Website
36
|
EMQ. Renal transplant
|
37
|
SBA. Endometrial hyperplasia
|
38
|
EMQ. Clue cells, koilocytes etc.
|
39
|
SBA. Coeliac disease & pregnancy
|
40
|
EMQ. Anatomy of fetal skull and
maternal pelvis
|
Abbreviations.
AST: American Society for Transplantation
Question 1
Approximately how many women who have had renal transplant
have pregnancies annually in the UK?
Option list.
A
|
10-20
|
B
|
30-40
|
C
|
50-100
|
D
|
100-200
|
E
|
200-300
|
F
|
300-400
|
G
|
400-500
|
H
|
>500
|
Question 2
Which, if any, of the following statements are true about
the findings of the UKOSS survey of renal transplant in pregnancy?
Option list.
A
|
the incidence
of PET was ~ 25%, roughly six times higher than the general population
|
B
|
the incidence
of PET was ~ 25%, roughly ten times higher than the general population
|
C
|
the incidence
of PET was ~ 50%, roughly ten times higher than the general population
|
D
|
the incidence
of PET was ~ 50%, roughly twenty times higher than the general population
|
E
|
none of the
above
|
Question 3
Various sources, such as AST, give factors linked to
reduced risks associated with pregnancy after RT. A lot of this is common
sense. Write down all the factors that would be in your list.
Question 4
What is the risk of graft rejection in the year after RT?
Option list.
A
|
< 5%
|
B
|
10-15%
|
C
|
15-20%
|
D
|
20-25%
|
E
|
unknown
|
Question 5
Which of the following factors are the 3 main ones
affecting pregnancy outcome?
Factors
1
|
anaemia
|
2
|
diabetes
|
3
|
hypertension
|
4
|
number of
immunosuppressive drugs being used
|
5
|
obesity
|
6
|
pre-pregnancy
graft function
|
7
|
proteinuria
|
8
|
urinary tract
infection
|
Option list.
A
|
1 + 2 + 3
|
B
|
1 + 2 + 6
|
C
|
2 + 3 + 4
|
D
|
2 + 4 + 6
|
E
|
3 + 6 +7
|
F
|
3 + 6 + 8
|
G
|
4 + 5 + 6
|
H
|
4 + 6 + 8
|
Question 6
Which of the following statements is true in relation to
the prevalence of hypertension in women after RT?
Option list.
A
|
> 20% have
hypertension
|
B
|
> 30% have
hypertension
|
C
|
> 40% have
hypertension
|
D
|
> 50 % have
hypertension
|
E
|
none of the
above
|
Question 7
State whether these drugs are regarded as safe or unsafe in
pregnancy.
|
|
Drug
|
Safe / unsafe
|
A
|
ACE inhibitor
|
Safe / unsafe
|
B
|
angiotensin receptor antagonist
|
Safe / unsafe
|
C
|
azathioprine
|
Safe / unsafe
|
D
|
ciclosporin
|
Safe / unsafe
|
E
|
clopidogrel
|
Safe / unsafe
|
F
|
erythropoietin
|
Safe / unsafe
|
G
|
hydroxychloroquine
|
Safe / unsafe
|
H
|
mycophenolate
|
Safe / unsafe
|
I
|
prednisolone
|
Safe / unsafe
|
J
|
tacrolimus
|
Safe / unsafe
|
K
|
warfarin
|
Safe / unsafe
|
TOG CPD. These are open access.
With regard to
renal transplant,
1. most recipients have a successful pregnancy
outcome. T F
2. pregnancy is associated with a 10% reduction
in GFR in recipients with prepregnancy eGFR >90 ml/ min/1.73m2 .
T F
3. hypertension complicates pregnancy in over
50% of recipients who did not require antihypertensive treatment prior to
pregnancy. T F
4. proteinuria is a predictor of poor pregnancy
outcome in recipients. T F
5. the risk of damage to the allograft at caesarean
delivery is about 1%. T F
6. a positive serological screening test for
aneuploidy in recipients is a recognised consequence of impaired renal
function. T F
7. superimposed pre-eclampsia in recipients has
defined diagnostic criteria. T F
8. erythropoietin requirements in recipients
fall in pregnancy. T F
9. breastfeeding is safe in recipients on
angiotensin converting enzyme inhibitors. T F
10. conception is not advised in recipients within
the first year following transplantation. T F
11. continuous electronic fetal monitoring is
recommended during labour in recipients. T F
12. the progesterone implant is a safe form of
postpartum contraception in recipients. T F
Women who have
donated a kidney,
13. are at increased risk of gestational hypertension.
