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Question 1
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A 16 week pregnant patient presents to the antenatal clinic. Protein values of ++ are found on urinalysis. Significant proteinuria is indicated in which of the following protein:creatinine values?
Your Answer: 30 mg/mmol
Explanation:Proteinuria of more than 1+ on dipstick should be investigated to quantify the amount of proteinuria. A protein: creatinine ratio can be used to determine the severity of proteinuria, where levels of more than 30 mg/mmol indicate significant proteinuria.
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This question is part of the following fields:
- Data Interpretation
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Question 2
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You are called to see a 24 year old patient who is currently in labour but is failing to progress. A fetal blood sample is sent for analysis. pH is 7.22. Which of the following is the appropriate course of action?
Your Answer: Consider delivery
Explanation:A normal pH value is above 7.25. A pH below 7.20 is confirmation of fetal compromise. Values between 7.20 and 7.25 are ‘borderline’.
The base deficit can also be useful in interpretation of the fetal scalp pH. A base excess of more than -10 demonstrates a significant metabolic acidosis, with increasing risk of fetal neurological injury beyond this level. Delivery should be considered.
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This question is part of the following fields:
- Data Interpretation
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Question 3
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The transvaginal ultrasound of a 37 year old woman reveals a left ovarian mass. The mass is a unilocular cyst with diffuse homogenous ground glass echoes as a result of hemorrhagic debris. Which of the following is the most likely diagnosis?
Your Answer: Endometrioma
Explanation:An endometrioma, also known as a chocolate cyst is a benign ovarian cyst that occurs as a result of the trapping of endometriosis tissue inside the ovary. The findings on transvaginal ultrasound are often a unilocular cyst, with ground glass echogenicity due to haemorrhage. Other benign masses that can be evaluated using transvaginal ultrasound are functional cysts, serous and mucinous cystadenomas and mature teratomas.
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This question is part of the following fields:
- Data Interpretation
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Question 4
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A midwife is concerned regarding CTG changes and suggests a fetal blood sample (FBS). At what dilatation would you NOT perform FBS?
Your Answer: Less than 3cm
Explanation:Fetal Blood Sampling (FBS) should only be performed when the cervix is >3cm dilated.
Indications for FBS:
1. Pathological CTG in labour
2. Suspected acidosis in labourContraindications to FBS
– Maternal infection e.g. HIV, HSV and Hepatitis
– Known fetal coagulopathy
– Prematurity (< 34 weeks gestation)
– Acute fetal compromiseInterpretation of FBS results:
pH >7.25 = Normal -Repeat in 1 hour if CTG remains abnormal
7.21 to 7.24 = Borderline – Repeat in 30 minutes
<7.20 = Abnormal - Consider delivery -
This question is part of the following fields:
- Data Interpretation
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Question 5
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Question 6
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Question 7
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A patient who has been seen in fertility clinic phones regarding the timing of her progesterone blood test. She has regular 35 day menstrual cycles. When testing for ovulation what day of her cycle should she have the test on?
Your Answer: 28
Explanation:The mid-luteal progesterone sample should be taken 7 days before the expected period i.e. day 21 in a 28-day cycle or day 28 of a 35 day cycle
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This question is part of the following fields:
- Data Interpretation
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Question 8
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A 32 year old patient has a transvaginal ultrasound scan that shows a mass in the left ovary. It is anechoic, thin walled, is without internal structures and measures 36mm in diameter. What is the likely diagnosis?
Your Answer: Functional cyst
Explanation:The diagnosis of functional ovarian cyst is made when the cyst measures more than 3 cm and rarely grows more than 10 cm. It appears as a simple anechoic unilocular cyst on USS. It is usually asymptomatic. If it is symptomatic then laparoscopic cystectomy should be performed.
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This question is part of the following fields:
- Data Interpretation
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Question 9
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Question 10
Correct
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A patient who has been seen in fertility clinic phones regarding the timing of her progesterone blood test. She has regular 35 day menstrual cycles. When testing for ovulation what day of her cycle should she have the test on?
Your Answer: 28
Explanation:When testing for ovulation the best test is to check the progesterone level. The mid luteal progesterone levels should be checked 7 days prior to the next period. That will be the 28th day in a 35 day cycle.
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This question is part of the following fields:
- Data Interpretation
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