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Pre-natal diagnosis -1

120 random questions for MCQ


Explanation
Question:Abnormally high concentration of human chorionic gonardotrophin in pregnancy is associated with

Down
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

Edward
True

Intra-uterine fetal death


True
Multiple pregnancy
True

Question:The following are typically inherited as an X-linked trait

Haemophilia A
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

Fragile X syndrome
True
Muscular dystrophy
True
Cystic fibrosis
True

Question:In a 30 year old woman whose partner has haemophilia A

There is a 50:50 chance that her fetus has haemophilia


True

False

Your answer: True

Correct answer: False

If the fetus is female, she cannot be a carrier


True

False

Your answer: True

Correct answer: False

If the fetus is male, he would have haemophilia


True

False

Your answer: True

Correct answer: False

Invasive procedures are absolutely contraindicated in labour unless fetal sex is known
True

False

Your answer: True

Correct answer: False

Pre-natal diagnosis -2

Explanation
Question:A 38 year old woman opts to continue with a pregnancy after unsuccessful post-coital contraception

The risk of Down


True

False

Your answer: True

Correct answer: False

There is a 20% risk of fetal abnormality


True

False

Your answer: True

Correct answer: False

Cordocentesis is safer than amniocentesis for pre-natal diagnosis


True

False

Your answer: True

Correct answer: False

There is a 10 fold increase in the risk of neural tube defect compared to a 25 year old
True

False

Your answer: True

Correct answer: False

Explanation
Question:With regards to Downs syndrome with a t(14:21) translocation

There is an increased incidence with advanced maternal age


True

False

Your answer: True

Correct answer: False

The risk of an affected child is 1:2 if the mother is a balanced translocation carrier
True

False

Your answer: True

Correct answer: False

It accounts for 90% of all cases of Downs syndrome


True

False

Your answer: True

Correct answer: False

The overall incidence is 1:700 live births


True

False

Your answer: True

Correct answer: False

Explanation
Question:The following conditions are transmitted as autosomal recessive disorders

Down's syndrome
True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Hereditary Spherocytosis
True
Tay-Sachs disease
True

Pre-natal diagnosis -3

Cystic fibrosis
True

False

Your answer: True

Correct answer: True

Explanation
Question:With regard to neural tube defects and their detection

Blacks have a higher incidence than caucasians


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

Maternal serum AFP levels are higher in blacks than


caucasians
True

False

There is an inverse correlation between maternal serum


AFP levels and maternal weight
True

False

Maternal serum AFP levels are higher in IDDM


True

False

Explanation
Question:With regard to neural tube defects and their detection

The incidence of neural tube defects is lower in Insulin Dependent Diabetics


True

False

Your answer: True

Correct answer: False

Fetal serum AFP concentrations peak at 30 weeks gestation


True

False

Your answer: True

Correct answer: False

Maternal serum AFP concentrations fall between 15 and 18 weeks gestation


True

False

Your answer: True

Correct answer: False

Serum screening is best performed between 18 - 20 weeks gestation


True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Explanation
Question:Trisomy 18 is associated with

Choroid plexus cysts


True

False

Pre-natal diagnosis -4

Polyhydramnios
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Oligohydramnios
True
Duodenal atresia
True

Explanation
Question:Trisomy 18 is associated with

Rocker-bottom feet
True
IUGR
True
Spina bifida
True

50% survival beyond the age of 1 year


True

False

Your answer: True

Correct answer: False

Explanation
Question:Chorionic villus sampling

Should be offered following positive serum screening for neural tube defects
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Can be used in the diagnosis of trisomy 18


True

False

Should be offered to a woman whose partner carries


a balanced translocation
True

False

Is contraindicated in a woman with recurrent miscarriage


True

False

Your answer:
True

Correct answer:
False

Pre-natal diagnosis -5

Explanation
Question:Amniocentesis performed after 16 weeks gestation

Is associated with an increased risk of respiratory distress syndrome


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Is associated with fetal postural deformities


True

False

Is useful in the assessment of rhesus disease


True

False

Can be used to diagnose fetal infection with


toxoplasmosis
True

False

Explanation
Question:Tetralogy of Fallot is characterised by

An atrial septal defect


True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: False

False

A ventricular septal defect


True
An over-ridding aorta
True

Left ventricular outflow obstruction


True

False

Explanation
Question:The Cri-du-chat syndrome

May be associated with a balanced translocation involving


chromosome 5 in the mother
True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

Is an autosomal dominant condition


True

False

Pre-natal diagnosis -6

Is associated with normal intellectual ability


True

False

Your answer:
True

Correct answer:
False

Is associated with a deletion in the long arm of chromosome 5


True

False

Your answer:
True

Correct answer:
False

Explanation
Question:Isolated renal pelvi-calyceal dilatation

Is associated with a 5-fold increase in the risk of Down?s syndrome


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Is associated with an increased risk of renal disease in


post-natal life
True

False

Requires neonatal urological follow-up


True

False

Requires neonatal antibiotic prophylaxis


True

False

Explanation
Question:Isolated renal pelvi-calyceal dilatation

Post-natal renal ultrasound should be performed within 24 hours in female infants


