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  • Question 1 - Which immunoglobulin is the first to be synthesised by the neonate? ...

    Correct

    • Which immunoglobulin is the first to be synthesised by the neonate?

      Your Answer: IgM

      Explanation:

      Fetal production of immunoglobulin begins early on at about 10 weeks gestation with the production of IgM antibodies. Maternal IgG, which is a key component of fetal immunity is passed on to the foetus through the placenta from 12 weeks of gestation. Secretory IgA is not produced until after birth, through breast milk.

    • This question is part of the following fields:

      • Immunology
      3
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  • Question 2 - Regarding Venous Thromboembolism (VTE) in pregnancy which of the following statements is TRUE?...

    Incorrect

    • Regarding Venous Thromboembolism (VTE) in pregnancy which of the following statements is TRUE?

      Your Answer:

      Correct Answer: Relative risk of VTE in pregnancy is 4 to 6 fold

      Explanation:

      Venous thromboembolic disease (VTE) is the most common cause of direct maternal death in the UK. In the most recent triennium, there were 41 fatalities, giving a maternal mortality rate of 1.94 per 100 000 – more than twice that of the next most common cause, pre-eclampsia. As pregnancy is a hyper coagulable state. There are alterations in the fibrinolytics and thrombotic pathways. There is also an increased production of clotting factors during pregnancy.

    • This question is part of the following fields:

      • Clinical Management
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  • Question 3 - Which one of the following factors commonly indicate repetitive late decelerations on cardiography...

    Incorrect

    • Which one of the following factors commonly indicate repetitive late decelerations on cardiography (CTG)?

      Your Answer:

      Correct Answer: Fetal hypoxia

      Explanation:

      Repetitive late decelerations can be caused by fetal hypoxia which results in constriction of the vessels to circulate blood from the peripheries to more important organs of the body like the brain and heart etc.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 4 - A 28 year old primigravida carrying a twin pregnancy presents at 32 weeks...

    Incorrect

    • A 28 year old primigravida carrying a twin pregnancy presents at 32 weeks gestation. She is lethargic, clinically jaundiced and complains of abdominal pain with frequent vomiting. A summary of her blood results are as follows:

      Your Answer:

      Correct Answer: Acute fatty liver of pregnancy

      Explanation:

      This patients bloods and symptoms suggest she has hepatic impairment. Acute fatty liver of pregnancy typically presents after the 30th week and she has risk factors for acute fatty liver of pregnancy: Multiple pregnancy Primigravida

    • This question is part of the following fields:

      • Clinical Management
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  • Question 5 - On the sixth day of her menstrual cycle, a 25-year-old lady comes to...

    Incorrect

    • On the sixth day of her menstrual cycle, a 25-year-old lady comes to your clinic with slight lower abdomen pain. She has no children and lives with her male companion. Her blood pressure is 110/70 mmHg, her pulse is 90 beats per minute, and her temperature is 37.5°C.
      On vaginal examination, no adnexal lump is palpated, however cervical motion pain is noticed.
      Which of the following is the most appropriate next step in management?

      Your Answer:

      Correct Answer: Cervical swabs for culture

      Explanation:

      Pain upon movement of the cervix with the health care provider’s gloved fingers is suggestive of an inflammatory process of the pelvic organs. CMT, when present, is classically found on bimanual examination of the cervix and uterus. While CMT is often associated with pelvic inflammatory disease, it can be present in other disease entities such as ectopic pregnancy, endometriosis, ovarian torsion, appendicitis, and perforated abdominal viscus.

      PID is not a singular disease entity but describes a spectrum of disease. It is an upper genital tract infection, which may affect the uterus, fallopian tubes, ovaries, and peritoneum. PID can begin as cervicitis, progress to endometritis, followed by involvement of the fallopian tubes as pyosalpinx, and ultimately involve the ovary as a tubo-ovarian abscess (TOA). The two most common causative pathogens are N. gonorrhoeae and C. trachomatis although the infection is often polymicrobial.

