1.

Mrs XYZ 70years old P3+0 has come to gynae OPD with the C/O vulval pruritis for the last 3yrs for
which she took different medications but there is only temporary relief. On examination there was 2x3
cm lesion on right labia majora, with indurated margins. What should be the diagnostic investigation you
should advise:

a) Wound swab
b) CT scan
c) MRI pelvis
d) Biopsy of lesion
e) Ultrasound pelvis

KEY: d

2.In the above scenario biopsy revealed vulval carcinoma. What is the most likely histopathological type
of carcinoma you expect:
a) Squamous cell carcinoma
b) Adenocarcinoma
c) Malignant melanoma
d) Sarcoma
e) Paget’s disease.

KEY:a

3.Mrs ABC 45 years old P4+1 came to gynae OPD with the C/O heavy menstrual cycles for the last 2
years. On examination uterus is 12 weeks size, regular margins, mobile and tender, fornices clear.
What is the most likely diagnosis:
a) Endometrial hyperplasia
b) Uterine fibroids
c) Adenomyosis
d) Endometrial carcinoma
e) Endometrial polyp.
Key: c

4.Mrs ABC 46years old P4 wife of laborer has come to gynae OPD with the C/O heavy and irregular
menstrual cycle for the last 3 years. On examination uterus is 12 weeks with irregular margins.
Ultrasound shows multiple uterine fibroids with largest measuring 6x5 cm. What should be the best
treatment option for her:
a) Myomectomy
b) Uterine artery embolization
c) Gn RH analogues
d) Hysterectomy
e) Progestogens
Key:d
Table 1.
General Nutrition Advice for Patients Who Fast

Avoid caffeinated drinks, fatty foods, heavily processed foods, and highglycemic
carbohydrates (e.g., refined flour or sugar, white bread, white rice).

Use monounsaturated oils, such as olive or canola oil, in cooking.

Eat a well-balanced predawn and evening meal during each day of the Ramadan fast. The
predawn meal is called suhoor and the evening meal is called iftar.

Emphasize complex carbohydrates that release energy more slowly while fasting (e.g.,
barley, wheat, oats, millet, semolina, beans, lentils).

Hydrate aggressively during nonfasting hours, especially in warmer climates.

Increase fiber-rich foods for slow digestion (e.g., bran, whole-grain cereals, whole-grain
bread, grains, fruits).