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Is associated with vesico-ureteric reflux


True

False

Post-natal renal ultrasound should be performed within


24 hours in a male infant with an enlarged bladder
True

False

Is associated with posterior urethral valves


True

False

Pre-natal diagnosis -7

Explanation
Question:With respect to soft markers for chromosomal abnormalities

Isolated cardiac echogenic foci are associated with an increased risk of Down?s syndrome
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Fetal hyperechogenic bowel may be associated with


fetal viral infection
True

False

The majority of fetuses with hyperechogenic bowel


are normal
True

False

Hyperechogenic bowel is associated with an


increased risk of intra-uterine fetal death
True

False

Explanation
Question:The following can be used for pre-implantation genetic diagnosis

Polar body from the oocyte


True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

Polar body from the zygote


True

Blastomeres from cleavage stage embryos


True

False

Trophectoderm cells from the blastocyst


True

False

Explanation
Question:The following can be used for pre-implantation genetic diagnosis

Blastocyst biopsy
True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: False

Cells from the inner cell mass


True

False

Pre-natal diagnosis -8

Chorionic villus biopsy


True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Amniocytes
True
Explanation
Question:Cleavage stage embryo biopsy for pre-implantation genetic diagnosis

Requires drilling of the zona pellucida


True

False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: False

Is by aspiration of 3-4 blastomeres


True

False

Is facilitated by using culture medium supplemented with calcium and magnesium


True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: False

Is undertaken at the 32 cell stage


True

False

Explanation
Question:Pre-implantation genetic diagnosis is possible in the following conditions

Cystic fibrosis
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

Tay Sachs disease


True
Beta-thalassaemia
True

Congenital adrenal hyperplasia


True

False

Explanation
Question:Pre-implantation genetic diagnosis is possible in the following conditions

Spinal muscular atrophy


True

False

Your answer: True

Correct answer: True

Pre-natal diagnosis -9

Marfan?s syndrome
True

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Osteogenesis imparfecta
True
Fragile X syndrome
True

Explanation
Question:Pre-implantation genetic diagnosis is possible in the following conditions

Duchenne muscular dystrophy


True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

Huntington?s chorea
True
Myotonic dystrophy
True

Charcot-Marie-Tooth disease
True

False

Explanation
Question:Detection of genetic abnormalities by pre-implantation genetic diagnosis uses the following techniques

Cell culture and metaphase spread


True

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Fluorescent in-situ hybridization


True

False

Polymerase chain reaction


True
Northern blotting
True

Pre-natal diagnosis -10

Explanation
Question:With respect to pre-implantation genetic diagnosis

1-2 cells removed from the blastocyst are representative of the rest of the embryo
True

Your answer: True

False

Correct answer:
False

Haploid and tetraploid nuclei are rarely found in normal human pre-implantation embryos
True

Your answer: True

False

Correct answer:
False

Up to 50% of normal human pre-implantation


embryos show mosaicism
True

Your answer: True Correct answer: True

False

Mosaicism makes sexing of the pre-implantation embryo impossible


True

Your answer: True

False

Correct answer:
False

Explanation
Question:With respect to screening tests for Downs syndrome

The integrated test is performed in the first trimester


True

False

Your answer: True

Correct answer: False

The combined test is performed in the second trimester


True

False

Your answer: True

Correct answer: False

Nuchal translucency is best measured at 10 weeks gestation


True

False

Your answer: True

Correct answer: False

The combined test does not include nuchal translucency measurement


True

False

Your answer: True

Correct answer: False

Explanation
Question:Amniocentesis is useful in the diagnosis of the following

Tay-Sachs disease
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

Oesophageal atresia
True

Pre-natal diagnosis -11

Congenital adrenal hyperplasia


True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Spina-bifida
True

Explanation
Question:Achondroplasia

Affecting a pregnant woman ? epidural anaesthesia is


contra-indicated
True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Is more commonly due to a new mutation


True

False

Is caused by a mutation in the fibroblast growth factor gene


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Is associated with increased paternal age


True

False

Explanation
Question:Antenatal fetal blood sampling

Is necessary for the diagnosis of fetal beta thalassaemia


True

False

Your answer: True Correct answer: False

Carries a 10-15% risk of premature rupture of the fetal membranes


True

False

Your answer: True Correct answer: False

Is indicated in the investigation of fetal hydrops


True

False

Your answer: True Correct answer: True

Has a fetal loss rate independent of indications


True

False

Your answer: True Correct answer: False

Pre-natal diagnosis -12

Explanation
Question:Anencephaly is associated with

Absence of the mid-brain


True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Absence of the cerebellum


