Thread: Need answers...

View Profile: Rani - MeDiCaLGeeK
I think this user is gynacologist, so you can send her pm.

I'm answering few quesrions.

1)Syphillis in pregnancy..qualitative vdrl is positive

a) treat syphillis
b) quantative vdrl
c) terminate pregnancy

Bcz pregnancy is one of the cause of false positive VDRL.

2) cervical intra epthelial neoplasia

a)is a cytologic diagnosis
b)histologic diagnosis
c)needs biopsy

4) which one is correct

a) food and water shuold be witheld during active labour?
b) uterine contractions can be palpated manually

4)which one is the end product of tricarboxylic acid cycle(krebs cycle)

a)glucose
bpyruvic acid
c)fatty acid
d)amino acids

None?
at the end of two cycles, the products are: two GTP, six NADH, two QH2, and four CO2

5)Rh immonoglobulin in not given in case of

a)positive antibody titre
b)at 28-34 weeks gestation
c)after amniocetesis
d)after chorionic villus sampling
e)after antepartum hemorrahage

Obviously, if Ab formed already, wht's use of RhIg. So it's for prevention , not for treatment..

========================

2)Most accurate diagnosis of ectopic pregnancy is
a)pelvic ultrasound
b)serial HCG
c)laproscopy
d)endometrial biopsy
e)culdocentesis

3)Pregnant woman with anterolateral placenta on US.examining finger cannot reach the placenta..the placenta is
a)low lying
b)marginal placenta
c)partial placenta previa
d)complete placenta previa

Confirm terminology by chking figure from standard textbook,

5)dyspareunia is caused by all of the following except:
a)cervicitis?
b)vaginitis
c)endometriosis
d)uterine prolapse
e)lack of lubricant

6)varicose veins will affect all of the following except:
a)great saphenous vein
b)short saphenous vein
c)popliteal
d)perforators

Ans by exclusion

7)16 yr old pregnant, which of the following is the least likely to be a complication of her pregnancy..
a)anaemia
b)toxemia - confirm if it's more in primi or multipara
c)pelvic complication
d)low birth wt infant
e)infant mortality

8)indication of hepatitis during pregnancy
a)SGOT
b)Alkaline phosphatase?
c)BUN
D)WBC
e)SGPT;ALT

10)Mechanism of anticonvulutory action of MGSO4 is
a)neuronal calcium channel blockade
b)peripheral neuromuscular blockade
c)reversal of cerebral arterial vasoconstriction
d)inhibition of platelet aggregation
e)release of endothelial prostacyclin.

unknown mechanism actually but central action propopsed.."magnesium's anticonvulsant mechanism of action is central, mediated through excitatory amino acid"

==============

Fibroid and pregnancy
a- can lead to sever anaemia
b- commonly lead to antepartum haemorrhage
c- should be removed surgically
d- is most likely to regress after deliveray
e- is commonly complicated with torsion

Which of the following polyps is generally
considered premalignant:
a- pedunculated polyp
b- villous polyp
c- polypoid adenoma
d- juvenile polyp
e- pseudo polyp

Etiologic factors that should be evaluated in
patient with habitual abortion includes all of the
following except:
a- genetic abnormalities
b- rubella infection
c- uterine abnormalities
d- luteal phase defect?
e- thyroid gland dysfunction

The following are accepted therapeutic options in
endometriosis except:
a- pregnancy?
b- danazol
c- surgical removal
d- radiotherapy
e- progesterone

DIC may be associated with all of the following
except:
a- preeclampsia ?(actually eclampsia)
b- acute inversion of uterus
c- abruption placenta
d-IUFD
e-DM

Laparoscopy indicated in all of the following
conditions except:
a- suspected endometriosis
b- chronic pelvic pain
c- primary amenorrhea
d- intestinal obstruction
e- infertility

===============

3- atrophic vaginitis is best treated with:
a- Oral metronidazole.
b- Topical miconazole.
c- Prolonged application of topical estrogen.
d- Oral estrogen & progestin therapy.
e- Topical sulfa cream

a topical estrogen is the best long-term treatment for vaginal itching due to atrophic vaginitis.

4-The most accurate Dx of Ectopic Pregnancy is:
a. Culdocentesis
b. Pelvic U/S
c. Endometrial Biobsy
d. Serial B-HCG
e. Laproscopy

5- U/S of pregnant lady showed posterior wall placenta. It dose not reach examining finger by vaginal exam. Which of the following is true?
a) Complete placenta previa
b) Normal site placenta
c) Low lying placenta
d) Placenta previa marginalis
e) Incomplete centralis

typeII PP?

View Profile: Rani - MeDiCaLGeeK
I think this user is gynacologist, so you can send her pm.

I'm answering few quesrions.

1)Syphillis in pregnancy..qualitative vdrl is positive

a) treat syphillis
b) quantative vdrl
c) terminate pregnancy

Bcz pregnancy is one of the cause of false positive VDRL.

