Title Obs & Gyne 12-2023 update 1.pdf ✅

SPOT LIGHT ON OBS & GYNE 2024 MCQS BOOK DR FADI QUTISHAT OBS & GYNE 12/2023 MCQs 1 st Edition • For internship doctors, residents and students in medical schools. • For preparation to internship exams, entrance exam for residency in JUH, Royal medical services and Ministry of health of Jordan. • More than 30 frequently tested facts • Past papers exam QUTISHAT FADI, MD 2023/2024
SPOT LIGHT ON OBS & GYNE 2024 MCQS BOOK DR FADI QUTISHAT OBS & GYNE 12/2023 1) Regarding pulmonary embolism, All true except A. Increases with maternal age B. Is a complication of severe iron deficiency anaemia C. Is treated with warfarin in pregnancy D. Maternal tachycardia is an early sign E. S1Q3T3 on ECG is charterstic Explanation In most pregnant patients with VTE, subcutaneous low molecular weight (LMW) heparin is the agent of choice; LMW heparin may be switched to unfractionated heparin in some patients prior to labor. Warfarin and direct oral anticoagulants are generally avoided in pregnancy. The rationale for LMW heparin, suitable agents for patients with acute renal failure or those who need rapid short-term control of anticoagulation.
SPOT LIGHT ON OBS & GYNE 2024 MCQS BOOK DR FADI QUTISHAT This table applies to VTE in pregnant individuals, with the exception of individuals with a prosthetic heart valve, which is discussed separately in UpToDate. Dose level – Prevention typically uses low or intermediate dose, but therapeutic dose may be used for prevention in selected cases (eg, individuals with recurrent unprovoked thrombotic events [with or without hereditary thrombophilia or antiphospholipid antibody syndrome] who are receiving long-term anticoagulation with warfarin or a direct oral anticoagulant such as rivaroxaban 20 mg daily or apixaban 5 mg twice daily). Choice of agent – LMW heparin is recommended for most patients. UFH is used when there may be a need for rapid discontinuation, such as for delivery or perioperatively or in individuals with severely reduced kidney function (eg, CrCl <30 mL/min). Only one heparin product is given at any point in time. Confirm the absence of preservatives (eg, benzyl alcohol) in the heparin product chosen.
SPOT LIGHT ON OBS & GYNE 2024 MCQS BOOK DR FADI QUTISHAT Refer to UpToDate for anticoagulation indications, choice of dose level, duration of pharmacologic therapy, and timing of switches between LMW heparin and UFH. ACCP: American College of Chest Physicians; ACOG: American College of Obstetricians and Gynecologists; aPTT: activated partial thromboplastin time; CrCl: creatinine clearance; IV: intravenous; LMW: low molecular weight; SUBQ: subcutaneously; UFH: unfractionated heparin; VTE: venous thromboembolism. * Our "intermediate" dose level differs from that used in society guidelines (eg, ACCP, ACOG). Some clinicians prefer to use a different "intermediate" dose level such as enoxaparin 40 mg SUBQ every 12 hours; however, this entails a significant increase in the number of injections over the course of the pregnancy. ¶ Some clinicians use 5000 units SUBQ every 12 hours throughout the pregnancy; however, this dose may be insufficient in some patients. Reference https://www.uptodate.com/contents/venous-thromboembolism-in- pregnancy-and-postpartum-treatment?csi=4709a66aea73-4f6cb1b9- 4ffb1a077d19&source=contentShare 2) The average age of the menopause is A. 45 years B. 51 years C. 55 years D. 60 years E. 40 years Explanation Natural menopause is defined as the permanent cessation of menstrual periods, determined retrospectively after a woman has experienced 12 months of amenorrhea without any other obvious pathologic or physiologic cause. It occurs at a median age of 51.4 years and is a reflection of complete, or near complete, ovarian follicular depletion, with resulting hypoestrogenemia and high follicle-stimulating hormone (FSH) concentrations. Reference https://www.uptodate.com/contents/clinical-manifestations-and- diagnosis-of-menopausecsi=bec72397-15c1-4344-9696- e5cc302d29e3&source=contentShare