A. 1 in 387 Live births .B. 1 in 8 pregnancies .C. 1 in 2000 pregnancies D. 1 in 1000 pregnancies E. 60%F. 20%G. 2.7%.H. 1%I. 1 in 752 Live births .J. 2 in 1000 pregnanciesK. 1 in 5000 L. 1 in 20 000.M. 1 in 10000<N. 1 in 714 live birthsO. 35-40%
The above options show various percentages about Gestational Trophoblastic Disease. Following scenarios , choose the appropriate option once ,more than once or none at all.1. You are teaching junior colleagues regarding Molar pregnancy Enthusiastic Junior asks u following question What’s in Incidence of GTD in UK
2. Ms, Tina, 14 year old comes to you in sexual reproductive clinic requesting for termination ,she has got a scan donev, Which shows molar pregnancy .when u counseled she ask you incidence of GTD in her age group Incidence of GTD at conception in an 14 year old conception
For below statements you can choose option once, more than once or none of all A. Perineal hematoma, inferior rectal artery. B. Vulval hematoma, inferior rectal artery. C.Broad ligament haematoma, uterine artery. D. Paravaginal hematoma, vaginal artery [or descending branch of uterine, or vaginal venous plexus]. E. Supra-vaginal hematoma, vaginal artery [or descending branch of uterine]F. Wound hematoma, superficial epigastric & superficial circumflex ileac vessels.G. Vulvo-vaginalhematoma, perineal branch of the internal pudendal. H. Sub-rectus hematoma, inferior epigastric vessels.I. Paravaginal Hematoma, internal pudendal vessels.3. A 32 year old PG delivered by SVD, 1h after delivery. She developed a Painful swelling on perineum around Rt mediolateral episiotomy extending to Rt vaginal wall
4. A 40 year old multigravida complaint of Severe pain down below 1h after Vaginal delivery of a 4.2 kg baby, no mass externally, No bleeding, tense bulge in the vagina.
A. Oral acyclovirB. IV acyclovirC. Administer VZIG to motherD. Administer VZIG to neonateE. Detailedusg after 5 weeksF. Serum for VZV IgG antibodiesG. Casearean sectionH. Induction of labourI. Administer IV ganciclovirJ. AmniocentesisK. Avoid contact with other pregnant womenL. Reassurance5. year old P1 at 24 weeks gestation contacts her GP with rashon her body. Her son has chicken pox recently. She did not have chicken pox in the past.
6. 32 year old primi at 38 weeks gestation comes to GP with h/o contact with her 5 year old nephew who had chicken pox 1 week ago.Shecant recollect having chicken pox herself.On checking the booking serum blood,IgG antibodies for varicella are positive.
A. 20%B. 1:10C. Less than 1:100D. 8:1000E. 4:10000F. 2-5/1000G. 8-12/100H. Reduces incidence of bowel and vascular trauma onlyI. Reduces incidence of vascular trauma onlyJ. Reduces incidence of bowel trauma onlyK. 15%L. A person in familyM. A person in villageN. A person in small townO. A person in large town 7. Need for emergency hysterectomy during a routine caesarean section
8. Risk of developing blood clots following caesarean section
A. Will continue treatment with tranexamic acid.B. Counsel the patient directly for hysterectomy considering age, ET and BMI in mind.C. Undertake outpatient hysteroscopy and endometrial biopsyD. Undertake outpatient hysteroscopy and endometrial biopsy and discuss risk/benefits of insertion of Mirena LNG-IUS with the woman prior to hysteroscopy.E. General anaesthetic day-case hysteroscopy and endometrial ablationF. Request a full blood count, endocrine profile (FSH, LH, testosterone, prolactin, day 21 progesterone, estradiol, TFTs) and fasting glucose/HbA1c.G. Hysteroscopic polypectomyH. Undergo imaging, with biomarkers and MDT meeting before any treatment.I. Laparotomy with hysterectomyJ. Staging Laparotomy with hysterectomy and bilateral salpingectomyK. Hysteroscopic guided polypectomy with endometrial biopsyL. Laparoscopic hysterectomy with bilateral salpingo-oopherectomyM. LNG-IUS followed by EB after 3 monthsFor each patient described below choose the single most appropriate management option from the list. Each option may be used once, more than once, or not at all.
9. Mrs.X is a 48-year-old woman, para 3, BMI- 38, presenting to secondary care with a 3-year history of worsening HMB with irregularity of her menstrual cycle. She is unresponsive to a 4 month course of transexamic acid treatment. Her cervical smear 12 months ago was normal. The woman's pelvic ultrasound shows endometrial thickness of 15 mm with no uterine structural abnormalities and normal ovaries. What is the further line of management?
10. A 54-year-old woman nulliparous, was operated for breast cancer 3 years back and is on Tamoxifen. She now complains of bleeding per vagina on and off for last 3 months. USG reveals multiple polys. What will be the next step in her management?
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