PLAB GYN-OBS MCQs 1
A 32yo woman woman of 39wks 39wks gestation gestation attends attends the the antenat antenatal al day day unit unit feeling feeling very unwell with sudden onset of epigastric pain associated with nausea and vomiting. Her temp is 36.7. !"am# she is found to have $%& tenderness. Her 'lood results show mild anemia( low platelets( elevated liver en)ymes and hemolysis. *hat is the most likely d"+ a Acut Acutee fat fatty ty live liverr of of preg pregna nanc ncy y a. Acut Acutee pyelo pyelone neph phri riti tiss '. holecystitis c. H!,, H!,,- synd syndro rome me d. Acut Acutee hepa hepati titi tiss
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A 27yo lady has had an an uncompl uncomplicate icated d pregnanc pregnancy y so far. far. he came came to the hospital 2h ago after her water 'roke. 'r oke. /he midwife is looking at her now. he has regular contractions. -.0 e"am revealed 2cm dilated cervi". 0ital signs are normal. *hat stage of la'our is she in+ a econd stage ' irst stage c ,atent st stage d /hird stage
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A term term 'a'y 'a'y 'orn 'orn to a 3yo 3yo woma woman n of 'lood 'lood grou group p Ave Ave deve develop lopss severe severe 4aundice within the first 25h of 'irth. *hat *hat is the most likely d"+ d"+ a Here Heredi dita tary ry sphe sphero rocy cyto tosi siss ' 6- c A8 inc incom ompa patti'i i'ilit lity d $h inco incom mpati pati'i 'ili lity ty e -hys -hysio iolo logi gica call 4aund 4aundic icee 5 A woma woman n : days post postop op for 'ilat 'ilatera erall salphin salphingo gooop oophe herec rectom tomy y and a'dominal hysterectomy has developed a'dominal pain and vomiting a;w a'dominal distension and can$ a' a'domen '. !"ploratory laparoscopy c. /
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d. % e. 8ari 8arium um ene enema ma A 3?yo 3?yo woma woman n has deliv delivere ered d after after an induc induced ed la'or la'or whic which h lasted lasted 26h. 26h. choose the single most likely predisposing factor for postpartum hemorrhage+ a Atonic uterus ' ervical;vaginal trauma c $upture uterus d i'roid uterus rus e Age of mother
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A 2:yo 2:yo woma woman n present presented ed to her her - on a routi routine ne check check up. up. %pon %pon vagin vaginal al e"am( she was fine e"cept for finding of cervical ectropion which was painless 'ut mild contact contact 'leeding on touch. touch. *hat is the ne"t ne"t management+ a !ndo !ndom metri etrial al a'la a'lati tion on nd ' ervical smear @2 line c olposcopy d Anti'iotics @1 @1 st line e 0aginal % f -ack -ack with with gau) gau)ee and and leav leavee to to dry dry
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A 32yo had a normal normal vaginal vaginal delivery delivery 1 1 days days ago. ago. Her Her uterus uterus has has involut involuted ed normally. hoose hoose the single most likely predisposing factor for --H+ a $etained pro prod duct ' B c %teri terin ne infe infecctio tion d 0on *i *ille' lle'ra rand nd dis disea ease se e -ost -ost part partum um hemo hemorr rrha hage ge
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A 51yo woman woman who has compl completed eted her family family(( has suffe suffered red from from e"tremel e"tremely y heavy periods for many years. =o medical t" has worked. he admits that she would rather r ather avoid open surgery. surgery. After After discussion( you collectively decide on a procedure that wouldn
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d. % e. 8ari 8arium um ene enema ma A 3?yo 3?yo woma woman n has deliv delivere ered d after after an induc induced ed la'or la'or whic which h lasted lasted 26h. 26h. choose the single most likely predisposing factor for postpartum hemorrhage+ a Atonic uterus ' ervical;vaginal trauma c $upture uterus d i'roid uterus rus e Age of mother
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A 2:yo 2:yo woma woman n present presented ed to her her - on a routi routine ne check check up. up. %pon %pon vagin vaginal al e"am( she was fine e"cept for finding of cervical ectropion which was painless 'ut mild contact contact 'leeding on touch. touch. *hat is the ne"t ne"t management+ a !ndo !ndom metri etrial al a'la a'lati tion on nd ' ervical smear @2 line c olposcopy d Anti'iotics @1 @1 st line e 0aginal % f -ack -ack with with gau) gau)ee and and leav leavee to to dry dry
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A 32yo had a normal normal vaginal vaginal delivery delivery 1 1 days days ago. ago. Her Her uterus uterus has has involut involuted ed normally. hoose hoose the single most likely predisposing factor for --H+ a $etained pro prod duct ' B c %teri terin ne infe infecctio tion d 0on *i *ille' lle'ra rand nd dis disea ease se e -ost -ost part partum um hemo hemorr rrha hage ge
