(Obstetric and Gynecology exam.

2008: ( assessment and final

MCQs + essays & short notes + OSCE

Done by : Dana Maarafi & Dalia Sadeq

:high level of testosterone and DHEA in women is produced in -1

a- ovary

b- adrenal gland

c- dysgerminoma

Indication of C/S in Kuwait is -2

a- repeat C/S

b- failure to progress

c- cephalopelvic disproportion

: What is NOT true about chorioamionitis -3

a- usually extremely sensitive for chemotherapy

b- usually extremely sensitive to radiotherapy

c- frequently found to secrete α- feto protein

genetic screening is indicated in next pregnancy if abortion -4

shows

a- polyploidy

b- trisomy

c- monosomy

:chrionic viili … detects -5

a- trisomy 13

b- trisomy 18

c- trisomy 21

:what is NOT true about HIV -6

a- C/S if membrane not ruptured , prevents vertical transmission

to fetus

b- 15% of new born will have the disease at 6 months

c- not transmitted by breast feeding

d- can be transmitted to fetus before birth

e- it is a retrovirus

:spasm at introitus during sexual intercourse -7

Vaginism

yr old female complaning of irregular bleeding, endometrial 45 -8

histology : benign prolifrative epithelium, she is suffering from hot
: flashes , Best treatment is

