|
36 |
Role-play. Menorrhagia |
|
37 |
Structured discussion. The uses of MgSO4
in O&G. |
|
38 |
EMQ. Gp B streptococcus and pregnancy |
|
39 |
EMQ. Retinoids and pregnancy |
|
40 |
Caldicott guardian. |
|
41 |
EMQ. Tetracyclines and pregnancy |
Candidate’s instructions.
You are an ST5. A patient
has been aggressive towards the reception and nursing staff, insisting that she
must see the consultant, not a junior doctor. She shouted at both the
receptionist and the nurses, saying: ‘I want to see the organ grinder, not the
bloody monkey’. The consultant says that she has no intention of seeing her and
that you need to learn to deal with difficult patients.
37. Structured discussion.
The uses of MgSO4 in O&G.
Candidate’s
instructions.
This is a structured
discussion about the uses of MgSO4 in O&G, with a very simple
structure.
The examiner will ask what
you know about the subject but not ask questions, prompt or otherwise assist.
It is up to you to give as full an account of the uses as you can muster.
Group B Streptococcus. EMQ. Answer.
Abbreviations.
ASAP: as soon as possible.
ASB: asymptomatic bacteruria
UKOSS: UK Obstetric Surveillance System.
CDC: USA’s. Centers for Disease Control and Prevention.
EDD: expected date of delivery.
EOGBSD: early onset GBSD.
GBS: group B streptococcus; full title:
‘Lancefield group B beta-haemolytic streptococcus’.
GBSD: GBS disease.
GBSIP: GBS in pregnancy.
GTG36: RCOG’s Green-top guideline 36: “GBS Disease, Early-onset”. 2017.
IAP: intrapartum antibiotic
prophylaxis.
LOGBSD: late-onset GBSD.
MSU: mid-stream specimen of urine
PCR: polymerase chain reaction.
PIF: patient information leaflet.
PPROM: preterm, prelabour rupture of membranes.
RCT: randomised control trial.
SROM: spontaneous rupture of membranes.
UKOSS: UK Obstetric Surveillance System.
UTI: urinary tract infection.
Option list 1.
|
A |
< 5% |
|
B |
10% |
|
C |
15% |
|
D |
20% |
|
E |
30% |
|
F |
40% |
|
G |
50% |
|
H |
>50% |
Question
1.
Which condition is of greatest significance
in relation to GBSIP?
Option list.
|
A |
chorio-amnionitis |
|
B |
early-onset GBS disease
in the neonate |
|
C |
late -onset GBS disease
in the neonate |
|
D |
maternal urinary tract
infection |
|
E |
maternal pneumonia |
|
F |
puerperal endometritis |
|
G |
stillbirth |
|
H |
none of the above |
Question
2.
What is the incidence of the condition of
greatest significance in relation to GBSD?
Use Option list 1.
Question
3.
Approximately how common is GBS
colonisation in adults? Use Option List 1.
Question
4.
What is the approximate rate of vertical transmission
in cases of maternal GBS colonisation?
Use Option List 1
Question
5.
Approximately how many neonates will
develop EOGBSD in cases of maternal GBS colonisation?
Use Option List 1
Question
6.
What is the first statement in the
executive summary section of GTG36?
Option list.
|
A |
all pregnant women should
be provided with an appropriate PIF |
|
B |
all pregnant women
should be given web addresses for GBS information website |
|
C |
clinicians should know the
risk factors for EOGBSD |
|
D |
clinicians should know the
relative risk for EOGBSD associated with the main risk factors |
|
E |
universal
bacteriological screening is not recommended |
Question
7.
What is the second statement in the
executive summary section of GTG36?
Option list.
|
A |
all pregnant women
should be provided with an appropriate PIF |
|
B |
all pregnant women
should be given web addresses for GBS information website |
|
C |
clinicians should know the
risk factors for EOGBSD |
|
D |
clinicians should know the
relative risk for EOGBSD associated with the main risk factors |
|
E |
universal
bacteriological screening is not recommended |
Question
8.
What is the third statement in the
executive summary section of GTG36?
Option list.
|
A |
all pregnant women
should be provided with an appropriate PIF |
|
B |
all pregnant women
should be given web addresses for GBS information website |
|
C |
clinicians should know the
risk factors for EOGBSD |
|
D |
clinicians should know the
relative risk for EOGBSD associated with the main risk factors |
|
E |
universal
bacteriological screening is not recommended |
Question
9.