T F
Combined
kidney-pancreas transplant recipients,
14. have a higher risk of gestational diabetes
than kidney transplant recipients. T F
Liver transplant
recipients,
15. have a lower risk of pregnancy complications
than renal transplant recipients. T F
With regard to
pregnancy in cardiothoracic transplant recipients,
16. lung transplant recipients have the highest
risk of adverse outcome of all solid organ transplants. T F
17. due to denervation, the transplanted heart
responds poorly to the physiological changes of pregnancy. T F
18. cardiothoracic transplant recipients should be
delivered by caesarean section. T F
Regarding
medications prescribed in patients with solid organ transplants,
19. tacrolimus levels require monitoring during
pregnancy. T F
20. warfarin is safe for breastfeeding mothers. T
F
37. Endometrial
hyperplasia.
Abbreviations.
BSO: bilateral salpingo-oophorectomy
c.f. compared with
EC: endometrial cancer
EH: endometrial hyperplasia
ES: endometrial surveillance
Question 1.
What is
the definition of endometrial hyperplasia?
Option List
A.
|
endometrial thickness ≥ twice that of proliferative endometrium
|
B.
|
endometrial thickness ≥ twice that of proliferative
endometrium in the absence of oestrogenic stimulation
|
C.
|
premenopausal
endometrial thickness ≥ 6 mm; postmenopausal thickness ≥ 4 mm.
|
D.
|
proliferation of endometrial glands with ↑ gland to
stroma ratio c.f. proliferative endometrium
|
E.
|
proliferation of endometrial stroma with ↑ stroma to gland
ratio c.f. proliferative endometrium
|
Question 2.
Approximately
how many cases of endometrial cancer are diagnosed annually in the UK?
Option List
|
|
≤ 1,000
|
|
|
1,000 - ≤
1,500
|
|
|
1,500 - ≤
3,000
|
|
|
3,000 - ≤
5,000
|
|
|
5,000 - ≤
10,000
|
Question 3.
Where does
endometrial cancer rank in the list of gynaecological cancers by incidence?
Option List
A.
|
1st.
|
B.
|
2nd.
|
C.
|
3rd.
|
D.
|
4th.
|
E.
|
5th.
|
Question 4.
Where does
endometrial cancer rank in the list of gynaecological cancers causing death?
Option List
A.
|
1st.
|
B.
|
2nd.
|
C.
|
3rd.
|
D.
|
4th.
|
E.
|
5th.
|
Question 5.
What is
the prevalence of EH compared with that of EC.?
Option List
A.
|
~ ¼
|
B.
|
~ ½
|
C.
|
similar
|
D.
|
> double
|
E.
|
> treble
|
Question 6.
What
classification system does the RCOG recommend for EH?
Option List
A.
|
BSGE
2015 classification based on endometrial thickness
|
B.
|
FIGO 2000 classification based on risk of malignancy
assessment
|
C.
|
FIGO 2005 classification based on histological grading
|
D.
|
WHO 2014 classification based on endometrial thickness
|
E.
|
WHO 2014 classification based on cytological atypia
|
Question 7.
A
48-year-old woman presents with erratic bleeding and menopausal symptoms.
Endometrial histology shows hyperplasia with no cytological anomaly. What is
the risk of progression to endometrial cancer in the next 10 years?
Option List
A.
|
< 1%
|
B.
|
≤ 5%
|
C.
|
5% - ≤
10%
|
D.
|
10% - ≤
15%
|
E.
|
> 15%
|
Question 8.
A
48-year-old woman presents with menopausal symptoms. Endometrial histology
shows hyperplasia with no cytological anomaly. What is the chance of
spontaneous regression of the endometrial hyperplasia?
Option List
A.
|
< 1%
|
B.
|
1% - ≤
10%
|
C.
|
10% - ≤
15%
|
D.
|
15% - ≤ 25%
|
E.
|
> 25%
|
Question 9.
