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Year 5 Obstetrics & Gynaecology (2)

Total questions: 15

Worksheet time: 9mins

Name
Class
Date
1.

A 20-year-old primigravida is complaining of abdominal pains at 8 weeks gestation. Ultrasound shows a missed miscarriage. What would support her diagnosis?

a)

Absent gestational sac

b)

Below 5th centile growth

c)

Congenital anomaly of fetus

d)

No fetal heart activity

2.

A 23-year-old woman fainted at home earlier. She is now attending A&E with shoulder tip & abdominal pains. Her blood pressure is 95/50 mmHg and pulse rate 120bpm.


What is the most appropriate diagnostic test?

a)

Culdocentesis

b)

Diagnostic laparoscopy

c)

Transvaginal ultrasound

d)

Serum gonadotrophins

3.

A 21-year-old student presents with offensive vaginal discharge. She is taking the combined contraceptive pills. There is tenderness and an inflammed cervix.


Which of the following would be an appropriate action?

a)

Analgesics for symptom relief

b)

Review of her contraceptive method

c)

Screening her sexual partner(s)

d)

Undergo a Pap smear testing

4.

A 28-year-old has dysmenorrhoea & irregular menses. She has no living children despite trying.

What is the most appropriate investigation?

a)

Day 21 progesterone

b)

Dilatation and curettage

c)

Menopausal serum markers

d)

Pelvic ultrasound scan

5.

An unmarried 37-year-old woman has abdominal pains. It worsens during her periods and when she opens her bowels.


What is the most appropriate treament for her?

a)

Gonadotrophin releasing hormones analogues

b)

Laparoscopic ovarian drilling

c)

Laser cauterization of uterosacral ligaments

d)

Oral progestogen medications

6.

A 32-year-old woman is asking contraceptive advice. She has had two unwanted pregnancy terminations and previous PID. What is the best option for her?

a)

Barrier method

b)

Intramuscular progesterone

c)

Copper intrauterine device

d)

Combined oral contraceptives

7.

A 31-year-old has been married to a 45-year-old with no children. Her periods are normal and recent HSG shows bilateral dye spillage.


What is the most likely cause for the couple’s infertility?

a)

Anovulation

b)

Male factor

c)

Relationship problem

d)

Tubal blockage

8.

A 36-year-old has had 2 early miscarriages in the past with no living children. Lately she has heavy painful periods and occasionally irritable towards her husband.


What is the most likely cause?

a)

Premature menopause

b)

Ovarian cyst

c)

Endometriosis

d)

Uterine fibroids

9.

A nulliparous 23-year-old has stopped her periods over the past 3 months.


Which is an appropriate first-line test?

a)

CT pituitary gland

b)

Serum prolactin

c)

LH / FSH assays

d)

Pelvic ultrasound

10.

A 28-year-old has feels that she has put on some weight lately. She attained menarche at 13 and has regular periods since. Examination shows visible hair on her face with florid acne.


What initial treatment should be given to her?

a)

Antibiotics

b)

Clomifene

c)

Combined contraceptive pills

d)

Metformin

11.

A 48-year-old has irregular heavy periods. Her last Pap smear was 5 years ago.


What is the most likely cause?

a)

Benign neoplasm of the uterus

b)

Dysfunctional uterine bleeding

c)

Female genital tract carcinoma

d)

Postmenopausal hormonal status

12.

A 70-year-old is at the gynae clinic for an examination and an ultrasound scan. Which of these would be a worrying finding?

a)

Fissures at the posterior fourchette

b)

Uterine wall thickness of 2mm

c)

Presence of dilated loops of bowel

d)

Palpation of an adnexae mass

13.

A 8-year-old has just begun menstruating. On examination she has axillary hair and secondary sexual characteristics.


What is the likely cause?

a)

Hyperthyroidism

b)

Mature teratoma

c)

Stromal ovarian tumour

d)

Renal hyperplasia

14.

You are examining a 50-year-old at Klinik Kesihatan when you see a friable suspiscious lesion on her cervix. What is next step of management?

a)

Pap smear

b)

Colposcopy

c)

Punch biopsy

d)

Referral to hospital

15.

A 60-year old has has severe post- menopausal symptoms. She is keen on the hormone replacement therapy (HRT).


What following advice is correct when counselling the patient?

a)

Decresed risk breast cancer

b)

Worsening cognitive function

c)

Increased cardiovascular risk

d)

More prevalent osteoporosis