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A 51yo woman woman who has compl completed eted her family family(( has suffe suffered red from from e"tremel e"tremely y heavy periods for many years. =o medical t" has worked. he admits that she would rather r ather avoid open surgery. surgery. After After discussion( you collectively decide on a procedure that wouldn
c i'r i'roi oid d rese resecctio tion d Dyomectomy e %ter %terin inee arte artery ry em'o em'oli li)a )ati tion on
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A 2:yo 2:yo had an , , 25h 25h ago ago for feta fetall distre distress. ss. he he now now compla complains ins of of intermittent vaginal 'leeding. 'servations# 2 satE9?F in air( 8-E125;?2mmHg( pulseE?5'pm( tempE37.?. /he midwife tells you that she had a retained placenta( which reCuired manual removal in the /. hoose the most appropriate ection complication in this case+ a $etained - - ' Aspiration pneumonitis pneumonitis c !ndometritis d %terine rup rupture e B
1 A 2:yo woman woman with with /1D /1D has delivered delivered a 'a'y 'a'y weighi weighing ng 5.:kg. 5.:kg. Her Her uterus is well contracted. hoose the single most likely predisposing factor for - -H from the options+ a Atonic uterus ' ervical;vaginal trauma c $etained - - d ,arg ,argee plac placen enta tall sit sitee $upture uterus
11 A 2?yo 2?yo woman woman at 39wk 39wk gestation gestation is in la'or la'or.. he develo develops ps a'dominal a'dominal pain pain and H$E12:'pm( 8-E1;52mmHg( tempE37.2 and saturationE99F. !"am# lower a'domen is e"Cuisitely tender. /Eprv /Eprv normal( now showing reduced varia'ility and late deceleration develops with slow recovery. he has had 1 prv , for a 'reech 'a'y. hoose the most appropriate complication for this lady+ a !ndometritis ' %/B c %rin rinary ary tra tract ct in4u in4ury ry d -leurisy e %terine rup rupture
12 A 3:yo lady who has 'een using B% for one year now complains of pelvic pain and heavy painful periods. elect the most likely cause leading to her symptoms+ a -B ' !ndometriosis c Adenomyosis d i'roids
13 A 5:yo waitress complains of pelvic pain which worsens premenstrually and on standing and walking. he also complains of postcoital ache. elect the most likely cause leading to her symptoms+ a -B ' !ndometritiosis c -elvic congestion syndrome d Adenomyosis e -remature ovarian failure
15 A 65yo woman has 'een on H$/ for 9yrs. he had regular withdrawal 'leeds until 3 yrs ago and since then has 'een taking a no 'leed prep. $ecently she noticed a 'rown vaginal discharge. hoose the single most appropriate initial inv+ a ervical smear ' High vaginal swa' c // d /ransvaginal % e !ndometrial sampling
1: A 55yo woman complains of heavy 'leeding per vagina. /ransvaginal % was done and normal *hich of the following would 'e the most appropriate inv for her+ a Hysterectomy ' !ndometrial 'iopsy c 8 d High vaginal swa' e oagulation profile
16 A 25yo woman presents with deep dyspareunia and severe pain in every cycle. *hat is the initial inv+ a ,aparoscopy ' -elvic % c Hysteroscopy d 0aginal wa'
17 A 3?yo woman( 1d postpartum presents to the - with h" of passing 'lood clots per vagina since yesterday. !"am# 8-E9;5mmhg( pulseE11'pm( tempE3?( uterus tender on palpation and fundus 2cm a'ove um'ilicus( 'lood clots GGG. hoose the single most likely d"; a A'ruption of placenta 2nd to preeclampsia ' oncealed hemorrhage c -rimary --H d econdary --H e $etained placenta
1? A 32yo female with 3 prv 1 st trimester miscarriages is d" with antiphospholipid syndrome. Anticardiolipin anti'odies Gve. he is now 1?wks pregnant. *hat would 'e the most appropriate management+ a Aspirin ' Aspirin warfarin c Aspirin heparin d Heparin only e *arfarin only
19 A 16yo girl came to the se"ual clinic. he complains of painful and heavy 'leeding. he says she doesn
2 A 23yo presents with vomiting( nausea and di))iness. he says her menstrual period has 'een delayed 5 weeks as she was stressed recently. /here are no symptoms present. *hat is the ne"t appropriate management+ a $efer to - psychiatry ' $efer to - !=/ c / 'rain d ipstick for 8h e D$B 'rain
21 *hich method of contraception can cause the risk of ectopic pregnancy+ a ' B% c Direna -22 A 31yo woman who is 32weeks pregnant attends the antenatal clinic. ,a's# Hg'E1.7( D0E91. *hat is the most appropriate management for this pt+ a olate supplement ' errous sulphate 2mg;d - c Bron de"tran =o t" reC 23 A 32yo woman of 39wks gestation attends the antenatal day unit feeling very unwell with sudden onset of epigastric pain a;w nausea and vomiting. /emp 36.7. !"am# $%& tenderness. 8loods# mild anemia( low plts( elevated ,/ and hemolysis. *hat is the most likely d"+ a Acute fatty liver of pregnancy ' Acute pyelonephritis c holecystitis d H!,,- syndrome e Acute hepatitis
