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1.A 23-year-old woman is using male and female barrier contraception to prevent sexually transmitted infections (STIs). She wants to know if there is further protection if a spermicide is included.What will you tell her regarding spermicidal creams and STIs?CorrectIncorrect
2.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 progestogen. How will you counsel her?CorrectIncorrect
3.A 28-year-old woman consults you about combined hormonal contraception (CHC). Her mother died of breast cancer at the age of 55 years. She is healthy but has a problem with painful periods. What will you tell her?CorrectIncorrect
4.A 17-year-old girl comes to the accident and emergency department. She had unprotected intercourse four days previously. She was not very keen on an intrauterine device (IUD). What other alternatives do you wish to offer?CorrectIncorrect
- A woman with sickle cell disease is seeking a long-acting reversible contraception method. She is asking if there is any method that may also help reduce her risk of sickle cell crisis and pain. What well you tell her?
6.A mother brings her 12-year-old daughter to your office for consultation. She is concerned because most of the other girls in her daughter’s class have already started their period. She thinks her daughter hasn’t shown any evidence of going into puberty yet. Knowing the usual first sign of the onset of puberty, you should ask the mother which of the following questions?CorrectIncorrect
7.A 17-year-old consults you for evaluation of disabling pain with her menstrual periods. The pain has been present since menarche, and is accompanied by nausea and headache. Her medical history is otherwise unremarkable, and pelvic examination is normal. She is not currently sexually active, and she has not tried any therapy for her dysmenorrhea.CorrectIncorrect
- A mother brings her daughter to see you for consultation. The daughter is 17 years old and has not started her period. She is 4 ft 10 in tall. On physical examination, she has no breast buds or pubic hair. Her pelvic examination demonstrates a uterus and cervix, but the ovaries are not palpable. As part of the workup, serum FSH and LH levels are drawn and both are high. Which of the following is the most likely reason for delayed puberty in this patient?
9.A 29-year-old P0 presents to your office with a chief complaint of symptoms of premenstrual syndrome (PMS). A detailed history reveals that she experiences emotional lability and depression for about 10 days prior to her menses. Once her period starts, she feels “back to normal.” She also reports a long history of premenstrual fatigue, breast tenderness, and bloating. Her previous physician prescribed oral contraceptives to treat her PMS 6 months ago, and she reports that the pills have alleviated all her PMS symptoms except for the depression and emotional symptoms. Which of the following is the best next step in the treatment of this patient’s problem?CorrectIncorrect
10.A 21-year-old woman presents to you for management of menstrual migraines. She has no other medical problems, does not smoke, and does not take any medications routinely. Her periods are regular and last 5 days. She says the flow is moderate and she does not have dysmenorrhea. She is sexually active with her partner of 1 year, and she uses condoms for contraception. She says she develops a debilitating migraine for the first 2 days of her period every month. She describes her headaches as unilateral, throbbing, and associated with nausea and photophobia. She has missed work due to these symptoms.What is the best next step in management of her migraines?CorrectIncorrect
11.A parous 35-year-old woman complains of cyclical heavy and painful menstrual bleeding. On
examination she is found to have an enlarged, ‘boggy’ uterus and a TVUSS suggests the possibility of adenomyosis. She has completed her family and currently relies on condoms for contraception. She smokes 10 cigarettes per day but is otherwise fit and well. Which treatment would you consider most appropriate? Choose the single best answer.CorrectIncorrect
12.Submucous fibroids are not associated with which of the following presentations? Choose the single best answer.CorrectIncorrect