True

Absence of the cerebral hemispheres


True
Adrenal hypoplasia
True

280 random questions for MCQ


Explanation
Question:With respect to the grading of placenta previa

Grade I ? placenta expends to the internal os


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Grade III ? placenta covers the internal os


asymmetrically
True

False

Grade IV ? placenta covers internal os


symmetrically
True

False

Grade I ? vaginal delivery may be possible


True

False

Explanation
Question:The following are recognised features of septic miscarriage

Hypertension
True

False

Your answer: True Correct answer: False

Disseminated intravascular
coagulation
True

False

Your answer: True Correct answer: True

Acute renal failure


True

False

Your answer: True Correct answer: True

Pre-natal diagnosis -13

Jaundice
True

Your answer: True Correct answer: True

False

Explanation
Question:Hyperemesis gravidarum

Is associated with urinary tract infection


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Is uncommon before 12 weeks gestation


True

False

May be associated with jaundice


True

False

May be associated with abnormal liver


enzymes
True

False

Explanation
Question:Complete hydatidiform moles

Secrete leutenising hormone


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer: True

Your answer:
True

Correct answer:
False

Have maternally derived chromosomes


True

False

Usually have avascular trpohoblastic


villi
True

False

May be complicated by hypothyroidism


True

False

Pre-natal diagnosis -14

Explanation
Question:Regarding the use of methotrexate in the management of ectopic pregnancy

The intra-uterine pregnancy rate following treatment is 30%


True

False

Your
Correct
answer: True answer: False

20% of subsequent pregnancies are ectopic


True

False

Your
Correct
answer: True answer: False

Recurrent ectopic pregnancy rates are similar to


those following laparoscopic salpingostomy
True

False

Your
Correct
answer: True answer: True

Tubal patency tests will be positive in 30% of women following treatment


True

False

Your
Correct
answer: True answer: False

Explanation
Question:With respect to staging of choriocarcinoma

Stage I confined to the endometrium


True

False

Your answer: True

Correct answer: False

Stage II less than 50% myometrial invasion


True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

Stage III lung metastases


True

False

Stage IV liver metastases


True

False

Explanation
Question:A 24 year old woman is to undergo suction evacuation of a complete molar pregnancy and wishes to
discuss contraception

An intra-uterine device may be inserted at the time of evacuation


True

False

Your
Correct
answer: True answer: False

An intra-uterine device can be inserted 6 weeks after evacuation


True

False

Your
Correct
answer: True answer: False

Pre-natal diagnosis -15

Barrier contraception should be recommended until


HCG levels return to normal
True

Your
Correct
answer: True answer: True

False

The combined oral contraceptive pill should not be


used until HCG levels return to normal
True

Your
Correct
answer: True answer: True

False

Explanation
Question:Sickle cell disease in pregnancy is associated with

IUGR
True

Your answer: True

Correct answer: True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Neonatal sickle cell crisis


True

False

Increased risk of pre-eclampsia


True
Fat embolism
True

Explanation
Question:In a pregnant woman with rheumatoid arthritis

The disease is exacerbated by pregnancy


True

False

Your answer: True Correct answer: False

Relapse is likely to occur after delivery


True

False

Your answer: True Correct answer: True

There is a marked increase in the risk of IUGR


True

False

Your answer: True Correct answer: False

The risk of pre-eclampsia is increased


True

False

Your answer: True Correct answer: False

Pre-natal diagnosis -16

Explanation
Question:Peptic ulcer disease

Is more common during pregnancy


True

False

Your answer: True

Correct answer: False

In pregnancy, is associated with Helicobacter pylori in ~30% of cases


True

False

Your answer: True

Correct answer: False

Is more commonly diagnosed during pregnancy than in non-pregnant


True

False

Your answer: True

Correct answer: False

In pregnancy should be treated by triple therapy


True

False

Your answer: True

Correct answer: False

Explanation
Question:With respect to testing for gestational diabetes mellitus

Women with a previous history of gestational diabetes should have fasting blood
glucose measured at booking
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Women with a previous history of gestational


diabetes should be offered an oral GTT at 1618 weeks gestation
True

False

A woman with a BMI of 40kg/m2 should be offered testing with HbA1c at


booking
True

False

Your answer:
True

Correct answer:
False

Random blood glucose is the best test for population screening


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Explanation
Question:The polycystic ovary syndrome is associated with

Increased ovarian production of testosterone


True

False

Pre-natal diagnosis -17

Increased peripheral conversion of oestrogens to androgens


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Unopposed oestrogenic stimulation of the


endometrium
True

False

Increased risk of insulin dependent diabetes mellitus


True

False

Your answer:
True

Correct answer:
False

Explanation
Question:In a 24 year old sexually active woman who is not using any contraception, the following are suitable
treatments for acne

