Thursday, 27 May 2021

Tutorial 27 May 2021

 

Contact us.


Website.

 

1

How to prepare. What to read. StratOG. TOG CPD. RCOG sample questions. Revision system. Study buddies. Statistics. Urogynaecology

2

EMQ. Maternal Mortality definitions

3

EMQ. Cystic fibrosis

4

EMQ. Phenylketonuria

5

EMQ. Mycoplasma genitalium

 

1.     How to prepare.

 

2.     EMQ. Maternal mortality definitions.

Option List.

A.   Death of a woman during pregnancy and up to 6 weeks later, including accidental and incidental causes.

B.   Death of a woman during pregnancy and up to 6 weeks later, excluding accidental and incidental causes.

C.    Death of a woman during pregnancy and up to 52 weeks later, including accidental and incidental causes.

D.   Death of a woman during pregnancy and up to 52 weeks later, excluding accidental and incidental causes.

E.    A pregnancy going to 24 weeks or beyond.

F.    A pregnancy going to 24 weeks or beyond + any pregnancy resulting in a live-birth.

G.   Maternal deaths per 100,000 maternities.

H.   Maternal deaths per 100,000 live births.

I.     Direct + indirect deaths per 100,000 maternities.

J.     Direct + indirect deaths per 100,000 live births.

K.    Direct death.

L.    Indirect death.

M.  Early death.

N.   Late death.

O.   Extra-late death.

P.    Fortuitous death.

Q.   Coincidental death.

R.    Accidental death.

S.    Maternal murder.

T.    Not a maternal death.

U.   Yes

V.   No.

W. I have no idea.

X.    None of the above.

Abbreviations.

AFE:                    Amniotic Fluid Embolism.

APH:                   Antepartum haemorrhage.

PPH:                   Postpartum haemorrhage.

SUDEP:               Sudden Unexplained Death in Epilepsy. 

 

Question 1.             

What is a Maternal Death?

Question 2.             

Which categories are included in the definition of MD? This is not a true EMQ as >1 Answer may be correct.

Option list.

A

accidental death

B

coincidental death

C

direct death

D

iatrogenic death

E

incidental death

F

indirect death

G

late death

Question 3.             

Which categories are included in the discussions in the MMRs? This is not a true EMQ as >1 Answer may be correct.

Option list.

A

accidental death

B

coincidental death

C

direct death

D

iatrogenic death

E

incidental death

F

indirect death

G

late death

Question 4.             

A woman dies from a ruptured ectopic pregnancy at 10 weeks’ gestation. What kind of death is it?

Question 5.             

A woman dies from a ruptured appendix at 10 weeks’ gestation. What kind of death is it?

Question 6.             

A woman dies from chickenpox at 30 weeks’ gestation. What kind of death is it?

Question 7.             

A woman dies from sepsis secondary to pyelonephritis at 20 weeks’ gestation. What kind of death is it?

Question 8.             

A woman dies from sepsis two weeks after C section. The sepsis was due to uterine infection that started as chorioamnionitis. What kind of death is it?

Question 9.             

A woman dies from hepatitis C at 40 weeks’ gestation. The infection was transmitted sexually. What kind of death is it?

Question 10.         

A woman dies from suicide at 10 weeks’ gestation. What kind of death is it?

Question 11.         

A woman with a 10-year-history of coronary artery disease dies of a coronary thrombosis at 36 weeks’ gestation. What kind of death is it?

Question 12.         

A woman has gestational trophoblastic disease, develops choriocarcinomas and dies from it 24 months after the GTD was diagnosed and the uterus evacuated. What kind of death is it?

Question 13.         

A woman develops puerperal psychosis from which she makes a poor recovery. She kills herself when the baby is 18 months old. What kind of death is it?

Question 14.         

A woman develops puerperal psychosis from which she makes a poor recovery. She kills herself when the baby is 6 months old. What kind of death is it?

Question 15.         

What is a “maternity”.

Question 16.         

What is the definition of the Maternal Mortality Rate?

Question 17.         

What is the Maternal Mortality Ratio?

Question 18.         

A woman is diagnosed with breast cancer. She has missed a period and a pregnancy test is +ve. She decides to continue with the pregnancy. The breast cancer does not respond to treatment and she dies from secondary disease at 38 weeks. What kind of death is it?

Question 19.         

A woman who has been the subject of domestic violence is killed at 12 weeks’ gestation by her partner. What kind of death is it?

Question 20.         

