17.
1
the pregnancy has not exceeded its 24th. week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman
2
the pregnancy has not exceeded its 24th. week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of any existing children of the family of the pregnant woman
3
the continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated
4
the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman
5
there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped
Scenario 13
Lead in.
The Abortion Act gives a number of legal grounds for TOP. Which of the following is listed as “A”.
Scenario 14
Lead in.
The Abortion Act gives a number of legal grounds for TOP. Which of the following is listed as “B”.
Scenario 15
Lead in.
The Abortion Act gives a number of legal grounds for TOP. Which of the following is listed as “C”.
Scenario 16
Lead in.
The Abortion Act gives a number of legal grounds for TOP. Which of the following is listed as “D”.
Scenario 17
Lead in.
The Abortion Act gives a number of legal grounds for TOP. Which of the following is listed as “E”.
Scenario 18
Lead in.
With regard to the he Abortion Act and grounds “F” and “G”. Which of the following statements are true?
1
“F” & “G” are grounds for TOP in an emergency with only one doctor needing to sign the legal form necessary for the TOP to take place
2
 “F” & “G” are grounds for TOP after 24 weeks.
3
“F” relates to TOP to save the woman’s life
4
“F” relates to TOP to prevent grave permanent injury her physical or mental health
5
“F” & “G” do not exist.
Option list
A
1  + 3
B
1  + 4
C
2 + 3
D
2 + 4
E
5
Scenario 19
Lead in
In relation to terms such as “substantial risk”, “grave permanent injury” and “seriously handicapped”, which of the following is true?
Option list
A
The terms were defined by a Parliamentary sub-committee, examples were given and are included in Appendix 2 (b) to the Act.
B
The terms were defined by a Parliamentary sub-committee, examples were given and are included in Appendix 2 (c) to the Act.
C
The terms were defined by the General Medical Council, examples were given and the information can be downloaded from the GMC website.
D
The terms were defined by the RCOG, examples were given and the information can be downloaded from the RCOG website.
E
The terms have not been defined.
Scenario 20
Lead in
Which of the following statement is true about the most common grounds for TOP?
Option list
1
TOP is most commonly done on ground A from the Abortion Act.
2
TOP is most commonly done on ground B from the Abortion Act.
3
TOP is most commonly done on ground C from the Abortion Act.
4
TOP is most commonly done on ground D from the Abortion Act.
5
TOP is most commonly done on ground E from the Abortion Act.
6
TOP is most commonly done on ground F from the Abortion Act.
7
TOP is most commonly done on ground G from the Abortion Act.
8
TOP is most commonly done on ground H from the Abortion Act.
Scenario 21
Lead in
Which of the following statements is true in relation to the upper gestational limit for TOP to be legal in the UK.
1
Termination of pregnancy is legal to 24 weeks
2
Termination of pregnancy is legal after 24 weeks if the mother’s life is at serious risk or there is a major risk of the fetus having a serious anomaly.
3
Termination of pregnancy is legal after 24 weeks if the mother’s life is at serious risk or there is a major risk of the fetus having a serious anomaly, but only if approved by the Department of Health’s “Late Termination of Pregnancy Assessment Panel”.
4
Termination of pregnancy is illegal after 24 weeks, but is still done if the mother’s life is at serious risk or there is a major risk of the fetus having a serious anomaly and there is a long-standing agreement that the police and legal authorities will “turn a blind eye”.
Scenario 22
Lead in
Which of the following statement are true in relation to TOP after 24 weeks?
Statements
1
TOP is illegal after 24 weeks
2
The mother must agree to feticide pre-TOP
3
Feticide must be offered
4
There must be very serious grounds for the TOP
5
Gender-selection TOP is unacceptable
Option list
A
1
B
1 + 2
C
2 + 3 + 5
D
3 + 4
E
3 + 4 + 5
Scenario 23
Lead in
Which form relates to certifying that a woman requesting a TOP can have it done legally?
Option list
A
HSA1
B
HSA2
C
HSA3
D
HSA4
E
HSA5
Scenario 24
Lead in
Which form must the practitioner performing the TOP complete to notify the TOP and return to Department of Health?
