Obstetrics & Gynecology 1

1. Question

Regarding the ovary, the following statements are true except

Ovarian lymphatics drain into the external iliac nodes
The round ligament of the ovary connects it to the upper end of the lateral wall of the uterus
The left ovarian artery is a branch of the abdominal aorta
The ovary lies medial to the obturator nerve
The ovarian fossa is bounded posteriorly by the internal iliac vessels and the ureter

2. Question

All of the following are effects of premature menopause apart from

Decreased cardiovascular risk
Infertility
Osteoporosis
Vasomotor symptoms
Vaginal dryness

3. Question

Induction of labour:

Is contraindicated in contracted pelvis
Is contraindicated in primigravida
Is for congenitally malformed babies
May increase cesarean section rate
Increases the risk of amniotic fluid embolism

4. Question

Which of the following is not true of cervical erosion

Presents as vaginal discharge
Is common in pregnancy
May manifest with post coital bleeding
Is common in post-menopausal women
May be treated with electrocautery

5. Question

A 32 year old woman presents to the gynecology clinic with infrequent periods. A hormonal profile is done and all of the following are constant with polycystic ovarian syndrome apart from

Increased androgen levels
Normal FSH
Normal estradiol
Decreased LH

6. Question

Stage IV endometrial carcinoma is associated with

Bladder invasion
Lung metastases
Renal failure
Bowel obstruction
Sub-urethral node

7. Question

A 20 year old woman presents to the clinic with a firm painful 2 cm lump in the upper outer quadrant of the right breast. The lump is well defined and extremely mobile. Your next step in managing this patient will be

Reassure and discharge if mammography is normal
Observe in outpatient clinics and further investigate if there are any changes
Perform an excision biopsy without the need for ultrasound
Perform an ultrasound and excision biopsy without fine needle aspiration (FNAC)
Perform an ultrasound FNAC

8. Question

Regarding Mother to child transmission of HIV, which is false

Occurs when a HIV positive woman passes the virus to her baby
Can occur during labour and delivery
Can occur through breastfeeding
Can be prevented by avoiding unwanted pregnancy among HIV positive women
Can be prevented with the use of condoms

9. Question

Menorrhagia associated with uterine leiomyoma is characterized by increased

Amount of menstrual flow only
Duration of menstrual flow only
Amount and duration of menstrual flow
Amount and frequency of menstrual flow
Frequency of menstrual flow

10. Question

Large chorioangioma is associated with

Polyhydramnios
Oligohydramnios
Both
None of the above
All of the above

11. Question

Concerning amenorrhea, which is true

A lady with testicular feminization syndrome has 46 XO karyotype
Imperforate hymen causes cryptomenorrhea
Sheehan’s syndrome is not synonymous with pituitary necrosis
Lactational amenorrhea is associated with high level of FSH/LH
Amenorrhea of menopause is pathological

12. Question

The following are indications for hysterectomy for leiomyoma

The presence of asymptomatic leiomyoma that are palpable abdominally
The presence of uterine bleeding that is uncomfortable for the patient, but without anemia
The presence of acute or severe pelvic discomfort
Patient concern in the presence of asymptomatic leiomyoma
Inability to secure hemostasis during myomectomy

13. Question

Which of the following is implicated in pregnancy associated GERD

Progesterone
Oestrogen
Relaxin
HCG
All of the above

14. Question

Shortest diameter of the pelvic cavity

Interspinous
Transverse
Antero-posterior
Oblique
True conjugate

15. Question

Invasive carcinoma of the cervix, which is true

Can usually be diagnosed by cervical cytology
May cause post menopausal bleeding
Can cause ureteric obstruction in advanced cases
Metastasizes at an early stage to the inguinal lymph nodes
Is estrogen dependent

16. Question

Which of the following is not a risk factor associated with cervical neoplasia

Multiple sexual partners
Low socio-economic status
Previous pelvic inflammatory disease
Cigarette smoking
Insertion of caustic substances into the vagina

17. Question

What is the average weight gain in pregnancy

12.5 kg at term
0.5 kg at first trimester
15 kg at term
0.5 kg per week at second trimester
A & B

18. Question

Commonest presentation of choriocarcinoma

Vaginal bleeding
Abdominal pain
Breathlessness
Perforation of the uterus
None of the above

19. Question

Which one of the following is a cause of vaginal discharge

Proliferative phase of menstrual cycle
Pregnancy
Elective cerclage
Eclampsia
Use of vaginal pessaries

20. Question

Which of the following will not require an abdominal incision

Marshall-marchetti-krantz procedure
Cervical cerclage
Cesarean hysterectomy
Total abdominal hysterectomy
None of the above

21. Question

Which of these is true about breast changes in pregnancy

Appearance of Montgomery tubercles on the areola
Decreased size and vascularity
Warm, tense and non-tender
Primary areola appearance
All of the above

22. Question

Which of the following is seen in partial mole

Triplody
Haploidy
Polyploidy
Diploidy
Tetraploidy

23. Question

The components of post-abortion care will not include

Appropriate referral
Manual vacuum aspiration
Post-natal care
Appropriate family planning method
Counseling of sexual life

24. Question

Which of the following drugs is not oxytocic?

Prostaglandin.
Progestogen.
Ergometrine.
Misoprostol.