25 A :7yo woman presents with dysuria( freCuency and urinary incontinence. he complains of dyspareunia. %rine culture has 'een done and is sterile. *hat is the most appropriate step+ a ral anti'iotics ' /opical anti'iotics c /opical estrogen d ral estrogen
e ral anti'iotics and topical estrogen 2: A pt came to the ! with severe lower a'dominal pain. 0itals# 8-E12:;?:mmHg( /empE3?.9. !"am# a'domen rigid( very uncomforta'le during par vaginal. he gave a past h" of -B 3 years ago which was successfully treated with anti'iotics. *hat is the appropriate inv+ a % ' A'domen >$ c / 26 A pregnant woman with longterm h" of osteoarthritis came to the antenatal clinic with complaints of restricted 4oint movement and severe pain in her affected 4oints. *hat is the choice of drug+ a -aracetamol ' teroid c =AB d -aracetamolGdihydrocoiene -ethadine 27 A 25yo 1?wk pregnant lady presents with pain in her lower a'domen for the last 25h. he had painless vaginal 'leeding. !"am# a'domen is tender( os is closed. *hat is the most pro'a'le d"+ a /hreatened miscarriage Bnevita'le miscarriage 2? A 27yo 35wk pregnant lady presents with headache( epigastric pain and vomiting. !"am# pulseE11:( 8-E15:;9:mmHg( proteinuria GG. he complains of visual distur'ance. *hat is the 'est medication for the t" of the 8-+ a 5g Dg5 in 1ml .9F= in :mins ' 2g Dg5 B0 'olus c :mg hydrala)ine B0 29 A 25yo girl comes to the woman se"ual clinic and seeks advice for contraception. he is on sodium valproate. a. he can
a 0aginal swa' ' !ndocervical swa' c % d A'dominal >$ ,aparoscopy 31 A :?yo lady presented with urinary incontinence. he looks an"ious for her condition. %rine culture is sterile. Her urodynamic study is normal. *hat is the ne"t step a Anti'iotics ' /opical estrogen c ystemic estrogen d ulo"etine e -elvic floor e"ercise 32 A 5:yo lady came to family planning clinic for contraception advice. he is not keen to 'e pregnant for the ne"t 3yrs. Her recent % showed multiple small su'mucosal fi'roid. *hat is the 'est method of contraception for her+ a !tonogestrol ' c B% d -e B% 33 A lady presents with a'dominal pain( dysuria( dyspareunia and vaginal discharge. *hat si your ne"t step+ a ,aparoscopy ' High vaginal swa' 35 A 6:yo female pt was given tamo"ifen( which of the following side effect caused 'y it will concern you+ a luid retention ' 0aginal 'leeding c ,oss of apetite d Headache and di))iness e Anorgasm 3: A 32yo woman of 3?wks gestation complains of feeling unwell with fever( rigors and a'dominal pains. /he pain was initially located in the a'domen and was a;w urinary freC and dysuria. /he pain has now 'ecome more generali)ed specifically radiating to the right loin. he says that she has felt occasional uterine tightening. / is reassuring. elect the most likely d"+ a Acute fatty liver of pregnancy ' Acute pyelonephritis
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c $oung ligament stretching d holecystitis e %/B A 6:yo presents with dyspareunia after se". he in menopause. he complains of 'leeding after se". *hat is the most pro'a'ly d"+ a ervical ca ' !ndometrial ca c varian ca d 8reast ca e 0aginal ca A 25yo primigravida who is 3wk pregnant presents to the la'or ward with a h" of constant a'dominal pain for the last few hours. he also gives a h" of having lost a cupful of fresh 'lood per vagina 'efore the pain started. A'dominal e"am# irrita'le uterus( /Ereactive. hoose the single most likely d"+ a A'ruption of placenta 2nd to preeclampsia ' Antepartum hemorrhage c -lacenta previa d 0asa previa e $evealed hemorrhage A 26yo woman had 'ipolar disorder for 1yrs and is on ,ithium for it. he is symptom free for the past 5 years. he is now planning her pregnancy and wants to know whether she should continue taking lithium. *hat is the single most appropriate advice+ a ontinue lithium at the same dose and stop when pregnancy is confirmed ' ontinue lithium during pregnancy and stop when 'reast feeding a. $educe lithium dosage 'ut continue throughout pregnancy '. $educe lithium gradually and stop when pregnancy is confirmed c. witch to sodium valproate A 39yo woman has not had her period for 1months. he feels well 'ut is an"ious as her mother had an early menopause. hoose the single most appropriate initial inv+ a erum estradiol conc. ' erum H;,H c erum progesterone conc. d =one e /ransvaginal %