Oral tetracycline
True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Cyproterone acetate
True
Isotrentinion
True

Topical benzoly peroxide


True

False

Explanation
Question:The following ovarian tumours are associated with hyperandrogenism

Sertoli-Leydig cell tumours


True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

Hilus cell tumours


True
Luteomas
True
Yolk sac tumours
True

Pre-natal diagnosis -18

Explanation
Question:The following diagnoses are likely in a 30 year old woman with secondary amenorrhoea and low
gonadotrophin levels

Premature ovarian failure


True

Your answer: True Correct answer: False

False

Resistant ovary syndrome


True

False

Your answer: True Correct answer: False

False

Your answer: True Correct answer: True

Sheehans syndrome
True

Prolactin secreting pituitary adenoma


True

False

Your answer: True Correct answer: True

Explanation
Question:Prolactin

Is a polypeptide hormone
True

False

Your answer: True

Correct answer: True

Is produced by posterior pituitary lactotrophs


True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Is produced by the endometrium


True
Is produced by decidua
True
Explanation
Question:Premature ovarian failure can be diagnosed in a woman aged 35 years

After 12 months of amenorrhoea


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

On the basis of sustained serum FSH levels


above 50iu/l
True

False

Pre-natal diagnosis -19

By finding a monophasic basal body temperature


True

Your answer:
True

False

Correct answer:
False

On the basis of sustained high serum concentration of androstendione


True

Your answer:
True

False

Correct answer:
False

Explanation
Question:Severe pregnancy-induced hypertension is associated with

Reduced renal uric acid clearance


True

Your answer: True

False

Correct answer: True

Elevated maternal serum cortisol concentration


True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Hypernatraemia
True
Hyperkalaemia
True

Explanation
Question:In the treatment of a 40 year old woman with ovarian carcinoma

Surgical treatment alone is recommended in well


differentiated stage Ib tumours
True

False

Your answer: Correct


True
answer: True

Stage IV disease has a 25% five year survival


True

False

Your answer: Correct


True
answer: False

In the presence of a pleural effusion, primary chemotherapy rather than surgery


should be recommended
True

False

Your answer: Correct


True
answer: False

Post-operative adjuvant chemotherapy should be


recommended for stage Ic disease
True

False

Your answer: Correct


True
answer: True

Pre-natal diagnosis -20

Explanation
Question:In the assessment of a screening protocol for ovarian cancer

Length bias refers to the greater likelihood of


detecting slower growing tumours with an apparent
improvement in survival
True

False

Your
answer:
True

Correct
answer:
True

Your
answer:
True

Correct
answer:
True

Your
answer:
True

Correct
answer:
True

Lead-time bias refers to the early detection of tumours


causing an apparent improvement in survival
True

False

An acceptable screening test should have a 99.6%


specificity and a 10% positive predictive value
True

False

Screening for ovarian cancer has been shown to reduce mortality in the general
population
True

False

Your
answer:
True

Correct
answer:
False

Explanation
Question:With respect to chemotherapeutic agents used in gynaecological oncology

Cis-platin is more nephro-toxic than


carboplatin
True

False

Your answer:
True

Correct answer:
True

Cis-platin causes less nausea and vomiting than carboplatin


True

False

Your answer:
True

Correct answer:
False

Forced diuresis is usually employed during paclitaxel therapy


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Intestinal perforation is a recognised


complication of methotrexate
True

False

Pre-natal diagnosis -21

Explanation
Question:During chemotherapy for gynaecological malignancies

Administration of N-acetylcystine or mesna reduces


the risk of haemorrhagic cystitis associated with
cyclophosphamide
True

False

Your
answer:
True

Correct
answer:
True

Your
answer:
True

Correct
answer:
True

Your
answer:
True

Correct
answer:
True

Your
answer:
True

Correct
answer:
True

Corticosteroids significantly reduce the risk of nausea


& vomiting
True

False

Forced diuresis reduces the risk of renal toxicity


associated with cis-platin
True

False

Methotrexate toxicity is worsened by concurrent


administration of aspirin
True

False

Explanation
Question:The following are associated with an increased risk of developing endometrial cancer

Late menopause
True

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Personal history of breast cancer


True
Use of raloxifen
True
Use of tamoxifen
True

Pre-natal diagnosis -22

Explanation
Question:Malignant mixed mullerian tumours of the endometrium

Are composed of malignant glandular and


malignant stromal elements
True

False

Your
Correct
answer: True answer: True

Are described as homologous if the malignant


stromal elements is a leiomyosarcoma
True

False

Your
Correct
answer: True answer: True

Are described as heterologous if the malignant srtomal element is an endometrial


stromal sarcoma
True

False

Your
Correct
answer: True answer: False

Carry a better prognosis compared to endometrial adenocarcinoma


True

False

Your
Correct
answer: True answer: False

Explanation
Question:With respect to the investigation of post-menopausal bleeding

