Part 2 MRCOG 500 EMQs and SBAs

286 Pages·2019·1.969 MB·English

by  Andrew Sizer, Bidyut Kumar, Guy Calcott

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k Part 2 MRCOk G: 500 EMQs k
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k Part 2 MRkCOG: 500 EMkQs
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e and SBeAs e
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Andrew Sizer
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sf Shrewsbury and Telford Hospital NHS Trust and Keele Unsivfersity School of Medicine sf
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o Bidyut Kumar o o
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Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board
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Guy Calcott
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Shrewsbury and Telford Hospital NHS Trust
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bInformation on this title: www.cambridge.org/b9781108709712 b
e DOI: 10.1017/9781108627801 e e
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© Andrew Sizer, Bidyut Kumar and Guy Calcott 2019
This publication is in copyright. Subject to statutory exception and to the provisions of relevant
collective licensing agreements, no reproduction of any part may take place without the written
permission of Cambridge Untiversity Press. t t
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First published 2019 n n n
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Printed and bound in Great Britain by Clays Ltd, Elcograf S.p.A.
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A catalogue rercord for this publication is available from the Brirtish Library. r
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e that any content on such websites is, or will eremain, accurate or appropriate. e
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Every effort has been made in preparing this book to provide accurate and up-to-date
information that is in accord with accepted standards and practice at the time of publication.
Although case histories are drawn from actual cases, every effort has been made to disguise
the identities of the individutals involved. Nevertheless, the authors, editors atnd publishers t
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can make no warranties that the information contained herein is totally free from error, not
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least because clinical standards are constantly changing through research and regulation.
. . .
The authors, editorse and publishers therefore disclaim all liability foer direct or consequential e
damages resultineg from the use of material contained in this booek. Readers are strongly e
advised to payr careful attention to information provided by thre manufacturer of any drugs or r
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equipments that they plan to use. s s
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Conftents f f
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e Foreword vii e e
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Preface ix
Author profiles xi
Acknowledgements xiii
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Normal rangese (non-pregnant) used in the MRCOG e xv e
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Abbreviations xvii
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Introduction xix
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Moodule 1 Clinical skills 1 o Module 13 Gynaecological o
o o problems 1o55
Module 2 Teaching and
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e assessment 7e Module 14 Subfertilitye 183
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Module 3 IT, clinical governance Module 15 Sexual and reproductive
and research 14 health 199
Module 5 Core sutrgical skills 21 Module 16 tEarly pregnancy t
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n n care 209 n
Module 6 Postoperative care 30
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e Modeule 17 Gynaecological e
Module 7 eSurgical procedures 41 e e
oncology 225
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Moduslfe 8 Antenatal care 52 sf Module 18 Urogynaecology and spfelvic
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Moodule 9 Maternal medicine 9o1 floor problems o 244
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b Module 10 Management of b b
e labour 122 e e
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Module 11 Management of Index 265
delivery 133
Module 12 Postpatrtum t t
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pronblems 144 n n
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Forfeword f f
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e Membership of the Royal Colleege of Obstetricians and Gynaecologeists (MRCOG) is a
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highly regarded qualification throughout the world and confirms that the successful
candidate has achieved a widely respected standard of knowledge, skills, attitudes and
competencies in the practice of obstetrics and gynaecology. The award of MRCOG is
made after successftully passing all three parts of the MRtCOG examination. The Part 2 t
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MRCOG is desingned to test the skills necessary to pasns from core clinical training (ST1– n
ST5) to highee.r specialist training (ST6 and ST7), ea.nd represents a significant hurdle ine .
this transietion. e e
Thisr book of practice questions is an invraluable resource for candidates prepraring
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for the Part 2 MRCOG examination. Written by experienced examiners and members
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oof RCOG examination subcommitteeos, this book gives candidates the moost relevant
oand authentic practice in preparatioon for the examination of all the curroently available
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resources. The authors have vast expertise in writing examination questions and coaching
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m candidates through courses, amnd therefore this book represents them most relevant exami-
nation preparation material available to date. The authors make very clear that this book
should be used in addition to the standard revision resources as recommended by the
RCOG but have helpfully referenced each and every explanation of the correct answer to
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enable the candidaete to focus their revision of each partiecular topic. e
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This resource should become an essential part of examination preparation for all can-
. . .