5 A 23yo woman with painless vaginal 'leeding at 36wks pregnancy otherwise seems to 'e normal. *hat should 'e done ne"t+ a. 0aginal % '. A'dominal % c. 0aginal e"am d. $eassurance 51 A 25yo woman has ?wk amenorrhea( right sided pelvic pain and vaginal 'leeding. he is apyre"ial. -eritonism is elicited in the $B. 0aginal e"am reveals right sided cervical e"citation. *hat is the most pro'a'le d"+ a !ctopic pregnancy ' alpingitis c !ndometriosis d varian torsion e varian tumor 52 A 26yo woman with regular menses and her 2?yo partner comes to the surgery complaining of primary infertility for 2yrs. *hat would 'e the single 'est investigation to see whether she is ovulating or not+ a 8asal 'ody temp estimation ' ervical smear c ay2 ,H and H d ay21 progesterone e !ndometrial 'iopsy 53 A 23yo woman is 'eing followed up 6wks after a surgical procedure to evacuate the uterus following a miscarriage. /he histology has shown changes consistent with a hydatidiform mole. *hat is the single most appropriate inv in this case+ a A'dominal % ' Daternal karyotype c -aternal 'lood group d erum 8H /ransvaginal % 55 A 2?yo woman has 'een admitted at 3?wks gestation. Her 8-E19;12mmHg and proteinuria GGG. Bmmediately following admission she has a grandmal sei)ure. *hat is the single most appropriate initial management+ a ia)epam B0 ' etal / c Hydrala)ine B0 d Bmmediate delivery
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e Dagnesium sulphate B0 A 27yo woman had preeclampsia and was delivered 'y section. he is now complaining of $%& pain different from wound pain. *hat inv will you do immediately+ a oagulation profile ' ,/ c ,iver % d D$e =one A pt with prv h" of H/=( the mem'ranes have ruptured and the cervi" is 3cm dilated. 5h later on e"amination showed that the cervi" was still 3cm dilated. *hat is the single most appropriate management for her la'or+ a $epeat vaginal e"amination in 5h ' / c section d !"ternal rotation e B0 syntocin drip A 27yo waitress has pelvic pain( dysmenorrhea and increasingly heavy periods. he also complains of dyspareunia. /here is generali)ed pelvic tenderness without peritonism. -elvic % is normal. *hat is the most likely d"+ a !ndometriosis ' %terine fi'roid c -elvic congestion syndrome d -B e /u'al pregnancy A 15yo girl is clinically o'ese. he has not started her periods yet and has severe acne. Among her inv( a high insulin level is found. *hat is the most pro'a'le d"+ a ushing
d 8iliary colic e $enal carcinoma : A 32yo woman -3 of 39wks gestation reports having spontaneous $D 5days ago. he didn
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c B0% d $enal artery oppler e $enal 'iopsy A 2?yo woman who is 32 wks pregnant in her 3 rd pregnancy is diagnosed as a case of placental a'ruption. After all the effective measures( she is still 'leeding. *hat is the underlying pathology+ a lotting factor pro'lem ' lauser
:? A young lady who is 2?wks pregnant presents with vaginal 'leeding. he has lost a'out 2ml of 'lood. !"am# uterus is tender. $esuscitation has 'een done. *hat is the most omp inv to esta'lish the d"+ a % ' / c dimer d lotting profile e =one
:9 A 32yo woman wants reversi'le form of contraception. he has one child delivered 'y emergency section. he also suffers from migraine and heavy periods. *hat is the most suita'le form of contraception for this lady+ a ' Dini pill c B% d 8arrier method e A'stinence
6 A 21yo female in her first pregnancy at 3?wks was 'rought to the ! with generali)ed tonic clonic sei)ure. B0 Dg5 was given 'ut fits was not controlled. he is having fits again. *hat is the single most imp immediate management of this pt+ a B0 Dg5 ' c d e
B0 dia)epam Bmmediate section B0 phenytoin Dg5 'olus
61 A 25yo lady with 8DBE3 complains of facial hair growth and h" of amenorrhea HE1.9( prolactinE5B%( estradiolE177.?mmol;l( progesteroneEnormal( ,HE33.2. *hat is the most pro'a'le d"+ a - ' -regnancy c ushing
63 A 32yo woman presents with h" of lower a'dominal pain and vaginal discharge. he had her menses 5wk ago. he has a temp of 3?.6. *hat is the most suita'le d"+ a Acute appendicitis ' Acute -B c !ndometriosis d !ctopic pregnancy e %/B 65 A 5yo female was on - which she stopped 6m ago. 8ut she has not had her periods since then. ,a's# HE22( ,HE25( prolactinE7( estradiolE?. *hat is the most appropriate d"+ a Hypothalamic amenorrhea ' -ost pill amenorrhea c -rolactinoma d -regnancy e -remature ovarian failure
6: A 37yo lady stopped taking - 1?m ago and she had amenorrhea for 12m duration. ,a's# HE?( ,HE7( prolactinE5( estradiolE:. *hat is the cause+ a Hypothalamic amenorrhea ' - c -rolactinoma d -ost pill amenorrhea e - 66 An African lady presents with heavy 'ut regular periods. Her uterine si)e correlates to 15wks pregnancy. *hat is the most appropriate d"+ a 8lood dyscrasia ' Hematoma c i'roids d Adenomyosis 67 A 29yo at 3?wks A presents with a 2h h" of constant a'dominal pain. he then passes 1ml of 'lood per vagina. *hat is the ne"t appropriate inv+ a % ' / c lotting screen d Hg'
e Ileihauer 8etke test 6? A 26yo woman had amenorrhea for 1wks and is pregnant. he e"periences hyperemesis. =ow she presents with vaginal 'leed. !"am# uterusE16wks( closed os. *hat is the most pro'a'le d"+ a /hyroto"icosis ' Hyperemesis gravidarum c /wins a. *rong dates '. Dolar pregnancy 69 A pregnant woman of 2( A 11wks presents with heavy vomiting( headache and reduced urine output. %rine analysis shows ketonuria. hoose the ne"t 'est step+ a % ' ral fluid replacement c erum 8H d -arental antiemetics e B0 fluids 7 A pt had inflammatory changes on cervical smear. /here is no vaginal discharge( no pelvic pain and no fever. *hat is the ne"t step+ a $epeat smear in 6m ' /ake swa' c /reat with anti'iotics d olposcopy
