Contact us.
Don’t answer the Abortion Act question. The answer
became very long so I thought I would be clever and make some of the option
lists do for more than one question. But I was not as clever as I thought and
ended up with some questions and answers that did not relate to each other. I’ll
sort this out and put the topic on for the next tutorial.
15 December 2016.
41
|
SBA. Appendicitis & pregnancy
|
42
|
EMQ. Abortion Act
|
43
|
EMQ. Anatomy of fetal skull and maternal pelvis
|
44
|
EMQ. Drugs in O&G 1
|
45
|
EMQ. Clue cells, koilocytes etc.
|
41. Appendicitis
in pregnancy
Abbreviations.
AIP
|
Appendicitis
in pregnancy
|
CRP
|
C
reactive protein
|
CT
|
computed
tomography, also known as computerised tomography
|
RLQP
|
right
lower quadrant pain
|
RUQP
|
right upper
quadrant pain
|
Question 1
Lead-in
What is
the approximate incidence of appendicitis in pregnancy?
Option List
A.
|
1 in 500
|
B.
|
1 in 1,000
|
C.
|
1 in 2,000
|
D.
|
1 in 5,000
|
E.
|
1 in 10,000
|
Question 2
Lead-in
When is appendicitis
in pregnancy most common?
Option List
A.
|
first
trimester
|
B.
|
second trimester
|
C.
|
trimester
|
D.
|
1st. and 2nd. stages of labour
|
E.
|
in the hours after the 3rd. stage of labour
|
F.
|
during the puerperium
|
Question 3
Lead-in
What
eponymous title is given to the surface marker for the appendix?
Option List
A.
|
McBarney’s
point
|
B.
|
MacBurney’s point
|
C.
|
McBurney’s point
|
D.
|
MacBorney’s point
|
E.
|
McBorney’s point
|
Question 4
Lead-in
Where is
the point referred to in the above question?
Option List
A.
|
1/3 of
the way along the line joining the anterior superior iliac spine and
umbilicus
|
B.
|
1/2 of the way along the line joining the anterior
superior iliac spine and umbilicus
|
C.
|
2/3 of the way along the line joining the anterior
superior iliac spine and umbilicus
|
D.
|
1/3 of the way along the line joining the left and
right anterior superior iliac spines
|
E.
|
1/2 of the way along the line joining the left and
right anterior superior iliac spines
|
Question 5
Lead-in
Which, if
any, of the following statements are true about the person after whom the point
in the above questions is named?
Statements
A.
|
he spent
2 years as a postgraduate working in Berlin, London, Paris and Vienna
|
B.
|
he was
Professor of surgery at the Roosevelt hospital, New York from 1889 to 1894
|
C.
|
he presented his classical paper on appendicitis to the
NY Surgical Society in 1889
|
D.
|
he was a transvestite
|
E.
|
he died of a heart attack while on a hunting trip
|
Question 6
Lead-in.
Pick the
best option from the list below in relation to right lower quadrant pain in AIP
in the pregnant and non-pregnant.
Option List
A
|
comparative figures for the pregnant and non-pregnant
are unknown due to the rarity of appendicitis in pregnancy
|
B
|
RLQP is
as common in the pregnant as in the non-pregnant
|
C
|
RLQP is
less common in the pregnant
|
D
|
RLQP is more common in the pregnant
|
E
|
RLQP is rare in pregnancy
|
Question 7
Lead-in.
Pick the
best option from the list below in relation to right upper quadrant pain in AIP
in the pregnant and non-pregnant.
Option List
A
|
comparative figures for the pregnant and non-pregnant
are unknown due to the rarity of appendicitis in pregnancy
|
B
|
RUQP is
½ as common in the pregnant as in the non-pregnant
|
C
|
RUQP is
as common in the pregnant as in the non-pregnant
|
D
|
RUQP is
twice as common in the pregnant as in the non-pregnant
|
E
|
RUQP is
four times as common in the pregnant as in the non-pregnant
|
Question 8
Lead-in.
Pick the
best option from the list below in relation to nausea in AIP in the pregnant
and non-pregnant.
Option List
A
|
comparative figures for the pregnant and non-pregnant
are unknown due to the rarity of appendicitis in pregnancy
|
B
|
nausea
is as common in the pregnant as in the non-pregnant
|
C
|
nausea
is less common in the pregnant
|
D
|
nausea is more common in the pregnant
|
E
|
nausea is rare in pregnancy
|
Question 9
Lead-in.
