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Obstetrics & gynaecology · Exam preparation
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FCOG Part IQuestion & explanation
Cardiovascular changes in pregnancy
A healthy primigravida has serial haemodynamic measurements. Her cardiac output has risen from about 4.5 L/min before pregnancy to about 6 L/min at 28 weeks, while her resting heart rate has risen only from 80 to 90 beats/min. Which change accounts for most of the rise in cardiac output?
A
An increase in heart rate
B
A rise in systemic vascular resistance
C
A rise in mean arterial pressure
D
An increase in stroke volume · Correct
Understand why.
Cardiac output rises by about 40% in pregnancy whereas heart rate rises by only about 10%, so the remainder must come from a larger stroke volume. Systemic vascular resistance falls rather than rises, and arterial pressure does not increase in normal pregnancy.
Bennett & Williamson (4th ed), Ch 10 Physiology
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14 topic sections
Anatomy
Bony pelvis, obstetric pelvis & fetal skull · Pelvic floor & perineum · Uterus, cervix, tubes & ovaries · Vulva & vagina · Urinary tract · Lower bowel & anal canal · and more
Source references: Bennett & Williamson Ch 5 Applied anatomy; Gray's Anatomy for Students, Pelvis and Perineum
Practice this topicEmbryology & Fetal Physiology
Gametogenesis & fertilisation · Implantation & early development · Placenta, membranes & amniotic fluid · Organogenesis · Urogenital & sexual differentiation · Birth defects & teratogenesis · and more
Source references: Bennett & Williamson Ch 3-4; Langman's Medical Embryology Ch 2-6, 8, 9, 13, 15, 16; Guyton & Hall Ch 84
Practice this topicCell Biology & Genetics
Cell structure & function · DNA, genes & protein synthesis · Cell cycle, mitosis & meiosis · Chromosomal disorders · Single-gene & multifactorial inheritance · Genetic testing & prenatal diagnosis
Source references: Bennett & Williamson Ch 1–2 (with Ch 9); Robbins Ch 4 (and Ch 6 cell cycle); Langman Ch 2 & 9
Practice this topicPhysiology
Cardiovascular changes in pregnancy · Respiratory changes in pregnancy · Renal, fluids & acid–base · Blood, haemostasis & blood groups · Gastrointestinal, liver & nutrition · Labour, parturition & puerperium · and more
Source references: Bennett & Williamson Ch 9–10; Guyton & Hall Ch 72, 83
Practice this topicEndocrinology
Hormone principles & steroidogenesis · Hypothalamus & pituitary · Menstrual cycle & ovulation · Puberty & menopause · Male reproductive endocrinology · Placental hormones & hCG · and more
Source references: Bennett & Williamson Ch 11; Guyton & Hall Ch 75–76, 81–82
Practice this topicImmunology
Innate immunity · Adaptive immunity & antibodies · Immunology of pregnancy · Red cell alloimmunisation · Hypersensitivity, autoimmunity & transplantation
Source references: Bennett & Williamson Ch 8 Immunology (primary); Guyton & Hall Ch 34, 35, 36; Robbins & Kumar Ch 5 Diseases of the Immune System
Practice this topicPhysics & Technical Gynaecology
Ultrasound principles · Ultrasound safety & image quality · Doppler · Radiation, X-rays & radioisotopes · Lasers & MRI
Source references: Bennett & Williamson (4th ed), Ch 13 Physics
Practice this topicGeneral Pathology
Cell injury, death & adaptation · Inflammation · Healing & repair · Thrombosis, embolism & haemodynamics · Shock & sepsis · Neoplasia · and more
Source references: Bennett & Williamson Ch 6; Robbins & Kumar Basic Pathology Chs 1, 2, 4
Practice this topicPathophysiology of O&G Disease
Pre-eclampsia & hypertensive disease · Haemorrhage, coagulopathy & thromboembolism in pregnancy · Diabetes & metabolic disease in pregnancy · Placental & fetal pathology · Trophoblastic disease & ectopic pregnancy · Benign gynaecological disease · and more
Source references: Robbins Basic Pathology Ch 3, 4, 10, 17; Bennett & Williamson Ch 4, 6, 10, 11; Guyton & Hall Ch 83-84; Langman Ch 9
Practice this topicMicrobiology & Virology
Bacterial structure, classification & diagnosis · Normal flora & genital tract infection · Sexually transmitted infections · Antibiotics & sterilisation · Fungi & parasites · Virology principles · and more
Source references: Bennett & Williamson Ch 7; Robbins & Kumar Ch 3, 17
Practice this topicPharmacology
Pharmacokinetics & pharmacodynamics · Drugs in pregnancy & teratogenesis · Placental transfer & lactation · Hormonal drugs & contraception · Drugs acting on the uterus · Antimicrobials & cytotoxics · and more
Source references: Bennett & Williamson Ch 12 Drugs and drug therapy
Practice this topicStatistics & Evidence-Based Medicine
Study design & bias · Sampling, distributions & descriptive statistics · Hypothesis testing, errors & power · Diagnostic & screening tests · Measures of effect & confidence intervals · Evidence-based medicine & trials
Source references: Bennett & Williamson Ch 14 (Statistics and evidence-based healthcare), Ch 15 (Clinical research methodology)
Practice this topicBioethics & Medico-Legal
Ethical principles & good practice · Informed consent & capacity · Confidentiality & disclosure · Minors & the Children's Act · Termination of pregnancy law
Source references: HPCSA Ethical Guidelines Booklets 1, 4, 5; Children's Act 38 of 2005 (ss110, 129-134); Choice on Termination of Pregnancy Act 92 of 1996
Practice this topicPublic Health & Women's Health
Determinants of women's health · Maternal & perinatal mortality · Antenatal & postnatal care systems · HIV, syphilis & infection prevention in pregnancy · Gender-based violence, adolescents & vulnerable groups
Source references: SA National Integrated Maternal and Perinatal Care Guideline (2024)
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