Data Interpretation Extra Questions

1. Which of the following is true concerning CTG monitoring.

2. Which of the following regarding diagnosis of diabetes in pregnancy is incorrect?

3. A positive result for protein on urine dipstick can indicate all of the following except

4. Regarding serum β HCG, which of the following is incorrect?

5. Regarding semen analysis, which of the following is correct?

6. Fetal blood sample is performed on a primiparous 24 year old woman at 7 cm dilatation, due to a pathological CTG. The result shows a pH of 7.24. Which is the most appropriate action based on this result?

7. An 18 year old pregnant woman attends antenatal clinic at 32 weeks gestation. Her urine sample reveals protein + & leucocytes +. She is asymptomatic of a urinary tract infection & is otherwise well. What is the most appropriate action?

8. A 22 year old primi books her pregnancy at 11 weeks gestation. Her booking blood tests reveal a Hb level of 10.1 g/dl. Electrophoresis reveals Hb karyotype HbAS. What is the diagnosis?

9. A 32 year old woman is being continuously monitored during labour using a CTG.she has had one previous LSCS for breech presentation at term. She is currently 40 weeks gestation & in spontaneous labour. The baseline of the CTG is 115 bpm. What is the accepted range for the baseline rate?

10. A 32 year old multiparous pregnant woman attends the antenatal clinic for review at 28 weeks gestation.she mentions that her 4 year old daughter has chicken pox.she is unsure whether she has had chicken pox before.serology results are as follows.
VZ virus IgM—negative,VZ virus IgG—positive.what do the serology results suggest regarding her immune status with respect to chicken pox?

11. A 40 year old primi is admitted & investigated for raised BP. Protein is 3+ on urine dipstick. A 24 hr urine collection is sent for protein calculation. What level of urinary protein excretion in 24 hrs indicates significant proteinuria?

12. A 27 year old primi presents with lower abdominal pain & some vaginal spotting. Her LMP was 5 weeks ago. Her se.βHCG on presentation is 258iu/L.as she is clinically stable, with no risk factors for ectopic pregnancy, she goes home & returns to the EPAY 2 days later for a repeat se.βHCG. The results are as follows D1-βHCG 258, D2 –βHCG 460 iu/L. Which of the statements below best describes this pts se.βHCG trend?

13. A couple with primary subfertility who have been trying to conceive for over 12 mths, attend a reproductive medicine unit. The male partner has already given a sample for analysis. The results of semen analysis are as follows—volume 4.5ml, sperm count 12million/ml, total motility 61%. What does this analysis indicate?

14. A 34 year old primi is induced at 40 weeks gestation & 12 days for postdates. The fetus is continuously monitored via a CTG. At 6 cm dilatation the CTG becomes pathological & FBS is done. The results of the FBS are as follows-sample 1-pH 7.19, sample 2-pH 7.20. What are the most appropriate interpretation & action based on the FBS results?

15. A 37-year-old multiparous woman with gestational diabetes is in labour. The labour is being continuously monitored using a cardiotocograph (CTG). She is reviewed by the obstetric team and the parameters of the CTG are noted.
Baseline: 130 beats per minute
Accelerations: present
Variability: < 5 beats per minute for 50 minutes
Decelerations: typical variable decelerations with more than 50% of contractions for 30 minutes
Contractions: three to four contractions in 10 minutes
On the basis of this report how is the CTG best classified?

16. A 23-year-old woman is admitted at 6 weeks’ gestation with severe hyperemesis gravidarum. Her serum potassium is 2.7 mmol/L.What is the normal range of serum potassium?

17. A 64 year old woman undergoes a TAH with BSO for endometrial carcinoma. The staging of the specimen is described as stage 1b. What is the definition of stage 1b endometrial carcinoma?

18. An 82-year-old woman is undergoing investigation for postmenopausal bleeding. Her serum lactate dehydrogenase (LDH) is found to be raised. Which of the following conditions is associated with a normal level of LDH?

19. A 54-year-old woman is investigated for abdominal bloating and weight loss. A range of blood tests are sent as part of her investigations. Which of the following serum levels would be increased if the she had hepatocellular cancer?

20. A 67-year-old woman is undergoing investigation for postmenopausal bleeding. An ultrasound scan shows her endometrial thickness to be 6 mm. What is considered a normal endometrial thickness for a postmenopausal woman?

21. A 32-year-old primiparous woman attends the maternity day unit at 34 weeks’ gestation complaining of itching of the palms of her hands. Her blood tests show raised bile acids of 17 μmol/L. Her alanine aminotransferase is raised to 180 IU/L. What is the most likely diagnosis?