      Documentation of infection with either of these two organisms must be done by cervical swabs for culture.

      Transvaginal ultrasound or CT scan can be done to confirm diagnosis however the absence of findings in these investigations doesn’t rule out the possibility of PID.

      Urinalysis can be done to exclude urinary tract infection, one of the possible differential diagnosis for PID.

      Thyroid stimulating hormone has no role in the diagnosis of PID.

    • This question is part of the following fields:

      • Gynaecology
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  • Question 6 - A 32 year old woman who is 14 weeks pregnant presents to the...

    Incorrect

    • A 32 year old woman who is 14 weeks pregnant presents to the clinic with yellow, frothy vaginal discharge and vaginal soreness. Trichomoniasis is confirmed after microscopy on a wet smear. Which of the following is the most appropriate treatment?

      Your Answer:

      Correct Answer: Metronidazole 400mg TDS 7 days

      Explanation:

      Trichomoniasis is considered a sexually transmitted infection found both in men and women caused by the flagellate protozoan Trichomonas vaginalis. The organism is mainly found in the vagina and the urethra. Though many infected women can be asymptomatic, they can also present with yellow frothy vaginal discharge, itching and vaginitis, dysuria or an offensive odour.

      For the diagnosis of t. vaginalis in women, a swab is taken from the posterior fornix during speculum examination and the flagellates are detected under light-field microscopy.

      The recommended treatment for t. vaginalis during pregnancy and breastfeeding is 400-500mg of metronidazole twice daily for 5 -7 days. High dose metronidazole as a 2g single dose tablet is not advised during pregnancy. All sexual partners should also be treated, and screening for other STIs should be carried out.

    • This question is part of the following fields:

      • Clinical Management
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  • Question 7 - A 23 year old female patient with DVT on anticoagulant came to your...

    Incorrect

    • A 23 year old female patient with DVT on anticoagulant came to your clinic for advice. She is on combined OCPs.
      What would you advice her?

      Your Answer:

      Correct Answer: Progesterone only pill

      Explanation:

      Women with medical conditions associated with increased risk for thrombosis generally should not use oestrogen-containing contraceptives.

      The majority of evidence identified does not suggest an increase in odds for venous or arterial events with use of most POCs. Limited evidence suggested increased odds of VTE with use of injectables (three studies) and use of POCs for therapeutic indications (two studies, one with POCs unspecified and the other with POPs).

      Discontinuing anticoagulants increases her risk of recurrent DVT.

    • This question is part of the following fields:

      • Gynaecology
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  • Question 8 - A 37-year-old woman is planning to conceive this year. Upon history-taking and interview,...

    Incorrect

    • A 37-year-old woman is planning to conceive this year. Upon history-taking and interview, it was noted that she was a regular alcohol drinker and has been using contraceptive pills for the past 3 years.
      Which of the following is considered to be the most appropriate advice for the patient?

      Your Answer:

      Correct Answer: Stop alcohol now

      Explanation:

      Alcohol exposure during pregnancy results in impaired growth, stillbirth, and fetal alcohol spectrum disorder. Fetal alcohol deficits are lifelong issues with no current treatment or established diagnostic or therapeutic tools to prevent and/or ameliorate some of these adverse outcomes.

      Alcohol readily crosses the placenta with fetal blood alcohol levels approaching maternal levels within 2 hours of maternal intake. As there is known safe level of alcohol consumption during pregnancy, and alcohol is a known teratogen that can impact fetal growth and development during all stages of pregnancy, the current recommendation from the American College of Obstetricians and Gynaecologists, Centre for Disease Control (CDC), Surgeon General, and medical societies from other countries including the Society of Obstetricians and Gynaecologists of Canada all recommend complete abstinence during pregnancy.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 9 - What is the definition of premature menopause? ...

