MRCOG Part One - Your Essential Revision Guide PDF
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Your Essential Revision Guide MRCOG PART ONE Your Essential Revision Guide MRCOG PART ONE fi The of cial companion to the Royal College of Obstetricians and Gynaecologists revision course Edited by Alison Fiander and Baskaran Thilaganathan ©2016RoyalCollegeofObstetriciansandGynaecologists Firstpublished2010 Allrightsreserved.Nopartofthispublicationmaybereproduced,storedortransmitted inanyformorbyanymeans,withoutthepriorwrittenpermissionofthepublisheror,in thecaseofreprographicreproduction,inaccordancewiththetermsoflicencesissued bytheCopyrightLicensingAgencyintheUK[www.cla.co.uk].Enquiriesconcerning reproductionoutsidethetermsstatedhereshouldbesenttothepublisherattheUK addressprintedonthispage. Registerednames Theuseofregisterednames,trademarks,etc.inthispublicationdoesnotimply,evenin theabsenceofaspecificstatement,thatsuchnamesareexemptfromtherelevantlaws andregulationsandthereforefreeforgeneraluse. Productliability Drugsandtheirdosesarementionedinthistext.Whileeveryefforthasbeenmadeto ensuretheaccuracyoftheinformationcontainedwithinthispublication,neitherthe authorsnorthepublisherscanacceptliabilityforerrorsoromissions.Thefinal responsibilityfordeliveryofthecorrectdoseremainswiththephysicianprescribingand administeringthedrug.Ineveryindividualcasetherespectiveusermustcheckcurrent indicationsandaccuracybyconsultingotherpharmaceuticalliteratureandfollowing theguidelineslaiddownbythemanufacturersofspecificproductsandtherelevant authoritiesinthecountryinwhichtheyarepractising. TherightsoftheauthorstobeidentifiedasAuthorsofthisworkhavebeenassertedby theminaccordancewiththeCopyright,DesignsandPatentsAct,1988. Amachine-readablecataloguerecordforthispublicationisavailablefromtheBritish Library[www.bl.uk/catalogue/listings.html] LibraryofCongressCataloging-in-PublicationData Youressentialrevisionguide:MRCOGpartone:theofficialcompaniontotheRoyal CollegeofObstetriciansandGynaecologistsrevisioncourse/editedbyAlisonFiander, BaskaranThilaganathan.–2. p.;cm. MRCOGpartone:theofficialcompaniontotheRoyalCollegeofObstetriciansand Gynaecologistsrevisioncourse Includesbibliographicalreferencesandindex. ISBN978-1-107-66713-6(paperback) I. Fiander,Alison,editor. II. Thilaganathan,Baskaran,editor. III. RoyalCollege ofObstetriciansandGynaecologists(GreatBritain). IV. Title:MRCOGpartone: theofficialcompaniontotheRoyalCollegeofObstetriciansandGynaecologists revisioncourse. [DNLM:1. Obstetrics–ExaminationQuestions.2. Gynecology–Examination Questions. WQ18.2] RG111 618.10076–dc3 2015032438 ISBN978-1-107-66713-6 PublishedbytheRCOGPressatthe RoyalCollegeofObstetriciansandGynaecologists 27SussexPlace,Regent’sPark LondonNW14RG RegisteredCharityNo.213280 RCOGPressEditor:FionaCourtenay-Thompson ArtworkbyOxfordDesigners&Illustrators (DavidMorris,ElaineLeggettandSueAldridge) Index:CathTopliffMSocInd(Adv) PrintedintheUnitedKingdombyBellandBainLtd Contents Abouttheauthors page ix Abbreviationsusedinthebook xiii Acknowledgements xii section 1 / introduction chapter1 AndrewSizerandMary 3 Revision Guide Part 1 MRCOG AnnLumsden section 2 / anatomy chapter2 DianaLawrence-Watt,Julia 7 Applied anatomy and imaging of the pelvis, femoral MontgomeryandMalcolm triangle and inguinal canal Johnston chapter3 DianaLawrence-Watt,Julia 29 Applied anatomy and imaging of the bladder, ureter, MontgomeryandMalcolm urethra, anus and perineum Johnston chapter4 DianaLawrence-Watt,Julia 41 Applied anatomy and imaging of the uterus, vagina, MontgomeryandMalcolm ovaries and breast Johnston section 3 / biochemistry chapter5 FionaLyall 53 Cell and molecular biology chapter6 AnthonyEMichael 75 Steroids and prostaglandins chapter7 MarkHeining 85 Fluid and acid–base balance chapter8 RosemaryBland 91 Calcium homeostasis and bones chapter9 MaryBoard 107 Human metabolism: carbohydrates, fats and proteins v tableofcontents section 4 / biophysics chapter10 NazarNAmsoandNeilPugh 129 Biophysics section 5 / embryology chapter11 RamSharma 151 Early embryology chapter12 VivekNama 163 Development of the urogenital tract chapter13 RohanD’Souza 173 Development and congenital anomalies of the gastrointestinal tract chapter14 RohanD’Souza 185 Development of the heart and the fetal circulation section 6 / endocrinology chapter15 DesHolden 203 Placental structure and function chapter16 GulBano 215 Hypothalamus and pituitary gland chapter17 GulBano 233 Adrenal and thyroid glands and the pancreas section 7 / genetics chapter18 ShwethaRamachandrappaand 271 Single-gene and chromosome abnormalities KatrinaTatton-Brown section 8 / immunology chapter19 SharonCooksonandIanSargent 293 Basic immunology section 9 / microbiology chapter20 SusanHopkinsandDaniel 317 Microbiology Brudney chapter21 PhilipRice 343 Viral infections in pregnancy chapter22 PhillipEHay 357 Infections in obstetrics and gynaecology section 10 / pathology chapter23 RajiGanesan 379 Cellular response to disease chapter24 RajiGanesan 383 Benign gynaecological pathology chapter25 RajiGanesan 387 Gynaecological neoplasia vi tableofcontents section 11 / pharmacology chapter26 KevinHayes 393 Pharmacokinetics, pharmacodynamics and teratogenesis chapter27 KevinHayes 405 Non-Hormonal Therapy in obstetrics and gynaecology chapter28 MichaelMarsh 413 Hormonal treatment in nonmalignant gynaecological conditions section 12 / physiology chapter29 HelenMason 425 Female reproductive physiology chapter30 HelenMason 431 Male reproductive physiology and the fertilisation process chapter31 AsmaKhalil 439 Physiology of pregnancy chapter32 ArisTPapageorghiou 449 Fetal physiology section 13 / statistics and epidemiology chapter33 FionaBroughtonPipkin 465 Basic statistics chapter34 AndrewHShennanandAnnette 481 Screening and trials statistics Briley chapter35 PrathibaMDeSilvaandArri 489 Epidemiology Coomarasamy section 14 / data interpretation chapter36 AndrewRSizer 511 Data interpretation Index 527 vii About the authors NazarNAmsoPhDFRCOGFHEA SharonCooksonPhD Obstetrics and Gynaecology, Cardiff University School Formerly Postdoctoral Research Assistant, University of Medicine, Cardiff, UK of Oxford, Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK GulBanoMDFRCP Senior Lecturer in Clinical Endocrinology, St George’s ArriCoomarasamyMBChBMDFRCOG Hospital NHS Trust, London, UK Professor of Gynaecology and Director of Tommy’s National Centre for Miscarriage Research, Institute of RosemaryBlandPhD Metabolism and Systems Research, University of Honorary Associate Professor, Warwick Medical Birmingham, UK; Consultant Gynaecologist and Sub- School, The University of Warwick, and University specialist in Reproductive Medicine and Surgery, Hospitals Coventry and Warwickshire NHS Trust, Birmingham Women’s Hospital, UK Coventry, UK RohanD’SouzaMDMSCMRCOGFCPSDNBDGODFP MaryBoardMADPhil(Oxon) Maternal–Fetal Medicine Physician, Mount Sinai Biochemistry Lecturer, St Hilda’s College, University of Hospital, Toronto, Canada; Assistant Professor, Oxford, Oxford, UK Obstetrics and Gynaecology, University of Toronto AnnetteBrileyMSc PrathibaMDeSilvaBSc(Hons)MBBSAICSM Consultant Midwife /Clinical Trials Manager, AcademicFoundationDoctor,WestMidlandsDeanery, King’s Health Partners, Division of Women’s Health, UK; Honorary Research Fellow, Birmingham Women’s St Thomas’ Hospital, London, UK Hospital and University of Birmingham, UK FionaBroughtonPipkinMADPhilFRCOG(adeundem) AlisonFianderDM,MSCFRCOG Professor Emeritus of Perinatal Physiology, Clinical Lead RCOG Leading Safe Choices Programme, University Department of Obstetrics and and Honorary Chair Obstetrics and Gynaecology, Gynaecology, City Hospital, Cardiff University, Cardiff, UK Nottingham, UK RajiGanesanMBBSCestMed EdFRCPath DanielBrudneyMRCP(UK) Consultant in Histopathology, Department of Cellular Specialty Registrar, Department of Microbiology, Pathology, Birmingham Women’s NHS Foundation Royal Free Hospital, London, UK Trust, Edgbaston, Birmingham, UK ix abouttheauthors PhillipEHayFRCP MichaelMarshMDFRCOG Reader in HIV/Genitourinary Medicine, Departmentof Consultant in Obstetrics and Gynaecology, King’s Genitourinary Medicine, St George’s, University of College Hospital, London, UK; Honorary Senior London, London, UK Lecturer, King’s College School of Medicine, London, UK; Honorary Senior Lecturer, Institute of Psychiatry, KevinHayesMRCOG London, UK Consultant and Senior Lecturer, St George’s, University of London, London, UK HelenMasonPhD Senior Lecturer, Basic Medical Sciences Division, MarkHeiningFRCA Faculty of Medicine and Biomedical Sciences, Consultant in Anaesthesia, Nottingham University St George’s, University of London, London, UK Hospitals NHS Trust, Nottingham, UK AnthonyEMichaelPhD,FRSB DesHoldenPhDMRCOG ReaderinReproductiveBiologyand DirectorofTaught Medical Director, Surrey and Sussex Healthcare NHS Programmes, School of Biological and Chemical Trust, Redhill, Surrey and Medical Director, Kent, Sciences, Queen Mary, University of London, Surrey and Sussex Academic Health Science Network London, UK SusanHopkinsFRCPIMScEpi JuliaMontgomeryFRCOG,MA Consultant in Infectious Diseases, Senior Educational Research Fellow, Honorary Department of Microbiology, Royal Free Hospital, Clinical Lecturer, Brighton and Sussex Medical School London, UK and Consultant Obstetrician and Gynaecologist, Brighton and Sussex University Hospitals Trust, MalcolmJohnstonMRCSFRCR Brighton, UK Consultant Radiologist, Brighton and Sussex University Hospitals and Western Sussex Hospitals and Senior VivekNamaMDMRCOG Lecturer and Lead for Radiology Education at Brighton Consultant Gyn Oncologist, Croydon University and Sussex Medical School, Brighton, UK Hospital, London, UK AsmaKhalilMRCOG ArisTPapageorghiouMRCOG Senior Research Fellow in Feto-Maternal Medicine, Consultant in Fetal Medicine and Obstetrics, University College London, UK Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George’s Hospital NHS Trust, DianaLawrence-WattPhD London, UK Emeritus Professor of Human Anatomy, Brighton and Sussex Medical School, Brighton, Sussex, UK NeilPughPhDFInstP Chair and Consultant Physicist, MaryannLumsdenMBBSMDFRCOG School of Medicine, Cardiff University, Professor of Medical Education and Gynaecology, Cardiff, UK SchoolofMedicine,UniversityofGlasgow,Glasgow,UK ShwethaRamachandrappaPhD FionaLyallMBAPhD Specialist Registrar in Clinical Genetics, Professor of Maternal and Fetal Health, School of South West Thames Regional Genetics Service, Medicine, University of Glasgow, Yorkhill Hospitals, Department of Genetics, St George’s Hospital NHS Glasgow, UK Trust, London, UK x abouttheauthors PhilipRiceFRCPath AndrewSizerMPHMDPhDMRCOGDFSRHPGCert Department of Microbiology, Norfolk and Norwich Consultant in Reproductive Medicine and University Hospitals NHS Foundation Trust, UK Surgery, Clinical Director for Gynaecology, Royal Shrewsbury Hospital, Shrewsbury, UK; Senior IanSargentPhD Lecturer, Keele University School of Medicine, Emeritus Professor of Reproductive Science, University Keele, UK of Oxford, Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK KatrinaTatton-BrownMD Consultant in Clinical Genetics, South West RamSharmaPhD Thames Regional Genetics Service, Department Lecturer, Centre for Learning Anatomical Sciences, of Genetics, St George’s Hospital NHS Trust, Division of Medical Education, School of Medicine, London, UK University of Southampton, Southampton General Hospital, Southampton, UK BaskaranThilaganathanMDFRCOG Director,FetalMedicineUnit,DepartmentofObstetrics AndrewHShennanMDFRCOG and Gynaecology, St George’s Hospital NHS Trust, Professor of Obstetrics, Maternal and Fetal Research London, UK Unit, Division of Women’s Health, King’s College London, UK xi
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