22. A 38-year-old woman attends a colposcopy clinic following an abnormal result of moderate dyskaryosis at cervical screening. The results of the biopsy taken at colposcopy indicate cervical intraepithelial neoplasia (CIN) II. What is the extent of cervical involvement in CIN II?

23. A 25-year-old nulliparous woman attends cervical screening for the first time. The results of her smear test show borderline nuclear changes. What is the appropriate follow-up for this woman?

24. A 25-year-old primiparous woman has a forceps delivery. She sustains trauma to the perineum. You perform a per rectal examination. You note that <50% of the thickness of the external sphincter has been torn. What grade of perineal tear has the patient sustained?

25. A 38-year-old multiparous woman is admitted with a heavy antepartum haemorrhage (APH) at 26 weeks’ gestation. She has had three previous caesarean sections. On examination, her abdomen is soft and non-tender. What is the most likely cause of this woman’s APH?

26. A 32-year-old primiparous woman with gestational diabetes is 32 weeks pregnant. At her antenatal clinic review her symphysis fundal height is measured as 38 cm. She is referred for an urgent scan to assess fetal growth and amniotic fluid index. Which amniotic fluid index would indicate polyhydramnios?

27. Pregnant lady with:
I) severe itching
ii) LFT normal
ii) Serum bile acids elevated
iii) Serum bilirubin normal
What is the diagnosis?

28. Patient with pleuritic chest pain shortness of breath. 1st investigation

29. Patient with high prolactin. Normal FSH and LH. low progesterone. high TSH. what is the cause

30. Patient c/o headache on the day of hysterectomy, she is known to have DM and hypothyroidism. ABG: pH 7.5, pCO₂ low, bicarb 24, normal anion gap

31. . Patient seen after hysterectomy with Hb 6.2g/dl, haematocrit 29%, Blood pressure 80/90, pulse 109 bpm. What is the most likely cause?

32. Pregnant woman climbed high attitude and felt breathless plus paraesthesia in her hands. What is the acid-base imbalance?

33. A 25-year old primigravida with underlying sickle cell disease presents at 32 weeks of pregnancy with intense itching. A set of liver function tests is requested, with the following results: ALT normal, bilirubin normal, albumin
slightly low, bile acid high, ALP slightly high. What is the most likely diagnosis?

34. Postoperative patient with history of DM and asthma. develops some feeling of unwellness. Sodium 112 mEq/L  and other parameters were in normal range. What is the diagnosis?

35.  X hormone (2 peak) : 1st at day 12 and 2nd at day 21 (1st peak > 2nd peak)
– Y hormone : constant throughout cycle except midcycle peak
– Z hormone : begin to rise few hrs after day 14 until midluteal peak
What is the X hormone?

36. Woman presents to endocrine clinic with anxiety, tachycardia and weakness.
TFT shows TSH decrease, Free T4 increase. What is the most likely cause?

37. Q about ECG trace (graph). Regular, tachycardia, NN QRS, absent p wave.
What is the correct interpretation of this ECG?

38. 28-year-old Asian woman G2P2 at 26 weeks gestation. Her BMI is 36 kg/m²
Glucose tolerance test report (75 g load) are as follows:
Fasting serum glucose : 4.7 mmol/l
2-hour serum glucose : 7.4 mmol/l
What is the diagnosis?

39. A 34-year-old woman attends antenatal clinic for a routine ultrasound scan. Abnormalities of placentation are detected and a magnetic resonance imaging (MRI) scan is organized by the fetal medicine consultant. The MRI report shows: ‘The placenta is lower anterior in which invades through the myometrium up to the uterine serosa’. What is the most likely diagnosis?

40. A pregnant woman desires screening test for down’s syndrome and the
following report is obtained:
Age related risk; 1:1000
MoM AFP; 1.05
MoM β-hCG; 0.85
Test risk; 1:10000
What will you counsel this woman?

41. The following image shows assisted conception technique by intracytoplasmic sperm injection. What will you see in the middle at 12’oclock?

42. The following diagram shows the hormonal level in a normal menstrual cycle. Which hormone is indicated in purple in the above diagram?

43. About 2 weeks postnatally, a 36-year-old multiparous woman starts to worry that her partner is spying on her as she cares for her baby. She begins to think she can hear someone telling she is doing tasks incorrectly. Her partner calls the health visitor who suspects that the most likely diagnosis is:

44. The non-pregnant uterus of a 20-year-old female measured 7 x 4 x 3 cm. She became pregnant, and just before delivery of a term infant, the uterus measured 34 x 18 x 12 cm. Which of the following cellular processes was the major reason for the increase in the size of the uterus?