A
48-year-old woman presents with erratic bleeding and menopausal symptoms. An
outpatient endometrial sample shows atypical hyperplasia. What is her lifetime
risk of EC?
Option List
A.
|
≤ 5%
|
B.
|
5% - ≤
10%
|
C.
|
10% - ≤
25%
|
D.
|
25% - ≤ 50%
|
E.
|
> 50%
|
Question 10.
Which of
the following are risk factors for the development of endometrial hyperplasia?
Option List
A.
|
aromatase
inhibitors
|
B.
|
clomiphene
used for induction of ovulation
|
C.
|
continuous combined HRT
|
D.
|
obesity
|
E.
|
tamoxifen
|
Question 11.
Which of
the following should be used for the diagnosis of endometrial hyperplasia?
Option List
A.
|
endometrial
histology
|
B.
|
CT scan
|
C.
|
hystero-salpingography
|
D.
|
MRI scan
|
E.
|
trans-vaginal ultrasound scan
|
Question 12.
Which of
the following are true of the management of endometrial hyperplasia without
cytological abnormality?
Option List
A.
|
identified
risk factors should be discussed with the woman
|
B.
|
observation with follow-up endometrial biopsies is
acceptable
|
C.
|
progestogens improve the chance of regression
|
D.
|
progestogen should not be used when women show no regression
after B
|
E.
|
progestogen should not be used when women have abnormal
bleeding
|
Question 13.
Which of
the following are true of the management of endometrial hyperplasia without
cytological abnormality?
Option List
A.
|
brachytherapy
is the recommended 1st. line treatment in the GTG
|
B.
|
cyclical
oral progestogen therapy is the recommended 1st. line treatment in
the GTG
|
C.
|
intra-cavity
methotrexate is the recommended 1st. line treatment in the GTG
|
D.
|
the COC
is the recommended 1st. line treatment in the GTG
|
E.
|
the
LNG-IUS is the recommended 1st. line treatment in the GTG
|
Question 14.
Which of
the following statements are true in relation to the management of endometrial
hyperplasia without cytological abnormality?
Option List
A.
|
treatment
should be for a minimum of 6 months
|
B.
|
women should be encouraged to continue with the LNG-IUS
for at least 3 years
|
C.
|
endometrial surveillance with biopsy should be provided
at a minimum of 12 monthly
|
D.
|
review schedules should be individualised
|
E.
|
two consecutive 6-monthly biopsies should be negative
before discharge is considered
|
Question 15.
Which of
the following are true in relation to hysterectomy as management of endometrial
hyperplasia without cytological abnormality?
Option List
A.
|
treatment
to achieve regression should be for at least 6 months before surgery is
considered
|
B.
|
treatment to achieve regression should be for at least 12
months before surgery is considered
|
C.
|
treatment to achieve regression should be for at least 24
months before surgery is considered
|
D.
|
recurrence of endometrial hyperplasia without
cytological abnormality after progestogen therapy is grounds for considering
hysterectomy
|
E.
|
hysterectomy should be recommended to the woman who
declines surveillance
|
Question 16.
Which of the following statements are true in
relation to women with endometrial hyperplasia without cytological atypia for
whom hysterectomy is being considered?
Option List
A.
|
post-menopausal
women should have bilateral salpingo-oophorectomy
|
B.
|
pre-menopausal women should have bilateral salpingo-oophorectomy
|
C.
|
bilateral salpingectomy should be offered to all women
not having BSO
|
D.
|
laparoscopic hysterectomy should be offered in preference
to abdominal
|
E.
|
the GTG uses the term “total hysterectomy” which is
really stupid
|
Question 17.
Which of
the following are true in relation to the management of atypical hyperplasia of
the endometrium?
Option List
A.
|
endometrial
ablation is satisfactory if ES can be done for at least 5 years
|
B.
|
brachytherapy is satisfactory if ES can be done for at
least 5 years
|
C.
|
hysterectomy ±
BSO or bilateral salpingectomy should be offered
|
D.
|
frozen section should be done at the time of
hysterectomy to determine the need for lymphadenectomy
|
E.
|
continuous oral progestogen therapy should given for at
least 12 months post-op
|
Question 18.
A woman
with atypical hyperplasia of the endometrium wishes to retain her fertility.