What risk
factors for EOGBSD are listed in GTG36? There is no option list – that would be
too easy. Just write what you know to be the main risk factors.
Question
10.
A woman was a GBS carrier in pregnancy. What
is the risk of recurrence in a future pregnancy?
Use Option List 1
Question
11.
What management
options should be offered to a pregnant woman with a history of a previously
affected baby but no evidence of GBS in the current pregnancy? This is not a
true EMQ as there may be > 1 correct answer.
Option list.
|
A |
inform her that the risk
of being a carrier in this pregnancy is 25% |
|
B |
IAP without screening |
|
C |
IAP if screening shows bowel
colonisation, but not if it is absent |
|
D |
IAP if screening shows
genital tract colonisation, but not if it is absent |
|
E |
IAP if screening shows urinary
tract colonisation, but not if it is absent |
|
F |
IAP if screening shows
any GBS colonisation |
|
G |
screening for GBS at
around 36 weeks, with IAP if testing is +ve |
What management options should be offered
to a pregnant woman with a history of GBS carriage in a previous pregnancy but no
EOGBSD or LOGBSD and no evidence of it in the current pregnancy? This is not a
true EMQ as there may be > 1 correct answer.
Option
list.
|
A |
inform her that the risk of being a carrier in this
pregnancy is 25% |
|
B |
IAP without screening |
|
C |
IAP if screening shows bowel colonisation, but not
if it is absent |
|
D |
IAP if screening shows genital tract colonisation,
but not if it is absent |
|
E |
IAP if screening shows urinary tract colonisation,
but not if it is absent |
|
F |
IAP if screening shows any GBS colonisation |
|
G |
screening for GBS at around 36 weeks, with IAP if testing
is +ve |
Question 13.
Which,
if any, of the following statements are true in relation to screening for GBS
in pregnancy?
Option
list.
|
A |
screening should be done 1-3 weeks before the ADD |
|
B |
screening should be done 2-4 weeks before the ADD |
|
C |
screening should be done 3-5 weeks before the ADD |
|
D |
screening should be done 4-6 weeks before the ADD |
|
E |
screening should be done 4-6 weeks before the ADD |
|
F |
screening should not be offered |
Question
14.
Which, if any,
of the following statements is true in relation to screening for GBS in twin pregnancy?
Option list.
|
A |
screening should be done
1-3 weeks before the ADD |
|
B |
screening should be done
2-4 weeks before the ADD |
|
C |
screening should be done
3-5 weeks before the ADD |
|
D |
screening should be done
4-6 weeks before the ADD |
|
E |
screening should be done
4-6 weeks before the ADD |
|
F |
screening should not be
offered |
Question
15.
Which, if any,
of the following statements is true in relation to screening for GBS?
Option list.
|
A |
oral, rectal &
vaginal swabs should be taken and an MSU |
|
B |
rectal & vaginal swabs
should be taken |
|
C |
rectal & vaginal
swabs should be taken and an MSU |
|
D |
a single swab can be
used, swabbing orally then vaginally, then rectally |
|
E |
a single swab can be
used, swabbing vaginally, then rectally |
|
F |
none of the above |
Question
16.
Which, if any,
of the following statements are true in relation to transport of swabs for GBS?
Option list.
|
A |
swabs should be transported
to the laboratory ASAP |
|
B |
swabs should be
transported to the laboratory refrigerated |
|
C |
swabs should be
transported in a non-nutrient medium |
|
D |
sways should be
transported in a nutrient-enhanced medium |
|
E |
Amies medium is suitable |
|
F |
Stuart medium is
suitable |
|
G |
blood agar is suitable |
Question
17.
Which, if any,
of the following statements are true in relation to processing of swabs for GBS?
Option list.
|
A |
processing should be done
ASAP |
|
B |
specimens should be refrigerated
if processing cannot be done immediately |
|
C |
specimens should be stored
at a temperature lower than –10oC if processing cannot be done immediately |
|
D |
testing should be done
using an enriched culture medium |
|
E |
testing should be done
using a cultured medium |
Question
18.
Which, if any,
of the following statements is true in relation to screening for GBS in twin pregnancy?
Option list.
|
A |
screening should be done
30-32 weeks |
|
B |
screening should be done
31-33 weeks |
|
C |
screening should be done
32-34 weeks |
|
D |
screening should be done
33-35 weeks |
|
E |
screening should be done
34-36 weeks |
|
E |
screening should be done
35-37 weeks |
|
E |
screening should be done
36-38 weeks |
|
F |
screening should not be
offered |
Question
19.