A woman is struck by lightning as she runs across a road. As a result, she falls under the wheels of a large lorry which runs over her abdomen, rupturing her spleen and provoking placental abruption. She dies of haemorrhage, mostly from the abruption. What kind of death is it?

Question 21.         

A woman is abducted by Martians who are keen to study human pregnancy. She dies as a result of the treatment she receives. As this death could only have occurred because she was pregnant, is it a direct death?

Question 22.         

Could a maternal death from malignancy be classified as “direct”?

Question 23.         

Could a maternal death from malignancy be classified as “Indirect”?

Question 24.         

Could a maternal death from malignancy be classified as “Coincidental”?

Question 25.         

A pregnant woman is walking on the beach at 10 weeks when she is struck by lightning and dies. What kind of death is this?

Question 26.         

A woman is sitting on the beach breastfeeding her 2-year old baby when she is struck by lightning and dies. What kind of death is this?

 

3.     EMQ. Cystic fibrosis.

And, to make you behave in a model fashion, there is no option list, so you have to decide the correct answer.

Scenario 1.

A woman is 8 weeks pregnant and known to be a carrier of cystic fibrosis.

Her husband is Caucasian. What is the risk of the child having cystic fibrosis?

Scenario 2.

A healthy woman attends for pre-pregnancy counselling. Her brother has cystic fibrosis. Her husband is Caucasian. He has been screened for cystic fibrosis. The test was negative.

What is the risk of them having a child with cystic fibrosis?

Scenario 3.

A healthy woman is a known carrier of cystic fibrosis. She attends for pre-pregnancy counselling. Her husband has cystic fibrosis. What is the risk of them having a child with CF?

Scenario 4.

A healthy woman attends for pre-pregnancy counselling. Her sister has had a child with cystic fibrosis. What is her risk of being a carrier?

Scenario 5.

A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.

What is the risk that she is a carrier?

Scenario 6 .

A woman attends for pre-pregnancy counselling. Her mother has cystic fibrosis.

The partner’s risk of being a carrier is 1 in X. What is the risk that she will have a child with CF?

Scenario 7.

A healthy Caucasian woman is 10 weeks pregnant. Her husband is a known carrier of cystic fibrosis.

Which test would you arrange?

Scenario 8.

A woman attends for pre-pregnancy counselling. She has read about diagnosing CF using cffDNA from maternal blood. Is it possible to test for CF in this way?

Scenario 9.

A woman and her husband are known carriers of cystic fibrosis. What is the risk of them having an affected child?

Scenario 10.

A woman and her husband are known carriers of cystic fibrosis. What can they do to reduce the risk of having an affected child?

Scenario 11.

A woman and her husband are known carriers of cystic fibrosis. Can CVS exclude an affected pregnancy?

Scenario 12.

A woman with cystic fibrosis is planning pregnancy. Her husband is a  known carriers of cystic fibrosis. What is the risk of having an affected child?

Scenario 13.

A woman with cystic fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been advised not to breastfeed because her breast milk will be protein-deficient due to malabsorption.

Is this advice correct?

Scenario 14.

A woman with cystic fibrosis has a normal delivery of a healthy, 3.2 kg. baby at term. She has been advised not to breastfeed because her breast milk will contain abnormally low levels of sodium.

Is this advice correct?

 

TOG CPD. 2009. 11. 1.

These are open access so are produced here.

Cystic fibrosis and pregnancy

Regarding cystic fibrosis,

1.     here are approximately 8000 people living with this disease in the UK.                 True / False

2.     the main cause of death is liver disease.                                                                     True / False

Women with cystic fibrosis

3.     have an approximately 50% reduced fertility.                                                            True / False

4.     have a life expectancy of approximately 50 years.                                                    True / False

With regard to pregnancy in women with cystic fibrosis,

5.     their babies usually have an appropriate birthweight for their gestational age.           True / False

6.     approximately 70% of babies are born prematurely.                                                 True / False

7.     the risk of developing gestational diabetes is higher than in the general population. True / False

8.     the risk of miscarriage is higher than in the general population.                                         True / False

9.     the risk of congenital malformations is similar to that in women who are carriers.    True / False

Women with cystic fibrosis who become pregnant,

10.   have a shortened life expectancy compared with women who do not.                          True / False

If a woman with cystic fibrosis becomes pregnant, the risk of the baby being born with cystic fibrosis

11.   is 50% if the father carries one of the common gene mutations for cystic fibrosis.             True / False