Which
condition did CMACE say should be excluded in women presenting acutely with
gastrointestinal symptoms?
Option List
A
|
aortic dissection
|
B
|
appendicitis
|
C
|
Caesarean
section scar pregnancy
|
D
|
ectopic pregnancy
|
E
|
pancreatitis
|
F
|
ovarian torsion
|
Question 10
Lead-in.
Pick the
best option from the list below in relation to abdominal guarding in AIP in the
pregnant and non-pregnant.
Option List
A
|
comparative figures for the pregnant and non-pregnant
are unknown due to the rarity of appendicitis in pregnancy
|
B
|
abdominal
guarding is as common in the pregnant as in the non-pregnant
|
C
|
abdominal
guarding is less common in the pregnant
|
D
|
abdominal
guarding is more common in the pregnant
|
E
|
abdominal
guarding is rare in pregnancy
|
Question 11
Lead-in.
Pick the
best option from the list below in relation to rebound tenderness in AIP in the pregnant and
non-pregnant.
Option List
A
|
comparative figures for the pregnant and non-pregnant
are unknown due to the rarity of appendicitis in pregnancy
|
B
|
rebound tenderness is as common in the pregnant as in
the non-pregnant
|
C
|
rebound tenderness is less common in the pregnant
|
D
|
rebound tenderness is more common in the pregnant
|
E
|
rebound tenderness is rare in pregnancy
|
Question 12
Lead-in.
Pick the
best option from the list below in relation to fever in AIP in the pregnant and
non-pregnant.
Option List
A
|
comparative figures for the pregnant and non-pregnant
are unknown due to the rarity of appendicitis in pregnancy
|
B
|
fever is
as common in the pregnant as in the non-pregnant
|
C
|
fever is
less common in the pregnant
|
D
|
fever
is more common in the pregnant
|
E
|
fever
is rare in pregnancy
|
Question 13
Lead-in
How useful
is the finding of leucocytosis in making the diagnosis of AIP?
Option List
A.
|
sine qua
non
|
B.
|
very useful
|
C.
|
not very useful
|
D.
|
I don’t know
|
Question 14
How useful
is the finding of a raised CRP level in the diagnosis of AIP?
Option List
A.
|
sine qua
non
|
B.
|
very useful
|
C.
|
not very useful
|
D.
|
I don’t know
|
Question 15
Lead-in
What are
the ultrasound features of appendicitis?
Option List
A
|
appendix
with diameter > 0.6 mm.
|
B
|
appendix with diameter > 1 cm.
|
C
|
blind-ending tubular structure
|
D
|
non-compressible
tubular structure
|
E
|
none of the above
|
Question 16
Lead-in
What
figures do W&M give for sensitivity & specificity for US diagnosis of appendicitis?
Option List
Sensitivity
|
Specificity
|
|
A
|
≥65%
|
≥80%
|
B
|
≥75%
|
≥85%
|
C
|
≥86%
|
≥97%
|
D
|
≥91%
|
≥98%
|
E
|
≥95%
|
≥95%
|
Question 17
Lead-in
Which, if
any, of the following statements are true about CT scanning for the diagnosis
of AIP?
Option List
A
|
CT scanning
has sensitivity > 85% and specificity >95%
|
B
|
CT scanning exposes mother and fetus to radiation doses
of little concern
|
C
|
CT scanning has replaced ultrasound scanning for AIP
|
D
|
CT scanning is not of proven value after inconclusive
ultrasound scanning
|
E
|
CT scanning is of proven value and most useful after inconclusive ultrasound scanning
|
Question 18
Lead-in
Which, if
any, of the following statements are true about MRI scanning for the diagnosis
of AIP?
Option List
A
|
MRI
scanning has sensitivity > 90% and specificity >97%
|
B
|
MRI scanning exposes mother and fetus to radiation
doses of little concern
|
C
|
MRI scanning has replaced ultrasound scanning for AIP
|
D
|
MRI scanning is not of proven value after inconclusive
ultrasound scanning
|
E
|
MRI scanning is of proven value and most useful after inconclusive ultrasound scanning
|
Question 19
Lead-in
Which, if
any, of the following statements are true about the complications of AIP?