    Incorrect

    • What is the definition of premature menopause?

      Your Answer:

      Correct Answer: Menopause at or before 40 years of age

      Explanation:

      Menopause is defined as the cessation of menstruation for a period of 12 months. Premature menopause is defined as cessation of menstruation before the age of 40.

    • This question is part of the following fields:

      • Endocrinology
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  • Question 10 - A 35-year-old lady with a 4-year history of hypertension is planning to conceive....

    Incorrect

    • A 35-year-old lady with a 4-year history of hypertension is planning to conceive. She has never been pregnant before and has stopped using contraception recently. She has a past medical history of asthma and the only medication she is on is ramipril 10 mg daily.
      On examination her blood pressure is found to be 130/85 mm/Hg.
      From the following which is the most appropriate initial management of her hypertension?

      Your Answer:

      Correct Answer: Cease ramipril and start methyldopa

      Explanation:

      In the given case pre-pregnancy counselling and management of chronic hypertension is very much essential.
      Some commonly prescribed antihypertensive drugs like ACE inhibitors, angiotensin receptor antagonists, diuretics and most beta blockers are contraindicated or is best to be avoided before conception and during pregnancy.
      Methyldopa is considered as the first line drug for the management of mild to moderate hypertension in pregnancy and is the most commonly prescribed antihypertensive for this indication.
      Hydralazine can be used during any hypertensive emergencies in pregnancy.
      Intake of Angiotensin receptor blockers and ACE inhibitors during the first trimester can lead to complications as they are both teratogenic; use of these drugs during second and third trimesters can result in foetal renal dysfunction, oligohydramnios and skull hypoplasia.
      Diuretics can cause foetal electrolyte disturbances and significant reduction in maternal blood volume.
      All beta blockers, except labetalol, can result in foetal bradycardia, and growth restriction in case its long-term use.
      Calcium channel antagonists, except nifedipine, are avoided during pregnancy due to its high risk for maternal hypotension and foetal hypoxia.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 11 - Engagement of the foetus can be defined as: ...

    Incorrect

    • Engagement of the foetus can be defined as:

      Your Answer:

      Correct Answer: When the greatest biparietal diameter of the fetal head passes the pelvic inlet

      Explanation:

      Engagement means when the fetal head enters the pelvic brim/inlet and it usually takes place 2 weeks before the estimated delivery date i.e. at 38 weeks of pregnancy.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 12 - A 32-year-old female presented with a lump in the upper outer quadrant of...

    Incorrect

    • A 32-year-old female presented with a lump in the upper outer quadrant of her left breast, which is 1.5cm in size and tender. What is the initial investigation to be done?

      Your Answer:

      Correct Answer: Ultrasound

      Explanation:

      Tenderness is usually suggestive of a benign breast mass such as a breast abscess. Ultrasound is used to distinguish solid from cystic structures and to direct needle aspiration for abscess drainage.

    • This question is part of the following fields:

      • Gynaecology
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  • Question 13 - A 28-year-old, currently at 26 weeks’ gestation of her third pregnancy, presents with...

    Incorrect

    • A 28-year-old, currently at 26 weeks’ gestation of her third pregnancy, presents with irregular uterine contractions for the past 24 hours and has concerns about premature delivery. She delivered her first child at 38 weeks of gestation and her second at 39 weeks gestation. On examination, BP and urinalysis have come back normal. Her symphysis-fundal height measures 27cm, the uterus is lax and non-tender. Fetal heart rate is 148/min. She also undergoes a pelvic examination along with other investigations.
      Which findings would suggest that delivery is most likely going to happen before 30 weeks’ of gestation?

      Your Answer:

      Correct Answer: The cervix is closed, but the fetal fibronectin test on cervical secretions is positive.

