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Early pregnancy care EMQ- part2

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1)

A27-year-old woman presents with history of bleeding at 8 weeks’
gestation.Ultrasound show saviable intrauterine pregnancy of 7weeks’
gestation.There is an18 ! 20 mmsub chorionichaematoma.O

2)

.A19-year-old has under gone a medical termination of pregnancy at 9
weeks. She presents 2 weeks later with heavy vaginal bleeding

3)

28-year-oldG1P0is12weekspregnant.ShecomplainsofPVbleeding
after inte rcourse. Her last cervicalsmear,6months ago, was reportedas
normal.

4)

415.A woman presents with hyperemesis and bleeding to the gynecology
assessment unit. An ultrasound scan suggests acompletemolar
pregnancyandthisisconfirmedfollowinghistopathologicalanalysisofthe
evacuatedproductsofconception.Whatisthekaryotypeofthespermthat
fertilisedtheoocyte

5)

A 16-year-old student attends the early pregnancy unit with mild
abdominal pain and not being able to pass urine for the past12 hours

A recent ultra sound examination showed a viable intrauterine singleton
pregnancy. On examination hervitalsignsarefound to bestablewithlower
abdominal distension.

6)

A17-year-old is bought in by ambulance after collap singina shop. Her
BPis100/70,HR115bpmandsats98%air.Shecomplainsofsevere
abdominal pain and shoulder pain and feels  faint.

7)

A31-year-old lady attends for a nuchal translucency scan  at 11weeks’
gestation She is foundtohaveagestationalsacof23mmwithayolksac.
Nofetalpoleisrecognised

8)

Acoupleareseeninthegynaecologyclinicaftertheirthirdmiscarriage.
Thekaryotypingisnormal.Thrombophiliascreeningisnegative.Pelvic
ultra sound is normal.

9) The proportion of partial moles that are triploidin origin

10)

A28 year-old-lady attends the gynaecology clinic after three consecutive
miscarriages.She and her partner are other wise well and anxioustostart
afamily.Whatisthemostappropriateadvice?

11) A 37-year-old woman presents to her GP with 6  weeks of amenorrhoea. She  under goes an ultra sound examination in the early pregnancy unitand is found to have a heterotopic pregnancy without cardiac activity in the ectopicsac.She is completely a symptomatic with stable vital signs.

 

12)

6 w pregnant.βhCG1000IU/L. Intrauterine sac measuring 50mm
containing a fetal pole ofcrown-rumplength10mm.No fetal heart activity
is identified.

13)

The risk of miscarriage in a recognized pregnancy in a woman aged
35–39years

14)

A 26-year-old woman presents to the A &E with fever, vomitingand
severe pain in her abdomen and flank.The last menstrual periodwas
6 weeks ago.Her urine pregnancy testis positive and urinalysis shows
multiple puscellsandepithelialcells.Onexamination,sheisfoundtobe
dehydratedwithapulseof98 beatsperminute(bpm),andherblood
pressure(BP)is80/40 mmHgwithrigidityandguardinginthepelvicregion

15)

A31-year-old woman presents with bleeding pervaginum.She is unsure
of the date of her lastmenstrualperiod.Onultrasoundthereisan
intrauterinegestationalsac17mminsizewithnocontents.

16)

.A recent immigrant to the U  K presents with shortness of breath
haemoptys is and vaginal bleeding.She describesa‘miscarriage’afew
monthsearlier.Apregnancytestisstronglypositiveandanultrasound
scanshowsahaemorrhagiccysticmassintheuterus.AchestX-rayshows
multiplenodulesinbothlungs.Whatisthemostlikelykaryotypeofthe
tumour?

17)

A28-year-old lady presents in her fourth pregnancy at 14weeks.Her
three miscarriages were in the middle trimester. On examination the cervix
is found to be 2 cm dilated with coning of the membrane son ultrasound

18)

A28-year-old lady presents with a positive pregnancy test in her fourth
pregnancy at 7 weeks. She has had three consecutive miscarriages. blood
results have shown anti cardiolipin antibodies outwoo casions.

A 36-year-old woman is referred from the radiology department after her
datingscanwithaspontaneous,viable7-weekquadrupletpregnancy.She
hasmilddysuriaandabdominalpain.ExaminationshowsPRof78 bpm
andBPof110/70mmHG withanormalabdominalexamination

19)  

20)

5w pregnant.βhCG600IU/Intrauterine gestation sac with mean
diametermeasuring20mm.Ayolksacwasidentifiedwithinthegestation
sac, but there is no evidence of a fetal pole

21)

10wpregnant with cramping pelvic pain and vaginal bleeding.Ultra sound
shows fetus with CRL 25 mm and fetal heart activity. Speculum
examinationshows3–4cm di late dcervicaloswithevidenceofactive
bleeding.

22)

A22-year-old is diagnosed with a 1.5cm left tubal ectopic pregnancy
(described as gestational Sac-like structure)on ultra sound.Her βh CGIs
1500IU/Landhasincreasedto1600IU/Lin48h.Sheisasymptomatic(no
pain or bleeding)and has no evidence of pelvic hemoperitoneum
ultra sound

23)

Anulliparous 21-year-oldladypresentswithabdominalpainoccurringfor
the past 4 hours.She gives a history of fainting. She has apositive
pregnancy test. She has irregular periods and can not recall the date of her
last menstrual period.Ultrasounds how sat Hicken domatium with no fetal
polewithintheuterus.ThereisasmallamountoffreefluidinPOD(Pouch
ofDouglas).Shecomplainsofleftadnexalpainandhassignsofperitonism.
Sheistachycardicandhasanormalbloodpressure.SerumbhCG(beta
humanchorionicgonadotrophin)is2300IUandhaemoglobinlevelis95
g/dL.

24)

A36-year-oldladywhoispara2presentsat10week’sgestationwith
excessive bleeding and feeling cold and clammy. She is tachycardic on
admissionwithaheartrateof120beats/ minute. On examination theosis
open.

25) A 33-year-oldprimigravidapresentstotheearlypregnancyunitat10-

week gestation with painful vaginal bleeding. On examination , her vital

signs are found to best able. Speculum examination reveals mild vaginal

bleeding with a closed cervix. Ultra sound examination shows viable

intrauterine pregnancy .Her urinalysis is normal.

26) The proportion of ectopic pregnancies that are cervical pregnancies

27)

A34-year-old is diagnosed by ultra sound to have probable complete
molar pregnancy at 10weeks’gestation.

28)

9 w pregnant.βhCG2500IU/L. left pelvic tenderness. Ultra sound shows
an empty uterus, free fluid in the pelvis(40mmby60mm)and a left
adnexal mass containing sac-like structure measuring2.5cm

29)

A28-year-old lady presents with her partner after two consecutive
miscarriages.Her last two miscarriages were in the middle trimester.She
complains of agrey is h discharge and her pregnancy testis positive

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