1. A 48-year-old woman presents with intermenstrual bleeding for two months and episodes of bleeding occurring any time in the cycle. There is no associated pain.
Differential diagnosis for intermenstrual bleeding does not include:
a. endocervical polyp
b. cervical malignancy
c. endometrial polyp
d. ovarian teratoma
e. atrophic vaginitis.
Ans: d
2. All of the following drugs are associated with hyperprolactinaemia, apart from:
a. reserpine
b. progesterone-only contraceptive pill
c. methyldopa
d. ranitidine
e. chlorpromazine.
Ans: b
3. All of the following are effects of premature menopause, apart from:
a. decreased cardiovascular risk
b. infertility
c. osteoporosis
d. vasomotor symptoms
e. vaginal dryness.
Ans: a
4. A 32-year-old woman presents to the gynaecology clinic with infrequent periods. A hormone profi le is done and all of the following are consistent with polycystic ovarian syndrome, apart from:
a. increased androgen levels
b. normal FSH
c. normal oestradiol
d. decreased LH
e. low progesterone levels.
Ans: d
5. A 28-year-old woman attends the colposcopy clinic after an abnormal smear test. The smear is reported as severe dyskaryosis and she has an intrauterine contraceptive device in situ. All of the following statements are likely to be true, apart from:
a. the cervix is macroscopically normal
b. acetic acid is applied and an irregular white area is apparent to the left of the cervical os
c. Lugol’s iodine is applied and the same area stains dark brown while the rest of the cervix stains pale
d. a biopsy is taken
e. the IUCD can stay, as it will not aggravate the cervical abnormality.
Ans: c
6. A 24-year-old woman presents with the absence of periods for nine months. She started her periods at the age of 13 years and had a regular 28-day cycle until 18 months ago. The periods then became irregular, occurring every two to three months until they stopped completely. The following are all included in the differential diagnosis of secondary amenorrhoea, apart from:
a. excessive exercise
b. hyperprolactinaemia
c. hyperthyroidism
d. premature ovarian failure
e. signifi cant weight loss
Ans: c
7. The following statements regarding adenomyosis are true, apart from one.
a. It tends to occur in women over 35 years.
b. Risk factors include increased parity, termination and quick labours.
c. The condition commonly occurs in association with endometriosis.
d. With each period, bleeding occurs from the endometrial tissue into the smooth muscle.
e. The diagnosis can be made by ultrasound or magnetic resonance imaging scan.
Ans: b
8. A 20-year-old woman is referred with a problem of post-coital bleeding. Over the past two months it has occurred on six occasions and there has been a small amount of bright red blood noticed after intercourse. There is no associated pain. The following investigations should initially be performed, apart from:
a. cervical smear
b. endocervical swab for chlamydia
c. colposcopy
d. endocervical swab for gonorrhoea
e. speculum examination to observe the cervix.
Ans: c
9. The following are all consistent with the diagnosis of antiphospholipid syndrome except:
a hydatidiform mole
b severe early-onset pre-eclampsia
c arterial or venous thrombosis
d mid-trimester fetal loss
e placental abruption.
Ans: a
10. The following are all causes of recurrent miscarriage, apart from:
a. parental chromosomal abnormality
b. activated protein C-resistance
c. uncontrolled hypothyroidism
d. chlamydia infection
e. submucosal fi broids.
Ans: d
11. Which one of the following statements about pituitary tumours is true?
a. Weight loss is a common feature of pituitary failure (hypopituitarism) due to a pituitary tumour.
b. Visual fi eld loss in female patients with prolactin-secreting pituitary tumours (prolactinoma) is usual.
c. Adrenocorticotrophic hormone (ACTH) secreting pituitary tumours cause a syndrome of cortisol excess that can lead to exaggerated vertical growth in adolescence.
d. Growth hormone defi ciency is a recognised feature in adult patients presenting with acromegaly due to a pituitary macroadenoma.
e. A low testosterone level is more common than a low thyroxine level in men with non-functioning gonads.
