FCPS PART 2 WRITTEN MEGA MOCK – PAPER C

1. In a pregnant women with a mechanical heart valve, which of the following anticoagulation regimens would be considered inadequate for prevention of thromboembolism involving the prosthesis?

2. a patient in labor gives a history of mitral stenosis. She is asymptomatic and currently taking a beta blocker, but she is not sure why her doctor recommended it. What complication is the prophylactic beta blocker trying to prevent in these patients?

3. With infective endocarditis, what is the most common causative organism in intravenous drug users?

4. All except which of the following support the diagnosis of superimposed preeclampsia

5. Which of the following medications is preferred for intrapartum prevention of eclampsia

6. d-Dimer concentration can be elevated in which of the following pregnancy related complications?

7. In women who are fully anticoagulated with low molecular weight heparin, periodic monitoring of anti-factor Xa levels is particularly important when which of the following comorbidities is present?

8. What is the most common presenting symptoms in patients with a pulmonary embolus?

9. An asymptomatic 17year old G1P0 at 16 weeks gestation presents for her first prenatal visit, and a urine culture is sent as part of routine care. The result show > 100,000 gram- negative rods. The diagnosis is which of the following?

10. After discharge from the hospital for acute pyelonephritis, patient should receive oral antimicrobial treatment for how long?

11. Which of the following viral infection has been associated with a marked increase in the risk for  intrahepatic  cholestasis of pregnancy

12. All except which of the following clinical findings would indicate a severe course of acute hepatitis that should promote hospitalization?

13. Which of the following findings on hemoglobin electrophoresis would be the most consistent with a diagnosis of β-thalassemia minor

14. Which of the following infections is increased in gravidas with overt diabetes?

15. Subclinical hyperthyroidism is characterized by which of the following changes in serum hormone level?

16. During insertion, which of the following increases IUD-related perforation?

17. Your patient complains of lower abdominal ache in the months following placement of her IUD. During examination, no IUD strings are seen. Which of the following is the most appropriate next management step?

18. A new patient request removal of her Implanon implant. You are unable to locate the device by palpation. What is the best next management step?

19. Drugs whose efficacy may be diminished by combination oral contraceptive pill use include which of the following?

20. The relative risk of which of the following cancers has been associated with current combination oral contraceptive pill use?

21. A proven benefit of combination oral contraceptive pills includes which of the following?

22. Latex condom efficacy is enhanced by which of the following?

23. The incidence of which of the following is increased with diaphragm use

24. Which of the following aspect of normal postpartum maternal anatomy are not advantageous for puerperal sterilization?

25. Puerperal sterilization failure results most commonly from which of the following?

26. During vasectomy, which of the following structures is ligated?

27. With the parkland method of female tubal sterilization, it is recommended that approximately what length of tubal segment be excised to allow adequate separation of tubal stumps?

28. Studies support that tubal ligation is a risk for which of the following psychological or sexual side effects?

29. A 27-year-old Emmy is a newly married woman is HIV positive on Truvada regimen. She is receiving her anti-HIV medications and is using a 35-mcg oestrogen combined oral contraceptive pills (COCP). She finished a pill packet 10 days ago, forgot to restart again and had unprotected sexual intercourse 2 days ago. She also missed two pills in her last week of the previous pill packet, when she was on honeymoon with her husband. A chlamydia urine polymerase chain reaction test is negative. She has history of severe asthma controlled by oral glucocorticoids. She attends asking for emergency contraception. What is the most appropriate method of emergency contraception in this situation?

30. A 8-year-old woman and her husband have come to the family planning clinic for advice on contraception. They have four children and do not want any more. As the registrar, you discuss with them permanent (vasectomy and sterilisation) and long-term reversible forms of contraception. They prefer permanent contraception and understand that permanent methods are irreversible. They would like to know the first-year failure rate for female (laparoscopic tubal occlusion) and male sterilisation procedures. Which of the following are the correct rates?

