Website
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49
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SBA. Cancer incidence and mortality.
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50
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EMQ. Retinoids and pregnancy
|
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51
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Viva. Obstructive sleep apnoea
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52
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EMQ. Drugs in pregnancy 1
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53
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EMQ. Disorders of sexual
development. AIS, MRKH etc.
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49. Cancer
incidence and mortality.
Question 1.
Lead-in
Which is
the most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Breast
|
|
C.
|
Cervix
|
|
D.
|
Endometrium
|
|
E.
|
Lung
|
Question 2.
Lead-in
Which is
the 2nd. most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Breast
|
|
C.
|
Cervix
|
|
D.
|
Endometrium
|
|
E.
|
Lung
|
Question 3.
Lead-in
Which is
the 3rd. most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Breast
|
|
C.
|
Cervix
|
|
D.
|
Endometrium
|
|
E.
|
Lung
|
Question 4.
Lead-in
Which is
the 4th. most common female cancer?
Option List
|
A.
|
Bowel
|
|
B.
|
Cervix
|
|
C.
|
Endometrium
|
|
D.
|
Lung
|
|
E.
|
Pancreas
|
Question 5.
Lead-in
Which is
the 5th. most common female cancer?
Option List
|
A.
|
Cervix
|
|
B.
|
Malignant melanoma
|
|
C.
|
Non-Hodgkin’s lymphoma
|
|
D.
|
Ovary
|
|
E.
|
Vulva
|
Question 6.
Lead-in
Which is
the 6th. most common female cancer?
Option List
|
A.
|
Cervix
|
|
B.
|
Malignant melanoma
|
|
C.
|
Non-Hodgkin’s lymphoma
|
|
D.
|
Ovary
|
|
E.
|
Vulva
|
Question 7.
Lead-in
Where does
cervical cancer feature in the list of the most common female cancers?
Option List
|
A.
|
10th.
|
|
B.
|
11th.
|
|
C.
|
13th.
|
|
D.
|
14th.
|
|
E.
|
20th.
|
Question 8.
Lead-in
Where does
vulval cancer feature in the list of the most common female cancers?
Option List
|
A.
|
10th.
|
|
B.
|
12th.
|
|
C.
|
16th.
|
|
D.
|
20th.
|
|
E.
|
none of the above
|
Question 9.
Lead-in
Which is
the most common cancer causing female death in the UK?
Option List
|
A.
|
Breast
|
|
B.
|
Bowel
|
|
C.
|
Lung
|
|
D.
|
Ovary
|
|
E.
|
Pancreas
|
Question 10.
Lead-in
Which is
the 2nd. most common cancer causing female death in the UK?
Option List
Question 11.
Lead-in
Which is
the 3rd. most common cancer causing female death in the UK?
Option List
Use
the one for question 9.
Question 12.
Lead-in
Which is
the 4th. most common cancer causing female death in the UK?
Option List
|
A.
|
Brain
|
|
B.
|
Oesophagus
|
|
C.
|
Ovary
|
|
D.
|
Pancreas
|
|
E.
|
Uterus
|
Question 13.
Lead-in
Which is
the 5th. most common cancer causing female death in the UK?
Option List
Use
the one for question 12.
Question 14.
Which is
the 6th. most common cancer causing female death in the UK?
Option List
Use
the one for question 9.
Question 15.
Lead-in
The
incidence of cervical cancer has fallen from the late 1970s until now. What is
the approximate figure for the fall?
Option List
|
A.
|
10%
|
|
B.
|
25%
|
|
C.
|
50%
|
|
D.
|
60%
|
|
E.
|
75%
|
Question 16.
Lead-in
Which, if
any, of the following statements are true in relation to CIN.