Option list
A
HSA1
B
HSA2
C
HSA3
D
HSA4
E
HSA5
Option list for scenarios 25 & 26.
A
True
B
False
C
Sometimes
D
Don’t know & don’t care
Scenario 25
Lead in
A doctor signing the form giving the grounds for a TOP must have seen the woman.
Scenario 26
Lead in
A doctor performing a TOP must be one of the doctors who signed the initial form giving the grounds for the TOP.
Scenario 27
Lead in
What is the time scale for the return of the form notifying that a TOP has taken place?
Option list
A
3 working days
B
5 working days
C
1 week
D
2 weeks
E
1 month
Scenario 28
Lead in.
A woman seeks 1st. trimester TOP on social grounds which she declines to discuss in detail.
Which of the following statements apply?
Option List
A
TOP can be done under clause A
B
TOP can be done under clause B
C
TOP can be done under clause C
D
TOP can be done under clause D
E
TOP can be done under clause E
F
TOP can be done under clause F
G
TOP can be done under clause G
F
there is no clause authorising TOP on social grounds
Scenario 28
A woman seeks 1st. trimester TOP. She has pulmonary hypertension and has been advised of the risks of pregnancy by her cardiologist.
Which of the following statements apply?
A
TOP can be done under clause A
B
TOP can be done under clause B
C
TOP can be done under clause C
D
TOP can be done under clause D
E
TOP can be done under clause E
F
TOP can be done under clause F
G
TOP can be done under clause G
F
there is no clause authorising TOP on these grounds
Scenario 29
A woman books at 26 weeks. She has an unplanned pregnancy and has been advised of the risks of pregnancy by her cardiologist.
Which of the following statements apply?
A
TOP should be offered under clause A
B
TOP should be offered under clause B
C
TOP should be offered under clause C
D
TOP should be offered under clause D
E
TOP should be offered under clause E
F
TOP should be offered under clause F
G
TOP should be offered under clause G
F
there is no clause authorising TOP on these grounds

43.         Anatomy of fetal skull and maternal pelvis.
Scenario 1.                
How many bones make up the vault of the skull?
Option list.
A.       
3
B.       
5
C.       
6
D.       
7
E.        
8
Scenario 2.                
What is the origin of the word “bregma”?
Option list.
A.       
the Greek word meaning “arrow”
B.       
the Greek word meaning “front of the head”
C.       
the Greek word meaning “top of the head”
D.       
the Greek word meaning “where lines intersect”
E.        
none of the above
Scenario 3.                
What is the origin of the word “lambdoid”?
Option list.
A.       
it is derived from “lambda”, the 11th. letter of the Greek alphabet, with the symbol “λ”
B.       
it is derived from the shape of the rear end of a newborn lamb, with legs apart for balance in the shape of an inverted “V”
C.       
it derives from the Norse noun “lam” meaning to hit
Scenario 4.                
What is the origin of the word “sagittal”?
Option list.
A.       
it derives from the Latin verb “sagire” meaning to be wise
B.       
it derives from the Latin noun “sagitta” meaning “arrow”
C.       
it derives from the Latin adjective “sagitta” meaning “pointing north”
D.       
it derives from the Latin adjective “sagitta” meaning “lacking tension”
Scenario 5.                
What is the meaning of the word “coronal”.
Option list.
A.       
it is the 11th. letter of the Greek alphabet
B.       
it derives from the Latin “corona” meaning “crown”.
C.       
it derives from the sun’s corona, meaning equator
Scenario 6.                
What is the definition of “vertex”?
Option list.
A.       
the most prominent part of the occiput
B.       
the area around the posterior fontanelle
C.       
the area bounded by the anterior fontanelle and the posterior fontanelle
D.       
the area bounded by the anterior & posterior fontanelles and the parietal bones
E.        
the area bounded by the anterior & posterior fontanelles and the parietal eminences
F.        
the area bounded by the anterior & posterior fontanelles and the parietal cardinals
Option list for questions 7 & 8.
Option list.
A.       
the anterior end of the sagittal suture
B.       
the area where the sagittal and lambda sutures meet
C.       
the area between the frontal and parietal bones
D.       
the posterior end of the sagittal suture
E.        
the area between the parietal bones and the occiput
Scenario 7.                