12.   is < 1 in 250 if the father does not carry any of the common CF mutations.                     True / False

During pregnancy, a woman with cystic fibrosis

13.   should be cared for by a multidisciplinary team, including a physician and an obstetrician with a special interest in CF in pregnancy.                                                                                 True / False

14.   should have a GTT if she did not have CF-related diabetes prior to pregnancy. True / False

In pregnant women with cystic fibrosis,

15.   the instrumental delivery rate is approximately 40%.                                                 True / False

16.   the use of epidural analgesia during delivery is contraindicated.                                 True / False

17.   the risk of poor pregnancy outcome increases if the FEV1 is < 70%.                                 True / False

Post- delivery in women with cystic fibrosis

18.   breastfeeding is contraindicated because of the high sodium content of breast milk.        True / False

Which of the following statements about cystic fibrosis are correct?

19.   Menarche in girls with CF occurs at the same time as in unaffected girls.                    True / False

20.   Fertility in women with CF is affected to the same extent as it is in men with CF.         True / False

 

4.     EMQ. Phenylketonuria.

Abbreviations.

PA:              phenylalanine.

PAH:           phenylalanine hydroxylase.

PKU:           phenylketonuria.

Tyr:             tyrosine.

Option list.

A.       

autosomal dominant

B.       

autosomal recessive

C.       

X-linked dominant

D.      

X-linked recessive

E.       

1 in 100,000

F.       

1 in 50,000

G.      

1 in 10,000

H.      

1 in 5,000

I.         

deficiency in phenylalanine hydroxylase

J.        

deficiency in phenylalanine oxidase

K.       

deficiency in phenylalanine transferase

L.        

deficiency in phenylketone hydroxylase

M.     

deficiency in phenylketone oxidase

N.      

raised PA levels

O.      

reduced PA levels

P.       

raised tyrosine levels

Q.      

reduced tyrosine levels

R.       

normal tyrosine levels

S.       

No

T.       

Yes

U.      

unknown

 

Question 1.  

What is PKU? Write your answer – there is no option list.

Question 2.  

What is PKU due to? Use the option list.

Question 3.  

What levels of PA and Tyr are typical in PKU? Use the option list. This is not a real EMQ as there are two answers.

Question 4.  

Is PKU subdivided into different categories? If “yes”, what are the categories? Write your answer – there is no option list.

Question 5.  

Which, if any, of the following statements is true about hyperphenylalaninaemia? This is not a true EMQ as more than one answer may be correct.

Option List

A.       

it blocks growth hormone

B.       

it destroys astrocyte miosis

C.       

it disrupts folic acid activity

D.      

it enhances vitamin A activity

E.       

it interferes with myelin synthesis

F.       

it negates the effects of vitamin C

G.      

nobody knows, nobody cares; especially me

Question 6.  

How is PKU inherited? Use the option list.

Question 7.  

Which chromosome houses the gene related to PKU transmission?

Question 8.  

How many mutations of the gene related to PKU have so far been identified?

Question 9.  

Is a person with PKU likely to have one or two mutations of the relevant gene?

Question 10.         

What is BH4?

Question 11.         

What is pegvaliase?

Question 12.         

What is the approximate prevalence of PKU in Caucasians?

Question 13.         

What is the approximate prevalence of PKU carrier status in Caucasians?

Question 14.         

The prevalence of PKU varies between ethnic groups.

Match each of the following ethnic groups to the closest prevalence given in the option list.

Option List

H.      

1 in 1,000

I.         

1 in 2,500

J.        

1 in 5,000

K.       

1 in 10,000

L.        

1 in 100,000

M.     

1 in 150,000

N.      

1 in 200,000

O.      

1 in 1,000,000

 

Ethnic group

Prevalence

Turkish

1 in 2,600

Irish

1 in 4,500

Caucasian

1 in 10,000

East Asian

1 in 10,000

Japanese

1 in 143,000

Finnish

1 in 200,000

Question 15.         

Which, if any, of the following are characteristic of PKU?

Option list.

A.       

alopecia

B.       

angst

C.       

facial dysmorphism

D.      

facial hair in females and pre-pubertal males

E.       

kyphosis

F.       

macroorchidism in post-pubertal males

Question 16.         

Are fetal PKU levels higher or lower than maternal? There is no option list.

Question 17.         

Which, if any, of the following  are true in relation to the maternal phenylketonuria syndrome? This is not a true EMQ as there may be more than correct answer.

