EMQs

Question 1

A woman from India and is on an
enzyme inducing antituberculosis drug,She states she gets irregular bleeding with
POP and wants short-term contraception.?

Answer 1

If they need COCP,( bleeding) then they should have a higher dose such as
50μg ethinylestradiol with a shorter pill free period for 4 days.

Question 2

best form of contraception : A 38 year old woman with history of breast cancer diagnosed 7 years ago. She has remained disease free for 5 years?

Answer 2

Barrier Method / UKMEC risk 3.

Question 3

best form of contraception < 18 y ?

Answer 3

1- IMP (1)
2- any + barrier or condom

Question 4

For older women which cases defined as UKmec 2 ?

Answer 4

• for women> 40 CHC 👉 VTE risk
• For women> 45 DMPA 👉 oestioprosis risk

Question 5

In the postpartum period for how long you aren’t going to use CHC as a contraceptive?

Answer 5

In breastfeeding women:6 weeks postpartum (UKmec 4)
* > 6 w 👉 UKmec 2
Non breastfeeding: 3 weeks

Question 6

In which UKmec category is CHC , in smoking women< 35 y ?

Answer 6

2

Question 7

In which UKmec category is CHC , in smoking women > 35y & < 15 cigarette/ D ?

Answer 7

3

Question 8

In which UKmec category is CHC , in smoking women > 35y & > 15 cigarette/ D ?

Answer 8

4

Question 9

In which UKmec category is CHC , in smoking women > 35y & stopped smoking< 1 year ?

Answer 9

3

Question 10

In which UKmec category is CHC , in smoking women > 35y & stopped smoking> 1 year ?

Answer 10

2

Question 11

In which UKmec category is CHC, in women with BMI 30-34 ?

Answer 11

2

Question 12

In which UKmec category is CHC, in women with BMI > 35?

Answer 12

3

Question 13

emergency contraception as she had unprotected sexual intercourse 4 days ago.?

Answer 13

Ulipristal acetate 30mg (Ellaone) ; up to 120 h
Or : copper coil.

Question 14

emergency contraception as she had unprotected sexual intercourse 2 days ago.?

Answer 14

Levonorgesterol 1500mg (Levonelle) : within 72 h

Question 15

A 42 year old lady complains of persistent irregular bleeding with Micronor. She is a chronic smoker and has a BMI of 37?

Answer 15

Desogesterol 75µg
( newer generation POP / less side effects)

Question 16

A 34 year old is 25 days postpartum. She is not breastfeeding and wants to start taking contraception pills. What to choose?

Answer 16

COC with 30µg ethinylestradiol

Question 17

She is having elective caesarean section for breech what is most appropriate
antibiotic regime ?

Answer 17

Single dose IV Ampicillin
Or first generation cephalosporin

Question 18

She has delivered and sustained a 3rd degree tear. She is being taken to theatre, most appropriate antibiotic regime?

Answer 18

IV Augmentin + IV metronidazole at the time of procedure

Question 19

A 32 year old patient had manual removal of placenta and is now day 1 post delivery and is well ,most appropriate antibiotic regime ?

Answer 19

No antibiotic

Question 20

An 18 year old is undergoing surgical termination of pregnancy.
most appropriate
antibiotic regime ?

Answer 20

PR Metronidazole 1gm

Question 21

woman had her second smear that came back as borderline. High Risk HPV test is positive, what is the most appropriate management plan ?

Answer 21

colposcopy for routine follow up in 6 weeks

Question 22

woman had her second smear that came back as mild dyskaryosis, High Risk HPV test is positive, what is the most appropriate management plan ?

Answer 22

Colposcopy within 6 weeks

Question 23

woman has low grade dyskaryosis and High Risk HPV Is negative, what is the most appropriate
management plan ?

Answer 23

Routine recall in 3 years

Question 24

woman had her first smear which was moderate dyskaryosis , what is the most appropriate
management plan ?

Answer 24

HPV testing in 12 months

Question 25

woman had her first smear which was high grade dyskaryosi , what is the most appropriate
management plan ?

Answer 25

colposcopy urgently

Question 26

A 46 year old woman has 3 inadequate smear repeated 3 months apart what is the most appropriate management plan?

Answer 26

referral to colposcopy as routine

Question 27

A 30 year old woman had LLETZ for CIN 3 , what is the most appropriate management plan?

Answer 27

Colposcopy in 12 months

Question 28

A 55 year old woman had LLETZ for CIN3 and the deeper margins are not clear of CIN3. What is the most appropriate management plan ?

Answer 28

LLETZ should be repeated

Question 29

A 54 year old lady presents with postmenopausal bleeding. The pipelle biopsy shows endometrial hyperplasia without atypia. She declines to have a coil.

Answer 29

Continuous oral progesterone therapy

Question 30

A 45 year old lady has 63% risk of ovarian cancer and 85% risk of breast cancer by age 70.
what is the most appropriate genetic syndrome ?

Answer 30

BRCA 1 Gene Mutation

Question 31

syndrome, which puts her at high risk of having synchronous endometrial cancer with ovarian cancer. most appropriate genetic syndrome ?

Answer 31

Lynch Syndrome

Question 32

A 30 year old woman has 27% risk of ovarian cancer and 84% risk of breast cancer.most appropriate genetic syndrome?

Answer 32

BRCA 2 Gene Mutation

Question 33

A 10 year old girl is found to have germline mutation in the tumour suppressor gene PTEN.
most appropriate genetic syndrome?

Answer 33

Bannayan-Riley-Ruvalcaba Syndrome

Question 34

A 43 year old woman is found to have an autosomal dominantgastrointestinal polyposis disorder
most appropriate genetic syndrome?

Answer 34

Peutz-Jegher’s Syndrome

Question 35

) A 19 year old young woman is found to have germline TP53 mutation
most appropriate
genetic syndrome?

Answer 35

Li-Fraumeni Syndrome

Question 36

enzyme inducing antituberculosis drug (not rifampicin) for the treatment of tuberculosis, best contraceptive? Best emergency contraception?

Answer 36

*DMPA
* Emergency: IUD or double dose Levonorgesterol ( 3000)
🔱 Ullipristal is contraindicated

Question 37

What are the enzyme inducing drugs ?

Answer 37

1- rifampicin ( it’s effect last 28 d after stopping)
2- carbamazepine
3-phenobarbital, phenytoin , topiramate