Get Through MRCOG Part 2

SBAs

Rekha Wuntakal, Madhavi Kalidindi, Tony Hollingworth

• Publisher: CRC Press
• Year: 2018
• ISBN:
  9781351058612
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Get Through MRCOG Part 2: SBAs provides 3 exams' worth of questions mapped to the RCOG syllabus in the newly introduced SBA style. With detailed explanations and relevant references to guidelines, this is the definitive resource for those taking the MRCOG Part 2 examination.

1

Maternal medicine

Questions

Thyroid

1.A 36-year-old woman with known hypothyroidism has been taking levothyroxine 100 micrograms once a day. Her most recent thyroid function tests performed 3 months ago were normal with a thyrotropin (TSH) of 2.5 mU/L. She has come to the early pregnancy unit with abdominal pain and a positive pregnancy test. Transvaginal ultrasound confirmed an intrauterine pregnancy.

How would you advise with regards to her levothyroxine dosage?

a.Decrease dose to 75 micrograms per day

b.Decrease dose to 50 micrograms per day

c.No change required

d.Increase dose to 125 micrograms per day

e.Increase dose to 150 micrograms per day

2.A 25-year-old woman known to have hyperthyroidism is going for radioactive iodine therapy. She has been trying to conceive for the last 6 months.

How long should she avoid pregnancy after this treatment?

a.3 months

b.6 months

c.9 months

d.12 months

e.15 months

3.A 28-year-old para 1 woman at 40 weeks’ gestation delivered a baby with a skin condition, diagnosed as ‘Aplasia cutis congenita’. She is known to have hyperthyroidism secondary to Grave disease and has been on anti-thyroid medication throughout the pregnancy.

Which one of the medications below is known to cause the above condition?

a.Carbimazole

b.Hydrouracil

c.Levothyroxine

d.Methythiouracil

e.Propylthiouracil

Renal disease in pregnancy

4.A 38-year-old nulliparous woman with moderate chronic renal failure comes to the preconception clinic as she wishes to have a baby. She had renal transplantation 3 years ago and her recent creatinine is around 130 with estimated glomerular filtration rate (GFR) of approximately 45. She is currently taking prednisolone, mycophenolate, angiotensin-converting enzyme (ACE) inhibitors and aspirin. You have advised her to stop mycophenolate and to start another immunosuppressant.

Which one of the immunosuppressant drugs would be contraindicated in pregnancy?

a.Azathioprine

b.Cyclosporine

c.Hydroxychloroquine

d.Sirolimus

e.Tacrolimus

5.A 25-year-old para 1 woman at 30 weeks’ gestation was brought in to the Obstetric day assessment unit with abdominal and back pains, vomiting and feeling unwell. Her observations are temperature 38.2°C, pulse 110 bpm, blood pressure (BP) 100/60 mm Hg, respiratory rate 18/min and oxygen saturations 98% on room air. On examination, she has suprapubic and right flank tenderness with 3+ leucocytes and positive nitrates on urine dipsticks. Foetal movements were good and cardiotocography was normal. You have admitted her and started broad spectrum intravenous antibiotics for acute pyelonephritis after doing the septic screen.

What is the recurrence rate of pyelonephritis during the pregnancy?

a.5%

b.10%

c.15%

d.20%

e.25%

Renal transplantation

6.A 35-year-old nulliparous woman with chronic renal failure had a successful renal transplantation surgery recently. She wishes to have children in the future and her GP has referred for preconception advice.

What is the recommended time interval for conception after an allograft transplantation?

a.6 months

b.12 months

c.18 months

d.24 months

e.30 months

Dermatological conditions in pregnancy

Skin

7.A 28-year-old woman at 32 weeks’ gestation in her first pregnancy presented with a rash and itching on the abdomen, trunk, legs and hands. On examination, there were vesicles and bullae. A diagnosis of pemphigoid gestationis was made by the dermatologists after skin biopsies.

Which one of the following statements is true about pemphigoid gestationis?

a.Associated with other autoimmune diseases

b.Most common dermatosis of pregnancy

c.Not associated with any adverse effect on mother or foetus

d.Rash usually begins in the abdomen with periumbilical sparing

e.Recurrence in subsequent pregnancies is rare

8.A 30-year-old primigravida at 35 weeks’ gestation with monochorionic diamniotic pregnancy presents with intense itching and rash on the abdomen. On examination there were erythematous papules and plaques in the striae gravidarum with umbilical sparing.

The most likely diagnosis is which one of the following?

a.Pemphigoid gestationis

b.Polymorphic...