McqMate
1. |
Which is not required for the diagnosis of pregnancy induced hypertension? |
A. | systolic BP rise of > 30mmHg above pre pregnancy level |
B. | diastolic BP rise of > 15mmHg above pre pregnancy level |
C. | an absolute BP of >140/90 |
D. | occur after the 20th week of gestation |
E. | proteinuria |
Answer» E. proteinuria |
2. |
Which is not a risk factor for preeclampsia? |
A. | molar pregnancy |
B. | multigravida |
C. | age < 20 years |
D. | multiple pregnancy |
E. | family history |
Answer» B. multigravida |
3. |
Which statement is not true with regards to preeclampsia? |
A. | it is due to a state of fluid overload |
B. | the oedema must be generalized |
C. | the proteinuria often occurs after the odema and hypertension |
D. | if left untreated it can progress to eclampsia and the HELLP syndrome |
E. | it is characterized by ischemia and thrombosis of end organs |
Answer» C. the proteinuria often occurs after the odema and hypertension |
4. |
Which is not accurate with regard to management of Eclampsia? |
A. | seizures are usually self terminating if left untreated but will recur |
B. | magnesium sulphate 4gm should be given over 15 minutes for seizure control, then infused at 1gm per hour |
C. | the desired BP is a diastolic BP of 90mmHg |
D. | magnesium sulphate does not lower BP |
E. | hydrallazine is the agent of choice to lower BP, 5mg every 20 minutes |
Answer» D. magnesium sulphate does not lower BP |
5. |
Which would be consistant with a seizure due to eclampsia? |
A. | there is status epilepticus |
B. | no proteinuria or hypertension |
C. | focal neurological signs |
D. | it responds to benzodiazapines |
E. | there is a persistently decreased conscious post seizure |
Answer» D. it responds to benzodiazapines |
6. |
Which is not a risk factor for an ectopic pregnancy? |
A. | fertility treatment |
B. | IUD in situ |
C. | Endometriosis |
D. | Previous tubal infection |
E. | Family history |
Answer» E. Family history |
7. |
.At what bHCG would the chance of an ectopic pregnancy be 90% if a transvaginal ultrasound showed an empty uterus? |
A. | 500 |
B. | 900 |
C. | 1200 |
D. | 1600 |
E. | 2000 |
Answer» C. 1200 |
8. |
At what bHCG can you reliably see an intrauterine pregnancy with a transabdominal ultrasound? |
A. | 4000 |
B. | 5000 |
C. | 5500 |
D. | 6500 |
E. | 7500 |
Answer» D. 6500 |
9. |
Which is incorrect with regards to ectopic pregnancy? |
A. | incidence in the standard population is 20/1000 |
B. | the incidence of a hetertopic pregnancy in the standard polulation is 1:4000 |
C. | the presence of abdominal or pelvic pain is the most sensitive symptom or sign |
D. | an intruterine gestational sac can usually be seen at 5 weeks on a TV ultrasound and at 6 weeks on a transabdominal ultrasound |
E. | the ectopic rate is subsequent pregnancies is 10% |
Answer» E. the ectopic rate is subsequent pregnancies is 10% |
10. |
Which is incorrect with regards to Rhesus isoimmunisation? |
A. | The chance of a Rh-ve mother developing antiD antibodies to a Rh+ve fetus is less than 20% (even if not given antiD) |
B. | Anti D must be given within 24 hours to have any substantial effect |
C. | The risk of maternofetal transfusion is very small in a first trimester abortion and thus a smaller dose of anti D could be given |
D. | The IgM anti D antibodies cannot cross the placenta but the IgG antibodies can |
E. | It is a blood product. |
Answer» B. Anti D must be given within 24 hours to have any substantial effect |
11. |
Which is incorrect with regards to anti D? |
A. | it is given IV |
B. | The Kleihauer test is done to determine to quantify the fetomaternal hemorrhage and thus the amount of anti D required |
C. | If the mother’s serum has antiD antibodies detected in her serum at 24-48 hours after injection then the dosage is adequate |
D. | If given from 3-10 days after fetomaternal transfusion is still has some effect |
E. | 1ml protects against 6ml of fetal RBC’s |
Answer» A. it is given IV |
12. |
with regards to the different categories of abortion which is incorrect? |
A. | in an incomplete abortion the cervix may be open or closed |
B. | in an inevitable abortion the cervix is open |
C. | in a complete abortion the cervix is closed and bleeding and pain minimal |
D. | in a threatened abort the cervix is open |
E. | in a septic abortion the pt is characteristically febrile with PV bleeding and crampy pain |
Answer» D. in a threatened abort the cervix is open |
13. |
Which statement is incorrect? |
A. | in the normal pregnancy the bHCG increases by 66% every two days |
B. | the bHCG should plateau at when it reaches 1-2 million at 20 weeks gestation |
C. | the current serum test can detect bHCG at 2-3 days post implantation |
