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MRCOG PART 2 SBAs and EMQs

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Week 19 - Medical disorders

Week 19 - Medical disorders Posted by PAUL A.

Question1

 

With respect to the schedule of ultrasound scans in pregnant women with pre-existing diabetes, the first scheduled scan should be performed at

 

A.    6 weeks

 

B.    7-9 weeks          

 

C.   8 – 10 weeks

 

D.   11-13 weeks

 

E.    12-15 weeks

 

 

Question2

 

With respect to the schedule of care in pregnant women with pre-existing diabetes, glycaemic control should be assessed by the diabetes care team

 

A.    Every week throughout pregnancy

 

B.    Every 1-2 weeks throughout pregnancy         

 

C.   Every 2 weeks in the first and second trimesters and every 3 weeks in the third trimester

 

D.   Every 4 weeks in the first trimester, every 3 weeks in the second trimester and every 2 weeks in the third trimester

 

E.    Every week in the first trimester and twice a week in the second and third trimesters

 

 

Question3

 

A26 year old woman with a 17 year history of type 1 diabetes attends the antenatal clinic at 14 weeks gestation. Screening at 12 weeks gestation identified evidence of diabetic retinopathy

 

A.    Termination of pregnancy should be offered to protect her sight

 

B.    Testing for retinopathy should be repeated after delivery

 

C.   Testing for retinopathy should be repeated at 16-20 weeks         

 

D.   Caesarean section should be recommended

 

E.    Testing for retinopathy should be repeated at 30-32 weeks

 

 

 

Question4

 

In women with type 1 diabetes, fetal growth scans should be undertaken

 

A.    Every 2 weeks from 28 weeks

 

B.    Every 2 weeks from 24 weeks

 

C.   At 28, 32 and 36 weeks          

 

D.   Every 4 weeks until 32 weeks then every 2 weeks until delivery

 

E.    Every 2 weeks until 36 weeks then weekly until delivery

 

 

Question5

 

A 34 year old woman with type 1 diabetes attends the antenatal clinic at 36 weeks gestation. Glycaemic control has been excellent and fetal growth is on the 50th centile. The woman has indicated that she wishes to await spontaneous labour and does not want induction of labour at any point. Weekly tests for fetal wellbeing should be offered

 

A.    From 36 weeks

 

B.    From 37 weeks

 

C.   From 38 weeks

 

D.   From 39 weeks           

 

E.    From 40 weeks

 

 

 

Question6

 

A 23 year old woman with type 1 diabetes presents with uterine contractions at 32 weeks gestation in her first pregnancy. There is no vaginal loss and she is feeling normal fetal movements. T = 37 C, P = 98 bpm, BP = 116/56 and urine analysis is normal. There are 3-4 palpable contractions every 10 minutes. The cervix is 1 cm long and the os is closed. Fetal fibronectin test is positive.

 

A.    Offer tocolytics and corticosteroids        

 

B.    Offer tocolytics but not corticosteroids

 

C.   Offer corticosteroids but not tocolytics

 

D.   Offer tocolytics only to cover in-utero transfer

 

E.    Offer nifedipine (but not atosiban) and corticosteroids

 

 

 

Question7

 

Which one is the most specific marker for SLE (Systemic Lupus Erythematosus)?

 

A.    Antinuclear antibodies

 

B.    Antiphospholipid antibodies

 

C.   Anti-smooth muscle antibodies

 

D.   Antibodies to double-stranded DNA        

 

E.    Anti-Rho antibodies

 

Question8

 

Systemic lupus erythematosus (SLE)

A.    Has its highest recorded prevalence in W Africa

B.    Is more prevalent in the Afro-Caribbean population in the UK than in Caucasians        

C.   Is more prevalent in people of Northern European origin

D.   Incidence is higher in post-menopausal than in pre-menopausal women

E.    Is more common in males than in females

 

 

Question9

Which drug is not recognized to be associated with SLE?

A.    Methyldopa

B.    Nifedipine            

C.   Hydralazine

D.   Quinidine

E.    Isoniazide

 

Question10

Which one is consistent with a diagnosis of systemic lupus erythematosus?

A.    Photosensitivity and positive anti-nuclear antibodies

B.    Lupus nephritis on biopsy with positive anti-nuclear antibodies        

C.   Malar rash with positive anti-phospholipid antibodies

D.   Arthritis with positive anti-nuclear antibodies

E.    Proteinuria outside of pregnancy with positive anti-phospholipid antibodies

 

 

Question11

Which one is not a clinical criterion for the diagnosis of systemic lupus erythematosus?

 

A.    Pericarditis

B.    Nasopharyngeal ulcers

C.   Genital ulcers       

D.   Photosensitivity

E.    Discoid rash

 

 

Question12

Which one is not an immunological criterion for the diagnosis of systemic lupus erythematosus?

A.    Positive anti-nuclear antibodies

B.    Positive anti-dsDNA antibodies

C.   Positive anti-Sm antibodies

D.   Positive anti-phospholipid antibodies

E.    Positive rheumatoid factor         

 

 

 

Question13

Systemic lupus erythematosus (SLE) can has a range of presentations. Which one is the typical presentation of SLE?

A.    Haematuria, arthritis and weight loss

B.    Fever, joint pain and rash           

C.   Fever, loin pain and joint pain

D.   Recurrent miscarriage, joint pain and rash

E.    Deep vein thrombosis, joint pain and fever

 

 

Question14

Women with SLE are at increased risk of infection and infection can mimic SLE flare. Which one is useful in differentiating SLE flare from infection?

