and Janesh Gupta2
(1)
Fetal Medicine, Rainbow Hospitals, Hyderabad, Telangana, India
(2)
University of Birmingham Birmingham Women’s Hospital, Birmingham, UK
EP1
The incidence of clinically recognised miscarriage in pregnancy is about:
A.
Less than1 %
B.
1–2 %
C.
5–10 %
D.
10–20 %
E.
20–30 %
EP2
The most common indication for women attending gynaecology emergency in the UK is:
A.
Bleeding in early pregnancy
B.
Missing IUCD
C.
Pain in the lower abdomen
D.
Pelvic organ prolapse
E.
Urinary incontinence
EP3
Which of the following routes of administration is inappropriate for the drug misoprostol:
A.
Oral
B.
Subdermal
C.
Sublingual
D.
Rectal
E.
Vaginal
EP4
Which one of the following ultrasound descriptions is diagnostic of miscarriage (GS, gestational sac; CRL, crown-rump length; FHR, fetal heart rate)?
A.
Mean GS diameter 25 mm, with no obvious yolk sac or fetal pole
B.
Mean GS diameter 25 mm containing a fetal pole with CRL = 3 mm without evidence of FHR
C.
Mean GS diameter 40 mm containing a fetal pole with CRL = 7 mm with evidence of FHR
D.
No identifiable intrauterine or extrauterine GS with serum βhCG 200 IU/L
E.
No identifiable intrauterine or extrauterine GS with serum βhCG 1500 IU/L
EP5
A 20-year-old, who is at 12 weeks’ gestation, has a 2-day history of vaginal bleeding and lower abdominal pain. Ultrasound shows a 25 mm fetal pole with absent fetal heart rate. Pelvic examination reveals her cervix to be 4 cm dilated with bulging intact membranes. Which one of the following is the most likely diagnosis?
A.
Cervical incompetence
B.
Incomplete miscarriage
C.
Inevitable miscarriage
D.
Pregnancy of uncertain viability
E.
Threatened miscarriage
EP6
A 29-year-old, who is at 6 weeks’ gestation, is diagnosed to have a right tubal ectopic pregnancy by transvaginal pelvic ultrasound. Which one of the following factors would enable systematic methotrexate to be offered as a medical treatment option for the ectopic pregnancy?
A.
Ectopic adnexal mass is 5 × 4 cm in size.
B.
Initial serum hCG 1000 IU/L.
C.
Presence of fetal heart beat in ectopic pregnancy.
D.
Ultrasound evidence of haemoperitoneum >50 mL.
E.
The woman has had previous salpingectomy so further salpingectomy surgery is contraindicated.
EP7
A 29-year-old, who is at 6 weeks’ gestation, presents with slight vaginal spotting. Transvaginal pelvic ultrasound shows no evidence of any intrauterine or extrauterine pregnancy. A serum βhCG is measured at initial presentation and repeated 48 h later. Which one of the following βhCG results is suspicious for a clinically significant ectopic pregnancy?
A.
500, 1200
B.
800, 200
C.
1000, 400