71 A 37yo infertile lady with :cm su'serosal and 3cm su'mucosal fi'roid is trying to get pregnant. *hich is the most suita'le option+ a lomifen therapy ' B0 c Dyomectomy d Hysterectomy e B% insemination
72 A 39yo woman in her 36 th week A with acute a'dominal pain is rushed for immediate delivery. Her report# 8-E11;6mmHg( Hg'Elow( 'iliru'inE22( A/E3:( -ltE6( A-//E6( -/E3( i'rinogenE.6. *hat is the cause+
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-regnancy induced hypertension B H!,,- syndrome Acute fatty live 'stetric cholestasis
73 A 36wk pregnant woman presents with sudden onset of uterine pain and 'leeding( uterus is tender( no prv ,. *hat is the most appropriate cause+ a -reeclampsia ' B c -lacental a'ruption d -lacental previa e !ctopic pregnancy f Dissed a'ortion g !ctropion
75 A 2?wk pregnant woman presents with uterine 'leeding after se"ual intercourse. *hat is the most appropriate cause+ a -reeclampsia ' B c -lacental a'ruption d -lacental previa e !ctopic pregnancy f Dissed a'ortion g !ctropion
7: A 6wk pregnant woman presents with a'dominal pain. he has prv h" of -B. *hat is the most likely d"+ a ' c d e f g
-reeclampsia B -lacental a'ruption -lacental previa !ctopic pregnancy Dissed a'ortion !ctropion
76 A 6wk pregnant woman presents with a'dominal pain. he has prv h" of -B. *hat is the most likely diagnosis+ a. -reeclampsia '. B c. -lacental a'ruption d. -lacental previa e. !ctopic pregnancy f. Dissed a'ortion g. !ctropion 77 A 33wk pregnant woman presents with vaginal 'leeding( low Hg'( low plt( increased 'iliru'in( A/ normal( A-// -/ increased. *hat is the most likely d"+ a -reeclampsia ' B c -lacental a'ruption d -lacental previa 7? A 2:yo lady at her 2? th week A came for check up. Her 8-E16;9:mmHg( protein in urineE6g;d. *hat is the most likely d"+ a !ssential H/= ' estational H/= c hronic H/= -reeclampsia 79 A 32yo woman has a h" of spontaneous a'ortions at 6wks( 12wks( and 2wks. he is now keen to conceive again. *hich of the following would you prescri'e for the ne"t pregnancy+ a Dg5 ' Aspirin c *arfarin ? A 52yo woman who smokes 2 cigarettes;d presents with complains of heavy 'leeding and prolonged menstrual period. *hat is the most appropriate t" for her+ a. /rane"emic acid '. a Defenemic acid ' B% c =orethisterone
?1 A 17yo senior school girl with complain of prolonged irregular menstrual period and heavy 'lood losses. *hat is the most appropriate t" for her+ a Defenemic acid ' c -d B% e Direna ?2 A 32yo presents with heavy 'lood loss( %# uterine thicknessJ15mm. *hat is the most appropriate t" for her+ a Defenemic acid ' c -d B% B% system @mirena
?3 A 37yo woman presents with heavy 'leeding. Bnv show su'serosal fi'roidE5cm and intramural fi'roidE6cm. *hich is the most appropriate t"+ a %A! ' A'dominal hysterectomy c Hysteroscopic Dyomectomy d 0aginal Hysterectomy e A'dominal myomectomy ?5 A woman with sickle cell disease complains of heavy menstrual 'lood loss. *hat is the most appropriate t"+ a ' Direna c epot provera d opper B% ?: A 36yo woman presented with massive 'leeding from multiple sites. ,a'# fi'rin degradation products# GGG( pltE3( 'leeding timeEprolonged( -/Eprolonged( A-//Eprolonged. *hat is the most likely d"+ a Hemophilia ' B c B/d actor 0 leiden e *arfarin
?6 A 3yo woman has -B which was treated with metronida)ole and cephalosporin. Bt is getting worse. *hat is the ne"t 'est inv+ a !ndocervical swa' ' % c ,aparotomy d High vaginal swa' ?7 A 36yo woman came with uterine 'leeding. 0aginal % reveals uterine thicknessE12mm. what is the most pro'a'le d"+ a ervical ca ' !ndometrial ca c varian ca d 8reast ca e 0aginal ca ?? A pregnant pt with $h Kve who hasn
?9 A 3yo primigravida who is 3wks A presents to the , with a'sent fetal movements. he also complains of severe headache( heart'urn and seeing floaters 'efore her eyes for the last few days. !"am# 8-E17;11mmHg( urine proteinEGGGG( rock hard uterus( no visi'le signs of fetal movements. hoose the single most likely d"+ a A'ruption of placenta 2nd preeclampsia ' Antepartum hemorrhage c -lacenta previa 9 A 3?yo woman( 1d post partum( presents to her - with a h" of passing 'lood clots per vagina since yesterday. !"am# 8-E9;5mmHg( pulseE11'pm( tempE3?( uterus tender on palpation and fundus is 2cm a'ove um'ilicus( 'lood clots GGG. hoose the single most likely d"+ a A'ruption of placenta 2nd preeclampsia ' oncealed hemorrhage
c -rimary --H d econdary --H e $etained placenta
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ca'ies