What does GTG
say about screening for GBS on maternal request when there are no factors
indicating increased risk?
Option list.
Option list.
|
A |
maternal request is not
an indication for screening |
|
B |
refer her to a hospital
with a policy of offering screening on request |
|
C |
screening should be
offered it still desired after explanation of the pros and cons and that it
is not recommended |
|
D |
the request should be
respected and screening offered |
|
E |
none of the above |
Question
20.
Which, if any,
of the following would be appropriate management of a pregnant woman with GBS
UTI?
Option list.
|
A |
offer IAP |
|
B |
repeat the MSU |
|
C |
treat the UTI and arrange
appropriate follow-up and GBS screening |
|
D |
treat the UTI, arrange
appropriate follow-up and offer IAP |
|
E |
none of the above |
Question
21.
What advice does ACOG797 give about the
use of clindamycin for GBS urinary tract infection.
Option list.
|
A |
it should be the 1st.
choice for treatment in those who are not allergic to it |
|
B |
it should be the 1st.
choice for treatment in those who are allergic to penicillin |
|
C |
it should only be used
intravenously for treatment of urinary tract infection |
|
D |
it should not be used
for urinary tract infection |
|
E |
it should be used, like
other antibiotics, based on the sensitivity of the infecting organism |
Question
22.
Which, if any,
of the following would be appropriate management of a pregnant woman with GBS on
a vaginal or rectal swab?
Option list.
|
A |
offer IAP |
|
B |
repeat the swab |
|
C |
treat the infection and arrange
appropriate follow-up and GBS screening |
|
D |
treat the infection, arrange
appropriate follow-up and offer IAP |
|
E |
none of the above |
Question
23.
Which, if any,
of the following statements are correct about induction of labour in women who
are carriers of GBS?
Option list.
|
A |
amniotomy is the
preferred method |
|
B |
membrane sweeping is contra-indicated |
|
C |
vaginal PGE2 is
the preferred method |
|
D |
an i.v. antibiotic
should be given with the start of the process |
|
E |
none of the above |
Question
24.
A woman with
no risk factors for GBS goes into preterm labour. Which, if any, of the
following statements are correct?
Option list.
|
A |
GBS screening should be
done with PCR or other ‘near-patient’ test |
|
B |
IAP should be offered |
|
C |
IAP should not be
offered unless clinical evidence of infection appears |
|
D |
tocolytics should be offered
|
|
E |
none of the above |
Question
25.
A woman with
no risk factors for GBS has PPROM. Which, if any, of the following statements are
correct?
Option list.
|
A |
GBS screening should be
done |
|
B |
IAP should be offered
immediately |
|
C |
IAP should be offered
when labour ensues or is induced |
|
D |
IOL should be offered |
|
E |
none of the above |
Question
26.
In which of
the following situations is polymerase chain reaction or other ‘near-patient’
testing recommended in relation to GBS?
Option list.
|
A |
women admitted with SROM
whose GBS status is unknown |
|
B |
women treated for GBS
infection in pregnancy admitted in preterm labour |
|
C |
women for whom C section
is planned but go into premature labour |
|
D |
unbooked patients admitted
in labour |
|
E |
unbooked patients
admitted with SROM |
|
F |
none of the above |
Question
27.
A woman who is
a known GBS carrier wishes to use a birthing pool. Which, if any, of the
following statements are correct?
Option list.
|
A |
use of a birthing pool
is contraindicated |
|
B |
use of a birthing pool
is not contraindicated |
|
C |
use of a birthing pool
is not contraindicated so long as appropriate IAP is given |
|
D |
use of a birthing pool
is acceptable, but the water must contain an antiseptic in a concentration
known to kill > 99.9% of all known bacteria and viruses |
|
E |
tell her not to be
stupid |
|
F |
none of the above |
Question
28.
A woman in
labour has a temperature of 38.40C. Which of the following is correct?
Option list.
|
A |
IAP should be offered |
|
B |
amoxicillin should be
offered unless she is allergic to penicillin |
|
C |
amoxicillin +
metronidazole should be offered unless she is allergic to penicillin |
|
D |
a cephalosporin should
be offered |
|
E |
a cephalosporin +
metronidazole should be offered |
|
F |
none of the above |
Question
29.
Which, if any,
of the following statements are true in relation to GBS and prematurity.
