OBG TEST @ DISCUSSION

GYNECOLOGY
• DR.RAMYASREE B DNB OBG

• INFERTILITY SPECIALIST

• MRCOG 1

• NATIONAL WIDE FACULTY FOR OBG FOR NEET PG ASPIRANTS AND FMGE
STUDENTS

• RECEIVED CERTIFICATE OF MERIT FOR BEING TOPPER IN MBBS PHASE3 PART

1 EXAMSIN 2009 • WINNER OF STATE LEVEL QUIZ ON CONTRACEPTION AT
KSOGA 2015

• LIFE MEMBER OF FOGSI , IMA .

• PRESENTED MANY CASES IN BSOG

1 )A 25 year old female has perfectly normal cycles since her puberty . Which of the following
pattern of hormones is expected in the proliferative phase,around the time of ovulation and
in luteat phase respectively ?

A. increased fsh , lh surge ,low estradiol

B. increasing estradiol , high fsh , high inhibin A
C.HIGH PROGESTERONE , HIGH FSH , HIGH ESTRADIOL
D.INCREASING ESTRADIOL ,high fsh, low inhibin a

2 ) A 21-year-old woman undergoes a laparoscopic ovarian cystectomy to remove adermoid

cyst. Three days after the operation, she presents to theemergencydepartment feeling unwell

and her haemoglobin level is found to be 6 g/dL. Damage to a blood vessel is suspected from

the laparoscopic procedure.Which vessel crosses the common andexternal iliac artery in the

infundibulopelvic fold?

A. Femoral artery B. Inferior mesenteric artery

C.Median sacral artery D. Ovarian artery
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3) amh secreted by which cells in female

a. Leydig cell b. Sertoli cell

c. Theca lutein d. Granulosa cell

4 ) Which of the following is true regarding Organ of Rosenmuller?

A.Forms paraovarian cyst
B.Consist of horizontal tubules in mesovarium
C.Tubules are lined by columnar cells
D.Represents cranial end of the Wolffian body

5 ) Identify the correct statement for the following image ?

A.Seen in a female fetus with CAH
B.Seen in male fetus with CAH
C.Is remanant of wolffian duct
D.Is remanant of Mullerian duct

6 ) Which of the following occurs first in the majority of girls with normal pubertal
development?

A. Achieving peak height velocity B. Menarche

C. Breast development D. Development of pubic hair

Q7 )A 35 year old women with three years of infertility

came to hospital for further investigation , vaginal smear
obtained on day 22 shows the following what is the
diagnosis ?
A.ovulatory cycle B.anovulatory cycle
C.premature ovarian failure D.b/l cornual block

8 ) An 18 year old unmarried girl comes with complaints of heavy, prolonged bleeding during
menses. Which among the following investigations is NOT usually advised?

a.Urine pregnancy test b.Ultrasound uterus and adnexa

c,.Coagulation profile d. Dilatation and curettage
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9.Which one of the following is true about Basal body temperature?
1. Biphasic pattern
2. Increase in the level of progesterone and norepinephrine
3. Temperature falls by 0.5˚C after ovulation
4. It can predict ovulation precisely
•Select the correct answer using the code given below:

A.1and 3 B. 1 and 2
C. 1 and 4 D. 2 and 3
10 ) A 25 year old woman on a routine usg done on day 24 of her cycle , shows a incidental
finding of a small thich walled right ovarian cyst with peripheral vascularity. A follow up scan
done days post menstrually shows no such cyst . The most probable mechanism involved in
resolution of this cystic structure is ?
A. increased levels of progesterone B.increased levels of estrogen
C.decreased levels of lh D.decreadsed levels of fsh

11 ) The following organism is associated with ?

a.Curdy white discharge
b.Iucd users
c.Greyish white foul smelling discharge
d.Pruiritis

