Question:The following are recognised complications of massive blood transfusion

Polycythaemia
True

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

Thrombocytosis
True
Iron overload
True
Hypokalaemia
True

Question:In early pregnancy

A gestation sac may be identified by trans-vaginal scan as early as 4.2
weeks from LMP
True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Sac diameter increases by ~1.2mm / day in normal pregnancy

True

False

Sac volume is better than sac diameter in estimating gestation age

True

False

A pseudo-sac is associated with the presence of the double decidual sign

True

False

Explanation

Question:In early pregnancy

A gestation sac can be identified by trans-abdominal scan when HCG
>6000IU/L
True

False

A pseudo-sac is visualised in over 80% of ectopic pregnancies

True

Your answer:
True

False

Correct answer:
False

In a normal pregnancy, fetal heart should always demonstrable if CRL > 6mm

True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

In a normal pregnancy, fetal heart should always be detectable if sac

diameter > 30mm
True

False

Explanation

Question:Recognised causes of vomiting in late pregnancy include

Ulcerative colitis
True

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: False

False

Red degeneration of uterine fibroid

True
Acute fatty liver of pregnancy
True
Multiple pregnancy
True

Explanation

Question:With respect to molar pregnancy

The lowest incidence is in women aged over 35 years

True

Your answer:
True

Correct answer:
False

False

Your answer:
True

Correct answer:
True

False

Your answer:
True

Correct answer:
False

False

There is a recognised geographical variation in incidence

True
The recurrence risk is ~ 1:500

True

The risk of choriocarcinoma is higher with complete moles compared to

partial moles
True

Your answer:
True

False

Correct answer:
True

Explanation

Question:A 35 year old woman is found to have a twin pregnancy with one normal and one
complete molar pregnancy at 10 weeks gestation.
The chances of a live birth in this pregnancy are ~ 1%
True

False

Your answer: True

Correct answer: False

Invasive testing for fetal karyotype or karyotype of the molar pregnancy are contraindicated
True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

The risk of preterm delivery is increased

True

False

Medical termination of pregnancy is recommended

True

False

Your answer: True

Correct answer: False

Explanation

Question:A 30 year old woman is found to have a tubal ectopic pregnancy. The following features
make her suitable for medical treatment
Serum HCG level > 10,000iu/ml
True

False

Your answer: True

Correct answer: False

Demonstration of a fetal heart echo on trans-vaginal scan

True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

False

Diameter of ectopic pregnancy < 2cm

True
Pulse of 110bpm
True

Explanation

Question:The following are recognised features of septic miscarriage

Hypertension
True

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

False

Disseminated intravascular coagulation

True
Acute renal failure
True
Jaundice
True

Explanation

Question:The following are recognised complications of early medical termination of pregnancy with
prostaglandins
Diarrhoea
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

Pyrexia
True
Bronchospasm
True
Hyponatraemia
True

Explanation

Question:A 30 year old woman is thought to have an ectopic pregnancy on trans-vaginal ultrasound
scanning
At laparoscopy, salpingotomy should be performed if the other tube appears normal

True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Laparoscopic management is associated with a greater incidence of

persistent trophoblastic tissue compared to laparotomy
True

False

Laparoscopic salpingotomy is associated with a significantly greater rate of repeat ectopic pregnancy compared
to laparotomy and salpingotomy
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

The rate of subsequent intra-uterine pregnancy does not differ

significantly between laparoscopic procedures and laparotomy
True

False

Explanation

Question:Hyperemesis gravidarum
Is associated with urinary tract infection
True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

False

Is uncommon before 12 weeks gestation

True
May be associated with jaundice
True

May be associated with abnormal liver enzymes

True

False

Explanation

Question:Hyperemesis gravidarum
Is characteristically associated with hypokalaemia

True

False

Your answer:
True

Correct answer: True

False

Your answer:

