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MRCOG PART 2 SBAs and EMQs

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SBA 8

Answers Posted by Anuradha M.
1-b 2-a 3-c 4-a 5-c 6-a 7-e 8-a 9-b 10-e 11-a 12-c 13-d 14-a 15-a 16-d 17-e
Please explain Posted by Anuradha M.

Q-3 

  • If total score 3 antenatally, consider thromboprophylaxis from 28 weeks. 

  •  

    Previous VTE provoked by major surgery 3 
please explain Posted by Anuradha M.

Q:4 according to RCOG guideline medical comorbidity is score 3 and should consider antenatal thromboprophylaxis from 28 weeks.
please explain Posted by Anuradha M.

Q:7 why is the answer not e?

She has SLE so will need aspirin. and has nephrotic syndrome so gets a score of 3 which means consider thromboprophylaxis from 28 weeks? Please explain.
please explain Posted by Anuradha M.

Q:9 why is the answer not e? 

There seems to be  a pattern that I seem to be missing in these questions. Here Chronic HTN so need aspirin from 12 weeks and Hx of provoked DVT so considered LMWH form 28 weeks as score 3?

 
please hellp Posted by farzana S.

Dear Paul,

Kindly give your valuable explanation to the answers.

We seem to be really confused with the interpretation of new guidelines.
Posted by H K.

Dear paul ,

 answer for last question shd be E as she has 3 risk factors so needs LMWH from 28 weeks and BMI>35 SO NEEDS SERIAL GROWTH SCAN.

KINDLY EXPLAIN,

THANK YOU

 
Posted by farzana S.

Dear Paul,

If gestational age is not mentioned in the guideline, then what shud be our answer a)from early pregnancy or 28wks? If at all question requires?

 

 
Posted by farzana S.

Dear Paul,

If gestational age is not mentioned in the guideline, then what shud be our answer a)from early pregnancy or 28wks? If at all question requires?

 

 
q10 Posted by UcasLucas L.
Dear paul, why do we start thromboprophylacis from 8wks? Appendix 3 states if vte score 3 consider prophylaxis from 28wks. If score of 4 or more then we start from 8wks. Why do westart from 8wks? I thought she only scored 3
question 9 Posted by Nyan Chin L.

please help explain, as road traffic is a non reqcurrence and a transient episode, why is it not 

aspirin form 12 week and LMWH from 28w then?
Posted by Farrukh G.

 

question 9 Posted by Nyan Chin L.
Mon Aug 10, 2015 06:43 am

please help explain, as road traffic is a non reqcurrence and a transient episode, why is it not 

aspirin form 12 week and LMWH from 28w then?

 

SEE RCOG GUIDELINES / NOTES

 

Intermediate risk – consider antenatal prophylaxis with LMWH

  • Hospital admission
  • Single previous VTE related to major surgery
  • High-risk thrombophilia + no VTE (antithrombin deficiency, protein C or S deficiency, compound or homozygous for low-risk thrombophilia)
  • Medical comorbidities e.g. cancer, heart failure, active SLE, IBD or inflammatory polyarthro-pathy, nephrotic syndrome, type I DM with nephropathy, sickle cell disease, current IVDU
  • Any surgical procedure e.g. appendicectomy
  • OHSS (first trimester only)

IT DOES NOT SAY FROM 28 WEEKS.

 
Post surgery stratification Posted by fiona H.

Dear Paul,

I was hoping you could clarify.  The section 4.2.3 on stratification in women with previous DVT states that LMWH can be withheld till 28 weeks provided no additional risk factors are present. It is level D evidence but i wonder if this changes some of the answers?

Best wishes

Fiona