Trans-vaginal scanning has 90% sensitivity in detection of endometrial polyps


True

False

Your answer: True

Correct answer: False

Dilatation and curettage is an acceptable approach


True

False

Your answer: True

Correct answer: False

Endometrial thickness of 6mm is normal


True

False

Your answer: True

Correct answer: False

Normal endometrial tissue on out-patient endometrial biopsy excludes endometrial


cancer
True

False

Your answer: True

Correct answer: False

Explanation
Question:Oestrogen-secreting ovarian tumours include

Endometriomata
True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Dysgerminomas
True

Pre-natal diagnosis -23

Granulosa cell tumours


True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

Serous cystadenoma
True

Explanation
Question:A 30 year old school teacher reports significant contact with a 5 year old boy with chicken pox at 14
weeks gestation

If the woman is varicella zoster IgM negative, varicella zoster immune globulin
should be administered as soon as possible
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

If the woman is varicella zoster IgG positive,


she should be reassured
True

False

If the woman is susceptible to chicken pox,


varicella zoster immune globulin may be
administered up to 10 days after contact
True

False

Once varicella zoster immune globulin has been administered to the woman, it is
safe for her to be in contact with other pregnant women or neonates
True

False

Your answer:
True

Correct answer:
False

Explanation
Question:The H1N1 influenza virus

Typically causes pneumonia


True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: False

Undergoes antigenic shift


True

False

Does not undergo antigenic drift


True

False

Is transmitted from pigs to humans


True

False

Your answer: True

Correct answer: False

Pre-natal diagnosis -24

Explanation
Question:The following are clinical features of H1N1 influenza in pregnant women

Joint pain
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

Haemoptysis
True
Dysuria
True
Headache
True

Explanation
Question:Chorionic villus sampling

Should not be performed after 20 weeks gestation


True

False

Your answer:
True

Correct answer:
False

If performed after 10 weeks gestation is associated with limb reduction


abnormalities
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Should be offered after a positive first


trimester screening test for Down
True

False

May be performed by the trans-abdominal


or trans-cervical routes
True

False

Explanation
Question:A child with Klinefelter?s syndrome

Has a (46, XXY) chromosomal complement


True

False

Your answer: True

Has ambiguous genitalia at birth

Correct answer: False

Pre-natal diagnosis -25

True

False

Your answer: True

Correct answer: False

Has severe intellectual impairment


True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Is fertile
True

Explanation
Question:With respect to soft markers for chromosomal abnormalities

Isolated cardiac echogenic foci are associated with an increased risk of Down?s
syndrome
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Fetal hyperechogenic bowel may be


associated with fetal viral infection
True

False

The majority of fetuses with hyperechogenic


bowel are normal
True

False

Hyperechogenic bowel is associated with an


increased risk of intra-uterine fetal death
True

False

Explanation
Question:With respect to polar body biopsy for pre-implantation genetic diagnosis

The first polar body can be biopsied after


fertilisation
True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

The second polar body can only be biopsied


after fertilisation
True

False

Biopsy of both polar bodies is required for


accurate genetic diagnosis
True

False

Diagnosis of paternally derived genetic abnormalities is possible

Pre-natal diagnosis -26

True

False

Your answer:
True

Correct answer:
False

Explanation
Question:Pre-implantation genetic diagnosis is possible in the following conditions

Spinal muscular atrophy


True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

Marfan?s syndrome
True

Osteogenesis imparfecta
True
Fragile X syndrome
True

Explanation
Question:The following can precipitate or exacerbate stress incontinence

Chronic obstructive airway disease


True

False

Your answer: True Correct answer: True

False

Your answer: True Correct answer: True

Chronic constipation
True

The alpha-adrenergic agonist phenylpropanolamine


True

False

Your answer: True Correct answer: False

False

Your answer: True Correct answer: True

Anterior colporrhaphy
True
Explanation
Question:With respect to the use of mesh in the repair of pelvic organ prolapse

Absorbable synthetic mesh is most commonly used


True

False

Absorbable synthetic mesh should not be used if a


permanent bridge is required between two structures

Your
answer:
True

Correct
answer: False

Pre-natal diagnosis -27

True

Your
answer:
True

False

Correct
answer: True

Biological grafts have the advantage of providing consistent tissue strength across
the graft
True

False

Your
answer:
True

Correct
answer: False

Your
answer:
True

Correct
answer: True

Non-absorbable mesh is the most suitable type of


mesh for abdominal sacro-colpopexy
True

False

Explanation
Question:In an uncomplicated pregnancy that has progressed beyond 41 weeks gestation, induction of labour,
when compared to expectant management, is associated with

Increased caesarean section rate


True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Decreased perinatal mortality


True

False

Increased risk of meconium aspiration


True

Your answer: True

False

Correct answer: False

Increased instrumental delivery rate


True

Your answer: True

False

Correct answer: False

Explanation
Question:Sweeping of the fetal membranes performed in normal pregnancies at term is associated with

