ABC

Question 1

USS measurement most sensitive indicator of IUGR

Answer 1

AC

US in 3rd trimester detects 85% IUGR using AC

Question 2

Best way to investigate a cardiac problem in rpreg lady

Answer 2

ECHO

Question 3

155 cm tall, 155 kg, which statement is true

• LSCS necessary
• Size of baby dependent on weight gain in preg
• Epidural contraindicated

Answer 3

-Size of baby dependent on weight gain in preg

Question 4

Best way to monitor fluid balance/dehydration post haemorrhage

Answer 4

Urine output

Question 5

Pushing for 1.75 hours, Mx if there is no progress?

Station =2, caput ++

Answer 5

Wrigley’s: fetal scalp visible, without separating labia (outlet) + OA/OP or R/L OA/OP

Neville: leading point of skull 0 to +2(midcavity) or rotation <45 deg from OA

Kiellands used in OT, mid cavity or asynclitism

Question 6

Multigravid, pushing for 1 h, presenting part above spines

Answer 6

LSCS

Question 7

Preg lady exposed to rubella igG titre 1:8

Answer 7

order rubella igM- check for acute infection

Question 8

genital herpes at k38

Answer 8

wait for SOOL and then reassess

if recurrent then vaginal birth isnt contraindicated, if primary then LSCS

Question 9

HIV postive preg lady
which is true
A: tx with antiretroviral will decrease the likelihood of the baby developing HIV

B. Mx of preg should be no diff to any other preg

C: Breastfeeding should be encouraged

D: Vag delivery and LSCS have the same outcome for baby contracting HIV

Answer 9

ANS: A

D true if woman in on tx and viral load is <50 copies/ml

Question 10

Mx of woman in labour with temp 37.6, ROM 4 hours, GBS neg

a. IV broad spectrum abx
b. IV penicillin
c. oral amoxi
d. screening samples
e. observe

Answer 10

E

Question 11

a. IV broad spectrum abx
b. IV penicillin
c. oral amoxi
d. screening samples
e. observe

Q. Mx of woman in labour with temp 37, ROM for 16 hours and GBS pos

Answer 11

B

Question 12

a. IV broad spectrum abx
b. IV penicillin
c. oral amoxi
d. screening samples
e. observe

Q: woman in labour, temp of 38, GBS pos, fetal tachy

Answer 12

A

Question 13

Woman presents with 3 cm solid, mobile breast lump- present 3 months

Answer 13

Fibroadenoma

Question 14

Best way to diagnose early endometriosis

Answer 14

GOld standard is laproscopy and histology

Question 15

12 year old with 6 months painless, irreg periods
MC cause
Cervical polyp
adenomyosis
Anovulatory DUB
Endometrial carcinoma

Answer 15

Anovulatory DUB

Question 16

Oxytocin, which is true:

• antidiuretic properties at therapeutic levels
• effective as ergo for PPH
• affects all smooth muscles

Answer 16

-antidiuretic properties at therapeutic levels

Question 17

4 y F, enuresis, on examination labial fusion, Mx

• topical oestrogen cream
• surgical division
• observe
• abx

Answer 17

oestrogen cream only if freq UTI or post micturation dribbling

Question 18

Ix for azoospermia

• seminal fructose
• karyotype
• serum testo
• FSH

Answer 18

FSH: raised then spermatogenic failure or non obstructive azoospermia so need donor sperm

if normal FSH- obstructive azoospermia then can try epididymal aspiration together with IVF and ICSI

Question 19

About NT

• able to detect 80% downs
• required TVS
• High PPV - positive predictive value
• best performed at k15

Answer 19

CFTS 90% sensitive for Downs’s (NT along has 75% sensitivity for Downs)

Question 20

24 y F G1P0, k34- acute abdo pain_ tender ut

Most liekly

Answer 20

placenta abruptio

not ut rupture, abortion, appendicitis

Question 21

OCP for epilepsy

Answer 21

ethinyloestradiol 50 mcg

not progesterone only pill

Question 22

forceps vs ventouse
1. most likely to cause maternal trauma + PPH

2. used in non fully diated cx
3. safely used when presenting part above spines

Answer 22

1. forceps
2. neither
3. neither

Question 23

multigravid at k32, strong contractions, breech. shoulder born, head stuck. Most likely cause

Answer 23

incomplete cervical dilatation

if term brrech then extension of head

Question 24

Alchohol advice

1. safest to avoid alcohol compeltely
2. safe to have a standard drink each week
3. safe to have 2/ week
4. 3. safe to have 2/ day for 5/7
5. safe to have alcohol in discrete episodes upto 10 SD a day, but only once a month and after 1st trimester

Answer 24

Ans 5

Binge drinking more harmful to fetus even if overall alcohol is lower than more regular drinking patterms

peak blood alcohol is more imp with regard to risk of fetal damage

Question 25

Contraception- wanting OCP
PV: 5 cm palpable mass, cystic mass

• Laparotomy
• Repeat PV in 3 months
• give OCP and repeat PV in 1 month
• USS and drainage of cyst
• Nothing

Answer 25

give OCP and repeat PV in 1 months

In premenopausal women Ca125 is not needed in simple ovarian cyst by US

Should do LDH, AFP and HCG in women under 40 to exclude germ cell tumour

Question 26

HIV in preg

LSCS may reduce vertical transmission
-Preg may advance HIV disease

-Breastfeeding should be encouraged

Answer 26

LSCS may reduce vertical transmission when viral load is high

Question 27

induce precipitate labour suddenly develops tachycardia, SOB, afebrile

Cause
AFE
pulm oedema
pneumonia
PPH

Answer 27

AFE : RF include precipitate labour

Question 28

which contracption increases risk of ectopic

OCP
prog only pill
diaphragm
condom
none

Answer 28

E:

? if preg occurs with prog only pill or mirena then the preg is more likely to be ectopic but the overall risk is lower

Question 29

52 y F, one year post last period, has hot flushes and atrophic vaginitis

Mx

Answer 29

HRT combined-oestrogen and MPA