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Question 1
Correct
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Pelvic ligaments can change at term resulting in?
Your Answer: Enlargement of the pelvic cavity
Explanation:The pelvis is supported by a variety of ligaments. At term, these ligaments allow for variation in its structure such that the overall size of the pelvic cavity is increased in order to accommodate the upcoming foetus into the cavity.
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This question is part of the following fields:
- Anatomy
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Question 2
Incorrect
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A 29-year-old lady presents to your clinic at her 26 weeks of gestation. She is worried as she came in contact with a child having chicken pox 48 hours ago and she has no symptoms.
You checked her pre-pregnancy IgG level for chicken pox which was negative, as she missed getting vaccinated for chickenpox before pregnancy.
What is the best next step in managing this patient?Your Answer: Check IgM level
Correct Answer: Give varicella zoster immunoglobulins
Explanation:This woman who is 26 weeks pregnant, has come in contact with a child having chickenpox 48 hours ago. As her IgG antibodies were negative during prenatal testing, she has no immunity against Varicella which makes her susceptible to get chickenpox.
Prophylactic treatment is required if a susceptible pregnant woman is exposed to chickenpox, which includes administration of varicella zoster immune globulin (VZIG), within 72 hours of exposure to infection.
As the patient has already checked for and was found to be negative, checking IgG level again is not relevant. Also, it was already revealed that she is not vaccinated against varicella before pregnancy.
If the patient had any symptoms typical of chickenpox, measuring IgM would have been helpful, but patient is completely asymptomatic in this case so measuring IgM is not indicated.
Vaccine for chickenpox is contraindicated during pregnancy as it is a live vaccine.
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This question is part of the following fields:
- Obstetrics
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Question 3
Incorrect
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Question 4
Correct
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A 39-year-old woman who is 8 weeks pregnant presented to the medical clinic for consultation regarding the chance of her baby having Down syndrome. She mentioned that she has read somewhere that one of the risk factors for Down syndrome is advanced maternal age. She is concerned and asks if there are ways in which she can know whether her baby will be affected.
Which of the following is considered as both the safest and the most accurate diagnostic tool for the exclusion of Down syndrome?Your Answer: Amniocentesis at 16 weeks gestation
Explanation:Amniocentesis is a prenatal procedure performed on a pregnant woman to withdraw a small amount of amniotic fluid from the sac surrounding the foetus.
The goal of amniocentesis is to examine a small amount of this fluid to obtain information about the baby, including its sex, and to detect physical abnormalities such as Down syndrome or spina bifida.
Amniocentesis is only performed on women thought to be at higher risk of delivering a child with a birth defect.Amniocentesis is performed between 16 and 20 weeks into the pregnancy. By around this time, the developing baby is suspended in about 130ml of amniotic fluid, which the baby constantly swallows and excretes. A thin needle is used to withdraw a small amount of this fluid from the sac surrounding the foetus.
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This question is part of the following fields:
- Obstetrics
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Question 5
Correct
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A 13-year-old woman is complaining of a lot of acne in her face. Her BMI is 37. She does not have her period yet. She has high insulin levels in her labs. What is the most likely diagnosis?
Your Answer: Polycystic Ovarian Syndrome (PCOS)
Explanation:The best answer is Polycystic Ovarian Syndrome (PCOS), supported by amenorrhea, obesity and acne. High insulin levels are indicative of PCOS and exclude Cushing syndrome (as this is associated with low insulin levels).
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This question is part of the following fields:
- Gynaecology
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Question 6
Correct
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Endometrial tissue found within the myometrium is classed as:
Your Answer: Adenomyosis
Explanation:Adenomyosis is a disorder characterised by the presence of endometrial glands deep within the myometrium. It presents with increasing severe secondary dysmenorrhoea and increased in the flow of menstrual blood.
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This question is part of the following fields:
- Clinical Management
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Question 7
Correct
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The femoral triangle is bounded superiorly by which of the following structures?
Your Answer: Inguinal ligament
Explanation:Boundaries of the Femoral Triangle:
Superior: Inguinal ligament
Medial: Medial border of the adductor longus
Lateral: Medial border of the sartorius
Floor: Pectineus, Adductor longus and Iliopsoas muscles
Roof: Fascia Lata -
This question is part of the following fields:
- Anatomy
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Question 8
Correct
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The major cause of the increased risk of morbidity & mortality among twin gestation is:
Your Answer: Preterm delivery
Explanation:Twin pregnancy is associated with a number of obstetric complications, some of them with serious perinatal consequences, especially for the second twin. The rate of perinatal mortality can be up to six times higher in twin compared to singleton pregnancies, largely due to higher rates of preterm delivery and fetal growth restriction seen in twin pregnancies. Preterm birth and birth weight are also significant determinants of morbidity and mortality into infancy and childhood. More than 50% of twins and almost all triplets are born before 37 weeks of gestation and about 15–20% of admissions to neonatal units are associated with preterm twins and triplets.
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This question is part of the following fields:
- Obstetrics
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Question 9
Incorrect
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A 34-year-old woman, known to have had a history of mild pulmonary hypertension, was admitted to the labour ward. She is at 36 weeks of pregnancy and is keen to have her baby delivered via caesarean section.
Which of the following is the most appropriate advice to give to the patient given her situation?Your Answer: Sildenafil
Correct Answer: Caesarean section
Explanation:Pulmonary hypertension (PH) is an increase of blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion. PH in pregnancy carries a 25–56% maternal mortality rate with a mixture of intrapartum and postpartum deaths.
Current recommendations for management of PH in pregnancy include termination of pregnancy if diagnosed early, or utilizing a controlled interventional approach with early nebulized prostanoid therapy and early elective caesarean section under regional anaesthesia. Other recommended therapies for peripartum management of PH include sildenafil and nitric oxide.
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This question is part of the following fields:
- Obstetrics
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Question 10
Incorrect
SESSION STATS - PERFORMANCE PER SPECIALTY