didates attemepting the Part 2 MRCOG examinatioen. e
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Dr Lissa Joels MB ChB MD FRCOG FHEA s s
Chkair of the RCOG Examination and Asskessment Committee 2015–18 k
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Prefface f f
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e The current format of the Part e2 MRCOG examination is now well eestablished with the
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change to written papers containing single best answer (SBAs) and extended matching
questions (EMQs) commencing in March 2015.
The Part 2 MRCOG examination is primarily concerned with testing candidates’
knowledge of the enttire specialty of obstetrics and gynaetcology as defined by the Royal t
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College of Obstentricians and Gynaecologists (RCOG)n curriculum. n
The new eP.art 3 examination now provides the ec.linical assessment. e.
It is alweays preferable to enter an examinatioen having had ample opportunity to preac-
tise the rtype of questions with which one will bre faced. To this end, we have producerd this
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book containing 250 SBA and 250 EMQ questions.
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o We have mapped the questions acrooss all the modules of the curriculumo that appear
oin the Part 2 MRCOG examination oand have used the following sources aos our primary
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references:
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m • RCOG guidelines m m
• National Institute for Health and Care Excellence (NICE) guidelines
• Articles in The Obstetrician & Gynaecologist.
The styles of thet 500 questions are different, but this twill mimic the actual examina- t
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tion, since numenrous authors have contributed to the nPart 2 MRCOG question bank. n
In this bo.ok, we have tried to conform to the s.tyle of questions found in the Part 2 .
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MRCOG eexamination but have deliberately seeparated the questions into the differeent
modulers of the syllabus. In this way, candidartes will be able to test their knowledrge in
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each sof the modules after they have complseted the necessary reading for that pasrticular
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moodule. For each answer, we have proovided a brief explanation and a refereonce to allow
ofurther or more in-depth reading oof that subject. The explanations giveon here are not
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meant to replace the wider reading of the subject that is required to attain the level neces-
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sary to pass the Part 2 MRCOG examination.
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Knowledge accumulates, practice alters and guidelines change. We will be grateful for
feedback.
We hope that candidates for the Part 2 MRCOG will find this book helpful in their
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preparation for thee Part 2 MRCOG examination. e e
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Autfhor profiles f f
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e Andrew Sizer e e
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Andrew Sizer is a Consultant Obstetrician and Gynaecologist at the Shrewsbury and
Telford Hospital NHS Trust and Senior Lecturer at Keele University School of Medicine.
He is currently RCOG College Tutor for the Trust and Undergraduate Lead for Women’s
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Health at the Shroepshire campus for Keele University. eWithin the Postgraduate School e
of Obstetrics annd Gynaecology in Health Education nEngland, West Midlands, he is the n
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Chair of Inteermediate Training (ST3–5). He is thee immediate past Chair of the Part 1e
MRCOG eexamination committee and is currente Chair of the standard setting commitetee
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and Hfonorary Deputy Director of Conferencfes at the RCOG. He was an examiner ffor the
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Parkt 2 MRCOG OSCE and is a current ekxaminer for the Part 3 MRCOG clinikcal assess-
moent. He is the lead author of two exisoting books for MRCOG examination opreparation:
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SBAs for the Part 1 MRCOG (2012) and Part 2 MRCOG: Single Best Answer Questions
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(2016). He is also the developer of the andragOG.co.uk website, where a variety of other
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m questions in a similar format mare available. m
Bidyut Kumar
Bid Kumar was appointed as a Consultant Obstetrician and Gynaecologist in 2001.