Option List
A
|
fetal
loss rate in uncomplicated AIP is about 1.5%
|
B
|
fetal loss rate in AIP complicated by peritonitis is
about 6%
|
C
|
fetal
loss rate in AIP complicated by perforation of the appendix is up to 36%
|
D
|
pre-term delivery rates increase in AIP complicated by
perforation of the appendix
|
E
|
a low level of suspicion should apply to the diagnosis
of AIP in relation to surgical intervention
|
Question 20
Lead-in
Which, if
any, of the following statements are true about surgery for AIP?
Option List
A
|
laparotomy
should be done through a grid-iron incision with the mid-point the surface
marker for the appendix in the right iliac fossa
|
B
|
laparotomy should be done through a right paramedian
incision starting at the level of the umbilicus
|
C
|
about
35% of laparotomies show no evidence of appendicitis
|
D
|
the appendix should be removed even if it looks normal
|
E
|
antibiotic therapy is an alternative to surgery in
early cases of AIP
|
Question 21
Lead-in
Which, if
any, of the following statements are true about surgery for AIP?
Option List
A
|
laparotomy
should be done through a grid-iron incision with the mid-point the surface
marker for the appendix in the right iliac fossa
|
B
|
laparotomy should be done through a right paramedian
incision starting at the level of the umbilicus
|
C
|
about
35% of laparotomies show no evidence of appendicitis
|
D
|
the appendix should be removed even if it looks normal
|
E
|
antibiotic therapy is an alternative to surgery in
early cases of acute AIP
|
Question 22
Lead-in
Which, if
any, of the following statements are true about surgery for AIP?
Option List
A
|
laparoscopic
appendicectomy is an acceptable alternative to laparotomy, but only in the 1st.
trimester
|
B
|
laparoscopic appendicectomy is an acceptable
alternative to laparotomy, but only in the 1st. & 2nd.
trimesters
|
C
|
laparoscopic appendicectomy is an acceptable
alternative to laparotomy, at all gestations
|
D
|
there is evidence that laparoscopic appendicectomy is
associated with doubling of the rate of fetal loss
|
42. EMQ. Abortion Act.
Lead-in.
TOP and the Abortion Act are likely to feature in every
written exam.
The following scenarios relate to the Abortion Act.
Scenario 1
Lead in.
What was the approximate rate of abortion in the UK in
2014?
Option list
A
|
1 per 1,000 resident women aged 15-44
|
B
|
10 per 1,000 resident women aged 15-44
|
C
|
15 per 1,000 resident women aged 15-44
|
D
|
20 per 1,000 resident women aged 15-44
|
E
|
50 per 1,000 resident women aged 15-44
|
F
|
100 per 1,000 resident women aged 15-44
|
Scenario 2
Lead in.
The rate of abortion has declined by > 20% in the UK
in the past ten years.
Pick the answer from the option list that best matches
the above statement.
Option list
A
|
False
|
B
|
Haven’t a clue
|
C
|
Maybe
|
D
|
No data exist
|
E
|
True
|
Scenario 3
Lead in.
What proportion of TOPs were performed at gestations <
10 weeks in 2014?
Option list
A
|
50%
|
B
|
60%
|
C
|
70%
|
D
|
80%
|
E
|
90%
|
Scenario 4
Lead in.
There has been a significant improvement in the
proportion of TOPs performed early in the past decade.
Option list
A
|
False
|
B
|
Haven’t a clue
|
C
|
Maybe
|
D
|
No data exist
|
E
|
True
|
Scenario 5
Lead in.
What proportion of TOPs were performed using medical, not
surgical techniques?
Option list
A
|
20%
|
B
|
30%
|
C
|
40%
|
D
|
50%
|
E
|
60%
|
F
|
70%
|
G
|
80%
|
Scenario 6
Lead in.
Which age had the highest rate of TOP?
Option list
A
|
18
|
B
|
19
|
C
|
20
|
D
|
21
|
E
|
22
|
F
|
23
|
G
|
24
|
H
|
25
|
Option list for scenarios 7 – 9.
Option list
A
|
the rate was much lower
|
B
|
the rate was slightly lower
|
C
|
the rate was much higher
|
D
|
the rate was slightly higher
|
E
|
the rate was unchanged
|
Scenario 7
Lead in.
What happened to the rate of TOP in 2014 for girls <
18 years compared with 2013?
Scenario 8
Lead in.
What happened to the rate of TOP in 2014 for girls <
16 years compared with 2013?
Scenario 9
Lead in.
What happened to the rate of TOP in 2014 for girls <
16 years compared with 2004?
