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2021 (June 2021) OSCE Stations Test sobre Obstetrics- OSCE June 2021, creado por Lit Med el 09/12/2021.

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Obstetrics- OSCE June 2021

Pregunta 1 de 11

1

You are a doctor obsterician gynecologist.
Today is 12 JUN2021

Mrs. R. K., 30 years old, primigravida, arrived to outpatient clinic for prenatal care. A woman complains for a morning nausea. Her period is late so she performed a pregnancy test. It was positive. Mrs. R.K. is worried, she wants to perform all laboratory tests as soon as possible. She thinks that she needs genetic testing for fetus chromosomal abnormalities, because she is 30 and read about such useful possibilities online.
LMP 5 APR 2021. Menstrual cycle was regular, 30 days in length, bleeding lasts for 5 days

From history: a woman has no chronic extragenital diseases, no surgery and allergies. Her grandmother had diabetes mellitus, and mother has hypertonic disease.

You made inspection, checked blood pressure – 130/84mmHg, recommended ultrasound scan of I trimester and performed laboratory tests:

Blood group – A, Rh factor – negative (blood group of husband – B, Rh factor – positive),
Tests for HIV, syphilis, hepatitis B – negative. Gliucose test – 4,4mmol/l.

CBC: hemoglobin – 132g/l, leucocytes – 11x10 /l, trombocytes – 220x10 /l.

Urinalysis - nitrites (1+), no leucocytes. Urine culture – bacterial colonisation ( >10 E.coli) was found.

Calculate estimated day of delivery using Naegeleʼs formula: Select one (1p)

Selecciona una de las siguientes respuestas posibles:

  • 12 JAN 2022

  • 30 DEC 2021

  • 14 JAN 2022

  • Naegeleʼs formula can not be used in this case because the length of cycle is not 28 days

  • 5 JAN 2022

Explicación

Pregunta 2 de 11

1

Are there the indications for a screening for chromosomal
abnormalities in the I trimester:
Select one or more (2p)

Selecciona una o más de las siguientes respuestas posibles:

  • Yes, they are, because a woman is 30 years old

  • No, they are not, because a woman is under 35 years old

  • No, they are not, because there are no data about the chromosomal pathology in womanʼs and her husbandʼs families

  • Yes, they are, a screening for chromosomal abnormalities in the I trimesteris a routine test for all women

  • Yes, they are, indication –womanʼs wish

Explicación

Pregunta 3 de 11

1

Please, evaluate womanʼs blood pressure (BP):
Select one (1p)

Selecciona una de las siguientes respuestas posibles:

  • Such BP is too high in the I trimester

  • A woman needs consultation of the cardiologist for further detailed examination

  • Normal

Explicación

Pregunta 4 de 11

1

The blood groups and Rh factors of spouses do not match. The
correct decisions are:

Select one or more (4p)

Selecciona una o más de las siguientes respuestas posibles:

  • After Rh prophylaxis is important to follow antibodies titre till the delivery

  • If Rh prophylaxis was done at 28 week of gestation, so after delivery antibodies titre should be tested – after results a decision about second dose will be given

  • If no antibodies are present, Rh prophylaxis is administrated at 28-30 gestational week

  • After Rh prophylaxis there is no need for the antibody screen later in pregnancy

  • After delivery the second dose of Ig should be provided if a newborn was Rh D positive

  • After delivery the second dose of Ig should not be provided if a newborn was Rh D negative

  • Antibody testing should be performed and repeated at 20 and 27-28 week of gestation

Explicación

Pregunta 5 de 11

1

Results of the urine analysis: the nitrites (1+) positive and
leucocytes negative. The bacterial colonisation (>10 E.coli) in
the urine culture was found.
Such results show:

Select one (1p)

Selecciona una de las siguientes respuestas posibles:

  • A low quality of the test. There are not enough data for infection, because no leucocytes are in the urine sample. The tests must be repeated

  • An infection of the urine bladder – cistitis

  • Acute pyelonephritis in pregnancy

  • Asymptomatic bacteriuria in pregnancy

Explicación

Pregunta 6 de 11

1

Results of the urine analysis: the nitrites (1+) positive and
leucocytes negative. The bacterial colonisation (>10 E.coli) in
the urine culture was found.
Your decision is:

Select one (!p)

Selecciona una de las siguientes respuestas posibles:

  • To start antibacterial therapy

  • To recommend a homeopathic treatment for urinary tract infection

  • To repeat the tests after 1 week and to start antibacterial therapy if the Abnormalities will persist

Explicación

Pregunta 7 de 11

1

You will perform a fetal ultrasound screening scan at:

Select one (1p)

Selecciona una de las siguientes respuestas posibles:

  • 16-17 week of gestation

  • 18-20 week of gestation

  • 30-32 week of gestation

  • I will not perform any ultrasound scan, because the scan at I trimester is already done and it was normal

Explicación

Pregunta 8 de 11

1

Should glucose tolerance test (GTT) be done in this case:

Select one (1p)

Selecciona una de las siguientes respuestas posibles:

  • Yes (at 30-32 week of gestation)

  • Yes (at 24-28 week of gestation)

  • GTT must be done at I trimester, because womanʼs
    grandmother has diabetes mellitus

  • No, because glucose at I trimester was normal

  • Yes (at 28-30 week of gestation)

Explicación

Pregunta 9 de 11

1

You will perform a Beta Hemolytic Streptococcus (GBS) Culture
test at 35 - 36 week of pregnancy. If it will be positive, then the
right statements are:

Select one or more (2p)

Selecciona una o más de las siguientes respuestas posibles:

  • A planned cesarean section must be recommend on purpose to reduce a risk for the newborn

  • A woman has GBS infection in the vagina, a treatment should be started before delivery on purpose to reduce a risk for the newborn

  • A woman is a carrier of GBS

  • A newborn is at risk of early neonatal sepsis

  • A woman does not need treatment before delivery but during delivery antibacterial therapy must be prescribed

Explicación

Pregunta 10 de 11

1

2 weeks left before estimated date of delivery. A woman started
to be nervous with her decision when she supposed to leave to
the hospital. Your advices:

Select one or more (3p)

Selecciona una o más de las siguientes respuestas posibles:

  • To go to the hospital if bloody spotting occurred

  • To go to the hospital if the uterus contractions started

  • To go to the hospital if the rupture of the fetal membranes occurred

  • To go to the hospital on the day which was calculated as estimated date of delivery

  • To go to the hospital if the contractions of uterus are every 10min and more often

  • To go to the hospital if fetal movements decreased

Explicación

Pregunta 11 de 11

1

You have to pay attention to fetal condition during pregnancy. Which methods are used to evaluate a fetal condition in III trimester:
Select one or more: (5p)

Selecciona una o más de las siguientes respuestas posibles:

  • Leopald maneuvers

  • Cardiotocography

  • Ultrasound fetometry

  • Assessment of biophysical profile

  • Calculation of fetal movements

  • Ultrasound and doplerometry data of fetus

  • Asessment of placenta location at ultrasound scan

  • Auscultation of fetal heart rate

  • All answers are correct

Explicación

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