 

A.    CRP

B.    CRP and ESR

C.   Complement C3 and C4       

D.   Complement C2 and C5

E.    Anti-dsDNA antibody titers

 

Question14

A 34 year old woman with a 5 year history of SLE attends for pre-conception assessment and counseling. Which investigation is not required?

A.   Anti-dsDNA antibody titers       

B.   Anti-Ro antibodies

C.  Anti-La antibodies

D.  Anti-phospholipid antibodies

E.   Renal function tests

 

 

Question15

With respect to the effect of pregnancy on SLE

A.    Pregnancy is associated with an increased risk of SLE flares

B.    Pregnancy reduces the risk of SLE flares

C.   SLE flares in pregnancy typically occur in the third trimester

D.   SLE flares typically occur in the first trimester or post-partum       

E.    In women who fall pregnant during remission, pregnancy increases the risk of developing renal disease

 

 

Question16

In pregnant women with SLE, the risk of developing pre-eclampsia is

A.    5%

B.    10%

C.   15%           

D.   25%

E.    45%

 

Question17

A 33 year old woman with SLE attends for pre-conception counseling. She is known to have anti-phospholipid antibodies and is on long-term warfarin therapy. SLE is in remission. With respect to management of anti-coagulation

A.    Warfarin should be stopped if she is planning a pregnancy

B.    Warfarin should be stopped at least 3 months before conception

C.   Warfarin should be stopped as soon as pregnancy is recognized       

D.   Warfarin should be stopped before 6 weeks gestation

E.    Warfarin should be stopped within 2 weeks of pregnancy being recognized

 

 

Question18

A 33 year old woman with SLE attends for pre-conception counseling. She is known to have anti-phospholipid antibodies and is on long-term warfarin therapy. SLE is in remission. With respect to management of anti-coagulation

A.    Switch to prophylactic LMW Heparin before stopping contraception

B.    Switch to therapeutic LMW heparin before stopping contraception

C.   Switch to prophylactic LMW Heparin before 6 weeks gestation

D.   Switch to therapeutic LMW Heparin as soon as pregnancy is recognized       

E.    Switch to prophylactic LMW Heparin before 12 weeks gestation

 

Question19

A 33 year old woman with SLE attends for pre-conception counseling. She is known to have lupus nephritis.

A.    She should be advised not to fall pregnant until after renal transplant

B.    She should be advised not to fall pregnant until 2 years after renal transplant

C.   She should be advised not to fall pregnant until anti-dsDNA antibodies are negative

D.   She should be advised not to fall pregnant until her disease is in remission for at least 6 months         

E.    She should be advised not to fall pregnant until her serum creatinine is within normal limits

 

 

Question20

A 23 year old woman attends the antenatal clinic at 6 weeks gestation. She is known to have SLE with active lupus nephritis. The fetal loss rate associated with this presentation is

A.    Up to 20%

B.    Up to 35%

C.   Up to 45%

D.   Up to 60%

E.    Up to 75%           

 

 

Posted by savitha S.

1b 2b 3c 4c 5d 6a 7d 8b 9b 10b 11c 12e 13b 14c 14a 15d 16c 17c 18d 19d 20c

Posted by sirisha P.

ddcccadbbbcebcaacedac

Posted by abdulnasir O.

B,B,C,C,D,A,D,B,B,B,C,E,B,C\A,D,C,C,D,D,E.

Posted by jayasree M.

D,B,C,C,C,E,D,C,B,B,C,E,B,C,A,C,D,C,D,D,C

Posted by Mobina C.

B B C C C A D B B E C E B C A A D D D D C

Posted by Mobina C.

B B C C C A D B B E C E B C A A D D D D C

medical disorders Posted by rasheeda B.

1B 2B 3C 4C 5C 6E 7D 8B 9B 10B 11C 12E 13B 14C 14A 15D 16C 17C 18D 19D 20E

Posted by Reena G.
1)b, 2)B, 3)C, 4)C,5)C 6)A,7)D,8)B,9)B,10)B,11)C, 12)E13)B 14)C,14)A,15)D16)C17)C 18)D,19)D,20)E
Posted by Hassan I.

1)b, 2)B, 3)C, 4)C,5)C 6)A,7)D,8)B,9)B,10)B,11)C, 12)E13)B 14)C,14)A,15)D16)C17)C 18)D,19)D,20)E

maternal medicine Posted by Hamdy H.

1-b2-d3-c4-c5-e6-a7-d8-b9-b10b11-a12-e13-b14-b15d16-c17c18-c19-e20-e

bdcceadbbbaebadcccee

ANSWERS Posted by PAUL A.

Answers

 

1)   B

2)   B

3)   C

4)   C

5)   D

6)   A

7)   D

8)   B

9)   B

10)                  B

11)                  C

12)                  E

13)                  B

14)                  C

15)                  A

16)                  D

17)                  C

18)                  C

19)                  D

20)                  D

21)                  E

SBA ABOUT RELAPSING MALARIA????? Posted by erptj P.


 

Options for Questions 5-5

 

A P. falciparum B P. ovale
C P. vivax D P. malariae
E P. vivax and P. ovale    

Explanation

 

Question 5 Which organism(s) produce hypnozoites that result in relapsing malaria infection?

I THINK THE ANSWER SHOULD BE E?????

Posted by Farrukh G.

Thanks - explanation is correct and we have updated the answer.