      Explanation:

      Predisposing factors of preterm delivery include a short cervix (or if it shortens earlier than in the third trimester), urinary tract or sexually transmitted infections, open cervical os, and history of a previous premature delivery. Increased uterine size can also contribute to preterm delivery and is seen with cases of polyhydramnios, macrosomia and multiple pregnancies. The shorter the cervical length, the greater the risk of a premature birth.
      In this case, the risk of bacterial vaginosis and candidiasis contributing to preterm delivery would be lower than if in the context of an open cervical os. However, the risk of premature delivery is significantly increased if it is found that the fetal fibronectin test is positive, even if the os is closed.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 14 - A 36-year-old woman is brought to the emergency department after she twisted her...

    Incorrect

    • A 36-year-old woman is brought to the emergency department after she twisted her ankle, once initial management of her current problem is done, you realize that she is 10 weeks pregnant.
      On further questioning, she admits to heroin addiction and says that Doc, I sometimes need to get high on meth, but my favorite wings to fly are cocaine though, since I cannot afford it, I take a bit when I manage to crash a party. She also drinks a bottle of whisky every day. During the past few weeks, she started worrying about not being a good mother, and for this she is taking diazepam at night which she managed to get illegally.
      Considering everything this patient revealed, which is most likely to cause fetal malformations?

      Your Answer:

      Correct Answer: Alcohol

      Explanation:

      Woman in the given case is taking a full bottle of Whisky every day. As per standards, a small glass of Whisky (1.5 Oz) is equivalent of a standard drink and a bottle definitely exceeds 12 standard drinks. This makes her fetus at significant risk for fetal alcohol syndrome (FAS) which is associated with many congenital malformations. Low-set ears, midfacial hypoplasia, elongated philtrum, upturned nose and microcephaly along with skeletal and cardiac malformations are the congenital malformations commonly associated with fetal alcohol syndrome.

      Health risks of benzodiazepines during pregnancy has not been clearly established, but there are inconsistent reports of teratogenic effects associated with fetal exposure to benzodiazepines. Neonatal abstinence syndrome of delayed onset can be associated with regular use of benzodiazepine in pregnancy.

      Use of Amphetamine in controlled doses during pregnancy is unlikely to pose a substantial teratogenic risk, but a range of obstetric complications such as reduced birth weight and many these outcomes which are not specific to amphetamines but influenced by use of other drug and lifestyle factors in addition to amphetamine are found commonly among women who use it during pregnancy. Exposure to amphetamines in utero may influence prenatal brain development, but the nature of this influence and its potential clinical significance are not well established.

      3,4- methylenedioxymetham phetamine(MOMA), which is an amphetamine derivative and commonly known as ecstasy, have existing evidences suggesting that its use during first trimester poses a potential teratogenic risk. So it is strongly recommended to avoided the use of ecstasy during 2-8 weeks post conception or between weeks four to ten after last menstrual period as these are the considered periods of organogenesis.

      Role of cocaine in congenital malformations is controversial as cases reported of malformations caused by cocaine are extremely rare. However, it may lead to fetal intracranial haemorrhage leading to a devastating outcome.

      Opiate addictions carry a significant risk for several perinatal complications, but it has no proven association with congenital malformation.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 15 - Which one of the following factors will most likely increase the chances of...

    Incorrect

    • Which one of the following factors will most likely increase the chances of ovulation in female?

      Your Answer:

      Correct Answer: LH surge

      Explanation:

      Different changes can occur during the menstrual cycle including an increased body temperature at the time of ovulation, thinning of the cervical mucus and few other changes, but it is the LH surge which is the most important factor necessary for ovulation.
      Mittelschmerz is characterised by recurrent midcycle pain which occurs around the time of ovulation.

    • This question is part of the following fields:

      • Physiology
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  • Question 16 - The UK childhood vaccination schedule includes vaccination against HPV for girls aged 12...

    Incorrect

    • The UK childhood vaccination schedule includes vaccination against HPV for girls aged 12 to 13. What HPV subtypes are vaccinated against with the vaccine Gardasil®?

