FCPS Part-2 Written-Sexual & Reproductive Health

1. What is the primary mode of action of the progestogen-only injectable method of contraception?

2. Which form of progestogen-only contraception is most strongly associated with loss of bone mineral density?

3. Vasectomy failure rate is quoted as approximately 1 in 2000 . By how many months postprocedure should the vasectomy be considered a failure if motile sperm are still observed in a fresh semen sample?

4.  a 26years old lady presenyted to you with UPSI,  she has used UPA for emergency contraception, she is otherwise using CHC for contraception. Ulipristal acetate (UPA) may itself reduce the efficacy of other hormonal contraception. When emergency contraception is administered because of a

missed combined oral contraceptive pill (CHC) the CHC should be continued. For how many days should additional contraception be advised?

5.  A 28-year-old woman with a BMI of 28, who has been taking

enalapril for essential hypertension, requests the combined oral

contraceptive pill. Her BP is well controlled on this treatment and today

is 134/88 mm Hg. To which UK Medical Eligibility Criteria would well-controlled

hypertension be considered?

6. A 32-year-old patient attended for routine cervical

screening which has shown borderline changes and HPV inadequate

results. She is not currently sexually active and has had normal smear

results before this test.What is the next appropriate step in management?

7. An 18-year-old nulliparous patient attends the gynaecology clinic for heavy painful menstrual bleeding. She is in a sexual relationship with a new partner and both have tested negative for STDs, though she has history of  chlamydia infection.She takes lamotrigine for epilepsy control and has not suffered any seizures for 3 years. General and pelvic examinations are normal, and her BMI is 30. What is the best appropriate method of contraception in her situation?

8. A 27-year-old patient presented with lower abdominal pain and vaginal discharge. her temperature of 99F , PR 86 bpm and  BP is120/83 mm Hg. Her abdomen is slightly tender in the right iliac fossa. On vaginal examination there is a mild adnexal tenderness, the IUCD threads are seen and a swab of mucopurulent discharge is taken. She has a new sexual partner and has not used barrier contraception. What is the most appropriate next step in her management?

9. Which one of the following is correct in relation to neisseria gonorrhoea?

10. Which one of the following is characteristically associated with the use of combined oral contraceptive pill?

11. a 22 years old pt has presented to you after single episode of unprotected sexual intercourse and is requesting emergency contraception   Which one of the following is appropriate?

12. you have just delivered a 22years old P2 patient, delivery was uneventful. she wants postnatal contraception. what will you advise her?

13. A 32-year-old woman presented with her male partner 34yrs. they have been trying to concieve for last 3 years. she is diagnosed with mild-stage pelvic endometriosis at diagnostic

laparoscopy. She has regular menstrual cycles. Her partner has normal semen

analysis. . Which of the following management options is the preferred initial treatment?

14. a 26years old lady had an ERPOC 1 week ago for a missed miscarriage following an

unplanned pregnancy at 10 weeks of gestation. The histology results suggest a molar pregnancy. she wants to avoid a further unplanned pregnancy. Her

beta hCG levels are 1000 mIU/l today.Which of the following contraceptives are best suited to her?

15. a 25years old lady has presented to you with h/o unprotected sexual intercourse 4 days back. she wants emergency contraception. She has irregular cycles otherwise,

she has never been screened for STIs but agrees to have it if needed. Which of the following is best suited for her?

16. Mrs XY is a 35-year-old woman who is a known case of congenital heart disease with a single ventricle.  and on regular follow-up with the cardiologist. She is stable in regard to her cardiac condition and wants an intrauterine contraceptive device (IUCD) inserted. Her cardiologist has given his consent for the same after reviewing her case. Which of the following is appropriate regarding the arrangements for the IUCD insertion in this case?

17. A couple have been trying to conceive for 3 years. The semen analysis shows:

Volume 1.5ml, 0.5 million sperm/ml, 40% motility and 3.5% normal forms. her wife is 32 years

has regular periods every 30days. hormonal profile all within normal

limits. Pelvic ultrasound is normal. Her BMI is 24.5 kg/m². Physical examination

of both partners is unremarkable.

18.A couple have been trying to conceive for 2 years. husband is 30 years old with semen analysis shows:

Volume 1.5ml, 23 million sperm/ml, 42% motility and 5.1% normal forms. her wife is 26years old with

regular periods every 28 days. hormonal profile is within normal limits.

Pelvic ultrasound 6 months ago was normal. She reports getting some

antibiotics for vaginal discharge 3 years ago but can’t remember which ones. Her BMI is 24.5

kg/m². Physical examination of both partners is unremarkable

19. A 26 year old woman wants effective contraception. She has tried multiple combined and progesterone only oral contraceptives but had to discontinue due to multiple side effects. She doesn’t want long acting reversible contraception . She is considering the use of a diaphragm with spermicide. What

would you advise her regarding timing of diaphragm removal after sexual intercourse?

