WEEK 1 END OF WEEK FORMATIVE

Question 1

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Answer 1

E - Provide treatment Doctors have a duty of care to provide treatment in an emergency, can only conscientiously object to carrying out the termination of pregnancy procedure

Question 2

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Answer 2

D - Advise the patient you have a conscientious objection to providing their treatment and arrange for them to see another doctor Must be done within a reasonable amount of time

Question 3

How long after a patient presents requesting a TOP should referral to treatment be done and how many weeks max before the pregnancy is terminated?

Answer 3

After a ptient presents requesting a TOP - should be referred for treatment by 2 weeks and the pregnancy should be terminated by 3 weeks after initial presentation

Question 4

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Answer 4

A - Verbal consent is sufficient in a conscious patient

Question 5

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Answer 5

C - 1in6 couples suffer from infertility

Question 6

Define infertility? What proportion of couples who suffer from infertility require assisted conception treatment?

Answer 6

Infertility is failure to achieve clinical pregnancy after 12 months of regular unprotected sex 1in6 (1in7 some sources) suffer from infertility and half of these couples require assisted conception treatment

Question 7

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Answer 7

Number 1 is the ischial spine B - Internal pudendal nerve and artery are associated with this bony landmark

Question 8

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Answer 8

B - Prolapse surgery for vaginal vault dissent

Question 9

Vaginal vault dissent is the same as a vaginal vault prolapse What is the vaginal vault and when does it usually prolapse?

Answer 9

The vaginal vault is the expanded region of the vaginal canal at the internal end of the vagina. The vaginal vault may prolapse after a hysterectomy, as there is no uterus supporting the interior end of the vagina.

Question 10

What is the prolapse surgery treatment of vaginal vault dissent?

Answer 10

Sacrospinous ligament supsension of the vagina

Question 11

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Answer 11

E - Generally occurs 14 days before the next menses Ovulation is usually diagnosed with a measurement of progesterone on day 21 of the mestrual cycle

Question 12

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Answer 12

A - Size, shape, mobility, position and cervical motion tenderness

Question 13

What are the two common different positions of the uterus? When is the uterus palpable between posterior cervix and non dominant hand on bimanual palpation?

Answer 13

Anteverted uterus and retroverted uterus Anteverted uterus is palpable on bimanual palpation

Question 14

Why is the anteverted uterus palpable instead of the retroverted?

Answer 14

Anteverted uterus is palpable as the cervix is posterior to it If retroverted, the cervix is anterior to the uterus and therefore cannot feel uterus between it and non dominant hand on the body wall

Question 15

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Answer 15

D - Pelvic inlet

Question 16

What makes up the iliopectineal line?

Answer 16

made up of the arcuate line - smooth round border on internal surface of the ilium The pectineal line - ridge on superior ramus of the pubic bone

Question 17

What is another name for the pectineal line? What does the iliopectineal line + pubic crest form?

Answer 17

Pectineal line also known as the pecten pubis Iliopectineal line (arcuate line + pectineal line) + pubic crest - forms the linea terminalis

Question 18

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Answer 18

E - Pelvic outlet

Question 19

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Answer 19

D - herpes simplex

Question 20

How is the herpes simplex virus diagnosed and what is the treatment?

Answer 20

Diagnosed by deroofing the blister and swab sent in viral transport medium for PCR Treat with aciclovir

Question 21

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Answer 21

A - bacterial vaginosis

Question 22

What is the causative organism of bacterial vaginosis and what is the usual treatment? WHat is the normal vaginal flora organism?

Answer 22

Gardnerella vaginalis is the causative organism - alters vaginal flora causing increase in vaginal pH (decreasing acidic environment) Treatment is metronidazole Normal organism is - lactobacilli (crispatus and jensenni) - not acidophilus

Question 23

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Answer 23

B - Candida albicans

Question 24

What is the treatment of the candida albicans? Should partner be treated also?

Answer 24

Treatment - oral fluconazole or topical clotrimazole Only treat partner if symptomatic - Candida is not usually sexually transmitted

Question 25

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Answer 25

E - blasctocyst

Question 26

What day is the morula formed? What day is blastocyst? What day is implantation usually?

Answer 26

Morula (8-16cell stage) formed by day 4 Divides to form blastocyst by day 5-6 of development Normal implantation occurs roughly on day 7

Question 27

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Answer 27

LH surge occurs 24-36 hours prior to ovulation (due to a high increase in oestrogen levels and this LH surge causes ovulation)

Question 28

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Answer 28

A - progesterone Thickens the endometrium

Question 29

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Answer 29

B - IVF

Question 30

What are the guidelines for a patient wanting to get IVF treatment? (what age, how long, how many cycles of IUI)

Answer 30

Guidleines recommend IVF treatment should be offered to women under 43 years of age who have been trying to get pregnant via regular unprotected sex for 2 years or who have 12 cycles of artifical insemination (IUI)

Question 31

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Answer 31

E - Surgical sperm aspiration retrieval and ICSI

Question 32

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Answer 32

A - Clomifene acetate

Question 33

What is clomifene acetate?

Answer 33

This is a medication used to treat infertility in PCOS by trying to initiate ovulatory cycles

Question 34

What are the first line treatments for infertility in PCOS?

Answer 34

Clomifene acetate, metofrmine or the two combined is 1st line for PCOS infertility management

Question 35

How often do levels of HCG double in a pregnancy?

Answer 35

The levels double by 50% usually every 48 hourse for 6 weeks

Question 36

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Answer 36

B - doubles by 50% in 48 hours

Question 37

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Answer 37

Oligospermia - low sperm count Asthenospermia -reduced sperm motility Oligoasthenospermia = B - low count and low motility

Question 38

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Answer 38

Astheno - low motility Teratoasthenospermia - low motlity and abnormal forms - D (abnormal morphology is the teratospermia (morphology =forms)

Question 39

What is measured in semen analysis?

Answer 39

Volume Density - numbers of sperm Motility - proportion of sperm that are moving Progression - how the sperm are moving Morphology - the forms of sperm

Question 40

What is oligospermia? What is asthenospermia? What is teratospermia? What is azoospermia?

Answer 40

Oligospermia - low sperm count (concentration - low density of sperm) Asthenospermia - low sperm motility - numbers of sperm moving is little Teratospermia - abnromal forms Azoospermia - semen contains no sperm

Question 41

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Answer 41

D - seminiferous tubules

Question 42

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Answer 42

B - leydig cells

Question 43

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Answer 43

C - Inevitable miscarriage

Question 44

Why is this an inevitable miscarriage?

Answer 44

The cervical os is open which means it is not a threatned miscarriage (os would be closed)

• Os open - incomplete or inevitable miscarriage
• As there is a foetal heartbeat cannot be incomplete miscarriage as the foetus would not be alive

Therefore answer is an inevitable miscarriage is going to occur