2009 March part II

Discussion in 'MRCOG Forum' started by Guest, May 2, 2007.

  1. Guest

    Guest Guest

    Options for Questions 1-2
    A. Amniotic fluid embolism I. Placental abruption
    B. Cardiomyopathy J. Placenta praevia
    C. Chest infection K. Pulmonary embolism
    D. CVA L. Pulmonary hypertension
    E. Endocarditis M. Sepsis
    F. Haemorrhage N. Substance misuse
    G. HELLP syndrome O. Thromboembolism
    H. Myocardial infarcation
    Q1:A previously healthy 18-year-old primigravida presents at 36 weeks feeling unwell and tired. Her brother died unexpectedly aged 19 years. Her CXR showed an enlarged heart. While being admitted she developed increasing shortness of breath and died despite intensive resuscitation.
    Answer : B - Cardiomyopathy

    Q2:A 30-year-old woman, 28 weeks' gestation in her sixth pregnancy presents to A&E with breathlessness and displays severe anxiety. She had complained of left-sided pelvic pain for a week. While being assessed she collapsed and it was not possible to resuscitate her.
    Answer : ? F. Haemorrhage

    Options for Questions 3-4
    A. Administer VZIG as soon as possible to mother G. Immediate caesarean section and transfer baby to the neonatal unit
    B. Administer VZIG to mother if maternal serology -ve H. Induction of labour
    C. Administer VZIG to neonate I. Reassurance
    D. Advise avoid contact with other pregnant women and neonates J. Separate mother and baby after delivery
    E. Detailed ultrasound examination K. Serum for VZV IgM antibodies
    F. Give intravenous Aciclovir L. Treat with oral Aciclovir
    (2009M)Q3: A 26-year-old Para 1+ 0 at 38 weeks gestation contacts her GP immediately after hearing that a child in her son's nursery has developed chickenpox. She has no memory of having the disease herself.
    Answer : B - Administer VZIG to mother if maternal serology -ve

    (2009M)Q4 : Mrs Jones is seen in the antenatal clinic at 40 weeks. She has a cough and smokes 20 cigarettes per day. She has a rash and feels generally unwell. Her sister's child has developed chickenpox. They spent a weekend together two weeks ago. She does not think she has ever had chickenpox. Serological investigation shows that she is susceptible to varicella zoster .
    Answer : ? C . Administer VZIG to neonate

    Options for Questions 5-6
    A. Atrophic vulvovaginitis H. Human papilloma virus infection
    B. Benign mucous membrane pemphigoid I. Lichen planus
    C. Candida infection J. Lichen sclerosus
    D. Contact dermatitis K. Lichen simplex et chronicus
    E. Eczema L. Psoriasis
    F. Herpes simplex infection M. Vulval intraepithelial neoplasia
    G. HIV infection N. Vulvodynia
    Q5: A 23-year-old woman presents with a two-year history of vulval, perineal and perianal irritation. The vulva is red, excoriated and there areas of white, thickened skin. Application of 3% Acetic acid shows areas of mosaic and coarse punctuation.
    Answer : M - Vulval intraepithelial neoplasia

    Q6 : A 78-year-old woman presents with vulval irritation and soreness. On examination the vulva is red in colour, slightly oedematous and there are small, red papules scattered randomly beyond the perimeter of the vulva. She also complains of soreness and irritation under the breasts.
    Answer : ? I. Lichen Planus

    Options for Questions 7-9
    A. Antihypertensive treatment H. Measure serum magnesium
    B. Calculate the mean arterial blood pressure I. Monitor patellar reflex every 15 minutes
    C. Carry out visual field assessment J. Provide a fluid challenge with colloids
    D. Immediate dose of 10ml 10% calcium gluconate intravenously K. Provide intravenous Hartmann's solution at the rate of 85ml per hour
    E. Insert central venous pressure line L. Transfer to intensive treatment unit
    F. Intravenous magnesium sulphate M. Transfer to the postnatal ward
    G. Measure serum aspartate transaminase immediately

    Q7 : A 20-year-old primigravida had a normal delivery of a live infant 12 hours previously. She has developed severe gestational proteinuric hypertension, her clotting is normal, serum albumin is 43g/dl, there is no ankle clonus and her blood pressure is 160/100mmHg. She has been given one litre of Hartmann's solution intravenously since her delivery and has been anuric. The central venous pressure is +10mmHg, serum sodium 132mmol/l, serum potassium 7.1mmol/l and serum urea 22mmol/l.
    Answer : L – Transfer to intensive treatment unit

