Day 4 – SBA – Studyebcog

1. A 16-year-old girl is referred to your clinic with primary amenorrhoea. She is fit and well and has normal secondary sexual characteristics on examination. She is 170 cm tall and weighs 62 kg. Blood investigations and ultrasound are normal. What is the most likely diagnosis?

A. Kallmann’s syndrome
B. Physiological causes
C. Resistant ovary syndrome
D. Turner’s syndrome
E. Uterovaginal agenesis

2. Whilst performing your antenatal morning ward round, you come across a 22-year-old woman in her first pregnancy at 37 weeks gestation who has been admitted with sickle cell crisis. She describes severe pain in her right arm, which is persistent. Which of the following is the most appropriate first-line management?

A. Book the patient for an induction of labour as soon as possible
B. Intramuscular pethidine
C. Intravenous antibiotics
D. Prescribe a blood transfusion
E. Prescribe thromboprophylaxis

3. You have been asked by your consultant to review the governance and standards of ultrasound training in your department. Which of the following would you undertake?

A. Develop an equipment replacement programme
B. Ensure all ultrasound images are archived
C. Review the evidence of training and continuing professional development in the department
D. Review the maintenance and calibration checks for each ultrasound machine
E. Review the reports of all examinations

4. A 28-year-old pregnant woman is diagnosed with stage 2 breast cancer. Which of the following is true regarding management?

A. Reconstruction can be performed at the same time as surgical treatment
B. Sentinel node assessment using radioisotope scintigraphy can be performed in pregnancy
C. Surgical treatment can be undertaken from the second trimester onwards
D. Systemic chemotherapy is contraindicated in the second trimester
E. Trastuzumab should be given during pregnancy instead of tamoxifen

5. A 24-year-old woman at 25 weeks gestation presents for advice following exposure to a child one week ago who developed chickenpox two days ago. Which of the following is true regarding varicella zoster virus (VZV)?

A. Following primary infection, the virus may not always remain dormant in sensory nerve root ganglia
B. HIV-positive women who develop chickenpox in pregnancy should be referred to hospital
C. It is infectious 48 hours after the rash appears until the vesicles crust over
D. VZIG should be given once a rash appears and chickenpox is diagnosed
E. VZV is an RNA virus which is transmitted by respiratory droplets and direct personal contact

6. A 22-year-old woman is diagnosed to have polycystic ovary syndrome. She asks about the risks of cardiovascular disease, as her mother has recently been diagnosed with hypertension. Which one of the following is a true cardiovascular risk from PCOS?

A. An abnormal lipid profile mainly consists of raised high density lipoprotein cholesterol
B. Blood pressure ≥ 140/90 mmHg not responding to healthy lifestyle changes warrants drug therapy
C. There is no need to rule out androgen-secreting tumours or serum
D. Women with PCOS have a high prevalence of impaired glucose tolerance test and type 2 diabetes mellitus compared to the general population
E. Women with PCOS have similar cardiovascular risks as weight-matched controls with normal ovarian function

7. A 30-year-old woman presents with a worsening cough, night sweats, and feeling unwell at 24 weeks gestation. She is found to be sputum positive for gram-positive, acid-fast bacilli, and a chest X-ray shows patch shadows in the upper zones with some fibrosis and areas of cavitation. Which of the following medication should be considered for treatment?

A. Amoxicillin and metronidazole
B. Azithromycin and erythromycin
C. Co-amoxiclav
D. Isoniazid and rifampicin
E. Zidovudine

8. One of your patients requires a hysteroscopy for investigation of postmenopausal bleeding. Which one of the following is true regarding outpatient hysteroscopy?

A. It is contraindicated in women with a BMI greater than 40 kg/m2
B. It may be achieved via the vaginoscopic route
C. Menstruation prevents the procedure
D. Operative procedures such as polypectomy will need to be performed under general anaesthetic
E. This procedure is contraindicated in nulliparous women

9. A 25-year-old woman presents in her second pregnancy at eight weeks gestation. She has previously had a painless preterm delivery at 26 weeks gestation, with no cause found. Which of the following is correct?

A. Cerclage is recommended for funneling of the cervix without cervical shortening
B. The insertion of a cerclage should be considered in women who have an incidentally identified short cervix of 25 mm length, or less, regardless of their parity
C. PPROM is not a contraindication to cervical cerclage
D. Prophylactic cervical cerclage is recommended in women with a history of previous cervical cone biopsy
E. Trans-abdominal cerclage can be performed in early pregnancy

10. A 57-year-old woman consults you for a review of her HRT, which she has been taking for three years now. Which of the following is correct?

A. Bisphosphonates are used as primary prophylactic treatment to prevent fractures
B. Clonidine can be used to treat vaginal dryness
C. Combined HRT should not be given to women who have had a bilateral salpingo- oophorectomy for BRCA mutation
D. Osteoporosis is confirmed with a T score of -2.5 on DEXA scan
E. Prophylactic removal of the uterus is not essential in treating women who are carriers for Lynch syndrome

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