Option List
|
A
|
there were ~ 20,000 new cases of CIN in 2015
|
|
B
|
there
were ~ 30,000 new cases of CIN in 2015
|
|
C
|
there were ~ 50,000 new cases of CIN in 2015
|
|
D
|
incidence rates for new cases of CIN are highest in women
aged 19 - 24
|
|
E
|
incidence rates for new cases of CIN are highest in
women aged 25 - 29
|
|
F
|
incidence rates for new cases of CIN are highest in
women aged 30 - 39
|
|
G
|
incidence rates for new cases of CIN ↑
by ~ 10 % since the 1990s
|
|
H
|
incidence rates for new cases of CIN ↑ by ~ 20 % since
the 1990s
|
|
I
|
incidence rates for new cases of CIN ↑ by ~ 30 % since
the 1990s
|
|
J
|
incidence rates for new cases of CIN ↑ by ~ 5 % in the
past decade
|
|
K
|
incidence rates for new cases of CIN ↑ by ~ 10 % in the
past decade
|
|
L
|
incidence rates for new cases of CIN ↑ by ~ 15 % in the
past decade
|
Question 17.
Lead-in
Which, if
any, of the following statements describes the change in incidence of cervical
cancer in the past decade.
Option List
|
A.
|
↑ by 5%
|
|
B.
|
↓ by 5%
|
|
C.
|
↑ by 10%
|
|
D.
|
↓ by 10%
|
|
E.
|
↑ by 15%
|
|
F.
|
↓ by 15%
|
|
G.
|
↑ by 20%
|
|
H.
|
↓ by 20%
|
|
I.
|
↑ by 25%
|
|
J.
|
↓ by 25%
|
Question 18.
Lead-in
What is
the peak age at which cervical cancer is diagnosed in the UK?
Option List
|
A.
|
20-24
|
|
B.
|
25-29
|
|
C.
|
30-34
|
|
D.
|
35-39
|
|
E.
|
40-44
|
|
F.
|
45-49
|
|
G.
|
50-54
|
|
H.
|
55-59
|
|
I.
|
≥60
|
Question 19.
Lead-in
What
proportion of cervical cancer is diagnosed in women < 45 years?
Option List
|
A.
|
20%
|
|
B.
|
30%
|
|
C.
|
40%
|
|
D.
|
50%
|
|
E.
|
60%
|
Question 20.
Lead-in
The
mortality rate from cervical cancer has fallen from the late 1970s until now.
What is the approximate figure for the fall?
Option List
|
A.
|
10%
|
|
B.
|
25%
|
|
C.
|
50%
|
|
D.
|
60%
|
|
E.
|
75%
|
Question 21.
Lead-in
The
mortality rate from cervical cancer has fallen in the past decade. What is the
approximate figure for the fall?
Option List
|
A.
|
10%
|
|
B.
|
25%
|
|
C.
|
50%
|
|
D.
|
60%
|
|
E.
|
75%
|
Question 22.
Lead-in
The
mortality rate from cervical cancer has fallen in the past decade. What is the
approximate figure for the fall?
Option List
|
F.
|
10%
|
|
G.
|
25%
|
|
H.
|
50%
|
|
I.
|
60%
|
|
J.
|
75%
|
Question 23.
Lead-in
When was
routine HPV vaccination of girls introduced in the UK?
Option List
|
A.
|
2000
|
|
B.
|
2002
|
|
C.
|
2004
|
|
D.
|
2006
|
|
E.
|
2008
|
Question 24.
Lead-in
From what
year might we expect to see a reduction in cervical cancer incidence as a result
of the HPV vaccination programme?
Option List
|
A.
|
2020
|
|
B.
|
2025
|
|
C.
|
2030
|
|
D.
|
2040
|
|
E.
|
2050
|
Question 25.
Lead-in
When was
routine HPV vaccination of boys introduced in the UK?
Option List
|
A.
|
2010
|
|
B.
|
2011
|
|
C.
|
2012
|
|
D.
|
2014
|
|
E.
|
None of the above
|
Retinoids & pregnancy.
I think
the questions you are likely to be asked will come from the TOG article by
Browne et al and are covered by the associated TOG CPD questions.
Hannah Browne, Gerald Mason and Thomas
Tang: “Retinoids and pregnancy”.
The article and CPD questions
are open access and reproduced here.
