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Question 1
Incorrect
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When the presenting part of the foetus is at the level of ischial spines, this level is known as?
Your Answer: Station -1
Correct Answer: Station 0
Explanation:Station 0 – This is when the baby’s head is even with the ischial spines. The baby is said to be engaged when the largest part of the head has entered the pelvis.
If the presenting part lies above the ischial spines, the station is reported as a negative number from -1 to -5. -
This question is part of the following fields:
- Obstetrics
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Question 2
Incorrect
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Question 3
Incorrect
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A 25 year old pregnant woman presents with constant abdominal pain, which has been present for the last few hours. Before the pain started she admits experiencing vaginal blood loss. She's a primigravida in her 30th week of gestation. Upon abdominal examination the uterus seems irritable. CTG is, however, reactive. What is the most probable diagnosis?
Your Answer:
Correct Answer: Antepartum haemorrhage
Explanation:Antepartum haemorrhage presents with bleeding, which may or may not be accompanied by pain. Uterine irritability would suggest abruptio, however contractions are present which may be confused with uterine irritability and in this case, there are no signs of pre-eclampsia present.
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This question is part of the following fields:
- Obstetrics
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Question 4
Incorrect
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A 25-year-old Aboriginal woman at ten weeks of gestation presents with a 2-week history of nausea, vomiting and dizziness. She has not seen any doctor during this illness.
On examination, she is found to be dehydrated, her heart rate is 135 per minute (sinus tachycardia), blood pressure 96/60 mm of Hg with a postural drop of more than 20 mm of Hg systolic pressure and is unable to tolerate both liquids and solids.Urine contains ketones and blood tests are pending.
How will you manage this case?Your Answer:
Correct Answer: Give metoclopramide and intravenous normal saline
Explanation:Analysis of presentation shows the patient has developed hyperemesis gravidarum.
She is in early shock, presented as sinus tachycardia and hypotension, with ketonuria and requires immediate fluid resuscitation and anti-emetics. The first line fluid of choice is administration of normal saline 0.9%, and should avoid giving dextrose containing fluids as they can precipitate encephalopathy and worsens hyponatremia.The most appropriate management of a pregnant patient in this situation is administration of metoclopramide as the first line and Ondansetron as second line antiemetic, which are Australian category A and B1 drugs respectively. The following also should be considered and monitored for:
1. More refractory vomiting.
2. Failure to improve.
3. Recurrent hospital admissions.Steroids like prednisolone are third line medications which are used in resistant cases of hyperemesis gravidarum after proper consultation.
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This question is part of the following fields:
- Obstetrics
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Question 5
Incorrect
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Regarding blood volume in pregnancy which of the following statements is TRUE?
Your Answer:
Correct Answer: Blood volume slowly increases by 40-50%
Explanation:Maternal blood volume expands during pregnancy to allow adequate perfusion of vital organs, including the placenta and foetus, and to anticipate blood loss associated with delivery. The rapid expansion of blood volume begins at 6–8 weeks gestation and plateaus at 32–34 weeks gestation. While there is some increase in intracellular water, the most marked expansion occurs in extracellular fluid volume, especially circulating plasma volume. This expanded extracellular fluid volume accounts for between 8 and 10 kg of the average maternal weight gain during pregnancy. Overall, total body water increases from 6.5 to 8.5 L by the end of pregnancy.
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This question is part of the following fields:
- Physiology
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Question 6
Incorrect
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The main support of the uterus is provided by:
Your Answer:
Correct Answer: The cardinal ligament
Explanation:The cardinal ligament (or Mackenrodt’s ligament, lateral or transverse cervical ligament) is a major ligament of the uterus. It is located at the base of the broad ligament of the uterus. It attaches the cervix to the lateral pelvic wall by its attachment to the Obturator fascia of the Obturator internus muscle, and is continuous externally with the fibrous tissue that surrounds the pelvic blood vessels. It thus provides support to the uterus.
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This question is part of the following fields:
- Anatomy
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Question 7
Incorrect
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A 41-year-old G2P1 woman who is at 30 weeks gestational age presented to the medical clinic for a routine OB visit. Upon history taking, it was noted that her first pregnancy was uncomplicated and was delivered 10 years ago. At 40 weeks then, she had a normal vaginal delivery and the baby weighed 3.17kg.
In her current pregnancy, she has no complications and no significant medical history. She is a non-smoker and has gained about 11.3 kg to date. She also declined any testing for Down syndrome even if she is of advanced maternal age.
Upon further examination and observation, the following are her results:
Blood pressure range has been 100 to 120/60 to 70.
Fundal height measures only 25 cm.
Which of the following is most likely the reason for the patient’s decreased fundal height?Your Answer:
Correct Answer: Fetal growth restriction
Explanation:A fundal height measurement is typically done to determine if a baby is small for its gestational age. The measurement is generally defined as the distance in centimetres from the pubic bone to the top of the uterus. The expectation is that after week 24 of pregnancy the fundal height for a normally growing baby will match the number of weeks of pregnancy — plus or minus 2 centimetres.
A fundal height that measures smaller or larger than expected — or increases more or less quickly than expected — could indicate:
– Slow fetal growth (intrauterine growth restriction)
– A multiple pregnancy
– A significantly larger than average baby (fetal macrosomia)
– Too little amniotic fluid (oligohydramnios)
– Too much amniotic fluid (polyhydramnios). -
This question is part of the following fields:
- Obstetrics
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Question 8
Incorrect
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Regarding amniotic fluid volume:
Your Answer:
Correct Answer: Maybe predicted by ultrasound
Explanation:Amniotic fluid can be measured with the help of ultrasound to gauge the amniotic fluid index. The normal value ranges between 8-18.
Amniocentesis is a procedure by which amniotic fluid is removed. In rhesus disease, it appears yellow due to raised bilirubin levels. -
This question is part of the following fields:
- Physiology
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Question 9
Incorrect
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A 28-year-old lady is complaining of mucopurulent vaginal discharge. On examination, copious amounts of thick mucoid material is found to be draining out of a large cervical erosion. She has had regular pap smears since 16 years of age, which have all been normal. Her last smear was done 4 months prior.
What is the best next step in her management?Your Answer:
Correct Answer: Cauterisation of the cervix.
Explanation:The best next step in management would be to remove the cervical ectropion using cautery. This would usually be performed under anaesthesia. It can take up to a month to heal following the procedure. Vaginal pessaries and antibiotics are typically not effective.
Indications for a cone biopsy include an abnormal pap smear, lesion suspected to be a CIN on colposcopic examination that cannot be fully visualised as well if there is a histological discrepancy between the smear and biopsy. Colposcopic examination is also unnecessary at this stage since she has not complained of any abnormal per vaginal bleed nor is her last pap smear abnormal.
Since the discharge is now affecting the patient’s life, treatment should be given so reassuring her that no treatment is needed is not appropriate.
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This question is part of the following fields:
- Gynaecology
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Question 10
Incorrect
SESSION STATS - PERFORMANCE PER SPECIALTY
