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GYNECOLOGY

ANATOMY AND EMBRYOLOGY


Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
$% The folloin& about the round li&ament of the uterus is 'are( correct E)*E+T:
a)
b) Passes into the inguinal canal.
c) d) Is derived from the gubernaculum.
e) Is continuous with the ovarian ligament at the cornu of the uterus.
,% The bod! of the uterus drains to the folloin& nodes E)*E+T:
a) Sacral.
b) Superficial inguinal.
c) Obturator.
d) Femoral.
e) External iliac.
-% The l!mphatic draina&e of the cer.i/ is to the folloin& l!mph nodes E)*E+T:
a) The femoral lmph nodes.
b) The internal iliac lmph nodes.
c) The para!cervical lmph nodes.
d) The pre!sacral lmph nodes.
e) The Obturator lmph nodes.
0% The folloin& is correct about the o.arian li&aments:
a) "ontain ureters.
b) "ontain ovarian arteries.
c) #re attached laterall to pelvic wall.
d) $ie anterior to the broad ligament.
e) #re homologous to part of the gubernaculums testis in the male.
1%
2% A3 the folloin& are correct about the pel.ic li&aments and fascia E)*E+T:
a) The cardinal ligaments arise from the inferior pubic rami.
b) Peritoneum covers the superior portion of the post vaginal wall.
c) The suspensor ligament of the ovar is superior to the round ligament.
d) The round ligament contains lmphatic vessels.
e) The ureter penetrates the cardinal ligament.
4% 5n the de.elopment of the o.aries6 all are correct E)*E+T:
a) The structures in the ovaries have different origins.
b) Involve migration of the germ cells.
c) Involve migration of the ovaries.
d) The homologous structure in the male is the testis.
e) %evelop at the &ubernaculum.
7% The presence of a uterus in a phenot!picall! normal male is due to:
a) $ac' of mullerian inhibiting factor.
b) $ac' of testosterone.
c) Increased levels of estrogens.
d) ()* ++ 'arotpe.
e) Presence of ovarian tissue earl in embronic development.
8% +re&nanc! complications that can occur due to bicornuate uterus include the folloin&
E)*E+T:
a) #bortion.
b) ,alpresentation.
c) Operative deliver.
d) Twin pregnanc.
e) Premature labor.
$9%+ossible clinical conse:uences of con&enital malformations of the female &enital s!stem
include all of the folloin& E)*E+T:
a) -abitual abortion.
b) "ongenital fetal malformations.
c) Ectopic pregnanc.
d) Obli.ue lie of the fetus.
e) Expulsion of intrauterine devices.
$$%5mperforate h!men mi&ht present ith the folloin& E)*E+T:
:
a) Primar amenorrhea.
b) "clic menstrual molimina.
c) #cute retention of urine.
d) pelvi!abdominal mass.
e) -pomenorrhea.
$,%The clinical findin&s of imperforate h!men include the folloin& E)*E+T:
a) -irsutism.
b) "rptomenorrhea.
c) -ematometra
d) Pelvi!abdominal swelling.
e) /etention of urine.
$-%
$0%Ambi&uous &enitalia at birth ma! be associated ith the folloin& E)*E+T:
a) congenital adrenal hperplasia.
b) maternal ingestion of dana0ol during pregnanc.
c) complete androgen insensitivit.
d) true hermaphroditism.
e) 'arotpe of () ++.
$1%Bicornuate uterus mi&ht predispose to:
a) /ecurrent preterm labor.
b) Primar amenorrhea.
c) /ecurrent obli.ue lie.
d) /etention of the placenta after deliver.
e) ,enorrhagia.
$2%The folloin& is deri.ed from &ubernaculum in female:
a) Ovarian ligament.
b) ,esovarium and ovarian ligament.
c) Ovarian ligament and broad ligament.
d) /ound ligament and broad ligament.
e) ,ac'enrodt1s ligament and ovarian ligament
$4%All are .esti&ial remnants E)*E+T:
a) 2obelt1s tubules.
b) Epoophoron.
c) Tubal fimbria.
d) Paraoophrorn.
e) &artner duct.
$7%
$8%;ro&enital sinus &i.es the folloin&:
a) 3rinar bladder.
b) S'ene1s ducts.
c) $ower part of the vagina.
d) The ureteric bud.
e) 4artholin1s glands
,9%Barr bod! ma! be found in the folloin& E)*E+T:
a) 2linefilter1s sndrome.
b) Turner1s sndrome.
c) %own1s sndrome.
d) #drenogenital sndrome.
e)
,$%*on&enital absence of the .a&ina is most commonl! associated ith:
a) #bsent secondar sexual characteristics.
b) #bsent uterus.
c) Exposure to diethl stilbosterol in utero.
d) Turner1s sndrome.
e) Imperforate anus.
Directions '<uestions ,, throu&h 02( ach set of matchin& :uestions in this section consists
of a list of 1 to 7 lettered options folloed b! se.eral numbered items" =or each item6
select the ONE best lettered option that is most closel! associated ith it" Each lettered
headin& ma! be selected once6 more than once6 or not at all"
<uestions ,,%,2
=or each of the folloin& epithelium6 select the or&an that is linin& it:
a) Stratified s.uamous
b) Pseudo!stratified
c) Transitional
d) "olumnar
,,%Dome of the urinar! bladder
,-%E/ternal urethral meatus
,0%Endocer.i/
,1%Adult .a&ina
,2%Endometrium
<uestions -,%-2 M*<
Match the homolo&ous correspondin& structures in both se/es
a) Testis
b) 5entral aspect of the penis
c) Penis
d) Scrotum
e) &ubernaculum testis
f) "remasteric muscle
g) &lans penis
-,%O.arian li&ament
--%Labia ma>ora
-0%Labia minora
-1%*litoris
-2%O.ar!
<uestions -4%0$
Match the ori&in of the or&an ith the or&an &i.en
a) ,esonephric duct
b) &enital tubercle
c) &ubernaculum
d) 3rogenital fold
e) Paramesonephric duct
f) 3rogenital sinus
-4%=allopian tube
-7%O.arian li&ament
-8%Labium minus
09%*litoris
0$%;terus
<uestions 0,%02
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$" - are correct6 choose B
," 0 are correct6 choose *
$6 ,6 -6 0 are correct6 choose D
All are correct6 choose E
04%5n the female &enitalia:
6. The anterior and posterior walls of the empt vagina lie in apposition.
7. The urethra opens in the vestibule.
8. 4artholin1s gland lies deep to the vestibular bulb.
(. Secretions arise from vaginal epithelial glands.
5. The labia minora have hair follicles.
07%The ner.e suppl! of the .ul.a and perineum is deri.ed from the folloin& ner.es:
6. Pudendal.
7. &enito!femoral.
8. Posterior cutaneous of thigh.
(. Obturator.
9. #nterior cutaneous of thigh.
08%The .ul.al blood suppl! is .ia the:
6. Internal pudendal arter.
7. 5aginal arter.
8. External pudendal arter.
(. Superior vesical arter.
9. ,iddle rectal arter.
19%The ma>or supports of uterus are:
6. The transverse cervical :cardinal) ligaments.
7. The uterosacral ligaments.
8. The pubo!cervical ligaments.
(. The infundibulo!pelvic ligaments.
9. The round ligaments.
1$%The l!mphatic draina&e from the uterine cer.i/ is throu&h the folloin& l!mph nodes:
6. External iliac.
7. Obturator.
8. Pre!sacral.
(. Superficial femoral.
9. Superficial inguinal.
1,%
1-%
10%
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
11%The .a&ina:
a) "ontains mucus secreting glands.
b) /elates posteriorl to the rectum in its middle third.
c) /elates anteriorl to the bladder base in its lowest third.
d) Is supplied in part b the uterine arter.
e) Is entirel derived from the ,3$$E/I#; duct.
12%The o.ar!:
a) Is derived from T3E GEN5TAL T;BER*LE
b) Is attached to the uterine cornu b the infundibulo!pelvic ligament.
c) $ies posteriorl to the board ligament.
d)
e) Is attached to the distal portion of the fallopian tube.
14%
a)
17%The cer.i/:
a)
b)
c) -as columnar epithelium lining the canal.
d) Produces a thic' scant discharge at ovulation.
e) -as the same proportion of muscle in its wall as the corpus uteri.
18%5mperforate h!men:
a) ,a lead to hematocolpos.
b)
c) Is fre.uentl associated with renal abnormalities.
d)
e)
29%The =olloin& statements about the loer part of the uterus are correct:
a)
b) The uterine arter passes inferior to the ureter.
c) # parous external os is slit!shaped.
d) Peritoneum passes to cover the upper part of vagina posteriorl.
e)
2$%5n the female pel.is6 the peritoneum co.ers:
a) The whole of the anterior wall of the uterus.
b) The whole of the posterior wall of the uterus.
c) The fallopian tube partiall.
d) The ovar full.
e) The upper half of the posterior wall of the vagina.
2,%The =allopian Tube:
a) Possesses a ciliated lining.
b) Is activel motile.
c) Is easil palpable on bimanual examination.
d) Is covered totall b peritoneum.
e) -as a thic' muscle laer in ampulla.
2-%The o.ar!:
a) $ies posterior to the broad ligament.
b) Is covered b peritoneum.
c) /eceives blood suppl from a branch from the internal iliac arter.
d) /ight ovarian vein drains directl into inferior vena cava.
e) -as lmphatic drainage to the para!aortic lmph nodes.
20%The uterus:
a) The uterine index in adult uterus is 6.
b) #nteflexion is maintained mainl b the tone of the uterosacral ligament.
c) The round ligament is attached to the anterior surface <ust below the cornu.
d) The uterine arter passes below the ureter :in the ureteric canal) to reach the uterus.
e) The uterus receives blood suppl from the ovarian arter.
RE+ROD;*T5AE ENDO*R5NOLOGY6 5N=ERT5L5TY AND
MEN#TR;AL D5#ORDER#
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
21%The functions of mid%c!cle L3 sur&e include the folloin& E)*E+T:
a) Enhances thecal cell androgen production.
b) $uteini0es granulosa cells.
c) Initiates resumption of meiosis.
d) Facilitates oocte expulsion.
e) Produces luteolsis.
22%=ollicle%stimulatin& hormone is elaborated b!:
a) "hromophobe cells of the adenohpophsis.
b) 4asophilic cells of the adenohpophsis.
c) #cidophilic cells of the adenohpophsis.
d) Follicular granulosa.
e
24%The folloin& is a normal findin& on the tent!%third da! of a normal tent!%ei&ht
da! menstrual c!cle pro.ide stron& e.idence that o.ulation has occurred:
a) "ervical mucus with positive arbori0ation if dried on a glass slide.
b) Subnuclear vacuolation apparent on endometrium biops.
c) -igh cornification index in vaginal ctolog preparations.
d) -igh level of total estrogens in a twent!four hour specimen of urine.
e) Presence of an apparentl health corpus luteum in an ovar.
27%The a.era&e blood loss resultin& from menstruation is:
a) 6= to 69ml.
b) 79 to 9= ml.
c) >9 to 6==ml.
d) 6=6 to 679ml.
e) 68= to 69=ml.
28%All the folloin& about precocious pubert! is true E)*E+TB
a) It ma involve menarche before the age of ? ears.
b)
c) "onstitutional factor is rare.
d) It ma be due to serious tumors.
e) It ma be associated with contra!sexual development.
49%All the folloin& about precocious pubert! is true E)*E+T:
a) It is usuall constitutional.
b) It ma be associated with long bone fractures.
c) Pubic hair is first sign.
d) It can be delaed b &n/- analogues.
e) It results in adult short stature.
4$%Menopause could be dia&nosed b!:
a) -istor of absent menstruation.
b) -igh FS- in oung age group.
c) #bsent menstruation for 6 ear at the age of 97 ear.
d) -ot flushes @ lac' of sleep.
e) Flushes lac'.
4,%+remature menopause is associated ith the folloin& E)*E+T:
a)
c) /adio therap.
d
4-%=acts about clomiphene citrate include the folloin& E)*E+T:
a) has antiestrogenic properties.
b) ma be started with a 9=!mg dose dail.
c) is useful in primar ovarian failure.
d) ma cause cervical mucus hostilit.
e) ma result in multiple pregnanc is a side effect of its use.
40%*omplications that could be attributed to post%menopausal hormonal chan&es include
the folloin& E)*E+T:
a) Procidentia.
b) "oronar heart diseases.
c) "ancer breast.
d) Stress urinar incontinence.
e) %epression.
42%5n 3irsutism6 the folloin& is true E)*E+T:
a) It ma be treated b dexamethasone when there is an adrenal cause.
b) "proterone acetate results in reduction of libido.
c) d) AAB of circulating testosterone is protein bound.
e) /aised
44%5n se.ere o.arian h!perstimulation s!ndrome 'O3##(:
a) Pleural effusion ma occur.
b) Intravascular clotting can be a complication.
c) -poproteinemia ma develop.
d) 4ilateral oophorectom is indicated.
e) Paracentesis ma be of benefit.
47%3!perprolactinemia ma! be associated ith the folloin& E)*E+T:
a) "hronic renal failure.
b) &alactorrhea.
c) "imetidine therap.
d) ,ethl dopa therap.
e) #drenogenital sndrome.
48%Galactorrhea 'non%&estational lactation( ma! result from the folloin& E)*E+T:
a) Pituitar adenoma.
b) -pothroidism.
c) /enal failure.
d) Intrapartum hemorrhage.
e) 4ronchogenic carcinoma.
79%Thc folloin& is true about &onadotrophin releasin& hormone 'GnR3( analo&ues:
a) The are given continuousl in vitro fertili0ation ccles :I5F) to stimulate follicular
growth.
b) The ma cause endometrial hperplasia.
c) The can be given intramuscular.
d) Their long term use increases bone densit.
e) Progesterone bac'!up is better used with its chronic use.
7$%The folloin& is true about danaCol E)*E+T:
a) It is a snthetic compound.
b) It has an androgenic properties.
c) It has an anabolic effects.
d) It has an antigonadotrophic effects.
e) The main indication is in the treatment of dsfunctional uterine bleeding.
7,%The folloin& is true about female se/ual d!sfunction E)*E+T:
a) Females have no refractor phase :unli'e males).
b) %spareunia is mainl introital.
c) Fear of pregnanc and sexual transmitted diseases can be a cause of dspareunia.
d) 3rine loss at orgasm suggests stress incontinence.
e) Pregnanc ma cause situational anorgasmia.
7-%5n .itro fertiliCation '$A=(:
a) %own regulation of the pituitar gland is achieved b the use of human menopausal
gonadotrophins :-,&).
b) I5F is indicated for treatment of luteal phase defect in infertilit.
c) I5F is indicated for treatment of unexplained infertilit.
d) Oocte retrieval is performed 7? hours after human chorionic gonadotropin :h"&)
in<ection.
e) Success rates are increased with increasing age.
70%Accepted parameters for a normal semen anal!sis are:
a) # sperm count of 6=!7= million per ml.
b) # volume of 6 ml.
c) )=B motilit.
d) )=B abnormal forms.
e) # positive mixed agglutination reaction.
71%The &eneral incidence of infertilit! is:
a) 1D"
b) 6=!69B.
c) 79B.
d) 8=B.
e) 89B
72%Accordin& to E3O 'orld health or&aniCation(6 the percenta&e of normal morpholo&!
of normal semen anal!sis is:
a) C 8=B.
b) D 8=B.
c) C9=B.
d) C >=B.
e) C A=B
74%The folloin& are ad.anta&es of laparoscop! in the dia&nosis of infertilit! E)*E+T:
a) &ood evaluation of tubal factor.
b) %iagnosis of endometriosis.
c) %iagnosis of #sherman1s sndrome.
d) &ood visuali0ation of pelvic adhesions.
e) %irect visuali0ation of corpus luteum.
77%The folloin& statements are true as re&ards serum pro&esterone measurement in
dia&nosis of infertilit! E)*E+T:
a) The normal level is 9 ngEml.
b) ,easurement is usuall done at da 76 of the ccle.
c) "an be used for assessment of the luteal phase defect.
d) The normal level is variable between individuals.
e) 3sed in diagnosis of anovulation
78%The character of normal cer.ical mucus at the time of o.ulation is:
a) -ighl viscous and turbid.
b) Spinnbar'eit test is less than ) cm.
c) "ontains low amount of crstals of sodium and potassium chloride.
d) Positive ferning test.
e) #cellular
89%+ol!c!stic o.arian disease characteriCed b! all of the folloin& E)*E+T:
a) Increase $- level.
b) Increase in androgen levels.
c) %ecrease in estrogen levels.
d) Oligomenorrhea.
e) #ndroid obesit
8$%3!steroscop! is important for dia&nosis of the folloin& factors in infertilit!
E)*E+T:
a) Intrauterine adhesions.
b) Submucous fibroids.
c) Peritubal adhesions.
d) "ornual bloc'.
e) Septate uterus
8,%D!sfunctional uterine bleedin& 'D;B( is fre:uentl! associated ith:
a) Endometrial polps.
b) #novulation.
c) "ervicitis.
d) Sstemic lupus erthematosus.
e) 5on Fillebrand1s disease.
8-%Treatment of d!sfunctional uterine bleedin& include the folloin& E)*E+T:
a) Progestin therap.
b) Estrogen therap.
c) %ana0ol.
d) Endometrial ablation.
e) 4romocriptine
80%True statements concernin& anore/ia ner.osa include the folloin& E)*E+T:
a) It is seen predominantl in females* rarel in males.
b) ,ost affected patients have an obsessive !compulsive personalit.
c) ,ean 7(!hour concentration of cortisol is twice normal.
d) Throid hormones are in the normal range.
e) Occasionall fatal
81%Amenorrhea could be due to hich of the folloin& E)*E+T:
a) "ombined oral contraceptive.
b) %epot medrox progesterone acetate.
c) &n/- analogues.
d) %ana0ol.
e) 4romocriptine.