Option list.
|
A |
IAP should be offered |
|
B |
premature babies are
less likely to develop EOGBSD than term babies |
|
C |
premature babies are just
as likely to develop EOGBSD as term babies |
|
D |
premature babies are four
times more likely to develop EOGBSD than term babies |
|
E |
premature babies are ten
times more likely to develop EOGBSD than
term babies |
|
F |
premature babies are less
likely to die of EOGBSD than term babies |
|
G |
premature babies are just
as likely to die of EOGBSD as term babies |
|
H |
premature babies are four
times more likely to die of EOGBSD than term babies |
|
I |
premature babies are ten
times more likely to die of EOGBSD than term babies |
Question
30.
A GBS carrier has
PPROM. Which, if any, of the following statements are correct?
Option list.
|
A |
IAP should be offered immediately |
|
B |
IAP should be offered
when labour starts |
|
C |
IAP should not be
offered |
|
D |
erythromycin should be
offered immediately if not contraindicated |
|
E |
erythromycin should be
offered when labour starts if not contraindicated |
|
F |
erythromycin should not be
offered |
|
G |
IOL should be offered
ASAP |
|
H |
IOL should not be offered |
|
I |
labour should be
augmented as soon as contractions start |
Question
31.
A GBS carrier goes
into premature labour Which, if any, of the following statements are correct?
Option list.
|
A |
IAP should be offered immediately |
|
B |
IAP should be offered
when contractions start |
|
C |
IAP should not be
offered |
|
D |
augmentation of labour should
be offered ASAP |
|
E |
augmentation of labour should not be offered |
|
F |
labour should be
augmented as soon as contractions start |
Question
32.
A woman whose
GBS carrier status is negative has PPROM. Which, if any, of the following
statements are correct?
Option list.
|
A |
expectant management for
up to 24 hours is acceptable |
|
B |
expectant management for
up to 48 hours is acceptable |
|
C |
IAP should be offered immediately |
|
D |
IAP should be offered
when contractions start |
|
E |
IAP should not be
offered |
|
F |
immediate IOL is acceptable |
|
G |
IOL should not be
delayed > 24 hours if labour does not ensue |
|
H |
IOL should not be
offered |
|
I |
labour should be
augmented as soon as contractions start |
Question
33.
A woman whose
GBS carrier status is unknown has PPROM. Which, if any, of the following statements
are correct?
Option list.
|
A |
expectant management for
up to 24 hours is acceptable |
|
B |
expectant management for
up to 48 hours is acceptable |
|
C |
IAP should be offered immediately |
|
D |
IAP should be offered
when contractions start |
|
E |
IAP should not be offered |
|
F |
immediate IOL is acceptable |
|
G |
IOL should not be delayed
> 24 hours if labour does not ensue |
|
H |
IOL should not be
offered |
|
I |
labour should be
augmented as soon as contractions start |
Question
34.
A GBS carrier has
SROM at 38 weeks. Which, if any, of the following statements are correct?
Option list.
|
A |
IAP should be offered immediately |
|
B |
IAP should be offered
when contractions start |
|
C |
IAP should not be
offered |
|
D |
IOL should be offered
ASAP |
|
E |
IOL should not be
offered |
|
F |
labour should be
augmented as soon as contractions start |
Question
35.
A GBS carrier goes
into labour at 38 weeks. Which, if any, of the following statements are
correct?
Option list.
|
A |
IAP should be offered immediately |
|
B |
IAP should be offered
when contractions start |
|
C |
IAP should not be
offered |
|
D |
augmentation of labour should
be offered ASAP |
|
E |
augmentation of labour should not be offered |
|
F |
labour should be
augmented as soon as contractions start |
Question
36.
A woman whose
GBS carrier status is negative has SROM at 38 weeks. Which, if any, of the
following statements are correct?
Option list.
|
A |
expectant management for
up to 24 hours is acceptable |
|
B |
expectant management for
up to 48 hours is acceptable |
|
C |
IAP should be offered immediately |
|
D |
IAP should be offered
when contractions start |
|
E |
IAP should not be
offered |
|
F |
immediate IOL is acceptable |
|
G |
IOL should not be
delayed > 24 hours if labour does not ensue |
|
H |
IOL should not be
offered |
|
I |
labour should be
augmented as soon as contractions start |
Question
37.
A woman whose
GBS carrier status is unknown has SROM at 38 weeks. Which, if any, of the
following statements are correct?
