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  • Question 1 - A patient undergoes medical abortion at 9 weeks gestation. What is the advice...

    Incorrect

    • A patient undergoes medical abortion at 9 weeks gestation. What is the advice regarding Rhesus Anti-D Immunoglobulin?

      Your Answer: Not required

      Correct Answer: All RhD-negative women who are not alloimmunized should receive Anti-D IgG

      Explanation:

      All non-sensitised RhD negative women should receive Anti-D IgG within 72 hours following abortion

    • This question is part of the following fields:

      • Clinical Management
      15.1
      Seconds

  • Question 2 - A 28 year old patient is treated for hydatidiform mole with methotrexate. What...

    Correct

    • A 28 year old patient is treated for hydatidiform mole with methotrexate. What is the mechanism of action of methotrexate?

      Your Answer: Inhibits dihydrofolate reductase

      Explanation:

      Methotrexate is a folic acid antagonist. It inhibits dihydrofolate reductase (DHFR). DHFR catalyses the conversion of dihydrofolate to the active tetrahydrofolate which is required for DNA synthesis. It is either administered as a single intramuscular injection or multiple fixed doses.

    • This question is part of the following fields:

      • Clinical Management
      10
      Seconds

  • Question 3 - Regarding uterine fibroids, which of the following statements is false? ...

    Correct

    • 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.

    • This question is part of the following fields:

      • Clinical Management
      61.9
      Seconds

  • Question 4 - You review a patient in the fertility clinic. The ultrasound and biochemical profile...

    Correct

    • You review a patient in the fertility clinic. The ultrasound and biochemical profile are consistent with PCOS. She has been trying to conceive for 2 years. Her BMI is 26 kg/m2. She is a non-smoker. You plan to initiate Clomiphene. According to NICE guidance how long should treatment continue for (assuming patient remains non-pregnant)?

      Your Answer: 6 months

      Explanation:

      Treatment with Clomiphene should not exceed 6 months.

    • This question is part of the following fields:

      • Clinical Management
      18.3
      Seconds

  • Question 5 - A patient attends the maternity unit as her waters have broken but she...

    Incorrect

    • A patient attends the maternity unit as her waters have broken but she hasn't had contractions. She is 39+6 weeks gestation. Speculum examination confirms prelabour rupture of membranes (PROM). According to NICE guidelines after what time period should induction be offered?

      Your Answer: 12 hours

      Correct Answer: 24 hours

      Explanation:

      Induction of labour is appropriate approximately 24 hours after rupture of the membranes.

    • This question is part of the following fields:

      • Clinical Management
      29.2
      Seconds

  • Question 6 - A 30 year old women who is 24 weeks pregnant attends EPU due...

    Incorrect

    • A 30 year old women who is 24 weeks pregnant attends EPU due to suprapubic pain. Ultrasound shows a viable foetus and also a fibroid with a cystic fluid filled centre. What is the likely diagnosis?

      Your Answer: Cystic degeneration of fibroid

      Correct Answer: Red degeneration of fibroid

      Explanation:

      Red degeneration of fibroids is one of 4 methods of fibroid degeneration. Although uncommon outside pregnancy it is thought to be the most common form of fibroid degeneration during pregnancy and typically occurs in the 2nd trimester. It is thought to arise from the fibroid outgrowing its blood supply and haemorrhagic infarction occurs. Ultrasound will typically show a localised fluid collection (blood) within the fibroid.

    • This question is part of the following fields:

      • Clinical Management
      35.3
      Seconds

  • Question 7 - Which organism is the most common cause of puerperal sepsis? ...

    Incorrect

    • Which organism is the most common cause of puerperal sepsis?

      Your Answer: Group B Streptococcus

      Correct Answer: Group A Streptococcus

      Explanation:

      Puerperal sepsis is defined as sepsis occurring after birth until 6 weeks postnatal. The most common cause of puerperal sepsis is Group A streptococcus. Until 1937, puerperal sepsis was the major cause of maternal mortality. The discovery of sulphonamides in 1935 and the simultaneous reduction in the virulence of the haemolytic streptococcus resulted in a dramatic fall in maternal mortality.

    • This question is part of the following fields:

      • Clinical Management
      12.4
      Seconds

  • Question 8 - How long does involution of the uterus take after parturition? ...

    Correct

    • How long does involution of the uterus take after parturition?

      Your Answer: 4-6 weeks

      Explanation:

      In the period immediately after the delivery of the placenta, known as the puerperium, the female reproductive system begins to undergo some physiological changes to return to a non-pregnant state. One of these changes is uterine involution. The myometrium contracts, constricting blood vessels which impedes blood flow. It is thought that the uterine tissues then undergo apoptosis and autophagy. It takes about 4-6 weeks for the uterus to decrease is size from about 1 kg to 60 grams.

    • This question is part of the following fields:

      • Clinical Management
      202.9
      Seconds

  • Question 9 - A 45 year old women is seen in clinic following hysteroscopy and biopsy...

    Incorrect

    • A 45 year old women is seen in clinic following hysteroscopy and biopsy due to irregular menstrual bleeding. Her BMI is 34 kg/m2. This shows atypical hyperplasia. Which of the following is the most appropriate 1st line management?

      Your Answer: Weight loss

      Correct Answer: Laparoscopic hysterectomy

      Explanation:

      Endometrial hyperplasia with atypia is at high risk of progression to cancer and hysterectomy is indicated There is high risk of progression to cancer with endometrial hyperplasia with atypia and hysterectomy is indicated. Although weight loss would be beneficial this shouldn’t delay surgical management.

    • This question is part of the following fields:

      • Clinical Management
      15.1
      Seconds

  • Question 10 - A patients MSU comes back showing heavy growth of E.coli that is resistant...

    Incorrect

    • A patients MSU comes back showing heavy growth of E.coli that is resistant to trimethoprim, amoxicillin and nitrofurantoin. You decide to prescribe a course of Cephalexin. What is the mechanism of action of Cephalexin?

      Your Answer: DNA Gyrase Inhibitor

      Correct Answer: inhibit peptidoglycan cross-links in bacterial cell wall

      Explanation:

      Cephalosporins are beta lactum drugs, like penicillin. They act by inhibiting the cross linkage of the peptidoglycan wall in bacteria.

    • This question is part of the following fields:

      • Clinical Management
      28.9
      Seconds

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Clinical Management (4/10) 40%
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