    Q8 : A 20-year-old primigravida delivered a live infant 24 hours previously. She has developed severe gestational proteinuric hypertension. Treatment with intravenous magnesium was required. Her fluid balance is satisfactory and serum urea, electrolytes and clotting profile are all normal. Her respiratory rate falls to 6 per minute and she is drowsy but rousable.
    Answer : ? D. Immediate dose of 10ml 10% calcium gluconate intravenously

    Q9 : A 20-year-old primigravida is 30 weeks' pregnant and has been transferred to the delivery suite with severe gestational proteinuric hypertension. She complains of severe frontal headache but has no other symptoms. She has a normal respiratory rate and her urine output has been satisfactory. Her blood pressure is 140/100mmHg. There are five beats of bilateral ankle clonus.
    Answer : ? F. Intravenous magnesium sulphate

    Options for Questions 10-12
    A. Damage to bladder / ureter I. Laparotomy
    B. Damage to bowel J. Pain
    C. Failure rate 1 in 200 K. Premature menopause
    D. Failure to gain entry into abdominal cavity L. Removal of ovaries
    E. Failure to identify disease M. Urinary retention
    F. Failure to visualise uterine cavity N. Uterine perforation
    G. Haemorrhage requiring blood transfusion O. Vaginal bleeding
    H. Haemorrhage requiring return to theatre
    Q10 : A 52-year-old woman with frequent heavy periods is listed for diagnostic hysteroscopy. She has had two children both delivered by caesarean section. She is hypertensive and her BMI is 26.
    Answer : N – Uterine perforation

    (2009M)Q11 : A 56-year-old woman is scheduled for laparotomy and possible bilateral salpingo-oophorectomy for an ovarian mass. She had a total abdominal hysterectomy at the age of forty for fibroids and is in discomfort with an ovarian mass which measures 15cm in diameter on ultrasound examination.
    Answer : ? Removal of ovaries? B . Damage to bowel ? [D] Failure to gain entry

    (2009M)Q12 : A 48-year-old nulliparous woman is scheduled for vaginal hysterectomy because of menorrhagia. Her uterus is enlarged equivalent to 14 weeks' gestation.
    Answer : ? urinary retention/ bladder or ureter injury / I] laparotomy
  2. zara

    zara Guest

    ans

    8. immediate Ca+2 gluconate is given,because it is antidote for mgso4
    toxicity.always monitor resp rate,deep tendon reflexes,plasma conc.
    mgso4,and urine output while giving mgso4,

    9. mgso4 is given.it is used both for treatment and prevention of eclamp
    sia and pre eclampsia

    11. damage to bowel.imp complication of laparotomy.



    12. haemorrhage requiring blood transfusion,because haemorrhage is imp complication of vaginal hysterectomy.
  3. Guest

    Guest Guest

    2.O . Thromboembolism
  4. Guest

    Guest Guest

    dear shin
    some of these qs were in march exam , what is the source of these qs ,did you sit for this exam ? it was confusing
  5. Guest

    Guest Guest

    EMQ 2009March
    Administer VZIG as soon as possible to mother G. Immediate caesarean section and transfer baby to the neonatal unit
    B. Administer VZIG to mother if maternal serology -ve H. Induction of labour
    C. Administer VZIG to neonate I. Reassurance
    D. Advise avoid contact with other pregnant women and neonates J. Separate mother and baby after delivery
    E. Detailed ultrasound examination K. Serum for VZV IgM antibodies
    F. Give intravenous Aciclovir L. Treat with oral Aciclovir
    Q3: A 26-year-old Para 1+ 0 at 38 weeks gestation contacts her GP immediately after hearing that a child in her son's nursery has developed chickenpox. She has no memory of having the disease herself.
    Answer : B - Administer VZIG to mother if maternal serology -ve

    Q4 : Mrs Jones is seen in the antenatal clinic at 40 weeks. She has a cough and smokes 20 cigarettes per day. She has a rash and feels generally unwell. Her sister's child has developed chickenpox. They spent a weekend together two weeks ago. She does not think she has ever had chickenpox. Serological investigation shows that she is susceptible to varicella zoster .
    Answer : ? F. Give intravenous Aciclovir ? C . Administer VZIG to neonate

    2009M EMQ
    Damage to bladder / ureter I. Laparotomy
    B. Damage to bowel J. Pain
    C. Failure rate 1 in 200 K. Premature menopause
    D. Failure to gain entry into abdominal cavity L. Removal of ovaries
    E. Failure to identify disease M. Urinary retention
    F. Failure to visualise uterine cavity N. Uterine perforation
    G. Haemorrhage requiring blood transfusion O. Vaginal bleeding
    H. Haemorrhage requiring return to theatre
    Q10 : A 52-year-old woman with frequent heavy periods is listed for diagnostic hysteroscopy. She has had two children both delivered by caesarean section. She is hypertensive and her BMI is 26.
    Answer : N – Uterine perforation