12 )A 37-year-old female, on oral

contraceptives presents with whitish vaginal
discharge. She does not have soreness or
itching. The discharge causes yellowish stains
in her underwear. pH of discharge is acidic.
Microscopy shows normal number of
lactobacilli. Most appropriate diagnosis is:
a. Bacterial vaginosis B. Leucorrhea
B.Chlamydia! Infection D. Vaginal candidiasis

13) a 25 year old patient comes with fever ,

pelvic pain , foul smelling discharge . Usg
shows as follows, what is the diagnosis ?
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A. chronic ovarian cyst
B. parovarian cyst
C. ovarian abscess
D. pyosalphnix

14 .IDENTIFY THE STRUCTURE ?

A.B/L PYOSALPHINX
B. NORMAL HSG
C.B/L CORNUAL BLOCK
D. B/L FIMBRIAL BLOCK

15 ) A 20-year-old pregnant woman presented to the

genitourinary medicine clinic with anogenital warts. She is
diagnosedas in image .What are her treatment options?

A. 5-fluorouracil.
B. Cryotherapy.
C. Imiquimod.
D. Podophylline.

16 )During diagnostic laparoscopy on a 28-year-old female for chronic pelvic pain, you noticed
inflammation of the liver capsule and adjacent peritoneum.
What is the most likely causative
organism?
A.Calymmatobacteriumgranulomt
s
B.Chlamydia trachomatis.
C.Haemophilus ducreyi.
D.HSV-type 2.
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GYNECOLOGY

17)A 24-year-old woman comes to the genitourinary medicine

clinic complaining of small multiple groups of painful vulval
ulcers. On examination, the base of the ulcer was
erythematous and inguinal lymph nodes were painful. What is
the most likely diagnosis?
A.Chancroid.
B.Granuloma inguinale.
C.Herpes simplex virus (HSV).
D.Lymphogranulma venereum.

18. A : Pregnancy favours monilial vaginitis

R: Vaginal pH decreases during pregnancy
A.Both A and R are true and R is the correct explanation of A
B.Both A and R Are true but R is not a correct explanation A
C.A IS TRUE BUT R IS FALSE
D. A IS FALSE BUT R IS TRUE

19 )What is true about primary amenorrhea ?

1.A.no menarche by 15 years
2.B. no thelarche by 13 years
3.C.gap >3 years between menarche and thelarche 4
4.D. low tsh and short startures
a.1, 2 b.1,2,3 C1,2,3,4 D1,4

20)Which test is of least significance in mosaic

turner
A.echo B.audiometry
C.GTT D. ANA
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21) 20 year old young girl presents to the clinic with primary amenorrhea. She has a female
phenotype, height 150 cm, poorly developed breasts. Further evaluation was done. Vagina
was present on examination, Ultrasound revealed normal uterus but gonads weren’t
detected. Further evaluation done showed 46 XYkaryotype.
The most probable diagnosis
A.Androgen insensitivity syndrome B. Noonan’s syndrome
C.True hermaphrodite D.Swyer syndrome

22) Female presents with virilisation . Clitromegaly with blins vagina . Pubic hair is normal
and breast is tanner stage 2. karyotype is xy . What is the diagnosis ?
A. sweyer syndrome B.ais
C. 5 alpha reductase deficiency D.17 hydroxylase deficiency
23) A 23-year-old female came with complaints of 4 months amenorrhea. The
FSH and LH were elevated above the normal value, thyroid function test were
normal. Which is the next step in management?
A.Give progesterone and stop after 10 days for withdrawalbleeding
B.Check USG for polycystic ovaries
C.Estimate serum estradiol values
D. Do a urine pregnancy test

