END OF POSTING EXAM O&G

BATCH 4 YEAR 5 GROUP 3

MCQ

SINGLE BEST ANSWER

1. Threaten miscarriage
A. Bed rest
B. Oral Stillbestrol
C. Curettage
D. Urgent hospital admission
E. IM mefenamic acid
2. Trial of vaginal delivery after caesarean section is allowed in all except
A. Previous caesarean section due to shoulder dystocia
B. Previous classical scar of caesarean section
C. Previous caesarean section due to breech delivery
D. Estimated fetal weight > 3500 g
E. Intrauterine fetal death

3. Risk of postpartum uterine atony associated with

A. Hypotension
B. Epidural anaesthesia
C. Median episiotomy
D. Twin pregnancy
E. Labour associated with an active rate of change of 2.3 cm/hour
4. Causes of miscarriage in first trimester
I am not sure of the answer gais.
A. Chromosomal abnormalities 50-60%
B. Chromosomal abnormalities 20-30%
C. Maternal hypothyroidism
D. Progesterone deficiency
5. Regarding breech
A. Constitutes 10% of term delivery
B. Common in post-term delivery
C. Vacuum extraction can be used after cervix fully dilated
D. Forceps can be used in after coming of head
E. ECV done in 32 – 34 weeks

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6. What is the normal progress in puberty in women?

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 A. Telarche, maximal growth velocity, menarche
B. Maximal growth velocity, telache, menarche
C. Telache, menarche, maximal growth velocity
D. Menarche, maximal growth velocity, telache
E. Menarche, weight gain, telache
7. Which of the following is not an indicator of fetal well-being on term?
A. CTG
B. Fetal lie
C. Fetal movement chart
D. Fetal tone
E. Umbilical Artery Doppler
8. All these tests can be useful in management of intrauterine fetal growth restriction (FGR)
except
A. Fetal kick chart
B. CTG non-stress test
C. Chorionic Villous Sampling
D. Biophysical profile
E. Umbilical Cord Doppler waveforms
9. Regarding post menopause
A. Malignancy is the commonest cause of post-menopausal bleeding
B. FSH and LH is low
C. Fibroid uterus tends to grow bigger
D. Hormone replacement therapy increases risk of breast CA
E. Endometrium is characteristically thick in ultrasound
10. In which individual will have increase chance of endometrial hyperplasia and
endometrial carcinoma ?
A. Multiparity
B. Crohn’s disease
C. Exogenous oestrogen
D. Combine OCP
E. Late menarche
11. 16 years old girl came with complaint of abdominal mass. These investigations can be
done EXCEPT
A. Ultrasound
B. MRI
C. Paps Smear
D. Laparoscopy
E. CT Scan

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 MEQ
Patient 10 week POA, worsening vomiting and diarrhoea for 2 weeks, she didn’t tolerate
orally for 1 week. At ED patient looks lethargic and dehydrated. Uterus size is of 14th week.
1. What is your management?
- Fluid resuscitation, adequate rest, lifestyle modification, anti-emetics

Ultrasound was done and showed honeycomb appearance.

2. What is your diagnosis?
- Gestational trophoblastic disease

3. Other important investigation acquired in this case.

- Serum B-HCG

Patient’s B-HCG is 500,000 units, suction and evacuation was performed. Patient is to be
discharge.
4. What would your advice to the patient before discharge?
- Explain and counsel the risk of recurrence of GTD
- follow up is mandatory, every 6 months
- 2 weekly B-HCG until it becomes undetectable
- Subsequently, monthly for 3 months and 3 monthly once for further 6 months
- Avoid pregnancy during the period of follow up.
o For contraception: until B-HCG revert back to normal (condom), after normal B-
HCG (IUD, IM Depo, COC), complete family (BTL)

5. What is the pathogenesis of hyadatiform mole?

- Hydatidiform mole is the disease of chorion characterized by macroscopic
appearance of cyst in varying sizes. It usually results from death of an ovum or
failure of the embryo to grow, in the case of complete hydatidiform mole.
- Secretion from the hyperplastic cells and transferred substances from the
maternal blood accumulates in the stroma of villus resulting in formation of
vesicles.
- The distention may also be due to edema and liquefaction of the stroma
- Vesicle fluid is interstitial fluid but rich in HCG

OSCE 1

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 OSCE 2

1. Name the instruments

Omnicup with traction force indicator
Wrigley’s forcep

2. What are the pre-requisites for instrumental delivery?

FORCEPS

3. What are the complications of instrumental deliveries?

Maternal complication

- Uterine, cervical, vaginal lacerations

- Postpartum hemorrhage
- Extension of episiotomy

Fetal complication
- Cephalon-hematoma
- Facial nerve and brachial plexus palsies
- Skull fracture and intracranial hemorrhage

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 OSCE 3

Write short notes on bacterial vaginosis

Refer to the other set lar. Aku malas nak copy paste again