Option list.
|
A |
expectant management for
up to 24 hours is acceptable |
|
B |
expectant management for
up to 48 hours is acceptable |
|
C |
IAP should be offered immediately |
|
D |
IAP should be offered
when contractions start |
|
E |
IAP should not be offered |
|
F |
immediate IOL is acceptable |
|
G |
IOL should not be
delayed > 24 hours if labour does not ensue |
|
H |
IOL should not be
offered |
|
I |
labour should be
augmented as soon as contractions start |
Question
38.
What vaginal
cleansing is recommended in GTG36 for women known to be colonised with GBS to
reduce fetal transmission in labour and delivery?
Option list.
|
A |
aqueous chlorhexidine 1% |
|
B |
povidone-iodine 1% |
|
C |
acetic acid 1% |
|
D |
aqueous bicarbonate of
soda 1% |
|
E |
none of the above. |
Question
39.
Option
list.
|
A |
a cephalosporin |
|
B |
a cephalosporin + clavulanic acid |
|
C |
a cephalosporin + metronidazole |
|
D |
a cephalosporin + streptomycin |
|
E |
amoxicillin |
|
F |
amoxicillin + clavulanic acid |
|
G |
amoxicillin + metronidazole |
|
H |
amoxicillin + streptomycin |
|
I |
benzylpenicillin |
|
J |
benzylpenicillin + clavulanic acid |
|
K |
benzylpenicillin + metronidazole |
|
L |
benzylpenicillin + streptomycin |
|
M |
tetracycline |
|
N |
tetracycline + clavulanic acid |
|
O |
tetracycline + metronidazole |
|
P |
tetracycline + streptomycin |
|
Q |
none of the above |
Question
40.
Which
antibiotic / antibiotic combination is the 2nd? choice for IAP,
assuming no allergy or other contraindication?
Option
list.
|
A |
a cephalosporin |
|
B |
a cephalosporin + clavulanic
acid |
|
C |
a cephalosporin +
metronidazole |
|
D |
a cephalosporin +
streptomycin |
|
E |
amoxicillin |
|
F |
amoxicillin + clavulanic
acid |
|
G |
amoxicillin +
metronidazole |
|
H |
amoxicillin +
streptomycin |
|
I |
benzylpenicillin |
|
J |
benzylpenicillin + clavulanic
acid |
|
K |
benzylpenicillin +
metronidazole |
|
L |
benzylpenicillin +
streptomycin |
|
M |
tetracycline |
|
N |
tetracycline + clavulanic
acid |
|
O |
tetracycline +
metronidazole |
|
P |
tetracycline + streptomycin |
|
Q |
none of the above |
Question
41.
How should
babies at risk of EOGBSD whose mothers have had adequate IAP be monitored for
signs of infection?
Option list.
|
A |
routine monitoring is
all that is required |
|
B |
they should be checked
at birth for signs of infection |
|
C |
their vital signs should
be checked hourly for 12 hours |
|
D |
their vital signs should
be checked hourly for 24 hours |
|
E |
their vital signs should
be checked hourly for 48 hours |
|
F |
their vital signs should
be checked 4 hourly for 12 hours |
|
G |
their vital signs should
be checked 4 hourly for 24 hours |
|
H |
their vital signs should
be checked 4 hourly for 48 hours |
|
I |
their vital signs should
be checked at 0, 1 & 2 hours, then hourly until 12 hours |
|
J |
their vital signs should
be checked at 0, 1 & 2 hours then hourly until 24 hours |
|
K |
their vital signs should
be checked at 0, 1 & 2 hours, then hourly until 48 hours |
|
L |
their vital signs should
be checked at 0, 1 & 2 hours, then 2 hourly until 12 hours |
|
M |
their vital signs should
be checked at 0, 1 & 2 hours, then 2 hourly until 24 hours |
|
N |
their vital signs should
be checked at 0, 1 & 2 hours, then 2 hourly until 48 hours |
|
O |
their vital signs should
be checked at 0, 1 & 2 hours, then 4 hourly until 12 hours |
|
P |
their vital signs should
be checked at 0, 1 & 2 hours, then 4 hourly until 24 hours |
|
Q |
their vital signs should
be checked at 0, 1 & 2 hours, then 4 hourly until 48 hours |
|
R |
none of the above |
Question
42.
What
antibiotic treatment should be provided for babies with signs of EOGBSD?
Option list.
|
A |
benzylpenicillin within 1
hour of birth |
|
B |
benzylpenicillin within 4
hours of birth |
|
C |
benzylpenicillin +
gentamycin within 1 hour of birth |
|
D |
benzylpenicillin +
gentamycin within 4 hours of birth |
|
E |
benzylpenicillin + metronidazole within 1 hour of birth |
|
F |
benzylpenicillin + metronidazole within 4 hours of birth |
|
G |
benzylpenicillin + streptomycin
within 1 hour of birth |
|
H |
benzylpenicillin + streptomycin within 4 hours of birth |
|
I |
none of the above |
Question
43.
