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  • Question 1 - A 46 year old women with a BMI of 34 is seen in...

    Correct

    • A 46 year old women with a BMI of 34 is seen in clinic following hysteroscopy and biopsy for irregular menstrual bleeding. Histology shows atypical hyperplasia. Which of the following is the most appropriate 1st line management?

      Your Answer: Laparoscopic hysterectomy

      Explanation:

      There is an increase risk of developing carcinoma of the uterus, if the endometrium shows hyperplasia with atypia. The standard surgery is total hysterectomy with bilateral salpingectomy which can be performed abdominally or laparoscopically If the disease is grade 1-2 and less than 1B i.e. less than 50% invasion of the uterine body.

    • This question is part of the following fields:

      • Clinical Management
      5.7
      Seconds

  • Question 2 - You receive a swab result from a patient who had complained of odorous...

    Correct

    • 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: Gardnerella vaginalis

      Explanation:

      BV typically presents as an increase in vaginal discharge and vaginal malodour caused by a change in vaginal bacterial flora. PV discharge due to BV is typically grey fluid that adheres to the vaginal mucosa. BV is a polymicrobial infection. Gardnerella is the most commonly associated pathogen. Other associated bacteria include Lactobacillus species, Prevotella, Mobiluncus, Bacteroides, Peptostreptococcus, Fusobacterium, Veillonella, Eubacterium species, Mycoplasma hominis, Urea plasma urealyticum and Streptococcus viridans.

    • This question is part of the following fields:

      • Clinical Management
      1.9
      Seconds

  • Question 3 - A mother typically becomes aware of fetal movements at what gestation? ...

    Correct

    • A mother typically becomes aware of fetal movements at what gestation?

      Your Answer: 18-20 weeks

      Explanation:

      Foetal movements often become apparent at about 18-20 weeks gestation. This phenomenon is also called quickening. The Foetal movements continue to increase in frequency and force until 32 weeks where they plateau. Foetal movements can be used to monitor the wellbeing of the foetus, alerting the mother and healthcare providers to a problem.

    • This question is part of the following fields:

      • Clinical Management
      4
      Seconds

  • Question 4 - When is the earliest appropriate gestational age to perform amniocentesis? ...

    Correct

    • When is the earliest appropriate gestational age to perform amniocentesis?

      Your Answer: 15+0 weeks

      Explanation:

      The best time to perform amniocentesis is at the gestational age of 15 weeks or more. There is increased risk of abortion, respiratory problems and fetal talipes if amniocentesis is performed before the gestational age of 14 weeks.

    • This question is part of the following fields:

      • Clinical Management
      1.2
      Seconds

  • Question 5 - A couple present to the fertility clinic after failing to conceive despite trying...

    Incorrect

    • 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: 47XYY

      Correct 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.

    • This question is part of the following fields:

      • Clinical Management
      17.5
      Seconds

  • Question 6 - Which of the following factors causes the greatest increase in risk of developing...

    Correct

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

      Your 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
      3
      Seconds

  • Question 7 - A patient is being discharged following a termination of pregnancy at 14 weeks....

    Correct

    • A patient is being discharged following a termination of pregnancy at 14 weeks. She had been taking Microgynon in the past but stopped taking this 6 months prior to falling pregnant as she wasn't in a serious relationship.

      Your Answer: Start immediately

      Explanation:

      Combined oral contraceptive pills (COCPs) can be started immediately following abortion or miscarriage. Note following childbirth COCPs should not be restarted for 3 weeks (assuming the patient is not breastfeeding).

    • This question is part of the following fields:

      • Clinical Management
      1.6
      Seconds

  • Question 8 - A 28 year old patient presents to clinic with a maculopapular rash to...

    Correct

    • A 28 year old patient presents to clinic with a maculopapular rash to the hands and soles of the feet. Examination reveals wart like lesions on the vagina and a diagnosis of condyloma latum is made. What stage of syphilis infection is this?

      Your Answer: Secondary

      Explanation:

      Condylomas are warty neoplasms of the vulvar area. The most common type are condyloma acuminatum which occur due to HPV 6 or 11. Condyloma latum are also known as secondary syphilis are less common. Both of these are sexually transmitted.

      Stages of Syphilis:
      – Primary 3-90 days
      Chancre and lymphadenopathy
      – Secondary 4-10 weeks
      Widespread rash typically affecting hands and soles of feet.
      Wart lesions (condyloma latum) of mucus membranes
      – Latent Early <1 yr. after secondary stage
      – Late >2 yr. after secondary stage
      Asymptomatic
      – Tertiary 3+ years after primary infection
      Gummas or
      Neurosyphilis or
      Cardiovascular syphilis

    • This question is part of the following fields:

      • Clinical Management
      3.2
      Seconds

  • Question 9 - Which vitamin deficiency leads to Wernicke's encephalopathy? ...

    Correct

    • Which vitamin deficiency leads to Wernicke's encephalopathy?

      Your Answer: B1

      Explanation:

      Vitamin B1 deficiency can lead to Wernicke’s encephalopathy. Alcoholics are at particular risk. In obstetrics all women with hyperemesis gravidarum should receive thiamine supplementation to prevent Wernicke’s.

    • This question is part of the following fields:

      • Clinical Management
      1.3
      Seconds

  • Question 10 - You receive a swab result from a patient who had complained of odorous...

    Correct

    • 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: 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
      2.6
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Clinical Management (9/10) 90%
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