82%Ehich of the folloin& conditions is suitable for clomiphene citrate stimulationF
a) &onadal dsgenesis
b) #sherman1s sndrome
c) /esistant ovar sndrome
d) Polcstic ovarian sndrome
e) 2allmann1s sndrome
84%*r!ptomenorrhea ma! present ith the folloin& E)*E+T:
a) #cute urinar retention.
b) -ematocolpos
c) $ower abdominal pain.
d) Premenstrual spotting.
e) "clic pain
Directions '<uestions 87 throu&h $$9(: Each set of matchin& :uestions in this section
consists of a list of 1 to 2 lettered options folloed b! se.eral numbered items" =or each
item6 select the ONE best lettered option that is most closel! associated ith it" Each
lettered headin& ma! be selected once6 more than once6 or not at all"
<uestions $9-%$94
Lin@ the folloin& s!ndromes to their correspondin& presentations
a) $aurence ,oon 4iedl.
b) 2allmann sndrome.
c) Sheehan sndrome.
d) Savage sndrome
e) #sherman sndrome.
f) Swer sndrome
$9-% =ailure of lactation"
$90% +ost curetta&e amenorrhea"
$91% Amenorrhea G anosmia"
$92% Retinitis pi&mentosa
$94% Resistant o.ar! s!ndrome
true?false
$$$% As re&ards luteiniCin& hormone6 the folloin& is 'are( true
6) Its plasma levels are increased throughout pregnanc.
7) Its plasma level is increased in postmenopausal women.
8) It is bound to plasma protein.
() It stimulates the snthesis of testosterone in the male.
9) Its release is stimulated b throtropin releasing hormone.
6) It stimulates androgen production.
7) Its plasma concentration is increased in pregnanc.
8) Its plasma concentrations are increased in ovarian failure.
() It is a steroid hormone.
9) It is released at a constant rate throughout the menstrual ccle.
$$-% As re&ards follicle stimulatin& hormone6 the folloin& is 'are( true:
6) It stimulates spermatogenesis.
7) Its plasma concentration is high in 2linefelter sndrome.
8) It stimulates ovarian estrogen production.
() It is produced in the hpothalamus.
9) It prevents regression of the corpus luteum.
+ituitar! follicle stimulatin& hormone is:
6 ) # glcoprotein.
7) Excreted in increased amount at menopause.
8) Excreted b the male.
() Secreted b pars intermedia of the hpophsis cerebri.
9) Identical with human chorionic gonadotrophin.
$$0% As re&ards o.ulation in the human the folloin& is 'are( true:
6) Is associated with a surge of luteini0ing hormone.
7) Is characteristicall followed b the development of secretor endometrium.
8) Is associated with an increase in motilit of the fallopian tube.
() Is associated with a sustained fall in basal bod temperature.
9) Is followed b a rise in urinar pregnanetriol.
$$1% As re&ards estro&en6 the folloin& is 'are( true:
6) "annot be detected in the blood of postmenopausal women.
7) Is produced in the corpus luteum.
8) Is mainl secreted b the ovar as estrone.
() Is the dominant gonadal hormone at pubert.
9) Is responsible for secretor changes in the endometrium.
$$2% The anterior pituitar!:
6) 7) Produces vasopressin.
8) Is controlled b releasing factors produced in the hpothalamus.
() 9) $ies above the optic chiasma.
$$4% 5n a normal human menstrual c!cle the corpus luteum:
6) /emains active for 8!( wee's.
7) Secretes progesterone.
8) Is maintained b human chorionic gonadotrophin.
() Secretes estrogen.
9) Secretes pregnanediol.
$$7%
$$8% 5n the first half of a normal menstrual c!cle:
6) ,itotic figures are seen in the endometrium.
7) Serum progesterone levels are high.
8) Some ovarian follicles degenerate.
() The endometrium is rich in glcogen.
9) The corpus luteum begins to degenerate.
$,9% 5n normal pubert!6 the folloin& features are characteristics:
6) Pubic hair growth is the first sign.
7) The first menstrual ccles are anovulator.
8) #xillar hair growth occurs after the first menstrual period.
() "hanges in the vaginal epithelium.
9) "essation of growth.
$,$% The folloin& hormonal chan&es occur after menopause:
6) Estrogen levels decrease dramaticall.
7) There is a relative increase in the testosterone level.
8) The main source of progesterone production is from the adrenal glands.
() Estradiol accounts for most of circulating estrogen which results mainl from
peripheral conversion of androstenedione.
9) &onadotrophins levels show no changes.
$,,% The folloin& are hormonal chan&es associated ith menopause:
7) Increased FS-.
8) Increased androstenedione.
() Increased S-4&.
9) Increased $-.
$,-% ;nopposed estro&en therap! for the postmenopausal oman:
6) Improves the urethral sndrome.
7) %ecreases urinar calcium excretion.
8) "auses increased incidence of endometrial carcinoma.
() "auses decreased incidence of mocardial infraction.
9) "auses hpertension.
$,0% +remature menopause in &enot!picall! female could be due to:
6) Turner1s sndrome.
7) 3se of O"s for long time.
8) Excess exposure to radiation.
() 2linefelter sndrome.
9) Testicular femini0ation sndrome.
$,1% The folloin& statements about osteoporosis are correct:
6) There is increased osteoclastic activit resulted in fragile bone.
7) Is prevented b estrogens.
8) 4isphosphonates are the most effective bone building drugs.
() %iagnosed mainl b determination of serum calcium.
9) Occurs more commonl in patients with Turner1s sndrome.
$,2% Ris@ factors for de.elopment of osteoporosis include the folloin&:
6) "igarette smo'ing.
7) $ong term glucocorticoid therap.
8) Premature ovarian failure.
() Is more common in blac' than white women.
9) Obese women.
$,4% Absolute contraindication for 3RT:
6) #ctive liver disease.
7) -pertension.
8) /ecent histor of thrombo!embolic attac'.
() &all bladder disease.
9) %iabetes mellitus.
$,7% 3irsutism:
6) #drenal en0me deficienc can present in adult women.
7) The oral contraceptive pill can be used to treat hirsutism.
8) "proterone acetate should be given in a contraceptive regimen.
() %examethasone is an alternative anti!androgen.
9) "irculating testosterone is alwas elevated in hirsute women.
$,8% #u&&estions of ano.ulation include:
6)
7) %isturbed menstrual ccles.
8) Serial ultrasound scans.
() Secretor changes detected at histological examination of the endometrium.
9) 4iphasic basal bod temperature chart.
$-9% *lomiphene citrate:
6) -as antiestrogenic effects.
7) Side effects include multiple pregnanc.
8) Ovarian hperstimulation sndrome is rare.
() Is a steroidal agent.
9) Is a natural product.
6) "auses breast carcinoma.
7) Is associated with ovarian cst formation.
8) Increases the ris' of fetal malformations.
() "auses vasomotor smptoms as a side effect.
9) Is prescribed in a starting dose of 9== mg dail for five dasEmonth.
$-,% Dru&s of antiestro&enic effects include:
6) Tamoxifen.
7) $-/- analogues.
8) "lomiphene citrate.
() ,ifepristone.
9) 4romocriptine.
$--% 5n +*OD:
6) P"O% is the commonest cause of anovulator infertilit.
7) Pregnant women with P"O% have an increased ris' of gestational diabetes.
8) #novulator women with P"O% are at increased ris' of endometrial cancer.
() -perlipidemia is a cause of P"O%.
9) The ma<orit of anovulator women with P"O% are estrogen deficient.
$-0% D!sfunctional uterine bleedin& is associated ith:
6) ,etropathia hemorrhagica.
7) #bnormal hormone profiles in more than 9=B of patients.
8) Increased levels of P&E7 in the endometrium.
() "hronic pelvic inflammator disease.
9) Estrogens inhibiting the arachidonic acid cascade.
$-1% A oman presentin& ith c!clical menorrha&ia at the a&e of 02 !ears:
6) Is li'el to be cured b an oral progestogen.
7) Is li'el to be cured b hormone replacement therap :-/T).
8) ma re.uire hsterectom if medical treatment fails.
() Should be treated b dilatation and curettage.
9) -as an ?=B chance of having anovulator ccles.
$-2% +atients ith testicular feminiCation characteristicall!:
6) #re ()* +G.
7) -ave a hpoplastic uterus.
8) -ave fairl developed breasts.
() #re chromatin positive.
9) -ave secondar amenorrhea.
$-4% 5n abnormal uterine bleedin& in adolescents:
6) In girls with severe menorrhagia coagulation disorder should be excluded.
7) Ovulator dsfunction is a rare cause.
8) Pregnanc complications should be excluded.
() The commonest hematological disorder is von Fillebrand1s disease.
9) Evaluation of the patient must include a pelvic examination.
$-7% TurnerHs s!ndrome:
6) Is associated with neonatal edema of the feet.
7) Is the commonest chromosomal abnormalit in aborted fetuses.
8) 4abies displa neonatal snee0ing.
() -as ventricular septal defect as the commonest cardiac abnormalit.
9) Is autosomal dominant.
$-8% Bromocriptine:
6) Is a dopamine agonist.
7) Inhibits prolactin secretion.
8) "an be administered vaginall.
() Is more potent than lisuride drug in treatment of hperprolactinemia.
9) "an cause hpertension.
$09% +rolactin:
a)
b) 4romocriptine is the drug of choice in hperprolactinemia.
c) Is secreted from the posterior pituitar gland.
d) #pproximatel one !third of patients with a micro!adenoma undergo spontaneous
resolution.
e) 4romocriptine must be stopped when pregnant.
$0$% 5n luteiniCed unruptured follicle:
a) Progesterone is secreted normall.
b) ,enstrual ccles are usuall regular.
c) #ntiprostaglandins are needed for rupture of ovarian follicles.
d) Induction of ovulation is a useful modalit for treatment.
e) Patient can benefit from human chorionic gonadotrophin :h"&) in<ections given in
high doses at mid!luteal phase.
$0,% Gonadotrophin releasin& hormone 'GnR3(:
a) Is used for induction of ovulation in patients with hpergonadotrophic hpogonadism.
b) Is indicated in treatment of infertilit associated with 2allmann1s sndrome.
c) ,ust be delivered continuousl for 9!) das to reach follicular maturit.
d) -as a similar incidence of multiple pregnanc rate as with human menopausal
gonadotrophin therap :-,&).
e) /is' of ovarian hperstimulation is absent.
$0-% 3uman menopausal &onadotrophin '3MG(:
a) #re extracted from postmenopausal blood.
b) "an be given intramuscular or intravenous.
c) ,a result in ovarian hperstimulation.
d) /e.uires human chorionic gonadotrophins :h"&) to be given after its use to induce
ovulation.
e) "an be monitored b serial measurement of serum progesterone levels.
GYNE*OLOG5*AL D5AGNO#5#
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,- are correct6 choose A
$6- are correct6 choose B
7*( are correct6 choose *
0 is correct6 choose D
All are correct6 choose E
$00% Rectal e/amination in the &!necolo&ical practice:
6) Is useful in the diagnosis of enterocele.
7) Is useful in suspected pelvic abscess.
8) Is indicated in the assessment of carcinoma of the cervix.
() Is to be preformed as a routine in the gnecological practice.
9) Is useful in assessment of ectopic pregnanc.
GEN5TAL D5#+LA*EMENT
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
$01% As re&ards c!stocele the folloin& is true E)*E+T:
a) Is a prolapse of the bladder in upper part of anterior vaginal wall.
b) Is common after the menopause.
c) Is the cause of stress incontinence of urine.
d) ,a lead to urinar infection.
e) Is ver uncommon in nulliparous women.
$02% Genital prolapse is associated ith the folloin& E)*E+T:
a) ,ultiparit.
b) Prolonged second stage of labor.
c) 3nrepaired hidden perineal tear.
d) Improperl applied forceps deliver.
e) ;egroes1 race.
$04% =actors important in the de.elopment of &enital prolapse include the folloin&
E)*E+T::
a) Poor tissue strength.
b) c) "hronic straining at bowel movements.
d) ,enopause.
e) "hildbirth trauma.
$07%
$08%
$19% As re&ards enterocele6 the folloin& is correct:
a) It is a prolapse of the rectum.
b) It ma occur following colposuspension.
c) Sigmoidoscop is used for diagnosis
d) It ma resolve spontaneousl.
e) It is a common cause of stress incontinence.
a) It is not a true hernia.
b) It is a herniation of the bladder floor into the vagina*
c) It is a prolapse of the uterus and vaginal wall outside the bod.
d) It is a protrusion of the pelvic peritoneal sac and vaginal wall into the vagina.
e) It is a herniation of the rectal and vaginal wall into the vagina.
$1,% As re&ards anterior colporrhaph! the folloin& is true E)*E+T:
a) ,a cause temporar retention of urine.
b) Is the treatment of midline defect of anterior vaginal wall prolapse
c) Is fre.uentl combined with vaginal hsterectom.
d) 4etter avoided in patients with urge incontinence.
e) Should be carried out onl after completion of childbearing.
Directions '<uestions $1- throu&h 69>)H Each set of matchin& :uestions in this section
consists of a list of 2 lettered options folloed b! se.eral numbered items" =or each item6
select the ONE best lettered option that is most closel! associated ith it" Each lettered
headin& ma! be selected once6 more than once6 or not at all" Match the most suitable
operation ith the disease entit! encountered
a) Sacrospinous colpopex
b) #nterior colporrhaph
c) 4urch colposuspension
d) $e Forte1s operation
e) Fothergill1s operation
f) Sacral cervicopex
$1-% #econd de&ree uterine descent in -,%!ear%old oman ants to preser.e her potential
fertilit!
$10% #econd de&ree uterine descent in 41%!ear%old%oman
$11% #tress 'urod!namic( incontinence
$12%Aault prolapse
$14% *!stocele ith midline defect
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
0 is correct6 choose D
A3 are correct6 choose E
$17% ;tero.a&inal prolapse:
6) The condition is worse in the erect position.
7) ,a cause intestinal obstruction if there is a large rectocele.
8) The cervix is often elongated.
()
$18% Retro.ersion of the uterus:
6) Is a common cause of infertilit.
7)
8) ,a be corrected b a fothergill operation.
() Occurs in 7=B of normal women.
9) Is caused b heav lifting.
$29% Genital prolapse%etiolo&ical factors include:
6) ,ultiparit.
7) Failed postnatal exercises.
8) "rede1s maneuver.
() First degree tears.
9)
$2$% #econd de&ree uterine prolapse:
6) is diagnosed when the cervix protrudes through the vulval orifice.
7) Is also 'nown as complete procidentia.
8)
$2,% #tructures hich pre.ent prolapse of the uterus and .a&ina include:
6) $evator ani muscle.
7) 3terosacral ligaments.
8) "ardinal ligaments.
() /ound ligaments.
9) 4road ligaments.
$2-% =actors predisposin& to the de.elopment of utero.a&inal prolapse include:
6) "ongenital wea'ness of the supporting ligaments.
7) Postmenopausal atroph.
8) In<ur during childbirth.
() Endometrial polps.
9) Ovarian tumors.
$20% The Manchester repair includes:
6) #mputation of the cervix.
7) Posterior colpoperineorrhaph.
8) #nterior colporrhaph.
() 5aginal hsterectom.
9)
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
$21% An enterocele:
a) 3suall contains rectum.
b) In lined b peritoneum.
c) Fre.uentl contains small bowel.
d) ,a be a long!term complication of vaginal hsterectom.
e)
$22% A c!stocele:
a) Is usuall associated with stress incontinence.
b) "ontains bladder.
c) ,a present as urinar retention.
d) Is treated b FothergillIs operation.
e) Is best treated with a ring pessar.
$24% Bac@ache due to &!necolo&ical causes:
a) ,a be caused b a mobile retroverted uterus.
b) Is usuall felt in the lumbar area.
c) ,a be caused b endometriosis.
d) ,a be due to uterine prolapse.
e) ,a be due to chronic pelvic infection.
GEN5TAL TRA*T 5N=E*T5ON#
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
$27% The folloin& about M!coplasma are correct E)*E+T:
a) "auses male infertilit.
b) Is gram!negative.
c) "an be successfull treated with penicillin.
d) "auses neonatal pneumonia.
e) "auses pelvic inflammator disease.
$28% The natural defense of the .a&ina to infection include all of the folloin& E)*E+T:
a) The vaginal p-.
b) The presence of %oderlein1s bacilli.
c) The phsical apposition of the pudendal cleft and the vaginal walls.
d) The bacteriostatic secretions of vaginal glands.
e) The vaginal stratified s.uamous epithelium.
$49% As re&ards Gardnerella vaginalis .a&initis all of the folloin& are correct E)*E+T:
a) It is usuall asmptomatic.
b) It ma present with a foul smell discharge.
e) It ma progress to acute pelvic inflammator disease.
d) Its discharge ma increase after intercourse.
e) It can be diagnosed b clue cells on &ram staining of vaginal discharge.
$4$% The folloin& about *hlam!dia trachomatis are correct E)*E+T::
a) "an be cultured from vaginal discharge.
b) Is a common cause of vaginal discharge.
c) ,a be treated with either erthromcin or aminoglcosides.
d) "an cause neonatal pneumonia.
e) "an cause sterile puria.
