Sept 2016 recall

Question 1

Risk of perforation at SMM

Answer 1

Up to 15/1000

Question 2

Need for repeat SMM

Answer 2

5/100

Question 3

1st line management in OAB

Answer 3

Bladder diary 3 days minimum

Question 4

1st line medical management in OAB

Answer 4

Antimuscarinic eg. darifenacin, oxybutinin (not in old ladies), tolteridone

Question 5

Success rate of methotrexate if HCG <1000
>5000

Answer 5

> 5000, 38%
<1000, 80-98%

Question 6

Commonest type of ureteric injury at laparoscopy

Answer 6

Transection

Question 7

Commonest vascular injury on 2nd port entry?

Answer 7

Inferior epigastric artery

Question 8

Commonest vascular injury in primary trocar entry?

Answer 8

Common iliac

Question 9

Where does the inferior epigastric branch from?

Answer 9

External iliac artery

Question 10

Fertility work up shows a very raised AMH, what does this predict?

Answer 10

High risk of OHSS

Question 11

Risk factor of bisphosponates for a woman with osteoporosis?

Answer 11

Necrosis of the jaw

Question 12

Most common cause of infertility if absent vas deferens?

Answer 12

Cystic fibrosis- can be tested by sweat test or saliva/blood genetic test
You should also offer a kidney US, 30% have a renal abnormality

Question 13

Previously healthy, now infertile and cloudy urine after ejaculation, what is this a sign of and what mx plan?

Answer 13

Retrograde ejactulation
Refer to urologist, causes can be neuropathy eg diabetes

Question 14

Normal sperm volume

Answer 14

> 1.5ml

Question 15

Normal sperm count

Answer 15

> 15million per ml

Question 16

Max sperm DNA fragmentation allowed

Answer 16

<30%

Question 17

Minimum sperm count

Answer 17

39 million

Question 18

% of sperm morphology

Answer 18

4%

Question 19

Acceptable sperm motility

Answer 19

32%

Question 20

When should sperm analysis be repeated if an abnormality has been detected?

Answer 20

Within 3 months

Question 21

What antral follicle count suggests a poor response to IVF gonadotrophin stimulation?

Answer 21

<4

Question 22

What AMH level suggests a poor response to IVF gonadotrophin stimulation?

Answer 22

<5.4
(>25 is a good indicator)

Question 23

What FSH level suggests a poor response to IVF gonadotrophin stimulation?

Answer 23

FSH >8.9

If it is <4 that predicts a good response

Question 24

When would you offer sperm washing?

Answer 24

HIV positive, not compliant with HAART or viral load >50

Question 25

2ndary amenorrhoea with hearing loss, what is the likely cause?

Answer 25

Turners syndrome

Question 26

What is the role of the caldicott guardian?

Answer 26

To protect patient confidentiality

Question 27

Risk of developing breast cancer with BRCA 1 and 2?

Answer 27

BRCA 1 85%
BRCA 2 84%

Question 28

Risk of developing ovarian cancer with BRCA 1 and 2?

Answer 28

BRCA 1 62%
BRCA 2 27%

Question 29

Which gynae cancers are people with LYNCH syndrome more at risk of?

Answer 29

Endometrial and ovarian
Lifetime risk of endometrial and colorectal 40-60%
Lifetime risk of ovarian 17%