a- OCP

b- sequential contraceptive pill

c- progesterone

d- unconjugated equine estrogen/ progesterone

: yr old female has grade IIA cervical cancer , best treated by 45 -9

a- radiotherapy

b- hysterectomy

c- hysterectomy and bilateral opherectomy

d- hysterectomy with bilateral salpingoopherectomy

yr old female has complex hyperplasia with atypia , 60 -10

: treatment of choice is

a- TAH-BSO

-b

: most likely to develop endometrial carcinoma is -11

a- simple atypia

b- complex atypia

c- adenomysis

in rheumatic heart disease . maximum rist is at -12

a- 1st trimester

b- 2nd trimester
c- 3rd trimester

d- 1st stage labor

e- 2nd stage labor

pregnancy is unlikely in -13

a- Vit B12 deficiency

b- TTP

during antenatal visit , while examining a lady. She became -14

: hypotensive. What is the 1st step to do

a- O2 mask

b- turn on lateral side

:which one of the following is diabetogenic in pregnancy -15

a- progesterone

b- HPL

(average age at menarche : ( not sure -16

a- 7-9

b- 11-12

c- 12-13

ovarian tumor present bilaterally… more likely metastasize to -17

a- LN

b- lung

c- liver

d- brain

risk of cervical cancer less in -18

a- early age at 1st sexual intercourse

b- late age of 1st intercourse

c- multiple partners

: all indicate poor prognosis n cancer except -19

a- menopause

b- low grade tumor

PID is -20

-a

:PCO causes all except -21

a- infertility

b- menorrhagia

c- dysmenorrheal

: Tx of endometriosis -22

a- danazol

-b

: increase risk of ectopic in -23

a- reversal of sterilization

b- bergoline

c- clomphine citrate

:Tx of amenorrhea -24

a- clomiphine citrate

b- low dose progesterone

placenta site in mother invaded and lined by : intermediate -25

trophoblast

: all are true of deceleration except -26

a- change position

b- give O2

c- prepare mother for C/S

* d- give oxytosin
: bladder instability -27

a- can be first seen after colposuspension

b- caused by MS

c- pelvic floor exercise has no rule in management

:about TVTO -28

a- rate of success is 100% if with anterior corporrhaphy

b- may cause urinary retention post –op

c- can cause bladder instability

:vaginal secretion in 10 yr old not puberty yet, all except -29

a- systemic steroids

b- foreign body

c- ring worm

d- dysgerminoma

e- ectopic ureter

:all of the following can cause PID except -30

a- tooth extraction

b- IUCD

c- multiple partners

d- female circumcision

:adenomyosis , all true except -31

a- cause bleeding

b- diagnosed by endometrial biopsy

:in non pregnant uterus , all true except -32

a- endometrium has 2 layers

b- has cervix and body

c- 7.5 cm in length

d- supplied by ovarian and uterine arteries

: which is true about implantation -33

a- 1 wk after fertalization *

b- 2 wks after ovulation

c- 2 days after ovulation

:which is true about menstruation -34

a- 10 days after LMP

*b- take place if no fertilization

c- occurs in an ovulatory cycle

:test used to detect ovulation -35

a- day 10 estradiol

b- day 14 LH

c- day 21 progesterone *

: 5α for reductase is -36

a- enzyme converting testosterone to DHT for development of

*male external genetalia

b- not present in women

:signs of respiratory distress in newborn -37

a- grunting

b- subcostal reccession

c- nasal flaring

d- B& C

the correct answer should be all of the above but was )

(not a choice

in Rh isoimmunization , all are true except: ( another Q with -38

( ! more than 1 answer

a- it occurs in O- mothers only

b- 2nd attack less severe

c- occur after prophylaxis

:dose of HRT of progesterone -39

a- 150 µl/ day

b- 30 µl/ day

c- 350 µl/ day

d- 150 ml/day

:ovarian tumor with tubal lining -40

a- serous cystadenoma

b- mucinous cystadenoma

c- brenner tumor

: not a risk factor for osteoporosis -41

a- sedimentary life

b- black race

c- early age of puberty

:most specific test to insure placenta is normal -42

a- U/S

b- Doppler flow in umbilical artery

TORCH is : toxoplasma, rubella, CMV, herpes -43

:not true about semen -44

a- normal amount is 10 ml *

b- 40 or more immobile = asthenozoospermia

c- normal count of sperms is 20-250 millions

hysteroscopy is contraindicated n : PID -45

:regarding iron deficiency anemia , all true except -46

a- causes PPH
b- contraindicate epidural

c- mAcrocytic hypochromic anemia

all of the following may occur as complication in pregnancy -47

:except

a- TTP

b- HELLP syndrome

c- B12 deficiency

d- fatty changes of liver

:GTD all true except -48

a- 20% progress to malignancy

b- complete mostly xx46

c- rate of 2nd molar is 2%

:in asymptomatic bacteria, all true except -49

a- 5% have it

b- more in multigravida

c- 3% have congenital anomalies

d- 30% progress to pyelonephritis

pain during intercourse = dysparunia -50

:not a component of bishop's score -51

a- fetal position

b- head station

c- cervical consistency

d- effacement

:true about placenta accreta -52

infiltrate myometrium to peritoneum making it impossible to

separate
: contraindication for vaginal delivery after C-section -53

a- previous 2 or more c-section

b- previous T incision

c- previous classical incision

d- previous rupture

e- all of the above

:absolute contraindication for ECV -54

a- previous 3 C/S *

b- PIH

fetal lie : spine of baby parallel to mother spine -55

: causes of high head -56

a- previous uterine surgery

b- small pelvis

c- deflexed head

: commonest uterine neoplasm is -57

a- lieomyoma *

b- endometrial cancer

c- MMT

d- liemyosarcoma

:ectopic pregnancy -58

*a- causes post coital bleeding

b- seen in postmenopausal

c- is a true ulcer

:causes of candidal vagintis , all except -59

a- broad spectrum antibiotic

b- COC

c- systemic steroids
-d

-e

:regarding prevention in HIV positive women -60

a- encourage to have monogamous relationship

b- use condom with spermaticide

c- donate blood generously

d- a & b

:which is not a thrtapeutic indication of laproscopy -61

a- entdometriosis cautary

b- lysis of adhesions

* c- peritoneum culture

which of the following 2 organisms commonly caused PID: -62

clamydia & gonorrhea

: matching 63-67

yr old no puberty , inguinal mass : testicular feminzation 19 -63

months no peiod after an abortion : no abnormalities 2 -64

yr old with amenorrhea : menopause 50 -65

yr old with amnorrhea premature menopause 30 -66

women with galactorrhea : CNS tumor -67

which is not true : first step in repairing perineal tear is suturing -68
the muscl