24) Child with primary amenorrhea with negative progesterone challenge test but positive
combined progesterone and estrogen test. Diagnosis may be:

a.Mullerian agenesis B .PCOD

C.Asherman syndrome D.Prolactinoma

25) 35 year old, mother of two children is suffering from amenorrhea from last 12 month. She
has a history of failure of lactation following second delivery but remained asymptomatic
thereafter. Skull X-ray shows empty sella diagnosis is:

a. Menopause b. Pituitary tumor

c.Sheehan’s syndrome d. Intraductal papilloma of breast

26) A 20-year-old woman is referred to the gynaecology clinic having had amenorrhoea for
the past 6 months and a negative pregnancy test. She has recently noticed anincreased
growth of hair on the face, chin and chest with clitoromegaly. Her blood test results show
very high levels of 17-hydroxyprogesterone.?
A.ADRENAL CANCER B. ADRENAL ADENOMA
C .OVARIAN CANCER D. CAH
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27. All of the following are causes of premature ovarian failure except:
A.Fragile X syndrome B. Kallmans syndrome
C.Mumps oophoritis d. Turner’s syndrome

28 ) A 32-year-old woman complains that she has not had a period for 3 months. Four home
pregnancy tests have all been negative. She started her periods at the age of 15 years and
until 30 years she had a normal 27-day cycle. She had one daughter by normal delivery 2
years ago, following which she breast-fed for 6 months. After that she had normal cycles
again for several months and then her periods stopped abruptly. She was using the
progesterone only pill for contraception while she was breast-feeding and stopped 6 months
ago as she is keen to have another child. She reports symptoms of dryness during intercourse
and has experienced sweating episodes at night as well as episodes of feeling extremely hot
at any time of day. There is no relevant gynaecological history. The only medical history of
note is that she has been hypothyroid for 10 years and takes thyroxine 100 μg per day. She
does not take any alcohol, smoke or use recreational drugs.Examination findings are
unremarkable Haemoglobin 12.2 g/dL White cell count 5.1 10*9/L
Platelets 203 10*9/L Thyroid-stimulating hormone 3.6 mu/L Follicle-stimulating hormone
45 IU/L Luteinizing hormone 30 IU/L What is the diagnosis ?
A. menopause B. pregnancy
C.premature ovarian failure D.pcos

29)An 18-year-old national gymnastic champion is referred to you. She experiences long
periods of secondary amenorrhea and she only has two to three periods each year. She is
training for the coming Olympics but her general practitioner advised her to visit you because
she is worried about her. She suffers from backache. Her BMI is 16.
What will you offer her?
A. Cyclic COCP. B. Cyclic progesterone for withdrawal bleeding.
C.Depomedroxy progesterone acetate. D.GnRH analogue.

30) 54 year old female with amenorrhea from last 16 months , what should be the hormone
levels ?
A. increased LH , decreased FSH B.Increased LH and FSH
C. high FSH, low LH D. LOW LH AND FSH
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31) A 48 years old female suffering from severe endometriosis underwent
hysterectomy. She wishes to take hormone replacement therapy. Physical
examination and breast are normal but X – ray shows osteoporosis. The
treatment of choice is:

a. Progesterone b. Estrogen and progesterone

c. Estrogen d. do not give hrt

32 )Hrt causes all except ?

A.low risk of hip fracture B. high risk of breast cancer
C.high risk of endometrial cancer D. high risk of colon cancer .

33) A 48-year-old woman presents with intermenstrual bleeding for 2 months.

Episodes of bleeding occur any time in the cycle. This is usually fresh red blood
and much lighter than a normal period. It can last for 1–6 days. There is no
associated pain. She has no hot flushes or night sweats. She is sexually active
and has not noticed vaginal dryness.She has three children and has used the
progesterone only pill for contraception for 5 years.Her last smear test was 2
years ago and all smears have been normal. She takes no medication and has no
other relevant medical history. IDENTIFY ?
A. endometrial polyp
B. endocervical polyp
C. cervical ectropion
D. cervical malignancy

34. 30 year old woman with complaint of dysmenorrhoea, dyspareunia with chronic pelvic
pain undergoes hysterectomy. From the cut section of hysterectomy specimen below identify
the condition:
A.Adenomyosis B.Fibroids
C.Leiomyoma D.ENDOMETRIOSIS

35)A 36 year old female, with two alive children

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complains of dysmennorhea and dyspareunia. TVS shows a thin walled cyst 4cm*5cm with
ecogenic fliud and no solid areas in right ovary. She dosent wish to concieve. Which is first
line management?
A.Perform lapaoscopic cystectomy
B.Treat with OCP continuously
C.Treat with GnRH
D.Treat with injection DMPA

36 )All are given in endometriosis except ?