45. Two days after undergoing total abdominal hysterectomy and bilateral salpingo- oophorectomy a 60-year-old woman develops high temperature and confusion. On examination; She has a temperature of 38.2°C, a respiratory rate of 28/min, a pulse of 103 beats/min, a blood pressure of 130/80 and a urine output of 10 ml/hr after catheterization. Which of the following is the most likely diagnosis?

46. Six hours after undergoing a laparoscopic tubal ligation, a 32-year-old woman complains of suprapubic pain and oozing. On examination there is a tender palpable suprapubic mass up to the umbilicus that is dull to percussion. Her Hb level is 11 g/dl. What is the most likely diagnosis?

47. A 43-year-old woman presents to her GP with a 2-month history of galactorrhoea. She is otherwise healthy and is not taking any medications. Nothing abnormal is found in the examination. Her hormonal profile was a follows :
FSH 8.7 iu/l
LH 4.5 iu/l
Oestradiol 100 pmol/l
Prolactin 700 mU/l
TSH 15 mU/l
Free T4 9 iu/l
What is the most likely cause ?

48. An 18-year-old woman presented with a history of 15 kg weight loss in the previous four months. She has been amenorrhoeic for some months. Her examination is completely normal. Her urine pregnancy test is negative. Her
laboratory results shows;
Luteinizing hormone; 0.3 mIU/l
Follicle-stimulating hormone; 0.2 iu/l
Prolactin 400 mU/l
Thyroid stimulating hormone; 1.5 mIU/L
Total T4; 200 nmol/L
Total T3; 2 nmol/l
What is the most likely diagnosis?

49. A 70-year-old lady had an ultrasound because she was feeling bloated which showed bilateral ovarian masses with no solid areas associated with abdominal ascites. She is post-menopausal and otherwise well. She was sent for a CA 125 which comes back as 50 U/mL. What is her risk of malignancy index score (RMI)?

50. A 28-year-old woman with complete hydatidiform mole is found to have bilateral multiple tiny ovarian cysts along with an enlarged uterus at 12 weeks’ gestational age. The quantitative β-hCG level of 300,000 mIU/mL.
What is the most likely type of these ovarian cysts?

51. A 35-year-old female presents in the emergency department (ED) with severe tachypnea. The following blood gases are obtained on room air:
pH 7.25
pCO2 7.8 kPa
pO2 10 kPa
HCO3- 18 mEq/L
Saturations 84 per cent
What does the blood gas show?

52. A 45-year-old woman with type 2 D.M undergoes an abdominal hysterectomy for fibroids and excess vaginal bleeding. Postoperatively, she develops shortness of breath. A chest X ray reveals bilateral hilar vascular marks with mild pleural effusion. Her blood investigation shows:
Sodium 110 mmol/L
Potassium 4.0 mmol/L
Bicarbonate 24 mmol/L
Urea 3.0 mmol/L
Creatinine 80 µmol/L
What is the most likely diagnosis?

53. The following ECG trace shows:
Regular rhythm, normal rate, multiple P wave before one NN QRS complex (4:1) What is the correct interpretation of this ECG?

54. A 36-year-old woman had intermenstrual and heavy menstrual bleeding for the past 2 months. She had a history of removal of cervical polyp 3 years ago and her cervical smears are normal. On physical examination, there are no remarkable findings. Her Hb level is normal. A pelvic ultrasound scan shows endometrial thickness of 19 mm and a round hyperechoic mass in the endometrial cavity measuring 10X8mm. What is the most likely diagnosis?

55. An 18-year-old woman has had pelvic discomfort for several months. On
pelvic examination, there is a right adnexal mass. Ultrasound picture of the right ovary shows cystic lesion measuring 3.3x 2.5 cm with echogenic septea. What is the most likely finding?

56. A 32-year-old Asian woman presents at 36 weeks of gestation with abdominal discomfort, 2+ proteinuria and a blood pressure of 140/90 mmHg. She has blood tests in accordance with the NICE guideline for the management of hypertension in pregnancy. The midwife asks you to review the following blood results. What do these results suggest? Urea 2.8 mmol/l, Creatinine 67 micromole/l ,Na- 138 mmol/l , K- 4.2 mmol/l, Urate 0.37 mmol/l , Albumin 32 g/l, ALP- 198 iu/l, ALT-  33 iu/l Bilirubin 5 mmol/l

57. A-27-year old woman complains of amenorrhea for 6 months. For the past few months she has been feeling generally tired. Prior to this she had a regular 30-day cycle. Her urine pregnancy test is negative. Pelvic examination is normal and routine bloods are ordered:
Luteinizing hormone; 33 mIU/l
Follicle-stimulating hormone; 51 iu/l
Prolactin; 300 mU/l
Thyroid stimulating hormone; 3.1 mIU/L (0.2-5.5)
Total T4; 100 nmol/L (50-500)
Total T3; 1.5 nmol/l (0.9-2.8)
Oestradiol; 70 pmol/l (100-500)
What is the most likely diagnosis?

