Exam questions

Question 1

What would indicate worsening pre-eclampsia?

Answer 1

Upper epigastric pain (HELPP)
Vomiting
Poor urine output
Frontal headache

Question 2

What does a low haemoglobin suggest in pregnancy?

Answer 2

Hb normally is lower in pregnancy due to physiological dilution. The Hb level is within normal (non-pregnant range) but high for pregnancy suggesting the patient is intravascularly fluid depleted

Question 3

Which risk factors would warrant a glucose tolerance test?

Answer 3

BMI 40
First degree relative with diabetes 
Previous GDM
Previous stillbirth 
Single episode of glycosuria at 12/40

Question 4

Which factors increase the likelihood of IUGR?

Answer 4

Bilateral notching of the blood flow signal on Doppler interrogation of the uterine arteries at 24 weeks gestation
Maternal systemic lupus eythematosus
Maternal type 1 diabetes
Raised maternal serum alphafetoprotein (AFP) on serum screening for Down’s syndrome
Recurrent vaginal bleeding during the pregnancy
Ultrasound demonstration of dichorionic twins

Question 5

What is suggestive of Twin pregnancy with uteroplacental insufficiency?

Answer 5

The presence of asymmetric growth restriction with abnormal Dopplers in one twin is suggestive of utero-placental insufficiency

Question 6

What is suggestive of Twin reversed arterial perfusion syndrome?

Answer 6

TRAP syndrome is a very rare problem where one twin has no head or heart and the other twin pumps blood to itself and the abnormal twin. The pump twin has a risk of cardiac failure. Not to be confused with TAPS (twin anaemia polycythemia sequence) which is a complication of TTTS

Question 7

Which investigations are performed for secondary amenorrhea?

Answer 7

FSH
Oestrogen 
Pelvic USS
prolactin
HCG