EMQ set 2

1 - D

2 - B

3 - D

4 - C

5 - A

6 - K

7 - B

8 - G

1 D

2 D

3 B

4 M

5 I

6 K

7 G

8 G

1-G( contractions present so not a failed induction. augement contraction with oxytocin)

2-C(preecclampsia with failed induction offer cs)

3-D( no high risk issue, repeat induction in 48 hrs)

4-M(adequate progress no additional intervention)

5-A(twin with intact membranes and suspected delay, perform amniotomy and reasses in 2 hrs, should be already on ctg  as high risk)

6-F (suspected delay but rotation present. stat ctg and reasses in 2 hrs)

7-B( diagnosed delay with absent memberane and adequate contraction  deliver by cs)

8-F( just diagnosed second stage with inadequate contractions, reasses in 1 hr)

1.A      2.C          3.F      4.A        5.I        6.K     7.G      8.G

1 C 2 D 3 C 4 A 5 M 6 K 7 G 8 F

1A, 2L, 3F, 4E, 5E, 6J, 7B, 8G

1-g

2-d

3-c

4-a

5-i

6-k

7-b

8-k

1g

2a

3c

4e

5b

6b

7b

8f

1. D
2. C
3. D
4. A
5. I
6. E
7. B
8. G

1-c   2-d   3-c   4-e   5-a   6-k   7-l   8-l

1-K, 2-B, 3-B, 4-E, 5-A, 6-K, 7-B, 8-F

1.D,2 c,  3 e,  4 a,  5 i,  6 H,  7 B, 8 K

1. C 2. D 3. C 4. A 5.A 6.K 7. G 8.F

1.D 2.D 3.B 4.E 5.I 6.K 7.L 8.K

1A,2C,3D,4E,5A,7L,8F

1   C

2   D

3   C

4   A

5   I

6   J

7   B

8   K

1-G

2-C

3-B

4-M

5-J

6-C

7-J

8-F

hi amswers for EMQ set 2

1. B

2.C

3. F

4.M

5.A

6.K

7.G/B

8.G

hi amswers for EMQ set 2

1. B

2.C

3. F

4.M

5.A

6.K

7.G/B

8.G

hi amswers for EMQ set 2

1. B

2.C

3. F

4.M

5.A

6.K

7.G/B

8.G

1.A   2.C   3. B   4.E    5.I   6.K   7.B    8.F

1.A   2.C   3. B   4.E    5.I   6.K   7.B    8.F

1.A   2.C   3. B   4.E    5.I   6.K   7.B    8.F

1.A   2.C   3. B   4.E    5.I   6.K   7.B    8.F

1-D   2-D  3-D  4-M  5-I  6-K  7-G  8-F

1,k

2 d

3 g

4 a

5 a

6 k

7 c

8 g

1 g

2 c

3 b

4 e

5 i

6k

7k

8 f

1 d

2 c

3 c

4 m

5 a

6 k

7 l

8 k

1. D  2. B  3. B  4. E  5. I  6. K  7. K  8. E

1C  2C  3C  4E  5I  6C  7K  8E

1.  A

2. B

3. C

4. A

5. I

6. K

7. F

8. G

1.C   2.B   3.B   4.C   5.I   6.K   7.B   8.F

1.G

2.C

3.D

4.A

5.I

6.K

7.G

8.K

j  

1.B

2.D

3.D

4.D

5.A

6.K

7.K

8.G

1-d 2-d 3-a 4-a 5-i 6-k 7-l 8-k

1. D
2. D
3. B
4. I
5. A
6. K
7. L
8. G

1. A

2. A

3. B

4. M (or E?)

5. A

6. K

7. B

8. F (or G?)

1- A 

2- A

3- D

4- F

5- I

6- K

7- B

8- K

1- A.    2- A   3- D  4- F   5- I   6- K     7-B     8- K

1) G 2) C 3) D 4) M 5) A 6) K  7) F/B 8) F

dear paul,

i failed to undersatand your answer to the emq question 5, since according to nice guideline, suspected delay in 1st stage should be managed with amniotomy (guideline point no:1.13.2)

thanks

Dear paul,

                    According to nice guidelines, amniotomy should be done for delay in 1st stage so why is answer for q 4 and 5 both different than amniotomy.

Thanks

hello jamil,

in question 4 the lady has made adequate progress hence no intervention is justified.

Dear Paul

In question 7, whilst I take on board the NICE guidelines recommend abdominal and vaginal examination in multips before starting oxytocin, the point is to examine whether there is obstruction. The choices are a little ambiguous, in that we have no details about fifths palpable, caput, moulding, and yet the "correct answer" says examine and start synto. Am I reading too much into this? On the options alone, with no further data on obstruction or not, I  would deliver a multip contracting 3-4 in 10 who has progressed 1cm n six hours by caesarean section.

Good day Sir!

This was really confusing and therefore very interesting set of EMQ. Good and Thank you that we learned something well before exam.

The lady in question 4, since she has normal progress, I was happy to say that I will examin her in 4 hours but no intervention is needed... When will we examine her then..

And in relation to question 8 can you please tell us (other than EMQ scenario) what would be reply if that particular lady was a multip? As we can not start oxytocin in that case.

Thank you for your consideration.

Thanks a lot Paul,

U have explained the guidline through an excellent set of Emqs.

It would be great if u can do the same with some other guidlines like Urinary incontinence (NICE guidline)

and NICE guidline on hypertension in pregnancy.