Which of the following are true?
Option List
A.
|
endometrial
and ovarian cancer must be ruled out to start with
|
B.
|
the MDT should decide management after reviewing the
results of the histology, imaging and tumour markers
|
C.
|
the woman should be advised is that medical advice is
to have hysterectomy because of the risk of cancer
|
D.
|
the LNG-IUS is the first-line preference for
conservative management
|
E.
|
oral progestogens should not be used
|
F.
|
she should have at least one clear endometrial biopsy
before conceiving
|
G.
|
referral to a fertility specialist should be arranged
to discuss ART
|
Question 19.
What
follow-up should be offered to the woman with atypical hyperplasia of the
endometrium who wishes conservative management?
Option List
A.
|
surveillance
includes endometrial biopsy
|
B.
|
surveillance should be at intervals of not more than 6
months until 2 consecutive, clear biopsies have been obtained
|
C.
|
surveillance should be at intervals of not more than 3
months until 2 consecutive, clear biopsies have been obtained
|
D.
|
long-term follow-up after 2 consecutive, clear biopsies
have been obtained can be at 6 – 12 month intervals
|
E.
|
long-term follow-up after 2 consecutive, clear biopsies
have been obtained can be at 12 – 24 month intervals
|
Question 20.
A woman
who has had successful conservative treatment for atypical hyperplasia of the
endometrium wishes to go onto HRT. Which of the following are true?
Option List
A.
|
continuous
progestogen therapy is necessary regardless of the type or mode of
administration of oestrogen replacement
|
B.
|
LNG-IUS or depot progestogens are preferred to oral
therapy
|
C.
|
hysterectomy should be recommended if not already done
|
D.
|
six-months TV scans should be done for endometrial
thickness
|
E.
|
none of the above
|
Question 21.
Which of
the following are true in relation to the woman with endometrial hyperplasia
who has been treated for breast cancer and are taking tamoxifen or aromatase
inhibitors.
Option List
A.
|
she
should be informed that tamoxifen ↑the risk of endometrial cancer
|
B.
|
she should be informed that aromatase inhibitors ↑the
risk of endometrial cancer
|
C.
|
she should be informed that the LNG-IUS ↓ the risk of
endometrial cancer for women on tamoxifen
|
D.
|
she should be informed that the LNG-IUS ↓ the risk of
endometrial cancer for women on aromatase inhibitors
|
E.
|
she should be informed that the effect of the LNG-IUS on
the risk of breast cancer recurrence is unknown and that it is not
recommended as a result
|
Question 22.
A woman is
found to have endometrial hyperplasia on an endometrial polyp. Which of the
following are true of the best management?
Option List
A.
|
complete
removal of the polyp must be checked
|
B.
|
hysteroscopy and curettage must be done to check the
endometrium
|
C.
|
an LNG-IUS should be recommended
|
D.
|
hysterectomy should be recommended
|
E.
|
none of the above.
|
Lead-in.
Pick one option
from the option list. Each option can be used once, more than once or not at
all.
Abbreviations.
Ct: Chlamydia
trachomatis
HSV: Herpes
simplex virus
LGV: lymphogranuloma
venereum
Ng: Neisseria
gonorrhoeae
Tv: Trichomonas
vaginalis
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 1
Which option or options from the option list best fit with
“clue cells”
Scenario 2
Which option or options from the option list
best fit with “fishy odour”?
Scenario 3
Which option or options from the option list
best fit with “flagellate organisms”?
Scenario 4
Which option or options from the option list
best fit with “inflammatory smear”?
Scenario 5
Which option or options from the option list
best fit with “koilocytes”?
Scenario 6
Which option or options from the option list
best fit with “non-specific urethritis in the male”?
Scenario 7
Which option or options from the option list
best fit with “strawberry cervix”?
Scenario 8
Which option or options from the option list
best fit with “thin grey/ white discharge”?
Scenario 9
Which option or options from the option list
best fit with “white, curdy discharge”?
Scenario 10
Which option or options from the option list
best fit with “frothy yellow discharge”?
Scenario 11
Which option or
options from the option list best fit with “protozoan”?
Scenario 12
Which option or
options from the option list best fit with “obligate intracellular organism”?