91 A 22yo lady who is in her last trimester of pregnant comes with h" of e"posure to a child d" with chicken po" 1d ago. he was investigated and was Gve for varicella anti'ody. *hat is the single most appropriate management+ a ive varicella Bg ' &uarantine c ive varicella vaccination d ral acyclovir e $eassure
92 A 3?yo woman( 1d post partum( presents to her - with a h" of passing 'lood clots per vagina since yesterday. !"am# 8-E9;5mmHg( pulseE11'pm( tempE3?( uterus tender on palpation and fundus is 2cm a'ove um'ilicus( 'lood clots GGG. hoose the single most likely d"+ a A'ruption of placenta 2nd preeclampsia ' oncealed hemorrhage c -rimary --H d econdary --H e $etained placenta f ca'ies
93 A 22yo woman who is 2wk pregnant came with pain and 'leeding per vagina. !"am# os is not open. *hat is the single most likely d"+ a /hreatened a'ortion ' Dissed a'ortion c A-H d Discarriage e Bnevita'le a'ortion 95 A primipara at fullterm in la'or has passed show and the cervi" is 3cm dilated. *hat is the single most appropriate management for her la'or+ a $epeat vaginal e"amination in 5h a. /
'. B0 syntocin drip c. $epeat vaginal e"amination in 2h Bnduction of la'our 9: A 32yo lady 1( 2?wks A came to her A= with a concern a'out pain relief during la'our. he has no medical illnesses and her pregnancy so far has 'een uncomplicated. he wishes to feel her 'a'y 'eing 'orn 'ut at the same time she wants something to work throughout her la'our. *hat method of pain relief 'est matches this lady
97 A 6?yo woman presents with postcoital 'leeding following her first episode of se"ual intercourse in 1yrs. *hat is the single most likely cause that has led to postcoital 'leeding+ a !ndometrial ca ' Atrophic vaginitis c !ndometrial polyp d ervical ca e ervical ectropion 9? A 35yo primigravida who is 16wk A comes for routine antenatal check up. Her 8-E16;1mmHg. he has a h" of repeated childhood %/B. *hat is the most likely cause of her high 8-+ a. !ssential H/= '. hronic pyelonephritis c. Acute pyelonephritis d. -reeclampsia
e. hronic %/B 99 A 25yo woman has had lower a'dominal pain for 12h. he is otherwise well. he is at 1wks A in a planned pregnany. *hat is the single most appropriate test to inv the cause of acute a'domen in this lady+ a A'dominal % ' Antiphospholipid screen c 8 a. /ransvaginal % '. ,aparoscopy
1 A pt is at term and in la'or( the mem'ranes have ruptured( the liCuor contains meconium 'ut the / is normal. /he cervi" is 3cm dilated. *hat is the single most appropriate action+ a 8- monitoring ' / c section d etal scalp 'lood sample e Bnternal rotation
11 A pt is at term and la'or. /he head has 'een delivered and you suspect shoulder dystocia. *hat is the single most appropriate action+ a section ' !pisiotomy
12 A 29yo female at 2?wks A presents to you with complains of hard stools and constipation for last 2wks. / shows fetal tachycardia. *hat is the single most appropriate t"+ a ral la"atives ' i'er diet c -hosphate enema d ,actulose $eassure
13 A 16yo girl presents with heavy 'leeding. *hat is the most appropriate initial inv+ a !ndometrial sampling ' /ransvaginal % a. Hysteroscopy '. -elvic % c. !"am under anesthesia
15 A woman who is 7wks pregnant presents with e"cessive and severe vomiting and put on B0 fluids and antiemetic @ondansteron. he is complaining of severe headache and can
1: A young lady with primary amenorrhea has normal ,H( H( estradiol and prolactin. hoose the single most likely d"+ - a - ' A'sent uterus c A'sent ovaries d /urner
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d. -regnancy e. Denopause A 6:yo lady presents with dyspareunia. *hat will you give her for her condition+ a. H$/ '. c. !strogen gel d. /estosterone gel A 3:yo lady with su'serosal fi'roidE5cm and su'mural fi'roidE6cm is planning for a child. *hich way will you remove the fi'roids+ a. ,aproscopy '. 0aginal myomectomy c. A'dominal myomectomy d. rugs e. $eassure A 32yo presents with heavy 'lood loss( %# uterine thicknessJ15mm. *hat is the 'est possi'le management for her+ a. '. %A! c. Hysteroscopy myomectomy d. A'dominal myomectomy e. !ndometrial a'lation A 2:yo primigravida of ?wk A presents with severe lower a'dominal pain( vaginal 'leeding and passage of clots. /he internal os is open. *hat is the most likely d"+ a. Appendicitis '. -lacental a'ruption c. !ctopic pregnancy d. A'ortion A mother got infected with Hep 8 during pregnancy. Her child is 'orn and she is worried a'out the risk of infection to the 'a'y with Hep 8. *hat would you give to the 'a'y+ a. Hep 8 Bg only '. Hep 8 full vaccine and Bg c. Hep 8 vaccine only once d. =othing until immune status is checked e. Hep 8 vaccine once and Bg uring antenatal visits( the following tests are routinely offered to all pregnant mothers apart from HB0 and Hep 8+ a. $u'ella and syphilis
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11.
