|
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?
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 |
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?
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!
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.
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
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 |
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 |
