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3,531 questions
A 32-year-old female is seen in the emergency department for acute shortness of breath. A helical CT shows no evidence of pulmonary embolus, but incidental note is made of dilatation of the ascending aorta to 4.3 cm. All the foilowing are associated with this finding except?
Maternal physiology changes throughout pregnancy to cope with the additional demands of carrying a foetus. Which of the following changes best represents a normal pregnancy?
At a booking visit a first time mother is told that she is rhesus negative. Which of these answers is the most appropriate advice for the mother?
A 19-year-old female presents with heavy irregular menstrual bleeding and has a BMI of 35. Which of the following is the most likely diagnosis?
A 19-year-old woman in her first pregnancy presents to the GUM clinic with an outbreak of primary herpes simplex infection on her labia. She is 33 weeks pregnant. What is the best advice regarding her herpes?
A 38-year-old woman with type 2 diabetes attends the maternal medicine clinic. She has a body mass index (BMI) of 48 and is currently controlling her sugars with insulin. You have a long discussion about her weight. What should not be routinely offered to this woman?
A 24-year-old woman in her first pregnancy has a significantly raised glucose tolerance test at 28 weeks gestation: 4.6 fasting 12.1 at one hour 9.1 at 2 hours (µmol/L). She is given the diagnosis of GDM. You are asked to counsel her about the effects of gestational diabetes on pregnancy. Which of the following is not an additional effect of having GDM?
A 33-year-old woman presents to hospital with a 2-day history of itching on the soles of her feet and the palms of her hands. Her pregnancy has been straightforward and she has good fetal movements. Liver function tests reveal an alanine transaminase (ALT) of 64 IU/L and bile acids of 30 µmol/L. You suspect that she might have developed obstetric cholestasis. Which of the following bits of advice is true?
A 19-year-old woman is referred to your pre-conception clinic. She has SLE and wants to fall pregnant. She is currently not on any treatment and has no symptoms. As part of your general counselling you should talk about the risks associated with pregnancy. Which of the following is not a particular risk to a woman with SLE?
A 24-year-old woman is in her first pregnancy. She has no significant medical history. She is 40 weeks and 2 days pregnant and has been contracting for 4 days. She is not coping with the pain. She has been given intramuscular pethidine. On examination she is found to be 4 cm dilated (fetus in the occipito-posterior position) having been the same 4 hours previously. What analgesia would you recommend?
A 61-year-old woman has recently been diagnosed with a stage la endometrial carcinoma. She has had four children, she has mild utero-vaginal prolapse and she has never been operated on. She needs to have surgery. You see her in clinic and talk about the different operations available to her. Which is the most appropriate operation?
A 25-year-old woman who has three children and has recently undergone a second termination of pregnancy presents with menorrhagia and seeks appropriate contraceptive advice. Which of the following would be the most appropriate agent for this patient?
A 42-year-old man presents to his GP with 'blotches' over his legs. He has been HIV positive for ten years. On examination, there are multiple purple and brown papules over his legs and his gums. A diagnosis of Kaposi's sarcoma is suspected. What is the most likely causative organism?
A SO-year-old man underwent coronary artery bypass grafting 2 days ago. A routine liver function test result now shows that both the direct and indirect bilirubin are elevated. All the other liver function tests are normal. Which of the following is the most likely cause?
You review a 28-year-old woman with palpitations. On examination you suspect that there is splitting of the first heart sound. Her BP is 123/80 mmHg, P 70/min regular, and her chest is clear, there are no other cardiovascular fmdings. You arrange a 12 lead ECG. Which part of the ECG is most closely associated with the first heart sound?
A 24-year-old woman attends the antenatal clinic. She has had a glucose tolerance test which is abnormal. A diagnosis of gestational diabetes is mad The primary purpose of this appointment is to explain to her what gestational diabetes means to her and her baby. You explain to her that sugar control is important and there are specific glucose ranges that she should try to adhere to. Which of the following would be correct advice for this woman?
A 24-year-old woman who is IDV positive is in her first pregnancy. She is 39 weeks pregnant and is seen by you in the antenatal clinic. She has just transferred to your care, with no other previous antenatal car She reports that her pregnancy has been uncomplicate Her CD4 count is 180/mm3 and her viral load is 5500 copies/mL. She has come to find out what advice you have for her delivery?
A 32-year-old man with AIDS who is experiencing chronic diarrhea, anorexia, and wasting is referred for evaluation for nutritional support. Results of physical examination are as follows: temperature, 97.6° F (36.4° C); heart rate, 67 beats/min; blood pressure, 102/62 mm Hg; respiratory rate, 12 breaths/min; height, 70 in; and weight, 50 kg. The patient appears chronically ill; there is bitemporal wasting, and his hair is easily pluckable. The patient says he has friends with AIDS who are receiving ''I.V. nutrition,'' and he would like to know if such therapy would benefit him. Which of the following statements regarding home total parenteral nutrition (TPN) is true?
You see a 75-year-old man with an acute episode of haematemesis, who was admitted the night before and is awaiting an upper GI endoscopy. You are asked on the ward round about the common causes of upper GI bleeding. From the list below, which of the following is the most common cause of upper GI bleeding?
17.53. The most likely diagnosis is: