Archives: Medical Student Finals

MSFinals-3394

A 28-year-old female patient named Emily, who is a G2P1, visits you, a locum general practitioner, to inform you about her pregnancy. Upon reviewing her medical history, you discover that Emily has asthma, gastro-oesophageal reflux, constipation, and a recent deep vein thrombosis. She is currently taking senna, over the counter ranitidine, budesonide and salbutamol inhalers, and rivaroxaban. However, none of her medications have been altered due to her pregnancy status. Can you identify which medication needs to be changed?

MSFinals-3395

A 35-year-old woman who has given birth before is experiencing advanced labour at 37 weeks gestation. An ultrasound reveals that the baby is in a breech presentation. Despite pushing for one and a half hours, the buttocks are still not visible. What is the appropriate course of action in this scenario?

MSFinals-3396

A pregnant woman at 39 weeks gestation with a history of type 2 diabetes begins to experience labor. An attempt is made for a vaginal delivery, but during the process, the baby’s left shoulder becomes stuck despite gentle downward traction. Senior assistance is called and arrives promptly, performing an episiotomy. What is the appropriate course of action to manage this situation?

MSFinals-3397

A 28-year-old pregnant woman (38+2, G1 P0) presents to the labour ward with vaginal bleeding and severe abdominal pain. She reports a small amount of vaginal bleeding and has no significant medical history. However, she is a smoker and consumes 10 cigarettes per day. On examination, her abdomen is tender and tense, and cardiotocography reveals late decelerations. Her vital signs are as follows: respiratory rate 22 breaths/min, oxygen saturation 98%, heart rate 125 beats/min, blood pressure 89/56 mmHg, and temperature 35.9 ºC. What is the initial management for the probable diagnosis?

MSFinals-3398

A 32-year-old woman is 38 weeks pregnant and has arrived at the hospital due to experiencing contractions. She has expressed her desire for a vaginal birth. Despite being in good health, alert, and stable, her cardiotocography indicates that the baby’s heart rate has increased from 164/min to 170/min after 10 minutes. As the woman is at full term, the obstetrician has decided to perform a caesarean section. What classification of caesarean section is this considered to be?

MSFinals-3399

A 28-year-old woman is in labor with her first baby. In the second stage, fetal distress is detected, and instrumental delivery is being considered. What would be a contraindication to this procedure?

MSFinals-3400

A 32-year-old G3P2 woman at 16 weeks gestation visits her doctor with concerns about a new rash on her 6-year-old daughter’s arm that appeared 2 days ago. The rash looks vesicular, and the mother reports that there is a chickenpox outbreak at school. The patient is unsure if she had chickenpox in her childhood.

What should be the next step in managing this situation?

MSFinals-3372

You review the blood results taken from a 12-week pregnant woman at her booking visit. In addition to the standard antenatal bloods she also had her rubella status checked as she didn’t have the MMR vaccine as a child. She is currently in good health.
Rubella IgG NOT detected
What would be the most suitable course of action?

MSFinals-3373

A 32-year-old woman who is 4 weeks postpartum and breastfeeding presents with a history of a painful, erythematosus breast for the past 24 hours.

Her blood pressure is 118/78 mmHg, her heart rate is 72 beats per minute and her temperature is 37.2 degrees celsius. On examination her left breast is tender and erythematosus and warm to touch. There is no palpable lump and no visible fissure. You take a sample of breast milk to send for culture.

What is the most appropriate first line management?

MSFinals-3374

A 29-year-old nulliparous woman who is at 39 weeks gestation goes into spontaneous labour. You are summoned to aid in the vaginal delivery. During delivery, you observe the head retracting against the perineum. Downward traction is ineffective in delivering the anterior shoulder. What is a true statement about shoulder dystocia?