58. 50-year-old woman with bipolar disorder is 12-week pregnant. She has been taken her lithium every night. Which of the following abnormality may occur if she continues to take lithium? (SEPT 2017)

59. What is the most likely karyotype?

60. A 16-year-old has recently become sexually active. She complains of intensely irritating greenish frothy vaginal discharge. The organism is seen under microscope with peri nuclear halo. What is the most likely causative organism? (MARCH 2017)

61. A 65-year-old nulliparous women presents with vaginal spotting. A hysterectomy is performed, and pathologic examination of the removed uterus reveals heterologous components of a malignant Tumor of the endometrial glands and metaplastic cartilage. Which of the following is the most likely diagnosis? (MARCH 2017)

62. A 25-year-old woman presents with right-sided pelvic pain for more than one year. An ultrasound scan is arranged which shows a 5 cm well-defined cystic lesion in the right adnexa with mixed echoes. There is no fluid in the cul-de-sac with the following sonographic image: (MARCH 2017)

What is the most likely diagnosis for the image of the adnexa?

63. Post-delivery the registrar notes that baby’s HR 150bpm, pink body and blue extremities, Grimace, some flexion &amp; friable cry. What is the Apgar score? (MARCH 2017)

64. Correct interpretation of the following Urogram: (MARCH 2017)

65. A 67-year-old woman attends for a preoperative assessment. She has been taking Bendroflumethiazide for several years for hypertension. Her ECG shows: What is the most likely electrolyte imbalance? (MARCH 2017)

66. A Couple with primary subfertility , who have been trying to conceive for over 12 months, attends a reproductive medicine clinic , the male partner has already give a semen sample for analysis which return back showing : 32 million spermatozoa , morphology >5, vitality >5% , live spermatozoa 63% , PH 7.2 , What is the correct interpretation of this result ? (MARCH 2017)

67. A 55-year-old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva. A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate. What is this characteristic of? (MARCH 2017)

68. 60. A 23-year-old woman who is six weeks by dates is referred to EPU with vaginal spotting, which continuous today. Ultrasound shows a fetal pole with a CRL of 4 mm. There is no fetal heart action noted. The ovaries and adnexa appear normal. What is the most likely diagnosis? (MARCH 2016)

69. A 32-year-old female presents with a two-month history of breathlessness, tachycardia and menstrual irregularity. Her Investigations revealed: (SEPT 2015). Serum hCG negative Serum T4 178 mmol/l, Serum TSH0.05 mU/L, Prolactin400 mmol/l. What is the most likely diagnosis?

70. Two months postoperatively, a 55-year-old woman who is being treated with a diagnosis of small lung cancer presents with excessive polyuria and depression and urine showed red cells +++ what is the electrolyte imbalance? (SEPT 2016)

71. A 28-year-old woman has undergone emergency hysterectomy due to obstetric haemorrhage during her 3rd pregnancy. The previous pregnancies were both term C-section deliveries. Examination of the uterus shows the placenta has not invaded the myometrium. What is the most likely diagnosis? (MARCH 2016)

72. In ECG, T wave represents

73. Abnormal LFTs, HbsAg -ve, HBeAg -ve, HBeAg +ve, HbsAg 3miu/hr, HbcAb +ve

74. 20-year-old girl goes for walking in a hill with friends and when she is on the extreme of the hill, she becomes little breathless and has paraesthesia in her hands. What is the appropriate acid base imbalance?

75. Indian Origin Lives in London Have History of Low-Grade Fever Weight Loss Cough For 5 Months. She is pregnant. CXR image given. Diagnosis?

76. An Asian woman books in for her third pregnancy at 12 weeks of gestation. She has recently moved to the UK from Thailand to be with her new husband. After pre -test counselling, with the aid of an interpreter, she agrees to hepatitis B virus (HBV) screening. The results return as follows. What is the significance of these results?
HBsAg POSITIVE
Anti-HBc POSITIVE
Anti-HBc IgM NEGATIVE
Anti-HBs NEGATIVE