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'. yphilis and to"oplasmosis c. Hep thalassemia d. D0 and ru'ella e. ickle cell anemia and Hep A pregnant lady at her 39wk A present with eclampsia. oon after her arrival in the la'our suit( B0 Dg5 and B0 hydrala)ine has 'een prescri'ed. /he pt then develops another fit in the hosp and maintenance dose of Dg5 has 'een started. *hat is your ne"t step in management+ a. Dg 5 'olus '. elivery of 'a'y c. Dg5 loading dose A 2?yo woman comes with sudden onset vomiting and pain per a'domen. !"am# mo'ile swelling in the right iliac fossa. *hat is the most pro'a'le d"+ a. !ctopic pregnancy '. /u'oovarian a'scess c. Acute appendicitis d. varian torsion e. iverticulitis A 32yo woman with prv h" of -B now presents with severe a'dominal pain. Her ,D- was ?wks ago. *hat is the most pro'a'le d"+ a. !ctopic pregnancy '. varian torsion c. Hematometrium d. hronic -B e. holecystitis A 2:yo who is 3?wks pregnant presents to the la'our ward with a h" of fewer fetal movements than usual during the evening. he also says that a'dominal contractions are coming veery few minutes and she is having a 'lood stained show per vagina for the last few minutes. !"am# cervi" is fully affaced( 9cm dilated( cephalic presentation and station is G1. hoose the single most likely d"+ a. A-H '. oncealed hemorrhage c. ,a'our d. B% e. B%$ A young lady with cervical ectropion 'leeds on touch. *hat is the most appropriate ne"t inv+ a. /ransvaginal %
'. ervical smear c. -unch 'iopsy d. erum estradiol e. olposcopy 15. A 3:yo woman who usually has 5 days midcycle 'leeding( had her period 1d ago. he has now presented with spots of 'lood. Her smear was normal 6m ago. !"am# cervical ectropion which doesn
a. '. c. d. e. f. g.
ervical smear !ndocervical swa' % guided 'iopsy ,aparotomy /ransvaginal % -unch 'iopsy erum estradiol
h. 1:. A girl with sickle cell anemia has painful 'leeding and vasoocclusive crisis during her periods. *hat is the 'est possi'le management for this pt+ a. '. c. d. e.
/rane"amic acid opper B% %A! epot provera
16. An 1?yo girl has menorrhagia and dysmenorrhea and reCuires contraception. *hat drug will you give her+ a. '. Direna coil c. opper / d. %A! 17. An o'ese woman with h" of migraine presented with heavy 'leeding during menstruation which is painful and needs contraception too. *hat is the 'est possi'le management for this pt+ a. '. c. d. e.
Direna coil opper / %A! epo provera
1?. A 53yo woman has suffered with heavy periods for many years and has tried many medical t" without success. he is constantly flooding and at times can
a. !ndometrial a'lation '. Hysterectomy c. Hysteroscopic;,aser resection of fi'roids d. Dyomectomy e. %A! 19. A 5?yo nulliparous woman feels tired all the time. Her periods are regular 'ut have always lasted for at least 1d. hoose the single most appropriate intial inv+ a. High vaginal swa' '. erum Hg' conc c. // d. =one e. A'dominal % 2. A woman is admitted to the hosp for elective a'dominal hysterectomy. 2m ago she was d" with 0/ and pulmonary em'olism and was started on warfarin. *hat is the most appropriate preop measure you will take on this occasion+ a. ontinue warfarin '. top warfarin c. top warfarin and start heparin d. Bncrease warfarin dose e. Add heparin 21. A 37yo woman had an elective , 1d ago. Lou are called to see her as she 'ecomes 8 with left sided chest pain and a cough. he has had 3 children( 2 'orn 'y ,. !"am# she has reduced air entry at left lung 'ase. Her o'servations include satE92F on air( 8-E1:;?5mmHg( pulseE12'pm( tempE37.2. hoose among the options which section complications has she developed+ a. '. c. d. e.