    Q11 : A 56-year-old woman is scheduled for laparotomy and possible bilateral salpingo-oophorectomy for an ovarian mass. She had a total abdominal hysterectomy at the age of forty for fibroids and is in discomfort with an ovarian mass which measures 15cm in diameter on ultrasound examination.
    Answer : ? Removal of ovaries? B . Damage to bowel ? [D] Failure to gain entry

    Q12 : A 48-year-old nulliparous woman is scheduled for vaginal hysterectomy because of menorrhagia. Her uterus is enlarged equivalent to 14 weeks' gestation.
    Answer : ?G. haemorrhage requiring blood transfusion// urinary retention/ bladder or ureter injury / I] laparotomy


    Can u tell me your answer upon these 2 questions.
    Actually they are download from RCOG website. However, only these 12 EMQ questions only they give on the website.
    How about we all try to solve them together?
  6. Guest

    Guest Guest

    dear shin
    my answer was
    1 - bowel injury I think failure to gain access to abd is only for laparoscopy , you think about if you try to open a patient after hysterectomy you will injure the bladder but may be the intestine

    2- I wrote laparotomy , I think it will be difficult to do the surgery totaly vaginal as they mentioned the word nullipara


    my friend wrote it bladder injury
  7. Guest

    Guest Guest

    Did you sit for the exam ?
    we can discuss the rest of the emqs togather
  8. Guest

    Guest Guest

    Yes, I sit the exam. pls do so
  9. Guest

    Guest Guest

    dear shin
    i can remember many qs
    1 - rate of ectopic preg in ivf i wrote less than 1 i think wrong
    2 - rate of ectopic preg in ivf cause tubal disease ??

    3 - 6 yrs old with copius dclear dischrge ( ectopic ureter )
    4 - toddler i think (labial fusion)

    5 - qs about elderly lady post operative pain ( urinary retention )
    6 - post erpc with remnant and pain ( i wrote sepsis but not sure of the answer)
    7 - post hysteroscopic something in bicornute uterus 48 hrs with abdominal pain and blaoting ( i wrote bowel injury but i think wrong)

    8 - easy qs about indirect maternal mortality
    9 - coincidental mortality( murder)

    10 - difficult qs statistics first about picking envelopes (i wrote patient choice randomized controlled trial ??? )
    11 - midwife making study about effect of water birth on analgesic use in the last 3 yrs (i wrote retrospective something it was the only retrospective choice ??)
    12 - another statistics qs i dont remember please try to tell what was it


    13 - ovarian cyst accident in young female ( i wrote laparotomy )
    14 - simple ovarian cyst in postmenopausal female ( i wrote follow up )
    15 ovarian cyst septate 2 ^3^4 in 56 yrs ( i wrote unilateral laparosc oopharectomy but i think wrong )

    16 - 3 qs about iv fluids
    diabetic for cs ( i wrote 5% dextrose ?????)
    17 - diabetic ketoacidosis ( saline with kcl )
    18 - hyperemesis gravidarum ( urea level was 8 mmol , i dont know the normal in mmol , we are using mg , what was your answer?)

    19 - what was your answer to the qs from rcog
    20 - ( i wrote bowel injury and laparotomy )


    21, 22 , 23 - all about ectopic

    bhcg 1100 ( i wote follow up u/s and hcg
    bhcg 6000 ( i wrote repeat u/s ????
    one lady with -ve hcg and lax abdomen 24 days menstr ( discharge ?)


    i will post more qs later I am busy now please comment on these

    amaal
  10. Guest

    Guest Guest

    MCQs Female genital multilation

    Short Essays: Rhesus, P4 , pregnancy 30 weeks , booking at your clinic with elevate serum antibody, what's your management ? what does current obstetric helps in investigate?
  11. jp

    jp Guest

    march emq

    qns on urinary incontinence,hiv ,hep b immunity
  12. jp

    jp Guest

    qn on hyperemesis was na,potassium levels normal,whicv iv fluid u will give

    hormonal levels
    1.pcos
    2.late onset ad hyperplasia3
    3.fsh alone low ,others normal,dont know the answer
  13. Guest

    Guest Guest

    3 rd qs was high lh and estrogen only answer ovulation

    what did you wrote jp about hyperemesis ? urea 8 mmol is that normal ?
    amaal
  14. jp

    jp Guest

    do u remember the choices for answer,what did u write
  15. jp

    jp Guest

    do u remember answers for the HIV and hep b
  16. jp

    jp Guest

    1.low risk pregnancy ,normal progress,mode of monitoring
    2.meconium stained liquor-uss foll by CTG
  17. Guest

