MRCOG Part 2 – Free Library – Antenatal Care – EMQ

Option List:
A. Admit for induction of labour.
B. Admit to control glucose.
C. US for foetal weight
D. US for Umblical Artery Doppler
E. CS at 38 weeks.
F. Reassure and send her home
G. Reassurance and reassess at 2 weeks
H. Induction of labour at 37-38 weeks
I. Increase pre-lunch insulin
Each of the following clinical scenarios relates to a woman with diabetes. From the list of options above, for each woman select the single most appropriate option. Each option may be used once, more than once or not at all.

1.  A para3 know case of diabetes is on insulin, came for routine ANC check up at 33 weeks with HbA1c of 7.4%, urine glucose 2+ and US showing foetal growth below 10th percentile. What is the appropriate next step?

2. Para 2 known case of type1 diabetes at 36 weeks of GA on insulin. Her HbA1c 6.5% came after lunch to diabetic joint clinic. Her urine analysis shows glucose 2+. US babies 40^th percentile. Patient is otherwise stable.

Option List:
A. 1 in 2
B. 1 in 12
C. 1 in 3
D. 1 in 4
E. 1 in 8
F. 2 in 3
G. 2 in 7
H. 3 in 4
I. 100%
J. 0%
A pregnant woman attends the antenatal clinic with a family history of genetic tests have been performed on her and her partner, that has revealed they both are carriers of cystic fibrosis. Both are carriers of the most common mutation associated with cystic fibrosis the deltaF508 mutation. The women and her partner have some questions which they put you in clinic. Which of the answers from the list is the most appropriate?

3. If this child is unaffected, what is the chance of her having an affected child in her next pregnancy?

4. What is the chance of her having an affected son?

5. Her sisters husband has a sister affected with cystic fibrosis deficiency and has asked your patient to make enquiries for her. What are the chances of her having an affected child? Neither of them has had any genetic tests?