      Your Answer:

      Correct Answer: 6, 11, 16, and 18

      Explanation:

      HPV Gardasil® is a quadrivalent vaccine against HPV Types 6, 11, 16, and 18. HPV types16 and 18 are responsible for 70% of cases of HPV related cancers. They are considered the most important high risk genotypes of HPV.

    • This question is part of the following fields:

      • Microbiology
      0
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  • Question 17 - A 27-year-old woman presents to her general practitioner because of secondary amenorrhoea since...

    Incorrect

    • A 27-year-old woman presents to her general practitioner because of secondary amenorrhoea since the last 12 months.
      She has a history of primary infertility.
      Of the hormone assays listed in the options, identify the assay that would indicate pregnancy if its result is significantly elevated.

      Your Answer:

      Correct Answer: Serum luteinising hormone {LH).

      Explanation:

      The levels of oestradiol (E2), progesterone, and prolactin (PRL) are all elevated during early pregnancy. However these elevations cannot be solely relied on to determine if pregnancy has occurred since increased levels of these hormones can also occur in pathologic states in non-pregnant women or, in some cases, even during menstrual cycles.

      The levels of follicle stimulating hormone (FSH) are suppressed in pregnancy because of the elevated E2 and progesterone levels.

      The correct answer is elevated levels of luteinising hormone (LH). This is because the beta sub-units of LH and human chorionic gonadotrophin (hCG) are almost identical and therefore, hCG is measured as LH in almost all LH assays (correct answer).

      The LH levels can be slightly raised in polycystic ovarian syndrome; however, it is unlikely that the levels would increase above 30 mIU/mL in this condition.

      The mid-cycle levels of LH can go up to 100-150 mIU/mL. If the levels are more than 200 mlU/mL, it usually indicates pregnancy.

    • This question is part of the following fields:

      • Gynaecology
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  • Question 18 - Ulipristal is thought to prevent pregnancy by what primary mechanism? ...

    Incorrect

    • Ulipristal is thought to prevent pregnancy by what primary mechanism?

      Your Answer:

      Correct Answer: Inhibition of ovulation

      Explanation:

      Ulipristal is a progesterone receptor modulator that is used up to 120 hours following unprotected intercourse. It inhibits ovulation. The dose is 30 mg.

    • This question is part of the following fields:

      • Clinical Management
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  • Question 19 - The typical female breast contains how many lobes? ...

    Incorrect

    • The typical female breast contains how many lobes?

      Your Answer:

      Correct Answer: 15-20

      Explanation:

      The female breast is made of about 15 to 20 individual lobes. The lobules each consists of alveoli which drain into a single lactiferous duct. The ductal system leads to lactiferous sinuses and collecting ducts which expel milk from openings in the nipple.

    • This question is part of the following fields:

      • Anatomy
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  • Question 20 - The median umbilical ligament is a remnant of what structure? ...

    Incorrect

    • The median umbilical ligament is a remnant of what structure?

      Your Answer:

      Correct Answer: Urachus

      Explanation:

      MEDIAL umbilical ligament = remnant fetal umbilical arteries
      MEDIAN umbilical ligament = remnant of urachus

    • This question is part of the following fields:

      • Anatomy
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  • Question 21 - Fentanyl is approximately how many times more potent than morphine? ...

    Incorrect

    • Fentanyl is approximately how many times more potent than morphine?

      Your Answer:

      Correct Answer: 100

      Explanation:

      Both of these drugs belong to opioid analgesics. Fentanyl is more potent than morphine by 80-100 times.

    • This question is part of the following fields:

      • Pharmacology
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  • Question 22 - You are called to see a 24 year old patient in A&E. She...

    Incorrect

    • You are called to see a 24 year old patient in A&E. She is 34 weeks gestation and her blood pressure is 147/96. Automated reagent strip testing shows protein 2+. You send for a protein:creatinine ratio and this shows a ratio of 36 mg/mmol. What is the appropriate course of action?