Ans: e
12. Which of the following statements concerning the anterior pituitary is true?
a. It develops in the embryo from a down-growth of the hypothalamus.
b. It secretes antidiuretic hormone (ADH).
c. It is regulated by hypothalamic-releasing hormones.
d. It secretes its hormones into the pituitary portal system.
e. It is down-regulated by low oestrogen levels.
Ans: c
13. Which one of the following statements about the implantation of the human embryo is true?
a. It will occur at any time over a period of about 14 days.
b. It will occur whether or not the zona pellucida is present.
c. It will occur when the cytotrophoblast contacts the endometrial epithelium and begins to invade the maternal tissue.
d. It will occur with the inner cell mass closest to the endometrium.
e. It will occur even if there is only cytotrophoblast present.
Ans: d
14. Which one of the following statements about puberty is true?
a. Puberty is preceded by falling plasma levels of adrenal androgens.
b. The fi rst menstrual period is called the adrenarche.
c. The pubertal growth spurt is the fi rst sign of puberty.
d. Pubic hair growth is stimulated in girls by oestrogen.
e. Spermatogenesis starts at puberty.
Ans: a
15. Which is the most appropriate statement concerning pulmonary embolism?
a. It is now rarely fatal, with the introduction of modern diagnostic tests and treatments.
b. It gives an area of lung which is unventilated on a ventilationperfusion scan.
c. It does not usually show up on a CT pulmonary angiogram.
d. It is likely that the patient has symptoms of deep-vein thrombosis.
e. It may give symptoms similar to pneumonia.
Ans: e
16. One of the following is true. It is recognised that the positive predictive value of initial mammography for breast cancer within the national screening programme in the UK is 16%. This means that:
a. 16% of people who have breast cancer are detected on initial mammography
b. 84% of people without breast cancer have a normal mammogram
c. 16% of initial mammograms are abnormal
d. a patient with an abnormal initial mammogram has a 16% chance of having breast cancer
e. out of every 100 patients with an abnormal mammogram,
Ans: d
17. One of the following is true. Successful fertilisation and subsequent normal embryonic development:
a. require at least two spermatozoa
b. require the retention of the cortical granules in the oocyte
c. are most likely when the oocytes have been ovulated in an immature stage
d. require exclusion of the second polar body
e. often occur when the oocyte has lost its zona pellucida.
Ans: d
18. One of the following is true. The increase in maternal blood volume in pregnancy occurs as a result of:
a. peripheral vasoconstriction
b. a reduction in progesterone
c. decreased synthesis of vasopressin
d. increased aldosterone synthesis
e. reduced renin activity.
Ans: d
19. One of the following is true. Decreased peripheral resistance in pregnancy has been attributed to an increase in synthesis of:
a. angiotensin
b. endothelin
c. nitric oxide
d. renin
e. thromboxane.
Ans: c
20. A 25-year-old woman on liver enzyme inducers is requesting contraceptive advice. The method providing her with the most reliable form of contraception would be:
a. combined oral contraceptive pill
b. Depo-Provera injection
c. diaphragm
d. male condom
e. progesterone-only pill.
Ans: b
21. A 35-year-old woman comes requesting long-term reversible contraception. You advise that the method that can provide the longest protection is:
a. contraceptive implant
b. copper intrauterine device
c. Depo-Provera injection
d. intrauterine hormonal system (IUS)
e. laparoscopic sterilisation.
Ans: b
22. Regarding cervical cancer, which is the true statement?
a. HPV types 6 and 12 are high risk for developing cervical cancer.
b. The new vaccines can prevent invasive carcinoma but not CIN.
c. As soon as the new vaccination is introduced, cervical screening programmes can cease.
d. HPV types 16 and 18 account for the majority of cervical cancer in the UK.
e. HPV is an oncogenic virus for squamous cell but not adenocarcinoma of the cervix.
Ans: d
23. Regarding the menstrual cycle, which is the true statement?
a. Menstruation occurs with vasodilation of the spiral arteries.
b. The LH surge triggers menstruation.
c. The Graafi an follicle develops during the luteal phase.
d. Both the follicle and the corpus luteum secrete oestradiol.
e. Progesterone levels fall after the onset of menstruation.
