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  • Question 1 - A 42 year old smoker attends clinic due to vulval soreness and shows...

    Incorrect

    • A 42 year old smoker attends clinic due to vulval soreness and shows you a number of vulval lumps. Biopsy is taken and reported as showing

      Your Answer: Chronic atrophic vulvitis

      Correct Answer: Vulval intraepithelial neoplasia (VIN)

      Explanation:

      This is VIN. Smoking is a risk factor. It is also more common in immunocompromised patients.

    • This question is part of the following fields:

      • Clinical Management
      19.5
      Seconds

  • Question 2 - What is the most common Type II congenital thrombophilia? ...

    Incorrect

    • What is the most common Type II congenital thrombophilia?

      Your Answer:

      Correct Answer: Factor V Leiden mutation

      Explanation:

      The most common congenital thrombophilia is Factor V Leiden mutation. Other congenital causes are JAK-2 mutations and the Prothrombin G20210A mutation. Protein C and S deficiencies are type 1 and antiphospholipid syndrome is not congenital it is an acquired thrombophilia.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 3 - You are called to see a 24 year old patient in A&E. She...

    Incorrect

    • 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:

      Correct 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.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 4 - Which of the following factors causes the greatest increase in risk of developing...

    Incorrect

    • Which of the following factors causes the greatest increase in risk of developing bladder cancer?

      Your Answer:

      Correct Answer: Smoking

      Explanation:

      Transitional cell carcinoma of the bladder is most commonly caused by cigarette smoke. Other risk factors include naphthylamine, azodyes and long term cyclophosphamide use.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 5 - You receive a swab result from a patient who had complained of odorous...

    Incorrect

    • You receive a swab result from a patient who had complained of odorous vaginal discharge. It confirms bacterial vaginosis (BV). Which pathogen is most commonly associated with BV?

      Your Answer:

      Correct Answer: Gardnerella vaginalis

      Explanation:

      Bacterial vaginosis is characterised by a foul smelling vaginal discharge without inflammation. The most common spp to cause this is gardnerella vaginalis. Other spp include mycoplasma hominis and bacteroides. It occurs due to growth and increase in anaerobic spp with simultaneous reduction in lactobacilli in vaginal flora causing an increase in vaginal pH. It is the most common cause of abnormal vaginal discharge in women of childbearing age.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 6 - When consenting a patient for abdominal hysterectomy what would you advise regarding the...

    Incorrect

    • When consenting a patient for abdominal hysterectomy what would you advise regarding the risk?

      Your Answer:

      Correct Answer: Injury to ureter or bladder is approximately 1%

      Explanation:

      Abdominal hysterectomy is performed through a Pfannenstiel incision. There are certain complications associated with hysterectomy including haemorrhage, injury to the ureter(1%) and less commonly bladder and bowel (0.04%).

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 7 - You see a 28 year old woman who is 22 weeks pregnant. She...

    Incorrect

    • You see a 28 year old woman who is 22 weeks pregnant. She complains of vaginal soreness and yellow frothy discharge. Microscopy confirms Trichomoniasis. What percentage of infected pregnant women present with yellow frothy discharge?

      Your Answer:

      Correct Answer: 20%

      Explanation:

      Trichomoniasis is considered a sexually transmitted infection found both in men and women, and is caused by the flagellate protozoan Trichomonas vaginalis. The organism is mainly found in the vagina and the urethra. Though many infected women can be asymptomatic, they can also present with yellow frothy vaginal discharge, itching and vaginitis, dysuria or an offensive odour. About 20-30% of women with the infection however are asymptomatic. For the diagnosis of t. vaginalis in women, a swab is taken from the posterior fornix during speculum examination and the flagellates are detected under light-field microscopy. The recommended treatment for t. vaginalis during pregnancy and breastfeeding is 400-500mg of metronidazole twice daily for 5 -7 days. High dose metronidazole as a 2g single dose tablet is not advised during pregnancy. All sexual partners should also be treated and screened for other STIs.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 8 - Which of the following dugs is a strong inducer of cytochrome P450? ...

    Incorrect

    • Which of the following dugs is a strong inducer of cytochrome P450?

      Your Answer:

      Correct Answer: Phenytoin

      Explanation:

      Antiepileptic, phenytoin more so than topiramate are inducers of cytochrome P450. They should not be given with COCPs. The metabolism of oestrogen and progestogen is increased by anti-epileptic drugs that induce cytochrome P450 leading to a loss of contraceptive effect.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 9 - Mifepristone when used for management of abortion works via what mechanism? ...

    Incorrect

    • Mifepristone when used for management of abortion works via what mechanism?

      Your Answer:

      Correct Answer: Anti-progestogen

      Explanation:

      Mifepristone is a prostaglandin antagonist. It acts as a competitive inhibitor of the receptor.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

  • Question 10 - Which of the following dugs is a strong inducer of cytochrome P450? ...

    Incorrect

    • Which of the following dugs is a strong inducer of cytochrome P450?

      Your Answer:

      Correct Answer: Phenytoin

      Explanation:

      It is important to be aware of which ant-epileptics induce cytochrome P450. Of the above Topiramate and Phenytoin are moderate and strong inducers respectively.

    • This question is part of the following fields:

      • Clinical Management
      0
      Seconds

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