A.estrogen valerate B.leuprolide
C.mpa D. acbergoline

37) 33 year old female case of heavy menstrual bleeding managed initially with non hormonal
treatment failed , next management is ?
A.hormonal treatment B.endometrial sampling
C.endometrial ablation D. hysterectomy

38)A 43-year-old patient is admitted with acute urinary retention, fever and dysuria. She
recollects having heavy periods for the past few months. On examination there is a central,
20-week-sized mass.?
A.transcervical resection of the endometrium (TCRE)
B. catheterisation and antibiotics
C. total hysterectomy
d.myomectomy with a prior gonadotrophin-releasing hormone (GnRH)analogue

39) A 45- year old multipara lady has single fibroid deducted on a routine USG. The fibroid in
in fact palpable clinically and in found to be 14-16 cms in size. The patient is currently
asymptomatic. What is the next line of management?

A. No treatment as asymptomatic B. Myomectomy

C.Hysterectomy D.Medical management
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40) A 30 year old, para two, with two live children has
menorrhagia for 2 years. She was ligated 4 years back. On
investigation, she is found to have a 2 cm × 2 cm submucous
myoma. What will be the best management option for her:

a. Total abdominal hysterectomy

b. Danazol 400 mg twice daily for 3 months
c. GnRH analogues
d. Hysteroscopic myoma resection

41 )Primary dysmenorrhea is ?
A.gnrh is the first line treatment
B.pain starts 1 day prior to resolves in 24 hrs post menstruation
C.psychological factor
D. pain starts 2 – 3days prior and resolves in 48 hrs

42) HSG is done:

a. day 2-3 B.day 8-10

C.day 14-20 d. At any time

43) What is the best way to differentiate between class 4 and class 5 uterine malformations ?

A. hsg B. mri
C.3 d usg D. SSG

44.What is the diagnosis of the following hsg

?
a.TB
B. GONOCOCCI
C.B/L CORNUAL BLOCK
D. POST TUBECTOMY
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45)WHAT is the diagnosis ?

A.TB
B.Gonococci
C.unicornuate uterus
D.didelphys

46)Identify the image ?

A. endometrial pipelle
B.karmans cannula
C. uterine curette
D. uterine retractor

47) A 59-year-old female with history of ovarian carcinoma in the

mother achieved menopause with smooth transition. And she is on
hormone replacement therapy. She developed abdominal pain and the
right adnexal mass was palpable, non tender. On routine examination
she has a 3×3 cm smooth cyst in her ovary. Which is the next step?
A.Do CA-125 levels, if normal advise regular checkup
B.Confirm USG findings by ordering CT scan
C.Do an exploratory laparoscopy to visualize the nature of cyst
D.Reassure and advice regular follow up once in 6 months

48) Which of the following strategy has been recommended to reduce the heredity risk for
ovarian cancer in women with BRCA - 1 and BRCA - 2 mutations

a. Use of oral contraceptive pills b. Screening with transvaginal ultrasound

c. Screening with CA - 125 d. Prophylactic oophorectomy
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49)An 18-year-old girl presents to her general practitioner with distention of theabdomen. An
ultrasound scan reveals a unilateral solid/cystic mass on the left side. An MRI scan confirms
that the ovarian tumour is confined to the left ovary and the right ovary looks normal.
However, her tumour markers, beta human chorionic gonadotropin (beta hCG) and alpha
fetoprotein, were normal. Sheis then referred to the gynaecology oncology centre for further
management,
following which she undergoes staging laparotomy and left-sided oophorectomy. One of the
components of the histology shows elements of glial tissue.
A Benign teratoma B Choriocarcinoma

