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MRCOG part 1 > Data interpretation > Flashcards

Data interpretation Flashcards

1
Q

What is a dermoid cyst

A

Similar to a teratoma but only has epidermal and dermal elements

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2
Q

What is a teratoma/mature teratoma

A

often has ecto/endo/meso elements.

Mature teratoma = has well differentiated elements from at least 2 germ cell layers - ecto/endo/meso. Developmentally mature skin with hair follacles, sweat glands, sometimes hair and other tissues.

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3
Q

How much of body weight is water?

A

60%

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4
Q

How much of body weight is plasma?

A

4%

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5
Q

How much of body weight is ICF and how much is ECF?

A

ICF = 40%
ECF = 20%

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6
Q

What is ultrasound frequency

A

> 20 kHz

In medical imaging it is between 2-15 MHz

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7
Q

Ultrasound appearance of miscarriage

A

1) mean gestation sack >/=25mm with no yolk sack

2) crown rump length >/=7mm with no fetal heart beat

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8
Q

USS appearance of complete molar pregnancy

A

snowstorm appearance = multiple anechoic areas within solid echos

bunch of grapes = represents hydropic swelling of the trophoblastic villi

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9
Q

USS appearance of partial mole

A

severe fetal abnormalities
abnormal gestation sack
enlarged placenta containing anechoic lesions

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10
Q

USS appearance of endometrioma

A

evidence of haemorrhagic debris - ground glass echos
diffuse homogenous low level echos

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11
Q

What are the normal FBS values

A

> 7.25 is normal
7.21-7.24 - borderline
<7.20 abnormal

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12
Q

Action if abnormal CTG and FBS is 7.26

A

Repeat in 1 hour if CTG remains abdnormal

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13
Q

Action if abnormal CTG and FBS is 7.21-7.24

A

Repeat in 30 minutes

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14
Q

Action if abnormal CTG and FBS is <7.20

A

Consider delivery

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15
Q

Indications for FBS

A

Abnormal CTG and cervix >3cm dilated

Acidosis suspected and cervix >3cm dilated

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16
Q

Contraindications for FBS

A

Maternal infection
Known coagulopathy of fetus
acute fetal compromise
prematurity <34 weeks

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17
Q

What are the main anion/cations intracellularly

A

ANION = phosphate
CATION = potassium

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18
Q

What are the main anion/cations extracellularly

A

ANION = chloride
CATION = sodium

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19
Q

With spirometry define: vital capacity, tidal volume, inspiratory reserve volume, inspiratory capacity

A

vital capacity = volume if exhale all the way then inhale all the way

tidal volume = resting breath volume

inspiratory reserve = inspiratory capacity - tidal volume

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20
Q

What do each of these indicate: hepatitisB surface antigen, anti-hepBcore, anti-hepBsurface, IgM anti-Hbcore

A

hepatitisB surface antigen = current infection

anti-hepBcore = immunity due to past infection

anti-hepBsurface = immmunity due to vaccination

IgM anti-Hbcore = recent infection

21
Q

Which 2 tests to be performed in all women struggling to conceive?

A

mid-luteal progesterone = should be >30. Antyhing <16 suggests anovulation

chlamydia screen

22
Q

Features on USS of a functional cyst

A

Anechoic
thin walled
unilocular
>3cm diameter - otherwise is a follicle
no solid components
no colour flow

23
Q

Describe the reassuring features of a CTG

A

Accellerations

No decellerations or early variable decellerations with no concerning characteristics for <90 minutes

Variability 5-25

HR 110-160

24
Q

Describe the non-reassuring features of a CTG

A

Variable decellerations with no concerning characteristics for 90 minutes or more

OR

Variable decellerations for MORE than 30 minutes with concerning characteristics in <50% contractions

Variable decellerations for LESS than 30 minutes with concerning characteristics in >50% contractions

Late decellerations in >50% contractions for LESS than 30 minutes with no other evidence of maternal/fetal compromise

Variability <5 for 30-50 minutes OR >25 for 15-25 minutes

HR 100-109 OR 161-180

25
Q

Abnormal features of CTG

A

HR <100 or >180

Variability <5 for >50 minutes OR >25 for >25 minutes

Late decellerations for >30 minutes

Variable decellerations for >30 minutes in >50% contractions

Acute bradycardia

Single prolonged decelleration lasting >3 minutes

26
Q

Summarise B-rules and M-rules

A

B-rules: NA USS

  • unilocular
  • no blood flow
  • presence of acoustic shadowing
  • solid components where largest solid component <7mm
  • smooth multilocular tumour where largest diameter <100mm

M-rules: IM BAP

  • irregular solid tumour
  • lots of blood flow
  • at least 4 papillary structures
  • Ascites
  • Irregular multilocular tumour where largest diameter is >100mm
27
Q

What should sperm PH be

A

> 7.2

28
Q

How much sperm should be in 1 round of ejaculate

A

> 1.5ml

29
Q

What is normal sperm count/ml and per ejaculate

A

> 15mil/ml

> 39mil total

30
Q

What is the normal % normal morphology in sperm

A

> 4%

31
Q

What is the normal motility/progressive motility of sperm

A

motility >40%
progressive motility >32%

32
Q

What is normal sperm vitality (total number of alive sperm)

A

> 58%

33
Q

What do you do if sperm count abnormal

A

repeat in 3 months

34
Q

What can steroids do to potassium

A

cause a mild hypokalaemia

35
Q

What do you see on bloods of alcoholic

A

macrocytic anaemia
<B12
low urea due to impaired hepatic synthesis of urea
low platelets
low WCC
abrnomal LFTs

36
Q

What to do if a scan does not reach miscarriage criteria

A

Repeat scan in 7 days

37
Q

What would you expect to see with JVP in: heart failure, pericardial constriction, AF

A

right heart failure/overload - raised JVP

pericardial constriction - paradoxical JVP (kussmaul’s)

AF - absent A waves

38
Q

What is the ideal ARTERIAL cord sample values following delivery

A

7.26-7.30

39
Q

What frequency of USS is used for transabdominal USS

A

3-3.5 Mhz

40
Q

What frequency of USS is used for transvaginal USS

A

5-7.5

41
Q

What is pernicious anaemia.

Which molecule does it prevent from being absorbed?

Incidence?

Peak age?

A

Autoimmune destruction of parietal cells in the stomach which normally produce intrinsic factor. IF binds to B12 so that it can be absorbed.

1/10,000

60

42
Q

What two tests are looked at to suggest menopause?

A

FSH >30 with a low progesterone

43
Q

What two tests are looked at to suggest menopause?

A

FSH >30 with a low progesterone

44
Q

What to do if in pregnancy there is protein in the urine?

What would the results tell you?

A

Organise a 24h urine collection to find out the total protein and protein:creatinine ratio

Results : total protein >300 mg = significant proteinuria

OR protein:creatitine ratio >30:1 mg/mmol

45
Q

What is the USS appearance of MUCINOUS cystadenoma?

A

Multilocular

variable levels of echogenicity due to the difference in contents of the locules

thin walled septa

usually large

46
Q

What is the USS appearance of SEROUS cystadenoma?

A

Unilocular

47
Q

What is the threshold pH for adverse neurological outcomes in arterial cord sampling?

A

<7.10

48
Q

When should mid-luteal progesterone be taken?

A

7 days before starting period so in 35 day cycle on day 28 or in 28 day cycle on day 21

MRCOG part 1 (20 decks)

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