What is the definition of the anterior fontanelle?
Scenario 8.                
What is the definition of the posterior fontanelle?
Scenario 9.                
How many other fontanelles are there?
A.       
0
B.       
2
C.       
3
D.       
4
E.        
6
Scenario 10.            
What is the falx cerebri?
Option list.
A.       
an area of dura mater at the back of the skull like a roof over the cerebellum
B.       
is an artefact on ultrasound suggesting the presence of cerebral tissue where there is none
C.       
is the horizontal fibrous platform on which the cerebellum rests
D.       
is a crescent-shaped fold of dura mater separating the cerebral hemispheres
Scenario 11.            
What is the importance of the falx cerebri in relation to delivery, particularly breech delivery?
Option list.
A.       
the falx cerebri is inserted into the tentorium cerebelli and traction on the base of the skull may lead to tentorial tears and intracranial bleeding
B.       
the falx cerebri is inserted into the bone of base of the skull and traction on the base of the skull may lead to tears of the falx and intracranial bleeding
C.       
the falx cerebri is inserted into the tentorium cerebelli and traction on the base of the skull may lead to tentorial tears leaving the cerebellum unsupported and liable to trauma
Option list for Scenarios 12 - 16
Option list.
A.       
suboccipito-bregmatic
B.       
suboccipito-frontal
C.       
occipito-frontal
D.       
mento-vertical
E.        
submento-bregmatic
Scenario 12.            
What diameter presents to the pelvis with vertex presentation?
Scenario 13.            
What diameter presents to the pelvis with typical occipito-posterior position?
Scenario 14.            
What diameter presents to the pelvis with brow presentation?
Scenario 15.            
What diameter presents to the pelvis with mento-anterior face presentation?
Scenario 16.            
What diameter presents to the pelvis with mento-posterior face presentation?
Option list for Scenarios 17- 21
Option list.
A.       
  9.0 cm.
B.       
  9.5 cm.
C.       
10.0 cm.
D.       
10.5 cm.
E.        
11.0 cm.
F.        
11.5 cm.
G.       
12.0 cm.
H.       
12.5 cm.
I.         
13.0 cm.
J.         
13.5 cm.
K.        
14.0 cm.
Scenario 17.            
What is the average length of the suboccipito-bregmatic diameter in a term baby?
Scenario 18.            
What is the average length of the suboccipito-frontal diameter in a term baby?
Scenario 19.            
What is the average length of the occipito-frontal diameter in a term baby?
Scenario 20.            
What is the average length of the mento-vertical diameter in a term baby?
Scenario 21.            
What is the average length of the submento-bregmatic diameter in a term baby?

44.         Drugs in O&G 1.
Lead-in.
The following scenarios relate to drugs & hypertension in pregnancy.
Abbreviations.
ACE:              angiotensin-converting enzyme
ARA:             angiotensin II receptor antagonist
Option list.
a)         False.
b)        True.
c)         5
d)        10
e)         15
f)          18
g)         20
h)        24
i)           contraindicated in the months before pregnancy
j)           contraindicated in the 1st. trimester
k)         contraindicated in the 2nd. trimester
l)           contraindicated in the 3rd. trimester
m)      contraindicated in all trimesters
n)        not contraindicated in pregnancy
o)        contraindicated in breastfeeding
p)        not contraindicated in breastfeeding
q)        an acute, severe illness like rheumatoid arthritis
r)          an acute, severe illness with encephalopathy and acute fatty liver
s)         an acute, severe illness with gastro-intestinal tract bleeding
t)      there is insufficient information to be able to provide advice

Scenario 1.
When are ACE inhibitors contraindicated in pregnancy?
Scenario 2.
When are ARAs contraindicated in pregnancy?
Scenario 3.
Can St. John’s Wort (SJW) be used in pregnancy?
Scenario 4.
Methyldopa is an acceptable option for the treatment of gestational hypertension. True / False.
Scenario 5.
Spironolactone is contraindicated in pregnancy. True/False
Scenario 6.
Furosemide is an acceptable option in the management of gestational hypertension. True / False.
Scenario 7.
When are thiazide diuretics contraindicated in pregnancy?
Scenario 8.
