29 May 2025.
|
17 |
EMQ. Hepatitis E |
|
18 |
SBA. Neonatal pulse oximetry screening |
|
19 |
EMQ.
Letrozole |
|
20 |
MCQP7. Q23. Folic acid fortification of flour |
|
21 |
EMQ. Folic acid fortification of flour |
|
22 |
EMQ.
Brexanolone |
|
23 |
EMQ. Zuranolone |
|
24 |
Role-play. Practise
introduction etc. |
Question 1.
What is the most
common cause of acute viral hepatitis in the UK?
|
A |
hepatitis A virus |
|
B |
hepatitis B virus |
|
C |
hepatitis C virus |
|
D |
hepatitis D virus |
|
E |
hepatitis E virus |
|
F |
herpes simplex virus |
|
G |
HIV |
Question 2.
Which, if any, of
the following are correct about HEV.
|
A |
it is a DNA virus |
|
B |
it belongs to the genus Hippieviridae |
|
C |
it belongs to the genus Hepeviridae |
|
D |
it belongs to the genus Hoppieviridae |
|
E |
there are six main genotypes |
|
F |
genotype 3 is the one of greatest
importance in the UK |
|
G |
the main reservoir of genotype 3 is
intensively-reared chickens |
|
H |
the main reservoir of genotype 3 is
domestic cats |
|
I |
a vaccine exists but is only licensed in
Russia |
|
J |
none of the above |
Question 3.
Which, if any, of
the following statements about HEV and pregnancy are true?
|
A |
pregnant women are more susceptible to HEV
infection |
|
B |
pregnant women are more likely to develop
serious disease that the non-pregnant |
|
C |
the main risk is neonatal death due to
vertical transmission |
|
D |
the main risk is maternal death |
|
E |
the risk of maternal death is highest with
infection in the 1st. trimester |
|
F |
↑
rates
of preterm birth have been reported |
|
G |
↑
rates of stillbirth have been reported |
Scenario 18.
Neonatal pulse oximetry
screening
Abbreviations.
cCHD: critical
congenital heart disease.
CHD: congenital
heart disease.
NPOS: neonatal
pulse oximetry screening.
NSC: National
Screening Committee.
RDS: respiratory
distress syndrome, AKA SDLDN.
Question
1. Which of the following best describes the
purpose of NPOS?
|
A |
detection of
congenital heart disease |
|
B |
detection of
critical congenital heart disease |
|
C |
detection of
uncritical congenital heart disease |
|
F |
detection of hypoplastic
left heart |
|
E |
detection of
patent ductus arteriosus |
|
D |
differentiating
between transient tachypnoea of the newborn and RDS |
|
G |
none of the
above |
Question
2. What is the approximate incidence of CHD in
neonates?
|
A |
1 in 50 |
|
B |
1 in 100 |
|
C |
1 in 150 |
|
D |
1 in 200 |
|
E |
1 in 250 |
|
F |
1 in 300 |
|
G |
none of the
above |
Question
3. What is the approximate % of CHD that is
critical CHD in neonates?
|
A |
10% |
|
B |
15% |
|
C |
20% |
|
D |
25% |
|
E |
30% |
|
F |
35% |
|
G |
40% |
Question
4. What is the National Screening Committee’s
advice on NPOS?
|
A |
all NHS units
to have it established by March 2026 |
|
B |
all NHS units
to have it established by March 2030 |
|
C |
further
research needed into cost-benefit ratio |
|
D |
further
research needed into adverse outcomes after false +ve results |
|
E |
further
research needed into risks of “overdiagnosis” |
|
F |
further
research needed into risk/benefit for non-cardiac conditions |
|
G |
none of the
above |
Question
5. What is the sensitivity of NPOS for detecting
cCHD before discharge from hospital?
|
A |
~ 50% |
|
B |
~60 % |
|
C |
~ 70% |
|
D |
~ 80% |
|
E |
~ 90% |
|
F |
~100 % |
Question
6. What % of NHS Trusts have introduced NPOS
despite the NSC’s reservations?
|
A |
~ 50% |
|
B |
~60 % |
|
C |
~ 70% |
|
D |
~ 80% |
|
E |
~ 90% |
|
F |
~100 % |
Scenario 19.
Letrozole
Abbreviations.
GnRH: gonadotrophin-releasing
hormone.
PCOS: polycystic ovarian
syndrome.
