Formative Questions Flashcards
which layer of the uterine wall is responsible for regenerating tissue lost during menstruation?
stratum basalis
which time point do the ovaries contain the greatest number of germ cells?
7 months gestation
what is the structure called that forms from the follicle following ovulation?
corpus luteum
what is the most likely embryonic explanation for a woman having two uteri?
an incomplete fusion of the paramesonephric duct
in males, which structure develops to form the vas deferens?
mesonephric duct
in females, which structure develops to form the superior portion of the vagina?
paramesonephric duct
what is the name of the regulatory body that regulates assisted conception treatment in the UK?
the human fertilisation and embryology authority (HFEA)
up to what stage can research on human embryos be performed in the UK?
day 14
A couple attend an infertility clinic. She has had a hysterectomy as management for grade 1b endometrial cancer. All infertility investigations are normal, including normal female ovarian reserve and semen analysis.
What treatment option should be discussed?
surrogacy
A couple attend an infertility clinic. The man had a vasectomy 5 years ago and was shown to be azoospermic following this.
What treatment option should be offered initially?
ICSI treatment with sperm obtained by surgical sperm aspiration
A couple attend an infertility clinic. Investigations for the man show he has obstructive azoospermia.
Which genetic condition is the most likely cause of this condition?
cystic fibrosis
at which stage in embryo development is embryo transfer most successful?
blastocyst
a couple present with a 5 year history of unexplained infertility - what is the best course of treatment?
IVF
a couple present to discuss assisted conception options, the man had a vasectomy three years ago - what is the best option?
surgical sperm retrieval and IVF
what is the best course of treatment for suspected HSV infection?
acyclovir
how long do male pubic lice live on average?
22 days
where does spermatogenesis occur in a testicle?
seminiferous tubules
which structures on the foetal skull outline the vertex?
anterior + posterior fontanelles
parietal eminences
A non-sexually active woman presents with a vaginal discharge which contains bubbles and has an offensive smell.
What is the most likely infection?
bacterial vaginosis
changes in the endometrium in the luteal phase are the direct effect of which hormone?
progesterone
how long does the luteal phase last in the menstrual cycle?
14 days
Following a dilation and curettage for a missed miscarriage the pathology report states that this is a “complete hydatidiform mole” (CHM).
What is this at higher risk of turning in to, when compared with partial moles?
choriocarcinoma
A 35-year-old woman seeks contraception. She has heavy and painful periods. She smokes 10 cigarettes daily. Her BMI is 33 and BP 128/70. She is taking a drug for epilepsy that is a liver enzyme inducer. Which of the following options would be the best contraceptive for this woman?
IUS
A 46 year old is looking for contraception. She has a BMI of 42 and smokes 20 cigarettes/day . She has a history of pelvic inflammatory disease. She also has a multiple fibroid uterus including intramural and submucous fibroid. What would you advice?
progesterone only pill
A 40 year old woman seeks contraception. She smokes 30 cigarettes a day. Her BMI is 40 and she has heavy menstrual periods. She is sexually active. Her uterus is retroverted and normal size. What would you advice?
mirena IUS
what is the legal limit for a social termination of pregnancy?
23 weeks + 6 days
how many signatures are required on the HSA1 form (aka green form) before a termination can take place?
two
A patient presents with fishy malodorous discharge. It is grey and whitish in colour. She is very bothered with the discharge. You have taken a swab. What is the most likely diagnosis?
bacterial vaginosis
A 16 year old girl is seen by her GP with some vaginal discharge. Her observations are normal. A swab test shows presence of Chlamydia. What is the best antibiotic treatment for her?
doxycycline
what is the preferred test for chlamydia in an asymptomatic female?
first void urine NAAT
what is a Figo stage 4 cervical cancer?
one where the cancer has spread to distant organs
how do you calculate the coverage of a screening programme?
screened population/eligible population x100
what is an ovarian mucinous cystadenoma?
a benign epithelial ovarian tumour
A 20-year-old woman presents to her GP complaining of painful periods. She currently uses an implant (Nexplanon) for contraception which she is very happy with. What is the most suitable initial treatment?