C Dysgerminoma D immature teratoma

50) A 56 year old female who attained menopause 3 years back has come with pain abdomen
. She has no history of PMB . No h/o foul smelling discharge or itching . On tvs scan shows a
right ovarian cyst of 5*6 cm with image as below . CA 125 done is reported as 50 iu /ml ,
what is the RMI score for the patient ?
A. 1000
B.450
C.50
D. 1350

51) A 35-year-old lady with post coital bleeding management is:

a. Clinical examination and pap smear

b. Visual examination with lugol iodine
c. Visual examination with acetic acid
d. Colposcopy
52 ) False statement regarding the procedure shown below is:
A. Used to treat high grade CIN
B. Uses freeze thaw freeze technique
C. Destroys dysplastic epithelium up to a depth of
5mm
D. It is an OPD procedure
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53) A 25YEAR old lady has a routine smear and is reported as having moderate dyskaryosis.
What is appropriate management?
a. Cryotherapy B. cryoablation
C. LEEP D. colposcopy

54) A 32old nulliparous woman is diagnosed with a cancer lesion at the anterior lip of the
cervix with extension of 6 mm and stromal invasion of 8 mm. There is no parametrial
invasion, neither is there any lesion elsewhere. Cystoscopy and sigmoidoscopy are normal.
She asks for fertility sparing treatment.
What is the most appropriate treatment in her case?
A. Chemoradiation.
B.Radical hysterectomy.
C.Radical trachelectomy and pelvic lymph node dissection.
D.Simple hysterectomy

55 ) A 60 YEARold woman presents with a first episode of PMB. What is the most appropriate
first line of investigation?

A. Dilatation and Curettage to assess the endometrium

B. Hysteroscopy to assess the endometrial cavity and obtain an endometrial sample
C. Pipelle biopsy to obtain an endometrial sample
D. Transvaginal sonography to assess the endometrial thickness

56 ) A 60 year old undergoes hysterectomy and bilateral salpingooophorectomy for grade 1

endometrial cancer. The final histology report confirms tumor invading the uterine serosa. As
per the new FIGO staging of endometrial cancer, what is the stage?

A. Stage IC B. Stage IIC

C. Stage IIIA D. Stage IIIB

57 )A 48-year-old woman is complaining of abnormal uterine bleeding, which has lasted for
two years. She has tried the combined oral contraceptive, oral progestogens, tranexamic acid
and mefenamic acid but without any improvement. She has three children and has been
sterilized. Her last cervical smear was two years previously and was normal. She had surgery
for breast cancer four years before. Her pelvic scan shows no uterine abnormalities. Her
endometrial sampling is normal.
What would you offer her as a further step of treatment?
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A. Endometrial ablation.
B.Expectant management awaiting the
menopause.
C.Hysterectomy.
D.Levonorgestrel-releasing intrauterine
system (LNG-IUS).

58) A woman who underwent D&C for molar pregnancy 6months ago presents with
persistent symptoms of abdominal pain and distention. On further evaluation, beta HCG
levels were persistently elevated and cannonball foci were found on the chest xray. What is
the appropriate management in this case?
A) Methotrexate with folinic acid B) Methotrexate
C) EMACO regimen D) Hysterectomy

59 )A 62-year-old lady attends the gynaecology clinic with a mass descending per vaginum.
She underwent total abdominal hysterectomy with bilateral salpingooophorectomy 10 years
ago for severe menorrhagia. On examination there is a grade II vault prolapse with poor
pelvic tone.?
A.transvaginal sacrospinous fixation
B. Reassure
C. open sacrocolpopexy
D. posterior intravaginal sling plasty

