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Question 1
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You are called to see a 24 year old patient in A&E. She is 34 weeks gestation and her blood pressure is 149/98. Urine dip shows protein 3+. You send a for a protein:creatinine ratio. What level would be diagnostic of significant proteinuria?
Your Answer: >30 mg/mmol
Explanation:Significant proteinuria = urinary protein:creatinine ratio >30 mg/mmol or 24-hour urine collection result shows greater than 300 mg protein
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This question is part of the following fields:
- Clinical Management
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Question 2
Correct
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Which of the following are required for Oxytocin to bind to its receptor?
Your Answer: Magnesium and Cholesterol
Explanation:Oxytocin binds to G-protein-coupled receptors and requires Magnesium and cholesterol for this process to occur.
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This question is part of the following fields:
- Clinical Management
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Question 3
Correct
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A couple present to the fertility clinic after failing to conceive despite trying for 2.5 years. The semen analysis shows azoospermia. You perform a full examination of the male partner which reveals Height 192cm, BMI 20.5, small testes and scant facial hair. You decide to organise karyotyping. What is the result likely to show?
Your Answer: 47XXY
Explanation:Klinefelter syndrome is associated with testicular atrophy, eunuchoid body shape, tall, long extremities, female hair distribution and gynaecomastia. It is a common cause of hypogonadism seen during fertility workup.
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This question is part of the following fields:
- Clinical Management
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Question 4
Correct
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You are called to see a 24 year old patient in A&E. She is 34 weeks gestation and her blood pressure is 149/98. Automated reagent strip testing shows protein 1+. What is the appropriate course of action regarding the urine result?
Your Answer: Send urine for protein:creatinine ratio
Explanation:For a diagnosis of Preeclampsia to be established, 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 should be present.
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This question is part of the following fields:
- Clinical Management
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Question 5
Correct
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Your consultant agrees to supervise you performing a Caesarean Section (CS). When making a Joel Cohen incision where should this be placed?
Your Answer: 3 cm above the symphysis pubis
Explanation:The Joel Cohen incision is superior to the Pffannenstiel incision. It is a straight incision that is 3 cm below the line joining the anterior iliac spines.
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This question is part of the following fields:
- Clinical Management
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Question 6
Correct
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According to the RCOG Green-top guideline published in 2013 at what stage of gestation should pregnant patients with PCOS be offered screening for gestational diabetes
Your Answer: 24-28 weeks gestation
Explanation:Screening for gestational diabetes should be offered and performed between 24-28 weeks. It should be noted PCOS alone does not make screening essential. It is advised for PCOS patients who are overweight or if not overweight but has other risk factors (age >40, personal history of gestational diabetes or family history of type II diabetes). Screening is via a 2-hour post 75 g oral glucose tolerance test.
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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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Which of the following contraceptives primary mode of action is inhibition of ovulation?
Your Answer: Cerazette®
Explanation:Desogestrel only POPs work mainly by inhibiting ovulation. Cerazette Is the only brand in this list which belongs to this group.
Types of Progesterone Only Pills
1. Traditional (e.g. Femulen®, Micronor®, Norgeston®)
Main mode of action: thickening cervical mucus preventing sperm entry at neck of womb and may also cause anovulation but this effect variable and unreliable
2. Desogestrel (e.g. Cerazette®)
Main mode of action: inhibition of ovulation and also cause thickening of cervical mucus
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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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Which of the following drugs is most associated with coronary artery spasm?
Your Answer: Ergometrine
Explanation:Ergot alkaloids e.g. Ergometrine, produce marked and prolonged alpha receptor mediated vasoconstriction. Its overdose can cause ischemia and gangrene of the limbs and bowel. It also causes coronary artery spasm and has been used by cardiologist as a provocation test.
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This question is part of the following fields:
- Clinical Management
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Question 9
Correct
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Which of the following tests for the detection of chlamydia is considered the gold standard?
Your Answer: Nucleic Acid Amplification Test
Explanation:Chlamydia is one of the most prevalent STIs in the UK. Many infected individuals can be asymptomatic making it difficult to detect. The gold standard in the diagnosis of Chlamydia is the nucleic acid amplification test (NAAT). A sample is taken from a vulvovaginal self swab, or a cervical swab on speculum examination in women.
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This question is part of the following fields:
- Clinical Management
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Question 10
Correct
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Regarding uterine fibroids, which of the following statements is false?
Your Answer: The risk of fibroids is increased by pregnancy
Explanation:Fibroids are a common gynaecological condition found in many women above the age of 35. They are however uncommon before puberty. They are most common in black women vs white women, and its prevalence increases from puberty to menopause. Risk factors for fibroids include increasing age, obesity and infertility. Protective factors, on the other hand, include pregnancy, as the risk of fibroids decreases with increasing numbers of pregnancies.
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This question is part of the following fields:
- Clinical Management
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SESSION STATS - PERFORMANCE PER SPECIALTY
