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Question 1
Incorrect
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You're delivering contraception counselling to a young couple. They chose the 'rhythm approach' after hearing about several methods (calendar calculation).
Menstrual periods last between 26 and 29 days for the woman. Which of the following abstinence durations is the most appropriate?Your Answer: From day 12 to day 17
Correct Answer: From day 6 to day 17
Explanation:Luteal phase is always fixed to 14 days. In this patient, ovulation will occur between days 12-15. Sexual encounter must be ceased until 24-36 hours before day 15 (day 17). The start date of abstinence, calculated by decreasing 6 days (life span of the sperm) from the earliest possible day of ovulation (12-6=6). Hence from day 6-17, sexual encounter must be avoided.
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This question is part of the following fields:
- Gynaecology
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Question 2
Correct
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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: 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 3
Incorrect
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Immediate delivery of the foetus is recommended at which fetal scalp pH?
Your Answer: 7.3
Correct Answer: 7.18
Explanation:A pH value below than 7.18 indicates acidosis which can result in hypoxic brain injury. In order to prevent brain injury, immediate delivery of the foetus should be planned. The normal range for a term baby is pH: 7.18 – 7.38, preterm pH: 7.14 – 7.4.
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This question is part of the following fields:
- Physiology
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Question 4
Incorrect
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A 29 year old obese woman presents complaining of difficult or painful sexual intercourse and dysmenorrhea. She is requesting a reversible contraceptive method. Which of the following would be most suitable?
Your Answer: Combined Oral Contraceptive Pill (COCP)
Correct Answer: Mirena
Explanation:Mirena is a form of contraception also indicated for the treatment of heavy menstrual bleeding and the management of dysmenorrhea, being able to reduce the latter considerably.
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This question is part of the following fields:
- Gynaecology
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Question 5
Correct
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The source of progesterone that maintains the pregnancy during early 1st trimester:
Your Answer: Corpus luteum
Explanation:In early pregnancy Progesterone is produced by the corpus luteum.. This organ is fundamental for pregnancy maintenance until the placenta (syncytiotrophoblast) takes over its function at the 7-9th week of gestation, just after the expression of major histocompatibility complex antigens is suppressed in extra-embryonic fetal tissue.
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This question is part of the following fields:
- Endocrinology
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Question 6
Incorrect
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You see a 23 year old women in clinic with cervicitis. Which gram negative intracellular organism is most likely to be responsible?
Your Answer: Neisseria gonorrhoeae
Correct Answer: Chlamydia trachomatis
Explanation:Chlamydia trachomatis (D-K subtypes) is the most common cause in this age group and fits the descriptors given.
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This question is part of the following fields:
- Microbiology
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Question 7
Correct
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Regarding the study of the prognosis of a disease, which of the following studies is most appropriate?
Your Answer: Cohort Study
Explanation:Cohort studies are the most appropriate study design to study the prognosis of a disease. A group of patients with the same condition are chosen and their baseline information is taken. The group is then followed up over time to see which patients live or die.
Case-control studies can also be useful where a group of individuals that have survived a condition are compared with cases of those who have died. Prognostic factors that distinguish the two groups are identified. This method, however, is limited by bias and the accuracy of medical information present. -
This question is part of the following fields:
- Epidemiology
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Question 8
Correct
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A 42 years old woman presents to a gynaecologic clinic with mid-cycle, moderate-intensity abdominal pain. There is also a similar episode of pain around a month ago, which remained for about 3 days and resolved spontaneously. She is otherwise healthy with a normal regular cycle of about 28 days duration.
Examination reveals normal vitals, soft and non-tender abdomen without any guarding or rebound tenderness.
The most likely cause of the patient's problem is?Your Answer: Ovulation pain
Explanation:This patient has developed symptoms of ovulation discomfort, which is also known as Mittelschmerz syndrome. Lower abdominal and pelvic pain that arises around the middle of a woman’s menstrual cycle characterises this condition.
The discomfort usually appears suddenly and disappears within hours, though it can continue up to three days.The symptoms of ovulation pain can include:
– Lower abdomen pain.