With regard to isotretinoin,
1. its mode of action is to reduce sebum
secretion. True
False
2.
it is used as a first-line treatment
for acne. True
False
3.
it has an elimination half-life of
less than 10 hours. True
False
4.
the dose prescribed is adjusted
according to the patient’s weight. True
False
5.
the estimated pregnancy rate while on treatment
is around 1%. True
False
Regarding side effects of
retinoids (such as isotretinoin) including their teratogenicity,
6.
mood disturbance is well documented. True
False
7.
derivatives of the mesonephric duct
are recognised malformations. True False
8.
limb deformities are common. True
False
9.
their use in pregnancy is associated
with ear abnormalities. True
False
With regard to the incidence of teratogenic effects of
isotretinoin,
10.
30% of affected fetuses have been
reported to perform poorly in neuropsychological tests.
11.
approximately half of fetuses exposed to
them suffer from mental retardation. True False
12.
about a third of fetuses exposed to them
have retinoid specific fetal malformations. True False
Concerning the pregnancy
prevention programme in those being placed on isotretinoin;
13.
the programme was launched in 2005 in
the UK. True
False
14.
contraception should be used for 1 month
prior to and 2 months following treatment.
True
False
15.
pregnancy tests should be taken monthly
throughout treatment. True
False
16.
exerts its teratogenic effect through a
mechanism that does not significantly affect vitamin A levels. True False
17.
affects the development of the branchial
arches by effecting haemopexin signalling.
True False
18.
is associated with a miscarriage of over
20% when used in the first trimester. True False
Concerning retinoid
embryopathy,
19.
topical application is not associated
with an increased risk. True
False
20.
the most common malformations are those
of the musculoskeletal system. True False
Breastfeeding
does not feature in the TOG questions.
Retinoid use is safe
during breastfeeding. True False
Retinoid use is safe
during breastfeeding. True False
51. Obstructive sleep apnoea.
Candidate's
Instructions.
This is a structured
discussion station. The examiner will ask you 11 questions. When you have
answered a question and moved to the next, you are not allowed to return as
later questions may give answers to earlier ones.
52. Drugs in
O&G 1.
Abbreviations.
ACE: angiotensin-converting enzyme
ACEI: angiotensin-converting
enzyme inhibitor
ARA: angiotensin
II receptor antagonist
HG: hyperemesis
gravidarum
IUGR: intra-uterine
growth retardation
LDA: low-dose
aspirin
MAOI: monoamine
oxidase inhibitor
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 and why 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?
53. AIS, MRKH and Swyer’s syndrome
Abbreviations.
AIS: androgen insensitivity syndrome.
AMH: anti-Mullerian hormone.
CAH: congenital adrenal hyperplasia.
CAI: complete androgen insensitivity syndrome.
DSD: disorder of sexual differentiation.
KS: Kallmann’s syndrome.
LMB: Laurence-Moon-Biedl syndrome.
MRKH: Mayer-Rokitansky- Küster-Hauser
syndrome.
PAI: partial androgen insensitivity syndrome.
PW: Prader-Willi syndrome.
SW: Swyer’s syndrome.
TU: Turner’s syndrome.
UPD: uni-parental disomy.
Option list 1.
A.
has a uterus of normal
size for her age.
B.
has a uterus that is
hypoplastic for her age.
C.
has a vestigial uterus
(anlagen).
D.
has no uterus.
E.
commonly has esthiomene
F.
I don’t know and I
don’t care.
G.
the question makes no
sense.
H.
none of the above.
Scenarios.
1. a girl with
congenital adrenal hyperplasia at the start of puberty.
2. a girl with complete
androgen insensitivity syndrome at the start of puberty.
3. a girl with a disorder
of sexual differentiation at the start of puberty.
4. a girl with Kallmann’s
syndrome at the start of puberty.
5. a girl with Laurence-Moon-Biedl
syndrome at the start of puberty.
6. a girl with Mayer-Rokitansky-Kuster-Hauser
syndrome at the start of puberty.
7. a girl with partial
androgen insensitivity syndrome at the start of puberty.
8. a girl with Prader-Willi
syndrome at the start of puberty.
9. a girl with Swyer’s
syndrome at the start of puberty.
10. a girl with
Turner’s syndrome at the start of puberty.