Scenario 10
Lead in
Approximately what proportion of women having TOP in 2014
had previously had one or more TOPs?
Option list
A
|
1%
|
B
|
5%
|
C
|
10%
|
D
|
20%
|
E
|
30%
|
F
|
40%
|
G
|
50%
|
Scenario 11
Lead in
There were 190,092 TOPs in 2014. How many deaths
occurred?
Option list
A
|
0
|
B
|
10
|
C
|
22
|
D
|
40
|
E
|
56
|
Scenario 12
Lead in
There were 190,092 TOPs in 2014. What was the rate of
significant complications?
Option list
A
|
<1%
|
B
|
1%
|
C
|
3%
|
D
|
5%
|
E
|
10%
|
Option list for scenarios 13-17.
1
|
the pregnancy has not exceeded its 24th.
week and that the continuance of the pregnancy would involve risk, greater
than if the pregnancy were terminated, of injury to the physical or mental
health of the pregnant woman
|
2
|
the pregnancy has not exceeded its 24th. week
and that the continuance of the pregnancy would involve risk, greater than if
the pregnancy were terminated, of injury to the physical or mental health of
any existing children of the family of the pregnant woman
|
3
|
the continuance of the pregnancy would involve risk to
the life of the pregnant woman greater than if the pregnancy were terminated
|
4
|
the termination is necessary to prevent grave permanent
injury to the physical or mental health of the pregnant woman
|
5
|
there is a substantial risk that if the child were born
it would suffer from such physical or mental abnormalities as to be seriously
handicapped
|
Scenario 13
Lead in.
The Abortion Act gives a number of legal grounds for TOP.
Which of the following is listed as “A”.
Scenario 14
Lead in.
The Abortion Act gives a number of legal grounds for TOP.
Which of the following is listed as “B”.
Scenario 15
Lead in.
The Abortion Act gives a number of legal grounds for TOP.
Which of the following is listed as “C”.
Scenario 16
Lead in.
The Abortion Act gives a number of legal grounds for TOP.
Which of the following is listed as “D”.
Scenario 17
Lead in.
The Abortion Act gives a number of legal grounds for TOP.
Which of the following is listed as “E”.
Scenario 18
Lead in.
With regard to the he Abortion Act and grounds “F” and
“G”. Which of the following statements are true?
1
|
“F” & “G” are grounds for TOP in an emergency with
only one doctor needing to sign the legal form necessary for the TOP to take
place
|
2
|
“F” & “G”
are grounds for TOP after 24 weeks.
|
3
|
“F” relates to TOP to save the woman’s life
|
4
|
“F” relates to TOP to prevent grave permanent injury her
physical or mental health
|
5
|
“F” & “G” do not exist.
|
Option list
A
|
1 + 3
|
B
|
1 + 4
|
C
|
2 + 3
|
D
|
2 + 4
|
E
|
5
|
Scenario 19
Lead in
In relation to terms such as “substantial risk”, “grave
permanent injury” and “seriously handicapped”, which of the following is true?
Option list
A
|
The terms were defined by a Parliamentary
sub-committee, examples were given and are included in Appendix 2 (b) to the
Act.
|
B
|
The terms were defined by a Parliamentary
sub-committee, examples were given and are included in Appendix 2 (c) to the
Act.
|
C
|
The terms were defined by the General Medical Council,
examples were given and the information can be downloaded from the GMC
website.
|
D
|
The terms were defined by the RCOG, examples were given
and the information can be downloaded from the RCOG website.
|
E
|
The terms have not been defined.
|
Scenario 20
Lead in
Which of the following statement is true about the most
common grounds for TOP?
Option list
1
|
TOP is most commonly done on ground A from the Abortion
Act.
|
2
|
TOP is most commonly done on ground B from the Abortion
Act.
|
3
|
TOP is most commonly done on ground C from the Abortion
Act.
|
4
|
TOP is most commonly done on ground D from the Abortion
Act.
|
5
|
TOP is most commonly done on ground E from the Abortion
Act.
|
6
|
TOP is most commonly done on ground F from the Abortion
Act.
|
7
|
TOP is most commonly done on ground G from the Abortion
Act.
|
8
|
TOP is most commonly done on ground H from the Abortion
Act.
|
Scenario 21
Lead in
Which of the following statements is true in relation to
the upper gestational limit for TOP to be legal in the UK.