D. | a falling bHCG does not rule out the chance of rupture in an ectopic pregnancy |
E. | approximately 50% of patients with a threatened abort will go on to complete the pregnancy |
Answer» B. the bHCG should plateau at when it reaches 1-2 million at 20 weeks gestation |
14. |
Which is not a true statement with regards to a normal pregnancy? |
A. | the resting heart rate increases by 15-20 beats / min by the end of the third trimester |
B. | the blood volume increases by 45% |
C. | polycythemia develops |
D. | there is a leucocytosis up to 18 000 |
E. | the bladder becomes an abdominal organ |
Answer» C. polycythemia develops |
15. |
Which statement is incorrect with regards to radiation exposure to the fetus? |
A. | the minimum exposure known to cause risk o the fetus is <0.1Gy (1000microGy) |
B. | a CXR and Pelvic Xray are well below the minimum toxic level |
C. | a VQ scan falls well below the toxic level |
D. | a CT abdomen falls well below the toxic level |
E. | a CXR has the same radiation as one transatlantic air flight |
Answer» D. a CT abdomen falls well below the toxic level |
16. |
Which is not true with regards to placental abruption and trauma in pregnancy? |
A. | it is the most common cause of death if the mother survives |
B. | the incidence in minor trauma is up to 5% and up to 50% in major trauma |
C. | it can occur up to 4 hours post accident |
D. | CTG monitoring for a 4 hours is thought to predict nearly all pts of minor trauma who will develop placental abruption |
E. | It is characterized by pelvic pain uterine contractions and vaginal bleeding |
Answer» C. it can occur up to 4 hours post accident |
17. |
Which statement is incorrect with regards to dysfunctional uterine bleeding |
A. | it is very rare in the teenage years |
B. | it is usually due to anovulatory cycles |
C. | oestrogen is used acutely to slow bleeding by contracting the uterine arteries |
D. | cyclical progesterone is used if it is a chronic problem |
E. | in patients over 35 years endometrail biopsy should precede oetrogen administration |
Answer» A. it is very rare in the teenage years |
18. |
Which three must be present to make the diagnosis of PID? |
A. | temp >38.3, abdo pain, vaginal discharge |
B. | temp > 38.3, abdominal pain, cervical excitation |
C. | abdo pain, adnexal tenderness, increased CRP |
D. | adnexal tenderness, vaginal discharge and increased CRP |
E. | abdominal pain, cervical excitation and adnexal tenderness |
Answer» E. abdominal pain, cervical excitation and adnexal tenderness |
19. |
Which agent is not one recommended in the 2000 antibiotic guidelines for the treatment of outpatient sexually acquired PID? |
A. | Metronidazole 400mg b.d orally for 14 days |
B. | ceftriaxone 250 mg IM stat dose |
C. | augmenten duo forte 875/125 b.d orally for 14 days |
D. | doxycycline 100mg b.d orally for 14 days |
E. | roxithromycin 300mg o daily for 14 days if breast feeding |
Answer» C. augmenten duo forte 875/125 b.d orally for 14 days |
20. |
The risk of infertility after a single episode of PID is approximately? |
A. | 5% |
B. | 10% |
C. | 20% |
D. | 25% |
E. | 35% |
Answer» B. 10% |
21. |
Non sexually acquired PID should be treated with doxycycline and what according to the 2000 Antibiotic Guidelines? |
A. | metronidazole |
B. | ciprofloxacin |
C. | ceftriaxone |
D. | augmented duo forte |
E. | cephalexin |
Answer» D. augmented duo forte |
22. |
Which is an incorrect statement with regards to ovarian torsion? |
A. | 70% of cases occur in women less than 30 years of age |
B. | 20% of cases in women less than 30 are associated with pregnancy |
C. | it has an increased incidence in women receiving ovarian stimulation treatment |
D. | a tender mass is felt in 10% of cases |
E. | when it occurs in post menopausal women, neoplasm should be excluded |
Answer» D. a tender mass is felt in 10% of cases |
23. |
Which of the below is not consistent with trichamonas vaginitis? |
A. | flagella are seen on a wet prep |
B. | copious frothy grey green discharge |
C. | a strawberry cervix on examination |
D. | evidence of other sexually transmitted diseases |
E. | treated with doxycycline |
Answer» E. treated with doxycycline |
24. |
Which is not a risk factor for vaginal candidiasis? |
A. | prepubertal |
B. | diabetes |
C. | immunosuppression |
D. | pregnancy |
E. | hormone replacement therapy |
Answer» A. prepubertal |
25. |
Which is not true with regard to bacterial vaginitis? |
A. | it is the most common cause of vulvovagintis in women of childbearing age |
B. | clue cells are seen |
C. | it can be a normal commensal |
D. | it is not sexually transmitted |
E. | treatment is with metronidazole |
Answer» D. it is not sexually transmitted |
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