A decreased risk of prolonged pregnancy


True

False

Your answer:
True

Correct answer:
True

Increased risk of neonatal group B streptococcal infection


True

False

Decreased requirement for formal induction


of labour

Your answer:
True

Correct answer:
False

Pre-natal diagnosis -28

True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

Increased risk of chorio-amnionitis


True

False

Explanation
Question:With respect to twin pregnancies

Chorionicity is best assessed at 6 8 weeks gestation


True

False

Your answer:
True

Correct answer:
False

The lambda sign is an ultrasound feature characteristic of monochorionic twins


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

The T-sign is an ultrasound feature


characteristic of monochorionic twins
True

False

The sensitivity of ultrasound scanning in identifying monochorionic twins


increases with increasing gestation age after 14 weeks
True

False

Your answer:
True

Correct answer:
False

Explanation
Question:The following are consistent with a diagnosis of twin-to-twin transfusion syndrome

Both fetuses are female


True

Your answer:
True

Correct answer:
True

False

Your answer:
True

Correct answer:
False

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

False

There are two separate placental masses


True
Polyhydramnios in both sacs
True

Artery-to-artery anastomoses are absent in a


monochorionic placenta
True

False

Explanation
Question:The following are relative contra-indications to endometrial resection

Pre-natal diagnosis -29

A 12 week size fibroid uterus


True

Your answer: True

False

Correct answer: True

Failed response to the levonorgestrel releasing intra-uterine system


True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Woman desires amenorrhoea


True
Dysmenorrhoea
True

Explanation
Question:Vesico-vaginal fistula is associated with

Ischaemic damage to the bladder during


hysterectomy
True

False

Your answer:
True

Correct answer:
True

False

Your answer:
True

Correct answer:
True

False

Your answer:
True

Correct answer:
True

False

Your answer:
True

Correct answer:
False

Cervical carcinoma
True
Irradiation injury
True
Diverticulitis of the colon
True
Explanation
Question:Wound dehiscence

Is reduced with mass closure of a mid-line


incision
True

False

Your answer:
True

Correct answer:
True

Is increased with early post-operative mobilisation


True

False

Usually occurs between 5-10 days after


surgery

Your answer:
True

Correct answer:
False

Pre-natal diagnosis -30

True

False

Your answer:
True

Correct answer:
True

Complete wound dehiscence should be managed conservatively with healing by


secondary intention
True

False

Your answer:
True

Correct answer:
False

Explanation
Question:With respect to the use of blood and blood products in obstetrics

If a woman has not received a blood transfusion, a group and save sample taken 2
weeks earlier can be used to cross-match blood
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Kell negative blood should be used for


transfusion
True

False

Blood used for transfusion in the UK is virally inactivated


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

In a low risk healthy woman with anti-Kell


antibodies, blood should be cross-matched
prior to elective caesarean section
True

False

Question:Following gynaecological surgery in which the peritoneum is not closed

Re-peritonisation occurs within 48h


True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Complete healing of peritoneal surfaces occurs


within 5 days
True

False

There is more adhesion formation compared to procedures in which the


peritoneum is closed
True

False

Your answer:
True

Correct answer:
False

Adhesion formation is a result of raw surfaces being apposed


True

Explanation

False

Your answer:
True

Correct answer:
False

Pre-natal diagnosis -31


Question:With respect to diathermy

Unipolar diathermy is safer than bipolar diathermy


True

Your answer: Correct


True
answer: False

False

Bipolar diathermy generates higher tissue


temperatures than unipolar diathermy
True

Your answer: Correct


True
answer: True

False

The patient does not have to be earthed when bipolar diathermy is used
True

Your answer: Correct


True
answer: False

False

Bipolar diathermy is ideal for cutting


True

Your answer: Correct


True
answer: False

False

Explanation
Question:Umbilical cord prolapse is associated with

Induction of labour
True

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

False

Occipito-posterior position
True
Epidural anaesthesia
True

Pre-term rupture of membranes


True

False

Explanation
Question:Continuous electronic fetal monitoring in labour

Is associated with a lower rate of neonatal


seizures
True

False

Your answer: Correct


True
answer: True

Results in a significant reduction in the number of babies with low Apgar scores a
1 minute

Pre-natal diagnosis -32

True

False

Your answer: Correct


True
answer: False

Should be recommended if regional analgesia is


used
True

False

Your answer: Correct


True
answer: True

Should be recommended in all prolonged


pregnancies (>42 complete weeks)
True

False

Your answer: Correct


True
answer: True

Explanation
Question:With regards to face presentation at term

Vaginal delivery may be safely achieved with a


mento-anterior position
True

False

Your answer:
True

Correct answer:
True

The incidence is increased by the use of epidural analgesia


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

The incidence is ~1:150 deliveries


True

False

The risk of congenital anomalies is not increased compared to vertex presentations