mefenamic acid
A 26-year-old woman presents to her GP with a 5 week history of worsening dull pelvic pain and smelly discharge. She has had a hormonal intrauterine device in situ for one year and does not menstruate with this. She has had the human papilloma virus vaccine but has not yet had any smear tests. What is the most likely diagnosis?
pelvic inflammatory disease
A 34-year-old lady presents to the gynaecology department complaining of heavy, painful periods, and difficulty conceiving. She is concerned, as she and her husband would like to start a family soon. On further investigation, an ultrasound scan reveals a 4.5cm submucosal uterine fibroid. Which one of the following treatments is most appropriate to treat her fibroids?
myomectomy
A 24 year old lady presents to her GP with cyclical pelvic pain associated with dyspareunia and dysmenorrhea.
On examination, she has a fixed, retroverted uterus. Which investigation is most useful?
laparoscopy
which is a possible cause of foetal growth restriction - hyperthyroidism or hypothyroidism?
hyperthyroidism
can warfarin be given in pregnancy?
no
can carbimazole be given in pregnancy?
yes
Pain from the body of the uterus is carried in which nerve fibres?
Visceral afferent fibres to T11-L2 spinal cord levels
Which structures can be used as a landmark to administer a pudendal nerve block?
ischial spine
What is the length of time considered normal for return of tissues to normal state following childbirth?
6 weeks
Normal Blood loss in labour is considered to be…
500mls
A previously well newborn term infant on the postnatal ward is noticed to be breathing quickly and feeding poorly. Which condition might be considered in your differential diagnosis?
group B strep
Where does most lymph (>75%) from the breast initially drain to?
axillary lymph nodes
Which hormone stimulates the lactiferous duct system to grow at puberty?
oestrogen
Which hormone stimulates the myoepithelial cells lining the milk ducts to contract?
oxytocin
What is the most common histological type of breast cancer?
invasive ductal cancer
A 55 year old female patient presents with scaling of the left nipple. She tried E45 and hydrocortisone cream prescribed by her GP for the past 4 weeks without any improvement. What is the most likely condition?
paget’s disease
A 53 year old female patient has been recalled after her first screening mammogram showing extensive microcalcifications in the inner quadrant of her left breast.
What is the most likely diagnosis?
ductal carcinoma in situ
A 28 year old woman presents with a painless, firm, discrete, mobile mass, which has a solid appearance on ultrasound scan.
What is the most likely diagnosis?
sclerosing adenosis
A 26 year old female patient, 3 weeks post-partum, breast feeding, presents with a hot swollen erythematous looking right breast with a fluctuant 3 cm breast lump.
What is the most likely diagnosis?
breast abscess
A 28-year-old woman who is P1 G2 is 30 minutes post-partum of an uncomplicated delivery. She suddenly begins gasping for breath with a blood pressure of 83/65mmHg, heart rate of 120bpm and a respiratory rate of 33/min. She appears cyanosed. She becomes unresponsive. What is the most likely diagnosis?
amniotic fluid embolism
A 29-year-old primiparous woman is in a prolonged labour following an induction at 41 weeks gestation. She is 6 cm dilated and the fetal head is 1 cm above the ischial spines. The midwife calls the senior registrar to look at her CTG. The fetal heart rate is progressively dropping, it is now below 100 beats per minute, and it has not recovered for more than 3 minutes.
What is the next best step in management?
emergency CS
A mother is concerned about a swelling she has noted on her newborn’s head. The girl was born four hours ago, using forceps delivery due to a prolonged second stage of labour. On examination, there is a swelling in the parietal region which does not cross the suture lines. The consultant tells her that it may take several months to resolve.
Which type of head injury is this likely to be?
cephalohaematoma
A 31 year old pregnant female is due to have an induction of labour at 38weeks gestation due to cholestasis of pregnancy. She undergoes a pelvic examination and a Bishop’s score of 1 calculated with the station at -1 but her cervix is closed and firm.
What treatment is most suitable?
vaginal prostaglandins
A patient suddenly collapses in the postnatal ward. She had a caesarean section 5 days ago and was due to be discharged. What is the most likely cause?
PE