25. Question

Concerning turner’s syndrome

Gonadal dysgenesis
Left sided heart failure
45 XO
Right heart failure
Same phenotype with Noonan’s syndrome

26. Question

Cervical changes in pregnancy are all except:

Increased collagen
Increased hyaluronic acid
Increased glands
Increased vascularity
None of the above

27. Question

Long term complications of Pelvic Inflammatory Disease does not include

Sepsis
Recurrent abortions
Ectopic pregnancy
Primary dysmenorrhea
Primary infertility

28. Question

All of the following cell types are derived from primordial germ cells except

1^st polar body
Ovum
Corona radiata
2^nd polar body
All of the above

29. Question

A 35 year old woman comes requesting long term reversible contraception. You advise that the method that can provide the longest protection is

Contraceptive implant
Copper intrauterine device
Depo-provera injection
Intrauterine hormonal system (IUS)
Laparoscopic sterilization

30. Question

Prognosticating factors in gestational trophoblastic disease does not include

Antecedent pregnancy
Age
Tumor size
Previous chemotherapeutic failure
Metastatic sites

31. Question

Which of the following cellular structures in an ovum discharged from the ovary is derived exclusively from the granular cells of a developing follicle

1^st polar body
2^nd polar body
Corona radiata
Zona pellucida
All of the above

32. Question

Regarding cervical cancer, which is the true statement?

HPV types 6 and 12 are high risk for developing cervical cancer
The new vaccines can prevent invasive carcinoma but not cervical intrauterine neoplasia
As soon as the new vaccination is introduced, cervical screening programmes can cease
HPV types 16 and 18 account for the majority of cervical cancer in the UK
HPV is an oncogenic virus for squamous cell but not adenocarcinoma of the cervix

33. Question

Molar pregnancy may present as

Pre-eclampsia
Incomplete miscarriage
Ovarian torsion
Intraperitoneal hemorrhage
None of the above

34. Question

How many oocytes are on the average produced during the reproductive life of a human female

420000
42000
4200
420
42

35. Question

Regarding the menstrual cycle, which is the true statement?

Menstruation occurs with vasodilation of the spiral arteries
The LH surge triggers menstruation
Both the Graafian follicle and the corpus luteum secrete estradiol
Progesterone levels fall after the onset of menstruation
The Graafian follicle develops during the luteal phase

36. Question

The commonest cause of post-partum hemorrhage is

Placenta accrete
Disseminated intravascular coagulation
Uterine atony
Vulvovaginal laceration
Forceps delivery

37. Question

Regarding the zona pellucida all of the following statements are true except

It forms a barrier permeable to large macromolecules
It is associated with all mammalian oocytes
It is secreted by the oocyte and granulosa cells
It disappears a day after fertilization
During the zona reaction, it becomes impermeable to the entry of other sperms

38. Question

Which one of the following statements about the menopause is correct

Progesterone levels rise after the menopause
LH levels rise after the menopause
The pituitary stops secreting LH and FSH at the menopause
Menstrual cycles remain regular until the last menstrual period
The number of oocytes in the ovary remains constant until the menopause

39. Question

Secondary amenorrhea implies that

An ovarian abnormality is present
The condition is physiologic
Menarche did not occur
Sexual development is normal
The endometrium is capable of responding

40. Question

At what menstrual week does the human chorionic gonadotropin of the maternal blood peak in the course of pregnancy

3-4
9-10
14-16
24-28
36-42

41. Question

The male contribution to a couple’s infertility is approximately

10%
25%
50%
75%
90%

42. Question

Changes of amniotic fluid volume and composition during pregnancy are attributed in part to the following

Fetal urination
Fetal swallowing
Maternal diseases
Fetal anomalies
Fetal lie

43. Question

Regarding the broad ligaments of the uterus, all of the following statements aretrue except:

The uterine tube lie within the free upper border
The ovary lies attached to its posterior later by the mesovarium
It extends from the side wall of the pelvis to the lateral margin of the uterus
The round ligament of the ovary is also called the suspensory ligament and is attached to the angle of the uterus
lateral one-fourth of the free border is called the infundibulopelvic ligament

44. Question

Which of these is true regarding semen analysis

Identifies men with high quality fertile spermatozoa
Identifies men with low sperm concentration that might affect fertility
Can always be used to predict fertility
Cannot identify abnormal spermatozoa
Identifies men with hypopituitarism

45. Question

Definitive therapy in severe pre-eclampsia is

Use of cation exchange resins
Use of hypotensive agents
Profound sedation
Termination of pregnancy
Use of aspirin to promote prostacycline activity

46. Question

Regarding the uterus, the following statements are true except

The nerve supply of the uterus is derived from the inferior hypogastric plexus
The posterior surface of the cervix is completely covered with peritoneum
Part of the uterus above the opening of the uterine tubes is its fundus
The long axis of the uterus is usually bent posteriorly on the long axis of the vagina
The internal iliac veins drain the uterine veins

47. Question

A 48-year-old woman with intermenstrual bleeding for 2 months and episodes of bleeding occurring any time of the cycle. There is no associated pain. Differential diagnosis for intermenstrual bleeding does not include

Endocervical polyp
Cervical malignancy
Endometrial polyp
Ovarian teratoma
Atrophic vaginitis

48. Question

The delivery of the fetal head in the assisted breech delivery is often facilitated with what type of forceps

Simpson
Piper
Kielland
Elliot
Bishop

49. Question

The following statements regarding the vagina are true except

Support to its upper part is provided by the transverse cervical ligament and the levator ani muscle
The upper part of the vagina has no peritoneal covering
The uterine artery sends a branch to the vaginal wall
The lumen of the vagina near its attachment to the cervix is divided into an anterior, posterior and 2 lateral fornices
The perineal body provides support to its lower part

50. Question

All of the following a=drugs are associated with hyperprolactinemia apart from

Reserpine
Methyldopa
Progesterone only contraceptive pill
chlorpromazine
Ranitidine

51. Question

The most frequent cause of uterine prolapse is

Inherent tissue weakness
Strenuous physical exercise
Fibromyomas
Ascites
Childbirth injuries