31. The most suitable method of selective feticide in a monochorionic twin pair with structural discordance endangering the viability of one fetus is by:

32. Twin to twin transfusion occurs in about 15 % of monochorionic pregnancies. When the Doppler studies are critically abnormal in either twin and are characterised as abnormal or reversed end-diastolic velocities in the umbilical artery, reverse flow in the ductus venosus or pulsatile umbilical venous flow, this corresponds to the following stage in Quintero’s system:

33. A 27-year-old primigravida has monochorionic diamniotic twin pregnancy with severe twin to twin transfusion at 25 weeks of gestation. She has undergone LASER ablation of the anastomotic vessels.

She is concerned about the recurrence of the problem. What will you tell her about the risk of recurrence of twin to twin transfusion post LASER?

34. Urethral diverticulum is very uncommon condition, Which of the following statements about urethral diverticulum is true?

35. Ms. XY is 57 years old. She has bensuffering from symptoms of an overactive bladder. Bladder retraining has not helped her. Her recent urine analysis is negative for infection. What is next step in her management?

36. A 35 years old woman delivered by outlet forceps due to poor maternal effort, she got extensive tear which is involving internal anal sphincter, A third-degree perineal tear is defined as:

37. Which all of the following are example of a problem arising from pelvic floor dysfunction except?

38. You review a woman in the urogynaecology outpatient clinic. You decided to start her on anticholinergic therapy as she has symptoms of overactive bladder that has failed to respond to lifestyle modification and bladder retraining. How long will it take before she can expect to see the full benefits of taking this medication?

39.Long-term’ intraurethral catheters are kept in situ for at the most:

40. A 51-year-old woman with two previous vaginal deliveries is seen in the gynaecology outpatient clinic complaining of leaking urine on coughing and sneezing for the past three months. She has no other urinary symptoms and is not on any medications. Abdominal and pelvic examination is normal. What would you tell her regarding the number of pelvic floor contractions to perform and the frequency of the exercise programme per day?

41.A 60-year-old, post menopausal woman complains of ‘something coming out of her vagina’ and diffi culty in opening her bowels. She had four children uneventfully with vaginal births. Her last child birth was 18 years back. The most likely diagnosis is:

42.Your consultant examines a 65-year-old patient who presented with symptoms of pelvic organ prolapse. She had a hysterectomy 10 years previously. The prolapse is noticed. The most distal portion of the prolapse protrudes more than 1 cm below the hymen but no farther than 2 cm less than the total vaginal length. What is the stage of this prolapse?

43. A 65-year-old woman is prescribed mirabegron (Betmiga, Astellas Pharma) for detrusor overactivity. What type of drug is mirabegron?

44. You see a woman in the gynaecology outpatient clinic. She has symptoms of frequency and urgency of micturition. You asked her to keep a bladder diary. Over what length of time should a bladder diary be undertaken?

45. Which of the following is not true about duloxetine?

46. A 36-year-old patient presents to the clinic with a lower abdominal dragging feeling for the past 10 days. Her urine dipstick shows positive for nitrites but she has no other symptoms of urinary tract infection (UTI). What is the management plan?

47. You review a 49-year-old woman in the gynaecology outpatient clinic with symptoms of frequency and urgency of micturition. She is a para 1, delivered vaginally 15 years ago. Her BMI is 27 and she smokes 15 cigarettes a day. She drinks four cups of coffee daily. Which of the following lifestyle interventions is the most important to improve her symptoms?

48.UGN9 Ms. XY is 60 years old. She presents with symptoms suggestive of an overactive bladder. Urine dip is negative for leucocytes and nitrites. She does not smoke or consume caffeine. Examination reveals no prolapse. Conservative therapies and OAB drugs have failed to improve her symptoms. After an MDT discussion, a decision is reached to try botulinum toxin Which of the following is an appropriate starting dose of the toxin?

49. Ms. Sara  is 65 years old. She presents to the urogynaecology specialist nurse with the complaint to feeling a bulge per vaginum. She has had a TAH +BSO 15 years ago. Which point corresponds to the vaginal vault/cuff scar on the POP –Q (pelvic organ prolapse quantifi cation system)?

50. Which of the following statements best describes the role of serum ferritin in
pregnancy?