13.A 40-year-old woman is found on pelvic examination to have an enlarged uterus. Ultrasound reveals a well-circumscribed intramural mass consistent with the leiomyoma. The patient asks: what is the incidence of sarcomatous degeneration in a uterine leiomyoma?CorrectIncorrect
14.A 36-year-old woman is complaining of having had heavy menstrual bleeding (HMB) two years. Abdominal examination reveals a 20-week sized uterus and her pelvic scan shows multiple interstitial fibroids. Her haemoglobin level is 9 gm/dL. She is nulliparous and wishes to preserve her fertility. What management option would you recommend?CorrectIncorrect
15.A 24-year-old woman is counselled regarding surgical treatment of a 7-cm symptomatic fibroid. She is keen to know all the facts and particularly wants to hear about new techniques. She wants to know the effect of the procedures on her future fertility. What information can you give her?CorrectIncorrect
16.A 39-year-old patient presents with symptoms of leakage of urine upon coughing, sneezing and during exercise. The symptoms started following the birth of her second child 18 months ago. What would be the first line of management?CorrectIncorrect
17.A 39-year-old para 1 patient presents with stress incontinencewith no other urinary symptoms. What would be the first line of management?CorrectIncorrect
18.A 38-year-old patient is suffering with stress incontinence. Her BMI is 32 kg/m2 and the patient is interested in lifestyle management for her incontinence. What is the most important lifestyle change that you would recommend?CorrectIncorrect
19.A 32-year-old multiparous woman has confirmed urodynamic stress incontinence and admits that she has not completed her family. What management would you propose for this patient?CorrectIncorrect
20.A 28-year-old woman presents with a history of pelvic pain, urinary urgency, increased frequency and nocturia. The pelvic pain ends to occur during bladder filling and is relieved by voiding and you suspect that the patient has interstitial cystitis. What other mandatory investigation is required in order to make an accurate diagnosis?CorrectIncorrect
21.A 64-year-old patient presents with a history of increased urinary frequency, nocturia, urgency and occasional urgency incontinence. What would be the next line of management?CorrectIncorrect
- There is good evidence that bariatric surgery improves the following in women except:
- A couple have been trying to conceive for 2 years. The semen analysis of 36 yrs old male partner shows: Volume 1.5ml, 0.5 million sperm/ml, 40% motility and 3.5% normal forms. Female partner is 32 years old with regular periods every 30 35 days. FSH,LH and day 21 progesterone are all within normal limits. Pelvic ultrasound 3 months ago was normal. Her BMI is 24.5 kg/m². Physical examination of both partners is unremarkable. what will you do next?
24.A 44 year old patient is seen with her partner in fertility clinic. She reports her last period was 5 months ago and the one prior to that 4 months earlier. She hasn’t taken contraception of any form for 4 years. Her BMI is 29 kg/m2. She is a non smoker. Her test results are below Partners semen analysis: All parameters within normal fertile range on 2 samples Ultrasound: left ovary 1.9 x 1.8 cm. Right ovary not clearly seen.
• FSH 36 IU/L, LH 44 IU/L
What is suitable treatment option for her?CorrectIncorrect
25.A 28 year patient and her partner are reviewed in clinic. They have been trying to conceive for 2½ years. The male partners semen analysis is normal. The female partner has regular periods, STI screen is negative, hormone profile is normal, pelvic ultrasound is unremarkable and hysterosalpingogram shows filled fallopian tubes and bilateral intraperitoneal spill of contrast . how will you proceed next?CorrectIncorrect
26.A couple are seen in clinic for follow up due to three consecutive 1st trimester miscarriages. The products of conception karyotype report suggests an unbalanced structural chromosomal abnormality. What is the most appropriate management?CorrectIncorrect
27. The direct biochemical evidence of hyperandrogenism is obtained by measurement of serum:CorrectIncorrect
- Measures to predict ovarian response to gonadotrophin stimulation in IVF are all except:
- The primary metabolic problem in congenital adrenal hyperplasia is a deﬁciency in production of:
- the WHO classiﬁcation of ovulation disorders describes three classes. Which one of the following is characteristically associated with high FSH and low oestrogen (WHO Class III)?
