MRCOG Part 2 Free Mini Mock SBA – Jan 9

1.A 30-year-old para 3 at 37+4 weeks’ gestation presents to the labour ward with heavy bleeding While transferring onto her labour room bed, she collapses. Cardiopulmonary resuscitation (CPR) is commenced. What would be the best airway protection during CPR in this patient?

2. A 40-year-old para 3 at 38+4 weeks’ gestation presents to the labour ward with heavy bleeding While transferring onto her labour room bed, she collapses, She is unresponsive, Cardiopulmonary resuscitation (CPR) is commenced, decision has been made to deliver her immediately for maternal interest. Which of the following statement is correct about peri-mortum caesarean section

3. A 35 year old lady presented in collapsed state in labour room, urgent basic life support resuscitation has been provided by arrest team but patient is unable to revive, decision of perimortem cesarean section has been made for maternal interest as her fundal height is above 20 weeks. What is the gestation limi to involve neonatologist at the time of delivery

4. A primigravida has been brought to the Accident and Emergency department in a collapsed state following a eclamptic fit at 32 weeks gestation. The resuscitation team has been called What is the most appropriate initial action in her case ?

5.24 -year-old multigravida at 32 weeks is presented with pre-labour rupture of membrane. She is 6cm dilated fully effaced cervix. On abdominal examination the head is 0/5 palpable per abdomen. You are asked to assess her 30 minute CTG trace . What would be your first step

6. All pregnant women are advice to take folic acid supplement (0.4 mg once daily) pre-pregnancy and antenatally. Nonetheless, which of the following group of women should using a higher dose supplementation of folic acid (5 mg once daily)?

7.The commonest instrument to cause perforation of uterus is

8.You are teaching your junior colleagues about Safe investigations in early pregnancy.one of the colleagues asks you about which investigation causes highest radiation exposure to fetus?

9. A 30-year-old woman has had her cervical screening hr HPV test positive and cytology result reported as mild dyskariosis. What will be your plan of management?

10. It is recommended that RMI should be used to triage post- menopausal women with ovarian cyst to assess low, moderate or high risk of malignancy. This is calculated as U (ultrasound score) × M (menopausal status) × CA125. 72 yrs old woman was found to have a 6 cm Lt ovarian multilocular cyst with solid component. Her Ca-125 is 65. What is her RMI?

11. Ms. Yen is 45 years old previous history of postcoital bleeding and had a LLETZ recently. The histology results confirm the presence of CIN 3, which has been not excised completely. How should she be followed up under the NHS cervical screening programme for her subsequent test?

12. 33 year old Emily visited for her follow up with GP. Earlier she had Colposcopy which showed acetowhite area. Colposcopic directed biopsy confirmed CIN1. On this follow up visit her hrHPV is positive which was followed by Cytology which showed borderline squamous changes. What is the next step in her management?

13. Treatment of CIN is Cone biopsy, LLETZ, laser conisation, laser ablation, cryocautery, cold coagulation, radial diathermy. No one superior to other. When excision is done the aim should be 80% of cases should have specimen removed as a single sample. Absolute risk of preterm delivery increases by what percentage if excision done between 10-14mm.

14. The prevalence of constipation is estimated to affect ——of pregnancies.

15. You are part of the team managing a 24-year-old pregnant woman who developed acute kidney injury at 28 weeks of gestation following a road traffic accident. What will be the pregnancy-specific indication for considering renal replacement in this woman?

16.A 29-year-old transplant patient on mycophenolate mofetil wishes to become pregnant. She attends a preconception clinic run by the transplant and obstetric multidisciplinary team. She is advised to switch the mycophenolate mofetil to azathioprine. How long should she be on the new medication for before she becomes pregnant?

17. A 28-year-old woman with type I diabetes attends the pre-conception clinic and is found to be struggling to control her diabetes. Her insulin requirements are not high. A decision is taken to commence her on an insulin pump in order to get her glycaemic control better before pregnancy. What would be the minimum interval from commencing the pump to her starting to try for a pregnancy?

18.A 30-year-old woman who suffers from inflammatory bowel disease (IBD), which has been active, reports that she is pregnant. She is currently taking sulfasalazine therapy. What is the likely course of the IBD in the pregnancy?

19. Your midwife calls you to see a patient in the labour ward. They are worried by the volume of blood loss and feel that she may require transfusion. What type of blood product should be stored by all units for use in major obstetric haemorrhage?

20 : You are reviewing a patient who delivered via ventouse 2 hours earlier. You note a bulge developed around her vagina. You suspect it’s a vulval hematoma. Which of the following vessels is responsible for a vulval haematoma?

21. You are counselling a patient during your postnatal rounds regarding the health benefits of breastfeeding with a woman who has recently delivered her child. When does NICE advise breastfeeding should ideally occur?

22. The midwife ring the buzzer to review a patient in the labour ward. She has beenbleeding heavily postpartum after delivering a 3.4kg baby boy. Antenatally she is uneventful and of low risk . You review her bloods which are as follows:

• Hb 70 g/l
• Platlets 74x 10º9
• PT 12.5 seconds (INR 1.0)
• APTT 36 seconds
• Fibrinogen 2.2 g/l

Which of the above results are deranged outside of the therapeutic targets for massive bloods loss?

Targets as set out British Committee for Standards in Haematology and published in GTG 52

23 .Mrs.Maha ,34 year old went for emergency cesarean section .she developed massive Postpartum hemorrhage , which ended in cesarean hysterectomy . Total duration of surgery was 4hours . during surgery, her arm abducted more than 90degrees .post op she developed ERB’S palsy,
which part of the brachial plexus was got damaged.

24. Mrs. Razanza, 60year old presented with mass per vagina .on examination she has Grade 3 prolapse on POPQ. After counseling she has decided for vaginal hysterectomy. At the end of hysterectomy, vault descends to introitus. To prevent vault prolapse, consultant decodes to proceed for Sacrospinous fixation. What measures need to be taken to prevent pudendal nerve injury?

25. Mrs. x, 24 year old had prolonged second stage, postnatal period she developed footdrop. Which nerve is commonly injured?