6>7! The sin&le%dose parenteral dru& of choice used in uncomplicated &onorrhea is:
a) "eftriaxone 79= mg
b) "efixime (== mg
c) "iprofloxacin 9== mg
d) Ofloxacin (== mg
e) Spectinomcin 9== mg
$4-% The folloin& about human papilloma .irus '3+A( infection are correct E)*E+T:
a) It is the most common viral ST%s.
b) It ma lead to "I; and cervical cancer.
c) It is due to /;# virus
d) Infection ma be wart or flat condloma.
e) Infection is usuall associated with others ST%s.
$40% The commonest site to be affected b! &enital tuberculosis is:
a) The ovaries
b) The fallopian tubes
c) The uterus
d) The cervix
e) The vagina
$41% The folloin& about bacterial .a&inosis are correct E)*E+T:
a) It is the commonest vaginal infection.
b) 5aginal P- is usuall D (.9.
c) The discharge cause considerable itching.
d) "ure ma be achieved b oral metronida0ole.
e) The organism is a bacterium.
$42% The folloin& about *andidaI infection are correct E)*E+T:
a) The infection is common with pregnanc
b) 5aginal P- is usuall al'aline.
c) 5ulval itching ma occur.
d) 5aginal isocona0ole or micona0ole are effective.
e) The organism is east!li'e.
$44% The folloin& about Trichomonas vaginalis 'T"A"( are correct E)*E+T:
a) T.5 ma be a sexuall transmitted disease
b) ,ost patients having T5 have smptoms.
c) The disease ma cause itching.
d) 3nli'e bacterial vaginosis* metronida0ole is ineffective therap.
e) It ma cause a flea!bitten appearance of the cervix
$47% Re&ardin& s!philis6 all of the folloin& are correct E)*E+T:
a) The organism is diagnosed b dar' field illumination.
b) The classic finding in primar sphilis is a hard chancre.
c) Secondar sphilis is associated with a rash over the hands and feet.
d) &ummas are found in late sphilis.
e) Sphilis is produced b a spirochete.
Directions '<uestions $48 throu&h $88(: Each set of matchin& :uestions in this section
consists of a list of , to 7 lettered options folloed b! se.eral numbered items" =or each
item6 select the ONE best lettered option that is most closel! associated ith it" Each
lettered headin& ma! be selected once6 more than once6 or not at all"
<uestions $48%$7-
Match each condition to the appropriate p3
a) &enerall acidic
b) &enerall al'aline
$48% *er.ical secretions
$79% #emen
$7$% ;rine
$7,% Menstruation
$7-% Normal .a&inal p3
<uestions $70%$77
Match the effect of each secretion
a) Turns p- of the vagina more acidic
b) Turns p- of the vagina more al'aline
c) 2eeps p- of the vagina constant
$70% Menopause
$71% Lactobacilli
$72% #emen
$74% Menstruation
$77% Estro&en therap!
<uestions $78%$8-
Match the &enital or&anism ith the most appropriate chemotherapeutic
a&ent:
a) #0ithromcin
b) Spectinomcin
c) Itracona0ole
d) Penicillin &
e) Tetraccline
f) "lindamcin
g) ,etronida0ole
$78% Neisseria gonorrheae ';ncomplicated(
$89% Chlamydia trachomatis
$8$% Gardnerella vagina I is
$8,% Candida albicans
$8-% Trichomonas vaginalis
<uestions $80%$88
Match the Genital infection ith the dia&nostic modalit!
a) "ulture on Thaer ,artin medium
b) "ulture on %orset egg medium
c) "ulture on Sabouraud medium
d) "ulture on aerobic blood agar
e) ,icro!immunofluorescent test
f) Festern blot
g) P"/ and Southern blot.
h) Fhiff test
$80% *hlam!dia infection
$81% *andidaI infection
$82% Gonorrhea infection
$84% Gardenerella .a&inalis
$87% 3+A
$88% 35A
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose C
$6,6-60 are correct6 choose D
All are correct6 choose E
,99% The folloin& about .a&inal dischar&e are correct:
6) $eucorrhea* means excessive amount of normal vaginal discharge.
7) "ervicitis is inflamed columnar epithelium on the cervix.
8) #trophic vaginitis is relativel common in postmenopausal women.
() Progesterone causes a proliferation of the vaginal epithelium.
9) The amount of vaginal discharge increases onl during infection.
,9$% As re&ards chlam!dial infection6 the folloin& are correct
6) The organisms are obligator intracellular organisms.
7) It ma cause sterile puria.
8) "hlamdia and gonorrhea are the main causes of PI%.
() The husband should be treated.
9) #0ithromcin 6 gm in single dose is an effective treatment.
,9,% Tuberculosis of Genital Tract:
6) The tubes are the commonest site.
7) Ft is detected in 9B of infertile patients.
8) The treatment is mainl medical.
() ,enstrual disorders are common.
9) The infection is usuall sexuall transmitted
,9-% The folloin& bacterial infections ma! be se/uall!%transmitted
6) ;eisseria gonococci.
7) &ardnerella vaginalis.
8) Treponema palladium.
() Trichomonas vaginalis.
9) &roup 4 streptococci.
,90% 3erpes #imple/:
6) Tpe I does not invade the genital organs.
7) In primar forms* the leading complaint is agoni0ing pain.
8) The recurrent attac's tend to be more severe and have generali0ed manifestations more
than the primar attac'.
() %uring primar infection vaginal deliver ma result in neonatal herpes in about (=B.
9) $ong!term suppression with acclovir increases the number of recurrent attac's.
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
,91% The folloin& about human +apilloma Airus is 'are( true:
a) It is a rare tpe of ST%.
b) It is classified into subtpes according to tpes of antibodies.
c) -as a definite pathological role in development of "I;.
d) 2oiloctic atpia is the main feature in the ctological stud.
e) The most effective anti!viral is acclovir.
,92% The folloin& about pel.ic tuberculosis is 'are( true:
a) Is most often bovine.
b) Is post primar.
c) Is associated with amenorrhea.
d) ,ore often involves the fallopian tubes.
e) Is decreasing in incidence.
,94% The folloin& about &enital tuberculosis is 'are( true:
a) The most affected site is the fallopian tube.
b) The main route of transmission is through sexual intercourse.
c) Infertilit is the leading complaint.
d) ;egative tuberculin test excludes the presence of the disease.
e) -sterectom J 4SO is the main therapeutic option.
TRA;MA TO T3E =EMALE GEN5TAL TRA*T
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
,97% Recto.a&inal fistulas result from all of the folloin& E)*E+T:
a) Obstetric deliver.
b) Irradiation to the pelvis.
c) "arcinoma.
d) -emorrhoidectom.
e) -erpes vulvitis.
GYNE*OLOG5* ;ROLOGY
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
,98% True incontinence occurs in all of the folloin& E)*E+T:
a) 5esicovaginal fistula
b) 4ilateral ureterovaginal fistula
c) 3nilateral ureterovaginal fistula
d) 5esico!cervicovaginal fistula
e) 5esico!urethrovaginal fistula
,$9% The most important suspensor! mechanism of the urethra is 'are(:
a) #nterior pubourethral ligaments
b) Intermediate pubourethral ligaments
c) Posterior pubourethral ligaments
d) Fhite line
e) Pubocervical fascia
,$$% All the folloin& about &enuine stress incontinence in the female are correct
E)*E+T:
a) It occurs transientl during pregnanc.
b) It is more common in parous women.
c) It can be corrected surgicall.
d) It is associated with a high urethral pressure profile amplitude on urodnamic studies
e) It is usuall associated with utero!vaginal prolapse.
,$,% The folloin& are treatment modalities for o.eracti.e bladder E)*E+T:
a) Parasmpathomimetics
b) Smooth muscle relaxants
c) #nticholinergics.
d) 4ehavioral therap
e) Tricclic anti depressants
,$-% ;tero%.esical fistula usuall! presents ith:
a) #menorrhea
b) ,enuria
c) %smenorrhea
d) Terminal hematuria
e) True incontinence
Directions '<uestions ,$0 throu&h ,,-(: Each set of matchin& :uestions in this section
consists of a list of 0 to 2 lettered options folloed b! se.eral numbered items" =or each
item6 select the ONE best lettered option that is most closel! associated ith it" Each
lettered headin& ma! be selected once6 more than once6 or not at all"
<uestions ,$0%,$7
Match the common presentation ith the disease entit!
a) True urinar incontinence
b) ,enuria
c) 3rge incontinence
d) Partial urinar incontinence
e) Overflow urinar incontinence
f) 3rinar incontinence at sexual penetration
,$0% Aesico.a&inal fistula
,$1% ;tero.esical fistula
,$2% Left uretero.a&inal fistula
,$4% Genuine stress incontinence
,$7% O.eracti.e bladder
<uestions ,$8%,,-
Match the operation ith the disease entit!
a) 3rodnamic stress incontinence
b) Overactive bladder
c) 5esicovaginal fistula
d) 5ault vesical fistula
,$8% #ims dedoublement operation
,,9% Burch colposuspension
,,$% Marshal Marchetti JrantC operation
,,,% *lam c!stoplast!
,,-% LatC@o operation 'partial colpocleisis(
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
$6,6-60 are correct6 choose D
All are correct6 choose E
,,0% 5n the treatment of &enuine stress incontinence 'G#5(:
6) Preoperative urethral pressure profilometr can predict the success of surgical
treatment.
7) Patients with co!existent detrusor instabilit could have surgical treatment.
8) 5aginal surger for stress incontinence carries a high failure rate.
() The standard operation is the suburethral sling
9) Phsiotherap will improve smptoms in about 7=B of patients.
779! ;rethral caruncle:
6) 3suall covered b transitional epithelium.
7) 3suall asmptomatic.
8) ,a resemble urethral carcinoma.
() 3suall originates from the anterior wall of the urethra.
9) Occurs in children.
BREA#T D5#EA#E#
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
,,2% The folloin& could be a treatment for mastal&ia E)*E+T:
a) Surger.
b) 4romocriptine.
c) %ana0ol
d) &ammalenolenic acid :&$#)
e) #ntiprostaglandins
,,4% The folloin& about nipple dischar&e are correct E)*E+T:
a) It is common complaint.
b) &alactorrhea is atpicall bilateral.
c) It is usuall phsiologic.
d) %uct ectasia is a benign cause for the discharge.
e) ,ammogram should be a part of the evaluation with blood discharge.
BEN5GN GYNE*OLOG5* D5#EA#E#
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
,,7% Re&ardin& cer.ical intraepithelial neoplasia '*5N(6 all the folloin& are correct
E)*E+T:
a) Transformation 0one is the most susceptible location for development.
b) It is usuall unifocal.
c) #bnormal vascular pattern seen b colposcop include punctuation* mosaicism and
acetowhite area.
d) Total hsterectom is a line of management.
e) "ervical coni0ation is best done b loop electrosurgical excision procedure
,,8% Re&ardin& cer.ical pol!ps all the folloin& are correct E)*E+T:
a) ,a cause post coital bleeding.
b) The most common tpe is mucous polps.
c) 3suall the arise from the cervical canal.
d) The are usuall pre cancerous.
e) "ervical polps should be sub<ected to histopathological examination.
,-9% A3 the folloin& about BartholinHs &lands are correct E)*E+T:
a) #re remnants of mesonephric origin.
b) "an commonl be infected b E coli.
c) Excision of the cst when infected is usuall contraindicated.
d) #re situated at the posterior parts of labia ma<ora.
e) Should be marsupiali0ed when acutel infected.
,-$% The commonest secondar! chan&e in uterine fibroids is:
a) Fatt degeneration
b) ,xomatous degeneration
c) -aline degeneration
d) "stic degeneration
e) "alcification
,-,% The most common site of uterine m!oma is:
a) Subserous
b) Interstitial
c) Subserous
d) "ornual
e) "ervical
,--% The folloin& are ris@ factors to de.elopin& uterine m!omata E)*E+TB
a) $ow parit
b) $ate menarche
c) ;egroid race
d) Positive famil histor of the disease
e) #ssociated endometriosis
,-0% #arcomatous chan&e in uterine fibroids occurs in:
a) =.=9B.
b) =.9B
c) 6.9B
d) 1D
e) 69B
,-1% All the folloin& about uterine fibroids are correct E)*E+T:
a) Occur in over 8=B of women of reproductive age.
b) "an undergo sarcomatous change in 9B of cases.
c) #re associated with menorrhagia.
d) "an cause polcthemia.
e) "an cause pressure manifestations in the pelvis.
,-2% 5ntramural fibroids mainl! cause:
a) Intermenstrual bleeding.
b) Postcoital bleeding.
c) Postmenopausal bleeding.
d) %eep dspareunia.
e) ,enorrhagia.
,-4% Endometriosis characteristicall! occurs in omen ho are:
a) In lower socio!economic group.
b) Perimenopausal.
c) ;ulliparous.
d) 3sing I3"%.
e) 3sing Oral contraceptives.
,-7% All the folloin& about uterine fibroids are correct E)*E+T:
a) #re estrogen dependent.
b) &et smaller during treatment with progestogens.
c) #re usuall asmptomatic.
d) Shrin' in response to treatment with $-/- agonists.
e) ,a be treated conservativel
,-8% The etiolo&! of endometriosis relates to the folloin& E)*E+T:
a) # transformation of celomic epithelium.
b) %irect invasion through the uterine serosa into the pelvic capacit.
c) /etrograde menstrual flow.
d) 5ascular transport of endometrial fragments.
e) $mphatic transport of endometrial fragments.
,09% The folloin& ph!sical findin&s are consistent ith a dia&nosis of endometriosis
E)*E+T:
a) Fixed retroversion of the uterus.
b) Tender pelvic masses.
c) #dnexal enlargement.
d) "ul!de!sac nodules.
e) Omental nodules
,0$% A oman ith s!mptomatic endometriosis is li@el! to ha.e the folloin& complaints
E)*E+T:
a) dspareunia
b) mood swings
c) painful defecation
d) severe dsmenorrhea
e) infertilit
,0,% Endometriosis treated ith prolon&ed estro&en and pro&esterone combination
therap! e/hibits hich of the folloin& histolo&ical characteristicsF
a) ,ar'ed edema
b) %ecidual!li'e reaction
c) &landular hpertroph
d) Inflammator infiltrate
e) "clic changes
,0-% The ma>or s!mptom's( of adenom!osis is?are
a) irregular uterine enlargement
b) menorrhagia and dsmenorrhea
c) urinar fre.uenc
d) dsmenorrhea and infertilit
e) pressure smptoms
,00% The =olloin& are effecti.e in the treatment of endometriosis E)*E+T:
a) "lomiphene.
b) Oophorectom.
c) -sterectom or %epo!provera.
d) Oral contraceptive.
e) %ana0ol.
,01% Retro&rade menstruation is the most accepted cause of endometriosis" The folloin&
statements ma! be cited as e.idence for this theor! E)*E+T:
a) Inversion of the cervix of a mon'e into the peritoneal cavit can cause endometriosis.
b) Endometrial tissue can be cultured successfull.
c) ,enstrual blood can come from the ends of the fallopian tubes of some women.
d) Endometrial glands can arise from celomic epithelium.
e) The disease is often found in the dependent portion of the pelvis.
,02% Non%neoplastic c!sts of the o.ar! include the folloin& E)*E+TB
a) Theca!lutein csts.
b) Pregnanc luteomas.
c) Endometriotic csts.
d) "orpus luteum csts.
e) %ermoid cst
,04% A 10%!ear%old oman is found to ha.e endometrial h!perplasia on endometrial
biops!" A functional o.arian tumor to be suspected is a:
a) $ipid cell tumor.
b) &ranulosa!theca cell tumor.
c) Sertoli!$edig tumor.
d) ,utinous cstadenocarcinoma.
e) Polcstic ovar.
,07% Treatment of beni&n o.arian neoplasms ma! include the folloin& E)*E+T:
a) %ebul'ing.
b) Ovarian cstectom.
c) 3nilateral oophorectom.
d) -sterectom plus unilateral salpingo!oophorectom
e) Pan hsterectom.
,08% 5n contrast to a mali&nant o.arian tumor6 a beni&n tumor has hich of the folloin&
&ross featuresF
a) Excrescences on the surface.
b) Peritoneal implants.
c) Intra!cstic papillae.
d) Free mobilit.
e) "apsule rupture.
,19% The most common beni&n mass of the cer.i/ and endocer.i/ is a:
a) polp
b) leiomoma
c) ;abothian cst
d) "ervical hood
e) &artner1s duct cst
,1$% A -4%!ear%old oman complains of postcoital bleedin&" The LEA#T li@el! cause of
her bleedin& ould be cer.ical
a) polps
b) ectropion
c) carcinoma
d) ;abothian cst
e) infection
,1,% All the folloin& about uterine fibroids are correct E)*E+T:
a) The originate from smooth muscle.
b) The contain muscle and connective tissues.
c) The are usuall multiple.
d) The are visuall submucous.
e) The are uncommon in the cervix.
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
$6,-60 are correct6 choose D
All are correct6 choose E
,1-% The complications of beni&n o.arian neoplasms include
6) Torsion.
7) Infection.
8) ,alignant change.
() /upture.
9) Incarceration.
,10% Re&ardin& the Bartholin c!st6 the folloin& are correct:
6) It is the commonest cst in the vulva.
7) True cstic swelling is present in anterior part of labium ma<or.
8) The main cause is obstruction of 4artholin gland duct b chronic infection.
() Should be excised if the patient is above 8= ears.
9) The main smptom is throbbing pain.