True

False

Your answer:
True

Correct answer:
False

Explanation
Question:Use of the combined oral contraceptive pill confers the following benefits

Reduction in the incidence of uterine fibroids


True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Reduction in the risk of breast cancer


True

False

40% reduction in the risk of ovarian cancer


compared to never users
True

False

50% reduction in the risk of benign breast


disease

Pre-natal diagnosis -33

True

False

Your answer:
True

Correct answer:
True

Explanation
Question:The progesterone-only oral contraceptive pill

Is associated with an increased risk of ectopic pregnancy when compared to


sexually active non-contraceptive users
True

False

Your answer: True

Correct answer: False

Is associated with an increased risk of ovarian theca-leutein cysts


True

False

Your answer: True

Correct answer: False

Has a 12 hour window for efficacy


True

False

Your answer: True

Correct answer: False

In dedicated users has a Pearl index of 0.1/100 woman years


True

False

Your answer: True

Correct answer: False

Explanation
Question:The following are essential for a clinical diagnosis of acute PID

Pyrexia >38C
True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: False

False

Leukocytosis >12,000/ml
True
Raised ESR or CRP
True

Lower abdominal tenderness


True

False

Explanation
Question:Actinomycetes Israelii

Spreads via lymphatics


True

False

If identified on cervical smear, is a contra-indication to subsequent use of IUDs

Pre-natal diagnosis -34

True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Is associated with sinus


formation
True

False

Is a gram positive aerobic organism


True

False

Your answer: True

Correct answer: False

Explanation
Question:With respect to tubal ligation

The risk of ectopic pregnancy is lower in sterilised


women compared to non-sterilised fertile women
True

Your
answer:
True

False

Correct
answer: True

The 10 year cumulative lift table probability of failure of sterilisation is 0.5%


True

Your
answer:
True

False

Correct
answer: False

The risk of laparotomy associated with laparoscopic sterilisation is 1;10,000


True

False

Your
answer:
True

Correct
answer: False

Your
answer:
True

Correct
answer: True

The risk of death associated with laparoscopy is


1:12,000
True

False

Explanation
Question:A 5 year old boy is thought to have suffered intra-partum asphyxia. The following would support the
diagnosis

Cardio-tocographic evidence of fetal


distress
True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

Ante-natal evidence of IUGR


True
Cord pH of 7.25

False

Pre-natal diagnosis -35

True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

Low Apgar scores at 1 minute


True

False

Explanation
Question:Screening for congenital dislocation of the hip

Ortolani?s test tests whether the hip is


already dislocated
True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Barlow?s test tests whether the hip can be


dislocated
True

False

If no abnormality is found before discharge, further screening is unnecessary


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

Dislocation is more common in the right hip


True

False

Explanation
Question:Phenytoin

Is best administered by im injection


True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

Has a short half-life in vivo


True

False

Is readily absorbed from the gut


True

False

Is metabolised by the liver


True

Explanation

False

Pre-natal diagnosis -36


Question:Obesity in pregnancy has been shown to be associated with

Gestational diabetes mellitus


True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Vitamin D deficiency
True
Thrombophilia
True
Iron deficiency
True

Explanation
Question:With specific reference to antenatal screening for pre-eclampsia, the following women should be
referred for specialist consultant antenatal care

A 42 year old woman in her first pregnancy with a


booking BP of 120/60
True

False

Your
Correct
answer: True answer: True

A 30 year old woman in her first pregnancy with


booking BP of 130/95
True

False

Your
Correct
answer: True answer: True

A 20 year old woman with BMI of 37 and a history


of pre-eclampsia in her previous pregnancy
True

False

Your
Correct
answer: True answer: True

A 20 year old woman with BMI of 22 and BP 110/75 at booking


True

False

Your
Correct
answer: True answer: False

Explanation
Question:A 45 year old woman makes a claim for compensation following an abdominal hysterectomy which
resulted in bladder injury and a vesico-vaginal fistula.

For the claim to be successful, the claimant must


prove that the operation was performed negligently
True

False

Your
answer:
True

Correct
answer: True

For the claim to be successful, the claimant must prove that she was not warned

Pre-natal diagnosis -37

about the risk of bladder injury

True

Your
answer:
True

False

Correct
answer: False

The claim will fail if the risk of bladder injury and vesico-vaginal fistula was
documented on the consent form
True

False

Your
answer:
True

Correct
answer: False

Your
answer:
True

Correct
answer: True

The claim will fail if it is likely that the vesicovaginal fistula was caused by the womans
underlying disease
True

False

Explanation
Question:A 45 year old woman makes a claim for compensation following an abdominal hysterectomy which
resulted in bladder injury and a vesico-vaginal fistula.

