Professional Documents
Culture Documents
MBBS1000
55 minutes on Part A
45 minutes on Part B
10 minutes on Part C1 To be handed in to receive Part C2
25 minutes on Part C2
45 minutes on Part D
NOTE:
YOU MAY TEAR OFF THIS FRONT PAGE TO KEEP WITH YOU DURING
THE EXAMINATION
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Page 1
PART A
Maddison B-F, who is 19, presents after work to your general practice, and complains
of urinary frequency and a bloated feeling in the abdomen. You record her recent
history, discover that her last period was 7 weeks ago, and are not surprised to find
that a pregnancy test is positive.
Maddison too is not altogether surprised that she is pregnant, although she becomes
upset and agitated. She is an A-grade netballer, and has been keenly anticipating the
beginning of the new season. However, you are also aware that her family is strongly
active in one of the local church communities, and she tells you that her parents would
be devastated by both her unplanned pregnancy and the prospect of a termination of
the pregnancy.
You spend thirty minutes with her before finishing for the day.
Question 1.
(5 marks)
Terminations
50
40
30
20
98
94
88
86
84
82
80
78
76
74
72
10
70
Live births
Year
a)
(3 marks)
Part A (cont)
b)
Page 2
Given that research shows that the rate of sexual activity amongst teenagers over this
time period has not changed significantly, give two (2) major reasons for the
demonstrated trends.
(2 marks)
Question 2.
(6 marks)
As Maddisons GP, you confirmed that she was pregnant by performing a urine pregnancy
test. You wonder how the urine pregnancy test compares with the gold standard serum
beta hCG (pregnancy) test. Read the information given below regarding a diagnostic study
of urine and serum pregnancy tests, and answer the questions that follow.
200 women who thought they may be pregnant, had both urine and serum
hCG pregnancy tests performed. The results of the blood test indicated that
155 women were pregnant. Of these, only 139 had tested positive on the urine
test. There were a total of 57 negative urine tests.
a)
(2 marks)
Part A (cont)
Page 3
b)
If the pre-test probability of a particular patient being pregnant is only about ~20%,
what is the post-test probability of that patient being pregnant given the positive test
result?
(2 marks)
b)
List two (2) potential harms associated with false negative pregnancy test results and
two (2) potential harms associated with false positive pregnancy test results.
(2 marks)
Part A (cont)
Question 3.
(a)
Page 4
(5.5 marks)
Circle the number of weeks after fertilization each of the two drawings depicts.
(2 marks)
Left side drawing
2 4 6
8
10 12 14 16 18 20
10 12 14 16 18 20
Part A (cont)
(b)
Page 5
(3.5 marks)
Possible answers:
1.
Uterine cavity
2.
Decidua parietalis
3.
Amnion
4.
Allantois
5.
Chorion laeve
6.
Yolk sac
7.
Decidua capsularis
8.
Mucous plug
9.
Cervix
10.
Decidua basalis
11.
Chorion frondosum
12.
Endometrium
A
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Q3 (a) & (b) Examiners use only
Part A (cont)
Question 4.
Page 6
(6 marks)
a)
Explain why, on the information provided, some people believe that if Maddison were
to have a termination of her pregnancy, it would be an illegal procedure in
Queensland.
(3 marks)
b)
Briefly explain the basis of the liberal moral view concerning the status of the foetus
and its implications for abortion law.
(3 marks)
Part A (cont)
Page 7
Fifteen (15) years pass. You saw Maddison only a couple of times following the
termination of her pregnancy at the age of 19. She returns to see you at the surgery
where you work part-time, having taken on two younger doctors who now run the
practice.
At this visit, she tells you she has returned to be closer to her parents, having spent
considerable time in Melbourne, developing a career in financial planning, and having
married John, a banker.
She tells you that she is ten weeks pregnant, but she appears to be quite stressed and
anxious. She has been referred to a local IVF specialist to continue managing the
pregnancy. She tells you that it has taken almost three years to become pregnant, and
that it has been possible only after numerous IVF attempts. She is currently working
full-time. She is taking a beta-blocker for hypertension, which has become somewhat
more difficult to manage during the pregnancy. She reluctantly indicates that she is
still smoking.
Question 5.
(4 marks)
Give two (2) ways in which a policy relating to Assisted Reproductive Technology could
(arguably) be ethically unjust, and briefly explain the basis of the alleged injustice.
(4 marks)
Part A (cont)
Question 6.
Page 8
(10 marks)
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Q6 Examiners use only
Part A (cont)
Question 7.
Page 9
(7 marks)
List five (5) symptoms of early (before 16 weeks) pregnancy and two (2) signs of early
pregnancy, other than urinary frequency and feeling of bloated abdomen.
Part A (cont)
Page 10
(6 marks)
a)
Explain why the foetus uses more glucose per kilogram body weight than does a
newborn infant.
(2 marks)
b)
How does the mother's metabolism change to ensure that the foetus is well supplied
with glucose?
(4 marks)
Part A (cont)
Question 9.
a)
Page 11
(10 marks)
Birth defects are reported in 2-3% of live births in Australia. Major neural tube defects
such as spina bifida have been proposed to be due to a lack of folic acid.
Suggest four (4) key questions that the parents of infants with spina bifida may ask
you in a discussion on the possible role of folate deficiency and indicate your replies.
(8 marks)
b)
Does the placenta protect the foetus from potential damage from drugs taken orally by
the mother? Explain your answer.
(2 marks)
Part A (cont)
Page 12
(5 marks)
Respond to the following statements as TRUE (T), FALSE (F) OR DONT KNOW (D)
CIRCLE YOUR CHOICE
1)
2)
3)
4)
5)
6)
7)
END OF PART A