,11% As re&ard purities .ul.a the folloin& are correct:
6) Pre malignant lesions are one of the causes.
7) ,alnutrition @ vitamins deficiencies ma lead to it.
8) Pruritus vulvae resistant to treatment should be sub<ected to biops.
() Estrogen can be used for treatment.
9) Surgical treatment includes circum!vulval incision* or simple vulvectom.
,12% As re&ards cer.ical ectop! 'erosion(6 the folloin& are correct:
6) It is an ulcer of the cervix.
7) It is treated conservativel in pregnant females.
8) "auteri0ation should be done as first line of therap.
() Pap smear is advisable before management.
9) "ommonl cause pain* dspareunia @ low bac' pain.
,14% Re&ardin& cer.ical ectropion:
6) It can be differentiated from cervical lesion b presence of cervical tear.
7) It ma associates incompetent cervix.
8) It is treated b trachelorrhaph if cervical tear is present.
() Endo!cervix appears due to ulceration.
9) It can be treated b cauteri0ation.
,17% =ibroids can result in:
6) ,enorrhagia.
7) Polcthemia.
8) "onstipation.
() #cute urinar retention.
9) Infertilit.
,18% 5n pel.ic endometriosis:
6) Treatment b dana0ol ma produce hirsutism.
7) The tubes are uncommonl bloc'ed.
8) There is a close association with the unruptured follicle sndrome.
() The amount of pelvic pain is related to the extent of the disease.
9) "lomiphene citrate should be used to induce ovulation.
,29% *haracteristic s!mptoms of endometriosis include:
6) %smenorrhea.
7) Superficial dspareunia.
8) Infertilit.
() #menorrhea.
9) Pre!menstrual tension.
,2$% =unctional o.arian masses include:
6) Follicular csts.
7) Endometriomas.
8) $uteomas.
() %ermoid csts.
9) Fibromas.
,2,% The folloin& is essential in dia&nosis of pel.ic endometriosis:
6) $aparoscop.
7) "#!679.
8) 4iops form the suspicious nodules.
() 3ltrasonograph.
9) -steroscop.
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
,2-% Beni&n c!stic teratoma 'dermoid c!st(:
a) It represents 9=B of the ovarian neoplasms.
b) It is the commonest ovarian tumor during pregnanc.
c) ,alignant change occurs in about 6.9B.
d) "horiocarcinoma is the commonest malignant change.
e) /arel causes harm to the patient when ruptures.
,20% Dermoid c!sts:
a) #re germ cell tumors.
b) #re bilateral in (=!)=B of cases.
c) #re the commonest neoplastic csts detected during pregnanc.
d) #re malignant in 6=B of cases.
e) #re fre.uentl +G.
,21% BrennerHs tumor
a) 3suall develops in patients over (= ears* h) 3suall is bilateral.
c) /arel turns malignant.
d) ,a secrete androgen.
e) 3suall found in the wall of mutinous cstadenoma.
,22% Dermoid c!sts:
a) /epresent 7=B of all ovarian neoplasms.
b) 3suall are unilateral.
c) #re the commonest ovarian tumors found during pregnanc.
d) ,a contain tissues of ectodermal origin.
e) 69B of cases turn malignant.
GYNE*OLOG5* ON*OLOGY
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
,24% 3i&h ris@ factors of *5N include the folloin& E)*E+T:
a) -P5 tpes )* 66.
b) -I5 is a predisposing factor for "I;.
c) Smo'ing
d) First sexual intercourse before 6? ears age
e) ,ultiple sexual partners
,27% *5N 555 lesions e/tendin& into the cer.ical canal are:
a) Often invasive.
b) Treated b radiotherap.
c) Treated b hsterectom.
d) Safel treated b cone biops.
e) Safel treated b large loop excision of the transformation 0one.
,28% The folloin& statements are true of lar&e loop e/cision of the cer.ical
transformation Cone 'LLETK( E)*E+TB
a) It is used even when a "O
7
laser is available.
b) It re.uires anesthesia.
c) It is a cheap and effective wa of removing the cervical transformation 0one.
d) Secondar hemorrhage is a rare complication.
e) "ervical stenosis ma occur.
,49% Endometrial h!perplasia could be e/pected in the folloin& conditions:
a) Endodermal sinus tumor.
b) "stic teratoma.
c) Polcstic ovar disease.
d) Sertoli!$edig cell tumor.
e) %sgerminoma.
,4$% Mali&nant melanoma represents hat percent of the hole cancer .ul.a occurrin&F
a) 6B
b) -D
c) 1D
d) 6=B
e) 69B
,4,% The colposcopic pattern of *5N 555 is characteriCed b! the folloin& E)*E+T:
a) Surface regularit of the s.uamous epithelium.
b) # mar'ed acetowhite appearance.
c) "oarse epithelial punctation.
d) # transformation 0one that bleeds to touch.
e) ,ultisector involvement of the transformation 0one.
,4-% *omple/ endometrial h!perplasia ithout at!pia in a oman a&ed 0$ !ears could be
treated ith the folloin& E)*E+T:
a) Progestins
b) Estrogens
c) Progestins plus estrogens
d) Oral contraceptive pills
e) -sterectom
,40% *arcinoma of the .ul.a:
a) usuall ulcerates even if not advanced.
b) Is usuall histologicall anaplastic.
c) Spreads initiall to iliac nodes via vaginal lmphatics.
d) Seldom involves lmph nodes at the time of presentation.
e) Is e.uall amenable to treatment b surger and radiotherap.
,41% Treatment of cancer of the .ul.a includes all the folloin& E)*E+T:
a) /adical excision of the vulva
b) %issection of femoral triangle.
c) 3nilateral or bilateral inguinal lmphadenectom.
d) Pre!operative radiation.
e) ,ethotrexate.
,42% Microin.asion of carcinoma of the cer.i/ in.ol.es a depth belo the base of the
epithelium of no more than:
a) 6 mm.
b) 7 mm.
c) 8 mm.
d) ( mm.
e) 9 mm.
,44% 5n.asi.e cancer of the cer.i/:
a) Is the commonest malignant tumor in women in the world.
b) Occurs most commonl in women under the age of (= ears.
c) Is usuall of s.uamous tpe.
d) Occurs less commonl in smo'ers
e) Is uncommon in developing countries.
,47% All the folloin& about microin.asi.e cancer of the cer.i/ are correct E)*E+T:
a) It consists onl of those showing earl stromal invasion.
b) It ma invade to a depth of 9 mm.
c) It should have a maximum width of > mm.
d) It ma invade lmphatic channels.
e) It ma metastasi0e
,48% Ele.ated fetoprotein is used for detection of:
a) "ancer vulva.
b) "ancer cervix.
c) Endodermal sinus tumor.
d) Serous cstadenocarcinoma.
e) ,ucinous cstadenocarcinoma.
,79% The commonest .ul.al mali&nanc! is:
a) #denocarcinoma.
b) S.uamous cell carcinoma.
c) 4asal cell carcinoma.
d) ,elanosarcoma.
e) $eiomosarcoma.
,7$% Radiotherap! is indicated in endometrial carcinoma in the folloin& situations
E)*E+T:
a) Preoperative /T is commonl performed to be followed b T#- J 4SO.
b) Postoperative ad<uvant therap.
c) #s primar treatment for the medicall impossible.
d) To specificall treat pelvic side wall involvement.
e) 5aginal recurrence after hsterectom.
,7,% 5n omen ith postmenopausal bleedin&6 it is best to perform endometrial samplin&
if the endometrium on trans.a&inal ultrasound is thic@er than:
a) 6 mm.
b) 7 mm.
c) ( mm.
d) ) mm.
e) 6= mm.
,7-% The definite dia&nosis of a Leiom!osarcoma re:uires ho man! mitotic cells per
3+=F
a) 6.
b) (.
c) 6=.
d) 6).
e) 7=.
,70% The folloin& are t!pes of epithelial o.arian tumors E)*E+T:
a) Endometrioid adenocarcinoma.
b) Transitional cell tumor.
c) 4renner1s tumor.
d) Thecoma.
e) ,ucinous cstadenocarcinoma.
,71% The most common primar! site for at!pical secondaries metastasiCin& to the o.ar!
is:
a) Stomach.
b) $ung. .
c) "olon.
d) 4reast.
e) Esophagus.
,72% As re&ards the spread of epithelial o.arian cancers6 all the folloin& are correct
E)*E+T:
a) 5ia the blood stream occurs earl in the disease.
b) To para!aortic lmph nodes puts the case at stage III.
c) To the underside of the diaphragm is common.
d) #round the peritoneal cavit has usuall occurred b the time of diagnosis.
e) To the omentum fre.uentl occurs.
,74% 5mportant pro&nostic factors concernin& o.arian epithelial carcinoma include the
folloin& E)*E+T:
a) 5olume of the tumor.
b) #ffection of ovarian stroma
c) Extent of the tumor.
d) -istological differentiation of the tumor.
e) Presence of ascites.
,77% The o.arian tumor that is best responds to radiotherap! is:
a) Serous cstadenocarcinoma
b) ,ucinous cstadenocarcinoma
c) Transitional adenocarcinoma
d) %sgerminoma
e) &ranulosa cell tumor
,78% The folloin& factor are associated ith endometrial cancer E)*E+T:
a) Obesit.
b) Smo'ing.
c) Polcstic ovarian disease and amenorrhea.
d) -eredit.
e) Tamoxifen use.
,89% The most acti.e chemotherapeutic dru& in endometrial cancer is:
a) Paclitaxel.
b) "isplatin.
c) "arboplatin.
d) %oxorubicin.
e) "clophosphamide.
,8$% The folloin& hormonal treatment ma! be used in treatin& endometrial cancer
E)*E+T:
a) Provera :medrox progesterone acetate).
b) The patients are ounger.
c) $-/- analogues.
d) Tamoxifen.
e) %iethl stilbestrol :%ES).
,8,% +atient outcome is better if the endometrial cancer cells are:
a) %iploid.
b) #neuploid.
c) Triploid.
d) Tetraploid.
e) Trisom.
,8-% +ostmenopausal bleedin& is a common presentation of the folloin& E)*E+T:
a) "ervical ectropion.
b) "arcinoma of the endometrium.
c) #trophic vaginitis.
d) "arcinoma of the cervix.
e) Sarcoma of the uterus
,80% The common presentations of carcinoma of the cer.i/ include the folloin&
E)*E+T:
a) #n asmptomatic abnormal smear.
b) Pelvic pain.
c) 5aginal discharge.
d) Postcoital bleeding.
e) Intermenstrual bleeding.
,81% All the folloin& about *A $,1 are correct E)*E+T:
a) Is a glcoprotein.
b) Is more commonl elevated in mucinous ovarian tumors than serous.
c) Is useful in screening for epithelial ovarian cancer.
d) Is a useful diagnostic mar'er in postmenopausal women with a pelvic mass.
e) Is accurate in predicting the presence of disease at second loo' laparotom.
,82% The folloin& factors increase the ris@ of a oman de.elopin& endometrial cancer
E)*E+TB
a) Obesit.
b) $ate menopause.
c) "ombined :estrogen and progestin) hormone replacement therap.
d) %iabetes mellitus.
e) # histor of polcstic ovar disease.
,84% 5ntra%peritoneal metastasis of a primar! carcinoma of the o.ar! e/tendin& to the
surface of the li.er ith positi.e retro%peritoneal l!mph nodes is consistent ith:
a) Stage IF
b) Stage II4.
c) Stage II".
d) Stage III.
e) Stage I5.
,87% Ehich of the folloin& statements about o.arian tumors in premenarcheal &irls is
trueF
a) The malignanc rate is low.
b) The ma<orit are of celomic epithelial origin.
c) Ovarian neoplasia of an tpe are relativel common.
d) ,ost ovarian enlargement in the newborn are functional csts.
e) &erm tumors are a fre.uent cause of precocious pubert.
,88% The folloin& are associated ith a reduced pre.alence of epithelial o.arian cancer
E)*E+T:
a) 3nilateral oophorectom.
b) Female sterili0ation.
c) I3"% usage.
d) 3se of combined oral contraceptive pills
e) Previous hsterectom.
-99% The folloin& factors ma@e a dia&nose of mali&nanc! more li@el! in a oman ith
an o.arian tumor E)*E+T:
a) Famil histor of ovarian cancer.
b) Previous use of the contraceptive pills.
c) ;ulliparit.
d) 4ilateralit of the tumor
e) Previous use of ovulation inducing drugs
-9$% Endometrial cancer ith .a&inal metastasis is sta&ed:
a) IIb.
b) IIIa.
c) IIIb.
d) IIIc.
e) I5a.
-9,% *arcinoma in situ of the cer.i/ precedes in.asi.e for an a.era&e period of:
a) 6 ear.
b) 7 ears.
c) 9 ears.
d) 6= ears.
e) 69 ears.
-9-% The folloin& o.arian tumors are ala!s mali&nant:
a) ,xoma peritonii.
b) Endodermal sinus tumor.
c) Solid teratoma.
d) &ranulosa cell tumors.
e) 4renner tumors.
-90% Ris@ factor for cancer o.ar! is:
a) Famil histor of cancer colon.
b) 3se of progesterone onl in<ectable contraception
c) 3se of oral contraceptive pills.
d) ,ultiparit.
e) Serous ovarian cst.
-91% The folloin& statements concernin& endometrial cancer are correct E)*E+T:
a) Involvement of the cervix occurs in stage II disease.
b) Invasion of the mometrium to a depth of more than 9=B puts the case into stage II.
c) Initial treatment of stage I disease is b total abdominal hsterectom and bilateral
salpingo!oophorectom.
d) Postoperative radiotherap is rarel re.uired in stage I# disease.
e) Five!ear survival is A=B in stage I.
-92% The folloin& criteria are in fa.or of dia&nosis of o.arian cancer durin& laparotom!
E)*E+T:
a) -uge ovarian cst.
b) Extra cstic papillae.
c) #reas of hemorrhage and necrosis.
d) -eterogeneous consistenc.
e) $imited mobilit
-94% Ehich of the folloin& &erm cell tumors is associated ith ambi&uous &enitaliaF
a) "horiocarcinoma.
b) &onadoblastoma.
c) %ermoid cst.
d) "arcinoid tumor.
e) Endodermal sinus tumor.
-97% True statements about mucinous carcinoma of the o.ar! include the folloin&
E)*E+T:
a) It usuall is diagnosed at a less advanced stage than serous carcinoma.
b) It tends to be unilateral.
c) It tends to be well differentiated.
d) It ma be developed in 8=!9=B of benign forms.
e) #ffected women have a 9= percent chance of surviving 5 ears.
-98% Ad>u.ant chemotherap! ma! be indicated in all the folloin& E)*E+T:
a) Stage I # cancer ovar.
b) Stage I c cancer ovar.
c) "ancer ovar stage II.
d) 4ul' cervical carcinoma.
e) "ancer vulva.
-$9% The folloin& statements re&ardin& endometrial carcinoma are true E)*E+T:
a) #ge is a significant prognostic factor.
b) Transtubal dissemination explains metastatic intra!abdominal spread.
c) Spillage of cancer cells at the time of surger is the cause of vaginal vault metastases.
d) One third of all cases of relapse will occur within 67 months of diagnosis.
e) Ten percent of cases of relapse occur at more than five ears from surger.
-$$% Eomen arc at hi&h ris@ for endometrial carcinoma if the! ha.e one or more of the
folloin& characteristics E)*E+T:
a) -pertension.
b) %iabetes.
c) Smo'ing
d) Obesit.
e) Familial histor of endometrial carcinoma.
-$,% Ris@ factor for cancer .ul.a is:
a) -I5 infection.
b) 5ulval dstroph.
c) $ichen sclerosis.
d) -erpes simplex.
e) 4artholin abscess.
Directions <uestions -$- throu&h -04: Each set of matchin& :uestions in this section
consists of a list of 0 to 7 lettered options folloed b! se.eral numbered items" =or each
item6 select the ONE best lettered option that is most closel! associated ith it" Each
lettered headin& ma! be selected once6 more than once6 or not at all"
<uestions -$-%-$4
Match the mean a&e of occurrence and the &enital mali&nanc!
a) (!9 ears
b) 6=!7= ears
c) (9!9= ears
d) 9>!)9 ears
-$-% Endometrial cancer
-$0% #arcoma botr!oid
-$1% *er.ical cancer
-$2% Aul.al cancer
-$4% D!s&erminoma
<uestions -$7%-,-
Match the main t!pe of spread of the folloin& mali&nancies and its correspondin& tumor
a) Tumor is locall malignant
b) $mphatic
c) -ematogenous
d) Transcelomic
-$7% #erous c!stadenocarcinoma of the o.ar!
-$8% D!s&erminoma of the o.ar!