1
|
Termination of pregnancy is legal to 24 weeks
|
2
|
Termination of pregnancy is legal after 24 weeks if the
mother’s life is at serious risk or there is a major risk of the fetus having
a serious anomaly.
|
3
|
Termination of pregnancy is legal after 24 weeks if the
mother’s life is at serious risk or there is a major risk of the fetus having
a serious anomaly, but only if approved by the Department of Health’s “Late
Termination of Pregnancy Assessment Panel”.
|
4
|
Termination of pregnancy is illegal after 24 weeks, but
is still done if the mother’s life is at serious risk or there is a major
risk of the fetus having a serious anomaly and there is a long-standing
agreement that the police and legal authorities will “turn a blind eye”.
|
Scenario 22
Lead in
Which of the following statement are true in relation to
TOP after 24 weeks?
Statements
1
|
TOP is illegal after 24 weeks
|
2
|
The mother must agree to feticide pre-TOP
|
3
|
Feticide must be offered
|
4
|
There must be very serious grounds for the TOP
|
5
|
Gender-selection TOP is unacceptable
|
Option list
A
|
1
|
B
|
1 + 2
|
C
|
2 + 3 + 5
|
D
|
3 + 4
|
E
|
3 + 4 + 5
|
Scenario 23
Lead in
Which form relates to certifying that a woman requesting
a TOP can have it done legally?
Option list
A
|
HSA1
|
B
|
HSA2
|
C
|
HSA3
|
D
|
HSA4
|
E
|
HSA5
|
Scenario 24
Lead in
Which form must the practitioner performing the TOP complete
to notify the TOP and return to Department of Health?
Option list
A
|
HSA1
|
B
|
HSA2
|
C
|
HSA3
|
D
|
HSA4
|
E
|
HSA5
|
Option list for scenarios 25 & 26.
A
|
True
|
B
|
False
|
C
|
Sometimes
|
D
|
Don’t know & don’t care
|
Scenario 25
Lead in
A doctor signing the form giving the grounds for a TOP
must have seen the woman.
Scenario 26
Lead in
A doctor performing a TOP must be one of the doctors who
signed the initial form giving the grounds for the TOP.
Scenario 27
Lead in
What is the time scale for the return of the form
notifying that a TOP has taken place?
Option list
A
|
3 working days
|
B
|
5 working days
|
C
|
1 week
|
D
|
2 weeks
|
E
|
1 month
|
Scenario 28
Lead in.
A woman seeks 1st.
trimester TOP on social grounds which she declines to discuss in detail.
Which of the following
statements apply?
Option List
A
|
TOP can be done under clause
A
|
B
|
TOP can be done under clause
B
|
C
|
TOP can be done under clause
C
|
D
|
TOP can be done under clause
D
|
E
|
TOP can be done under clause
E
|
F
|
TOP can be done under clause
F
|
G
|
TOP can be done under clause
G
|
F
|
there is no clause authorising
TOP on social grounds
|
Scenario 28
A woman seeks 1st. trimester
TOP. She has pulmonary hypertension and has been advised of the risks of
pregnancy by her cardiologist.
Which of the following
statements apply?
A
|
TOP can be done under clause
A
|
B
|
TOP can be done under clause
B
|
C
|
TOP can be done under clause
C
|
D
|
TOP can be done under clause
D
|
E
|
TOP can be done under clause
E
|
F
|
TOP can be done under clause
F
|
G
|
TOP can be done under clause
G
|
F
|
there is no clause
authorising TOP on these grounds
|
Scenario 29
A woman books at 26 weeks. She
has an unplanned pregnancy and has been advised of the risks of pregnancy by
her cardiologist.
Which of the following
statements apply?
A
|
TOP should be offered under
clause A
|
B
|
TOP should be offered under clause
B
|
C
|
TOP should be offered under
clause C
|
D
|
TOP should be offered under
clause D
|
E
|
TOP should be offered under
clause E
|
F
|
TOP should be offered under
clause F
|
G
|
TOP should be offered under
clause G
|
F
|
there is no clause
authorising TOP on these grounds
|
43. Anatomy
of fetal skull and maternal pelvis.
Scenario 1.
How many bones make up the
vault of the skull?
Option list.
A.
|
3
|
B.
|
5
|
C.
|
6
|
D.
|
7
|
E.
|
8
|
Scenario 2.
What is the origin of the word
“bregma”?
Option list.