    Guest Guest

    the answers for hiv infection was counselling and retasting window period , for haba b infection i think the answer was assurance of immunity,
    what was your answer in the first 2 qs and the hyperemesis qs ?
  18. jp

    jp Guest

    why the answer for hiv was reinstating about window period,she was hiv positive
  19. jp

    jp Guest

    1.low risk pregnancy-intermittent monitoring
    2,uss foll by ctg-for meconium stained liquor

    do u remember choices for hyperemesis,i dont know the ans
  20. Guest

    Guest Guest

    she was hiv negative only her partner was positive

    the choices for hyper emesis were all types of infusions exept normal saline , they wrote 9% saline not0,9% , i dont know the correct answer,

    for the pt with muconeum, i think contin fetal monitoring
  21. jp

    jp Guest

    SAQ

    how did u go on for gyn saq on cyclical abdominal pain and Rh iso immunisation
  22. Guest

    Guest Guest

    I write weight associated amenorrhea, I thought it associated with hypogonadotrophic hypogonadism
  23. jp

    jp Guest

    saq

    can anyone comment on SAQ march 2009
  24. Guest

    Guest Guest

    2009March SAQ
    Question 1:
    A 23-year-old woman is admitted from the antenatal clinic with a confirmed blood pressure (BP) of 150,115mmHg and 2 + proteinuria at 28 weeks' gestation.
    A. Describe your initial assessment of the patient. (9 marks)
    B. Discuss which drugs you would use, and indicate when and how you would initiate drug therapy. (11 marks)
    Question 2:
    A 22-year-old woman who had a renal transplant 12 months ago wishes to conceive.
    A. Discuss the factors, related to her renal transplant, which indicate a good outcome in a future pregnancy. (10 marks)
    B. Discuss, and justify, any additional monitoring you would undertake in the antenatal period. (10 marks)
    Question 3:
    A woman unbooked in her third pregnancy is found to have a significantly raised Anti Rhesus D level at 30 weeks' gestation.
    A. Discuss the assessments that should be performed to determine the risk to the fetus, and their place in current obstetric management. (14 marks)
    B. If you consider the fetus may be anaemic what management options can be considered? (6 marks)
    Question 4:
    A low risk woman in advanced labour requires delivery for failure to progress.
    A. Describe the prerequisites for safe operative vaginal birth. (9 marks)
    B. Discuss the other factors to take into consideration when performing an operative vaginal birth. (6 marks)
    C. Describe the situations where there is a higher rate of failure with operative vaginal birth. (5 marks)
    Question 5:
    A 16-year-old with normal growth, BMI and secondary sexual characteristics attends the gynaecology clinic with a history of primary amenorrhoea and cyclical lower abdominal pain. An endocrine profile, including FSH, LH, prolactin, testosterone and thyroid function tests, is reported as normal.
    A. Discuss what additional information from the history and examination is helpful in establishing a diagnosis. (8 marks)
    B. Discuss the differential diagnosis. (5 marks)
    C. Justify which further investigations you would perform to establish the diagnosis, and outline the principles of management. (7 marks)
    Question 6:
    A 19-year-old sexually active single nulliparous woman with frequent sever migraine presents with a request for reliable long acting contraception.
    A. Describe the methods of long acting reversible contraception (LARC) available. (4 marks)
    B. Discuss the general (4 marks) and specific (12 marks) advantages and disadvantages of the various long acting reversible contraceptive (LARC) methods with particular reference to this woman.
    Question 7:
    A 38-year-old woman presents with vaginal bleeding at 8 weeks' gestation. An ultrasound scan suggests a likely complete molar pregnancy.
    A. Discuss your clinical management, including how you would counsel the patient. (10 marks) Four months after the initial diagnosis she has persistent vaginal bleeding and a rising BhCG.
    B. Discuss the principles of her further management and outline what additional investigations are required. (10 marks)
    Question 8:
    Menorrhagia and dysmenorrhoea can be managed medically.
    A. Discuss when women should be referred for hospital specialist intervention. (7 marks)
    B. Discuss which factors influence the treatments that you would offer, and their success. (13 marks).
  25. Guest

    Guest Guest

    dear colleagues
    i did nt pass
    amaal
  26. Guest

    Guest Guest

    hav update 2009 march q
  27. Guest

    Guest Guest

    Hi ,

    Any one sitting MRANZCOG exam ?
  28. Guest

    Guest Guest

    hellow
    i passed sep 2009 part 1.please give me information about the books & others,i ve still 2 years remain.i need guideline.help me.[/i]
  29. guest mg

    guest mg Guest

    would some body please send me the emq and mcq questions for mrcog part 2 for the past 4 exams,I attended tice but i failed so please help me ,I have a problem with the emq and mcq so i need the previously collected and answered questions

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