Membership practice MCQs Flashcards
- A 22-year-old woman is seen at 10 weeks gestation in her second pregnancy, her first child being born with a closed spina bifida.
Which of the following statements is TRUE?
A. The risk of a neural tube defect in this pregnancy is 10%
B. Amniocentesis is indicated at 15-16 weeks
C. She should start on a folate supplement now
D. An ultrasound examination is indicated at 11-12 weeks
D
- The primary group of lymph nodes that drain the vulva is the
A. deep inguinal.
B. deep femoral.
C. obturator.
D. superficial inguinal.
D
3. One hundred high-risk patients undergo a fetal biophysical profile (FBPP). Ten patients have a positive test. Two stillbirths result, both of which are from among the patients with a positive FBPP. The sensitivity of the FBPP in this population is A. 0%. B. 20%. C. 80%. D. 100%.
D
- Intraoperative findings that are indications for abandoning radical hysterectomy for cervical cancer include all of the following EXCEPT
A. Stage IIA disease with a unilateral 30 mm diameter ovarian cyst.
B. intraperitoneal metastasis.
C. extra-nodal parametrial/pelvic sidewall disease.
D. extensive, unresectable pelvic lymph node disease.
A
- Of the following, what is the SMALLEST fetal pole size in which a competent ultrasonologist would be confident diagnosing a missed abortion on transvaginal ultrasound because of the absence of fetal heart activity?
A. 7 mm
B. 9 mm
C. 11 mm
D. 13 mm
A
- Which of the following genetic conditions is NOT associated with a particular ethnic group or groups?
A. Tay-Sachs disease
B. von Willebrand disease
C. Sickle cell disease
D. alpha thalassaemia
B
- An epileptic patient on phenytoin (Dilantin) requests contraception. You recommend the
A. combination pill with 35 μg of ethinyloestradiol.
B. combination pill with 30 μg of ethinyloestradiol.
C. Mirena IUD.
D. progestagen only pill with 35 μg of levo-norgestrel.
C
- Which one of the following statements concerning twin-twin transfusion syndrome (TTS) is
LEAST CORRECT?
A. In stage I TTS there is polyhydramnios, stage II empty bladder of the donor twin, stage III absent or reversed umbilical arterial doppler waveform, stage IV fetal hydrops, stage V fetal death of one or both twins
B. The presence of increased arterial-arterial anastamoses on the surface of the placenta is associated with an increased risk of TTS
C. Survival in twin-twin transfusion syndrome is approximately 30% untreated, 50% if treatment is available
D. Serious disability still occurs in approximately 10% of TTS survivors treated with laser coagulation (where both twins are survivors)
B
- Thyroid hormone
A. must be present for the fetus to grow normally.
B. is active in the fetus in the form of reverse T3.
C. is necessary for shivering, but not non-shivering thermogenesis in the fetus.
D. has increased concentrations in the fetus after birth because of a surge in TSH concentrations.
D
- The failure rate among typical users of which of the following methods of contraception is LESS THAN 1%?
A. Combined oral contraceptives
B. Depot medroxyprogesterone acetate
C. Progestogen only contraceptive pills
D. Condoms
B
- Regarding the current status of therapy for mild or moderate endometriosis, which of the following statements is LEAST correct?
A. monthly fecundity over the first 36 weeks is significantly increased after laparoscopic treatment of mild or moderate endometriosis
B. there is a tendency for fertility to plateau at the same level with either surgical therapy or expectant management of mild or moderate endometriosis
C. danazol reduces both pain and disease progression with endometriosis
D. after a course of GnRH analogue therapy, fecundity is transiently improved in comparison to expectant management
D
- An 18 year old, 63 kg nullipara, with a history of two terminations of pregnancy, presents at 21 weeks’ gestation with pain and bleeding. Limbs are palpable through an 8 cm dilated cervix. Ultrasound reveals the fetus in a transverse lie with its back uppermost and the arms and legs occupying the lower uterine segment. Which of the following is the MOST APPROPRIATE form of management?
