Options:
A, Abruption of placenta Secondary to pre-eclampsia
B, APH
c, Concealed hemorrhage
D, In labour
E, Intrautrine death
F, Placenta accreta
G, Placenta previa
H, preterm labour
i, Primary PPH
J, Secondary PPH
1) A 25- y/o , who's 38 wks pregnant, presents to the labour ward wid a h/o fewer fetal movements than usual during the evening. She also says that abdominal contractions are coming every few minutes n she's been havin a bloodstained show per vagina 4 the last few minutes. O/E : cervix is fully effaced, 9-cm dilated, cephalic presentation and station is +1.
2) A 30- y/o primigravida, who's 30 wks pregnant, presents to the labour ward wid absent fetal movements. She also C/O severe headache, heartburn and seeing floaters b4 her eyes for the last few days. O/E: BP 170/110 , Urine, protein ++++, rock-hard uterus, wid no visible signs of fetal movements per abdomen.
3) A 20- y/o pregnant , 32/40 weeks by date, presents to the antenatal clinic with a H/O painless per vaginal bleeding after inercourse. O/E: P/A- Soft and relaxed, uterus= dates, CTG-- reactive.
4) A 24 y/o primigravida, who's 30 wks pregenant , presents to the labour ward wid a H/O constant abdominal pain for the last few hours. She also gives a H/O havin lost a cupful of fresh blood per vagina b4 the pain started. Abdominal examination shows an irritable uterus. CTG- reactive.
5) A 38 y/o woman, 10 days postpartum , presents to her GP wid a h/o passing blood clots per vagina since yesterday. O/E her BP is 90/40 , pulse 110bpm, temp: 38C , P/A, uterus tender on palpation and fundus 2cm above the umbilicus, P/S, blood clots ++++
Gyanae Investigations:
Options;
A, Cervial punch biopsy
B, colposcopy and LLETZ
C, Diagnostic hysteroscopy and endometrial biopsy
D, Diagnostic laproscopy and tubal dye test
E, Diagnostic laparotomy
F, Hycosy
G, Hysterosalpingography
H, Pregnacy test and serum BHCG
i, Serum LH and serum FSH
J, T/V USS of the pelvis
K, Pippele biopsy and saline sonography
Single MOst Appropriate Ix
6) A 55 y/o comes to your Gyanaecological clinic wid a H/O intermenstural bleeding while on cyclical combined HRT.
7)A 23- Y/O is rushed into A&E in a state of shock. Her partner informs you that she'd been C/O lower abd: pain this morning n then suddenly collapsed. He also tells you that her LMP was 6-7 wks ago. A portable TAS shows free fluid in the pelvis . O/E her GCS score is 3, pulse 140bpm and BP 70/40.
8) A 35 y/o pt: comes to your clinic wid a 2 yr H/O primary subfertility. She also gives a H/O menstrual irregularity, severe dysmenorrhoea and dyspareunia.
9) A 42- y/o woman comes to your clinic wid a 4- yr H/O secondary infertility. She already has a 6 year old child who was conceived after IVF treatment. It has only been recently that she has had the financial means to seriously consider a second child. She also informs you that for the last few months her periods have gradually become more and more irregular and she has also been experiencing night sweats.
10) A 48 y/o Asylum seekerpresents to your clinic wid a H/O a bloodstained foul smelling vaginal discharge. On per speculum exam: you see a large ulcerated mass arising from the cervix.
Please friends explain the answers if possible. Many thanx.
Hi KAMI : my Gynae
& Obs
: is not very good , trying to appear in July PLAB
1 , i think these questions are from Aneesa Naik Emqs book pak: ??? can you please post your answer and explanation. I read this book ages ago, and forgot !!!
thanx
can moderator or any senior member help me to find out the correct ansewer coz kazmi suppose to post answer as doraemon has posted the ansewer , ARE THEY CORRECT ?? If not can someone help please. ???
Options:
A, Abruption of placenta Secondary to pre-eclampsia
B, APH
c, Concealed hemorrhage
D, In labour
E, Intrautrine death
F, Placenta accreta
G, Placenta previa
H, preterm labour
i, Primary PPH
J, Secondary PPH
1) A 25- y/o , who's 38 wks pregnant, presents to the labour ward wid a h/o fewer fetal movements than usual during the evening. She also says that abdominal contractions are coming every few minutes n she's been havin a bloodstained show per vagina 4 the last few minutes. O/E : cervix is fully effaced, 9-cm dilated, cephalic presentation and station is +1.
Answer : D, In labour – the picture is one of a patient near the end of II stage of labor
2) A 30- y/o primigravida, who's 30 wks pregnant, presents to the labour ward wid absent fetal movements. She also C/O severe headache, heartburn and seeing floaters b4 her eyes for the last few days. O/E: BP 170/110 , Urine, protein ++++, rock-hard uterus, wid no visible signs of fetal movements per abdomen.
Answer - A, Abruption of placenta Secondary to pre-eclampsia. + E, Intrautrine death. Her BP and urine proteins as well as headache etc point to a severe Pre-elampsia. Abruptiio placent will cause a rocky hard uterus with strong possibility of fetal demise.
3) A 20- y/o pregnant , 32/40 weeks by date, presents to the antenatal clinic with a H/O painless per vaginal bleeding after inercourse. O/E: P/A- Soft and relaxed, uterus= dates, CTG-- reactive.
Answer: G, Placenta previa- Typicall painless bleeding is due to placenta previa
4) A 24 y/o primigravida, who's 30 wks pregenant , presents to the labour ward wid a H/O constant abdominal pain for the last few hours. She also gives a H/O havin lost a cupful of fresh blood per vagina b4 the pain started. Abdominal examination shows an irritable uterus. CTG- reactive.
Answer - B, APH Since there is visible cupful of blood loss, it is unlikely to be concealed hemorrhage. Also Abruptio placent usually leads to fetal loss or severe compromise, whereas here the CTG is reactive. Hence APH is the most logical.
5) A 38 y/o woman, 10 days postpartum , presents to her GP wid a h/o passing blood clots per vagina since yesterday. O/E her BP is 90/40 , pulse 110bpm, temp: 38C , P/A, uterus tender on palpation and fundus 2cm above the umbilicus, P/S, blood clots ++++
Answer: J, Secondary PPH. A primary PPH and placenta accreta would have been seen immediately post partum and not after 10 days. This is secondary PPH.
|
Topic Tags: 
