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Question 1
Incorrect
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A 23-year-old woman complains of a tender lump that is smooth and mobile in her left breast measuring 1-2 cm. What is the most likely diagnosis?
Your Answer: Fibroadenoma
Correct Answer:
Explanation:Fibroadenoma usually occurs in younger women. These non-tender masses can be removed for aesthetic purposes. Breast cysts are common shifting masses inside the breast tissue more common in women over the age of 35.
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This question is part of the following fields:
- Gynaecology
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Question 2
Incorrect
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A 47 year old women has a transvaginal ultrasound that shows a partially echogenic mass with posterior sound attenuation owing to sebaceous material and hair within the cyst cavity. What is the likely diagnosis?
Your Answer:
Correct Answer: Mature teratoma
Explanation:These are the most common ovarian tumours in young women. The most common form is the mature dermoid cyst (cystic teratoma). It can consist of a combination of all the type of tissues (mesenchymal, stromal and epithelial). Any mature tissue type can be present such as muscle, cartilage, bone, teeth and often hair. Treatment is cystectomy.
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This question is part of the following fields:
- Data Interpretation
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Question 3
Incorrect
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What kind of epithelium lines the endocervix?
Your Answer:
Correct Answer: Columnar
Explanation:Its important to note the endo and ectocervix have 2 epithelial types. Where columnar and squamous epithelia meet is the transformation zone (or squamous-columnar junction, SCJ). This is relevant as it is the primary site for dysplasia and is where smears are taken from.
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This question is part of the following fields:
- Pathology
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Question 4
Incorrect
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At the 18th week of her pregnancy, a 32-year-old woman presents with a fishy-smelling, thin, white homogeneous, and offensive vaginal discharge. Under light microscopy, a sample of the discharge contains clue cells.
Which of the following assertions about this condition is correct?Your Answer:
Correct Answer: There is a relapse rate of over 50% in 6 months
Explanation:Reported cure rates for an episode of acute BV vary but have been estimated to be between 70% and 80%. Unfortunately, more than 50% of BV cases will recur at least once within the following 12 months. Because the aetiology of BV is still not entirely understood, identifying the cause of recurrent cases is challenging. Reinfection may play a role in explaining recurrent BV, but
treatment failure is a more likely contributor. There are several theories that try to explain recurrence and persistent symptoms. The existence of a biofilm in the vagina is one such theory and is the subject of ongoing research. Biofilms occur when microorganisms adhere to surfaces. G vaginalis, one of the primary organismsBV is not a sexually transmitted infection. The antibiotic of choice to treat BV is Metronidazole. Reassurance is not acceptable as a means of treatment.
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This question is part of the following fields:
- Gynaecology
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Question 5
Incorrect
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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:When it comes to questions on venous drainage the ovarian vein is likely to be a common question given its varied drainage depending on laterality. The right ovarian vein travels through the suspensory ligament of the ovary and generally joins the inferior vena cava whereas the left ovarian vein drains into the left renal vein.
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This question is part of the following fields:
- Anatomy
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Question 6
Incorrect
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Spinnbarkheit is a term which means:
Your Answer:
Correct Answer: Threading of the cervical mucous
Explanation:Spinnability (or Spinnbarkeit), which measures the capacity of fluids to be drawn into threads, represents an indirect measurement of the adhesive and elastic properties of mucus.
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This question is part of the following fields:
- Physiology
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Question 7
Incorrect
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A 22-year-old primigravid woman present to the emergency department.
She is at 40 weeks gestation and complains of a 24-hour history of no fetal movements.
On auscultation, fetal heart beats are clearly audible with a measurement of 140/min.
On diagnostic testing, the cardiotocograph (CTG) is normal and reactive.
On physical examination, her cervix is 2cm dilated and fully effaced.
She is reassured and allowed to return home.
24 hours later, she calls to complain she has still felt no fetal movements, adding up to a 48 hour history.
What is the best next step in management?Your Answer:
Correct Answer: Admit for induction of labour.
Explanation:Labour induction is indicated as no fetal movements have been felt for 24 hours, with a normal cardiotocograph (CTG) and the pregnancy is at near/full term with a favourable cervix.
Amniotic fluid volume assessment would have been indicated 24 hours earlier as, if it was low, induction would have been indicated then, despite a normal CTG.
Ultrasound examination of the foetus is not indicated as it is necessary to expedite delivery.
Carrying out another CTG, with or without oxytocin challenge, is not indicated, although MG monitoring during induced labour would be mandatory.
Delivery immediately by Caesarean section is not indicated unless the lack of fetal movements is due to fetal hypoxia. This can result in fetal distress during labour, necessitating an emergency Caesarean section if the cervix is not fully dilated.
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This question is part of the following fields:
- Obstetrics
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Question 8
Incorrect
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Haemolytic Disease of the New-born falls into what type of hypersensitivity reaction?
Your Answer:
Correct Answer: Type II
Explanation:It is classified under type II hypersensitivity reaction. Antibodies are formed against the rhesus antigen i.e. D antigen. Hence when the Antibody reacts with the antigen on the RBC it results in activation of the complement cascade leading to lysis.
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This question is part of the following fields:
- Immunology
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Question 9
Incorrect
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Which one of the following has the most significant effect on slowing drug metabolism in pregnancy?
Your Answer:
Correct Answer: Progesterone effect on gastric motility
Explanation:Progesterone down regulates gastric motility meaning drugs are absorbed and metabolised more slowly, thus drugs are absorbed, metabolised and cleared more slowly. Most of the drugs are transported after binding to the albumin.
Lower albumin levels mean a greater unbound drug fraction but as this may be thought to increase drug concentrations it actually leaves more available for hepatic clearance or renal excretion so overall drug concentrations are unchanged and metabolism increased.
Increase in hepatic flow will increase the metabolism of the drug as the drug will be transported faster.
Increased renal blood flow will result in the faster clearance of the drug from the body. -
This question is part of the following fields:
- Clinical Management
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Question 10
Incorrect
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A 10 day old infant present with signs of disseminated Herpes Simplex Virus (HSV) infection. Her mother had her first episode of HSV three weeks prior to delivery. The infant was treated with antivirals upon clinical suspicion. What is the case fatality rate of infants who develop disseminated HSV despite treatment?
Your Answer:
Correct Answer: 30%
Explanation:Congenital Herpes Simplex Virus infection may cause high levels of morbidity and mortality in neonates. Risk of infection with HSV 1 and 2 is highest within 6 weeks of delivery and is transferred to the neonate via maternal secretions at birth. Affected babies can present as skin manifestations, CNS infection, or disseminated infection, which carries an 85% risk of mortality if left untreated. Treatment with high dose antivirals such as acyclovir can help decrease the case mortality rate to 30% in cases of disseminated infection.
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This question is part of the following fields:
- Microbiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
