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MRCOG Part 1 > Numbers to Memorise > Flashcards

Numbers to Memorise Flashcards

1
Q

Clotting factors that increase during pregnancy

A

All except factor 11 and 13

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2
Q

A healthy 32 year old woman is found to have gestational diabetes at 28 weeks of gestation. What is her risk of developing type 2 diabetes over the next 10 years?

A

50%

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3
Q

Risk of recurrence of preeclampsia?

A

15-20%

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4
Q

Risk of hypertensive disease in pregnancy if previous preeclampsia

A

1 in 7

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5
Q

Risk of developing preeclampsia if previous preeclampsia necessitating delivery before 34 weeks

A

1 in 3

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6
Q

Risk of congenital malformations with anti epileptic drugs?

A

Lamotrigine: 2%
Carbamazepine : 3.4%
Sodium valproate: 10.7%
AED poly therapy: 16.8%
Background rate: 2.3%

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7
Q

Risk of neonatal congenital CMV infection

A

1st and 2nd trimester: 30-40%
3rd trimester: 40-70%

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8
Q

Percentage of Brenner tumors showing malignant change

A

5%

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9
Q

Ultrasound frequency for TVUS

A

5-7.5 MHz

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10
Q

Percentage of free thyroid hormones in circulation

A

T3: 0.3%
T4: 0.03%

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11
Q

Gestation at which differentiation of external genitalia happens

A

9-11 weeks

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12
Q

Percentage of non epithelial ovarian cancer

A

10%

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13
Q

Risk of cystic fibrosis in Caucasian population

A

1 in 25

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14
Q

Cord gases interpretation

A

Arterial or venous <7.1 is severe
BE more than 12 is severe
Arterial normal is 7.28
Venous normal is 7.35 (like adult)
BE +/- 4 is normal

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15
Q

Which day of the menstrual cycle does inhibin B peak?

A

Day 7

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16
Q

Risk of needing a blood transfusion following physiological third stage of labour

A

40 in 1000

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17
Q

Risk of needing a blood transfusion following active management of the third stage of labour

A

14 in 1000

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18
Q

Risk of nausea and vomiting during active management of the third stage of labour

A

100 in 1000

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19
Q

Risk of blood loss of more than 1000 mL during physiological management of the third stage of labour

A

29 in 1000

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20
Q

Dose of adrenaline for anaphylaxis

A

0.5 mL of 1 in 1000 IM (500 mcg)

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21
Q

Proportion of women in the UK who are Rh neg (white population)

A

Approx 16%

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22
Q

Temperature of the room for preterm babies

A

At least 26 degrees

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23
Q

Fetal blood volume

A

10-12% of body weight
At the moment of birth, blood volume is 78mL per kg (approx 280mL for 3.5kg baby)
DCC for up to 5 min increases to 126 mL/kg

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24
Q

Response time following IV oxytocin

A

Uterine response occurs almost immediately (1 min)

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25
Q

Uterine response time following IM oxytocin

A

3-5 minutes
Persists for 2-3 hours

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26
Q

Uterine response following ergometrine

A

IV - immediate and persists for 45 min (not recommended due to risk of severe hypertension)
IM - 2-5 minutes, persists for 3+ hours

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27
Q

Moderately useful positive predictive value

A

5-10

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28
Q

Very useful positive predictive value

A

> 10

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29
Q

Moderately useful negative predictive value

A

0.1 - 0.2

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30
Q

Very useful negative predictive value

A

0.1

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31
Q

Threshold value for positive FFN

A

50 ng/mL

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32
Q

Components of mature human breast milk

A

Fat 3-5%
Protein 0.8-0.9% (higher in colostrum)
Carbohydrates (lactose) 6.9-7.2%
Mineral constituents 0.2%

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33
Q

Size of particles in surgical smoke

A

0.1-5 micrometres

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34
Q

Spinal segment where aorta and IVC pass through diaphragm

A

Aorta: T12
IVC: T8

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35
Q

Half life of LH and FSH

A

LH: 20 min
FSH 3-5 hours

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36
Q

Percentage increase in plasma volume in the first trimester

A

40-50%

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37
Q

Percentage increase in red cell mass in the first trimester

A

25-30%

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38
Q

Percentage increase in respiratory volumes in early pregnancy
- minute volume
- residual volume, functional residual capacity and expiratory reserve volume
- vital capacity and expiratory reserve
- PEFR and FEV1

A

Minute volume 50%
Residual volume, functional residual capacity and expiratory reserve volume all decrease by 20%
Vital capacity and expiratory reserve are unchanged
Physiological dead space increases
PEFR and FEV1 unchanged

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39
Q

Percentage increase in cardiovascular parameters during first trimester:
Cardiac output
Blood volume
Heart rate
Pulmonary capillary pressure
Pulmonary vascular resistance

A

Cardiac output 40%
Blood volume 50%
Heart rate 10%
Pulmonary capillary pressure unchanged
Pulmonary vascular resistance falls by 35%

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40
Q

By which week does the nadir of BP happen?

