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Question 1
Incorrect
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A 45 year old women has a transvaginal ultrasound that is reported as showing a partially echogenic mass with posterior sound attenuation owing to sebaceous material and hair within the cyst cavity. What is the likely diagnosis?
Your Answer: Germ Cell Tumour
Correct Answer: Mature teratoma
Explanation:Dermoid cysts and teratomas contain elements from multiple germ cell layers. They are often considered the same entity (even in medical texts) however a dermoid is composed only of dermal and epidermal elements. A teratoma has mesodermal and endodermal elements Mature teratomas are composed of well-differentiated derivations from at least 2/3 germ cell layers (i.e. ectoderm, mesoderm, and endoderm). They contain developmentally mature skin complete with hair follicles, sweat glands, sometimes hair, and sometimes sebum, blood, fat, bone, nails, teeth, eyes, cartilage, and thyroid tissue.
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This question is part of the following fields:
- Data Interpretation
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Question 2
Correct
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A 32 year old patient has a transvaginal ultrasound scan that shows a mass in the left ovary. It is anechoic, thin walled, is without internal structures and measures 36mm in diameter. What is the likely diagnosis?
Your Answer: Functional cyst
Explanation:The diagnosis of functional ovarian cyst is made when the cyst measures more than 3 cm and rarely grows more than 10 cm. It appears as a simple anechoic unilocular cyst on USS. It is usually asymptomatic. If it is symptomatic then laparoscopic cystectomy should be performed.
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This question is part of the following fields:
- Data Interpretation
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Question 3
Correct
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A 40 year old women has a transvaginal ultrasound reported as showing a 6cm x 5cm cystic mass of the right ovary with multiple septa noted and varying degrees of echogenicity within locules. What is the likely diagnosis?
Your Answer: Mucinous cystadenoma
Explanation:The characteristics of the mucinous cystic adenoma of the ovaries is the presence of a large tumour which is multicystic and the penetration of the peritoneum into the cavities forming septas. The serous tumours can only be differentiated on the bases of the contents.
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This question is part of the following fields:
- Data Interpretation
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Question 4
Correct
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A 16 week pregnant patient presents to the antenatal clinic. Protein values of ++ are found on urinalysis. Significant proteinuria is indicated in which of the following protein:creatinine values?
Your Answer: 30 mg/mmol
Explanation:Proteinuria of more than 1+ on dipstick should be investigated to quantify the amount of proteinuria. A protein: creatinine ratio can be used to determine the severity of proteinuria, where levels of more than 30 mg/mmol indicate significant proteinuria.
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This question is part of the following fields:
- Data Interpretation
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Question 5
Correct
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A patient who is 12 weeks pregnant is being seen in the antenatal clinic. Urinalysis shows protein ++. A 24 hour urine collection is organised. Greater than what level would indicate significant proteinuria?
Your Answer: 300 mg over 24 hours
Explanation:pre-eclampsia is defined as hypertension of at least 140/90 mmHg recorded on at least two separate occasions and at least 4 hours apart and in the presence of at least 300 mg protein in a 24 hour collection of urine, arising de novo after the 20th week of pregnancy in a previously normotensive woman and resolving completely by the sixth postpartum week.
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This question is part of the following fields:
- Data Interpretation
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Question 6
Correct
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A 29 year old patient has a transvaginal ultrasound scan that shows a mass in the left ovary. It is anechoic, thin walled, is without internal structures and measures 36mm in diameter. What is the likely diagnosis?
Your Answer: Functional cyst
Explanation:Features of functional ovarian cysts on ultrasound are: Thin walled and unilocular Must be >3cm diameter (if <3cm described as follicle) Anechoic (absence of internal echoes) No colour flow No solid components
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This question is part of the following fields:
- Data Interpretation
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Question 7
Incorrect
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What is the normal range for variability in cardiotocography (CTG) analysis?
Your Answer: 5-40 bpm
Correct Answer: 5-25 bpm
Explanation:Cardiotocography, also known as the non-stress test is used to monitor fetal heartbeat and uterine contractions of the uterus. An abnormal CTG may indicate fetal distress and prompt an early intervention. Variability refers to the variation in the fetal heartbeat form one beat to another. Normal variability is between 5-25 beats per minute while an abnormal variability is less than 5 bpm for more than 50 minutes, or more than 25 bpm for more than 25 minutes.
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This question is part of the following fields:
- Data Interpretation
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Question 8
Incorrect
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You are called to see a 24 year old patient who is currently in labour but is failing to progress. A fetal blood sample is sent for analysis. pH is 7.22. Which of the following is the appropriate course of action?
Your Answer: Repeat in 1 hour if CTG remains abnormal
Correct Answer: Consider delivery
Explanation:A normal pH value is above 7.25. A pH below 7.20 is confirmation of fetal compromise. Values between 7.20 and 7.25 are ‘borderline’.
The base deficit can also be useful in interpretation of the fetal scalp pH. A base excess of more than -10 demonstrates a significant metabolic acidosis, with increasing risk of fetal neurological injury beyond this level. Delivery should be considered.
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This question is part of the following fields:
- Data Interpretation
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Question 9
Correct
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The transvaginal ultrasound of a 37 year old woman reveals a left ovarian mass. The mass is a unilocular cyst with diffuse homogenous ground glass echoes as a result of hemorrhagic debris. Which of the following is the most likely diagnosis?
Your Answer: Endometrioma
Explanation:An endometrioma, also known as a chocolate cyst is a benign ovarian cyst that occurs as a result of the trapping of endometriosis tissue inside the ovary. The findings on transvaginal ultrasound are often a unilocular cyst, with ground glass echogenicity due to haemorrhage. Other benign masses that can be evaluated using transvaginal ultrasound are functional cysts, serous and mucinous cystadenomas and mature teratomas.
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This question is part of the following fields:
- Data Interpretation
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Question 10
Correct
SESSION STATS - PERFORMANCE PER SPECIALTY