Aspiration pneumonia Aspiration pneumonitis pontaneous pneumothora" -ulmonary em'olism 0/
22. A 32yo woman of 3?wks A attends the antenatal day unit with pain in the suprapu'ic area that radiates to the upper thighs and perineum. B t is worse on walking. Her urine dipstick showed a trace of protein 'ut no white cells( nitrates or 'lood. *hat
c. ymphasis pu'is dysfunction d. ,a'or e. omplicated femoral hernia 23. A 25yo primigravida presents to the ! with a history of ?week amenorrhoea followed 'y heavy vaginal 'leeding and severe( crampy a'dominal pain. !"am# H$E11;min and 8-E12;?mmHg. /he uterus is 'ulky. /he cervi" is dilated and there is active 'leeding from the cervical os( 'ut no tissue has 'een e"pelled. *hich of the following is the most likely d"+ a. Bnevita'le a'ortion '. /hreatened A'ortion c. Bncomplete a'ortion d. Dissed A'ortion 25. A 31yo woman( :-5( who has amenorrhoea for 12 weeks and a positive pregnancy test presents to the ! with vaginal 'leeding. ymphysialfundal height measurement corresponds to 22 weeks gestation. %ltrasound e"amination reveals 'ilateral cystic masses. =o fetal parts are seen during the e"amination. /he cervi" is closed. *hich is the most likely d"+ a. /u'al pregnancy '. !ndometriosis c. Hydatidiform mole d. /hreatened a'ortion 2:. A married 2:yo woman presents with 6h h" of a'dominal pain located in the ,B. /he pain is persistent( of increasing intensity and not radiating first e"perienced while she was lying down. he feels giddy when she tr ies to stand erect. /he last menstrual period was 6 weeks ago. /he radial pulseE13;min and 8-E?;5mmHg. -elvic % shows free intraperitoneal fluid. *hat is the most appropriate ne"t step in management+ a. Bmmediate laparoscopy. '. Bmmediate laparotomy. c. -regnancy test @urine or serum. d. 'servation for 25 hours in the B% 26. A 32yo woman of 5wks gestation attends the antenatal day unit with sudden onset epigastric pain with nausea and vomiting. he is clinically 4aundiced. Her 'iochemistry results show a raised 'iliru'in( a'normal liver en)ymes( high uric acid and hypoglycemia. *hat
d. H!,,- syndrome e. Acute hepatitis 27. A 29yo woman presents to her - with trou'lesome heavy periods. /he med t" that she has tried have made little difference. he is known to have large uterine intramural fi'roids. Lou confirm that she is currently trying for more children. elect the most appropriate management for menorrhagia in this pt+ a. ana)ol '. !ndometrial a'lation c. Hysterectomy d. Hysteroscopic resection of fi'rosis e.
Dyomectomy
2?. A healthy 'a'y 'oy is 'orn at term to a woman who was unwell with confirmed acute hep 8 during pregnancy. /he mother is very concerned that she may have infected the 'a'y with hep 8. *hat B=,! preventative intervention should 'e given to the 'a'y+ a. ull course of hepatitis 8 vaccine '. Hepatitis 8 immunoglo'ulin alone c. Hepatitis 8 vaccine and hepatitis 8 immunoglo'ulin d. Hepatitis 8 vaccine as single dose e. =one until hepatitis 8 status confirmed 29. A 2?yo woman who has had a prv pulmonary em'olism in pregnancy wishes to discuss contraception. he has menorrhagia 'ut is otherwise well. *hat is the B=,! most suita'le contraceptive method for this patient+ a. '. opper B% c. ,evonorgestrel intrauterine system d. -rogestogen implant 3. A 27yo woman who takes the - has had painless vaginal spotting and discharge for 3 days. Her last menstrual period( which lasted four days( finished 1 days ago. Her last cervical smear two years ago was normal. A'dominal and vaginal e"aminations are normal apart from a mild ectropion with contact 'leeding. *hat is the B=,! most appropriate initial inv+ a. ervical smear '. olposcopy c. !ndocervical swa' d. !ndometrial 'iopsy e. -elvic %
31. A 19yo woman has had progressive 'ilateral iliac fossa pain and dyspareunia for 3days. he has an offensive vaginal discharge and feels unwell and feverish. Her tempE39. An initial antimicro'ial regimen is commenced. *hat B=,! set of organisms are the most appropriate for the antimicro'ial regimen to cover+ a. =eisseria gonorrhoeae and andida al'icans '. =eisseria gonorrhoeae and andida al'icans and ardnerella vaginalia c. =eisseria gonorrhoeae and hlamydia trachomatis d. =eisseria gonorrhoeae and hlamydia trachomatis and andida al'icans e. =eisseria gonorrhoeae and hlamydia trachomatis and ardnerella vaginalis 32. A primigravida in the 17th week of her symptomless gestation is found( on %( to have evidence of placental tissue covering the cervical os. 8y the end of her pregnancy she is likely to develop+ a. -lacental migration '. %terine myoma c. %terine rupture d. horiocarcinoma e. horangioma f. 0asa previa g. h. i. j.
Remember in Your Prayers.. Regards:
k. Dr. IRSHAD HUSSAIN, AYUB TA!HIN" H#SPITA$, ABB#TTABAD. %.
m.
&AY '(, )'*+.