2) cervical intra epthelial neoplasia

a)is a cytologic diagnosis
b)histologic diagnosis
c)needs biopsy

4) which one is correct

a) food and water shuold be witheld during active labour?
b) uterine contractions can be palpated manually

4)which one is the end product of tricarboxylic acid cycle(krebs cycle)

a)glucose
bpyruvic acid
c)fatty acid
d)amino acids

None?
at the end of two cycles, the products are: two GTP, six NADH, two QH2, and four CO2

5)Rh immonoglobulin in not given in case of

a)positive antibody titre
b)at 28-34 weeks gestation
c)after amniocetesis
d)after chorionic villus sampling
e)after antepartum hemorrahage

Obviously, if Ab formed already, wht's use of RhIg. So it's for prevention , not for treatment..

========================

2)Most accurate diagnosis of ectopic pregnancy is
a)pelvic ultrasound
b)serial HCG
c)laproscopy
d)endometrial biopsy
e)culdocentesis

3)Pregnant woman with anterolateral placenta on US.examining finger cannot reach the placenta..the placenta is
a)low lying
b)marginal placenta
c)partial placenta previa
d)complete placenta previa

Confirm terminology by chking figure from standard textbook,

5)dyspareunia is caused by all of the following except:
a)cervicitis?
b)vaginitis
c)endometriosis
d)uterine prolapse
e)lack of lubricant

6)varicose veins will affect all of the following except:
a)great saphenous vein
b)short saphenous vein
c)popliteal
d)perforators

Ans by exclusion

7)16 yr old pregnant, which of the following is the least likely to be a complication of her pregnancy..
a)anaemia
b)toxemia - confirm if it's more in primi or multipara
c)pelvic complication
d)low birth wt infant
e)infant mortality

8)indication of hepatitis during pregnancy
a)SGOT
b)Alkaline phosphatase?
c)BUN
D)WBC
e)SGPT;ALT

10)Mechanism of anticonvulutory action of MGSO4 is
a)neuronal calcium channel blockade
b)peripheral neuromuscular blockade
c)reversal of cerebral arterial vasoconstriction
d)inhibition of platelet aggregation
e)release of endothelial prostacyclin.

unknown mechanism actually but central action propopsed.."magnesium's anticonvulsant mechanism of action is central, mediated through excitatory amino acid"

==============

Fibroid and pregnancy
a- can lead to sever anaemia
b- commonly lead to antepartum haemorrhage
c- should be removed surgically
d- is most likely to regress after deliveray
e- is commonly complicated with torsion

Which of the following polyps is generally
considered premalignant:
a- pedunculated polyp
b- villous polyp
c- polypoid adenoma
d- juvenile polyp
e- pseudo polyp

Etiologic factors that should be evaluated in
patient with habitual abortion includes all of the
following except:
a- genetic abnormalities
b- rubella infection
c- uterine abnormalities
d- luteal phase defect?
e- thyroid gland dysfunction

The following are accepted therapeutic options in
endometriosis except:
a- pregnancy?
b- danazol
c- surgical removal
d- radiotherapy
e- progesterone

DIC may be associated with all of the following
except:
a- preeclampsia ?(actually eclampsia)
b- acute inversion of uterus
c- abruption placenta
d-IUFD
e-DM

Laparoscopy indicated in all of the following
conditions except:
a- suspected endometriosis
b- chronic pelvic pain
c- primary amenorrhea
d- intestinal obstruction
e- infertility

===============

3- atrophic vaginitis is best treated with:
a- Oral metronidazole.
b- Topical miconazole.
c- Prolonged application of topical estrogen.
d- Oral estrogen & progestin therapy.
e- Topical sulfa cream

a topical estrogen is the best long-term treatment for vaginal itching due to atrophic vaginitis.

4-The most accurate Dx of Ectopic Pregnancy is:
a. Culdocentesis
b. Pelvic U/S
c. Endometrial Biobsy
d. Serial B-HCG
e. Laproscopy

5- U/S of pregnant lady showed posterior wall placenta. It dose not reach examining finger by vaginal exam. Which of the following is true?
a) Complete placenta previa
b) Normal site placenta
c) Low lying placenta
d) Placenta previa marginalis
e) Incomplete centralis

typeII PP?

THANKS FOR THE RESPONCE........

some doubts..

In this question, lack of lubricant seems to be right answer, but in some books it says prolapse, and some books says cervicitis...I am confused...


1- Dyspareunia caused by all of the following except:
a) cervicitis
b) endometriosis
c) lack of lubricant
d) vaginitis
e) uterine prolapse