60 )An 82-year-old lady has a complete vaginal prolapse. She is living in a nursing home and
suffers from severe dementia, frequent urinary retention and ischaemic heart disease. On
examination she has a grade III uterovaginal prolapse with a grade III cystocele and rectocele.
There is a 2 cm decubitus ulcer on the cervix. The vaginal wall is thin and atrophic.?
A. vaginal hysterectomy
B.local oestrogens
C. do nothing
D. ring pessary and oestrogens
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61) Kamla, a 48 years old lady underwent hysterectomy. On the seventh day, she developed
fever, burning mictuirition and continuous urinary dribbling. She can also pass urine
voluntarily. The diagnosis is:
a. Vesicovaginal fi stula b. Urge incontinence
c. Stress incontinence d. Ureterovaginal fi stula

62 ) Dye test for fistula, all are true except:

a. If the middle swab is stained with dye, the diagnosis is vesicovaginal fistula
b. If the lower swab is stained with dye, the diagnosis is urethrovaginal fistula
c. Upper most swab stained with urine but not with dye and lower two swabs are dry,
diagnosis is ureterovaginal fistula.
d. If the middle swab is stained with dye, the diagnosis is genuine stress incontinence.

63) A 40-year-old lady who is para 2 is diagnosed with urodynamic stress incontinence.
She has tried pelvic floor exercises but has not found it to be useful. She is a fitness
instructor.Whatisthemostappropriatemanagement?
A.Burch colposuspension

B. tension-free vaginal tape

C. collagen injection
D. weight reduction

64. A young multiparous woman of 30 years age had 3rd degree of

uterovaginal prolapse without any cystocele or rectocele. There is no stress
incontinence. The uterus is retroverted. Uterocervical length is 3 inches. All
other symptoms are normal. The best treatment plan for her will be: • a.
Observation and reassurance till child bearing is over
A.Observation and reassurance till child bearing is over
b.Shirodkar’s vaginal repair
c.Shirodkar’sabdominal sling
d. Fothergill’s operation
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65)A 47-year-old presents with irregular, heavy bleeding. She is para 2 and has been
sterilised. She continues to bleed with cyclical progesterone prescribed by her GP. what is the
next step ?
A. hysteroscopic biopsy B. endometrial pipelle
C. d and c D. tvs

66 ) A 20-year-old girl attends the family planning walk-in clinic for a pregnancy test, which is
positive. She is unsure of the date of her last menstrual period. She is a smoker and defaulted
on her last depot contraceptive injection. She was treated for abdominal pain and discharge
per vaginum last week. What is the most appropriate option?
A.serum bhcg B. tvs
c,. Tas D. mtp

67) Which method the following picture depicts ?

A.billings method
B.symptothermal method
C.calendar method
D. standard day method

68 )What is the advantage of the following contraceptive over all other barrier
contraceptive /
a.Reusable
b.Prevents STD
c.Prevents pregnancy
d. No added benefit

69)A 28 YEAR OLD PATIENT INSERTED CUT 3 YEARS BACK CAME

FOR FOLLOW UP ,XRAY DONE SHOWS THE FOLLOWING , WHAT IS
THE MANAGEMENT ?
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A.Reassure and send
B.USG removal
C.Laparoscopic removal
D.Hysteroscopic removal

70 ) Female having inserted cu t 6 months ago . Now she has amenorrhea since two cycles .
Cause may be ?
A. pid B. endometriosis
C. ectopic pregnancy D, perforation

71) 32 year old becomes pregnant with iucd insitu , tail of iucd being seen next course of
action is ?
a. MTP
b. REMOVE THE IUCD
c. CONTINUE THE PREGNANCY
d. REMOVE IUCD AND TERMINATE
PREGNANCY

72) A couple is advised to use barrier methods after vasectomy till :

A.3 months
B.no sperms in ejaculate
C.next 15 ejaculations
D. none of the above

73 ) A 32 year old woman, P2L2 has come to the hospital for

advice on contraception. She is a model and couldn’t
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tolerate excessive weight gain.When asked about her
menstrual history, she says that she soaks through a pad
every 2 to 3 hours and she has to get up in the middle of the
night to change her pad. She also has severe cramps. She
said she doesn’t prefer taking pills because she has never
been able to remember to take a pill daily.What is the best
method of contraception?

a)Depot- medroxyprogesterone acetate

b)Progestin- only pill (minipill)
c)Combined oral contraceptive pills
d)Levonorgestrel – IUS

74 ) All the following are emergency contraception except ?

