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Past MCQs > Early pregnancy gynae > Flashcards

Early pregnancy gynae Flashcards

1
Q

You are performing a laparotomy for a ruptured right ectopic pregnancy in a 17 yo. A 10cm right ovarian cyst is noted. Left ovary appears normal. Optimal management is:

A - RSO
B - Aspiration of cyst
C - Cystectomy
D - Cystectomy and biopsy of other ovary
E - R oopherectomy
A

C - Cystectomy

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2
Q

A woman has two 23 week pregnancy losses due to a uterine septum. Which of the following is most appropriate advice?

A - metroplasty
B - expectant management
C - she will carry the next pregnancy longer
D - against pregnancy
E - hysteroscopic removal of septum
A

E - hysteroscopic removal of septum

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3
Q

An incompetent cervix can be due to the following except:

A - DES
B - Uterine anomaly
C - Cone biopsy
D - Cervical laceration
E - Cervical infection
A

E - Cervical infection

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4
Q

Most common time for subseptate uterus to abort?

A - 8-14 weeks
B - 12-16 weeks
C - 14-18 weeks
D - 18-22 weeks

A

A - 8-14 weeks

44% risk of first trimester miscarriage
PTB 25% rate

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5
Q

Regarding ectopics:

A - continuing US and BHCG delays intervention and leads to greater risk of rupture
B - recurrence risk about 10%
C - better chance of subsequent live birth with salpingostomy vs salpingectomy

A

B - recurrence risk about 10%

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6
Q
  1. What is the MINIMUM MSD for the diagnosis of a blighted ovum (anembryonic pregnancy)
    a. 15mm
    b. 20mm
    c. 25mm
    d. 30mm
A

c. 25mm

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7
Q

A patient who previously had a pregnancy terminated at 18 weeks for a neural tube defect consults you regarding the likelihood of recurrence of this condition. You advise her that the risk of recurrence is

a. ¼
b. 1/25
c. 1/100
d. 1/250

A

b. 1/25

The risk of recurrence for isolated NTDs is approximately 2-4% with one affected sibling
With two affected siblings, the risk is approximately 10%

US: 5.5 per 10,000 live births

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8
Q

Chromosome mosaicism is detected at CVS performed for advanced maternal age. As a NEXT STEP you would recommend

a. A repeat of the CVS
b. An amniocentesis
c. Consideration of termination of pregnancy
d. No further action

A

b. An amniocentesis

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9
Q

The MOST COMMON clinical presentation of women with a Hydatidiform mole is

a. Abnormal bleeding
b. Hyperemesis
c. Preeclampsia
d. Large for dates uterus

A

a. Abnormal bleeding

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10
Q

A 35yo G1P0 has a second trimester maternal serum screen (MSST2) arranged by her GP, which is increased risk for Down syndrome. What would you do FIRST?

a. Arrange CVS
b. Arrange amniocentesis
c. Arrange USS to check gestational age of fetus
d. Arrange a TOP
e. Arrange contact with a Down syndrome support group in case she wishes to continue the pregnancy

A

c. Arrange USS to check gestational age of fetus

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11
Q

A 20yo woman is seen in the first trimester at 10 weeks. Her last child was born with a closed spina bifida. Which is true?

a. The risk of NTD in this pregnancy is 10 percent
b. Amniocentesis is indicated at 15 weeks
c. She should start folic acid now
d. Ultrasound is indicated at 11-12 weeks

A

d. Ultrasound is indicated at 11-12 weeks

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12
Q

A 40yo primagravida books at 10 weeks. Which is MOST CORRECT

a. The chance of Down syndrome is 3%
b. The chance of any chromosomal abnormality at CVS is 4%
c. The chance of NTD is 1%
d. The chance of miscarriage following amniocentesis at 15 weeks is 2%

A

b. The chance of any chromosomal abnormality at CVS is 4%

Chance of NTD 2-4%
40y - 1 in 100 risk of Down syndrome

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13
Q

At routine AN screening, a woman from Nauru has a negative RPR and positive TPHA. The most likely explanation is

a. The patient has early syphilis
b. The patient has late latent syphilis
c. The result is false positive
d. The patient has been treated for syphilis in the past

A

d. The patient has been treated for syphilis in the past

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14
Q

You are called to the emergency room for a patient with severe abdominal pain, vaginal bleeding, hypotensive and tachycardic. She has bicornuate uterus, positive urine pregnancy test 2 weeks ago. USS shows empty uterus and large adnexal mass. You instruct the ER doctor to

a. Schedule patient for laparoscopy and salpingostomy
b. Order FBC and LFT for probable methotrexate
c. Not make any decisions until you arrive in half an hour
d. Begin scheduling laparoscopy/laparotomy.

A

d. Begin scheduling laparoscopy/laparotomy.

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15
Q

In a first trimester twin pregnancy at 12 weeks, there is discordancy of nuchal thickness. The most important information required is

a. Chorionicity
b. Zygosity
c. Karyotypes
d. Amniotic fluid indices

A

a. Chorionicity

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16
Q

A woman had a CXR and was found to be 16 weeks pregnant. She asks about the evidence of potential harm from diagnostic radiography on the fetus. You tell her

a. There is no association with proven detrimental effects
b. There is a small increase in childhood malignancy
c. There is a small increase in fetal chromosomal damage
d. There is a small increase in growth restriction

A

b. There is a small increase in childhood malignancy

very small potential risk

17
Q

All of the following statements about partial molar pregnancy are true except

a. The karyotype is usually triploid
b. Beta HCG follow up is indicated after evacuation
c. Progression to choriocarcinoma doesn’t occur, although there may be persistent GTN after evacuation
d. Early pre eclampsia is more common in patients with a partial mole than a normal pregnancy

A

c. Progression to choriocarcinoma doesn’t occur, although there may be persistent GTN after evacuation

18
Q

Which is the smallest fetal pole that a sonographer could be confident in diagnosing a missed miscarriage on transvaginal scan because of the absence of cardiac activity?

a. 7mm
b. 9mm
c. 11mm
d. 13mm

A

a. 7mm

19
Q

The most common fetal chromosome abnormality observed in spontaneous miscarriages is

a. Autosomal trisomy
b. Triploidy
c. Sex chromosome abnormality
d. Chromosomal translocation

A

a. Autosomal trisomy

20
Q

Which statement about spontaneous miscarriage is correct?

a. Bacterial vaginosis increases the risk of first trimester miscarriage
b. The most common fetal chromosome abnormality in triploidy
c. In utero exposure to Diethyletilboestrol (DES) increases a womans chance of having a miscarriage
d. The karyoptypic abnormalities in spontaneous miscarriage are similar to those in liveborn children

A

c. In utero exposure to Diethyletilboestrol (DES) increases a womans chance of having a miscarriage

Autosomal trisomy is the most common fetal chromosome abnormality observed in spontaneous miscarriages

21
Q

A woman with hyperemesis in the first trimester of pregnancy has thyroid function tests which show reduced TSH, increased T4, and normal T3. This result is most likely to represent:

a. Hydatidiform mole
b. Thyrotoxic phase of autoimmune thyroid disease
c. Normal findings in early pregnancy
d. Graves disease

A

c. Normal findings in early pregnancy

Past MCQs (18 decks)

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