A woman is
noted to be pyrexial in labour, temperature = 38.4OC. What antibiotic
therapy, if any, should be provided, assuming she has no drug allergies?
Option list.
|
A |
benzyl penicillin |
|
B |
amoxicillin |
|
C |
amoxicillin + clavulanic
acid |
|
D |
broad spectrum antibiotic
that covers GBS and is in accordance with the local antibiotic advice. |
|
E |
a cephalosporin |
|
F |
clindamycin |
|
G |
quinolone antibiotic that
covers GBS and is in accordance with the local antibiotic advice. |
|
H |
none of the above |
Question
44.
A woman is
found to have GBS colonisation but declines IAP. Which, if any, of the
following are appropriate?
Option list.
|
A |
advise her that she
should stay in hospital for at least 48 hours so the baby can be monitored |
|
B |
ask her to transfer to
another hospital if she won’t take your advice re the GBS protocol |
|
C |
explain the rationale of
the policy relating to IAP and maternal GBS colonisation |
|
D |
get the hospital lawyer
to ask the Court of Protection to appoint a Deputy to authorise IAP. |
|
E |
give her a good slapping |
|
F |
tell her to think about
the baby, not herself |
Question
45.
What possible adverse
effects of IAP are discussed in GTG36?
Option list.
|
A |
anaphylaxis |
|
B |
antibiotic resistance |
|
C |
disturbance of neonatal microbiome |
|
D |
NEC |
|
E |
asthma in children |
|
F |
cerebral palsy in
children |
|
G |
impaired functional
development in children |
|
H |
inflammatory bowel
disease in children |
|
I |
schizophrenia in
adolescents |
Question
46.
What advice
should be given about breastfeeding?
Option list.
|
A |
it should be encouraged |
|
B |
it should be encouraged but
withheld during administration of IAP |
|
C |
it should be encouraged but
withheld during administration of IAP and the week after |
|
D |
it is contraindicated |
|
E |
none of the above. |
39. Retinoids and pregnancy.
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”. TOG. 2014. Volume16, Issue1, Pages 7-11.
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, so I have added it..
Retinoid use is safe during breastfeeding. True False
40. Caldicott guardian.
Question 1.
Option List
|
A |
it is a large lizard, unique to the
Galapagos Islands |
|
B |
it is the Trust Board member
responsible for child safeguarding procedures |
|
C |
it is the Trust Board member responsible
for complaint procedures |
|
D |
it is the person within a Trust
responsible for patient confidentiality in relation to information |
|
E |
it is the person within a Trust
responsible for dealing with bullying |
Question 2.
Lead-in
The Caldicott Report identified 6 basic principles. What are they?
Option list.
There is none. Imagine
that there is information about you stored on the computers of the local NHS
Trust. What conditions would you want to lay down about sharing of that
information within the Trust, with other NHS organisations and with non-NHS
organisations?
Question 3.
Lead-in
The Caldicott Report made numerous recommendations. Which was
particularly important for major NHS organisations such as Trusts?
Option List
|
A. |
the need to appoint a Caldicott Guardian |
|
B. |
the need to create a
Caldicott Register |
|
C. |
the need to create a
Caldicott Police Department |
|
D. |
the need to create a
link between the Caldicott Department and the DOH |
|
E. |
none of the above. |
Question 4.
What is the definition of the key role deriving from the answer to question
3?
Option List
There is none lest it give you the answer to question 3!
41. Tetracycline and pregnancy.
Question
47.
Option list.
|
A |
tetracyclines are β-lactam antibiotics |
|
B |
tetracyclines inhibit
bacterial protein synthesis |
|
C |
tetracyclines are
bactericidal |
|
D |
tetracyclines bind
strongly to calcium and form stable complexes in bone |
|
E |
tetracyclines bind
strongly to fetal bone and teeth |
|
F |
there is evidence that
tetracyclines are teratogenic |
|
G |
tetracyclines are
contraindicated in pregnancy |
|
H |
tetracyclines are contraindicated
during breastfeeding |
|
I |
tetracyclines taken in
the 1st. trimester are grounds for offering TOP |
|
J |
tetracyclines may cause
fatal maternal hepatic damage |