Ans: d
24. Regarding Müllerian duct abnormalities which is the true statement?
a. occur about 1 in 500
b. the commonest uterine abnormality is septate uterus
c. occur not infrequently with gastrointestinal abnormalities
d. surgical correction of a septate uterus is followed by fetal salvage in <60% of cases
e. longitudinal vaginal septa are more common than transverseones.
Ans: b
25. Choose the correct statement: Uterine leiomyosarcomas:
a. are associated with exposure to tamoxifen
b. originate from leiomyomas
c. pelvic radiotherapy has a signifi cant impact on survival
d. commonly metastasise to the brain
e. anthracycline-based chemotherapy has no place in treatment.
Ans: a
26. Which one of the following statements about the menopause is correct?
a. Progesterone levels rise after the menopause.
b. LH levels rise after the menopause.
c. The pituitary stops secreting LH and FSH at the menopause.
d. Menstrual cycles remain regular until the last menstrual period.
e. The number of oocytes in the ovary remains constant until the menopause.
Ans: b
27. Choose the correct statement: The female reproductive tract plays important roles in sperm transport by:
a. trapping most spermatozoa in the cervical crypt for many days
b. regulating sperm transport so that cells reach the site of fertilisation around the time of ovulation
c. allowing sperm transport at all stages of the ovarian cycle
d. preventing spermatozoa from swimming out of the peritoneal cavity
e. providing an acidic environment to keep the spermatozoa active.
Ans: b
28. Which one of the following statements is true: Semen analysis:
a. identifi es men with high-quality fertile spermatozoa
b. identifi es men with low sperm concentrations that might affect fertility
c. can always be used to predict fertility
d. cannot identify abnormal spermatozoa
e. identifi es men with hypopituitarism.
Ans: b
29. One of the following is true. A malignant tumour arising in the mesenchymal tissue is called:
a. adenoma
b. carcinoma
c. lymphoma
d. melanoma
e. sarcoma.
Ans: e
30. One of the following is true. Affording moral status to a human embryo/fetus means that it now has:
a. an inalienable right to life
b. a right to life
c. a right to consideration
d. a right dependent on moral consensus
e. a right not to be harmed.
Ans: d
31. At term amniotic fluid volume is
a. 800ml
b. 500 ml
c. 400 ml
d. 600 ml
Ans: a
32.what is the principal carbohydrate present in Amniotic fluid ?
a. Glucose
b. Fructose
c. Mannose
d. Galactose
Ans: a
33. Oligohydramnios is related which of the following condition ?
a. Renal Agenesis
b. esophageal atresia
c. anencephaly
d. down's syndrome
Ans: a
34. Early amniocentesis is done in which period of pregnancy
a. 12-14 wks
b. 14-16 wks
c. 16-18 wks
d. 9-11 wks
Ans: b
35. Immune rejection of fetus prevented by
a. HCG
b. HPL
c. oestrogen
d. progesterone
Ans: a
36. what happens to GFR in a case of Pre-eclampsia ?
a. GFR Decreases
b. GFR increases
c. remains same
d. none of the above
Ans: a
37. Shortest diameter of pelvic Cavity
a. Interspinous
b. transverse
c. antero-posterior
d. oblique
Ans: a
38. Large Chorioangioma associated with
a. polyhydroamnios
b. oligohydramnios
c. both
d. none
Ans: a
39. Commonest presentation of Choriocarcinoma
a. vaginal bleeding
b. abdominal pain
c. breathlessness
d. perforation of the uterus
Ans: a
40. Frog eye appearance is seen in
a. Anencephaly
b. acardia
c. down's syndrome
d. patau's syndrome
Ans: a
41. what of the following is seen in Partial mole
a. Triploidy
b. haploidy
c. polyploidy
d. diploidy
Ans: a
42. Cervical changes in pregnancy are all except ?
a. increased collagen
b. increased Hyaluronic acid
c. Increased glands
d. increased vascularity
Ans: b