Question 1. What type of drug is letrozole?
|
A |
aromatase agonist |
|
B |
aromatase antagonist |
|
C |
glucagon-like peptide-1 (GLP-1)
receptor agonist |
|
D |
glucagon-like peptide-1 (GLP-1)
receptor antagonist |
|
E |
GnRH agonist |
|
F |
GnRH antagonist |
|
G |
neurokinin-3 receptor agonist |
|
H |
neurokinin-3 receptor antagonist |
|
I |
synthetic androgen |
|
J |
synthetic oestrogen |
|
K |
synthetic progestogen |
Question 2. For which of the following is letrozole
licensed in the UK.
|
acne |
|
|
B |
halitosis |
|
C |
hormone
receptor -ve breast cancer |
|
D |
hormone
receptor +ve breast cancer |
|
E |
hormone
receptor -ve breast cancer in the postmenopausal |
|
F |
hormone
receptor +ve breast cancer in the postmenopausal |
|
G |
endometriosis |
|
H |
fibroids |
|
I |
hirsutism |
|
J |
ovarian
hyperstimulation syndrome |
|
K |
PCOS |
|
L |
precocious
puberty |
|
M |
risk
reduction in carriers of BRCA1 mutations |
|
N |
risk
reduction in carriers of BRCA2 mutations |
Question 3. For which of the following has letrozole
been used off-licence?
|
A |
boys with short stature and delay of
puberty |
|
B |
cyclical breast pain |
|
C |
endometriosis |
|
D |
fibrocystic breast disease |
|
E |
fibroids |
|
F |
frozen-thawed embryo transfer |
|
G |
gynecomastia |
|
H |
male breast cancer |
|
I |
male infertility |
|
J |
ovulation induction |
|
K |
PCOS |
|
L |
postnatal depression |
|
M |
prevention of GnRH agonist treatment flare
effect |
|
N |
prostate cancer |
Scenario 20.
MCQP7. Q23. Folic acid fortification
of flour
Folic acid & pregnancy.
a. the dosage
for routine prophylaxis of neural tube defect is 0.4 mg. daily.
b. the dosage
for prophylaxis for patients with spina bifida or who have had a pregnancy
affected by neural tube defect is 5mg. daily.
c. folic acid
reduces the risk of neural tube defect by more than 70%.
d. folic acid
and anti-epilepsy drugs may interact adversely.
e. folic acid
reduces the risk of placental abruption.
f. folic acid
can provoke sub-acute combined degeneration of the cord.
g. fortification
of flour with folic acid was introduced in the USA in 1998.
h. fortification
of flour with folic acid in the USA has been linked to a 50% reduction in the
incidence of neural tube defects.
i. fortification
of flour with folic acid was introduced in the UK in 2005.
Scenario 21.
EMQ. Folic acid fortification of
flour
EMQ with no option list!
Abbreviations.
FFF: fortification of flour with folic acid.
NTD: neural tube defect.
1.
What is the incidence of NTD in the UK?
2.
What is the risk of an affected sibling for the woman who becomes
pregnant after
having a baby with
NTD?
3.
Which foods contain significant amounts of folic acid?
4.
What percentage of folic acid is destroyed by cooking / food
storage?
5.
How many people in the UK are estimated to have a folate-deficient
diet?
6.
What is the significance of the MTHFR (Methylenetetrahydrofolate reductase gene)?
7.
What is the significance of the Meckel-Gruber syndrome to this
issue?
8.
By what gestation has the neural tube closed?
9.
What proportion of pregnant women have taken folic acid
preconceptually?
10. What dose and duration of
folic acid is advised for routine periconceptual use?
11. List the women to whom a
higher dose should be offered.
12. How effective is
periconceptual folic acid consumption in reducing NTD risk in the low-risk
population?
13. How effective is
periconceptual folic acid consumption in reducing NTD risk in women who have
had an affected baby?
14. What is the risk of NTD
recurrence for a woman who has had two affected babies?
15. What is the risk of NTD in
Ireland?
16. What is
the significance of the name “Bukowski” in relation to folic acid?
17. What effect does
periconceptual folic acid have on the risk of stillbirth?
18. What effect does
periconceptual folic acid have on the risk of autistic spectrum disorder?
19. What effect does
periconceptual folic acid have on maternal haemoglobin levels?
20. What recommendations have been
made by the RCOG to improve folic acid levels in pregnancy?
21. Which names are of importance
in the history of folic acid and NTD?
22. Which neurological condition
has been thought potentially problematic with folic acid supplementation?
Scenario 22.
Brexanolone. Which, if any, of
the following statements are true?
|
A |
Brexanolone it is a water soluble form of
allopregnanolone |
|
B |
allopregnanolone is an oestrogen
metabolite and levels mirror those of oestrogen |
|
C |
allopregnanolone is a potent modulator of GABAA receptors in the brain |
|
D |
brexanolone is effective in the treatment
of postpartum depression |
|
E |
brexanolone is administered orally |
|
F |
brexanolone is licensed for use in the UK |
Scenario 23.
Zuranolone. Which, if any, of the following statements are true?
|
A |
Zuranolone it
is a water soluble form of allopregnanolone |
|
B |
allopregnanolone
is an oestrogen metabolite and levels mirror those of oestrogen |
|
C |
allopregnanolone
is a potent modulator of GABAA receptors
in the brain |
|
D |
Zuranolone is
effective in the treatment of postpartum depression |
|
E |
Zuranolone is
administered orally |
|
F |
Zuranolone is
licensed for use in the UK |
Scenario 24.
Role-play. Candidate’s
instructions will be sent shortly before the tutorial.
