MATERNAL HEALTH

Question 1

most common organism cause of infection/wound deheiscence after episiotomy

Answer 1

Group A strep

Question 2

when can copper coil be inserted as emergency contraception?

Answer 2

five days post UPSI on current cycle or 5 days after ovulation

Question 3

high risk for neural tube defect - folic acid supplementation how?

Answer 3

5mg daily up to 12 weeks

Question 4

high risk group for neural tube defects

Answer 4

malabsorption/chrons, BMI more than 30, taking anti-epileptic, family and personal history of neural tube

Question 5

non medication management of N+V in pregnancy

Answer 5

ginger, accupressure and accupunture

Question 6

What is the first line MOST appropriate antihypertensive agent in the post-natal period for white person?

Answer 6

Enalapril

Question 7

What is the first line MOST appropriate antihypertensive agent in the post-natal period for afro-carribean?

Answer 7

Nifedipine

Question 8

Antihypertensive assoicated with post-natal depression

Answer 8

Methyldopa - should be stopped 2 days before birth

Question 9

Treatment for bacterial vaginosis on pregnant women

Answer 9

Metronidazole 400 mg twice-daily for 5–7 days

Question 10

What day of menstrual cycle makes COCP need another form of contraception

Answer 10

Day 6 or later

Question 11

Medication that can cause oligospermia

Answer 11

Sulfasalazine

Question 12

Which one of the following mood stabilising drugs is MOST likely to be associated with congenital abnormalities?

Answer 12

Sodium valproate

Question 13

Window for levonorgestrel after UPSI

Answer 13

72 hours

Question 14

When can IUD inserted as emergency contraception

Answer 14

It can be inserted up to five days after the first episode of unprotected sexual intercourse (UPSI). If the timing of ovulation can be estimated, insertion can be beyond five days of UPSI, as long as it does not occur beyond five days after ovulation.

Question 15

According to the Civil Aviation Authority (CAA) what is the gestation at which most airlines no longer permit flying?

Answer 15

36 weeks

Question 16

Contraception given to patients with epilepsy

Answer 16

Contraceptive injectable (can also give IUD or IUS)

Question 17

IUD inserted after age 40, when can it be removed

Answer 17

can remain in situ until one year after the last menstrual period (LMP) if it occurs when the woman is 50 or older. If a woman is under 50, the IUD can remain in situ for two years after the LMP.

Question 18

The recommended vaccines in pregnancy (in the United Kingdom)

Answer 18

influenza, pertussis, and Covid-19

Question 19

When can influenza be given at gestational age

Answer 19

Any gestational age

Question 20

When can pertussis be given as vaccine for pregnant women

Answer 20

18-20 weeks

Question 21

continuous machine-like murmur that is maximally heard under her left clavicle, diagnosis?

Answer 21

Patent ductus arteriosus (PDA)

Question 22

progestogen only implant primary mode of action

Answer 22

prevention of ovulation

Question 23

pregnancy can be terminated in the UK until what age of gestation

Answer 23

24 weeks

Question 24

You see a 28-year-old who has recently had emergency contraception in the form of ulipristal acetate. She is asking for advice on when she can start her regular combined oral contraceptive pill.

Answer 24

Regular hormonal contraception can be started 5 days after ulipristal acetate

Question 25

First line of treating gestational hypertension

Answer 25

Labetalol

Question 26

When are anomaly scans done

Answer 26

18–20 weeks of gestation

Question 27

injectable progestogen main risk for wome age 50, so avoid, why?

Answer 27

decrease bone density

Question 28

one risk factor for pre-eclampsia

Answer 28

first pregnancy or first pregnancy with a new partner

Question 29

when can aciclovir be given for chickenpox in pregnnacy

Answer 29

within 24 hours of onset of rash and 20 weeks gestation or later

Question 30

refer to foetal medicine for chicken pox when

Answer 30

16-20 weeks age of gestation or 5 weeks after infection

Question 31

Which is the SINGLE MOST likely outcome associated with intermittent rather than daily oral iron supplementation during pregnancy?

Answer 31

Fewer maternal side effects

Question 32

patient on rifampicin and rifabutinin on COCP, how long should additional contraception be used

Answer 32

duration of abx + further 4 weeks

Question 33

When can LNG IUD be isnerted after delivery

Answer 33

48 hours after delivery or 4 weeks post partum if not breastfeeding and 3 months if breastfeeding (risk o futerine perforation)

Question 34

LNG IUS licence for how many years

Answer 34

8 years

Question 35

Down syndrome screening is ideally done either from

Answer 35

11–14 weeks or 15–20 weeks gestation

Question 36

Which ONE of the following may be associated with the maternal use of potent or very potent topical steroids in pregnancy?

Answer 36

Low birth weight

Question 37

What is the recommended time interval at which the semen analysis should be repeated?

Answer 37

Three months

Question 38

LNG IUS can be removed at what age

Answer 38

55 - natural fertility can be assumed

Question 39

progestogen only pill - late taking pill offers still protection if late how many hours

Answer 39

no more than 3 hours, 12 hours for desogestrel

Question 40

first line for constipation in pregnancy

Answer 40

isuphaga or bulk-forming laxatives

Question 41

tests can be done to screen for down syndrome

Answer 41

Quadruple test (hCG, Inhibin-A, unconjugated oestriol and alpha fetoprotein)

Question 42

Which ONE of the following groups of women is at greatest risk of inadequate vitamin D stores during pregnancy?

Answer 42

Women with a pre-pregnancy body mass index greater than 30 kg/m2

Question 43

delay for conception after vaccination with rubella

Answer 43

one month

Question 44

thrush pregnant woman, mangamenr

Answer 44

clotrimazole pessary without applicator

Question 45

most common abnormality associated with infertility in men

Answer 45

Varicocele

Question 46

What is the most common adverse effect of the progesterone-only implant?

Answer 46

Irregular bleeding

Question 47

UK antenatal screening programme for haemoglobinopathies at what age of gestation should be performed

Answer 47

Screening should ideally take place by 10 weeks gestation

Question 48

which is the SINGLE MOST appropriate DIAGNOSTIC test for endometriosis

Answer 48

Laparoscopy

Question 49

when should emergency contraception be considered for those taking COCP and missed a pill

Answer 49

if UPSI on pill free interval or first week

Question 50

flu-like illness, which medication to offer pregnant women

Answer 50

oseltamivir

Question 51

National guidelines currently recommend some supplements in pregnancy which are? 2 answers

Answer 51

Folic acid and vitamin D

Question 52

When can women retain IUS until 55

Answer 52

If it had been inserted from 45 years old

Question 53

Limit for flying for multiple pregnancy (age of gestation)

Answer 53

32 weeks

Question 54

Woman on HRT now requiring contraception , she is 50. What to give and what to avoid

Answer 54

Progestogen options are safe but avoid injectables as it reduces bone density. Give 52mcg LNG IUD for 5 years with oestrogen only HRT