Maternity Reproductive1. A 29-year-old shop assistant attends the surgery asking which blood-borne infection tests are routinely offered at NHS antenatal booking. Select TWO correct statements.Select all that apply.A. Most appropriate: HIV, syphilis and hepatitis BB. The following is not the most appropriate next step: Hepatitis C and HTLV as the only national testsC. Most appropriate: Routine rubella IgG as the sole booking serologyD. Most appropriate: No infection screening unless she requests it privatelyCheck
Maternity Reproductive2. A 38-year-old civil servant with chronic hypertension has a positive pregnancy test at 6 weeks. She takes ramipril 5 mg daily. What is the most appropriate immediate medicines action? The most appropriate action is: Stop the ACE inhibitor and arrange alternative antihypertensives suitable in pregnancyTRUE. TrueFALSE. FalseCheck
Maternity Reproductive3. A 31-year-old office worker is 22 weeks pregnant with new blood pressure 148/96 mmHg, no proteinuria and no PET symptoms. She has no asthma. What is usual first-line treatment in UK practice (NG133)? The most appropriate action is: Ramipril in this clinical contextTRUE. TrueFALSE. FalseCheck
Maternity Reproductive4. A 24-year-old hairdresser is 18 weeks pregnant. She had a pertussis booster 3 years ago. What is the UK antenatal pertussis advice?A. No vaccine this pregnancy because she was boosted within 5 years for this presentationB. Give live pertussis vaccine at 8 weeks onlyC. Defer until the infant's 8-week immunisationsD. Offer pertussis-containing vaccine from 16 weeks in every pregnancyCheck
Maternity Reproductive5. A 22-year-old student is 12 weeks pregnant. Rubella IgG is unrecordable on an opportunistic test. She asks for MMR today. What is the most appropriate advice?A. Do not give live MMR in pregnancy; vaccinate postnatally if still non-immuneB. Give MMR immediately because congenital rubella risk outweighs live-vaccine theoryC. Give MMR and book a medical termination the same weekD. Give two live MMR doses 4 weeks apart while pregnantCheck
Maternity Reproductive6. A 30-year-old midwife is 28 weeks pregnant with pleuritic pain and breathlessness. Observations are stable. Why is a negative D-dimer not used to rule out PE in primary care?A. D-dimer is always zero in the third trimester so is diagnostic of PEB. NICE requires D-dimer before any chest X-rayC. D-dimer cannot reliably exclude VTE in pregnancyD. A negative D-dimer replaces imaging in all pregnant womenCheck
Maternity Reproductive7. A 29-year-old woman 10 days postnatal and exclusively breastfeeding asks for codeine after a perineal repair. What is the MHRA-aligned advice?A. Do not prescribe codeine in breastfeedingB. Codeine is first-line because it is weak and 'safe in lactation'C. High-dose codeine is preferred to paracetamolD. Codeine must be given to all women after instrumental birthCheck
Maternity Reproductive8. A 28-year-old woman is day 5 after a normal birth. Her partner reports she has not slept, believes the baby is 'not hers' and is talking to the television. She is not violent now. What is the most appropriate action (NG91)?A. Reassure that this is normal baby blues and review at the 6-week check for this presentation in this NHS general-practice settingB. Emergency same-day specialist psychiatric assessment (postpartum psychosis until proven otherwise)C. Start GP lithium today and review in a monthD. Advise stopping breastfeeding as the only treatmentCheck
Maternity Reproductive9. A 40-year-old accountant with diabetic nephropathy takes losartan. She has a positive home pregnancy test. What should happen to the losartan? The most appropriate action is: Continue losartan for renal protection throughout pregnancy for this presentation in this NHS general-practice settingTRUE. TrueFALSE. FalseCheck
Maternity Reproductive10. A 34-year-old woman 3 weeks postnatal and breastfeeding has a tension-type headache. What analgesic is generally first-line and compatible with breastfeeding? Select TWO correct statements.Select all that apply.A. Most appropriate: Paracetamol (with ibuprofen if needed and no contraindication)B. The following is not the most appropriate next step: Codeine phosphate 60 mg four times dailyC. Most appropriate: Aspirin 300 mg four times daily long term for this presentationD. Most appropriate: Methotrexate 10 mg as analgesiaCheck