A. RU 486 • B LNG IUS •
C. CENTROCHROMAN • D.CU T

75 ) Female missed OCP on 4 DIFFERENT days in 1st 2 week of menstrual cycle

What will you advise ?
1) continue taking the pill
2) take all 4, pills at once and continue taking pills
3) adopt another method of contraception
4) Continue current pack, consider additional contraceptive method for
remaining days.. N consider emergency contraception if unprotected intercourse
happened in last 2days.

76) Use of OCP’s are known to protect against following malignancies except:
a. Ovarian carcinoma b. Endometrial carcinoma
c. Uterine sarcoma d. Carcinoma cervix

77) A 39-year-old woman consults you about the risk of venous thrombosis if she uses a
combined hormonal contraceptive. She shows you a brand, which contains 35 μg
ethinylestradiol and levonorgestrel norethisterone. How will you counsel her?
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A.She should change to an intrauterine contraceptive device.
B.She should change to another oral contraceptive, which contains one of the new
progestogens.
C.Her current pill has the lowest risk of blood clotting.
D.Her current pill has the highest risk of blood clotting.

78 ) On a Saturday morning, an 18-year-old girl comes to the accident and emergency

department requesting advice as she had unprotected sexual intercourse on the 18th day of
her cycle. She does not wish to become pregnant. She did
not accept your advice for an intrauterine device (IUD) fitting. What alternatives can
you offer her?
A.Copper IUD is the only available option for women on enzyme-inducing medications.
B.Offer hormonal emergency contraception and advise her to stop the enzymeinducing drugs
until she has her next period.
C.Offer a single 30 mg dose of progesterone receptor modulator, ulipristal acetate(UPA)
(ellaOne®).
D.Offer a single 3 mg dose of levonorgestel (LNG)

79)Following instrument is used for ?

A)tubal ligation
B)clamp ovarian pedicle
C)uterine pedicle clamp for hysterectomy

80) The contra eption method shown below is made of:

A.Quinacrine pellet
B.Quinacrine pellet with LNG
C.Molybdenum-cobalt steel alloy
D.Nickel-titanium steel alloy
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81) All the following are options for ovulation induction except

A.Ovarian drilling B.Ulipristal

C.Letrozole D.Clomiphere Citrate

82.A 50-year old woman presents with abdominal uterine bleeding for 2 years. What shall be
the next of management?

A.Hysterectomy B.LNG – IUD

C.Endometrial aspiration and cervical curettage D.Progesterone for 3 months

83 )A 32 year old visit on infertility clinic with regular cycles of 28 days. What should
be the test for ovulation?
A. Serum LH at 21 days B.Serum progesterone at 21 days

C.Serum LH at 14 days D. Serum progesterone at 14 days

84) An couple with primary infertility for 2 years presents at an infertility clinic. The
woman is 28 yrs old, a known case of PCOD, has had 3 cycles of clomiphene therapy with
demonstrated ovulation but no pregnancy. Her HSG report shows bilateral patent tubes
and a normal intrauterine cavity.
The male partner is a healthy 30 yr old, with a semen analysis showing a total sperm count
of 15 million, progressive motility of 40 %, normal sperm morphology in 20 % sperms.
Which of the following should be the next step in management?
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A.ovulation induction with intrauterine insemination
B. Letrozole with follicular monitoring and timed intercourse
C, In vitro fertilization
D. TESA followed by ICSI

