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Question 1
Incorrect
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A 41 year old woman is referred to EPAU with spotting in early pregnancy. What is the risk of miscarriage in women in this age group?
Your Answer: 75%
Correct Answer: 50%
Explanation:Miscarriage rates:
20-24 – 9%
25-29 – 11%
30-34 – 15%
35-39 – 25%
40-44 – 51%
>45 – 75% -
This question is part of the following fields:
- Epidemiology
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Question 2
Incorrect
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A 61 year old patient undergoes laparotomy for a suspicious left sided ovarian mass. Following histology the patient is diagnosed with a stage 1A ovarian epithelial cancer. What is the 5 year survival for stage 1 ovarian cancers?
Your Answer: 25%
Correct Answer: 90%
Explanation:The five year survival of stage 1 ovarian cancer is 70-90%
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This question is part of the following fields:
- Epidemiology
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Question 3
Correct
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A patient arrives on labour ward she is 37 weeks pregnant. Her last pregnancy ended with delivery via uncomplicated lower segment C-Section 4 years ago. Contractions are 5 minutes apart and on examination the cervix is 5cm dilated. What is the risk of uterine rupture with vaginal delivery?
Your Answer: 25 per 10,000
Explanation:Consideration of the risk of scar rupture is probably the most important consideration when determining whether delivery should be by elective Caesarean section or by trial of vaginal delivery.
Most published studies do not differentiate between scar dehiscence and rupture, however, analysis of observational and comparative studies indicates that the excess risk of uterine rupture following trial of labour compared with women undergoing repeat elective Caesarean section is considerably lower than 1 per cent (25/10000); indeed, some studies do not demonstrate any increased risk. -
This question is part of the following fields:
- Epidemiology
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Question 4
Correct
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Regarding ovarian cancer, which factors are thought to lower the risk?
Your Answer: Taking statins
Explanation:Ovarian cancer is a gynaecological cancer that commonly affects women over 40 years. Risk factors for ovarian cancer include: infertility, a family history of ovarian, breast or colorectal cancer. There are some protective factors, which include: high parity and breastfeeding, early age at menarche and late age at menopause, and combined oral contraceptives, and statins.
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This question is part of the following fields:
- Epidemiology
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Question 5
Correct
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Which of the following factors as shown to decrease ovarian cancer risk?
Your Answer: Taking statins
Explanation:Factors shown to decrease risk of ovarian cancer are:
– Oral contraceptive use
– Higher Parity
– Breast feeding
– Hysterectomy
– Tubal Ligation
– Statins
– SLE -
This question is part of the following fields:
- Epidemiology
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Question 6
Correct
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Regarding ectopic pregnancy, where is the most common site of implantation?
Your Answer: Ampullary tubal
Explanation:Ectopic pregnancies can quickly become a gynaecological emergency if left untreated. The majority of ectopic pregnancies (95-97%) are tubal occurring in the fallopian tube as opposed to the abdomen, ovary or cervix. In tubal ectopics, the most common site of occurrence is in the ampulla (70%), followed by the isthmus, fimbria, and the cornua.
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This question is part of the following fields:
- Epidemiology
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Question 7
Correct
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WHO defines the perinatal mortality rate as
Your Answer: The number of stillbirths and deaths in the first week of life per 1000 births
Explanation:WHO defines perinatal death as the number of still births and death in the first week of life per 1000 births.
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This question is part of the following fields:
- Epidemiology
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Question 8
Correct
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A 38 year old woman in early pregnancy is rushed to the emergency department complaining of vaginal bleeding and abdominal pain. What percentage of women her age have miscarriages?
Your Answer: 25%
Explanation:With increasing maternal age, the risk of miscarriage increases. For women between the ages of 40-44, the miscarriage rates sit at about 50% and increases to over 75% for women 45 years and over. The miscarriage rate for women between the ages of 35-39 is 25%.
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This question is part of the following fields:
- Epidemiology
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Question 9
Correct
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Which of the following is known to increase the risk of endometrial cancer?
Your Answer: PCOS
Explanation:The risk factors of endometrial cancer include obesity, diabetes, late menopause, unopposed oestrogen therapy, tamoxifen therapy, HRT and a family history of colorectal and ovarian carcinoma.
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This question is part of the following fields:
- Epidemiology
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Question 10
Correct
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Study Z gets funding to increase the population size from 1000 to 2000 patients. What effect is this likely to have on the results?
Your Answer: Decrease type 2 errors
Explanation:Increasing sample size decreases type 2 errors and increases power of the results. Sensitivity and specificity of the test should remain constant regardless of sample size. Confidence intervals are applied by a statistician and are dependent on the mean.
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This question is part of the following fields:
- Epidemiology
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Question 11
Correct
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According to the WHO, maternal mortality ratio is defined as which of the following?
Your Answer: Maternal deaths per 100,000 live births
Explanation:The World Health Organisation defines the maternal mortality ratio as the number of maternal deaths during a given period per 100,000 live births during the same period. This measure indicates the risk of death in a single pregnancy.
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This question is part of the following fields:
- Epidemiology
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Question 12
Correct
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Regarding miscarriage rates, which of the following statements is correct?
Your Answer: In women over 45 years of age miscarriage rate approximately 75%
Explanation:With increasing maternal age, the risk of miscarriage increases. For women between the ages of 40-44, the miscarriage rates sit at about 50% and increases to over 75% for women 45 years and over. The miscarriage rate for women between the ages of 35-39 is 25%.
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This question is part of the following fields:
- Epidemiology
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Question 13
Correct
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Regarding the study of the prognosis of a disease, which of the following studies is most appropriate?
