-
Question 1
Incorrect
-
Question 2
Incorrect
-
Which of the following will require Anti-D administration post partum?
Your Answer:
Correct Answer: Rhesus negative mother, non-sensitised, fetal cord blood Rh positive
Explanation:Rhesus positive mothers should not get anti-D. They have Rhesus antigens and the anti-D would result in maternal blood being bound and removed from her circulation. The danger is to children born to mothers who are rhesus negative. As the mother may develop antibodies against Rhesus positive fetal blood. Therefore if the baby is Rhesus negative then there is no risk of alloimmunisation (sensitisation)
-
This question is part of the following fields:
- Immunology
-
-
Question 3
Incorrect
-
A young woman came to your clinic seeking help. She has been married for two years and has yet to conceive. The following are the findings of blood tests:
Luteinizing hormone levels are low.
Low levels of follicle stimulating hormone.
Thyroid stimulating hormone (TSH) levels are low.
Prolactin-high.
What is the most effective way to deal with infertility?Your Answer:
Correct Answer: Bromocriptine
Explanation:The most common treatment approach is with the dopamine receptor agonists, bromocriptine, and cabergoline. Bromocriptine normalizes prolactin and decreases tumour size in 80%–90% of patients with microadenomas. Bromocriptine should be given to this patient who has developed hyperprolactinemia anovulation.
Women with hyperprolactinaemic anovulation are treated with dopamine agonists such as bromocriptine.
This patient has also developed symptoms of a low-functioning pituitary gland tumour, which bromocriptine will assist to shrink. Before starting bromocriptine, a head MRI scan should be considered to confirm the suspected diagnosis.Clomiphene is an oestrogen receptor modulator that is selective. It works by competing with oestrogen receptors in the hypothalamus. This disrupts normal negative feedback mechanisms, causing the release of pituitary gonadotropins, particularly LH, to rise, triggering ovulation.
When the levels of gonadotropins and oestrogen are normal but the women still have ovulatory dysfunction, it is successful in inducing ovulation. In hypogonadotropic hypogonadism and hypogonadotropic hypogonadism patients, clomiphene is frequently ineffective. -
This question is part of the following fields:
- Gynaecology
-
-
Question 4
Incorrect
-
Gonadotropin-releasing hormone (GnRH) stimulates the release of:
Your Answer:
Correct Answer: Luteinizing hormone
Explanation:Gonadotropin-releasing hormone (GnRH) is the hormone responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary gland.
-
This question is part of the following fields:
- Endocrinology
-
-
Question 5
Incorrect
-
A 30-year-old G2P1 woman presented to the maternity unit, in labour at 38 weeks gestation. During her previous pregnancy she delivered a healthy baby through caesarean section. The current pregnancy had been uneventful without any remarkable problems in antenatal visits except for the first trimester nausea and vomiting.
On arrival, she had a cervical dilation of 4 cm and the fetal head was at -1 station. After 5 hours, the cervical length and fetal head station are still the same despite regular uterine contractions. Suddenly, there is a sudden gush of blood, which is approximately 1000 ml and the fetal heart rate have dropped to 80 bpm on CTG.
Which of the following could be the most likely cause for this presentation?Your Answer:
Correct Answer: Ruptured uterus
Explanation:Due to the previous history of caesarean section, uterine rupture would be the most likely cause of bleeding in this patient who is at a prolonged active phase of first stage of labour.
Maternal manifestations of uterine rupture are highly variable but some of its common features includes:
– Constant abdominal pain, where the pain may not be present in sufficient amount, character, or location suggestive of uterine rupture and may be masked partially or completely by use of regional analgesia.
– Signs of intra abdominal hemorrhage is a strong indication. Although hemorrhage is common feature, but signs and symptoms of intra-abdominal bleeding in cases of uterine rupture especially in those cases not associated with prior surgery may be subtle.
– Vaginal bleeding is not considered as a cardinal symptom as it may be modest, despite major intra-abdominal hemorrhage.
– Maternal tachycardia and hypotension
– Cessation of uterine contractions
– Loss of station of the fetal presenting part
– Uterine tenderness
As seen in this case, fetal bradycardia is the most common and characteristic clinical manifestation of uterine rupture, preceded by variable or late decelerations, but there is no other fetal heart rate pattern pathognomonic of rupture. Furthermore, fetal heart rate changes alone have a low sensitivity and specificity for diagnosing a case as uterine rupture.
Pain and persistent vaginal bleeding despite the use of uterotonic agents are characteristic for postpartum uterine rupture. If the rupture extends into the bladder hematuria may also occur.
A definite diagnosis of uterine rupture can be made only after laparotomy. Immediate cesarean section should be performed to save both the mother and the baby in cases where uterine rupture is suspected. -
This question is part of the following fields:
- Obstetrics
-
-
Question 6
Incorrect
-
A 25-year-old female presents to a gynaecologist with a complaint of abnormal vaginal bleeding, usually postcoital. On pelvic examination, the cervix of was found to be of an unusually bright red colour and its texture was rougher than normal. Which of the following will you choose as the next step in the management of this condition?
Your Answer:
Correct Answer: Cervical smear (2nd line)
Explanation:Before considering invasive procedures, a cervical smear must first be performed. Antibiotics can only be given when inflammation has been confirmed and culture results have identified the organism causing the inflammation. Endometrial ablation, colposcopy and vaginal US are all invasive procedures that are not relevant in the immediate management of this patient.
-
This question is part of the following fields:
- Gynaecology
-
-
Question 7
Incorrect
-
Question 8
Incorrect
-
Question 9
Incorrect
-
From which germ cell layer does the GI tract initially develop?
Your Answer:
Correct Answer: Endoderm
Explanation:GI Tract initially forms via gastrulation from the endoderm of the trilaminar embryo around week 3. It extends from the buccopharyngeal membrane to the cloacal membrane. Later in development there are contributions from all three germ cell layers.
-
This question is part of the following fields:
- Embryology
-
-
Question 10
Incorrect
-
Bishop scoring is used for:
Your Answer:
Correct Answer: The success rate of induction of the labour
Explanation:The Bishop score is a system used by medical professionals to decide how likely it is that you will go into labour soon. They use it to determine whether they should recommend induction, and how likely it is that an induction will result in a vaginal birth.
-
This question is part of the following fields:
- Obstetrics
-
SESSION STATS - PERFORMANCE PER SPECIALTY
