M24 Flashcards
1
Q
A
B
2
Q
A
C
3
Q
A
A
4
Q
A
A
5
Q
A
D
6
Q
A
A (abd circumference 5th percentile but preserved head growth (most important))
7
Q
A
C
8
Q
A
C (HBGM should be FG < 6 and PPG < 7)
9
Q
A
D
10
Q
A
B
11
Q
A
C
12
Q
A
C
13
Q
A
C
14
Q
A
B (overactive bladder –> antimuscarinics (oxybutynin)
15
Q
A
B (adequate hydration and pain relief with an epidural will minimize risks of seizures in labor and provide maximum safety in the event of a seizure)
MgSO4 is for managing seizure
Pethidine = opioid (can induce seizure)
16
Q
A
A
Doxycycline is 1st line but not used in prengnacy due to AE
17
Q
A
C (candida –> use an azole to manage)
18
Q
A
B
19
Q
A
D
20
Q
A
D
21
Q
A
D
22
Q
A
D
23
Q
A
D
24
Q
A
B
25
Q
A
C (if gonodotrophins are elevated into the menopausal range a repeat FSH measurement is indicated in 1 month. If the result indicates that FSH is elevated a diagnosis of primary ovarian insufficiency can be established)
26
Q
A
B
27
Q
A
C
28
Q
A
A
29
Q
A
A
30
Q
A
B
31
Q
A
A (as endometrial thickness >4mm requires biopsy)
32
Q
A
B (Benign looking endometrial cells –> investigate if postmenopausal or >45 and symptomatic (e.g. AUB), treat as normal if < 45yo
33
Q
A
A
34
Q
A
C
35
Q
A
A
36
Q
A
A
37
Q
A
B
38
Q
A
A
39
Q
A
A
40
Q
A
B
41
Q
A
B
42
Q
A
A
43
Q
A
A
44
Q
A
A
45
Q
A
A
46
Q
A
B
47
Q
A
A
48
Q
A
C (vault smear done at 6 and 18 months post total hysterectomy)
49
Q
A
A (always offer screening first before invasive diagnostic testing) can also do NIPT/ chromosomal microarray
50
Q
A
A
51
Q
A
A
52
Q
A
B
53
Q
- HT on enalapril, 8 week pregnant
- 20/F G1P0 20 weeks gestation with chlamydia, currently on clindamycin
- alpha thal carrier on folic supplement. low MCV
- Female with 2 miscarriage prviosuly, known carrier of balanced translocation chromosome disorder
A
- A
- G
- B
- I
54
Q
- Recurrent miscarriage, anti cardiolipin ab+. Now 8 weeks of pregnancy
- G2P1 lady, contact with son who has chickenpox; herself asymptomatic and told you that she is not immune
- HBV+ mother with high viral load at 28w
- caucasian BMI 40 complete C section after failed IOL. Cant leave bed for 2 days due to pani, now ha SOB and vague chest pain. DVT picture.
A
- B
- H (as asymptomatic so VZIG single dose effective. If has vesicles –> than give acyclovir)
- F
- C
55
Q
- 54/f PMB. TVUS found endometrial thickness 2.4mm and no lesion
- 52/F PMB. TVUS found endometrial thickness 8.2mm with cystic lesions
- 32/F HMB and clots. TVUS found 3.5 x 3.5 x 3.2cm well circumscribed hypoechoic lesion in anterior wall of uterus abutting the endometrium
- 32/F with heayv painful menstruation. TVUS show posterior uterine wall thickening of 3.5cm. Endometrial thickness 5.6mm
A
- B
- D (if with atypia –> requires total hysterectomy)
- G
- A
56
Q
- lady 36wk breech presentation wish vaginal birth
- 35yo GA37 week multiple pregnancy DCDA. 1st twin cepahlic delivered vaginally. 2nd twin breech now. CTG shows reactive
- 30yo GA 38 week with poorly controlled DM presented with unstbale lie. Wish vaginal delivery
- 25yo GA32wk admitted for leaking. Speculum shows clear liquor and cord prolapse. Fetus shows persistent bradycardia
A
- ECV
- Assisted breech vaginal delivery
- Admission for monitoring from 37w
- Classical CS (as preterm so lower section of uterus not well formed)
57
Q
- previous open myomectomy which breached endometrial cavity. Now presented with irregular contraction. Cervix 3cm dilated
- 39 weeks gestation, lady with preeeclampsia. Had an epileptic fit when her cervix was 9cm dilated and now stabilized. FHR normal, now in labor
- Induction of labor with 6 contractions per 10 minutes
- F/26 nulliparous, pushed for 90 minutes in 2nd stage. On epidural analgesics. Reactive FHR. Contractions good. Cervix fully dialted. fetal station +2, 2cm caput, 1+ moulding
A
- F
- B
- I (hyperstimulation of uterus normally from augmentation by oxytocin)
4.F
58
Q
- young couple tried for half a year still cant concieve. all test normal
- 37yo previous surgery saw adhesions. HSG shows bilateral blocked duct
- Husband premature ejaculation, seen counsellor for 1 year still not good. wife all normal
- Newly married, PCOS. No clinical signs of hyperandrogenism, no hormonal abnormality. BMI 22, follicles 18/22 in L and R ovary.
A
- A
- G (as advanced maternal age)
- C
- D
59
Q
- lady with 6 weeks missed period, pregnancy test 1 week ago was positive. today have 1st checkup and TUCS does not hv intrauterine sac. HCG is negative.
- lady with 6 weeks missed period, pregnnacy test 1 week ago was positive. Today have abd pain and bleeding, BP 80/30, HR 120bpm. TVUS shows absent intrauterine sac and right adnexal mass with moderate free fluid amount free fluid in POD
- Similar scenario as above but stable vitals and HCV2500. Patient prefers not to have surgery
- Lady with 6 weeks missed period, PT test one week ago positive. Today bleeding. Previous spontaneous miscarriage 6 months ago
A
- C
- F
- D
- G (use progesterone in cases of threatened miscarriage in women who had history of miscarriage)
60
Q
- 20yo unprotected sex after party within 24 hours
- 45/F heavy smoker with menorrhagia and anemia has trypanophobia
- 45/F G4P3 plan to have elective CS later at 39 weeks of gestation. Completed family
- History of CA breaast treated 2y ago, wants contraception, dont want surgery
A
- H
- D
- I
- F (only option for CA breast –> cannot use hormonal contraceptives or LNG IUD)
61
Q
- 40/F with suction evacuation for complete molar pregnancy 2 weeks ago. Pre op HCG 100,000. 1 week later drop to 20,000 than rise to 25,000 in 2 weeks
- 28/F microinvasive SCC found on LLETZ, 1x1x2mm with margin involvement
- 70/F with recurrent ovarian cancer despite multiple lineage of chemotherapy, admitted due to SOB. cachexic and wheelchair bound. CXR found progressive lung met. Daughter wished active cancer tx
- 29/F early stage 1a1 endometrial CA due to fertility wish, given mirena. Endometrail biopsy later found non atypical endometrial hyperplasia
A
- A
- H
- E
- D
62
Q
- 28yo 10 day post partum increase lochia, antepartum unremarkable, fever 38.5. Tender uterus, os closed
- young lady has asthma, postpartum after elective. delivered placenta. profuse uterine bleeding, uterus soft 600ml blood loss. IV syntocinon full rate not responsive. BP 80/30
- uterus 14w size os still open, no fever haemodynamically unstable
- multiple STOP, controlled cord traction for 15min and still attached –> bleeding os open
A
- K (to rule out RPOG with concomitant infection)
- I
- C
- J
