Data interpretation

Question 1

What is a dermoid cyst

Answer 1

Similar to a teratoma but only has epidermal and dermal elements

Question 2

What is a teratoma/mature teratoma

Answer 2

often has ecto/endo/meso elements.

Mature teratoma = has well differentiated elements from at least 2 germ cell layers - ecto/endo/meso. Developmentally mature skin with hair follacles, sweat glands, sometimes hair and other tissues.

Question 3

How much of body weight is water?

Answer 3

60%

Question 4

How much of body weight is plasma?

Answer 4

4%

Question 5

How much of body weight is ICF and how much is ECF?

Answer 5

ICF = 40%
ECF = 20%

Question 6

What is ultrasound frequency

Answer 6

> 20 kHz

In medical imaging it is between 2-15 MHz

Question 7

Ultrasound appearance of miscarriage

Answer 7

1) mean gestation sack >/=25mm with no yolk sack

2) crown rump length >/=7mm with no fetal heart beat

Question 8

USS appearance of complete molar pregnancy

Answer 8

snowstorm appearance = multiple anechoic areas within solid echos

bunch of grapes = represents hydropic swelling of the trophoblastic villi

Question 9

USS appearance of partial mole

Answer 9

severe fetal abnormalities
abnormal gestation sack
enlarged placenta containing anechoic lesions

Question 10

USS appearance of endometrioma

Answer 10

evidence of haemorrhagic debris - ground glass echos
diffuse homogenous low level echos

Question 11

What are the normal FBS values

Answer 11

> 7.25 is normal
7.21-7.24 - borderline
<7.20 abnormal

Question 12

Action if abnormal CTG and FBS is 7.26

Answer 12

Repeat in 1 hour if CTG remains abdnormal

Question 13

Action if abnormal CTG and FBS is 7.21-7.24

Answer 13

Repeat in 30 minutes

Question 14

Action if abnormal CTG and FBS is <7.20

Answer 14

Consider delivery

Question 15

Indications for FBS

Answer 15

Abnormal CTG and cervix >3cm dilated

Acidosis suspected and cervix >3cm dilated

Question 16

Contraindications for FBS

Answer 16

Maternal infection
Known coagulopathy of fetus
acute fetal compromise
prematurity <34 weeks

Question 17

What are the main anion/cations intracellularly

Answer 17

ANION = phosphate
CATION = potassium

Question 18

What are the main anion/cations extracellularly

Answer 18

ANION = chloride
CATION = sodium

Question 19

With spirometry define: vital capacity, tidal volume, inspiratory reserve volume, inspiratory capacity

Answer 19

vital capacity = volume if exhale all the way then inhale all the way

tidal volume = resting breath volume

inspiratory reserve = inspiratory capacity - tidal volume

Question 20

What do each of these indicate: hepatitisB surface antigen, anti-hepBcore, anti-hepBsurface, IgM anti-Hbcore

Answer 20

hepatitisB surface antigen = current infection

anti-hepBcore = immunity due to past infection

anti-hepBsurface = immmunity due to vaccination

IgM anti-Hbcore = recent infection

Question 21

Which 2 tests to be performed in all women struggling to conceive?

Answer 21

mid-luteal progesterone = should be >30. Antyhing <16 suggests anovulation

chlamydia screen

Question 22

Features on USS of a functional cyst

Answer 22

Anechoic
thin walled
unilocular
>3cm diameter - otherwise is a follicle
no solid components
no colour flow

Question 23

Describe the reassuring features of a CTG

Answer 23

Accellerations

No decellerations or early variable decellerations with no concerning characteristics for <90 minutes

Variability 5-25

HR 110-160

Question 24

Describe the non-reassuring features of a CTG

Answer 24

Variable decellerations with no concerning characteristics for 90 minutes or more

OR

Variable decellerations for MORE than 30 minutes with concerning characteristics in <50% contractions

Variable decellerations for LESS than 30 minutes with concerning characteristics in >50% contractions

Late decellerations in >50% contractions for LESS than 30 minutes with no other evidence of maternal/fetal compromise

Variability <5 for 30-50 minutes OR >25 for 15-25 minutes

HR 100-109 OR 161-180

Question 25

Abnormal features of CTG

Answer 25

HR <100 or >180 Variability <5 for >50 minutes OR >25 for >25 minutes Late decellerations for >30 minutes Variable decellerations for >30 minutes in >50% contractions Acute bradycardia Single prolonged decelleration lasting >3 minutes

Question 26

Summarise B-rules and M-rules

Answer 26

B-rules: - unilocular - no blood flow - presence of acoustic shadowing - solid components where largest solid component <7mm - smooth multilocular tumour where largest diameter <100mm T-rules - irregular solid tumour - lots of blood flow - at least 4 papillary structures - Ascites - Irregular multilocular tumour where largest diameter is >100mm

Question 27

What should sperm PH be

Answer 27

>7.2

Question 28

How much sperm should be in 1 round of ejaculate

Answer 28

>1.5ml

Question 29

What is normal sperm count/ml and per ejaculate

Answer 29

>15mil/ml >39mil total

Question 30

What is the normal % normal morphology in sperm

Answer 30

>4%

Question 31

What is the normal motility/progressive motility of sperm

Answer 31

motility >40% progressive motility >32%

Question 32

What is normal sperm vitality (total number of alive sperm)

Answer 32

>58%

Question 33

What do you do if sperm count abnormal

Answer 33

repeat in 3 months

Question 34

What can steroids do to potassium

Answer 34

cause a mild hypokalaemia

Question 35

What do you see on bloods of alcoholic

Answer 35

macrocytic anaemia

Question 36

What to do if a scan does not reach miscarriage criteria

Answer 36

Repeat scan in 7 days

Question 37

What would you expect to see with JVP in: heart failure, pericardial constriction, AF

Answer 37

right heart failure/overload - raised JVP pericardial constriction - paradoxical JVP (kussmaul's) AF - absent A waves

Question 38

What is the ideal ARTERIAL cord sample values following delivery

Answer 38

7.26-7.30

Question 39

What frequency of USS is used for transabdominal USS

Answer 39

3-3.5 Mhz

Question 40

What frequency of USS is used for transvaginal USS

Answer 40

5-7.5

Question 41

What is pernicious anaemia. Which molecule does it prevent from being absorbed? Incidence? Peak age?

Answer 41

Autoimmune destruction of parietal cells in the stomach which normally produce intrinsic factor. IF binds to B12 so that it can be absorbed. 1/10,000 60

Question 42

What two tests are looked at to suggest menopause?

Answer 42

FSH >30 with a low progesterone

Question 43

What two tests are looked at to suggest menopause?

Answer 43

FSH >30 with a low progesterone

Question 44

What to do if in pregnancy there is protein in the urine? What would the results tell you?

Answer 44

Organise a 24h urine collection to find out the total protein and protein:creatinine ratio Results : total protein >300 mg = significant proteinuria OR protein:creatitine ratio >30:1 mg/mmol

Question 45

What is the USS appearance of MUCINOUS cystadenoma?

Answer 45

Multilocular variable levels of echogenicity due to the difference in contents of the locules thin walled septa usually large

Question 46

What is the USS appearance of SEROUS cystadenoma?

Answer 46

Unilocular

Question 47

What is the threshold pH for adverse neurological outcomes in arterial cord sampling?

Answer 47

<7.10

Question 48

When should mid-luteal progesterone be taken?

Answer 48

7 days before starting period so in 35 day cycle on day 28 or in 28 day cycle on day 21