ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

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  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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🩺 Managing Malignant Germ Cell Tumours: Key Insights and Surveillance Strategies


 🩺 Managing Malignant Germ Cell Tumours: Key Insights and Surveillance Strategies



Malignant ovarian germ cell tumours (MOGCTs) are a rare yet critical subset of ovarian cancers, constituting 1.5% of cases in Europe. 
With approximately 100 diagnoses annually in the UK, effective management and meticulous follow-up are essential. Here are some crucial points and surveillance strategies for managing MOGCTs:

 🔍 Early Detection and Treatment

- Prevalence: MOGCTs represent 1.5% of ovarian cancers in Europe.

- Early Diagnosis: 60-70% are diagnosed at an early stage.

- Initial Treatment: Typically treated with surgery followed by active surveillance or adjuvant chemotherapy.

- Chemotherapy Sensitivity: MOGCTs are more responsive to chemotherapy compared to other ovarian tumour 

 🏥 Surgical Considerations

- Radical Surgery: Recommended for women who have completed their family or are beyond childbearing age, including total hysterectomy and bilateral salpingo-oophorectomy.
- Less Invasive Staging: Current trends emphasize less invasive surgical staging to reduce morbidity associated with full lymphadenectomy.


💊 Chemotherapy Regimens and Complications


- Standard Regimens:
  - if age is above...EP (Etoposide and Cisplatin)
  - if age is below 40years.BEP (Bleomycin, Etoposide, and Cisplatin)
- Adverse Effects: Potential short and long-term complications include:
  - Ototoxicity and hearing loss
  - Nephrotoxicity
  - Pulmonary dysfunction
  - Raynaud's phenomenon
  - Avascular necrosis
  - Secondary malignancies (e.g., acute myeloid leukemia)
Also premature ovarian insufficiency in 3%

- Fertility Preservation:Oocyte cryopreservation is advised before chemotherapy due to the risk of inferility.



 📅 Active Surveillance

- Recurrence Risk: Highest in the first two years post-treatment.
- Surveillance Plan:
 Based on RCOG and European guidelines, involving:
  - Regular examinations
  - Pelvic ultrasounds
  - Tumour marker assessments
  - Chest X-rays (CXR)
  - CT abdomen and pelvis (CTAP)

-  The program described by Vasquez and Rustin includes a demanding visiting schedule to detect recurrence over a 10-year period.



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ANEMIA IN PREGNANCY : MCQS AND IMPORTANT MCQS By DR MARIA RAFI

Image
  1.  A 30-year-old pregnant female is undergoing routine blood tests . Pregnancy is associated with an increase in which of the following? A) Mean Cell Hemoglobin Concentration (MCHC) B) Serum ferritin concentration C) Hematocrit D) Total Iron Binding Capacity (TIBC) ✅ Answer: D) Total Iron Binding Capacity (TIBC) Explanation: Pregnancy leads to increased TIBC due to higher transferrin synthesis to compensate for increased iron demand. Serum ferritin and iron decrease due to increased iron utilization. Hematocrit reduces due to physiological hemodilution , not an actual decrease in RBC mass. DR MARIA RAFI ;923324747587 2.  A 28-year-old female, para 2+0 , presents with Hb 7 g/dL . What is the next best investigation? A) Hb electrophoresis   B) Total iron-binding capacity (TIBC) C) MCV and peripheral smear ✅ D) Serum iron Answer: A) Hb electrophoresis Explanation: The first step is to check MCV (Mean Corpuscular Volume) to classify anemia...
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