Option list.

A.       

asymptomatic bacteruria is more common

B.       

cholestasis of pregnancy is more common

C.       

early onset gestational hypertension is more common

D.      

eczema is more common

E.       

gallstones are more common

F.       

miscarriage is more common

G.      

MPKUS is usually due to non-adherence to a low phenylalanine diet

H.      

porphyria is more common

I.         

reversible posterior cerebral syndrome is more common

J.        

urinary tract urea stones are more common

K.       

none of the above

Question 18.         

What are the main consequences for the offspring of untreated PKU in the mother?

Question 19.         

Is screening for PKU a routine part of the neonatal screen in the UK?

Question 20.         

The test for PKU used to be known by the name of its inventor. Who was he and why did he have a particular interest? There is no option list and no one is going to ask you except me!

Question 21.         

What conditions are included in the routine neonatal ‘heelprick’ screening test? There is no option list.

Question 22.         

Is neonatal screening for PKU still done using Guthrie’s bacterial inhibition method? If not, what method is used? There is no option list.

Question 23.         

What is the main treatment of PKU and what problems are associated with it? There is no option list.

Question 24.         

How long should the main treatment of PKU be continued and why? There is no option list.

Question 25.         

Lead-in

A woman with PKU is planning her first pregnancy at the age of 22. She has been off the PKU-restricted diet since the age of 10 and can barely remember being on it. Should she be advised to re-start the diet? If ‘yes’, when should she start and what explanation would you give for the advice?

Question 26.         

Lead-in

Which if any of the following statements are true about screening for PKU and its effects in the neonate born to a woman with PKU ?

Option list.

A.       

routine bloodspot screening alone is required

B.       

the neonate should be examined by a paediatrician for signs of PKU

C.       

the baby should have developmental assessment, even if it does not have PKU

D.      

an ultrasound scan should be done because of the increased risk of developmental dysplasia of the hip

E.       

the baby should be started on a low PA diet until all assessments are complete

F.       

none of the above.

Question 27.         

Lead-in

Is breast-feeding advisable for women with PKU?

Question 28.         

Lead-in

Are any other therapeutic approaches available? If ‘yes’, what are they and how do they work? If ‘yes’ use the option list for the mode of action.

Option List

A.       

it binds PA to circulating plasma proteins, reducing its free levels

B.       

it increases hepatic metabolism of PAH.

C.       

it increases renal excretion of PA

D.      

it is a co-factor for PAH, increasing its efficacy in reducing PA levels

E.       

it is phenylalanine ammonia lyase, capable of breaking down PA

F.       

it is a synthetic PAH enzyme

G.      

it reduces absorption of PA from the small bowel

 

TOG CPD questions. These are open-access, so reproduced here.

Regarding phenylketonuria (PKU):

1.        it is a deficiency of the amino acid phenylalanine (Phe).                                              True  False

2.        it is an X-linked recessive inherited metabolic disease.                                              True  False

3.        it results in a deficiency in the amino acid tyrosine.                                              True  False

4.        it is treated with a low-phenylalanine restricted diet.                                              True  False

5.        the incidence is approximately 1:1000.                                                                 True  False

6.        the Newborn Screening Programme has been a great success in the diagnosis and management of children with PKU.                                                                         True  False

7.        neonates with fetal alcohol syndrome and PKU are clinically difficult to distinguish at birth.                                                                                                                           True  False

8.        in utero exposure to very high levels of phenylalanine results in reversible neurological damage to the fetus.                                                                                           True  False

9.        pregnancy outcome is improved substantially when treatment results in low maternal phenylalanine concentrations ideally before conception.                                             True  False

10.      oral methods of contraception should be switched to barrier methods at least 12 months before conception.                                                                                           True  False

11.      the risk of congenital heart defects is estimated to be 7–10%.                                    True  False

12.      it is an indication for early delivery by caesarean section.                                             True  False

13.      neonates born to mothers with PKU should be offered screening for PKU as per the routine national screening programme.                                                                                  True  False

14.      breastfeeding is contraindicated in women with PKU.                                             True  False

With regard to the biochemistry of PKU:

15.      Phe is passively transported across the placenta.                                               True  False

16.      fetal Phe levels are approximately 1.25-2.5 times > than maternal levels.                 True  False

Children born to women with PKU:

17.      tend to have blue eyes.                                                                                           True  False

18.      are fair skinned.                                                                                                        True  False

With regard to the effect of high Phe levels on loss of IQ or behavioural changes:

19.      these changes are reversible in utero.                                                                   True  False

20.      they are reversible with resumption of diet deficient of Phe.                                     True  False

 

5.     EMQ. Mycoplasma genitalium.

Lead-in.

