Passmedicine

Question 1

Combined test for Downs syndrome consists of what (2)?

Answer 1

US skin for nuchal translucency
Blood test (beta-hCG [raised] and PAPP-A [raised])

Question 2

What does the quadruple test for Downs consist of ? (4)

Answer 2

AFP (low)
Unconjugated oestriol (low)
beta-hCG (high)
Inhibin A (high)

Question 3

When are the a) combined and b) quadruple tests offered?

Answer 3

a) 10-14 weeks

b) 14-20 weeks

Question 4

How should GBS+ women be treated?

Answer 4

Intrapartum antibiotics

Question 5

Sudden abdominal pain in 2nd/3rd trimester; bleeding present in 80% cases and shock may be out of keeping with visible loss

Answer 5

Placental abruption

Question 6

When are oxytocin and prostaglandins contraindicated in labour?

Answer 6

Fetal distress

Question 7

Four causes of primary postpartum haemorrhage

Answer 7

Tone
Tissue (retained placenta)
Trauma
Thrombin (coagulation abnormalities)

Question 8

Which vitamin is potentially teratogenic?

Answer 8

Vitamin A

Question 9

First-line treatment for pregnancy-induced hypertension

Answer 9

Oral labetalol

Question 10

Management of seizures in eclampsia

Answer 10

Magnesium sulphate

Question 11

Most common cause of puerperal pyrexia

Answer 11

Endometritis

Question 12

Why should trimethoprim be avoided in the first trimester?

Answer 12

Folate antagonist

Question 13

When do NICE recommend anti-D prophylaxis should be given?

Answer 13

In Rh-ve mothers at 28 and 34 weeks

Question 14

What is the most likely pathogen in early onset neonatal sepsis?

Answer 14

Group B strep

Question 15

In monochorionic twin pregnanies what is the aim of regular US monitoring between 16 and 24 weeks?

Answer 15

To detect twin to twin transfusion syndrome

Question 16

Management of uterine atony

Answer 16

Bimanual uterine compression with oxytocin IV infusion

Question 17

When should women with risk factors for gestational diabetes be offered a glucose tolerance test?

Answer 17

28-34 weeks

Question 18

What are the criteria for PCOS diagnosis?

Answer 18

2 of:
polycystic ovaries
oligo-ovulation or anovulation
clinical/biochemical evidence of hyperandrogenism

Question 19

What is acute pelvic inflammatory disease characterised by?

Answer 19

Lower pelvic pain plus two of:
cervical excitation and adnexal tender
peritonism
raised WCC
Temperature higher than 38
Pulse higher than 90

Question 20

The pregnant uterus- date at which:

a) first becomes palpable
b) reaches the umbilicus
c) reaches the xiphisternum

Answer 20

a) 12 weeks
b) 20 weeks
c) 36 weeks

Question 21

Why does haemoglobin concentration fall in pregnancy?

Answer 21

Dilution

Question 22

Symptoms of endometriosis(6)

Answer 22

Abnormal uterine bleeding
Dysmenorrhoea
Dysparenia
Dyschezia
Adnexal tenderness
Difficulty conceiving

Question 23

What is the underlying pathophysiology of endometriosis?

Answer 23

Growth of ectopic endometrial tissue, often in the pelvis/ovary

Question 24

What does HbA1C measure? What is considered as good glycaemic control?

Answer 24

Glycosylated haemoglobin over the past 120 days. less than 6%

Question 25

Risk factors for placenta accreta? (3)

Answer 25

Past C-section
Asherman syndrome (endometrial adhesions)
Pelvic inflammatory disease

Question 26

Where do a) endometrial and b) cervical cancers first metastasize to?

Answer 26

a) para-aortic lymph nodes

b) pelvic lymph nodes along the iliac arteries

Question 27

What are Krukenberg tumours and what do they contain histologically?

Answer 27

Gastric tumours that metastasize to the ovary; signet ring cells

Question 28

Management of primary first episodes of genital herpes in pregnancy?

Answer 28

Oral aciclovir until delivery and C section