Correct answer: True

Is a diagnosis of exclusion
True

True
In severe cases may be complicated by Wernicke?s
encephalopathy
True

False

Your answer:
True

Correct answer: True

False

Your answer:
True

Correct answer:
False

Is typically associated with hypertension

True

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

Explanation

Question:Mifepristone
Is a 19-keto-steroid and a progesterone antagonist
True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Blocks uterine oestrogen receptors

True

False

Can cause severe vaginal bleeding

True

False

May interfere with glucocorticoid function

True

Your answer: True

False

Correct answer: True

Explanation

Question:The following are associated with an increased risk of first trimester miscarriage
PCOS
True

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Treated hypothyroidism
True

Well controlled insulin dependent diabetes

True

False

Balanced translocation in the father

True

False

Explanation

Question:Regarding the diagnosis of ectopic pregnancy

Diagnostic laparoscopy has a false negative rate of about 4%

True

False

Your answer:
True

Correct answer:
True

Viable intra-uterine pregnancies are detectable by trans-vaginal ultrasound when serum beta-HCG levels are
1000iu/l
True

False

Your answer:
True

Correct answer:
False

Single serum progesterone measurements are useful in the diagnosis of ectopic pregnancy

True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Use of colour Doppler can differentiate an incomplete miscarriage

from an ectopic pregnancy
True

False

Explanation

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

An un-ruptured ectopic pregnancy of <3.5cm diameter can be treated
successfully with methotrexate
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

An ectopic pregnancy with fetal cardiac activity is a contra-indication to

methotrexate treatment
True

False

The success rate of single dose methotrexate treatment is about 90%

True

False

An increase in abdominal pain is a frequent complaint following

methotrexate administration
True

False

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 answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

20% of subsequent pregnancies are ectopic

True

False

Recurrent ectopic pregnancy rates are similar to those following

laparoscopic salpingostomy
True

False

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

True

False

Explanation

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

Normal trophoblast cells are more sensitive to methotrexate than malignant trophoblast cells

True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Serum beta-HCG levels may increase between days 1 and 4

following methotrexate treatment
True

False

A rise in serum beta-HCG levels 48h after methotrexate administration is an indication for surgical treatment
True

Your answer: True

False

Correct answer: False

Increased abdominal pain following methotrexate administration is an indication for surgical treatment
True

Your answer: True

False

Correct answer: False

Explanation

Question:In the management of a pregnancy of unknown location

Women should initially be followed-up every week

True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

Active intervention should be recommended if HCG levels rise above the

discriminatory zone
True

False

Serial HCG levels should be measured until HCG is undetectable

True

False

Up to 75% of women will require active intervention if expectant management is undertaken

True

Your answer:
True

False

Correct answer:
False

Explanation

Question:With respect to the diagnosis of molar pregnancy

The majority of complete molar pregnancies are diagnosed by early pregnancy ultrasound scan
True

False

Your answer: True

Correct answer: False

Absence of cystic spaces in the placenta is suggestive of a partial molar pregnancy

True

False

Your answer: True

Correct answer: False

HCG levels are not useful in the diagnosis of molar pregnancy

True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Molar pregnancy can be present in an anembryonic

pregnancy
True

False

Explanation

Question:With respect to staging of choriocarcinoma

Stage I confined to the endometrium
True

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: False

False

Your answer: True

Correct answer: True

False

Your answer: True

Correct answer: True

False

Stage II less than 50% myometrial invasion

True
Stage III lung metastases
True
Stage IV liver metastases
True

Explanation

Question:With respect to hyperemesis gravidarum

The severity is directly related to serum HCG concentration
True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Wernicke?s encephalopathy is a recognised complication

True

False

There is an association with transient hypothyroidism in ~ 5% of women

True

False

Metabolic alkalosis is a recognised complication

Your answer: True

Correct answer: False

True

Your answer: True

False

Correct answer: True

Explanation

Question:With respect to gestational trophoblastic disease

Complete molar pregnancy has a 10x increased risk of occurring in a
subsequent pregnancy compared to women with no history of molar pregnancy