-,9% Mali&nant melanoma of the .ul.a
-,$% Basal cell carcinoma of the .ul.a
-,,% #:uamous cell carcinoma of the .ul.a
-,-% #:uamous cell carcinoma of the cer.i/
<uestions -,0%--,
Match the appro/imate mali&nant potential of the folloin& beni&n condition
o.er a decade ith the condition of concern
a) =B
b) =.9B
c) 6B ! 6.9B
d) 8B
e) 9B
f) ?B
g) 8=B
-,0% O.arian fibroma
-,1% O.arian mucinous c!stadenoma
-,2% O.arian dermoid c!st
-,4% #imple endometrial h!perplasia ithout at!pia
-,7% *omple/ endometrial h!perplasia ithout at!pia
-,8% #imple endometrial h!perplasia ith at!pia
--9% *omple/ endometrial h!perplasia ith at!pia
--$% ;terine leiom!oma
--,% *er.ical mucous pol!p
<uestions ---%--4
Match the tumor mar@er or b!product ith the appropriate tumor
a) -uman chorionic gonadotrophin
b) #lpha!fetoprotein
c) "# 679
d) Estrogen
e) Progesterone
f) Testosterone
g) ;on of the above
---% D!s&erminoma
--0% *horiocarcinoma
--1% Theca cell tumor
--2% Endodermal sinus tumor
88>! #erous c!stadenocarcinoma
<uestions --7%-0,
Match the chemotherapeutic a&ent ith its characteristic side effect
a) Pulmonar fibrosis
b) "ardiotoxicit
c) Peripheral neuropath
d) /enal failure
e) -emorrhagic cstitis
--7% Adriam!cin
--8% Aincristine
-09% *!clophosphamide
-0$% *isplatinum
-0,% Bleom!cin
<uestions -0-%-04
Match the findin&s ith the least sta&e of the tumor
a) Stage I #
b) Stage T46
c) Stage I 47
d) Stage II#
e) Stage II4
f) Stage -I
g) Stage I5# h) Stage I54
-0-% Tumor siCe of 1 cm hich is confined to the cer.i/
-00% Tumor of siCe - cm hich e/tends to the pel.ic all
-01% Tumor siCe of 0 cm ith multiple hepatic secondaries
-02% Tumor siCe of 0 cm ith bilateral h!dronephrosis
-04% Tumor siCe of , cm ith affection of , cm of the .a&inal .ault
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
$6,6-60 are correct6 choose D
All are correct6 choose E
-07% +rimar! carcinoma of the .a&ina:
6) ,ore commonl occurs in the upper vagina than in the lower.
7) Is associated with cervical cancer.
8) Is usuall treated with radiotherap.
() 3suall presents as pelvic pain.
9) Is usuall an adenocarcinoma.
-08% All the folloin& about in.asi.e cancer of the .ul.a are correct:
6) Is usuall s.uamous in tpe.
7) "arries a poor prognosis.
8) Is associated with other genital malignancies.
() Is best treated b local vulvectom.
9) Is painful.
-19% 5ncidence of all of the folloin& is increased ith tamo/ifen use:
6) Endometrial polp.
7) Twin pregnanc
8) Endometrial adenocarcinoma.
() "ervical dsplasia.
9) 3terine fibroids.
-1$% Tumor mar@er are reliable for folloin& of:
6) Serous cstadenocarcinoma of ovar.
7) &ranulosa cell tumor.
8) &erm cell ovarian tumor :endodermal sinus tumor).
() "ancer cervix.
9) "ancer vulva.
-1,% *arcinoma of the o.ar!:
6) "ancers of epithelial origin comprise A=B of total primar ovarian malignancies.
7) 4orderline tumors ma metastasi0e but do not invade ad<acent tissue.
8) Transcelomic metastases are a common finding at laparotom.
() -/T ma reasonabl be prescribed after surger of ovarian cancer.
9) Is predisposed to b prolonged use of the oral contraceptive pill.
-1-% =ibromas of the o.ar!:
6) "ommonl present as a large abdominal mass.
7) Fre.uentl become malignant.
8) ,a be associated with a hdrothorax.
() Is usuall cstic
9) Often contain teeth.
-10% Tn a omen presentin& ith postmenopausal bleedin&:
6) -steroscop is a useful diagnostic tool.
7) The most common cause of bleeding is endometrial cancer.
8) Sonographic measurement of endometrial thic'ness is useful.
() 4enign causes of bleeding are rare.
9) %ilatation and curettage is almost alwas accurate.
-11% *ancer o.ar! commonl! presents b!:
6) #bdominal swelling.
7) ,enstrual disturbance.
8) &astrointestinal upset.
() 3rinar retention.
9) "hange* in voice.
-12% *ancer o.ar! sta&in& depends upon:
6) Surgical exploration.
7) 3ES examination.
8) Surgical sampling of peritoneal fluid @ lmph node sampling and omental biops.
() ,/I examination.
9) "linical examination onl.
-14% Endometrial carcinoma:
6) 9B occur in women below the age of (= ears.
7) Obesit is a recogni0ed ris' factor.
8) ?=B of women present with postmenopausal bleeding.
() Screening is advisable for all women.
9) Treatment is essentiall b radiotherap.
-17% The folloin& tumors of the o.ar! are commonl! hormone secretin&:
6) Serous cstadenomas.
7) &ranulosa cell tumors.
8) Transitional cell tumors.
() $edig cell tumor.
9) ,ature cstic teratomas.
-18% 5n endometrial carcinoma6 pro&esto&en therap! is useful in the folloin&
circumstances:
6) Fell!differentiated endometrial carcinoma lesions.
7) Steroid receptor positive endometrial carcinoma patients.
8) #s an ad<uvant to surger.
() /ecurrent endometrial carcinoma.
9) In the treatment of pulmonar metastases.
-29% Differential dia&nosis of .ul.al cancer include:
6) &ranuloma inguinale.
7) Sphilis.
8) -erpes simplex tpe II infection.
() /odent ulcer.
9) "ondloma accuminata.
-2$% 5n sta&e 55 carcinoma of the cer.i/6 the folloin& are correct:
6) The upper third of the vagina ma be involved.
7) The tumor is fixed to the lateral pelvic wall.
8) There ma be extension into the bod of the uterus.
() # five!ear survival rate of ?=B can be expected.
9) The growth is confined to the cervix.
-2,% The folloin& about cancer cer.i/ are correct:
6) #denocarcinoma occurs in about 6=B of cases.
7) Is the most common cancer among women.
8) Is more common in smo'ers.
() %oes not spread b direct infiltration.
9) Is more common in nulliparous women.
-2-% #!mptoms of cer.ical cancer ma! include:
6) Perimenopausal bleeding.
7) 3remia.
8) Postmenopausal bleeding.
() Incontinence of urine.
9) Severe pain.
-20% D!s&erminomas:
6) #re commoner in ounger than older women.
7) Fre.uentl present with abdominal pain.
8) #re common in patients with testicular femini0ation sndrome.
() #re treated initiall b radiotherap.
9) #re bilateral in 9=B of cases.
-21% D!s&erminoma of o.ar!:
6) Is common below the age of 8=.
7) /ecurs late* over ten ears.
8) Is radio!sensitive.
() ,a produce alpha!fetoprotein :#FP).
9) Is associated with gonadal dsgenesis.
-22% *hemotherapeutic a&ents used to treat epithelial o.arian cancers:
6) #re more effective after ctoreductive surger.
7) #re best given continuall for six months.
8) Should contain platinum for best effect.
() 3suall results in a cure.
9) Should be used for all stages of the disease.
-24% 5n o.arian cancer:
6) #dvanced disease is seen in more than 9=B of cases.
7) For all stages combined* the five!ear survival is less than 8=B.
8) Survival is related to the residual tumor present postoperativel.
() /etroperitoneal nodal metastases are rare.
9) #utosomal dominant inheritance ma occur.
-27% =5GO sta&in& of cancer cer.i/:
6) Stage IIIa denotes involvement of the lower 6E8 of the vagina.
7) 7=B include of lmph nodes involvement in stage I4.
8) "stoscop is essential for proper staging.
() /ectal examination is useful in the staging sstem.
9) Is a surgical staging sstem.
-28% 5n assessin& the histopatholo&ical t!pe of cer.ical intraepithelial neoplasia :"I;)
present6 the folloin& factors are ta@en into account:
6) ;umbers of mitotic figures.
7) The nuclear!ctoplasmic ratio.
8) Epithelial differentiation.
() "rpt involvement.
9) The presence of human papilloma virus :-P5).
-49% Ehen usin& e/foliati.e c!tolo&! to dia&nose cer.ical neoplasia:
6) The aim is to sample the surface cells of the cervical transformation 0one.
7) The sampling device must cover 8)=K of the cervix.
8) Fixation must ta'e place immediatel.
() #spiration of cells from the posterior fornix pool is less useful than using an #re
spatula to scrape the cervical surface.
9) The presence of endometrial cancer will be detected in >=B of cases.
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
-4$% As re&ard .ul.al intraepithelial neoplasia:
a) Paget1s disease is considered a variant of 5I;.
b) 5I;!I can be visible macroscopicall.
c) %iagnosis of 5I; is best archived b ctolog and colposcop.
d) 5I; can be treated b "O
7
laser to a depth of 8 mm.
e) 5I; can be treated b wide local excision to a depth of 9 mm.
-4,% 5n dia&nosis of *5N:
a) Pap smear is best method for diagnosis.
b) -P5 %;# detection can be used.
c) $ow grade s.uamous intra epithelial lesions include "I; I* II.
d) #bnormal Pap smear is an indication for cervical biops.
e) #bnormal Pap smear with colposcop is an indication for colposcop directed biops.
-4-% As re&ards the pro&nosis of cer.ical cancer:
a) /ecurrence occurs in 89B of cases.
b) The ma<orit of recurrence occurs after 8 ears of treatment.
c) The 9 ears! survival for stage II is 9=B.
d) Surgical management of local recurrence following radical surger is disappointing.
e) In stages I4 @ II# there is little difference between results of surger @ radiotherap.
-40% The folloin& statements appl! to carcinoma of the cer.i/:
a) #denos.uamous and tumors of mixed histological tpe all arise from transition 0one
epithelium.
b) ;inet per cent are pure s.uamous cell tumors.
c) ,ixed adenos.uamous tumors are associated with poorer survival rates than pure
adenocarcinomas.
d) The presence of vascular space permeation is a prognostic indicator independent of
lmph node status.
e) The ris' of lmph node metastases in women with microinvasive disease is ?.9B.
-41% A patient ith sta&e 5b carcinoma of the cer.i/ under&oes a radical h!sterectom!
and pel.ic l!mphadenectom!:
a) Prophlactic heparin is mandator.
b) Irradiation is an alternative comparable therapeutic modalit
c) 3reteric fistulae are usuall due to intra!operative surgical trauma.
d) Significant long!term bladder dsfunction is common.
e) Pelvic lmphocst formation is characteristicall a late complication.
-42% A ,7%!ear%old oman under&oes a radical h!sterectom! includin& pel.ic
l!mphadenectom! for a - cm diameter sta&e 5b s:uamous cell carcinoma of the
cer.i/:
a) -er prognosis will be better after surger than following radiotherap.
b) Pre!operative intracavitar cesium reduces recurrence.
c) Oophorectom is unnecessar.
d) Post!operative radiotherap would improve the prognosis if the pelvic nodes contained
tumor.
e) Para!aortic lmphadenectom should be emploed as a routine at the time of radical
hsterectom.
-44% Endometrial cancer:
a) "onstitutes 79!8=B of all gnecological malignancies.
b) The commonest tpe is adenos.uamous.
c) Pelvic nodes are involved in 9B of poorl differentiated cases.
d) #denos.uamous carcinoma has a better prognosis than adenocarcinoma.
e) -as a greater tendenc to metastasi0e if it involves the lower uterus than the fundus.
-47% *oncernin& second%loo@ laparotom! in epithelial o.arian cancer:
a) This should be restricted to research protocols onl.
b) This has no effect on long!term prognosis.
c) This should be considered in all patients with advanced epithelial ovarian cancer.
d) This applies especiall to patients who have not responded to chemotherap.
e) 3p to 9= per cent of patients with a negative second!loo' laparotom will have a
recurrence.
=AM5LY +LANN5NG
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
-48% Ehich of the folloin& listin&s correctl! ran@s contracepti.e methods in terms of
decreasin& effecti.eness:
a) Oral contraceptives* diaphragm* I3%* spermicides* rhthm.
b) I3%* oral contraceptives* diaphragm* spermicides* rhthm.
c) /hthm* oral contraceptives* I3%* diaphragm* spermicides.
d) Oral contraceptives* I3%* spermicides* diaphragm* rhthm.
e) Oral contraceptives* I3%* diaphragm* spermicides* rhthm.
-79% The use of combined oral contracepti.es reduces the ris@ of:
a) Ectopic pregnanc.
b) -epatic adenoma.
c) Salpingitis.
d) Ovarian cancer.
e) Endometrial cancer.
-7$% Re&ardin& the pro&esterone onl! pill:
a) )=B of women using it will ovulate.
b) Ideall it should be ta'en <ust before bedtime.
c) The pearl index is higher in the older reproductive age group.
d) Is associated with a lower ris' of an ectopic pregnanc than for a non!user.
e) Is at least as effective as the combined contraceptive pill.
-7,% A3 these methods could be used durin& lactation E)*E+T:
a) %epot provera.
b) ,ini pills.
c) "ombined contraceptive pills.
d) I.3.%.
e) ,ale condom.
-7-% Mechanism of action of copper 5;D includes:
a) Inhibition of ovulation.
b) Tubal bloc'.
c) ,echanical inflammator reaction of the endometrium.
d) Increased tubal motilit.
e) "ervical mucus hostile to the sperms.
-70% All the folloin& are health benefits of combined oral contracepti.e pills E)*E+T:
a) Endometrial carcinoma protection.
b) Protection against surface ovarian tumors.
c) Treatment of benign breast lesions.
d) Protection against cancer breast.
e) %ecrease amount of menstrual flow.
-71% The side effects of combined oral contracepti.e pills include the folloin& E)*E+T:
a) ;ausea.
b) %i00iness.
c) 5aginal discharge.
d) ,enorrhagia.
e) Feight gain.
Directions <uestions -72 throu&h -80: Each set of matchin& :uestions in this section
consists of a list of 2 lettered options folloed b! se.eral numbered items" =or each item6
select the ONE best lettered option that is most closel! associated ith it" Each lettered
headin& ma! be selected once6 more than once6 or not at all"
<uestions -72%-89
Match the folloin& contracepti.e method ith the most li@el! associated condition:
a) "ombined oral contraceptives
b) Progestin!onl pill
c) "ondoms
d) "ervical cap
e) Intrauterine device :I3%)
f) "oitus interruptus
-72% To/ic shoc@ s!ndrome
-74% *holelithiasis
-77% Actinom!ces 5sraeli
-78% 3i&hest ris@ of contracepti.e failure
-89% D!smenorrhea
<uestions -8$%-80
=or each oman6 select the LEA#T appropriate contracepti.e method
a) "ombined oral contraceptives
b) Progestin!onl pill
c) $evonorgestrel implant
d) "ondoms
e) %iaphragm
f) Intrauterine device :I3%)
-8$% A $4%!ear%old oman ith a histor! of ectopic pre&nanc!
-8,% A ,1%!ear%old oman ho is nursin&
-8-% A -7%!ear%old oman ho smo@es 09 ci&arettes dail!
-80% A -4%!ear%old oman ith a lar&e c!stocele
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
$6,6-60 are correct6 choose D
All are correct6 choose E
-81% The absolute contraindications use of combined oral contracepti.e pills:
6) %.5.T
7) -eav smo'ing.
8) Sic'le cell anemia.
() -pertension.
9) %iabetes mellitus.
-82% The folloin& methods protect a&ainst se/uall! transmitted diseases:
6) ,ale condom.
7) %iaphragm.
8) Female condom.
() "ombined contraceptive pills.
9) I3%.
-84% The folloin& are contraindications to usin& combined oral contracepti.es:
6) Pulmonar embolus.
7) Porphria.
8) Sic'le!cell disease.
() Previous &I; III.
9) %epression.
-87% The folloin& statements re&ardin& pro&esto&en onl! oral contracepti.e
preparations are correct
6) The are a suitable method of contraception for breast feeding women.
7) Foman needs to ta'e them at the same time each da.
8) The are more reliable as the patient1s age increases.
() The are contraindicated in smo'ers over the age of (=.
9) The are as reliable as the combined oral contraceptive pill in preventing pregnanc.
-88% The folloin& statements re&ardin& pro&estin onl! in>ectables as contracepti.es are
correct:
6) The have no effect on lactation and can be used b breastfeeding women.
7) The mechanism of their action is mainl b suppression of ovulation.
8) /eturn to fertilit after discontinuation is usuall delaed.
() The can cause osteoporosis.
9) %,P# :%epo!medroxprogesterone acetate) is ta'en ever month.
099% The folloin& statements re&ardin& norplant are correct:
6) The main mechanism of action is hostilit of the cervical mucus.
7) It contains estrogen.
8) It is composed of the ProgestinH levonorgestrel.
() It is irreversible contraceptive.
9) Side effects are rare.
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
09$% Emer&enc! contraception:
a) Is contraception used after intercourse but prior to implantation.
b) Fhen used estrogens must be ta'en within >7 hours of intercourse.
c) Fhen using estrogens* rarel the have side effects.
d) Fhen using the I3"%* it must be inserted the Lmorning afterL.
e) Established contraindications to the oral contraceptive pill and the intrauterine
contraceptive device still appl.
09,% The combined oral contracepti.e pill:
a) Is safe for women to use till the menopause provided the are health non!smo'ers.
b) "ontaining third!generation progestogens are more androgenic than pills containing
norethisterone.
c) ,a be associated with a slightl increased ris' of earl onset breast cancer in women
who start to use it in their teens.
d) Is associated with a reduction of almost 9=B in the ris' of both endometrial and
ovarian cancer.
e) # high!dose :9= ug estrogen) preparation should be used b women ta'ing the
anticonvulsant sodium valproate.
09-% Ehich of the folloin& statements ith re&ard to the copper 5;*D are correctF
a) ,odern copper I3"%s are clinicall effective and safe for at least five ears.
b) It reduces the number of sperm reaching the fallopian tube and their capacit to
fertili0e the egg.
c) The ris' of pelvic infection :PI%) is low :D7 cases PI%E6=== woman ears of use) and
does not increase with long!term use.
d) Is contraindicated in women with Filson1s disease.
e) $evonorgestrel releasing devices are associated with a highl significant reduction in
blood loss in women with menorrhagia.
090% 5n hormonal contraception:
a) Ethinl Estradiol :EE) is the estrogen present in the combined oral contraceptive pills
:"O"s).
b) Progestins are snthetic compounds that mimic the structure of natural progesterone.
c) Failure rate is about 6E-FG with "O"s and 9E-FG with POPs.
d) "ombined oral contraceptive pills reduced ris' of anemia.
e) -istor of hepatic adenoma is a contraindication of "O" pills.
091% 5ntrauterine de.ices:
a) #s a mechanism of action* it neither affects ovulation nor steroidogenesis.
b) Failure rate is 9!6=E-FG.
c) Perforation of the uterus is rare.
d) Fhen intrauterine pregnanc occurs on top of I3"% spontaneous abortion ris' of 9=B
if the I3"% is left and 79B if removed.
e) If a pregnanc occurs in I3"% user* the ris' of it being ectopic is lower than in women
using other contraceptive methods.
OBSTETRICS
NORMAL +REGNAN*Y
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
092% =ertiliCation:
a) Occurs in the uterine cavit.
b) If occurred b two spermato0oa* causes a trisomic conceptus.
c) Is associated with a surge of maternal luteini0ing hormone.
d) Is associated with production of the first polar bod.
e) %epends on haluronidase release b the sperm.
094% Ehich of the folloin& is NOT characteristic of arachidonic acidF
a) The non!esterified form is a precursor of prostaglandin.
b) The esterified form is stored in the decidua vera.
c) It is found in high levels in the amniotic fluid.
d) It is liberated from the esterified form b phospholipase.
e) It combines with prostaglandin snthetase to produce prostaglandin.
097% Ehich of the folloin& is NOT in.ol.ed in the s!nthesis of prosta&landinF
a) Fetal membranes.
b) Phospholipase.
c) Esterified arachidonic acid.
d) Prostaglandin snthetase.
e) Progesterone.
098% #uccenturiate placenta could be associated ith:
a) #ntepartum hemorrhage.
b) Postpartum hemorrhage.
c) Preterm deliver.
d) Postterm deliver.
e) "ongenital fetal malformations.
0$9% Ehich of the folloin& hormones is NOT a product of placental s!nthesis or
production:
a) -uman chorionic gonadotropin :h"&).
b) -uman placental lactogen :hP$).
c) %opamine
d) Progesterone.
e) Estriol.
0$$ % Ehich is NOT a characteristic of human placental lacto&en6 the &roth hormone of
pre&nanc!:
a) It elevates free fatt acids.
b) It elevates plasma insulin levels.
c) It induces lipolsis.
d) It inhibits gluconeogenesis in the mother.
e) It stimulates glucose upta'e in the mother.
0$,% Ehich of the folloin& is NOT a characteristic of pro&esterone:
a) It is an intermediar product in steroid metabolism.
b) It contains 76 carbon atoms.
c) Its main source during earl pregnanc is the corpus luteum of pregnanc.
d) It is a precursor of testosterone.
e) Its ovarian source is important after the first A wee's of pregnanc.
0$-% 5n the normal fetus and neborn6 the folloin& statements are correct E)*E+T:
a) Prostaglandins dela closure of the ductus arteriosus after birth
b) &lucose reaches his circulation b facilitated diffusion.
c) The central nervous sstem is full mature at birth.
d) The ductus venosus conves oxgenated blood before birth.
e) There is high pulmonar vascular resistance before birth.
0$0% The folloin& .essels contain o/!&enated blood in the fetus E)*E+T:
a) 3mbilical arter.
b) %uctus venosus.
c) The inferior vena cava as it enters the right atrium.
d) "arotid arter.
e) 3mbilical vein.
0$1% 5n earl! de.elopment:
a) The amnion is a double laer of fetal mesodermal origin.
b) The decidua capsularis is a component of the chorion.
c) "horionic villi are the functional hormonal units.
d) -uman chorionic gonadotrophin is produced mainl b ctotrophoblast.
e) /elaxin is produced b the chorion laeve.
0$2% The functional unit of the placenta is:
a) The decidua
b) The chorionic villus
c) The cotledon
d) The ctotrophoblast
e) The chorion laeve
0$4% The folloin& statements re&ardin& human chorionic &onadotrophin 'h*G( are
correct E)*E+T:
a) Is a glcoprotein.
b) -as an a subunit similar to FS-.
c) /eaches a pea' level at about 7= wee's1 gestation.
d) Is thought to stimulate fetal testosterone secretion.
e) Is produced b snctiotrophoblast.
0$7% #oftenin& of the cer.ical isthmus that occurs earl! in &estation is called:
a) -egar1s sign.
b) "hadwic'1s sign.
c) 4raxton!-ic'1s contraction.
d) Palmer1s sign.
e) "ullen1s sign.
0$8% A pre&nant uterus that is lar&er than the period of amenorrhea could be due to:
a) &enerali0ed edema.
b) Obesit.
c) Intrauterine growth retardation.
d) 4reech presentation.
e) Polhdramnios.
0,9% Ehich of the folloin& si&ns or s!mptoms are NOT present in a $,%ee@ pre&nanc!:
a) "hadwic'1s sign.
b) Muic'ening.
c) 3ltrasonographic fetal heart action.
d) #menorrhea.
e) -egar1s sign.
0,$% A pre&nant .e&etarian is li@el! to be deficient in hich of the folloin& substancesF
a) "alcium.
b) Folic acid.
c) Iron.
d) Protein.
e) 5itamin 467.
0,,% Ehich of the folloin& is NOT a basis in Nae&eleHs rule for estimatin& a omanHs due
dateF
a) /egular monthl menstrual ccles.
b) # pregnanc of 7?= das.
c) Ovulation about da 6(.
d) "cle regulation with birth control pills before conception.
e) "onception at midccle.
0,-% Ehich of the folloin& is NOT a usual screenin& test in an earl!6 uncomplicated
pregnancN
a) /epeat human chorionic gonadotropin :h"&) levels.
b) -emoglobin.
c) Serolog.
d) "ervical ctolog.
e) 4lood tpe and /h factor.
0,0% Ehich of the folloin& dietar! instructions NOT appropriate for a pre&nant
omanF
a) /estrict salt inta'e.
b) Ta'e 67== mg calcium dail.
c) Ta'e ?== mg folic acid dail.
d) Ta'e supplemental iron.
e) &ain at least 69 Ibs during the pregnanc.
0,1% Ehich of the folloin& complications does NOT occur in the second trimester of
pre&nanc!:
a) Premature labor.
b) "ervical incompetence.
c) Premature rupture of membranes.
d) #bruptio placentae.
e) /ound ligament pain.
0,2% Ehich of the folloin& is NOT a characteristic of a ,7%ee@ pre&nanc!:
a) 5iabilit
b) # fetal weight of 6=== g.
c) $ecithin to sphingomelin :$ES) ratio of less than 7H6
d) The absence of tpe II fetal lung alveoli cells
e) The presence of phosphatidl glcerol.
0,4% The 5N*ORRE*T statement about fetal scalp +3 measurement:
a) It is a good indicator of chronic fetal hpoxia.
b) It is measured using an invasive test.
c) It can be repeated ever hour if abnormal.
d) ;ormal value of fetal P- should be C>.79.
e) ,aternal p- ma affect the fetal p-
0,7% The correct statement about bioph!sical profile is:
a) It is made up of four components.
b) # score of ) is satisfactor.
c) Perinatal mortalit rises with falling biophsical profile score.
d) #mniotic fluid volume is an important sign of acute asphxia.
e) It consists of %oppler flow readings of the umbilical cord.
0,8% Mana&ement of intrapartum acute fetal distress includes the folloin& E)*E+T:
a) Oxgen administration.
b) "hange of maternal position.
c) Intraamniotic oxgen supplement
d) "orrection of maternal hpotension.
e) ".S if the cervix is not full dilated.
0-9% The folloin& statements re&ardin& obstetric ultrasound are correct E)*E+T:
a) It can be used with amniocentesis.
b) It carries a ma<or ris' to the fetus.
c) It can diagnose placental grading.
d) It is a useful tool in the assessment of amniotic fluid volume.
e) It could estimate the approximate intrauterine fetal weight
0-$% ;ltrasound can be helpful in the dia&nosis of all the folloin& E)*E+T:
a) Incompetent cervix.
b) Fetal cardiac anomalies.
c) Tpe of twins.
d) Site of implantation
e) Placental location
0-,% Amniocentesis is useful in the folloin& situations E)*E+T:
a) Suspected open neural defect.
b) ,anagement of un!sensiti0ed /h!negative pregnant women.
c) Tests for fetal lung maturit.
d) Suspected chorioamnionitis.
e) Examine fetal cells for the chromosomal pattern.
0--% The count%to%ten chart to record fetal mo.ements:
a) Is an accurate method to assess the fetal wellbeing.
b) It is the time needed to appreciate ten fetal movements.
c) It is the number of fetal movements in ten minutes.
d) If the result is unsatisfactor* immediate deliver of the fetus is indicated.
e) If the result is satisfactor* the fetus is definitel in safe condition.
0-0% =etal lun& maturation is ensured b! the presence of:
a) $ecithin.
b) Prostaglandin.
c) Sphingomelin.
d) Phosphatidl glcerol.
e) "ortisol.
0-1% 5n the fetal circulation6 the 5N*ORRE*T statement is:
a) There are two umbilical veins @ one umbilical arter.
b) The ductus venosus connects the umbilical vein with I5".
c) The blood is shifted from the right atrium to the left atrium via the foramen oval.
d) Prostaglandins maintain patenc of ductus arteriosus.
e) The inferior vena cava contains both oxgenated @ deoxgenated blood.
Directions <uestions 0-2 throu&h 011: Each set of matchin& :uestions in this section
consists of a list of 0 to 7 lettered options folloed b! se.eral numbered items" =or each
item6 select the ONE best lettered option that is most closel! associated ith it" Each
lettered headin& ma! be selected once6 more than once6 or not at all"
<uestions 0-2%009
Match the dru& used in pre&nanc! ith its presumpti.e effect on the fetus
a) Ototoxicit
b) 4one affection
c) 2ernicterus
d) "ardiotoxicit
e) &re bab sndrome
f) ;eural tube defect
0-2% *hloramphenicol
0-4% #ulphonamides
0-7% *arbamaCepine
0-8% Tetrac!cline
009% Gentamicin
<uestions 00$%000
Match the fetal structure ith the adult correspondence
a) $igamentum venosum
b) $igamentum teres
c) $igamentum arteriosum
d) ,edian umbilical ligament
e) $ateral umbilical ligament
00$% ;mbilical arter!
00,% Ductus .enosus
00-% Ductus arteriosus
000% ;rachus
<uestions 001%019
Match the substance ith its method of placental transfer
a) #ctive transport
b) Facilitated diffusion
c) Simple diffusion
d) pinoctosis
e) ;ot transferred
001% Glucose
002% Non fractionated heparin
004% =ractionated heparin
007% Amino%acids
008% O/!&en
019% 5mmuno&lobulins
<uestions 01$%011
Match the ph!siolo&ic condition in the non pre&nant state belo ith its
chan&e durin& pre&nanc! abo.e
a) Increases
b) %ecreases
c) /emains constant
01$% 5ntestinal peristalsis
01,% #erum cortisol le.el
01-% #erum th!ro/ine le.el
010% Respirator! rate
011% *ardiac output
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
$6,6-60 are correct6 choose D
All are correct6 choose E
012% The folloin& statements re&ardin& fertiliCation are correct:
6 ! It occurs in the ampullar region of the fallopian tube.
7! The sperm penetrates the ovum b the action of prostaglandins.
8! #fter penetrating the ovum* the head of the sperm swells to form the male
pronucleus.
(! The fertili0ed ovum starts to divide b meiotic division to form the 0gote.
9! ,ultiple sperms succeed in penetrating the ovum.
014% *oncernin& the decidua6 the folloin& statements are correct:
6 ! It is a speciali0ed endometrium of pregnanc.
7! It is the site of implantation of the blastocst.
8! It is a protective laer against the invasive power of the trophoblast.
(! It has a relation with trophoblast that follows the laws of transplantation
immunolog.
9! The decidua parietalis shares in the formation of the placenta.
017% 5n human placentation6 the folloin& structures lie beteen maternal and fetal
blood:
6 ! Trophoblast.
7! "apillar endothelium.
8! ,esenchme.
(! %ecidua.
9! "horion laeve.
018% Re&ardin& the +lacenta6 the folloin& statements are correct:
6 ! It is formed b the decidua vera @ chorion frondosum.
7! Placental hormones are secreted b the Snctium.
8! Placental transfer occurs mainl b simple diffusion.
(! -datidiform mole is a benign placental tumor.
9! It is usuall large in intrauterine growth retardation.
029% Re&ardin& the normal umbilical cord6 the folloin& statements are correct:
6 ! It contains two arteries.
7! It is covered b amnion and chorion.
8! It contains Fharton1s <ell.
(! It usuall pulsates at a rate e.ual to the maternal pulse rate.
9! It contains two veins.
02$% The folloin& statements re&ardin& estro&ens in pre&nanc!6 are correct:
6! E8 :estriol) is the main estrogen during pregnanc.
7! The are decreased in cases of anencephal.
8! The are secreted b the snctium.
(! The stimulate the alveolar development in breasts.
9! The are of maternal source onl.
02,% The folloin& statements re&ardin& human chorionic &onadotrophins 'h*G( are
correct:
6 ! It is secreted b the snctium.
7! It starts to be measurable in maternal blood 6= das post conception.
8! It is luteotropic.
(! Its maximum serum level is at 6= wee's of gestation.
9! Its secretion is controlled b the placenta* ovar and pituitar gland.
02-% The folloin& statements re&ardin& the placenta the folloin& statements are
correct:
6 ! It is formed of maternal and fetal parts.
7! The placental barrier get thinned b 9!) months of pregnanc.
8! Placenta succenturiata ma be a cause of post partum hemorrhage.
(! Its maternal surface is covered b an amniotic membrane.
9! Each cotledon is composed of a few numbers of chorionic villi.
020% The folloin& statements re&ardin& the amniotic fluid are correct:
6 ! It has a fetal contribution as well as maternal one.
7! It has functions during pregnanc as well as during labor.
8! Its mar'ed diminution ma lead to s'eletal abnormalities in the fetus.
(! It is increased in anencephal.
9! Its P- is acidic.
021% As re&ards the amniotic fluid6 the folloin& statements are correct:
6 ! The water constitutes AAB of its composition.
7! It reaches its maximum volume at term.
8! It 'eeps the fetal temperature constant.
(! In the first trimester* it is mainl of fetal origin.
9! It is a stagnant fluid.
022% As re&ards a feto protein the folloin& statements are correct:
6! It is reduced concentration in the maternal serum in %own1s sndrome.
7! It is produced b the ol' sac.
8! It constitutes apart of the triple test
(! /eaches its highest concentration in the maternal serum at about 6) wee's
gestation.
9! -as a similar concentration in fetal serum and amniotic fluid.
024% The folloin& statements re&ardin& human placental lacto&en '3+L( are correct:
6 ! It elevates free fatt acids.
7! It inhibits gluconeogenesis.
8! It induces lipolsis.
(! It decreases plasma insulin levels.
9! It stimulates glucose upta'e in mother.
027% The folloin& statements re&ardin& the umbilical cord are correct:
6 ! "ontains two arteries and one vein.
7! #bnormal long cord can lead to cord prolapse.
8! "ontains Fharton1s Oell.
(! It is covered with amniotic membrane.
9! Its umbilical vein carries oxgenated blood from placenta to the fetus.
028% Earnin& s!mptoms that are &i.en to a pre&nant lad! include:
6! 4leeding per vagina.
7! Sudden loss of fluid per vagina.
8! #bdominal pain.
(! $eg cramps.
9! Excessive salivation :ptalism).
049% The folloin& laborator! in.esti&ations are component of the routine antenatal care
6 ! /h tping.
7! -emoglobin.
8! 3rine analsis for sugar and protein.
(! -"&
9! 3rine culture.
04$% *ardiac output durin& normal pre&nanc!:
6 ! Increase in the first trimester.
7! 5aries with phsiological changes in heart rate.
8! 5aries with stro'e volume when the heart rate is constant.
(! Is reflexl reduced in a hot environment.
9! Is greater from the left ventricle than from the right.
04,% The folloin& statements re&ardin& blood composition in normal pre&nanc! are
correct:
6! The pac'ed cell volume falls.
7! There is a rise in the iron!binding capacit.
8! The blood cholesterol rises.
(! The total red cell mass falls b about 7=B
9! The protein bound iodine level falls.
04-% The folloin& statements re&ardin& non%stress test 'N#T( are correct:
6! 3sed with the aid of internal fetal %oppler.
7! $ong term variabilit of the fetal heart beats is a good sign.
8! $ate deceleration is a reassuring sign.
(! Short term variabilit of the fetal heart beats is a good sign.
9! ;ormal baseline fetal heart rate at term is 6==.
040% The folloin& statements re&ardin& Mannin& bioph!sical profile of the fetus are
correct:
6 ! Score ten is the maximum value.
7! Score 0ero is given for dead fetus.
8! Score ) is non!reassuring
(! It includes four parameters.
9! It can be performed starting at 7= wee's gestational age.
041% *irculator! chan&es in a health! oman durin& normal pre&nanc! include:
6 ! # uterine blood flow at term of the order of 9== mlEminute.