A.
|
the Greek word meaning “arrow”
|
B.
|
the Greek word meaning “front of the head”
|
C.
|
the Greek word meaning “top of the head”
|
D.
|
the Greek word meaning “where lines intersect”
|
E.
|
none of the above
|
Scenario 3.
What is the origin of the word
“lambdoid”?
Option list.
A.
|
it is derived from “lambda”, the 11th.
letter of the Greek alphabet, with the symbol “λ”
|
B.
|
it is derived from the shape of the rear end of a
newborn lamb, with legs apart for balance in the shape of an inverted “V”
|
C.
|
it derives from the Norse noun “lam” meaning to hit
|
Scenario 4.
What is the origin of the word
“sagittal”?
Option list.
A.
|
it derives from the Latin verb “sagire” meaning to be
wise
|
B.
|
it derives from the Latin noun “sagitta” meaning
“arrow”
|
C.
|
it derives from the Latin adjective “sagitta” meaning
“pointing north”
|
D.
|
it derives from the Latin adjective “sagitta” meaning
“lacking tension”
|
Scenario 5.
What is
the meaning of the word “coronal”.
Option list.
A.
|
it is the 11th. letter of the Greek alphabet
|
B.
|
it derives from the Latin “corona” meaning “crown”.
|
C.
|
it derives from the sun’s corona, meaning equator
|
Scenario 6.
What is the definition of
“vertex”?
Option list.
A.
|
the most prominent part of the occiput
|
B.
|
the area around the posterior fontanelle
|
C.
|
the area bounded by the anterior fontanelle and the
posterior fontanelle
|
D.
|
the area bounded by the anterior & posterior
fontanelles and the parietal bones
|
E.
|
the area bounded by the anterior & posterior
fontanelles and the parietal eminences
|
F.
|
the area bounded by the anterior & posterior
fontanelles and the parietal cardinals
|
Option list for questions 7 & 8.
Option list.
A.
|
the anterior end of the
sagittal suture
|
B.
|
the area where the sagittal
and lambda sutures meet
|
C.
|
the area between the frontal
and parietal bones
|
D.
|
the posterior end of the
sagittal suture
|
E.
|
the area between the parietal
bones and the occiput
|
Scenario 7.
What is the definition of the
anterior fontanelle?
Scenario 8.
What is the definition of the
posterior fontanelle?
Scenario 9.
How many other fontanelles are
there?
A.
|
0
|
B.
|
2
|
C.
|
3
|
D.
|
4
|
E.
|
6
|
Scenario 10.
What is the falx cerebri?
Option list.
A.
|
an area of dura mater at the back of the skull like a
roof over the cerebellum
|
B.
|
is an artefact on ultrasound suggesting the presence of
cerebral tissue where there is none
|
C.
|
is the horizontal fibrous platform on which the
cerebellum rests
|
D.
|
is a crescent-shaped fold of dura mater separating the
cerebral hemispheres
|
Scenario 11.
What is the importance of the
falx cerebri in relation to delivery, particularly breech delivery?
Option list.
A.
|
the falx cerebri is inserted into the tentorium
cerebelli and traction on the base of the skull may lead to tentorial tears
and intracranial bleeding
|
B.
|
the falx cerebri is inserted into the bone of base of
the skull and traction on the base of the skull may lead to tears of the falx
and intracranial bleeding
|
C.
|
the falx cerebri is inserted into the tentorium
cerebelli and traction on the base of the skull may lead to tentorial tears leaving
the cerebellum unsupported and liable to trauma
|
Option list for Scenarios 12 - 16
Option list.
A.
|
suboccipito-bregmatic
|
B.
|
suboccipito-frontal
|
C.
|
occipito-frontal
|
D.
|
mento-vertical
|
E.
|
submento-bregmatic
|
Scenario 12.
What diameter presents to the
pelvis with vertex presentation?
Scenario 13.
What diameter presents to the
pelvis with typical occipito-posterior position?
Scenario 14.
What diameter presents to the
pelvis with brow presentation?
Scenario 15.
What diameter presents to the
pelvis with mento-anterior face presentation?
Scenario 16.
What diameter presents to the
pelvis with mento-posterior face presentation?
Option list for Scenarios 17- 21
Option list.
A.
|
9.0 cm.
|
B.
|
9.5 cm.
|
C.
|
10.0 cm.
|
D.
|
10.5 cm.
|
E.
|
11.0 cm.
|
F.
|
11.5 cm.
|
G.
|
12.0 cm.
|
H.
|
12.5 cm.
|
I.
|
13.0 cm.
|
J.
|
13.5 cm.
|
K.
|
14.0 cm.
|
Scenario 17.