True

False

Your
answer:
True

Correct
answer: True

Your
answer:
True

Correct
answer: False

Your
answer:
True

Correct
answer: True

Complete molar pregnancy occurs most frequently in the first pregnancy

True

False

Complete molar pregnancy occurs in less than 1.5/1000 pregnancies in

Western Europe

True

False

Hydatidiform mole (chorioadenoma destruens) characteristically produces leutenising hormone

True

Your
answer:
True

False

Correct
answer: False

Explanation

Question:Concerning vaginal ultrasound in early pregnancy

The yolk sac is detected within the amniotic cavity
True

False

Your answer: True

Correct answer: False

The yolk sac reaches its maximum diameter at ~12 weeks gestation
True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

The yolk sac can be detected ~35 days from the LMP
True

False

The fetus grows at the rate of 0.1cm per day

True

False

Explanation

Question:Concerning vaginal ultrasound in early pregnancy

Absence of cardiac activity in an embryo of 3mm reliably indicates a non-viable pregnancy
True

False

Your answer: True

Correct answer: False

Your answer: True

Correct answer: True

Your answer: True

Correct answer: True

An intra-uterine gestation sac is reliably visualised 20 days

from ovulation
True

False

The diameter of the gestation sac grows at the rate of 1mm

per day
True

False

The early gestation sac is typically located in the left or right uterine cornua
True

Your answer: True

False

Correct answer: False

Explanation

Question:A healthy 20 year old woman is found to have a complete molar pregnancy at 9 weeks
gestation. She has a 14 weeks size uterus and vaginal bleeding is moderate
Anti-D immunoglobulin is not required if she is Rhesus negative

True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
True

Oxytocin may be used to manage haemorrhage once the uterus is empty

True

False

If she is admitted 3 weeks later with persistent vaginal bleeding, a repeat surgical evacuation should be
undertaken
True

False

Your answer:
True

Correct answer:
False

Your answer:
True

Correct answer:
True

If she is readmitted 2 weeks later with persistent vaginal bleeding, a

pregnancy test is recommended
True

False

Explanation

Question:A 17 year old woman attends for anomaly scan at 21 weeks gestation and is found to
have a partial molar pregnancy with a 14 weeks size fetus. Following further investigation and
counselling, she opts for termination of pregnancy

Medical management with mifepristone and misoprostol is considered first line

True

False

Your answer: True

Correct answer: False

If she is Rhesus negative, anti-D immunoglobulin is not necessary

True

False

Your answer: True

Correct answer: False

If fetal parts are visible after termination of pregnancy, histological examination of products of conception is
not necessary
True

False

Your answer: True

Correct answer: False

Persistent vaginal bleeding 6 weeks after termination of pregnancy is an indication for chemotherapy
True

False

Your answer: True

Correct answer: False

Explanation

Question:A 27 year old woman with a complete molar pregnancy has undergone suction evacuation
If her HCG levels are normal 8 weeks after evacuation, follow-up should be discontinued
True

False

Your answer: True

Correct answer: False

If HCG levels are still elevated 12 weeks after evacuation, repeat evacuation should be performed
True

False

Your answer: True

Correct answer: False

If HCG levels are still elevated 8 weeks after evacuation, chemotherapy is indicated
True

False

Your answer: True

Correct answer: False

She has a 0.5% risk of requiring chemotherapy

True

False

Your answer: True

Correct answer: False

Explanation

Question:With respect to the treatment of gestational trophoblastic neoplasia

Women with a prognostic score less than 6 should be treated with single
agent methotrexate
True

False

Folinic acid should be administered to women treated with methotrexate

Your answer:
True

Correct answer:
True

True

False

Your answer:
True

Correct answer:
True

Your answer:
True

Correct answer:
False

A woman with a prognostic score of 8 should be treated with radiotherapy

True

False

Women undergoing chemotherapy have an increased risk of congenital malformations in future pregnancies

True

False

Your answer:
True

Correct answer:
False