A. internal podalic version and breech extraction
B. external cephalic version under a beta-mimetic infusion
C. take no specific action
D. destructive procedure (embryotomy)
C
- A 25 year old woman has developed hirsutism, weight gain, and deepening of the voice over the last year. Her menstrual cycles are irregular and infrequent. Examination reveals severe facial hair growth and clitoromegaly. The uterus is slightly enlarged. The patient is obese and the ovaries are very difficult to palpate. Investigation shows a testosterone concentration of 17.3 nmol/L (normal range 0.5 - 2.8) and a DHEAS concentration of 9.8 umol/L (normal range 0.9 - 11.7). The MOST APPROPRIATE next step in this patient’s evaluation is
A. measurement of serum androstenedione.
B. measurement of serum 17-hydroxyprogesterone.
C. CT scan of the adrenals.
D. vaginal ultrasound of the ovaries.
D
- A major histologic ovarian structural change associated with menopause is proliferation of
A. theca interna cells.
B. granulosa cells.
C. epithelial surface cells.
D. stromal cells.
D
- In an adolescent, which of the following is a manifestation of a defect in the migration of primordial germ cells?
A. Precocious puberty
B. Pubertal failure
C. Pubertal delay
D. Congenital absence of the vagina
B
- What is the prevalence of PLA-1 (HPA-1a) negative women in the population?
A. 0.02%
B. 0.1%
C. 0.5%
D. 2%
D
- Which of the following conditions is associated with the highest risk of thromboembolism in the puerperium?
A. Anti-thrombin III deficiency
B. Factor V Leiden homozygosity
C. Protein S deficiency
D. Hyperhomocysteinaemia
A
- Obstetric cholestasis is associated with
A. right upper quadrant tenderness.
B. preeclampsia.
C. pruritus without rash.
D. Gilbert’s syndrome.
c
- Your patient is a 17 year old with short stature and severe oligomenorrhoea. LH 8, FSH 9, 17OHP 11.5, Testosterone 2.9, DHEAS 13.8.
(Normal ranges for assays reported are, LH 4-25, FSH 3-25, 17-hydroxyprogesterone (17OHP) nmol/L <5.5, Testosterone 0.5-2.5nmol/l, dehydroepiandrosterone (DHEAS) umol/L 0.9-11.7)
This patient is MOST LIKELY to have the diagnosis of
A. Sertoli-Leydig cell tumour.
B. late onset congenital adrenal hyperplasia.
C. Adrenal Cortical adenoma.
D. Cushing syndrome
B
- Which of the following conditions is related to a preventable increased risk of preterm delivery?
A. Periodontal disease
B. Dental caries
C. Endodontal disease
D. Impacted wisdom teeth
A
- What is the MOST COMMON mode of transmission of Toxoplasma Gondii to women in Australia?
A. Contact with domestic cats.
B. Ingestion of kangaroo meat.
B.C. Ingestion of sheep meat from the Western District of Victoria.
D. Ingestion of undercooked meat.
D
- Which of the following is the KEY mode of current therapy for fetal alloimmune thrombocytopenia?
A. Maternal immunoglobulin infusion
B. In-utero fetal platelet transfusion
C. Corticosteroid therapy with prednisolone
D. Plasmapheresis
A
- In the newborn infant, normal circulatory changes associated with neonatal life include an increase in all of the following EXCEPT
A. the flow in the pulmonary veins.
B. the left atrial pressure.
C. pulmonary vascular resistance.
D. renal blood flow.
C
- A 30 year old woman, gravida 4, para 3, presents with spontaneous rupture of membranes and irregular contractions at 40 weeks gestation. Her current and prior pregnancies were uncomplicated. Full blood count at the time of admission reveals a platelet count of 85x109/L per mm, but is otherwise normal. She is asymptomatic. The management of her labour should include
A. fetal platelet count (by scalp sample).
B. notification of blood bank to have platelet packs available for maternal transfusion.
C. normal labour management and neonatal platelet count.
D. caesarean section rather than midforceps to minimise fetal trauma.
C