85) A 36-year-old Asian woman attends the infertility clinic with her husband. She has been
trying to conceive for the last 2 years. She is overweight and gives a history of irregular
periods over the last 2 years. Her history and investigations are suggestive of polycystic ovary
syndrome (PCOS). She has been using clomiphene citrate for the last 6 months with day 21
progesterone of 10 ng/L. Her husband’s semen analysis is normal.what is management ?
a.Perform laparoscopy and dye test
B Arrange in vitro fertilisation
(IVF)
C.Bilateral ovarian drilling
D.Counsel and offer support

86) Ms XY (30 years) and her male partner (26 years) have been trying to conceive naturally
for the last 3 years. They have had infertility investigations over the last year. These include a
normal semen analysis, normal USS pelvis, normal HSG, normal TSH, prolactin, D3 FSH, LH
and normal AMH. Her day 21 progesterone suggest ovulation. Ms XY is rubella immune and
has negative swabs for an STI. Her recent cervical smear is normal. Which of the following
treatment options are best suited to her?
A. Clomiphene citrate
B. IUI
C. IVF-ICSI
D. IVF

87 ) PESA/MESA is helpful in:

a. Pretesticular azoospermia b. Testicular azoospermia
c. Post-testicular azoospermia d. Asthenospermia

88) pulsatile gnrh is indicated in ?

A. endometriosis B. precocious puberty
C. male infertility D.FIBROID
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89) A couple present to the subfertility clinic for results. The female partner has an FSH of 6.1
IU/L, an LH of 4.8 IU/L, a prolactin of 210 nmol/L and a day 21 progesterone of 38 nmol/L.
Laparoscopy 6 months ago showed a normal pelvis. She is awaiting HSG. Semen analysis
results were as follows: volume 3 mL, sperm count 10 106million/ml, 18 per cent forward
progression with motility and normal forms greater than 50 per cent. No agglutination or
white cells were found. No organisms were seen.?
A. oligoasthenospermia B.oligospermia
C.erectile dysfunction D.hypospadiasis

90) Patient in infertility treatment with hMG and USG given below diagnosis ?
a) OHSS
b)Theca lutein cysts
c)granulosa cell tumor
d)PCOS

91) Which of the following is best marker of ovarian reserve:

A. Serum FSH B. Inhibin A
C. Inhibin B D. Serum anti mullerian hormone

92)Lady with infertility with bilateral tubal block at cornua; best method of management is:

a. Laparoscopy and hysteroscopy b. Hydrotubation

c. IVF d. Tuboplasty

93 ) Female with primary infertility with pcos , hirsutism , BMI > 30 . What do you advise ?
A. finasteride
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B.finasteride + metformin
C.weight loss +metformin+ clomiphene citrate
D. weight loss +metformin +urinary gonadotrophin

94 ) In Abdominal hysterectomy, the first clamp

includes:
a.Uterine artery
B.Cornual structures
C.Uterosacral.ligament
D.None of the above

95 )Women of 40 years age with severe cardiac compromise , she had to undergo an
operation for which the surgeon gave clearance , which of the following surgery must not be
done ?
A.total hysterectomy B. subtotal hysterectomy
C. vaginal hysterectomy D. laparoscopic hysterectomy

96 ) a 25 year old lady with septate uterus was undergoing hysteroscsopic septal resection
,the surgeon was using normal saline as irrigating fluid for the cavity . During the surgery the
nurse informs that there is a 1000 ml deficit of irritating fluid . What is the next step to be
done ?
a.Stop the surgery
b.Change the fluid to glycine
c.Continue the surgery with careful monitoring of fluis status
d,give furosemide to patient and continue surgery
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97) WHERE IS THE FOLLWING INSTRUMENT USED ?

A.LAPAROSCOPY
B . HYSTEROSCOPY
C. FALLAPOSCOPY
D. HSG