Obstetric and Gynecology Exam

7/30/2019 Obstetric and Gynecology Exam

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Obstetric and Gynecology exam. 2008: ( assessment and final(

MCQs + essays & short notes + OSCE

Done by : Dana Maarafi & Dalia Sadeq

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

a- ovary

b- adrenal gland

c- dysgerminoma

2-Indication of C/S in Kuwait is

a- repeat C/S

b- failure to progress

c- cephalopelvic disproportion

3-What is NOT true about chorioamionitis:

a- usually extremely sensitive for chemotherapy

b- usually extremely sensitive to radiotherapy

c- frequently found to secrete - feto protein

4-genetic screening is indicated in next pregnancy if abortion

shows

a- polyploidy

b- trisomy

c- monosomy

5-chrionic viili detects:

a- trisomy 13

b- trisomy 18

c- trisomy 21

6-what is NOT true about HIV:

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

to fetus

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


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c- not transmitted by breast feeding

d- can be transmitted to fetus before birth

e- it is a retrovirus

7-spasm at introitus during sexual intercourse:

Vaginism

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

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

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

a- radiotherapy

b- hysterectomy

c- hysterectomy and bilateral opherectomy

d- hysterectomy with bilateral salpingoopherectomy

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

treatment of choice is:

a- TAH-BSO

b-

11-most likely to develop endometrial carcinoma is:

a- simple atypia

b- complex atypia

c- adenomysis

12-in rheumatic heart disease . maximum rist is at

a- 1st trimester

b- 2nd trimester


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c- 3rd trimester

d- 1st stage labor

e- 2nd stage labor

13-pregnancy is unlikely in

a- Vit B12 deficiency

b- TTP

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

hypotensive. What is the 1st step to do:

a- O2 mask

b- turn on lateral side

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

a- progesterone

b- HPL

16-average age at menarche : ( not sure(

a- 7-9

b- 11-12

c- 12-13

17-ovarian tumor present bilaterally more likely metastasize to

a- LN

b- lung

c- liver

d- brain

18-risk of cervical cancer less in

a- early age at 1st sexual intercourse

b- late age of 1st intercourse


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c- multiple partners

19-all indicate poor prognosis n cancer except:

a- menopause

b- low grade tumor

20-PID is

a-

21-PCO causes all except:

a- infertility

b- menorrhagia

c- dysmenorrheal

22-Tx of endometriosis:

a- danazol

b-

23-increase risk of ectopic in:

a- reversal of sterilization

b- bergoline

c- clomphine citrate

24-Tx of amenorrhea:

a- clomiphine citrate

b- low dose progesterone

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

trophoblast

26-all are true of deceleration except:

a- change position

b- give O2

c- prepare mother for C/S

d- give oxytosin*


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27-bladder instability:

a- can be first seen after colposuspension

b- caused by MS

c- pelvic floor exercise has no rule in management

28-about TVTO:

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

b- may cause urinary retention post op

c- can cause bladder instability

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

a- systemic steroids

b- foreign body

c- ring worm

d- dysgerminoma

e- ectopic ureter

30-all of the following can cause PID except:

a- tooth extraction

b- IUCD

c- multiple partners

d- female circumcision

31-adenomyosis , all true except:

a- cause bleeding

b- diagnosed by endometrial biopsy

32-in non pregnant uterus , all true except:

a- endometrium has 2 layers

b- has cervix and body


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c- 7.5 cm in length

d- supplied by ovarian and uterine arteries

33-which is true about implantation:

*a- 1 wk after fertalization

b- 2 wks after ovulation

c- 2 days after ovulation

34-which is true about menstruation:

a- 10 days after LMP

b- take place if no fertilization*

c- occurs in an ovulatory cycle

35-test used to detect ovulation:

a- day 10 estradiol

b- day 14 LH

*c- day 21 progesterone

36-5 for reductase is:

a- enzyme converting testosterone to DHT for development of

male external genetalia*

b- not present in women

37-signs of respiratory distress in newborn:

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(

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

more than 1 answer( !

a- it occurs in O- mothers only


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b- 2nd attack less severe

c- occur after prophylaxis

39-dose of HRT of progesterone:

a- 150 l/ day

b- 30 l/ day

c- 350 l/ day

d- 150 ml/day

40-ovarian tumor with tubal lining:

a- serous cystadenoma

b- mucinous cystadenoma

c- brenner tumor

41-not a risk factor for osteoporosis:

a- sedimentary life

b- black race

c- early age of puberty

42-most specific test to insure placenta is normal:

a- U/S

b- Doppler flow in umbilical artery

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

44-not true about semen:

*a- normal amount is 10 ml

b- 40 or more immobile = asthenozoospermia

c- normal count of sperms is 20-250 millions

45-hysteroscopy is contraindicated n : PID

46-regarding iron deficiency anemia , all true except:

a- causes PPH


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b- contraindicate epidural

c- mAcrocytic hypochromic anemia

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

except:

a- TTP

b- HELLP syndrome

c- B12 deficiency

d- fatty changes of liver

48-GTD all true except:

a- 20% progress to malignancy

b- complete mostly xx46

c- rate of 2nd molar is 2%

49-in asymptomatic bacteria, all true except:

a- 5% have it

b- more in multigravida

c- 3% have congenital anomalies

d- 30% progress to pyelonephritis

50-pain during intercourse = dysparunia

51-not a component of bishop's score:

a- fetal position

b- head station

c- cervical consistency

d- effacement

52-true about placenta accreta:

infiltrate myometrium to peritoneum making it impossible to

separate


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53-contraindication for vaginal delivery after C-section:

a- previous 2 or more c-section

b- previous T incision

c- previous classical incision

d- previous rupture

e- all of the above

54-absolute contraindication for ECV:

*a- previous 3 C/S

b- PIH

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

56-causes of high head:

a- previous uterine surgery

b- small pelvis

c- deflexed head

57-commonest uterine neoplasm is:

*a- lieomyoma

b- endometrial cancer

c- MMT

d- liemyosarcoma

58-ectopic pregnancy:

a- causes post coital bleeding*

b- seen in postmenopausal

c- is a true ulcer

59-causes of candidal vagintis , all except:

a- broad spectrum antibiotic

b- COC

c- systemic steroids


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d-

e-

60-regarding prevention in HIV positive women:

a- encourage to have monogamous relationship

b- use condom with spermaticide

c- donate blood generously

d- a & b

61-which is not a thrtapeutic indication of laproscopy:

a- entdometriosis cautary

b- lysis of adhesions

c- peritoneum culture*

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

clamydia & gonorrhea

63-67matching:

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

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

65-50yr old with amenorrhea : menopause

66-30yr old with amnorrhea premature menopause

67-women with galactorrhea : CNS tumor

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

the muscl

69-patient has hip pain, anemia, jaundice, pregnant and not

improving with iron supplement . what to do?

*a- Hb electrophoresis

b- fragility tst

c- comb's test

d- G6PH level

70-signs of separation of placenta include:


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a- soft uterus

*b- visible lengthening of cord

c- impalpable fundus

d- membrane visible at introitus

71-which one is not a manifistation of fibroid:

a- menorrhagia

b- recurrent abortion

c- infertility or subfertility

*d- genuine stress incontinence

72-absolute contraindication of OCP:

*a- recent DVT

b- diabetes

73-regaring liemyosarcoma , all true except:

a- fleshy texture

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

c- mitosis < 5-10 / high power field

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

75-placenta has : 20 -25 segments

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

a- 6 months use of trivial

b- continuous HRT*

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

Written exam: assessment


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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:

1-what is recurrent abortion ? outline the management

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

management

3-list indications, prerequisite and complication of forceps

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

prevent them

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

6-what is HELLP ? outline management

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

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:

1-informed consent of tubal ligation

2-breast feeding : advantages for mother and baby

3-HE?

4-laproscopy : indications, procedure complications


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5-uses of MgSO4 in gyn

6-medical management of ectopic pregnancy

7-chronic pelvic pain : etiology and management

8-pain relief during labor

OSCE: final exam

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

2-lady pregnant in her 26 wks (LMP was given only) symphysis fundal

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(

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

bishop's score is 4?

4-multile fibroids : presentation + 4 treatment

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

how to prevent them

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

of IUCD, in emergency contraception what to use?

7-trichomonas vaginalis pic shown ( wet test(

Question about vaginal secretion

Name condition, 4 differentials, how to differentiate between them , list2 of them STDs, manage 1

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

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(


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9-case of iron deficiency anemia : 4 abnormalities in lab test, name

condition , Tx, 4 investigations

Obstetric and Gynecology Exam

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