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POSTGRAD.

EXAMS
Khaled M A Khaled
CONSULTANT
DEPT. OF OBSTETRICS AND GYNAECOLOGY
Colchester Hospital University Foundation NHS Trust
MCQs
Read Carefully and Understand Clearly
Do Not Read Between the Lines
Guess or Not To Guess
Organise Your Time
MCQs
In the Part 2 MRCOG examination you are allowed 1 hour and 30
minutes for 225 questions.
The EMQ paper is combined with the MCQ, with a total of 165
minutes.
This might appear too little, but it is not. The items you are sure of
will take only a few seconds.
The same applies to those items about which you are totally
ignorant. We suggest you go through the whole paper first,
answering those questions to which you are sure you know the
answers.
As you are unlikely to change these answers, you are advised to
record them on the answer sheet from the outset
Fill-in the Answer Sheet Correctly
Hints
Common/ characteristic/ usual/ typical: what is expected to be
found in the average, textbook description
Recognised/ may occur/ can occur: has been described, even if
rarely.
Essential feature: must occur to make a diagnosis.
Frequently/ often: imply a rate of occurrence greater than 50%.
Never: 0%.
Always: 100%.
Rare: <5%.
Beware that absolutes are very rare in medicine. Items that
contain always or never are often false.
EMQ TECHNIQUES
Read Carefully and Understand Clearly
Approach each question independently
Approach the questions clinically
Do Not Read Between the Lines
Guess or Not To Guess
Organise Your Time
Fill-in the Answer Sheet Correctly
Hints for EMQ Answering
Read the lead-in statement first.
Ask yourself the question Do I really understand
what the lead in statement says?
Consider each question one by one.
Think the answer to the item in your mind.
Select the correct answer from the list of options
Correctly enter your answer into the mark sheet.
Oxytocin

In labour, should be given in 5% dextrose. F
Is secreted by the anterior pituitary gland. F
Has an anti-diuretic effect. T
Is a glycoprotein. F
The lupus anticoagulant

Results in an increased risk of postpartum
haemorrhage. F
Is present in about 5% of the obstetric population. F
Should be checked in cases of recurrent pregnancy
loss. T
May be associated with a fetal loss rate in excess of
50%. T
Causes prolongation of the clotting time in vitro. T
Is a recognised cause of congenital heart block. F
In multiple pregnancy
Scanning should be arranged at 20 weeks to assess the
zygosity. F
Fetuses of disparate sex indicate dizygotic twins. T
Fetuses of similar sex are usually monozygotic. F
A membrane detected on ultrasound indicates a
dichorionic pregnancy. F
Scanning in the first trimester can assess fetal number
and chorionicity. T
When calculating the perinatal mortality (PNM)
rate in the UK

The total number of live birth is used as a denominator. F
The number of stillbirths is included in the enumerator. T
Babies dying as a result of lethal congenital abnormality are
excluded. F
The total number of babies dying in the neonatal period is
included in the enumerator. F
Babies born dead before 28 weeks gestation are not included. F
All babies born before 20 weeks are not included. F
Factors associated with increased PNM
include

Social class 1. F
Smoking. T
Primigravidity. T
Increased parity. T
Increased maternal age. T
Previous pre-term labour. T
Previous TOP. F
Increased paternal age. F
Respiratory distress syndrome

Is increased in incidence in term babies born with a
weight below the third centile. F
Is increased in incidence in babies born by elective
caesarean section. T
Affects about 90% of babies born before 32 weeks. F
Is more common in female infants. F
Is increased in incidence in term babies born to
Heroin addicted mothers. F
Does not occur at term. F
Babies of diabetic mothers are at an increased risk of:

Hyperglycaemia. F
Hypocalcaemia. T
Renal vein thrombosis. T
Hypertrophic cardiomyopathy. T
Anaemia. F
Hyperbilirubinaemia. T
Developing diabetes later on in life. T
Neural tube defect. T
IUGR. T
The following vaccine can be safely
administered during pregnancy:

Tetanus vaccine. T
Diphtheria vaccine. T
Salk polio vaccine. T
Sabin polio vaccine. F
Rubella vaccine. F
Measles vaccine. F
In a pregnant woman who develops Hepatitis B
(HB):

Breast-feeding is contraindicated. F
Hepatitis B virus is found in breast milk. T
Her baby should be given both active and passive
immunisation after delivery. T
Caesarean section will reduce the risk of vertical
transmission. F
The presence of HBe antibodies indicate high
infectivity. F
There is a higher incidence of prematurity. T
Fetal blood sampling in labour

Should be performed if there is a deceleration lasting
for over 3 minutes. F
Is contraindicated when the mother is a Hepatitis B
carrier. T
Is contraindicated in cases of maternal HIV infection.
T
Is contraindicated during preterm labour at 32 weeks.
T
Is contraindicated in cases of maternal herpes simplex
genital infection. T
Thrombophilia screen had been done in a case of DVT at 32
weeks gestation. The
following conditions could be diagnosed with certainty from the
results:

Protein S deficiency. F
Anti-thrombin deficiency. F
Factor V Leiden mutation. T
Prothrombin G20210A variant. T
The fetal biophysical profile (BPP) may have useful reliable
applications in the following clinical circumstances:

Insulin dependent diabetes mellitus. F
A pregnancy at 42 weeks. T
Multiple pregnancy. T
Maternal hypertensive disorder. T
Preterm rupture of the membranes. T
Recognised complications of prenatal invasive
diagnostic tests include
A miscarriage risk of 5% for amniocentesis. F
A risk of limb reduction defects for chorionic villus
sampling (CVS) performed before 10
weeks. T
A risk of neonatal postural limb defects following
amniocentesis. T
An increased risk of miscarriage if amniocentesis is
performed at 13 rather than 16 weeks. T
Rhesus isoimmunisation in Rhesus positive women. F
Breast-feeding is contraindicated if the mother
is taking:

Heparin. F
Warfarin. F
Insulin. F
Low dose aspirin. F
Combined oral contraceptive pill. F
Lithium. T
Tetracycline. T
Metronidazole. F
Phenindione. T