      Your Answer:

      Correct Answer: Admit for observation

      Explanation:

      It is important to be aware of the difference between management of simple hypertension and pre-eclampsia in pregnancy. A BP of 140/90 to 149/99 mmHg is classed as mild hypertension. Without proteinuria this can be monitored once weekly and the patient can be discharged. If proteinuria is present with any degree of hypertension the patient requires admission and BP should be monitored at least 4 times daily according to NICE guidance.

    • This question is part of the following fields:

      • Clinical Management
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  • Question 23 - A 34-year-old woman, gravida 1 para 1, presented to the emergency department complaining...

    Incorrect

    • A 34-year-old woman, gravida 1 para 1, presented to the emergency department complaining of left breast pain six weeks after a spontaneous, uncomplicated term vaginal delivery. She reported having noticed the pain and redness on her left breast a week ago. From her unaffected breast, she continued to breastfeed her infant.
      Upon history taking, it was noted that she has no chronic medical conditions and for medication, she only takes a daily multivitamin. Her temperature was taken and the result was 38.3 deg C (101 deg F).
      Further observation was done and the presence of an erythematous area surrounding a well-circumscribed, 4-cm area of fluctuance extending from the areola to the lateral edge of the left breast was noted. There was also the presence of axillary lymphadenopathy.
      Which of the following is the next step to best manage the condition of the patient?

      Your Answer:

      Correct Answer: Needle aspiration and antibiotics

      Explanation:

      Breast infections can be associated with superficial skin or an underlying lesion. Breast abscesses are more common in lactating women but do occur in nonlactating women as well.

      The breast contains breast lobules, each of which drains to a lactiferous duct, which in turn empties to the surface of the nipple. There are lactiferous sinuses which are reservoirs for milk during lactation. The lactiferous ducts undergo epidermalization where keratin production may cause the duct to become obstructed, and in turn, can result in abscess formation. Abscesses associated with lactation usually begin with abrasion or tissue at the nipple, providing an entry point for bacteria. The infection often presents in the second postpartum week and is often precipitated in the presence of milk stasis. The most common organism known to cause a breast abscess is S. aureus, but in some cases, Streptococci, and Staphylococcus epidermidis may also be involved.

      The patient will usually provide a history of breast pain, erythema, warmth, and possibly oedema. Patients may provide lactation history. It is important to ask about any history of prior breast infections and the previous treatment. Patients may also complain of fever, nausea, vomiting, purulent drainage from the nipple, or the site of erythema. It is also important to ask about the patient’s medical history, including diabetes. The majority of postpartum mastitis are seen within 6 weeks of while breast-feeding

      The patient will have erythema, induration, warmth, and tenderness to palpation at the site in question on the exam. It may feel like there is a palpable mass or area of fluctuance. There may be purulent discharge at the nipple or site of fluctuance. The patient may also have reactive axillary adenopathy. The patient may have a fever or tachycardia on the exam, although these are less common.

      Incision and drainage are the standard of care for breast abscesses. If the patient is seen in a primary care setting by a provider that is not comfortable in performing these procedures, the patient may be started on antibiotics and referred to a general surgeon for definitive treatment. Needle aspiration may be attempted for abscesses smaller than 3 cm or in lactational abscesses. A course of antibiotics may be given before or following drainage of breast abscesses.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 24 - What is meant by a barr body? ...

    Incorrect

    • What is meant by a barr body?

      Your Answer:

      Correct Answer: It is the condensed non-functioning X chromosome

      Explanation:

      Barr body is an inactive and non functioning X chromosome found in female somatic cells and is presents with a rim around the nucleus

    • This question is part of the following fields:

      • Cell Biology
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  • Question 25 - A 30-year-old female is being investigated for subfertility. At what day of her...

