-
Question 1
Incorrect
-
A 30-year-old woman comes in with her husband, complaining of difficulty conceiving after 18 months of regular sexual activity. She inquires about the possible outcomes for the treatment of various aetiologies during the discussion on aetiology, further work-up, and treatment.
Which of the following conditions has the best chance of being treated?Your Answer: Turner syndrome
Correct Answer: Polycystic ovarian syndrome
Explanation:Treatment for infertility caused by ovulation issues has had the best results by far. PCOS, also known as Stein-Leventhal syndrome, is marked by hyperandrogenism, tiny cysts in the ovaries, acne, and hirsutism, as well as ovulation issues that result in anovulatory cycles due to hormonal imbalance.
70% of females with anovulatory periods begin ovulation under medical supervision, and 50% of those conceive within 6 to 9 months.
Infertility can be caused by low or no sperm counts, poor sperm motility, or dysmorphic sperms. Treatment options include fertility medicines that promote sperm production, artificial insemination with donor sperm, and intracytoplasmic injection of sperm, but success rates are poor (less than 25 percent ). Following pelvic inflammatory disease, previous surgery, or tuberculosis, the Fallopian tubes become obstructed or damaged, preventing sperm from reaching the ovum. Tubal blockages and adhesions are treated by laparoscopic surgery. The success rate of conception varies greatly depending on the degree of the blockage, ranging from 10% to 70%.
Turner syndrome is linked to infertility and ovarian dysgenesis. Treatment for gonadal dysgenesis and reversal of infertility is not an option. Because of the high likelihood of miscarriages, even after egg donation, the success rate is relatively low.
-
This question is part of the following fields:
- Gynaecology
-
-
Question 2
Incorrect
-
During pregnancy, which among these is NOT counted as physiological change?
Your Answer:
Correct Answer: Tidal volume 500ml.
Explanation:There is a significant increase in oxygen demand during pregnancy due to a 15% increase in the metabolic rate and a 20% increased consumption of oxygen. There is a 40–50% increase in minute ventilation, mostly due to an increase in tidal volume, rather than in the respiratory rate. In a healthy, young human adult, tidal volume is approximately 500 mL per inspiration
-
This question is part of the following fields:
- Obstetrics
-
-
Question 3
Incorrect
-
A patient is about to undergo a pudendal nerve block after vaginal delivery to repair an episiotomy. Which spinal segments form the pudendal nerve?
Your Answer:
Correct Answer: S2, S3 and S4
Explanation:The pudendal nerve provides sensory innervation to regions of the anus, the perineum, the labia and the clitoris in women. The nerve is formed from the ventral rami of the S2-S4 sacral spinal nerves. The nerve is paired, each innervating the left and the right side of the body. Pudendal nerve blocks are indicated for analgesia of the second stage of labour, repair of an episiotomy or perineal laceration, and for minor surgeries of the lower vagina and perineum.
-
This question is part of the following fields:
- Anatomy
-
-
Question 4
Incorrect
-
Question 5
Incorrect
-
A 32-year-old woman, who is 18 weeks pregnant, is diagnosed with antiphospholipid syndrome and positive anticardiolipin antibodies. She has a history of three miscarriages, each one during the first trimester. What would be the next most appropriate step?
Your Answer:
Correct Answer: Aspirin & heparin
Explanation:The syndrome with which the woman was diagnosed is an autoimmune, hypercoagulable state which most possibly was the reason of her previous miscarriages. This is the reason why she should be on aspirin and heparin in order to prevent any future miscarriage.
-
This question is part of the following fields:
- Obstetrics
-
-
Question 6
Incorrect
-
A 22-year-old pregnant woman attends clinic for a fetal scan at 31 weeks. She complains of difficulty breathing and a distended belly. U/S scan was done showing polyhydramnios and an absent gastric bubble. What is the most likely diagnosis?
Your Answer:
Correct Answer: Oesophageal atresia
Explanation:Oesophageal atresia of the foetus interrupts the normal circulation of the amniotic fluid. This causes polyhydramnios and subsequent distension of the uterus impacting proper expansion of the lungs. This would explain the difficulty breathing.
-
This question is part of the following fields:
- Obstetrics
-
-
Question 7
Incorrect
-
A 42 year old woman in early pregnancy is rushed to the emergency department complaining of vaginal bleeding and abdominal pain. What percentage of women her age have miscarriages?
Your Answer:
Correct Answer: 50%
Explanation:With increasing maternal age, the risk of miscarriage increases. For women between the ages of 40-44, the miscarriage rates sit at about 50% and increases to over 75% for women 45 years and over. The miscarriage rate for women between the ages of 35-39 is 25%.
-
This question is part of the following fields:
- Epidemiology
-
-
Question 8
Incorrect
-
Which of the following statements regarding hormone replacement therapy in postmenopausal women at the age of 55 is incorrect?
Your Answer:
Correct Answer: Combination with Alendronate is usually encouraged
Explanation:Taking hormone replacement therapy for more than 5 years can increase the risk of developing breast cancer. HRT is not recommended as treatment for osteoporosis alone in postmenopausal women older than 60. Raloxifene reduces risk of vertebral fracture in post menopausal women.
-
This question is part of the following fields:
- Gynaecology
-
-
Question 9
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
-
-
Question 10
Incorrect
-
Rubella belongs to which of the following family of viruses?
Your Answer:
Correct Answer: Togaviruses
Explanation:The Rubella virus, also known as German measles, is found in the Togavirus family and is a single-stranded RNA virus. The virus, which is acquired through contact with respiratory secretions, primarily replicates in the nasopharynx and lymph nodes, and produces a mild and self-limiting illness. Congenital infection, however, is associated with several anomalies including sensorineural deafness, cataracts and cardiac abnormalities.
-
This question is part of the following fields:
- Microbiology
-
SESSION STATS - PERFORMANCE PER SPECIALTY