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He has been a RCOG tutor and a member of the Wales Deanery Specialty Training
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Committee. H.e is an honorary lecturer at Cardiff U.niversity Medical School and an hon-.
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orary Senior Lecturer at Bangor University. He is a current Part 3 MRCOG examiner
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and hasr a number of current and former rolers at the RCOG including the Part 2 crourse
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faculsty, Part 2 MRCOG EMQ subcommittsee and Green-top Guideline committese. He is
Edkitor-in-Chief of Ultrasound, the journakl of the British Medical Ultrasound Sokciety, and
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an Associate Editor of the The Obstetrician & Gynaecologist. He actively contributes to
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b the education and continued profebssional development of many healthcabre professionals.
e Bid is an editor-author of Fetal Meedicine, a textbook of the RCOG’s Adevanced Skills series
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(2016) and a co-author of Tasks for Part 3 MRCOG Clinical Assessment (2018). Bid also
works for the National Guideline Alliance (NICE) as a topic lead for the review of many
obstetric guidelines.
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Guy Calcott
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Guy Calcotte .is a newly appointed Consultant Oeb.stetrician and Gynaecologist at thee .
Shrewsburey and Telford Hospital NHS Trust witeh a special interest in high-risk obstetreics,
maternfarl medicine and early pregnancy caref. rHe qualified with a distinction in Mefdricine
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and Surgery from Imperial College School of Medicine in 2009 and a First Class Honours
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Boachelor of Science in Surgery and Anoaesthesia. He completed foundation toraining and
oearly obstetrics and gynaecology traoining at North West Thames before reolocating to the
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West Midlands in 2013. He completed the MRCOG in 2015 and has been presenting and
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m teaching on Part 2 MRCOG cmourses two to three times per year sinmce 2016.
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Ackfnowledgements f f
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e The authors would like to ackenowledge the contribution of Mr Seujeewa Fernando,
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Consultant Obstetrician and Gynaecologist, Wrexham Maelor Hospital, to the questions
included in module 18.
We would also like to thank the following doctors for being our ‘proofreaders’ dur-
ing the first drafts tof the manuscript and for their usefutl feedback: Dr Joanne Ritchie t
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MRCOG, Dr Bannchhita Sahu MRCOG, Dr Michael Alngeo MRCOG, Dr James Castleman n
MRCOG, Der .Hector Georghiu MRCOG and Dr Pee.dro Melo MRCOG. e.
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Norfmal ranges (non-prfegnant) f
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used in the MRCOG
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Haematology
Haemoglobin (female): 115–160 g/l
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Haematocrit (femaele): 37–47% e e
Total white cell ncount: 4.0 × 109–11n.0 × 109/l n
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Platelets: e 150 × 109e–400 × 109/l e
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Clinicfal chemistry f f
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Sodkium: k135–145 mmol/l k
Pootassium: o 3.5–5.2 mmol/l o
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Urea: 2.5–7.0 mmol/l
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e Creatinine: e 60–120 μmol/l e
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Liver function
Albumin: 35–50 g/l
Total bilirubin: t 0–22 μmol/l t t
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Alkaline phosphatase: 40–130 IU/l
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Alanine aminotransferase (ALT): 0–40 IU/l
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γ-Glutamyl transferase: 0–75 U/l
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Bile acidrs: 0–14r μmol/l r
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Enkdocrine k k
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Thyroid-stimulating hormone (TSH): 0.35–5.5 mU/l
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b Free T4: b 11–24 pmol/l b
e Follicle-stimulating hormone (FeSH): 1–11 IU/l e
m Luteinising hormone (LH): m 2–13 IU/l m
Testosterone (female): 0.5–3.0 nmol/l
Testosterone (male): 8–30 nmol/l
Prolactin: t 0–520 mU/l t t
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Free androgen inndex: 0.5–6.5% n n
Sex hormone-.binding globulin: 18–144 nm.ol/l .
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Cancer rantigen 125 (CA125): 0–35r IU/ml r
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Plekase note: normal ranges can vary amonkg laboratories. k
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