7! # continuous increase in stro'e volume.
8! # maximum increase in resting cardiac output is from 8=B to )=B.
(! # rise in cardiac output onl during the second and third trimesters.
9! The peripheral blood flow is reduced.
042% 5n late pre&nanc!6 an increase occurs in the blood concentration of:
6 ! Fibrinogen.
7! Transferrin.
8! "holesterol
(! #lbumin.
9! Sodium.
044% Reco&niCed features of TurnerHs s!ndrome include:
6 ! "oarctation of the aorta.
7! -pogonadotrophic hpogonadism.
8! Increased carring angle.
(! Increased incidence with advanced maternal age.
9! #nosmia.
047% Reco&niCed features of TurnerHs s!ndrome include:
6 ! "oarctation of the aorta.
7! Elevated serum gonadotrophin levels.
8! ;eonatal peripheral edema.
(! "hromatin positive buccal cells.
9! #nosmia.
048% +ro&esterone hormone:
6! Its main source during earl pregnanc is the corpus luteum of pregnanc.
7! It is the precursor of testosterone.
8! It is an intermediate product in steroid metabolism.
(! It is an index of the maternal!fetal placental unit.
9! Its ovarian source is important after the first A wee's of pregnanc.
079% Eith re&ard to normal pre&nanc!6 the folloin& statements are correct:
6! In the middle trimester glomerular filtration rate is increased 9=B above non!
pregnant values.
7! The median respirator rate is increased in the third trimester.
8! # plasma creatinine of =.) mgEd$ and a plasma urea of 69 mgEd$ is within
normal limits in pregnanc.
(! ,aternal weight gain is a good predictor of a small for gestation age :S&#)
infant.
9! ,aximum maternal weight gain occurs between 7= and 7( wee's1 gestation.
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
07$% The folloin& statement's( re&ardin& intrapartum cardiotoco&raph! is 'are( correct:
a) It is useful in high ris' pregnanc.
b) It is a relation between fetal heart rate and fetal 'ic's.
c) /eactive trace means a reassuring test.
d) ?=B of abnormal test pattern in the absence of fetal hpoxia.
e) A=B of earl decelerations will need cesarean section
07,% The folloin& statement's( re&ardin& fetal heart rate is 'are( correct:
a) ;ormal baseline is between 66=!69=.
b) #cceleration means increase in fetal heart rate more than 6= beatsEmin lasting less
than 6= seconds.
c) Fetal 4radcardia means a rate less than 6== bEmin for 69 min.
d) $oss of beat to beat variabilit is a poor sign.
e) ma be increased in maternal throtoxicosis
07-% The folloin& statement's( re&ardin& Obstetrical ultrasound is 'are( correct:
a) #fter 8= wee's gestation* it is more accurate than ;aegele1s rule in calculating the
E%%.
b) Transabdominal transducer has a fre.uenc more than 6= ,-0.
c) It can differentiate between tpes of abortion.
d) It is useful in the follow up of intrauterine contraceptive device :I3"%).
e) It is useful in the management of antepartum hemorrhage.
070% #tud! of the blood flo .elocit! in the umbilical arteries b! Doppler ultrasound
shos:
a) It increases with advancing gestational age.
b) It decreases in cases of intrauterine growth restriction.
c) It increases with maternal hpertension.
d) It increases with placental insufficienc.
e) #bnormal changes in twin!to!twin transfusion.
NORMAL LABOR
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
071% *ephalopel.ic disproportion in the absence of &ross pel.ic abnormalit! can be
dia&nosed b!:
a) 3ltrasound.
b) # maternal stature of D699 cm.
c) Trial of labor.
d) +!ra pelvimetr.
e) Pelvic examination.
072% The cardinal mo.ements of labor and deli.er! in.ol.e a se:uence of e.ents that
occurs in an orderl! fashion" Ehich of the folloin& se:uences is correctF
a) %escent* internal rotation* flexion.
b) Engagement* flexion* descent.
c) Engagement* internal rotation* descent.
d) Engagement* descent* flexion.
e) %escent* flexion* engagement.
074% Re&ardin& as!nclitism6 the 5N*ORRE*T statement is:
a) In the anterior parietal bone presentation* the sagittal suture lies posteriorl.
b) In the posterior tpe* the posterior parietal bone has passed the sacral promontor.
c) In the posterior tpe* the anterior parietal bone has passed the smphsis pubis.
d) The posterior tpe is more common in primigravidas while the anterior tpe is more
common in multigravidas.
e) #snclitic head is more easil engaged than snclitic head.
077% As!nclitism is best defined as:
a) Flexion of the descending fetal head from pelvic floor resistance.
b) Failure of the sagittal suture to lie exactl midwa between the smphsis ad sacral
promontor.
c) Failure of the descent because of inade.uate uterine contractions.
d) Inabilit of the fetal head to pass through the pelvic inlet.
e) Inabilit of internal rotation after the fetal head has reached the ischial spines.
078% *aput succedaneum:
a) /esolves spontaneousl after labor.
b) ,a lead to <aundice of the bab postpartum.
c) Indicates a traumatic vaginal deliver.
d) Indicates that the fetal head is engaged.
e) Is a sign of intrauterine fetal death.
089% En&a&ement is said to ha.e occurred hen hich of the folloin& e.ents ta@es placeF
a) The infant1s head is within the pelvis.
b) The biparietal diameter of the infant1s head is through the plane of the inlet.
c) The presenting part is <ust above the level of the ischial spines.
d) The vertex is in the transverse position.
e) The infant1s head is flexed.
08$% A oman deli.ers a 0"1 @& infant ith a midline episiotom! and suffers a third%
de&ree tear" 5nspection shos that hich of the folloin& structures is intactF
a) #nal sphincter.
b) Perineal bod.
c) Perineal muscles.
d) Fascia.
e) /ectal mucosa.
08,% The 5N*ORRE*T statement about en&a&ement is:
a) The biparietal diameter :4P%) passes the plane of pelvic inlet in cephalic presentation.
b) The lowest part of the head is at station !6.
c) Short cord is one of causes of non!engagement.
d) Tn multipara* it ma occur onl at the 7
nd
stage of labor.
e) "an be diagnosed b the rule of fifths.
08-% +rimi&ra.ida6 ,0 !ears%old6 in labor for $2 hours and the cer.i/ is arrested at 8 cm
for - hours6 position is RO+6 station 9 and molded" There is fetal late decelerations
o.er the last -9 minutes" Deli.er! is BE#T mana&ed b!:
a) Forceps rotation and then traction.
b) 5entouse :vacuum) extraction.
c) "raniotom then forceps.
d) $ower segment cesarean section :$S"S).
e) 3pper segment cesarean section :3S"S).
080% +rimi&ra.ida ith a full! dilated cer.i/ for , hours6 head station L %$ ith moldin&
and diffuse caput can be safel! deli.ered b!:
a) "esarean section.
b) Forceps deliver.
c) 5acuum extraction.
d) Internal podalic version then breech extraction.
e) Fundal compression with deep episiotom.
081% Ehich of the folloin& is NOT a characteristic of acti.e%phase uterine contractionsF
a) The create (= mm -g of pressure.
b) The cause dilation of the cervix.
c) The cause thic'ening of the lower uterine segment.
d) The occur!ever 7 to ( minutes.
e) The last for (9 seconds.
082% Normal labor includes the folloin&:
a) %eliver of a 8A wee's bab.
b) %eliver b mid forceps.
c) 4reech deliver.
d) Twin pregnanc delivered vaginall.
e) Induction of labor b oxtocin.
084% The folloin& statements re&ardin& true labor pains are correct E)*E+T:
a) The are regular.
b) The are relieved b sedation or enema.
c) The are associated with cervical dilatation.
d) The ma be associated with /O,.
e) The increase in intensit b time.
087% A $2%!ear%old primi&ra.ida presents ith se.ere preeclampsia" #he has meconium%
stained amniotic fluid" *ontractions occur e.er! - minutes6 and there is a late
deceleration ith each contraction" =etal chan&es ould include hich of the
folloin&F
a) %ecreased lactic acid.
b) Increased p-.
c) Increased P"O
7
.
d) %ecreased bicarbonate.
e) Increased PO
7
!
088% A oman arri.es at the hospital in acti.e labor statin& that her membranes ruptured
, hours earlier" The fetal heart rate '=3R( monitor shos decelerations that do not
seem related to an! point in the contraction and :uic@l! return to baseline ith
&ood .ariabilit!" Ehich of the folloin& is characteristic of these decelerationsF
a) The are associated with fetal head compression.
b) The are caused b uteroplacental insufficienc.
c) The are indications of fetal metabolic acidosis.
d) The are associated with a rise in fetal p-.
e) The are influenced b the ruptured!membrane status.
199% A patient in the acti.e phase of labor is 1%cm dilated6 and the fetal heart monitor
shos decreased .ariabilit!" The monitor shos a baseline fetal rate of $,1 beats
per minute 'bpm(6 ith occasional late decelerations" A fetal scalp p3 of 4",, is
obtained" This situation indicates hich of the folloin& conditions or actionsF
a) Significant fetal metabolic acidosis.
b) The need to repeat the fetal scalp p- test in 7= minutes.
c) The need for immediate cesarean section
d) "horioamnionitis with maternal fever.
e) The need for an intrauterine pressure catheter.
19$% A -$%!ear%old oman has been pushin& in the second sta&e of labor for , hours" The
.erte/ is at the M, station" Each contraction is associated ith a fetal brad!cardia as
lo as $99 beats per minute 'bpm( that lasts for -9 seconds" This clinical scenario
su&&ests hich of the folloin& situationsF
a) Sstemic fetal hpoxia.
b) Poor fetal outcome.
c) #n association with oligohdramnios.
d) Fetal head compression.
e) # depressed fetal p-.
19,% Ehich of the folloin& fetal mechanisms does NOT compensate for the normal lo
fetal arterial partial pressure of o/!&en '+O
,
(F
a) Increased fetal cardiac output.
b) Increased fetal sstemic blood flow rates.
c) Increased fetal pulmonar blood flow.
d) Increased affinit of fetal blood for oxgen.
e) Increased fetal oxgen!carring capacit.
19-% Ehich of the folloin& e/planations is NOT an e/planation for decreased
.ariabilit! to the fetal heart rate '=3R( tracin&F
a) Fetal Lsleep stateL.
b) Prematurit.
c) 4arbiturate ingestion.
d) Fetal stimulation.
e) #sphxia.
190% Ehich of the folloin& is NOT a characteristic or associated findin& ith late
decelerationsF
a) The are seen in patients with preeclampsia.
b) The ma be associated with respirator al'alosis.
c) The are associated with a decreased uteroplacental blood flow.
d) The usuall are accompanied b a decrease in partial pressure of oxgen
:PO
7
).
e) The usuall are accompanied b an increase in partial pressure of carbon dioxide
:P"O
7
).
191% A oman ith ruptured membranes is in the acti.e phase of labor and is 1%cm
dilated ith sustained6 deep .ariable decelerations" The decision is made to
perform a cesarean section" Ehich of the folloin& ould NOT be an appropriate
intrauterine resuscitati.e measure done before the cesarean sectionF
a) Increase the intravenous fluids.
b) Place the patient in the supine position.
c) Start nasal oxgen.
d) Start amnio!infusion.
e) #dminister subcutaneous terbutaline.
192% A ,1%!ear%old pre&nant oman presents to the labor floor reportin& e/treme
abdominal pain and hea.! .a&inal bleedin&" The fetal heart monitor shos a fetal
brad!cardia ith late decelerations" Ehich of the folloin& acid%base
characteristics ould NOT be present in the fetusF
a) /espirator al'alosis.
b) #n increased partial pressure of carbon dioxide :P"O
7
).
c) # drop in fetal p-.
d) #ccumulation of lactic acid.
e) ,etabolic acidosis.
194% Epidural anesthesia:
a) %oes not affect uterine activit.
b) Is contraindicated in patients with heart valve lesions.
c) Should be routinel administered during the first stage of labor.
d) Increases the ris' of postpartum hemorrhage.
e) Should be offered to highl selected cases in labor.
197% The folloin& statements re&ardin& ischial spines are correct E)*E+T:
a) The ma'e the beginning of the forward curve of the pelvis.
b) The are landmar's for pudendal nerve bloc' procedure.
c) The indicate a normal pelvis when particularl prominent.
d) The help to assess station of the presenting part.
e) The lie at the level of the plane of least pelvic dimensions.
Directions <uestions 198 throu&h 1,0: Each set of matchin& :uestions in this section
consists of a list of 0 to 7 lettered options folloed b! se.eral numbered items" =or each
item6 select the ONE best lettered option that is most closel! associated ith it" Each
lettered headin& ma! be selected once6 more than once6 or not at all"
<uestions 198%1$8
Match the diameter &i.en ith the correspondin& description
a) A cm
b) A.9 cm
c) 6=.9cm
d) 66 cm
e) 66.9 cm
f) 67cm
g) 67.9 cm
h) 68.9 ! 68.>9 cm
198% Ri&ht obli:ue diameter of the pel.ic inlet
1$9% Left obli:ue diameter of the pel.ic inlet
1$$% True con>u&ate of pel.ic inlet
1$,% Obstetric con>u&ate
1$-% #acrocot!loid diameter
1$0% Bispinous diameter
1$1% Bituberous diameter
1$2% Biparietal diameter
1$4% Mento.ertical diameter
1$7% #uboccipito bre&matic diameter
1$8% Occipitofrontal diameter
<uestions 1$8%1,0
Match the appropriate terra ith the description &i.en:
a) $ie
b) Station
c) %enominator
d) Position
e) Presentation
1,9% Left occipito anterior
1,$% Mentum
1,,% Lon&itudinal
1,-% Aerte/
1,0% Kero
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
$6,6-60 are correct6 choose D
All are correct6 choose E
1,1% The folloin& statements relatin& to ischial spines are correct:
6 ! The lie between the greater and lesser sciatic notches.
7! The mar' the beginning of the forward curve of the birth canal.
8! The internal pudendal nerve lies in close relation to the spines.
(! Fhen the widest transverse diameter of the fetal s'ull is at the level of the spines*
the head is engaged.
9! The are of particular prominence in the normal female pelvis.
1,2% An anthropoid pel.is:
6 ! Is of good obstetric value.
7! Is associated with deep transverse arrest.
8! -as a narrow sub pubic arch.
(! -as a male!shaped brim.
9! Is associated with spondlolisthesis.
1,4% =etal presentation:
6 ! Is the part of the fetus that enters the pelvis first.
7! In face presentation the occiput and bac' comes into contact.
8! Is usuall cephalic*
(! The denominator is the lowest part of the presenting area.
9! In cephalic presentation* it is more common to be face.
1,7% The folloin& statements re&ardin& occipito anterior presentations are correct:
6 ! The bac' of the fetus is parallel to the bac' of the mother.
7! $eft occipito anterior presentation the head descends in the left obli.ue diameter.
8! The head of the fetus is full flexed.
(! The bac' of the fetus is directed posteriorl.
9! The are less common than occipitoposterior.
1,8% En&a&ement of the head can be assessed b!:
6 ! #bdominal examination.
7! /elationship to ischial tuberosit.
8! /elationship to ischial spines.
(! %egree of molding.
9! %egree of caput formation.
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
1-9% Re&ardin& the fetal s@ull fontanelles:
a) There are onl 7 fontanelles.
b) The posterior fontanelle is closed at 7? w's &.#.
c) The anterior fontanelle is closed at birth.
d) ;eonatal brain 3ES is done usuall through the posterior fontanelle.
e) The anterior fontanelle is irregular in shape.
1-$% +lacental separation:
a) Often occurs b Schult0 method.
b) %uncan method is more liable for retained parts.
c) The earliest sign isH the uterus becomes more globular* smaller and harder*
d) ;ormall ta'es 6 !7 hours in primigravida :P&).
e) "an be diagnosed b stop of pulsation of the cord.
1-,% =irst sta&e of labor:
a) $asts for maximum ? hours in primigravida :P&).
b) Starts with true labor pains @ ends after deliver of the fetus.
c) $atent phase is the first phase of this stage.
d) Includes cervical dilatation @ effacement.
e) #ctive phase is characteri0ed b increased rate of cervical dilatation and descent of the
presenting part.
1--% The first sta&e of labor:
a) Ends in expulsion of the fetus.
b) 4egins when membranes rupture.
c) "an be shortened with the use of oxtocin.
d) ;ormall lasts for more than 7( hours in a primigravida.
e) Is prolonged in malposition of the head.
NORMAL AND ABNORMAL +;ER+ER5;M
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
1-0% The folloin& statements re&ardin& maternal mortalit! are correct E)*E+T:
a) It is defined as Lthe death of an woman due to an cause whilst pregnant or within (7
das of the TOP* irrespective of the duration and the site of the pregnancP from an
cause related to or aggravated b the pregnanc or its management but not from
accidental or incidental causes.
b) In Egpt it is 6= per 6==.=== live births.
c) Pulmonar Embolism is the most important cause in developed countries
d) ,aternal mortalit rate is affected b maternal age* parit @ mode of deliver.
e) It can be reduced b proper antenatal care.
1-1% Maternal mortalit! refers to the number of maternal deaths that occur as the result
of the reproducti.e process per:
a) 6=== births.
b) 6=.=== births.
c) 6==.=== births.
d) 6=.=== live births.
e) 6==.=== live births.
