MRCOG Part One - Your Essential Revision Guide

526 Pages·2016·24.76 MB·English

by  Edited by Alison Fiander

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
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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