Question of the Week

We are progressing rapidly with an extensive update of our notes, SBAs and EMQs based on intelligence from the Jan 2025 exams. Most of the areas examined were covered by our material and we have further annotated the notes and questions accordingly. However, there were a small number of new topics. We have written the relevant questions and updated the notes. We will delete old questions to keep the number at 2000 SBAs and 1500 EMQs.

In order not to further increase the total number of questions, we will not add our own questions on these ‘new’ topics to the database. Instead we will post a ‘Question of the week’ here every Monday to highlight these new topics.

Relugolix is recommended by NICE for the treatment of symptomatic fibroids. One benefit of Relugolix over traditional GnRH analogues is that it

A)   Does not cause menopausal symptoms

B)   Is administered orally

C)   Can be used by women trying to conceive

D)   Can be used for up to 12 months

E)    Is not associated with weight gain

Correct answer = B

Which one is a poor prognostic feature in endometrial cancer?

A) Pathogenic POLE mutation (POLEmut)

B) P53 abnormal (p53abn)

C) Invasion of more than 50% of the myometrium

D) Mismatch repair deficiency (MMRd)

E) Presence of tumour in both ovaries

Correct answer = B

For pregnant women in the UK, the COVID-19 vaccine can be administered

A) From 12 weeks of gestation

B) From 16 weeks of gestation

C) From 20 weeks of gestation

D) From 28 weeks of gestation

E) At any gestational age

Correct answer = E

Which drug / drug group is associated with drug-inducedcystitis?

A) Anti-thyroid drugs

B) Anti-fungal drugs

C) Penicillins

D) Local anaesthetics

E) Diazepam

Correct answer = C

A 72 year old woman has been referred for colposcopy because of post-menopausal bleeding and an ulcerating lesion on her cervix. Biopsy confirms squamous cell carcinoma. MRI scan shows a 6 cm lesion on the ectocervix extending into the lower third of the vagina and the parametrium but not extending to the pelvic side-wall. There is pelvic and para-aortic lymphadenopathy. The stage of the tumour is

A) IIB

B) IIIC1

C) IIIC2-r

D) IIIC2-p

E) IVA

Correct answer = C) IIIC2-r

A 24 year old woman with polycystic ovary syndrome has been referred because of hair on her chin and face. She has tried shaving, waxing and laser treatment with unsatisfactory results. Her BMI is 23 kg/m2.

A) Reassure

B) Cyproterone acetate

C) Clomifene citrate

D) Eflornithine + review after 4 months

E) Eflornithine + review after 12 months

F) Spironolactone

G) Finasteride

H) Flutamide

I) Combined oral contraceptive pill

J) Medroxyprogesterone acetate

C?

Correct answer = D: Eflornithine + review after 4 months

A 76 year old woman has undergone laparotomy for ovarian cancer. She suffers from mild dementia which is associated with a fear of hospitals and new environments. Which one is the most appropriate option for post-operative analgesia?

A) Spinal analgesia

B) Epidural analgesia

C) Combined spinal-epidural analgesia

D) Intravenous opioids

E) Intravenous paracetamol

F) Oral tramadol

G) Transversus abdominis plane block

H) Morphine PCA

I) Rectal NSAIDs

J) Oral diclofenac

Thanks for the answer for the previous question.

For post-op analgesia, answer is G?

Correct answer = G

A 17 year old girl with learning disability attends the gynaecology clinic accompanied by her mother. The girl has heavy and painful periods that have not responded to the combined oral contraceptive pill. Her mother is requesting the levonorgestrel intra-uterine device (IUS).

A) Insert IUS in the girl’s best interest

B) Obtain consent from the mother

C) Obtain consent from the girl

D) Assess capacity and obtain consent from the girl

E) Contact the safeguarding team

F) Obtain second opinion from another doctor

G) Request advice from legal services

H) Decline the request

I) Ask psychologist to assess capacity

J) Refer to social services

Thanks for the previous answer.

For this question, is the answer D?

Correct answer = D