A

Week 24

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41
Q

ECG changes in pregnancy

A

Deviation of electrical axis to the left by 15 degrees
ST segment depression and flattening/depression of T waves in III

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42
Q

Cardiac output changes in labour

A

First stage increase by 10-25%
Second stage increase by 40%
Immediately after delivery increase by 10-20%

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43
Q

Diameters of fetal skull:
Suboccipito-bregmatic
Suboccipito-frontal
Occipitofrontal
Submento-bregmatic
Submento-vertical
Mento-vertical

A

Suboccipito-bregmatic 9.5 cm (occipital protuberance to anterior fontanelle)
Suboccipito-frontal 10cm + (incomplete flexion)
Occipitofrontal 11.5cm (to the root of the nose = OP position)
Submento-bregmatic 9.5cm (completely extended face presentation)
Submento-vertical 11.5cm (incompletely extended face)
Mento-vertical 13.5cm (brow - cannot be delivered vaginally)

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44
Q

Renal physiological changes in pregnancy

A

GFR increased by 50% (peak between 16-24 weeks, falls in late pregnancy)
Renal plasma flow increases by 75%
Serum urea and creatinine decrease by 25%
Colloid osmotic pressure decreased by 10%
Aldosterone increased 6-8x - increases salt and water reabsorption
Total body water increases by 6-8L (ECF by 3L, 1.5L of which is plasma)
Increased protein excretion

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45
Q

Percentages of bound and free testosterone

A

Men: Free (metabolically active) 1-2%
Bound to sex hormone binding globulin 69%
Bound to albumin 30%
Women: Free 1%
80% SHBG, 19% albumin

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46
Q

Recurrence rate of ectopic pregnancy

A

18.5% (15-20%)

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47
Q

Percentage of aldosterone bound to plasma proteins

A

50%

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48
Q

Proportion of catecholamines produced by the adrenal medulla

A

85% adrenaline and 15% noradrenaline

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49
Q

Half life of glucagon and insulin

A

6 minutes

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50
Q

Chance of pneumonia complicating varicella in pregnancy

A

10-14%

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51
Q

Risk of progression of leiomyoma to leiomyosarcoma

A

0.1%

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52
Q

Risk of recurrence of preeclampsia

A

15-20%

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53
Q

Percentages of white blood cells
Lymphocytes
Neutrophils
Eosinophils

A

Lymphocytes 20-40%
Neutrophils 40-60%
Eosinophils 2-5%

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54
Q

Shoulder dystopias risk of brachial plexus injury

A

2.3-16%

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55
Q

Which day does the neural tube close?

A

Day 28

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56
Q

most commonly injured vessel in sacrospinous ligament suspension

A

Inferior gluteal artery

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57
Q

The male equivalent of the Skene gland is the

A

Prostate

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58
Q

The ductus arteriosus is derived from the

A

Sixth left pharyngeal arch

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59
Q

Nerve supply to pharyngeal arch derivatives

A

First arch - mandibular branch of the trigeminal nerve
Second arch - facial nerve
Third arch - glossopharyngeal nerve
Fourth arch - superior laryngeal branch of the vagus
Sixth arch - recurrent laryngeal branch of the vagus

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60
Q

Percentage of couples presenting with recurrent miscarriage who carry a chromosomal anomaly

A

3-5%

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61
Q

Percentage of first trimester miscarriages with abnormal karyotype

A

70%

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62
Q

Proportion of first trimester miscarriages that have evidence of chromosomal rearrangements

A

5%

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63
Q

HCG cut off for methotrexate

A

Less than 3,000 IU/litre

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64
Q

Success rates of single dose methotrexate treatment

A

85-94%

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65
Q

Percentage of women who experience tubal rupture during follow up

A

7%

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66
Q

Recurrent ectopic rates among women trying to become pregnant, following treatment with methotrexate

A

8-10%

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67
Q

Incidence of ectopic pregnancy in the UK

A

1 in 100

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68
Q

Gestational age when CRL is 10mm

A

7 weeks

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69
Q

Fetal heart rate activity first detectable on transvaginal scanning at how many days from the LMP?

A

37

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70
Q

What proportion of women with recurrent first trimester miscarriage have anti-phospholipid antibodies?

A

15%

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71
Q

The percentage of women in the general population who have anti-phospholipid antibodies

A

About 2%

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72
Q

What percentage of molar pregnancies are complicated by the development of choriocarcinoma?

A

2-3% (5% of complete moles and 0.05% partial moles)

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73
Q

Risk of choriocarcinoma developing after a normal full term pregnancy

A

1in 50,000

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74
Q

Risk of recurrence of molar pregnancy

A

1 in 55 after one affected pregnancy, 1 in 7 after two

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75
Q

Following ectopic pregnancy, what percentage of women treated with single dose regimen of methotrexate will require surgical intervention?

A

About 10%

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76
Q

FIGO definition of “infrequent menstruation”

A

Cycles lasting longer than 38 days

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77
Q

Percentage of pituitary tumours that secrete prolactin

A

80%

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78
Q

Percentage of precocious puberty that is idiopathic in girls (and boys)

A

75% (40%)

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79
Q

Percentage of stimulated IVF cycles that develop mild OHSS

A

33%

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80
Q

Percentage of stimulated IVF cycles that develop severe OHSS

A

0.3-0.5%

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81
Q

The sensitivity of microscopy in diagnosing endocervical infection with Neisseria gonorrhoea when compared with culture

A

30-50%

82
Q

Efficacy of CHC

A

Perfect use 0.3% unwanted pregnancy
Typical use 9%

83
Q

PEARL index for levonorgestrel and desogesterel POP

A

1.41/100 woman years levonorgestrel
0.17/100 woman years desogestrel

84
Q

The risk of venous thromboembolism in a woman of reproductive age not using any contraception

A

4-5 per 10,000 woman years

85
Q

The risk of venous thrombo-embolism in the immediate post-partum period

A

300-400 per 10,000 woman years

86
Q

The risk of expulsion of the levonorgestrel IUS or CuIUD

A

1 in 20

87
Q

The rate of uterine perforation associated with IUC

A

1.2 per 1000 insertions

88
Q

Bone mineral density loss at the spine after 12 months of depo-medroxyprogesterone acetate use

A

0.5-3%

89
Q

Half life of mirabegron

A

50 hours

90
Q

Wound strength after 2, 3, 4 and 12 weeks

A

2: 3-5%
3: 20%
4: 50%
12: 80%

91
Q

What happens to kidney volume in fetus on postnatal day 4?

A

2 fold decrease in volume

92
Q

Lifetime risk of breast cancer in women in the UK

A

15%

93
Q

Lifetime risk of breast cancer in men in the UK

A

Less than 0.1%

94
Q

Risk of endometrial cancer in a woman with Lynch syndrome

A

40-60%

95
Q

Lifetime risk of endometrial cancer in general population

A

3%

96
Q

Lifetime risk of ovarian cancer in Lynch Syndrome

A

10-12% (predominantly clear cell or endometroid in histology)

97
Q

Risk of developing endometrial cancer if endometrial hyperplasia with atypia

A

8% after 4 years
12.4% after 9 years
27.5% after 19 years

98
Q

Lifetime risk of breast and ovarian cancer in BRCA 1 mutations

A

Breast: 85%
Ovarian: 63%

99
Q

Lifetime risk of breast and ovarian cancer in BRCA 2 mutations

A

Breast: 84%
Ovarian: 27%

100
Q

The most appropriate gestational age for chorionic villus sampling (CVS) and amniocentesis

A

CVS after 10 weeks, Amnio after 15 weeks

101
Q

Success rate of VBAC

A

85-90%

102
Q

Risk of uterine rupture with VBAC

A

1 in 200

103
Q

Risk of stillbirth beyond 42 weeks gestation

A

1 in 1000

104
Q

Following adequate iron therapy in women with iron deficiency anaemia, haemoglobin should be expected to increase by

A

20 g/L over 3-4 weeks

105
Q

Hyperemesis gravidarum affects what percentage of pregnancies

A

0.3-3.6%

106
Q

The risk of neonatal herpes following vaginal birth to a woman with primary genital herpes around the time of delivery

A

About 40%

107
Q

The risk of neonatal herpes following vaginal birth to a woman with recurrent genital herpes around the time of delivery

A

About 1%

108
Q

Risk of neonatal infection if maternal chicken pox 1-4 weeks before delivery (and risk of developing clinical varicella)

A

Up to 50% (23% develop clinical varicella)

109
Q

Incubation period of measles

A

10-14 days

110
Q

Risk of fetal varicella syndrome

A

Approx 1% and <28 weeks does not occur after 28 weeks and if very rare between 20-28 weeks
Approx 0.5% in first trimester

111
Q

Maternal breast exposure to radiation during CT pulmonary angiography (CTPA)

A

10mGy

112
Q

Fetal exposure to radiation during CTPA and V/Q scan

A

CTPA 0.1mGy
V/Q 0.5mGy

113
Q

How long does it take for a pudendal block to become effective for vaginal operative delivery?

A

5-10 minutes

114
Q

Uterine rupture most commonly occurs at which dilatation

A

4-5 cm

115
Q

Max dose of lidocaine

A

4mg/kg without adrenaline
4-7mg/kg with adrenaline

116
Q

When testing for anaesthesia prior to caesarean section, what is the lowest level of the block needed to ensure the woman is pain free?

A

T5

117
Q

If a woman had received standard oxytocic management for the third stage of labour, by what amount would she have reduced her risk of requiring therapeutic oxytocic drugs?

A

44%

118
Q

Plasma half life of oxytocin

A

1-6 minutes

119
Q

Increase in caloric requirements after 1st trimester

A

200kcal

120
Q

Nagele’s rule (for a 28 day cycle)

A

EDD = 9 months + 7 days

121
Q

Lowest platelet count to allow vaginal birth or CS

A

50

122
Q

Lowest platelet count to allow epidural

A

80

123
Q

Daily dose of radiotherapy for cervical cancer

A

1.8-2.0 Gy

124
Q

Length of urethra

A

Male 15-29cm long
Female 4cm long

125
Q

Risk of developing SCC from VIN

A

15% (between 9-18.5%)

126
Q

CMV affects what proportion of pregnancies

A

0.2-2.2% (1 in 50 to 1 in 500)
In the UK approximately 1 in 150 babies will be born with congenital CMV infection

127
Q

Risk of female (and male) carriers of 13q21q or 14q21q Robertsonian translocations having a baby with Down syndrome

A

10% (male 1-3%)

128
Q

The chance of malignant transformation occurring in a mature cystic terratoma

A

1%

129
Q

The radiation exposure from one chest x-ray as equivalent to the amount of radiation exposure one experiences from natural surroundings in how many days?

A

10 days

130
Q

When the variable under study cannot distinguish between the two groups, i.e. where there is no difference between the two distributions, the area will be equal to

A

0.5

131
Q

MAP formula

A

Diastolic pressure + 1/3(pulse pressure)

132
Q

Percentage of aldosterone bound to plasma proteins

A

50%

133
Q

Onset and half life of oral labetalol

A

Onset: peak plasma levels 1-2 hours after administration
Half life: 6-8 hours

134
Q

Percentage of pregnancies that have a platelet count below the normal range

A

8-10%

135
Q

Estimated gestational age at a crown rump length of 10mm

A

7 weeks

136
Q

Percentage of people with pancreatic cancer who have BRCA mutation

A

4-7%

137
Q

Phenylalanine ratio between maternal and fetal circulation

A

Fetal 1.25-2.5 x maternal concentrations

138
Q

Risk of gestational hypertension if previous gestational hypertension?

A

1 in 7

139
Q

Risk of developing preeclampsia if chronic hypertension

A

Up to 1 in 50

140
Q

Risk of developing hypertensive disease in pregnancy if any history of previous hypertension

A

1 in 5

141
Q

Aim to keep platelets above what level in PPH

A

50

142
Q

Aim to keep APTT and PT during PPH

A

Below 1.5

143
Q

Autonomic sympathetic nerve supply to the uterus and pelvis

A

T10, T11, T12 and L1 spinal nerves (inferior hypogastric plexus/pelvic plexus)

144
Q

Recurrence rate of polymorphic eruption of pregnancy (PUPP)

A

7%

145
Q

Risk of developing SCC from lichen sclerosus

A

<5%

146
Q

Risk of serious neonatal infection with PROM

A

1% (vs. 0.5% with intact membranes)

147
Q

Incidence of placenta accreta (including increta and percreta) in the UK

A

1.7 per 10,000 deliveries

148
Q

Incidence of PE in the UK

A

1.3/10,000 maternities

149
Q

Relative risk of VTE in pregnancy compared to non pregnancy

A

4-6x

150
Q

Absolute risk of VTE in pregnancy and the puerperium

A

1-2/1000 pregnancies

151
Q

Infertility rate with endometriosis

A

40%

152
Q

Risk of thrombosis in patient with factor V leiden compared with general population

A

80x higher

153
Q
A
154
Q

Half life of misoprostol

A

40 minutes

155
Q

the male scrotum is typically how many degrees cooler than body temperature?

