Archives: Medical Student Finals

MSFinals-3540

Which of these is a contraindication for using epidural anaesthesia during delivery?

MSFinals-3541

As the obstetrics FY2 doctor, you are reviewing the labour ward patient list. What discovery in one of the patients, who is slightly older, would prompt you to initiate continuous CTG monitoring during labour?

MSFinals-3504

Sophie, a 35-year-old woman who is G1P0 and 16 weeks pregnant, visits you to discuss her 12-week combined screening test results. Her HCG levels are high, PAPP-A levels are low, and the nuchal translucency is thickened. Sophie has researched the results and is worried that her baby may have Down’s syndrome. She is extremely upset and anxious. This is her first pregnancy after trying for a year, and she is concerned that her age may affect her ability to conceive again. However, Sophie is uncertain about continuing with the pregnancy and is contemplating termination.

What advice would you offer Sophie?

MSFinals-3505

A 42-year-old woman has visited her doctor to discuss her plans of getting pregnant. She is seeking guidance on basic lifestyle modifications and medications she should be taking. The doctor advises her to take a high dose (5 mg) of folic acid. What is the rationale behind taking high dose folic acid?

MSFinals-3506

A 35-year-old woman who is 11 weeks pregnant with twins presents with vomiting. She cannot keep anything down, is dizzy and tired, and is urinating less frequently.

Her past medical history includes hypothyroidism and irritable bowel syndrome. She smokes 6 cigarettes a day. The foetus was conceived via in-vitro fertilisation (IVF).

On examination, it is found that she has lost 3.2kg, with a pre-pregnancy weight of 64.3kg. Her blood results show the following:

Na+ 124 mmol/L (135 – 145)
K+ 3.2 mmol/L (3.5 – 5.0)
pH 7.46 (7.35-7.45)

What factors in this patient’s history have increased the risk of her presentation?

MSFinals-3507

A 30-year-old woman, who recently gave birth, visits her GP for a regular check-up. She expresses her worries about the medications she is taking for different health issues and their potential impact on her breastfeeding baby. Can you advise her on which medications are safe to continue taking?

MSFinals-3509

A 33-year-old woman gives birth to a healthy baby at 38 weeks gestation without any complications during delivery. Following a physiological third stage of labor, the patient experiences suspected uterine atony and loses 800 ml of blood. She has a medical history of asthma.

An ABCDE approach is taken, and IV access is established. The obstetric consultant attempts uterine compression, but the bleeding persists. The patient’s heart rate is 92 bpm, and her blood pressure is 130/80 mmHg.

What is the next appropriate step in managing this patient?

MSFinals-3510

A 28-year-old woman para 1+0 is 36+5 weeks pregnant and is being monitored and treated for pre-eclampsia. Her current treatment is with labetalol and her blood pressure has been well controlled. During her antenatal clinic visit, she reports a severe headache, one episode of vomiting, and blurred vision. Her blood pressure is currently 154/98 mmHg. Upon examination, papilloedema is observed. As a result, she is admitted to the hospital. What is the appropriate course of action?

MSFinals-3511

A woman who is 32 weeks pregnant is admitted to the obstetric ward. She has been monitored for the past few weeks due to pregnancy-induced hypertension but has now developed proteinuria. Her blood pressure is 162/94 mmHg. What is the most appropriate antihypertensive to start?