– The pain typically occurs about two weeks before the menstrual period is due.
– The pain is felt on the right or left side, depending on which ovary is releasing an egg.
– The pain may switch from one side to the other from one cycle to the next, or remain on one side for a few cycles.
The duration of pain ranges anywhere from minutes to 48 hours. -
This question is part of the following fields:
- Gynaecology
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Question 9
Incorrect
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A patient attends clinic with a vaginal prolapse. On examination the vaginal prolapse is visible 1.5cm above the plane of the hymen. According to the POPQ classification what grade is this prolapse?
Your Answer: Grade 4
Correct Answer: Grade 1
Explanation:This is a grade 1 prolapse
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This question is part of the following fields:
- Anatomy
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Question 10
Correct
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A baby with shoulder dystocia suffers a brachial plexus injury. You diagnose Erb-Duchenne palsy. Which nerve roots are typically affected?
Your Answer: C5 and C6
Explanation:Erb’s or Erb-Duchenne palsy is a type of brachial plexus injury. The brachial plexus comprises C5 to T1 nerve roots. In Erb’s palsy C5 and C6 are the roots primarily affected. Shoulder Dystocia is the most common cause of Erb’s palsy.
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This question is part of the following fields:
- Clinical Management
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Question 11
Correct
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The inguinal canal is reinforced posteriorly by which structure?
Your Answer: Conjoint tendon
Explanation:The Inguinal Canal
– Anterior wall: formed by the external oblique aponeurosis throughout the length of the canal; its lateral part is reinforced by muscle fibres of the internal oblique.
– Posterior wall: formed by the transversalis fascia; its medial part is reinforced by pubic attachments of the internal oblique and transversus abdominis aponeuroses that frequently merge to variable extents into a common tendon—the inguinal falx (conjoint tendon)—and the reflected inguinal ligament.
– Roof: formed laterally by the transversalis fascia, centrally by musculo-aponeurotic arches of the internal oblique and transversus abdominis, and medially by the medial crus of the external oblique aponeurosis.
– Floor: formed laterally by the iliopubic tract, centrally by gutter formed by the infolded inguinal ligament, and medially by the lacunar ligament. -
This question is part of the following fields:
- Anatomy
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Question 12
Incorrect
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An 26 year old patient currently 9 weeks pregnant. This is her 1st pregnancy. She has been suffering with nausea and vomiting that has failed to respond to conservative measures including ginger, dietary changes and acupuncture. She wants to start medical therapy. Which of the following is 1st line drug treatment according to NICE guidance?
Your Answer: Metoclopramide
Correct Answer: Promethazine
Explanation:Promethazine or Cyclizine are 1st choice options for management of nausea and vomiting in pregnancy according to NICE. Prochlorperazine is also appropriate 1st line.
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This question is part of the following fields:
- Pharmacology
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Question 13
Correct
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When does ovulation occur?
Your Answer: 36 hours after LH surge
Explanation:Ovulation occurs in the mid stage of the menstrual cycle, usually 36 hours after the LH surge. It is this LH surge which is necessary for the ovulation to occur.
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This question is part of the following fields:
- Physiology
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Question 14
Correct
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A 25-year old Asian woman comes to your clinic at 36 weeks of gestation. She was diagnosed with breech at 32 weeks. She is not in labor and a manual examination of the uterus is suggestive of breech position.
Which one of the following would be the next best step in management of this patient?Your Answer: Pelvic ultrasound
Explanation:An ultrasonography is performed for confirmation, as well as for the evaluation of maternal pelvis, fetal size and viability in cases were breech presentation is suspected on manual examination. As there is a chance for spontaneous correction of breech presentation into cephalic during 36 to 37 weeks, this should be considered in every future visit. The chances for spontaneous version reduces to 25% if breech position persists beyond this period of time.
It an external cephalic version should be offered to all women with breech presentation, provided there are no contraindications or indication for cesarean delivery due to other reasons.