1-2% Ehich of the folloin& is the 5N*ORRE*T statement re&ardin& postpartum
mastitis:
a) The most common pathogenic organism is staphlococcus aureus*
b) It usuall occurs within the first postpartum wee'.
c) The offending organism could be cultured from breast mil'.
d) The mother was probabl a chronic carrier of the organism prior to breast feeding.
e) There is no contraindication to the continuance of breast feeding.
1-4% The folloin& statement about birth control after deli.er! is correct:
a) It is not important until after the first menses.
b) It is not necessar in a woman who is nursing.
c) It should begin immediatel in a non!lactating woman.
d) It is not necessar for 8 months after a cesarean section
e) The best method is intrauterine device in C A=B of cases.
ABNORMAL +REGNAN*Y
Directions: Each of the numbered items or incomplete statements in this section is
folloed b! ansers or b! completions of the statement" #elect the ONE lettered anser
or completion that is BE#T in each case"
1-7% The folloin& is associated ith increased abortion rate E)*E+T:
a) Tobacco.
b) -perprolactinemia prior to pregnanc.
c) /adiation over 9 rads.
d) "offee in excess of ( cups per da.
e) "lass #6 diabetes mellitus.
1-8% The ma>or cause of first trimester abortion is:
a) "hromosomal anomalies.
b) #natomic defects of the uterus or cervix.
c) "ircumvallate placentation.
d) Endocrine factors.
e) Immunological factors.
109% #ubacutel! disturbed tubal pre&nanc! can be e/cluded if:
a) ,enstrual pattern is normal.
b) ;o pelvic pain.
c) 63"% is intrauterine.
d) Transvaginal ultrasound is normal.
e) Serum Qh"& is negative.
10$% Most common site of occurrence ectopic pre&nanc! is:
a) Isthmic or interstitial portion of the Fallopian tube.
b) "orneal end of the tube.
c) #mpullar portion of the fallopian tube.
d) Fimbrial end of the Fallopian tube.
e) Ovar.
10,% *ontraindication to medical therap! 'Methotre/ate( in tubal pre&nanc! is:
a) Ectopic si0e 8 cm or less.
b) %esire for future fertilit.
c) -istor of active hepatic or renal disease.
d) # sonographicall non viable pregnanc.
e) #bsence of active bleeding.
10-% The ris@ factors for an ectopic pre&nanc! include the folloin& E)*E+T:
a) -istor of pelvic inflammator disease.
b) Previous ectopic pregnanc.
c) 3se of combined oral contraceptives.
d) #ssisted reproductive techni.ues.
e) 63% use.
100% The folloin& statements re&ardin& ectopic pre&nanc! are correct E)*E+T:
a) #ccounts for 6=B of all maternal mortalit.
b) There has been a four fold increase over the past 7= ears.
c) The ma<orit of cases :over A9B) occur in the tube.
d) The incidence of ectopic is directl related to the prevalence of salpingitis.
e) The effect of ectopic pregnanc on the future fertilit is insignificant.
101% Dia&nosis of ectopic pre&nanc! can be ruled out in almost all clinicall! si&nificant
cases if:
a) Transvaginal sonograph showed no abnormalities in the adnexal region.
b) Serum Q!h"& was negative.
c) Patient did not miss her period.
d) Patient is using the I3"% for contraception.
e) There is no pelvic fluid b transvaginal uterine ultrasound.
102% The underl!in& patho&enic process in h!datidiform mole is:
a) #ndrogenesis.
b) Parthenogenesis.
c) Parent mutation.
d) ;ormal fertili0ation.
e) ;on dis<unction.
104% The folloin& statements re&ardin& h!datidiform moles are correct E)*E+T:
a) 3suall have female 'arotpe.
b) ma be complicated b throtoxicosis.
c) ma be complicated b ovarian csts.
d) a feto!protein is a good mar'er of disease post!evacuation.
e) Is more prevalent in the advanced age group.
107% The folloin& statements re&ardin& .esicular mole are correct E)*E+T:
a) # fetus ma coexist in utero.
b) Invasive mole penetrates the mometrium and has identifiable chorionic villi.
c) "ommonl comprises cells with ()++ chromosomes of paternal origin.
d) -as a greater than 7=!fold increase in incidence in mothers over (9 ears old.
e) #fter evacuation of a hdatidiform mole* the patient is monitored using Q!hP$ assas.
108% The folloin& statements re&ardin& &estational trophoblastic disease are true
E)*E+T:
a) -datidiform moles arise from paternal genetic material.
b) "horiocarcinoma is characteri0ed b an absence of chorionic villi.
c) There is a high incidence in South! East #sia.
d) "horiocarcinoma is highl chemosensitive with methotrexate as the agent most
fre.uentl used.
e) Over ?=B of patients with hdatidiform mole have Q!h"& levels that return to normal
b 7 wee's after suction evacuation.
119% Ris@ factors for persistent trophoblastic disease folloin& molar e.acuation include
the folloin& E)*E+T:
a) Goung age :D7= ears old).
b) Old age :C (= ears old).
c) Increased uterine si0e.
d) Presence of theca lutein csts.
e) Q!h"& level C 6==*=== ml3Eml.
11$% The best contracepti.e method for patients ith &estational trophoblastic diseases:
a) Tubal ligation.
b) -sterectom.
c) "ombined oral contraceptive pills.
d) Intra!uterine contraceptive device.
e) Subcutaneous implants.
11,% The ris@ of recurrence of molar and or trophoblastic disease in subse:uent
pre&nancies is:
a) 7B.
b) 9B.
c) ?B.
d) 6=B
e) 69B.
11-% The folloin& is the main difference beteen complete and partial .esicular mole:
a) Propensit of metastases.
b) Triploid @ diploid.
c) ;eed for chemotherap.
d) Trophoblastic hperplasia.
e) #ndrogenesis.
110% The most common site of metastatic disease in choriocarcinoma is:
a) 4rian.
b) $iver.
c) 5agina.
d) $ung.
e) Ovar.
111% Theca lutein c!st are characteriCed b! the folloin& E)*E+T:
a) #re best treated conservativel.
b) #re best treated surgicall.
c) #re seen occasionall in normal pregnanc.
d) #re seen in ovarian hperstimulation sndrome.
e) #re liable to complications including hemorrhage* rupture and torsion.
112% The folloin& are ris@ factors for the de.elopment of placental abruption E)*E+T:
a) Smo'ing.
b) Folic acid deficienc.
c) Pre!eclampsia.
d) -istor of threatened abortion.
e) Previous placental abruption.
114% The percenta&e of patients ith a histor! of prematurit! ho ill ha.e another
premature infant is:
a) =B to 6=B.
b) 7=B to 8=B.
c) (=B to 9=B.
d) )=B to >=B.
e) ?=B to A=B.
117% A $2%!ear%old primi&ra.ida reports that she is e/periencin& re&ular menstrual
crampin& e.er! , minutes" #he is ,7 ee@s pre&nant" After ta@in& a histor!6 the first
thin& that the ph!sician should do is:
a) Send her to the labor floor immediatel.
b) "onfirm the fre.uenc of contractions b abdominal palpation.
c) Evaluate fetal well!being with a fetal monitor.
d) Evaluate the cervix b speculum examination.
e) Immediate cesarean section.
118% The most common cause of .a&inal bleedin& complicatin& premature labor is:
a) # vaginal laceration.
b) #n endocervical polp.
c) "ervical dilation.
d) Placenta previa.
e) Placental abruption.
129% A -8%!ear%old former Ol!mpic athlete '&ra.ida 16 para 9-$$( comes for her first
prenatal .isit at 7 ee@sH &estation" After under&oin& a prenatal &enetic counselin&
session6 she as@s her ph!sician about current recommendations concernin& her ris@
of ha.in& a premature infant" The ph!sician should e/plain that:
a) She is at no ris' for premature deliver.
b) She can continue her plans for running a marathon in 6 month.
c) -er age has no bearing on this pregnanc.
d) -e would li'e to see her more often to perform cervical* examinations.
e) -e would li'e to see her more often onl if an smptoms of premature labor develop.
12$% Ehich of the folloin& is a si&n of late premature laborF
a) Increased vaginal discharge.
b) Increased uterine contractions.
c) $ow bac' pain.
d) "ervical dilation* to ( cm.
e) Forsening pelvic pressure.
12,% Ehich of the folloin& is NOT a predisposin& factor for premature laborF
a) ,aternal age older than 8= ears.
b) Smo'ing more than 6= cigarettes per da.
c) Exposure to diethlstilbestrol :%ES) in utero with a documented uterine structural
abnormalit.
d) ,ultiparit with more than four previous deliveries.
e) Twin gestation.
12-% Ehich of the folloin& dru&s is NOT used to inhibit premature laborF
a) Ethanol.
b) ,agnesium sulfate.
c) Phenobarbital.
d) /itodrine.
e) Terbutaline.
120% The first step in the assessment of the postterm &estation is:
a) 3ltrasound examination.
b) %etermination of the true length of gestation.
c) ,easurement of fetal heart rate :F-/).
d) %etermination of amniotic fluid volume.
e) "ontraction stress test.
121% The perinatal mortalit! rate at 00 ee@sH &estation is:
a) $ess than 6 B.
b) 6 B to 7B.
c) 7B to 8B.
d) (B to 9B.
e) )B to >B.
122% After ha.in& identified a fetus at ris@ in prolon&ed pre&nanc!6 mana&ement should
consist of:
a) #mniocentesis for maturit studies.
b) %eliver regardless of the status of the cervix.
c) Fetal sampling of scalp p-.
d) ,easurement of human chorionic somatomammotropin.
e) /epeat antepartum studies in 6 wee'.
124% Ehich of the folloin& is NOT included in the bioph!sical profile for the ris@
assessment of a postterm fetusF
a) Fetal breathing.
b) #mniotic fluid volume.
c) Fetal tone.
d) "ontraction stress test :"ST).
e) Fetal motion.
127% A oman ho is $2 ee@s pre&nant has a maternal serum a%fetoprotein 'M#A=+(
le.el of ,"7 multiple of the mean 'MOM(" Ehich of the folloin& conditions is NOT
an e/planation of this abnormal findin&F
a) #nencephal.
b) %own sndrome.
c) %uodenal atresia.
d) Omphalocele.
e) Twins.
128% A ,0%!ear%old oman is in a car accident and is ta@en to an emer&enc! room here
she recei.es a chest /%ra! and film of her loer spine" 5t is later disco.ered that she
is $9 ee@s pre&nant" #he should be counseled that:
a) The fetus has received 9= rads.
b) Either chorionic villus sampling :"5S) or amniocentesis is advisable to chec' for fetal
chromosomal abnormalities.
c) #t 6= wee's the fetus particularl susceptible to derangements of the central nervous
sstem.
d) The fetus has received rads below the assumed threshold for radiation damage.
e) The accident ma cause placental abruption
149% The folloin& statements re&ardin& biochemical screenin& for DonHs #!ndrome are
correct E)*E+T:
a) -as been shown to improve detection rates compared to maternal age alone.
b) %iagnosis b chorionic villus sampling :"5S) is one component of the triple test.
c) Is most strongl dependent on maternal serum a feto!protein :,S#FP).
d) # boo'ing ultrasound examination is re.uired prior to biochemical screening.
e) Parental 'arotpe analsis is indicated if there is a famil histor of %own1s
Sndrome.
14$% A pre&nant oman is routinel! screened for hich of the folloin& disease entitiesF
a) Parvovirus.
b) Toxoplasmosis.
c) "tomegalovirus :",5).
d) Sphilis.
e) -erpes simplex virus :-S5).
14,% The folloin& statements re&ardin& to/oplasmosis in a pre&nant oman are correct
E)*E+T:
a) It can be ac.uired b eating infected raw meat.
b) It can be ac.uired b contact with cat feces.
c) Infection in earl pregnanc ma lead to abortion.
d) It is diagnosed b the presence of Ig&.
e) Fetal affection ma occur transplacentall.
14-% Ehich of the folloin& is a common reser.oir for to/oplasmosisF
a) School!age children.
b) 4ird droppings.
c) "ats.
d) "ontaminated seafood.
e) 4lood.
140% Ehich of the folloin& factors is NOT associated ith an increased ris@ of perinatal
morbidit!F
a) $ow socioeconomic status.
b) $ow maternal age :less than 7= ears old).
c) -eav cigarette smo'ing.
d) #lcohol abuse.
e) Exercise.
141% Maternal a&e !oun&er than ,9 !ears does NOT increase the ris@ for hich of the
folloin& conditionsF
a) $ow birth weight.
b) Fetal death.
c) 3terine dsfunction.
d) # geneticall abnormal conceptus.
e) Premature deliver.
142% The folloin& complications could fre:uentl! affect the elderl! primi&ra.ida
E)*E+T:
a) &estational diabetes mellitus.
b) Pre!eclampsia.
c) Precipitate labor.
d) 5esicular mole.
e) Placental abruption.
Directions <uestions 144 throu&h 17$: Each set of matchin& :uestions in this section
consists of a list of 0 to 7 lettered options folloed b! se.eral numbered items" =or each
item6 select the ONE best lettered option that is most closel! associated ith it" Each
lettered headin& ma! be selected once6 more than once6 or not at all"
a) "onservative treatment
b) #llowance or trial of vaginal deliver
c) Elective cesarean section
d) Emergenc cesarean section
e) "esarean hsterectom
144% +atients ith placenta pre.ia ith se.ere bleedin& G immature fetus
147% +atient ith placenta pre.ia centralis accidentall! disco.ered at -4 ee@s plus 0 da!s
&estation"
148% +atient ith mild placental abruption6 no fetal distress at -- ee@s &estation
179% +atient ith se.ere accidental hemorrha&e6 intrauterine fetal death6 cer.i/ is 7 cm
dilated
17$% +atient ith placental ed&e at - cm from the cer.ical internal os6 presentin& in acti.e
labor
Directions: Each of the folloin& numbered items or incomplete statements in this section
is folloed b! numbered items that in certain combination leads to the BE#T lettered
combined anser or?and completion" Accordin& to the folloin& directions6 choose the
BE#T lettered anser:
5f
$6,6- are correct6 choose A
$6- are correct6 choose B
,60 are correct6 choose *
$6,6-60 are correct6 choose D
All are correct6 choose E
17,% Medical treatment of ectopic pre&nanc! could be tried if:
6! Serum p!h"& is D8=== millEml.
7! There is sonographicall viable pregnanc.
8! Patient is hemodnamicall stable.
(! Ectopic sac is C( cm in diameter.
9! Ectopic pregnanc is disturbed.
17-% The folloin& statements re&ardin& recurrent 'habitual( abortion are true:
6 ! The most common hormonal cause in habitual abortion is progesterone
deficienc.
7! ;o etiological factor is identified in approximatel 9=B.
8! The incidence is 6B of abortions.
(! It is defined as 8 consecutive induced abortions.
9! The most common genetic abnormalit in habitual abortion is polploid.
170% The folloin& statements re&ardin& missed abortion are true:
6 ! It implies that despite fetal death* the pregnanc has been retained.
7! 3ltrasound is helpful in its diagnosis*
8! ,il' secretion ma start spontaneousl from the breast.
(! There ma be brownish vaginal discharge.
9! There are exaggerated pregnanc smptoms.
171% As re&ards placenta pre.ia6 the folloin& are true:
6 ! It is manifested b painless bleeding.
7! The initial hemorrhage is usuall fatal.
8! It ma predispose to postpartum hemorrhage.
(! Its incidence is unaffected b parit.
9! Its incidence is decreased with maternal age.
172% The folloin& statements re&ardin& the dia&nosis of earl! ectopic pre&nanc! are
true:
6! Transvaginal ultrasound is helpful in con<unction with h"& in diagnosis of earl
ectopic.
7! "linical examination is almost diagnostic of ectopic.
8! $aparoscop is the golden standard for diagnosis in doubtful cases.
(! Q!subunit h"& is doubled ever (? hours.
9! "uldocentesis is a current method for earl diagnosis.
174% As re&ards the mana&ement of ectopic pre&nanc!6 the folloin& are true:
6 ! The ma<orit of undisturbed cases can be treated laparoscopicall.
7! "ervical pregnanc ma need hsterectom.
8! Few ectopic pregnancies can resolve spontaneousl.
(! Salpingectom is the onl option for surgical management.
9! $aparoscop is preferred in shoc'ed patients.
Directions: 5n the folloin& :uestions6 each item has 1 lettered options each of hich
could be a true or a false statement" Tic@ each of these options accordin& to hether the!
are false or true
177% *onser.ati.e mana&ement of ectopic pre&nanc! b! intratubal in>ection of
methotre/ate:
a) Is contraindicated in the presence of tubal rupture.
b) Should be limited to cases with a tubal diameter of 8!( cm.
c) Is particularl effective when ultrasound examination demonstrates fetal cardiac
activit.
d) Should be followed b serial measurement of serum progesterone until values fall to
the non!pregnant range.
e) Is safe provided that citrovorum factor is administered concurrentl.
178% As re&ards .asa pre.ia:
a) It is a common condition.
b) It occurs with circumvallate placenta.
c) It is the onl cause of antepartum hemorrhage of fetal origin.
d) The fetal mortalit is 9=!>9B.
e) It can be treated b a conservative wa.
189% *omplications of abruptio placentae include:
a) -emorrhagic shoc'.
b) "onsumptive coagulopath.
c) #cute renal failure is common in the mild form.
d) ,aternal mortalit rate of 6=B.
e) I3F% in all cases if less than R of the placenta is separated.
18$% A *ou.elaire uterus:
a) Is an indication for hsterectom.
b) ma contract well with stimulation.
c) /esults from excessive oxtocin.
d) /e.uires fibrinogen therap.
e) "omplications of severe abruption.