the diagnosis of dyspareunia is made when the patient complains of recurrent or persistent genital pain before, during, or after sexual intercourse that is not caused exclusively by lack of lubrication or by vaginismus. Clinically, it is often difficult to separate dyspareunia from vaginismus, since vaginismus may occur secondary to a history of dyspareunia and even mild vaginismus is often accompanied by dyspareunia.
Causes
Numerous medical causes of dyspareunia exist, ranging from infections (candidiasis, chlamydia, trichomoniasis, urinary tract infections), endometriosis,[5] tumors, xerosis (dryness, especially after the menopause) and LSEA. Dyspareunia may result from female genital mutilation, when the introitus has become too small for normal penetration (often worsened by scarring).
Physical causes
Because there are numerous physical conditions that can contribute to pain during sexual encounters, a careful physical examination and medical history are always indicated with such complaints.
In women, common physical causes for coital discomfort include
1. infections of the vagina, lower urinary tract, cervix, or fallopian tubes (e.g., mycotic organisms (esp. candidiasis), chlamydia, trichomonas, coliform bacteria);
2. endometriosis;
3. surgical scar tissue (following episiotomy); and
4. ovarian cysts and tumors.[6]
5. In addition to infections and chemical causes of dyspareunia such as monilial organisms and herpes,
6. anatomic conditions, such as hymenal remnants, can contribute to coital discomfort.
7. Estrogen deficiency is a particularly common cause of sexual pain complaints among postmenopausal women, although vaginal dryness is often reported by lactating women as well.[7]
8. Women undergoing radiation therapy for pelvic malignancy often experience severe dyspareunia due to the atrophy of the vaginal walls and their susceptibility to trauma.
9. Vaginal dryness is sometimes seen in Sjögren's syndrome, an autoimmune disorder which characteristically attacks the exocrine glands that produce saliva and tears.
10. Dyspareunia is now believed to be one of the first symptoms of a disease called Interstitial Cystitis (IC). Patients may struggle with bladder pain and discomfort during or after sex. For men with IC, pain occurs at the moment of ejaculation and is focused at the tip of the penis. For women with IC, pain usually occurs the following day, the result of painful, spasming pelvic floor muscles. Interstitial cystitis patients also struggle with urinary frequency and/or urinary urgency.

Dyspareunia as a significant factor
Patients with deep, internal, or thrust dyspareunia often express a feeling that some sort of internal collision is occurring during sexual activity.
Any pelvic pathology may be responsible for this discomfort, but abnormalities such as
1. endometriosis,
2. pelvic adhesions,
3. pelvic relaxation,
4. malposition (retroversion),
5. adnexal pathology or prolapse, and
6. uterine fibroids are the most likely causes.
7. Interstitial cystitis IC may cause dyspareunia before it proceeds to chronic unremitting pain.
8. IBS may also cause dyspareunia and pain at the apex of the vagina.



12- Anti D Ig not given to a pregnant if:
a) 25-28wk
b) antiDAb titer of 1:8
c) after amniocentesis
d) after antepartum hemorrhage
e) after chorion villi biopsy


Since Rh IgG became the standard of care in the United States, the risk of Rh incompatibility has been reduced from 10-20% to less than 1%. Because of its short half-life, Rh IgG routinely is administered once at 28-32 weeks' gestation and again within 72 hours after birth to all Rh-negative pregnant females as a part of routine prenatal care.
The current recommendation is that every Rh-negative nonimmunized woman who presents to the ED with antepartum bleeding or potential fetomaternal hemorrhage should receive 300 mcg of Rh IgG IM. For every 30 mL of fetal whole blood exposed to maternal circulation, 300 mcg of Rh IgG should be administered. A lower 50-mcg dose preparation of Rh IgG is available and recommended for Rh-negative females who have termination of pregnancy in the first trimester when fetomaternal hemorrhage is believed to be minimal.


IN SOME QUESTION PAPER THIS QUESTION IS SLIGHTLY CHANGED, IN THAT CASE I THINK ANSWER SHOULD BE "A" HERE..????????????



6- Not correct during management of labour
a) Intensity of uterine contractions can be moniterd manually.
b) Maternal vital signs can vary relative to uterine contractions.
c) Food & oral fluid should be withheld during active labor
d) Advisable to administer enema upon admission
e) IVF should be administered upon admession

This question too is slightly changed in some papers, and in this case what should be the answer.....????

Q 12, anti D , option "b) antiDAb titer of 1:8 " is definately wrong..if Antibodies already formed, you cant give AntiD.

oh ok!!...now I got it....................

I was thinking that, it is for both prevention and cure...

Which of the following diseases is usually
associated with increased maternal mortality when
it occurs in pregnancy:
a- syphilis
b- biliary cholestasis
c- pheochromocytoma
d- herpes genitalis
e- toxoplasmosis


-All of the following are true regarding infertility
except:
a- male-coital factor is is the causes in 40/ of
cases
b- abnormal semen analysis should show
greater than 20/ million/ml sperm count
c- Abnormalities of uterine cavity are seldom
the cause of infertility
d- it can be unexplained in about 15/ of cases
e- Endometrioses is rarely associated with
infertility

All of the following are true regarding infertility
except:
a- male-coital factor is is the causes in 40/ of
cases
b- abnormal semen analysis should show
greater than 20/ million/ml sperm count
c- Abnormalities of uterine cavity are seldom
the cause of infertility
d- it can be unexplained in about 15/ of cases
e- Endometrioses is rarely associated with
infertility[/QUOTE]

ohk....

1)which one of the following is not the cause of habitual abortions

a)uterus didelphys
b)endometrial polyp
c)endometriosis
d)ashermans syndrome
e)chromosomal abnormality