Many of the questions are not true EMQs as they have more than one correct answer. I have tried to include all the facts I think might feature in the exam and packing more than one into a question reduces the total number of questions and makes the document a bit more manageable. It also reduces the amount of typing I have to do.

Abbreviations.

BASSH:         British Association for Sexual Health and HIV.

BASHHMG:  British Association for Sexual Health and HIV’s “National guideline for the management of infection with Mycoplasma genitalium”. 2018

MG:               Mycoplasma genitalium.

NHSCS:         NHS Cervical Screening Programme

Scenario 1.              

Which, if any, of the following statements are true in relation to MG? This is not a true EMQ as there may be more than one correct answer.

Option list.

A

MG was first isolated in 2001

B

MG was first isolated from men with non-gonococcal urethritis (NGU)

C

MG belongs to the Cutemollies class

D

MG is the smallest known yeast with the ability to self-replicate

E

MG is the smallest known bacterium with the ability to self-replicate

F

MG has an unusual, double-layered cell wall

G

MG has an unusual protrusion at one end

H

MG’s protrusion enables it to adhere to epithelial cells

I

MG’s protrusion enables it to invade epithelial cells

J

MG is best seen on a Gram stain

Scenario 2.              

Which, if any, of the following statements are true in relation to Mycoplasmas?

Option list.

A

are the largest known bacteria

B

have no cell wall

C

have no nuclei

D

are resistant to ß-lactam antibiotics

E

are resistant to sulphonamides

F

colonies show a ‘scrambled egg’ appearance on culture on agar

G

particularly affect mucosal surfaces

Scenario 3.              

Which, if any, of the following statements are true in relation to Mg?

Option list.

A

when the organism was originally found, culture took 50 days

B

Mg is facetious

C

Mg is a facultative aerobe

D

Mg is a facultative anaerobe

E

Mg is a facultative aerobe & anaerobe

F

Mg is fastidious

Scenario 4.              

Which, if any, of the following are true in relation to the approximate prevalence of MG?

Option list.

A

it is ~ 0.1%

B

it is ~ 1.0%

C

it is ~ 5.0%

D

it is ~ 5-10%

E

it is > 10%

F

none of the above

Scenario 5.              

Which, if any, of the following is true in relation to screening for MG? This is a true EMQ with only one correct answer.

Option list.

A

screening for MG is now included in the NCSP

B

screening for MG is now offered as part of the NHSCS

C

screening should be offered to all sexually active women < 30 years old

D

screening should only be offered to those with symptoms suggestive of infection

E

screening should be offered to all partners of those with MG infection

F

none of the above

Scenario 6.              

Which, if any, of the following are included in BASHHMG as risk factors for infection with MG?

Option list.

A

Cigarette smoking

B

Multiple dancing partners

C

Multiple sexual partners

D

Non-white ethnicity

E

Younger age

F

None of the above

Scenario 7.              

Which of the following statements is true in relation to MG and co-infection with other organisms?

Option list.

A

MG excretes bactericidal toxins and co-infection is rare

B

MG co-infection is most often with chlamydia

C

MG co-infection is most often with E. coli

D

MG co-infection is most often with HIV

E

MG co-infection is most often with TB

F

None of the above

Scenario 8.              

Which of the following statements is true in relation to MG and men?

Option list.

A

It is the most common cause of NGU

B

It is the most common cause of epididymitis

C

It is the most common cause of prostatitis

D

It is a well-recognised cause of male sub-fertility

E

Most men with MG infection are asymptomatic

E

None of the above

Scenario 9.              

Which, if any, of the following statements are true in relation to MG and women?

Option list.

A

MG is linked to an risk of cervicitis

B

MG is linked to an risk of endometritis

C

MG is linked to an risk of female infertility

D

MG is linked to an risk of miscarriage

E

MG is linked to an risk of otitis media

F

MG is linked to an risk of pelvic inflammatory disease

G

MG is linked to an risk of postcoital bleeding

H

MG is linked to an risk of postmenopausal bleeding

I

MG is linked to an risk of preterm birth

J

MG is linked to an risk of damage to Fallopian tube cilia

K

MG is linked to an risk of puerperal psychosis

L

MG is linked to an risk of puerperal sepsis

M

Most infected women are asymptomatic

N

None of the above

Scenario 10.           