Salbutamol is contraindicated for the management of premature labour. True / False.
Scenario 9.
Ergometrine is an integral part of active management of the 3rd. stage.  True / False.
Scenario 10.
When is aspirin contraindicated in pregnancy & the puerperium?
Scenario 11.
When are NSAID’s contraindicated in pregnancy and why?
Scenario 12.
Pethidine: adverse neonatal effects are most likely if the drug is administered in the six hours before birth.  True / False.
Scenario 13.
Pethidine: what is the half-life in the mature neonate?
Scenario 14.
Pethidine is contraindicated in those taking MOAIs or who have taken them in the previous 2 months. 
Scenario 15.
Pethidine is relatively contra-indicated when there is significant blood loss.  True / False.
Scenario 16.
Pethidine has greater analgesic effect in labour than Diamorphine.                  True / False.
Scenario 17.
What is Reye’s syndrome and which family of drugs is particularly linked?
Scenario 18.
What is “torsades de pointes” and when is it of importance in the management of HG?

45.         EMQ. Clue cells, koilocytes etc.
Abbreviations.
LGV:                 lymphogranuloma venereum
Option list.
A
Actinomyces
B
Bacterial vaginosis
C
Bacteroides
D
Chlamydia trachomatis
E
Chlamydial infection of the genital tract
F
Herpes Simplex
G
Human Papilloma Virus
H
Lymphogranuloma venereum
I
Monilia
J
Neisseria gonorrhoeae
K
Trichomonas vaginalis
Scenario 22.            
Which option or options from the option list best fit with “clue cells”
Scenario 23.            
Which option or options from the option list best fit with “fishy odour”?
Scenario 24.            
Which option or options from the option list best fit with “flagellate organisms”?
Scenario 25.            
Which option or options from the option list best fit with “inflammatory smear”?
Scenario 26.            
Which option or options from the option list best fit with “koilocytes”?
Scenario 27.            
Which option or options from the option list best fit with “non-specific urethritis in the male”?
Scenario 28.            
Which option or options from the option list best fit with “strawberry cervix”?
Scenario 29.            
Which option or options from the option list best fit with “thin grey/ white discharge”?
Scenario 30.            
Which option or options from the option list best fit with “white, curdy discharge”?
Scenario 31.            
Which option or options from the option list best fit with “frothy yellow discharge”?
Scenario 32.            
Which option or options from the option list best fit with “protozoan”?
Scenario 33.            
Which option or options from the option list best fit with “obligate intracellular organism”?
Scenario 34.            
Which option or options from the option list best fit with “blindness”?
Scenario 35.            
Which option or options from the option list best fit with “LGV”?
Scenario 36.            
Which option or options from the option list best fit with “multinucleated cells”?
Scenario 37.            
Which option or options from the option list best fit with “serotypes D–K”?
Scenario 38.            
Which option or options from the option list best fit with “serovars L1-L3”?
Scenario 39.            
Which of the following are true in relation to Amsel’s criteria?
A
used for the diagnosis of bacterial vaginosis
B
used for the diagnosis of trichomonal infection
C
clue cells present on microscopy of wet preparation of vaginal fluid
D
flagellate organism present on microscopic examination of vaginal fluid
E
pH ≤ 4.5
F
pH > 4.5
G
thin, grey-white, homogeneous discharge present
H
frothy, yellow-green discharge present
I
fishy smell on adding alkali (10%KOH)
J
fishy smell on adding acid (10%HCl)
K
koilocytes present
L
absence of vulvo-vaginal irritation
Scenario 40.            
Which of the following are true in relation to Nugent’s Amsel’s criteria?
A
used for the diagnosis of bacterial vaginosis
B
used for the diagnosis of trichomonal infection
C
clue cells present on microscopy of wet preparation of vaginal fluid
D
pH ≤ 4.5
E
pH > 4.5
F
count of lactobacilli
G
count of Gardnerella and Bacteroides
H
count of white cells
Scenario 41.            
Garnerella vaginallis can be cultured from the vagina of what proportion of normal women?
A
< 10%
B
11 - 20%
C
21 - 30%
D
31 - 40%
E
41 - 50%
F
> 50%





No comments:

Post a comment