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This question is part of the following fields:
- Obstetrics
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Question 15
Correct
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A chronic alcoholic lady presented to the medical clinic with complaints of an increase in abdominal size. Ultrasound was performed and revealed a foetus in which parameters correspond to 32 weeks of gestation. Upon history taking, it was noted that she works in a pub and occasionally takes marijuana, cocaine, amphetamine and opioid.
Which of the following is considered to have the most teratogenic effect to the foetus?Your Answer: Alcohol
Explanation:All of the conditions that comprise fetal alcohol spectrum disorders stem from one common cause, which is prenatal exposure to alcohol. Alcohol is extremely teratogenic to a foetus. Its effects are wide-ranging and irreversible. Although higher amounts of prenatal alcohol exposure have been linked to increased incidence and severity of fetal alcohol spectrum disorders, there are no studies that demonstrate a safe amount of alcohol that can be consumed during pregnancy. There is also no safe time during pregnancy in which alcohol can be consumed without risk to the foetus. Alcohol is teratogenic during all three trimesters. In summary, any amount of alcohol consumed at any point during pregnancy has the potential cause of irreversible damage that can lead to a fetal alcohol spectrum disorder.
In general, diagnoses within fetal alcohol spectrum disorders have one or more of the following features: abnormal facies, central nervous system abnormalities, and growth retardation.
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This question is part of the following fields:
- Obstetrics
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Question 16
Correct
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The uterine vein drains where?
Your Answer: Internal iliac vein
Explanation:The venous drainage of the uterus is via the uterine veins which form a plexus passing below the artery within the base of the broad ligament communicating with the rectal and the vesical venous plexus before draining into the internal iliac veins.
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This question is part of the following fields:
- Anatomy
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Question 17
Correct
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You see a patient who is 32 weeks pregnant. She complains of tingling to the right buttock and shooting pain down the leg. You suspect Piriformis syndrome. Regarding Piriformis which of the following statements are true?
Your Answer: Insertion is onto the greater trochanter
Explanation:The proximal attachment of the piriformis muscles is from the anterior surface of sacrum and it attaches distally to the superior border of the greater trochanter of the femur. It is innervated by the anterior rami of S1 and S2.
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This question is part of the following fields:
- Anatomy
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Question 18
Correct
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Which one of the following muscles is the most important muscle forming the pelvic floor?
Your Answer: Levator ani
Explanation:Levator ani muscle is composed of three different muscles i.e. iliococcygeus, pubococcygeus and the puborectalis muscle. It is the main muscle that supports the organs of the pelvic cavity.
Bulbocavernosus and Ischiocavernosus muscles are located in-between the anus and scrotum and play an important role in sexual response in males.
Superficial and deep transverse perineal muscles are located in the perinium and pass in front of the anus. -
This question is part of the following fields:
- Anatomy
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Question 19
Correct
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The rectus sheath is formed by which of the following?
Your Answer: aponeuroses of transversus abdominis, external and internal oblique
Explanation:The rectus sheath is formed by the decussation and interweaving of the aponeuroses of the fl at abdominal muscles. The external oblique aponeurosis contributes to the anterior wall of the sheath throughout its length. The superior two thirds of the internal oblique aponeurosis splits into two layers (laminae) at the lateral border of the rectus abdominis; one lamina passing anterior to the muscle and the other passing posterior to it. The anterior lamina joins the aponeurosis of the external oblique to form the anterior layer of the rectus sheath. The posterior lamina joins the aponeurosis of the transversus abdominis to form the posterior layer of the rectus sheath.
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This question is part of the following fields:
- Anatomy
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Question 20
Correct
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All are true about monozygotic pregnancy, EXCEPT:
Your Answer: The 1st commonly presents as breech
Explanation:The 1st commonly presents as cephalic. Monozygotic (MZ) twins originate when a single egg is fertilized to form one zygote, which then divides into two embryos. Although they share the same genotype they are not phenotypically identical.
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This question is part of the following fields:
- Genetics
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SESSION STATS - PERFORMANCE PER SPECIALTY