    Incorrect

    • A 30-year-old female is being investigated for subfertility. At what day of her menstrual cycle should blood be collected for progesterone, if she has a regular 28-day menstrual cycle?

      Your Answer:

      Correct Answer: Day 21

      Explanation:

      Maximum levels of progesterone are detected at day 21 of 28 days in the menstrual cycle, assuming that ovulation has occurred at day 14. A value of >30nmol/l indicates an ovulatory cycle.

    • This question is part of the following fields:

      • Gynaecology
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  • Question 26 - A 26 year old patient with a past medical history of 2 terminations...

    Incorrect

    • A 26 year old patient with a past medical history of 2 terminations of pregnancies over the past 2 years, presents to the emergency centre complaining of severe abdominal pain and some vaginal bleeding. She has a regular 28 day cycle, and is on an oral contraceptive pill, but missed last month's period. Her last termination was over 6 months ago. She smokes almost a pack of cigarettes a day.
      Which of the following is the most likely diagnosis?

      Your Answer:

      Correct Answer: Ectopic pregnancy

      Explanation:

      The clinical picture demonstrated is most likely that of a ruptured ectopic pregnancy. The period of amenorrhea may point to pregnancy, while the past medical history of 2 recent terminations of pregnancy may indicate a failure of her current contraceptive method. Smoking cigarettes have been shown to not only decrease the efficacy of OCPs, but also serve as a known risk factor for ectopic pregnancy. The lady is unlikely to have endometritis as her last termination was over 6 months ago. The lack of fever helps to make appendicitis, PID and pyelonephritis less likely, though they are still possible.

    • This question is part of the following fields:

      • Clinical Management
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  • Question 27 - What epithelium cell type lines the endometrium? ...

    Incorrect

    • What epithelium cell type lines the endometrium?

      Your Answer:

      Correct Answer: Columnar

      Explanation:

      The endometrium is lined by columnar epithelium

    • This question is part of the following fields:

      • Pathology
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  • Question 28 - Galactopoiesis is maintained by which hormone? ...

    Incorrect

    • Galactopoiesis is maintained by which hormone?

      Your Answer:

      Correct Answer: Prolactin

      Explanation:

      The production of milk is regulated by the hormone Prolactin. Oxytocin on the other hand is responsible for the let down reflex that occurs during breast feeding.

    • This question is part of the following fields:

      • Clinical Management
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  • Question 29 - Hypemesis gravidarum occurs in what percentage of pregnancies? ...

    Incorrect

    • Hypemesis gravidarum occurs in what percentage of pregnancies?

      Your Answer:

      Correct Answer: 1.50%

      Explanation:

      Nausea and vomiting experienced in 80% of pregnancies Hyperemesis gravidarum (HG) is an extreme form of nausea and vomiting which affects around 1.5% of women. Caused by high levels HCG. Definitions vary but most consider it to be defined by severe nausea and vomiting associated with weight loss greater than 5% of pre-pregnancy weight with metabolic disturbance (typically dehydration and/or ketosis).

    • This question is part of the following fields:

      • Clinical Management
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  • Question 30 - You are asked to see a 26 year old patient following her first...

    Incorrect

    • You are asked to see a 26 year old patient following her first visit to antenatal clinic. She is 9 weeks pregnant and bloods have shown her to be non-immune to Rubella. She is concerned about congenital rubella syndrome (CRS). What is the most appropriate advice to give?

      Your Answer:

      Correct Answer: Advise vaccination after birth regardless of breast feeding status

      Explanation:

      Congenital rubella infection that occurs after 16 weeks gestation does not typically cause fetal abnormalities. This however plays no part in vaccination advice. Rubella vaccine is live and should not be given during pregnancy. The mother should be offered vaccination after giving birth. It is safe for the vaccine (typically given as combined MMR) to be administered if the mother is breastfeeding.

    • This question is part of the following fields:

      • Microbiology
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SESSION STATS - PERFORMANCE PER SPECIALTY

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