Which, if any, of the following statements are true in relation to current concerns about Mg?

Option list.

A

It could become a ‘superbug’, resistant to most antibiotics, within a decade

B

Infection is often misdiagnosed as chlamydia with risk of antibiotic resistance

C

‘superbug’ status would be likely to lead to an in renal failure

D

‘superbug’ status would be likely to lead to an in female infertility

E

‘superbug’ status would be likely to lead to an in male infertility

Scenario 11.           

Which, if any, of the following are used in the recommended test for MG infection in women?

Option list.

A

blood testing for MG IgG

B

blood testing for MG IgM

C

cervical smears checked microscopically for the diagnostic intracellular inclusion bodies

D

culture and sensitivity of cervical swab specimens using MG-specific culture medium

E

culture and sensitivity of 1st. void MSSU using MG-specific culture medium

F

culture and sensitivity of vaginal swab specimens using MG-specific culture medium

G

NAATs that detect the MG G-antigen

H

NAATs that detect MG DNA

I

NAATs that detect MG RNA

J

serum testing for MG-specific antigen

K

vaginal swabs taken by the woman

L

none of the above

Scenario 12.           

Which, if any, of the following statements are true in relation to testing for antibiotic resistance after initial tests are +ve for MG?

Option list.

A

test for resistance to cephalosporins

B

test for resistance to macrolides

C

test for resistance to penicillin

D

test for resistance to quinolones

E

test for resistance to macrolides

F

test for resistance to streptomycin

F

test for resistance to sulphonamides

F

test for resistance to tetracyclines

G

None of the above

Scenario 13.           

Which, if any, of the following statements are true in relation to estimates of antibiotic resistance in current strains of MG in the UK?

Option list.

A

20% are resistant to cephalosporins

B

40% are resistant to macrolides

C

50% are resistant to penicillin

D

50% are resistant to quinolones

E

10% are resistant to streptomycin

F

90% are resistant to sulphonamides

F

40% are resistant to tetracyclines

F

None of the above

Scenario 14.           

Which, if any, of the following is BASHHMG’s recommended 1st. line treatment of uncomplicated MG?

Option list.

A

azithromycin 1 gram daily for 7 days

B

doxycycline 100 mg twice daily for 7 days

C

doxycycline 100 mg twice daily for 10 days

D

doxycycline 100 mg twice daily for 7 days

E

doxycycline 100 mg twice daily for 7 days then azithromycin 1 gram daily for 2 days

F

moxifloxacin 400mg orally once daily for 7 days

G

moxifloxacin 400mg orally once daily for 10 days

H

none of the above

Scenario 15.           

Lead-in

Which, if any, of the following is BASHHMG’s recommended 1st. line treatment of complicated MG?

Option list.

A

doxycycline 100 mg twice daily for 10 days

B

doxycycline 100 mg twice daily for 14 days

C

moxifloxacin 400mg orally once daily for 10 days

D

moxifloxacin 400mg orally once daily for 14 days

E

none of the above

Scenario 16.           

Lead-in

This is not an EMQ or SBA!

Fill in the gaps in the table below, using option list.

Option list.

A

aminoglycoside

B

cephalosporin

C

macrolide

D

penicillin

E

quinolone

F

tetracycline

Table.

Drug name

Category of drug

azithromycin

 

doxycycline

 

moxifloxacin

 

Scenario 17.           

Which, if any, of the following statements is true in relation to test of cure (TOC) after treatment of MG?

Option list.

A

TOC should be offered to everyone who has been treated for MG

B

TOC should only be offered to those who had signs of infection before treatment

C

TOC should only be offered to those who had symptoms of infection before treatment

D

TOC should only be offered to those who had signs and symptoms before treatment

E

TOC should only be offered to those who continue to have signs or symptoms two weeks or more after the start of treatment

F

none of the above

Scenario 18.           

Which, if any, of the following statements are true in relation to the timing of test of cure (TOC) after treatment of MG?

Option list.

A

TOC is best done at 3 weeks after start of treatment

B

TOC is best done at 4 weeks after start of treatment

C

TOC is best done at 5 weeks after start of treatment

D

TOC is best done at 6 weeks after start of treatment

E

TOC should not be done < 2 weeks from the start of treatment

F

TOC should not be done < 3 weeks from the start of treatment

G

TOC should not be done < 4 weeks from the start of treatment