21
August 2025. Role-players: 1.
Role-players:
2.
|
27 |
Role-play. |
|
28 |
Role-play. |
|
29 |
EMQ. Hepatitis B |
|
30 |
SBA. Kisspeptin |
27.
Role-play
1. Candidate’s
instructions will be e-mailed shortly before the tutorial.
28.
Role-play
1. Candidate’s
instructions will be e-mailed shortly before the tutorial.
29.
Topic. Hepatitis B and pregnancy.
Abbreviations.
GDM: gestational
diabetes mellitus.
HBeAg: hepatitis B e
antigen
HBsAg: hepatitis B
surface antigen
HBcAb: antibody to
hepatitis B core antigen
HBsAb: antibody to
hepatitis B surface antigen
HBIG: hepatitis B
immunoglobulin
Question
1.
Is screening for
HBV in pregnancy recommended in the UK?
Question
2.
An asymptomatic
primigravida books at 10 weeks. Her partner had an acute HBV
infection 4 months ago. What
results on routine blood testing would indicate that she has an acute HBV
infection?
Question
3.
An asymptomatic
primigravida books at 10 weeks. Her partner had an acute HBV
infection 4 months ago. What
results on routine blood testing would indicate that she is immune to the HBV
as a result of infection?
Question
4.
An asymptomatic
primigravida books at 10 weeks. Her partner had an acute HBV
infection 4 months ago. What
results on routine blood testing would indicate that she is immune to the HBV
as a result of HBV vaccine?
Question
5.
An asymptomatic
primigravida books at 10 weeks. Her partner had an acute HBV
infection 9 months ago. What
results on routine blood testing would show that she is a chronic carrier of HBV
infection, assuming that she became infected early in the partner’s illness?
Question
6.
Testing shows that he is positive for HBsAg,
positive for HBcAb but negative for IgM
HBcAb. What does
this mean in relation to his HBV status?
Question
7.
Testing shows that he is negative for HBsAg,
positive for HBcAb and positive for
HBsAb. What does this mean in relation to his HBV status?
Question
8.
How common is
chronic HBV carrier status in UK pregnant women?
Question
9.
What is the risk
of death from chronic HBV carrier status?
Question
10. A primigravid woman at 8 weeks gestation is found to be
non-immune to HBV. She has
recently married and her
husband is a chronic carrier. What should be done to protect her from
infection?
Question
11. A woman is a known carrier of HBV. What is the risk of
vertical transmission in the first
trimester?
Question
12. What is the risk of the neonate who has been infected by
vertical transmission
becoming a carrier without
treatment?
Question
13. Should antiviral maternal therapy in the 3rd.
trimester be considered for women with
HBeAg or high viral load?
Question
14. How effective is hepatitis B prophylaxis for the neonate in
preventing chronic carrier
status as a result of vertical
transmission?
Question
15. What
alternative treatment could be used if HBIG is not available?
Question
16. Can a woman who is a chronic HBV carrier breastfeed safely?
Question
17. Hepatitis
B infection is the most dangerous of the viral hepatitis infections in
pregnancy.
Question
18. A pregnant woman who is not immune to HBV has a partner who
is a chronic carrier.
Can HBV vaccine be administered
safely in pregnancy?
Question
19. How long can HBV survive outside the body?
Question
20. A pregnant woman who is not immune has a partner with acute
hepatitis due to HBV.
He cuts his hand and bleeds
onto the kitchen table. How should she clean the surface to ensure that she
gets rid of the virus?
Question 21.
Is it true that the presence of HBeAg in
maternal blood is a particular risk factor for
vertical
transmission? Not really a scenario, but never mind!
Question 22.
What does 5 log10 copies /mL mean?
|
A |
> 10 copies
/ mL |
|
B |
> 100 copies
/ mL |
|
C |
> 1,000
copies / mL |
|
D |
> 10,000
copies / mL |
|
E |
> 100,000
copies / mL |
|
F |
this has scared
me witless and I am going straight home to complain to my Mum |
Question 23.
Which, if any, of
the following statements are true about amniocentesis and CVS and
the risk of vertical transmission if the mother is HbsAg+ve?
|
A |
they are contraindicated |
|
B |
they should be done with cover with HBIG |
|
C |
they should be done with cover with a drug that is effective for HBV and safe in pregnancy. |
|
D |
none of the above |
Question
24. Which, if any, of the following statements are true about
treatment in the third
trimester to reduce the risk of
vertical transmission?
|
A |
women who are HbsAg+ve should
be offered testing for HBV DNA levels in the 3rd. trimester |
|
B |
there is no effective
treatment for HBV in the 3rd. trimester |
|
C |
the risks of treatment for
HBV in the 3rd. trimester outweigh the benefits |
|
D |
drug treatment for HBV in the
3rd. trimester adds nothing beneficial to the normal use of HBIG +
HB vaccination of the neonate |
|
E |
none of the above. |
Question
25. Which, if any, of the following drugs is recommended for
use in the third trimester to
reduce the risk of vertical transmission?
|
A |
acyclovir |
|
B |
lamivudine |
|
C |
telbivudine |
|
D |
tenofovir |
Question
26. Does elective Cs before labour and with the membranes
intact reduce the vertical
transmission rate?
Question
27. Which hepatitis virus normally produces a mild illness, but
represents a major risk to
pregnant women, with a
mortality rate of up to 5%?
Question
28. A pregnant woman has a history of viral hepatitis and
informs the midwife at booking
that she is a carrier and that
she has a significant risk of cirrhosis and has been advised not to drink
alcohol. Which is the most likely hepatitis virus?
Question
29. Which hepatitis virus is an absolute contraindication to
breastfeeding after
appropriate treatment of the
infected mother and prophylaxis for the baby?
Question
30. Which hepatitis virus is linked to an increased risk of
obstetric cholestasis?
Question
31. Which, if any, of the following statements is true in
relation to HepB and the risk of
GDM?
|
A |
the risk is about the same |
|
B |
the relative risk is about
0.1. |
|
C |
the relative risk is about
0.2. |
|
D |
the relative risk is about
0.5. |
|
E |
the relative risk is about
1.2. |
|
F |
the relative risk is about
1.5. |
|
G |
the relative risk is about
2.0 |
|
H |
the relative risk is about
3.0 |
|
I |
the risk is unknown |
30.
Kisspeptin.
DYNOP: dynorphin
KSP: kisspeptin.
NKB: neurokinin
B
Question
1.
Pick the best statement.
|
A |
is a pheromone released by the salivary glands during
passionate embraces which
syntocinon secretion and sense of pleasure |
|
B |
is a digestive enzyme released by the salivary glands
during passionate embrace |
|
C |
is a digestive enzyme found in human carnivores but not
vegetarians |
|
D |
is thought necessary for trophoblastic invasion and low
levels have been linked to miscarriage, recurrent miscarriage and ↑ risk of PET |
|
E |
is named after “Kiss me quick” chocolate |
|
F |
does not exist and this question is a very poor joke by
someone who should know better |
Question
2.
Which, if any of the following are
true.
|
A |
KSP is a KNDy neuropeptide secreted in the hypothalamus |
|
B |
KSP stimulates GnRH neurones |
|
C |
KSP stimulates FSH production > LH production |
|
D |
KSP stimulates FSH production < LH production |
|
E |
KSP stimulates FSH production and LH production equally |
|
F |
KSP is a key factor in puberty |
|
G |
KSP is a key factor in normal reproductive physiology |
|
H |
¯
KSP is pathognomonic for Kallmann’s syndrome. |
|
I |
dynorphin stimulates GnRH neurones |
|
J |
neurokinin B stimulates GnRH neurones |
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