The Bolam test is used to determine the degree of suffering and award
compensation
True

False

Your answer:
True

Correct answer:
False

The Bolam test is used to determine the outcome of the operation if it had been
performed by a competent surgeon
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

The Bolam test is based on what is


accepted as proper by a responsible body
of medical opinion
True

False

The Bolam test is based on the opinions and practices of the majority of
gynaecologists
True

False

Your answer:
True

Correct answer:
False

Explanation
Question:With respect to clinical negligence claims

A doctors acts or omissions will be judged on the basis of the best doctor in that
specialty
True

False

Your answer:
True

Correct answer:
False

Pre-natal diagnosis -38

A judge has to weigh the opinions of experts called by the claimant and defence
and decide which opinion is preferred
True

Your answer:
True

False

Correct answer:
False

If the intervention was performed by a Specialist Trainee, other Specialist Trainees


will be called as expert witnesses
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

If the incident took place in 2001 but the claim


is brought in 2009, the standard will be based on
clinical practice in 2001 rather than the year of
the claim
True

False

Explanation
Question:The Bolam test

Is used by the courts to quantify damages in clinical negligence claims


True

False

Your answer: True

Correct answer: False

Is based on the recommendations found in NICE and other Royal College


guidelines
True

False

Your answer: True

Correct answer: False

Is based on the opinions of the majority of competent clinicians


True

False

Your answer: True

Correct answer: False

Does not apply to claims brought by parents on behalf of their children


True

False

Your answer: True

Correct answer: False

Explanation
Question:You have been asked to run a problem-based learning session for medical students focused on
hypertensive disorders in pregnancy

The group should consist of at least 10 students


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

The students should determine their own


learning needs
True

False

Pre-natal diagnosis -39

Each student should be asked to bring a problem they have encountered relating to
hypertensive disorders in pregnancy
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

The students should have access to the library


and the internet during the session
True

False

Explanation
Question:Aspirin 75mg daily to reduce the risk of hypertensive disease should be offered from 12 weeks
gestation until delivery in the following women

A 35 year old in her first pregnancy with a BMI


of 40 kg/m2 at booking
True

Your answer: Correct answer:


True
True

False

A 16 year old in her first pregnancy with a BMI of 22 kg/m2 at booking


True

Your answer: Correct answer:


True
False

False

A 23 year old who developed pre-eclampsia at 39


weeks in her last pregnancy
True

Your answer: Correct answer:


True
True

False

A 23 year old insulin-dependent diabetic with a


BMI of 23 kg/m2 at booking
True

Your answer: Correct answer:


True
True

False

Explanation
Question:Lasers used in gynaecological surgery

Can operate in continuous wave and pulsed


mode
True

False

Your answer:
True

Correct answer:
True

Operate in continuous wave mode by Q-switching


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

When operating in continuous wave mode, is


always on
True

False

Pre-natal diagnosis -40

When operating in continuous wave mode results in continuous exposure of the


tissue to laser light
True

Your answer:
True

False

Correct answer:
False

Explanation
Question:Use of depo-medroxyprogesterone acetate is associated with health risks that outweigh the benefits
(UKMEC category 3) in the following circumstances

A 40 year old woman with diabetic


nephropathy
True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

A 38 year old woman with diabetic


retinopathy
True

False

A 45 year old woman with angina


True

False

A 23 year old woman with SLE but no anti-phospholipid antibodies


True

False

Your answer:
True

Correct answer:
False

Explanation
Question:In a woman who is requesting contraception, the risks associated with use of the copper IUCD
outweigh the benefits (UKMEC category 3) in the following circumstances

Immediately following a spontaneous miscarriage at 18 weeks


True

False

Your answer:
True

Correct answer:
False

Immediately following medical termination of pregnancy for fetal abnormality at


20 weeks
True

False

Your answer:
True

Correct answer:
False

Immediately following first trimester surgical termination of pregnancy


True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Immediately following surgical evacuation of


a complete molar pregnancy at 8 weeks
gestation
True

False

Pre-natal diagnosis -41

Explanation
Question:In a woman requesting contraception, the risks associated with the use of the levonorgestrel IUS
outweigh the benefits (UKMEC category 3) in the following circumstances

The woman has a past history of inshaemic heart disease


True

False

Your answer: True

Correct answer: False

The woman has a past history of stroke


True

False

Your answer: True

Correct answer: False

The woman had surgical termination of an unwanted first trimester pregnancy 7


days earlier
True

False

Your answer: True

Correct answer: False

The woman had a spontaneous miscarriage at 18 weeks gestation 7 days earlier


True

False

Your answer: True

Correct answer: False

Explanation
Question:In a woman using the progestogen-only contraceptive pill, additional contraception should be used if
she is also taking the following drugs

Carbamazepine
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

Phenytoin
True
Lamotrigine
True

Lamotrigine + sodium valproate


True

False

Your answer: True

Correct answer: False

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