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Question 1
Incorrect
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A 38 year old woman has had amenorrhea for a year now. She admits she stopped her COCP treatment 18 months ago. Her blood exams reveal the following: FSH=8, LH=7, Prolactin=400, Oestradiol=500. What is the most likely diagnosis?
Your Answer: Prolactinoma
Correct Answer: Hypothalamic amenorrhea
Explanation:Functional Hypothalamic Amenorrhea (FHA) is a form of chronic anovulation, due to non-identifiable organic causes and often associated with stress, weight loss, excessive exercise, or a combination thereof. Investigations should include assessment of systemic and endocrinologic aetiologies, as FHA is a diagnosis of exclusion. A multidisciplinary treatment approach is necessary, including medical, dietary, and mental health support. Medical complications include, among others, bone density loss and infertility.
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This question is part of the following fields:
- Gynaecology
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Question 2
Incorrect
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A 19-year-old female books an appointment at the antenatal clinic at 13 weeks gestation.
One week ago, she had a Papanicolaou (Pap) smear done which showed grade 3 cervical intraepithelial neoplasia (CIN3).
What is the best next step in her management?Your Answer: Colposcopy and large loop excision of the transformation zone (LLETZ biopsy).
Correct Answer: Colposcopy.
Explanation:The best next step in her management is a colposcopy.
Patients diagnosed with high-grade lesions (CIN 2 or 3) or adenocarcinoma in situ (AIS) during pregnancy should undergo surveillance via colposcopy and age-based testing (cytology/HPV) every 12-24 weeks.
Cone biopsy and long loop excision of the transformation zone (LLETZ biopsy) are not recommended if the lesion extends up the canal and out of the vision of the colposcope.
It is not necessary to terminate the pregnancy.Because repeat colposcopic examination during pregnancy offers all of the information needed, the repeat Pap smear is best done after the pregnancy has ended.
Unless colposcopy indicates aggressive cancer at an earlier time, the ultimate therapy required is usually not decided until the postpartum visit.
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This question is part of the following fields:
- Gynaecology
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Question 3
Incorrect
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Which of the following terms best describes the pelvic type of small posterior sagittal diameter, convergent sidewalls, prominent ischial spines, and narrow pubic arch?
Your Answer: Platypelloid
Correct Answer: Android
Explanation:There are four types pelvic shapes:
1) Android pelvis: it has a larger inlet and smaller outlet along with small posterior sagittal diameter, prominent ischial spines and has a two finger arch.
2) Gynecoid pelvis: it has a transverse or nearly a circular ellipse and it is the most favourable for delivery.
3) Anthropoid pelvis: the brim is an anteroposterior ellipse.
4) Platypelloid pelvis: in this type the pelvic brim is kidney shape -
This question is part of the following fields:
- Anatomy
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Question 4
Incorrect
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During normal pregnancy, the renal glomerular filtrate rate (GFR) can increase as much as:
Your Answer: 25%
Correct Answer: 50%
Explanation:Pregnancy involves remarkable orchestration of physiologic changes. The kidneys are central players in the evolving hormonal milieu of pregnancy, responding and contributing to the changes in the environment for the pregnant woman and foetus. The functional impact of pregnancy on kidney physiology is widespread, involving practically all aspects of kidney function. The glomerular filtration rate increases 50% with subsequent decrease in serum creatinine, urea, and uric acid values.
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This question is part of the following fields:
- Physiology
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Question 5
Correct
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A 32-year-old woman at 33 weeks of gestation presents with vaginal bleeding.
A pelvic ultrasound was done, which confirms the diagnosis of placenta praevia and you are planning a cesarean section as it is the most appropriate mode of delivery.
Which among the following is considered a possible outcome of cesarean section delivery?Your Answer: Increase risk of adhesions
Explanation:Obstetric complications during or following a cesarean section delivery include:
-Increased risk of maternal mortality.
-Increased need for cesarean sections in the subsequent pregnancies.
-Increased risk for damage to adjacent visceral organs especially bowels and bladder.
-Increased risk of infections.Increased risk for formation of adhesions is a complication after cesarean section and this is the correct response for the given question.
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This question is part of the following fields:
- Obstetrics
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Question 6
Correct
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A 23 year old female patient with DVT on anticoagulant came to your clinic for advice. She is on combined OCPs.
What would you advice her?Your Answer: Progesterone only pill
Explanation:Women with medical conditions associated with increased risk for thrombosis generally should not use oestrogen-containing contraceptives.
The majority of evidence identified does not suggest an increase in odds for venous or arterial events with use of most POCs. Limited evidence suggested increased odds of VTE with use of injectables (three studies) and use of POCs for therapeutic indications (two studies, one with POCs unspecified and the other with POPs).
Discontinuing anticoagulants increases her risk of recurrent DVT.
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This question is part of the following fields:
- Gynaecology
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Question 7
Incorrect
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What is the incidence of hyperthyroidism in complete molar pregnancy?
Your Answer: 50%
Correct Answer: 3%
Explanation:As B-HCG and TSH have similar structures, increased B-HCG can lead to hyperthyroidism, however there is only a 3% chance of this happening.
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This question is part of the following fields:
- Clinical Management
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Question 8
Correct
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Regarding missed abortion, all of the following are CORRECT, EXCEPT:
Your Answer: Immediate evacuation should be done once the diagnosis is made
Explanation:Expectant management has been reported with unpredictable success rate ranging from 25–76%. Waiting for spontaneous expulsion of the products of conception would waste much time, during which women may suffer uncertainty and anxiety. However, when additional surgical evacuation is needed owing to failure, they may suffer from an emotional breakdown. It is thus not recommended for missed early miscarriage due to the risks of emergency surgical treatment and blood transfusion.
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This question is part of the following fields:
- Obstetrics
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Question 9
Correct
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A 28 year old patient presents to clinic with a maculopapular rash to the hands and soles of the feet. Examination reveals wart like lesions on the vagina and a diagnosis of condyloma latum is made. What stage of syphilis infection is this?
Your Answer: Secondary
Explanation:Condylomas are warty neoplasms of the vulvar area. The most common type are condyloma acuminatum which occur due to HPV 6 or 11. Condyloma latum are also known as secondary syphilis are less common. Both of these are sexually transmitted.
Stages of Syphilis:
– Primary 3-90 days
Chancre and lymphadenopathy
– Secondary 4-10 weeks
Widespread rash typically affecting hands and soles of feet.
Wart lesions (condyloma latum) of mucus membranes
– Latent Early <1 yr. after secondary stage
– Late >2 yr. after secondary stage
Asymptomatic
– Tertiary 3+ years after primary infection
Gummas or
Neurosyphilis or
Cardiovascular syphilis -
This question is part of the following fields:
- Clinical Management
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Question 10
Correct
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What is the average lifespan of a basophil (white blood cell)?
Your Answer: 3-4 days
Explanation:Basophils are granulocytic white blood cells. They express IgE antibody on their surface and react to release prostaglandins and leukotrienes to mediate an inflammatory, allergic reaction.
Blood Cell Lifespans:
Red Blood Cells 120 days
Platelets 5-9 days
White blood cells 2-5 daysNeutrophils (up to 5 days)
Basophils (2 to 3 days)
Eosinophils (2 to 5 days)
Monocytes (1 to 5 days)
Lymphocytes (variable) -
This question is part of the following fields:
- Physiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