20. A 35years old woman consults you about her contraception. She wants a method

with the lowest risk of thrombosis because she has a family history of venous thromboembolism

in her first-degree relative. She doesnot want any intrauterine devices. How will you counsel her?

21. A 32-year-old woman consults you about combined hormonal contraception.

she had first degree relative with breast cancer who died at the age of 55 years. She is healthy but has a problem with painful periods. What is best suited to this situation?

22. An 18-year-old girl who is on an enzyme-inducing drug
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?

23. A 17-year-old girl comes to you with history of unprotected

intercourse four days ago. She is not very keen on an intrauterine

device (IUD). What other you can offer?

24. A woman with systemic lupus erythematosus comes to see you regarding safer

contraception. she also has positive antiphospholipid antibodies.

According to the UK medical eligibility criteria (UKMEC), which contraceptive would

you offer

25.  A 33-year-old woman is using levonorgestrel intrauterine system. She has recently

suffered from a cerebral transient ischaemic attack. She is now improving. she wants effective

contraception What will you tell her ?

26. Strawberry cervix is characteristic of

27. normal vaginal pH?

28. infection with bacterial vaginosis in pregnancy is associated with which of following?

29.Which of the following is associated with rise in vaginal pH in post menupausal women?

30. A 28 years old patient  has recently been diagnosed with HIV . presented to you with c/o a painless warty lesion on vulva from last 1 week. she reports having a single lesion 4 months back as well which resolved itself with in 2 weeks. what is wrong with this patient?

31. A patient is diagnosed with PID  , on investigation chlamydia trachomatis is diagnosed. which of the following best explain mechanism of tubal damage caused by said organism?

32. A 16 years old patient presented with history of warty lesions on vulva. She became sexually active 4 months back. She has never been vaccinated against HPV. Which of following has almost 100% initial clearance rates ?

33. A 32 years old patient presented with c/o abdominal pain from last 1 week. Pain is associated with fever and vaginal discharge. She had IUCD inserted 1 year back. Urine pregnancy test was negative. She was admitted for i.v antibiotics . after 48hours of treatment patient as persistent c/o abdominal pain. Laproscopy was planned. On laproscopy both fallopian tubes were seen to be swollen and having . on histopathology it shows sulphur granules. Which of the following organism is responsible?

34. A 28years old patient has presented to get her IUCD removed which was inserted 2 years back because she wants to concieve . her last menstrual period was 9 weeks back. She had regular cycle previously. Her urine pregnancy test confirms that she is pregnanct.. her transvaginal scan confirms intrauterine pregnancy of 8weeks  she is afebrile and no other compalint. She wishes to continue this pregnancy. On examination thread of IUCD is visible.. which of the following option is suitable for this patient?

35. Risk of perforation with IUCD?

36. A 32 years unmarried girl on oral progesterone for heavy and irregular cycles, on 16 day of medication she started yellowish vaginal discharge slightly blood stained what could be the cause?

37. A 22 years old woman presents reporting that she is using phenytoin for epilepsy. She doesnt want to concieve and is satisfied with her current method of contraception and wishes to continue to use IM DMPA. which of the following fits best to her situation?

38.A 38 years old lady had a myocardial infarction 5 months ago . she is para 4 and doesnot want to have any children further. Which of the following contraceptive methods would be associated with a UKMEC Category 4 in this situation ?

39. For which of the following conditions would you consider a hospital setting for the insertion of an intrauterine device?

40. A 29 years old patient has history of secondary dysmenorrhea from last 2 years. she wants to have a reliable method of contraception that also helps with painful periods. which of the following is suitable for her situation??

1. subcutaneous DMPA is preferable in women with dysmenorrhoea

41. A 24years old athelete has presented to you effective contraception. she wants a reliable method with minimum side effects. With regard to affects of hormones on bone health, which of the following is true?

42. A 32 years old patient has consulted for a safe method of contraception.. she is known case of cardiac disease since childhood. Which of the following antibiotic regimens is correct for routinely inserting or removing an IUD in a woman with valvular heart disease?

43. what is the safe limit for a woman to continue with progestogen-only injectables?

44. Which of the following is true with regards to anti-Müllerian hormone:

45. With regards to intracytoplasmic sperm injection (ICSI) which of following is false:

46.  Which of the following tests can be used to assess ovulation

47. With regards to azoospermia:

48. Gonadotrophins are not raised in which of the following conditions:

49. With regards to hyperprolactinaemia:

50. Klinefelter syndrome: