O+G test

Question 1

Leading cause of maternal death in UK

Answer 1

Sepsis

Question 2

Leading cause of maternal death in first trimester

Answer 2

Ectopic

Question 3

Leading cause of maternal death worldwide

Answer 3

Haemorrhage

Question 4

At what gestation does fetes gain legal rights in UK?

Answer 4

None until birth

Question 5

Most common site of ectopic pregnancy

Answer 5

ampulla

Question 6

Most common place of rupture of ectopic pregnancy

Answer 6

isthmus

Question 7

Cervical cytology result = borderline + HPV+

Answer 7

colposcopy

Question 8

Types of HPV considered to be high risk?

Answer 8

16, 18, 31, 33

Question 9

what type of hormone is oestrogen

Answer 9

steroid

Question 10

where is LH produced

Answer 10

anterior pituitary

Question 11

which does not produce progesterone:
corpus luteum
adrenal cortex
adipose fat
thyroid
placenta

Answer 11

thyroid

Question 12

which hormone does not exhibit diurnal variation
cortisol
TSH
FSH
GH
prolactin

Answer 12

FSH - monthly cyclical pattern in females

NB during puberty only, LH higher at night

Question 13

what is responsible for ovulation

Answer 13

LH surge

Question 14

which of the following is not a function of oestrogen
maintaining bone density
vasodilation
reduce platelet activation
increase skin pigmentation
proliferation of endometrium

Answer 14

reduce platelet activation

(patchy kin/linea nigra during pregnancy)
(vasodilation –> hot flushes)
(INCREASED platelet activation –> increased clots/VTE)

Question 15

Which is not true re B-hCG?
stimulates release of thyroid
produced by certain tumours e.g. germ cell
produced primarily by fetes in pregnancy
can cause ovarian cysts
high in multiple pregnancies

Answer 15

produced primarily by fetes in pregnancy

produced by syncitiotrophoblasts

Question 16

1st line treatment for heavy menstrual bleeding

Answer 16

Mirena

Question 17

mechanisms of COCP

Answer 17

reduce ovulation
reduce endometrial receptivity to blastocyte
reduce FSH release from pituitary
reduce sperm penetration of mucus plug

Question 18

what day post fertilisation os blastocyst formed?

Answer 18

5

Question 19

what gestation can feral movements first be felt?

Answer 19

18 weeks

Question 20

what gestation should you investigate if no fetal movements felt yet?

Possible causes?

Answer 20

20 weeks

anterior placenta
obesity
oligohydramnios

Question 21

which is abnormal in pregnancy
low Hb
high WCC
low platelets
low Cr
high alk phos

Answer 21

low platelets

common but not normal

Question 22

what does foramen ovale carry?

Answer 22

oxygenated blood RA –> LA

Question 23

Which is not autosomal recessive?
(and what is each condition)
tay sachs
CF
Wilsons
Sickle cell
Huntingtons

Answer 23

Huntingdons = autosomal dominant neurodegeneration

Tay Sachs = progressive deterioration of neurons due to accumulation of gangliosides (cell membrane components = sphingolipids), begins ~ 6months, death by 4 years. No cure.

CF = mutation in CFTR gene = cF transmembrane conductance regulator. Thick secretions. Dx = newborn screening, genetic testing, sweat test. No cure. Mx = resp physio, psych, lifestyle, abx, transplant?

Wilsons = copper accumulation in tissues –> neuro/psych sx + liver disease

Question 24

Trisomy 13

Answer 24

Patau’s

small head
no eyebrows
clenched fist
polydactyly
shield chest
large occiput
undescended testes
small mouth/jaw/neck
cleft lip/palate
malformed ears

Question 25

``` what does not support the uterus? infundilbular round cardinal uterosacral pubocervical ```

Answer 25

infundibular = ovary --> wall cardinal = transverse cervical - NB close to ureters in hysterectomy

Question 26

``` which is not a term for a female pelvis: android gynaecoid platypolloid ovaloid anthropoid ```

Answer 26

ovaloid ``` android = heart shaped (like male) gynaecoid = 50% = best shape platypolloid = large transverse diameter anthropoid = large AP diameter ```

Question 27

72 years, brown stained vagina discharge, single episode. What is the most likely diagnosis?

Answer 27

Atrophic vaginitis | NB > malignancy but must rule malignancy out!

Question 28

34 yr, PV bleed + lower abdo pain, thickened endometrium, no adnexal mass, small amount of fluid in pouch of Douglas

Answer 28

ectopic pregnancy NB only 30% present haemodynamically unstable!! Diarrhoea often presents before PV bleed Diarrhoea + positive BhCG = ectopic. Fluid in pouch of Douglas = diagnostic

Question 29

Symptoms of endometriosis

Answer 29

``` None dysmennorhoea chronic pelvic pain deep dyspareunia subfertility cyclical bowel/bladder sx (pain/bleeding) dyschezia (pain on defecation) dysuria ```

Question 30

15 years, severe vomiting, PV bleeding, + ruing BhCG, 6 weeks after LMP, newly distended abdomen

Answer 30

Molar pregnancy hCG produced by trophoblastic tissue causes nausea and vomiting complete mole > partial mole due to more trophoblastic tissue (partial mole is part fetus)

Question 31

Gestation that fundus should leave pelvis

Answer 31

12 weeks

Question 32

11 yr, lower ab pain for 3/7, decreased appetite, temperature, tender to palpation in RIF, not sexually active, pre-pubertal, passing urine normally, runny most, cervical LN.

Answer 32

Mesenteric adenitis NB often presents with RIF pain therefore commonly mistaken for appendicitis.