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MRCOG PART 2 SBAs and EMQs

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notes336
EMQ1502
SBA2115
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medical disorders test emq doubt

medical disorders test emq doubt Posted by MONA V.

 

ptions for Questions 10-10
A Warfarin until 12 weeks B Warfarin after 12 weeks
C Prophylactic LMWH D Therapeutic LMWH
E Low dose aspirin F Warfarin + low dose aspirin
G Aspirin + prednisolone H Test for anti-Ro antibodies
I Prophylactic LMWH plus aspirin J Therapeutic LMWH plus aspirin
K Prophylactic LMWH plus prednisolone L Therapeutic LMWH plus prednisolone

Instructions:For the scenario described below, choose the single most appropriate management from the above list. Each option may be used once, more than once, or not at all.
Explanation
Question 10 A 35 year old woman with systemic lupus erythematosus and anti-phospholipid antibodies attends the antenatal clinic at 10 weeks gestation in her second pregnancy. Her first pregnancy was complicated by a missed miscarriage at 15 weeks gestation. She has no other risk factors for venous thrombo-embolism.
 

 

 

Sir , 

can you clarify doubt . should the answer for question be option  "e " as  SLE with antiphospholipid antibodies does not need LMWH. kindly clarify..

Posted by Farrukh G.

Correct answer is I as indicated in the explanation.

 

 

  • VTE – risk especially increased in women with anti-phospholipid antibodies. Women already on warfarin should be switched to therapeutic LMWH as soon as the pregnancy is recognized. Women with antiphospholipid syndrome but no previous VTE should be treated with prophylactic LMWH and low-dose aspirin during subsequent pregnancies. Women with SLE + antiphospholipid antibodies but no past morbidity can be managed with low-dose aspirin +/- hydroxychloroquine.

We have updated the answer.