patient has hip pain, anemia, jaundice, pregnant and not -69
? improving with iron supplement . what to do

a- Hb electrophoresis *

b- fragility tst

c- comb's test

d- G6PH level

:signs of separation of placenta include -70

a- soft uterus

b- visible lengthening of cord *

c- impalpable fundus

d- membrane visible at introitus

: which one is not a manifistation of fibroid -71

a- menorrhagia

b- recurrent abortion

c- infertility or subfertility

d- genuine stress incontinence *

:absolute contraindication of OCP -72

a- recent DVT *

b- diabetes

:regaring liemyosarcoma , all true except -73

a- fleshy texture

(b- arise from one cell type ( not sure about choice

c- mitosis < 5-10 / high power field

hypertion bfore 20 weeks can be caused by : GTD -74

placenta has : 20 -25 segments -75

: bleeding n post-menopausal women can occur in al except -76

a- 6 months use of trivial

* b- continuous HRT

women after miscariage should take OCP after : 2 weeks -77

Written exam: assessment

Essay 1 : 30 yr old P0+1+0+1 delivered by emergency C-section at
36 wks for fetal distress. Now she is 37 week pregnant . discusse
(her management (fetus was breech but not sure

Essay 2: 68 yr old diabetic on oral hypoglycemic , presented with

cystic mass arising from the pelvis with ascitis . discuss her
management

:Shot Notes

what is recurrent abortion ? outline the management -1

what is stress incontinence ? list differential diagnosis , outline -2

management

list indications, prerequisite and complication of forceps -3

list 5 causes and complications of peurpural pyrexia and how to -4

prevent them

list 5 indications, complications and the procedure of D&C -5

what is HELLP ? outline management -6

list 5 causes of STD and management of 1 of them -7

? -8

Written exam : final

Essay 1: a nurse P 0+0+ 4 + 0 recurrent miscariages at 14-16 wks
..……… ? gestation. how to manage

Essay 2: 72 yr old teacher complaining of 3 days of bleeding per

vagina for first time , LMP 10 yrs ago , no abdominal pain , no
swelling, no change in bowel habit, no weight loss. Discuss
management

:Short notes

informed consent of tubal ligation -1

breast feeding : advantages for mother and baby -2

? HE -3

laproscopy : indications, procedure complications -4

uses of MgSO4 in gyn -5

medical management of ectopic pregnancy -6

chronic pelvic pain : etiology and management -7

pain relief during labor -8

OSCE: final exam

endometriosis : clinical presentation, 2 theories, 4 treatments -1

lady pregnant in her 26 wks (LMP was given only) symphysis fundal -2
hight was 31. Pic of U/S shown

(So >> , large for gestational age + pic of polyhydraminous ( U/S

Name of A: LGA . list of cases

. B: polyhydraminous

(how to diagnose B in U/S (list 2 ways

induction of labor set : name of each, indications, which one is used if -3

? bishop's score is 4

multile fibroids : presentation + 4 treatment -4

semen analysis: list 4 abnormalities , 4 Tx, 2 complication to spouse , -5

how to prevent them

contraception : name each, effectivness of each, advantage of OCP, C/I -6

? of IUCD, in emergency contraception what to use

(trichomonas vaginalis pic shown ( wet test -7

Question about vaginal secretion

Name condition, 4 differentials, how to differentiate between them , list

2 of them STDs, manage 1

scenario of lady with GDM after delivery of baby's head , difficulty in -8

delivery rest of body

Pic of macrosomic baby was shown

Name condition : shoulder dystocia

List risk factor, how to manage ( 4 intial steps) , complication ( 2 for

(mother, 2 for baby
case of iron deficiency anemia : 4 abnormalities in lab test, name -9
condition , Tx, 4 investigations