Your Answer: Cohort Study
Explanation:Cohort studies are the most appropriate study design to study the prognosis of a disease. A group of patients with the same condition are chosen and their baseline information is taken. The group is then followed up over time to see which patients live or die.
Case-control studies can also be useful where a group of individuals that have survived a condition are compared with cases of those who have died. Prognostic factors that distinguish the two groups are identified. This method, however, is limited by bias and the accuracy of medical information present. -
This question is part of the following fields:
- Epidemiology
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Question 14
Correct
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Evidence from meta-analysis of RCTs is what level of evidence?
Your Answer: Ia
Explanation:The levels of evidence range from I-IV:
1a: Systematic reviews (with homogeneity) or metanalysis of randomized controlled trials: highest level of evidence.
1b: Individual randomized controlled trial (with narrow confidence interval)
1c: All or none randomized controlled trials
2a: Systematic reviews (with homogeneity) of cohort studies
2b: Individual cohort study or low quality randomized controlled trials (e.g. <80% follow-up)
2c: Outcomes Research; ecological studies
3a: Systematic review (with homogeneity) of case-control studies
3b: Individual case-control study
4: Case series (and poor quality cohort and case-control studies)
5: Expert opinion without explicit critical appraisal, or based on physiology, bench research or first principles. -
This question is part of the following fields:
- Epidemiology
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Question 15
Incorrect
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All of the following factors increase the risk of endometrial cancer except which one?
Your Answer: Diabetes
Correct Answer: High Coffee Consumption
Explanation:The risk factors for uterine carcinoma include obesity, diabetes, Nulliparity, late menopause, unopposed oestrogen therapy, tamoxifen therapy, HRT and a family history of ovarian or uterine carcinoma.
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This question is part of the following fields:
- Epidemiology
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Question 16
Correct
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A patient arrives on labour ward she is 38 weeks pregnant. Her last and only pregnancy ended with delivery via uncomplicated lower segment C-Section 3 years ago. Contractions are 6 minutes apart and on examination and the cervix is 6cm dilated. She wants to know the chances of a successful vaginal delivery if she proceeds with a vaginal delivery after C-section(VBAC). What is the chance of successful delivery with VBAC?
Your Answer: 75%
Explanation:There is 70% chance that a women who has had a C-section can deliver via spontaneous vaginal delivery.
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This question is part of the following fields:
- Epidemiology
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Question 17
Correct
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Evidence from a panel of experts is what level of evidence
Your Answer: IV
Explanation:Level I: Evidence obtained from at least one properly designed randomized controlled trial. Level II-1: Evidence obtained from well-designed controlled trials without randomization. Level II-2: Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one centre or research group. Level II-3: Evidence obtained from multiple time series designs with or without the intervention. Dramatic results in uncontrolled trials might also be regarded as this type of evidence. Level III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.
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This question is part of the following fields:
- Epidemiology
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Question 18
Correct
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WHO defines the perinatal mortality rate as
Your Answer: The number of stillbirths and deaths in the first week of life per 1000 births
Explanation:The number of stillbirths and deaths in the first week of life per 1000 births.
According to WHO the perinatal period commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth. -
This question is part of the following fields:
- Epidemiology
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Question 19
Correct
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Which of the following is the most common cause of maternal mortality?
Your Answer: Cardiac disease
Explanation:The most common cause of maternal mortality is Cardiovascular deaths due to post partum bleeding followed by hypertensive disorders of pregnancy, sepsis and complications of labour.
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This question is part of the following fields:
- Epidemiology
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Question 20
Correct
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A 42 year old woman in early pregnancy is rushed to the emergency department complaining of vaginal bleeding and abdominal pain. What percentage of women her age have miscarriages?
Your Answer: 50%
Explanation:With increasing maternal age, the risk of miscarriage increases. For women between the ages of 40-44, the miscarriage rates sit at about 50% and increases to over 75% for women 45 years and over. The miscarriage rate for women between the ages of 35-39 is 25%.
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This question is part of the following fields:
- Epidemiology
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Question 21
Correct
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Which of the following studies is most appropriate to assess the efficacy of a new medication to reduce pain caused by endometriosis?
Your Answer: Randomised Control Trial
Explanation:Randomized control trials are the gold standard when it comes to assessing the treatment options or interventions in medicine. Since its introduction, RCT has questioned the validity of treatments such as oral hypoglycaemic agents, myocardial infarction hospitalization, varicose veins, toxicity and applicability of many preventive and therapeutic procedures. The basic steps include drawing up the protocol, selecting a study population, randomization, intervention, follow up and assessment of the outcome. Note if assessing prognosis or diagnostic tests Cohort and Cross Sectional Analysis are best.
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This question is part of the following fields:
- Epidemiology
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Question 22
Correct
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According to the WHO, maternal death is defined as which of the following?
Your Answer: The death of a women whilst pregnant or within 42 days of termination of pregnancy
Explanation:The WHO defines maternal death as female death from any cause related to pregnancy or its management, including childbirth or within 42 days of termination of pregnancy. This is irrespective of the duration or site of the pregnancy.
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This question is part of the following fields:
- Epidemiology
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Question 23
Incorrect
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Which of the following has been shown to increase ovarian cancer risk?
Your Answer: Oral contraceptive pill use
Correct Answer: Hormone replacement therapy (oestrogen only)
Explanation:Factors that increase the risk of ovarian cancer include nulliparity, IUD, endometriosis, cigarette smoking, HRT and obesity.
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This question is part of the following fields:
- Epidemiology
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SESSION STATS - PERFORMANCE PER SPECIALTY