Scenario 13
Which option or
options from the option list best fit with “blindness”?
Scenario 14
Which option or
options from the option list best fit with “LGV”?
Scenario 15
Which option or
options from the option list best fit with “multinucleated cells”?
Scenario 16
Which option or
options from the option list best fit with “serotypes D–K”?
Scenario 17
Which option or
options from the option list best fit with “serovars L1-L3”?
Scenario 18
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 19
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 20
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%
|
39. Coeliac
disease and pregnancy.
Abbreviations.
AGA: anti-gliadin
antibodies
CD: coeliac disease.
DGP: IgG deamidated
gliadin peptide.
EMA: IgG endomysial
antibodies.
FGR: Fetal growth
restriction.
HLA: Human leucocyte
antigen.
IgA: immunoglobulin A.
tIgA: total
immunoglobulin A.
tTGA: IgA
tissue transglutaminase antibody.
vLBW: very low birth weight.
vPTB: very pre-term birth
(<30/52).
Question 1.
What is
coeliac disease?
Option List
F.
|
allergy
to gluten
|
G.
|
malabsorption due to large bowel inflammation
|
H.
|
an auto-immune disorder triggered by gluten sensitivity
causing villous atrophy of the descending colon in individuals with a genetic
predisposition
|
I.
|
an auto-immune disorder triggered by gluten sensitivity
causing villous atrophy of the gastric mucosa in individuals with a genetic
predisposition
|
J.
|
an auto-immune disorder triggered by gluten sensitivity
causing villous atrophy of the small bowel in individuals with a genetic
predisposition
|
Question 2.
What is
the prevalence of coeliac disease in women of reproductive age?
Option List
F.
|
0.1%
|
G.
|
0.5%
|
H.
|
1%
|
I.
|
2-5%
|
J.
|
5-10%
|
Question 3.
Which of the following groups have an increased risk of
CD?
Option List
F.
|
1st.
degree relatives of those with CD
|
G.
|
those with type 1 diabetes
|
H.
|
those
with iron deficiency anaemia
|
I.
|
those
with osteoporosis
|
J.
|
those
with unexplained infertility
|
Question 4.
Which of
the following are features of CD in the non-pregnant population?
Option List
A.
|
abdominal
bloating and pain
|
B.
|
amenorrhoea
|
C.
|
anaemia
|
D.
|
recurrent miscarriage
|
E.
|
unexplained infertility
|
Question 5.
How do
pregnant women with CD present most commonly?
Option List
A
|
anaemia
|
B
|
failure to gain weight in pregnancy
|
C
|
intra-uterine growth retardation
|
D
|
low BMI
|
E
|
no recognised abnormality
|
Question 6.
Which of
the following commonly occur in pregnant women with CD?
Option List
A
|
anaemia
|
B
|
failure to gain weight in pregnancy
|
C
|
intra-uterine growth retardation
|
D
|
low BMI
|
E
|
no recognised abnormality
|
Question 7.
How should the woman with suspected CD be investigated
initially?
Option List
F.
|
jejunal
biopsy
|
G.
|
IgA EMA
|
H.
|
IgA tTGA
|
I.
|
IgA EMA
+ IgA tTGA
|
J.
|
tIgA +
tTGA
|
Question 8.
Which, if
any, of the following statements are true in relation to the woman due to have
testing for suspected CD?
Option List
A.
|
continue
with a diet that includes gluten ≥ once daily for at least 1 month
|
B.
|
continue with a diet that includes gluten ≥ once daily
for at least 6 weeks
|
C.
|
continue with a diet with ≥ 10 gm. gluten daily for at
least 1 month
|
D.
|
continue with a diet with ≥ 10 gm. gluten daily for at
least 6 weeks
|
E.
|
follow a strict gluten-free diet for at least 3 months
|
Question 9.
What
advice should be given to those who have gone on to a gluten-free diet in the
month before testing?
Option List
A.
|
the gluten-free diet may render the serological tests
–ve, but not intestinal biopsy
|
B.
|
the gluten-free diet may render the intestinal biopsy
–ve, but not the serological tests
|
C.
|
the
gluten-free diet may render all the tests -ve
|
D.
|
if she is happy with the gluten-free diet, there is
no point in testing
|
E.
|
she is not qualified to make medical decisions and
should not be so stupid on future occasions
|
Question 10.
