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  • Question 1 - The broad ligament contains which of the following structures? ...

    Incorrect

    • The broad ligament contains which of the following structures?

      Your Answer: Cardinal ligament

      Correct Answer: Uterine artery

      Explanation:

      The contents of the broad ligament:
      Fallopian tubes
      Ovarian artery
      Uterine artery
      Ovarian ligament
      Round ligament of uterus

    • This question is part of the following fields:

      • Anatomy
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      Seconds
  • Question 2 - A 30 year old women who is 24 weeks pregnant attends EPU due...

    Incorrect

    • A 30 year old women who is 24 weeks pregnant attends EPU due to suprapubic pain. Ultrasound shows a viable foetus and also a fibroid with a cystic fluid filled centre. What is the likely diagnosis?

      Your Answer:

      Correct Answer: Red degeneration of fibroid

      Explanation:

      Red degeneration of fibroids is one of 4 methods of fibroid degeneration. Although uncommon outside pregnancy it is thought to be the most common form of fibroid degeneration during pregnancy and typically occurs in the 2nd trimester. It is thought to arise from the fibroid outgrowing its blood supply and haemorrhagic infarction occurs. Ultrasound will typically show a localised fluid collection (blood) within the fibroid.

    • This question is part of the following fields:

      • Clinical Management
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  • Question 3 - Regarding monozygotic twins, all of the following are correct, EXCEPT: ...

    Incorrect

    • Regarding monozygotic twins, all of the following are correct, EXCEPT:

      Your Answer:

      Correct Answer: Has a constant incidence 1:600 births

      Explanation:

      The incidence of monozygotic twins is constant worldwide (approximately 4 per 1000 births). Approximately two thirds of twins are dizygotic.

    • This question is part of the following fields:

      • Genetics
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  • Question 4 - Fetal distress commonly occurs when the head is in the occipito-posterior (OP) position...

    Incorrect

    • Fetal distress commonly occurs when the head is in the occipito-posterior (OP) position during labour. Which of the following statements is the most probable explanation for this?

      Your Answer:

      Correct Answer: Incoordinate uterine action.

      Explanation:

      Incoordinate uterine action almost always results in fetal distress due to increased resting intrauterine pressure. All other statements can also cause fetal distress, however, these are not as common as incoordinate uterine action. Syntocin infusion for labour augmentation and administration of epidural anaesthetic for pain relief can also increase the risk of fetal distress.
      Cardiotocograph (CTG) monitoring during labour is highly recommended in patients where the fetal head is found in the OP position. Moreover, it is mandatory when there is Syntocin infusion or epidural anaesthesia.

    • This question is part of the following fields:

      • Obstetrics
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  • Question 5 - A 16 week pregnant patient presents to the antenatal clinic. Protein values of...

    Incorrect

    • A 16 week pregnant patient presents to the antenatal clinic. Protein values of ++ are found on urinalysis. Significant proteinuria is indicated in which of the following protein:creatinine values?

      Your Answer:

      Correct Answer: 30 mg/mmol

      Explanation:

      Proteinuria of more than 1+ on dipstick should be investigated to quantify the amount of proteinuria. A protein: creatinine ratio can be used to determine the severity of proteinuria, where levels of more than 30 mg/mmol indicate significant proteinuria.

    • This question is part of the following fields:

      • Data Interpretation
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  • Question 6 - A patient undergoes oophorectomy and the ovarian veins are ligated. Which vein does...

    Incorrect

    • A patient undergoes oophorectomy and the ovarian veins are ligated. Which vein does the left ovary drain into?

      Your Answer:

      Correct Answer: Left renal

      Explanation:

      The right ovarian vein ascends and enters the inferior vena cava and the left ovarian vein drains into the longer left renal vein.

    • This question is part of the following fields:

      • Anatomy
      0
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  • Question 7 - A 27 year old patient is maintained on warfarin during pregnancy due to...

    Incorrect

    • A 27 year old patient is maintained on warfarin during pregnancy due to a mechanical mitral valve. She has read about warfarin embryopathy. Which of the following is a typical feature?

      Your Answer:

      Correct Answer: Stippled epiphyses

      Explanation:

      Warfarin is teratogenic if it is used in the first trimester. It causes bone defects and haemorrhages in the developing foetus. It causes the formation of multiple ossification centres in the long bones. Resulting in stippled epiphyses and hence deform long bones.

    • This question is part of the following fields:

      • Pharmacology
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  • Question 8 - A young patient presented with foul smelling greyish vaginal discharge. She also has...

    Incorrect

    • A young patient presented with foul smelling greyish vaginal discharge. She also has burning and itching. She is sexually active.
      What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Gardnerella vaginalis

      Explanation:

      Bacterial vaginosis (BV) is a clinical condition characterized by a shift in vaginal flora away from Lactobacillus species toward more diverse bacterial species, including facultative anaerobes. The altered microbiome causes a rise in vaginal pH and symptoms that range from none to very bothersome. Future health implications of BV include, but are not limited to, increased susceptibility to other sexually transmitted infections and preterm birth. Fifty to 75 percent of women with BV are asymptomatic. Symptomatic women typically present with vaginal discharge and/or vaginal odour. The discharge is off-white, thin, and homogeneous; the odour is an unpleasant fishy smell that may be more noticeable after sexual intercourse and during menses.

    • This question is part of the following fields:

      • Gynaecology
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  • Question 9 - At the time of delivery, if there is a laceration of perineal body...

    Incorrect

    • At the time of delivery, if there is a laceration of perineal body but not the anal sphincter, this type of laceration is classified as?

      Your Answer:

      Correct Answer: Second degree

      Explanation:

      Perineal tears are common at the time of child birth. First degree perineal laceration means that the wound is so small that it doesn’t require any stitches and usually heals on its own. 2nd degree means that skin and smooth muscles are both torn. 3rd degree tear means that the tear is beyond the perineal muscles and the muscles surrounding the anal canal, while in 4th degree, the perineal tear goes through the anal sphincter up to the rectum.

    • This question is part of the following fields:

      • Anatomy
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  • Question 10 - 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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