A

2-2.5 degrees celsius

156
Q

Risk of fetal laceration with CS

A

2%

157
Q

Risk of bladder injury and ureteric injury at CS

A

Bladder injury 1 in 1000
Ureteric injury 3 in 10,000

158
Q

Percentage chance of being symptom free at 12 months following 3rd degree tear repair

A

60-80%

159
Q

Incidence of OASIS in the UK

A

2.9% (6.1% in primip, 1.7% in multip)

160
Q

Mortality rate of severe sepsis and septic shock

A

Severe sepsis 20-40%
Septic shock 60%

161
Q

Incidence of PPH in the UK

A

13.8%

162
Q

Duration of afterpains

A

2-3 days

163
Q

How long does uterine involution take?

A

4-6 weeks

164
Q

What is the approximate risk of HIV transmission during a single episode of receptive vaginal unprotected sexual intercourse with a known HIV positive person?

A

0.1%

165
Q

Percentage chance of labour starting spontaneously within 24 hours of SROM at term?

A

60%

166
Q

Frequency of endometrial surveillance in women with endometrial hyperplasia WITHOUT atypia

A

6 monthly

167
Q

The average functioning adult kidney contains approximately how many nephrons?

A

1,000,000

168
Q

Percentage of trichomonas infections that are asymptomatic

A

50%

169
Q

Radiological volume of ovaries post menopause or ovarian failure

A

Approx 2 cubic cm

170
Q

Frequency of monopolar diathermy

A

500 KHz (must be greater than 100)

171
Q

Half life of ergometrine

A

30-120 minutes

172
Q

What percentage of women develop antibodies to Human Papilloma Virus (HPV) following infection?

A

50-60%

173
Q

Male infertility rate in CF patients

A

95%

174
Q

Rate of molar pregnancy in the UK

A

1 in 600 - 1 in 2000

175
Q

Number of seminiferous tubules per testis

A

1-3

176
Q

Number of lobules per testis

A

250-400

177
Q

CT abdomen is equivalent to how many CXR/days of background radiation

A

400 CXR or 2.7 years of background radiation

178
Q

What percentage of unilateral ureteric injuries are diagnosed post operatively?

A

70%

179
Q

Size of a resting follicle

A

0.02mm

180
Q

Size of a follicle that is ready to ovulate?

A

20mm

181
Q

What is the average haemoglobin concentration in a newborn at term?

A

170

182
Q

With regard to plasma calcium, what proportion is carried in an ionised form?

A

45%

183
Q

How many oocytes are available at birth and at the time of puberty

A

Time of birth: 1-2 million
Puberty: 400,000

184
Q

What proportion of vulval cancers are squamous cell carcinoma?

A

90%

185
Q

What is the risk of scar rupture in VBAC in spontaneous labour?

A

2 in 1000

186
Q

Chance of being diagnosed with cervical cancer with low grade abnormality and HPV pos

A

0.1% (1 in 1000)

187
Q

Still birth rate

A

1 in 200

188
Q

Sudden infant death rate

A

1 per 10,000 live births

189
Q

How long does it take the uterine cavity and placental bed to acquire a new endometrial layer?

A

Uterine cavity: 1 week
Placental bed: 3 weeks

190
Q

At what gestation is physiological anaemia most pronounced?

A

32 weeks

191
Q

By what percentage does oxygen consumption rise in pregnancy?

A

20% (50ml/min)

192
Q

What is the change in total lung capacity in pregnancy?

A

Decreased by 200 ml

193
Q

At term the maternal cardiac output is increased by 1.5 L/minute.

What percentage of this increased blood flow is distributed to the uterus?

A

30% (400ml/min)

194
Q

Percentage of PEs that are asymptomatic

A

60-80%

195
Q

How many hours after the LH surge does ovulation occur?

A

12 hours

196
Q

Earliest appropriate age to perform CVS

A

11 weeks

197
Q

Percentage of oestrogen bound and free

A

40% bound to SHBG
58% bound to albumin
2% free

198
Q

HCG values at 1, 4, 5-6 and 7-8 weeks

A

1: 5-50
4: 600 - 10,000
5-6: 1,500 - 100,000
7-8: 16,000 - 200,000

199
Q

Insensible losses

A

30 mL/kg/day

200
Q

HCG at time of first missed period

A

Approx 100

201
Q
A

MRCOG Part 1 (4 decks)

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