Which of
the following conditions should make consideration of testing for CD sensible?
Option List
F.
|
amenorrhoea
|
G.
|
Down’s syndrome
|
H.
|
epilepsy
|
I.
|
recurrent miscarriage
|
J.
|
Turner’s syndrome
|
K.
|
unexplained infertility
|
Question 11.
What recommendation does NICE make about the information
to be provided to healthcare professionals with the results of serological
tests for CD?
Option List
A.
|
the
results alone should be provided
|
B.
|
the results
with the local reference values for children, adult men and adult women
|
C.
|
the
results with the local and national reference values for children, adult men
and adult women
|
D.
|
the
results with interpretation of their meaning
|
E.
|
the
results with interpretation of their meaning + recommended actions
|
Question 12.
How is the
diagnosis of CD confirmed after +ve serological testing?
Option List
A
|
colonoscopy
|
B
|
enteroscopy
|
C
|
gastroscopy
|
D
|
rectal
biopsy
|
E
|
small
bowel biopsy
|
Question 13.
Which skin
condition is particularly associated with CD?
Option List
A.
|
atopic
eczema
|
B.
|
dermatitis herpetiformis
|
C.
|
dermatitis multiforme
|
D.
|
dermatographia
|
E.
|
psoriasis
|
Question 14.
Which of
the following are likely to be absorbed less well than normally in women with
CD?
Option List
A.
|
carbohydrate
|
B.
|
fat
|
C.
|
folic acid
|
D.
|
protein
|
E.
|
vitamins B12, D & K
|
Question 15.
What is
the appropriate treatment of CD?
Option List
A.
|
antibiotics:
long-term in low-dosage
|
B.
|
azathioprine
|
C.
|
cyclophosphamide
|
D.
|
rectal steroids
|
E.
|
none of the above
|
Question 16.
Which of
the following do not contain gluten?
Option List
A.
|
barley
|
B.
|
oats
|
C.
|
rapeseed oil
|
D.
|
rye
|
E.
|
wheat
|
40. 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
|
Scenario 7.
What is the definition of the
anterior fontanelle?
Option list.
A.
|
the anterior end of the sagittal suture
|
B.
|
the area where the sagittal and coronal 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 8.
What is the definition of the
posterior fontanelle?
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 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
|
Scenario 12.
What diameter presents to the
pelvis with vertex presentation?
Option list.
A.
|
suboccipito-bregmatic
|
B.
|
suboccipito-frontal
|
C.
|
occipito-frontal
|
D.
|
mento-vertical
|
E.
|
submento-bregmatic
|
Scenario 13.
What diameter presents to the
pelvis with typical occipito-posterior position?
Option list.
A.
|
suboccipito-bregmatic
|
B.
|
suboccipito-frontal
|
C.
|
occipito-frontal
|
D.
|
mento-vertical
|
E.
|
submento-bregmatic
|
Scenario 14.
What diameter presents to the
pelvis with brow presentation?
Option list.
A.
|
suboccipito-bregmatic
|
B.
|
suboccipito-frontal
|
C.
|
occipito-frontal
|
D.
|
mento-vertical
|
E.
|
submento-bregmatic
|
Scenario 15.
What diameter presents to the
pelvis with mento-anterior face presentation?
Option list.
A.
|
suboccipito-bregmatic
|
B.
|
suboccipito-frontal
|
C.
|
occipito-frontal
|
D.
|
mento-vertical
|
E.
|
submento-bregmatic
|
Scenario 16.
What diameter presents to the
pelvis with mento-posterior face presentation?
Option list.
A.
|
suboccipito-bregmatic
|
B.
|
suboccipito-frontal
|
C.
|
occipito-frontal
|
D.
|
mento-vertical
|
E.
|
submento-bregmatic
|
Scenario 17.
What is the average length of
the suboccipito-bregmatic diameter in a term baby?
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 18.
What is the average length of
the suboccipito-frontal diameter in a term baby?
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 19.
What is the average length of
the occipito-frontal diameter in a term baby?
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 20.
What is the average length of
the mento-vertical diameter in a term baby?
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 21.
What is the average length of
the submento-bregmatic diameter in a term baby?
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.
|