31.A 15-year-old girl is seen in the paediatric gynaecology clinic due to persistent vaginal discharge. Examination reveals the following:Partial removal of the clitoris and the prepuce is noted. The hymen is intact.The possibility of female genital mutilation (FGM) is raised. What type of FGM is this?CorrectIncorrect
32.A 21 year old who complains of superficial dyspareunia is seen in the gynaecology clinic. She has just started her first ever sexual relationship. On examination, the following features are noted: Normal vulva and vagina. Clitoris is intact. A piercing is noted in the right labium minorum. What type of FGM is this?CorrectIncorrect
33.A 33-year-old woman is newly arrived in the United Kingdom from Africa and is complaining of dyspareunia. How many women undergo FGM each year according to WHO estimates?CorrectIncorrect
34.A 45-year-old woman undergoes an abdominal hysterectomy for a large fi broid uterus. She is found to have a fi broid in broad ligament, and there is a concern that her ureter may have been damaged during the diffi cult surgery. Which of the following is the least possible site of ureteric injury in this surgery?CorrectIncorrect
35.Regarding nonabsorbable suture materials, which of the following statements is correct?CorrectIncorrect
36.A patient who underwent an abdominal hysterectomy a few days ago complains of numbness over the skin over the anterior aspect of the upper thigh. This could be attributed to neuropathy of the:CorrectIncorrect
37.Which of the following is an example of a self-retaining retractor?CorrectIncorrect
38.A 55-year-old patient presents with a history of urinary symptoms of urgency, increased frequency and nocturia. The patient states that she does not have symptoms of hesitancy and feels as though she empties her bladder completely. What would be the first line of management?CorrectIncorrect
39.A patient presents as an emergency with urinary retention. Upon taking a history, you also discover that the patient has been having hematuria for several weeks. What is an absolute contraindication to inserting a suprapubic catheter?CorrectIncorrect
40.A fit and healthy 52-year-old patient with confirmed detrusor overactivity has tried three different medical treatments (Oxybutynin, Solifenacin, Mirabegron). The procedure that should be offered to the patient isCorrectIncorrect
41.More than 100 human papillomavirus (HPV) types have been identified to date. Clinically, HPV types are classified as high risk (HR) or low risk based upon their oncogenic potential. Which twoHRHPV types together account for approximately 70 percent of cervical cancers worldwide?CorrectIncorrect
42.The natural history of cervical intraepithelial neoplasia (CIN) lesions is better known than in the past. Respectively, what percentages of CIN 1 lesions are expected to spontaneously regress and progress to invasive malignancy without treatment?CorrectIncorrect
43.A 40-year-old woman has been in a mutually monogamous relationship for 25 years. She is upset that her recent Pap test result is low-grade squamous intraepithelial neoplasia (LSIL), consistent with human papillomavirus (HPV) changes. HPV infection is reliably diagnosed by which of the following clinical tests?CorrectIncorrect
- A 42-year-old multipara has negative screening Pap test and positive human papillomavirus (HPV)DNA test results. These were repeated 1 year later with the same results. She is a long-time cigarette smoker and has had six lifetime sexual partners. She has not had a new sexual partner for 7 years. What is her strongest risk factor for cervical cancer?
45.Clinical studies have conclusively shown which of the following to be increased by liquid-based Pap tests compared with conventional (glass slide) Pap testing?CorrectIncorrect
46.The most common cause of death from gynaecological malignancy in the developed world:CorrectIncorrect
47.A 45-year-old woman complains of intermenstrual bleeding for the past 6 months. Past history includes 6 normal vaginal deliveries and hypertension and last smear was over 5 years ago. On speculum examination, there is a raised 2 cm friable area on the cervix. What is the most likely diagnosis?CorrectIncorrect
48.A 40-year-old woman with severe dyskariosis on smear underwent olposcopy and large loop excision of transformation zone (LLETZ). Histology confirmed a moderately differentiated squamous cell carcinoma 4mm deep and 6mm wide. Clinical and radiological examination confirmed organ confined disease. What stage of cervical cancer is this?CorrectIncorrect
49.A 53-year-old woman is diagnosed with stage IA1 cervical squamous cell carcinoma after histological, clinical and radiological assessment. What is the most appropriate management plan?CorrectIncorrect
50.Administration of tamoxifen is a cornerstone in the treatment of breast cancer, but it has a weak estrogenic effect on the endometrium. A woman who is taking Tamoxifen presents with post-menopausal bleeding (PMB). What is her risk of developing endometrial cancer when compared to the general population?CorrectIncorrect