What is the average length of
the suboccipito-bregmatic diameter in a term baby?
Scenario 18.
What is the average length of
the suboccipito-frontal diameter in a term baby?
Scenario 19.
What is the average length of
the occipito-frontal diameter in a term baby?
Scenario 20.
What is the average length of
the mento-vertical diameter in a term baby?
Scenario 21.
What is the average length of
the submento-bregmatic diameter in a term baby?
44. Drugs
in O&G 1.
Lead-in.
The following scenarios relate to drugs &
hypertension in pregnancy.
Abbreviations.
ACE: angiotensin-converting
enzyme
ARA: angiotensin II receptor antagonist
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 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?
45. EMQ.
Clue cells, koilocytes etc.
Abbreviations.
LGV: lymphogranuloma venereum
Option list.
A
|
Actinomyces
|
B
|
Bacterial vaginosis
|
C
|
Bacteroides
|
D
|
Chlamydia trachomatis
|
E
|
Chlamydial infection of the genital tract
|
F
|
Herpes Simplex
|
G
|
Human Papilloma Virus
|
H
|
Lymphogranuloma venereum
|
I
|
Monilia
|
J
|
Neisseria gonorrhoeae
|
K
|
Trichomonas vaginalis
|
Scenario 22.
Which option or options from
the option list best fit with “clue cells”
Scenario 23.
Which
option or options from the option list best fit with “fishy odour”?
Scenario 24.
Which
option or options from the option list best fit with “flagellate organisms”?
Scenario 25.
Which
option or options from the option list best fit with “inflammatory smear”?
Scenario 26.
Which
option or options from the option list best fit with “koilocytes”?
Scenario 27.
Which
option or options from the option list best fit with “non-specific urethritis
in the male”?
Scenario 28.
Which
option or options from the option list best fit with “strawberry cervix”?
Scenario 29.
Which
option or options from the option list best fit with “thin grey/ white
discharge”?
Scenario 30.
Which
option or options from the option list best fit with “white, curdy discharge”?
Scenario 31.
Which
option or options from the option list best fit with “frothy yellow discharge”?
Scenario 32.
Which option or options from the option list best fit
with “protozoan”?
Scenario 33.
Which option or options from the option list best fit
with “obligate intracellular organism”?
Scenario 34.
Which option or options from the option list best fit
with “blindness”?
Scenario 35.
Which option or options from the option list best fit
with “LGV”?
Scenario 36.
Which option or options from the option list best fit
with “multinucleated cells”?
Scenario 37.
Which option or options from the option list best fit
with “serotypes D–K”?
Scenario 38.
Which option or options from the option list best fit
with “serovars L1-L3”?
Scenario 39.
Which of the following are true in relation to Amsel’s
criteria?
A
|
used for the diagnosis of
bacterial vaginosis
|
B
|
used for the diagnosis of
trichomonal infection
|
C
|
clue cells present on
microscopy of wet preparation of vaginal fluid
|
D
|
flagellate organism present
on microscopic examination of vaginal fluid
|
E
|
pH ≤ 4.5
|
F
|
pH > 4.5
|
G
|
thin, grey-white, homogeneous
discharge present
|
H
|
frothy, yellow-green
discharge present
|
I
|
fishy smell on adding alkali
(10%KOH)
|
J
|
fishy smell on adding acid
(10%HCl)
|
K
|
koilocytes present
|
L
|
absence of vulvo-vaginal
irritation
|
Scenario 40.
Which of the following are true in relation to Nugent’s
Amsel’s criteria?
A
|
used for the diagnosis of
bacterial vaginosis
|
B
|
used for the diagnosis of
trichomonal infection
|
C
|
clue cells present on microscopy
of wet preparation of vaginal fluid
|
D
|
pH ≤ 4.5
|
E
|
pH > 4.5
|
F
|
count of lactobacilli
|
G
|
count of Gardnerella and
Bacteroides
|
H
|
count of white cells
|
Scenario 41.
Garnerella vaginallis can be cultured from the vagina of
what proportion of normal women?
A
|
< 10%
|
B
|
11 - 20%
|
C
|
21 - 30%
|
D
|
31 - 40%
|
E
|
41 - 50%
|
F
|
> 50%
|
No comments:
Post a Comment