SMLE 2019

OB/GYN
FEBRAUARY-JUNE
Corrected by: Glory Team
Rearranged By: Hussain Alhashem
Adam Alkhars
Hussain Alameer
 1. 56 Years postmenopausal her pap smear hx was normal except one month
ago revealed ASCUs , then given local estrogen for one month then pap
smear repeated revealed intraepithelial lesion,Next step is?
A. conization
B. hysterectomy
C.Colposcopy
N.B: Any high risk lesion on pap smear (high vaginal swab) should be followed by
colposcopy

2. Pap smear screening is done every?

A.2years
B.3 Years
C.5 years
N.B: Based on the age and HPV testing, but in general it is done every 3 years N.B: Pap
smear if less than 21 years so no need.
N.B: Pap smear if between 21 and 29 years so pap test every 3 years.
N.B: Pap smear if between 30 and 65 years so pap test every 3 years or pap test + HPV test
every 5 years.
N.B: Pap smear if more than 65 years so no need if previous results are normal.
N.B: Pap smear in married women should be done after 3 years from marriage regardless of
the age.

3. 64 Years postmenopausal bleeding since 5 days HB 11 Pt ,PTTnormal,tvus revealed

normal except endometrial thickness 13mm, Best management?
A. progesterone
B. Endometrial biopsy.
C. Hysterectomy
D. reassure
N.B: Any endometrial thickening more than 5mm , you should do endometrial biopsy.
N.B: Indications of endometrial biopsy: any abnormal uterine bleeding with one of the
following (age more than 40, DM, PCOS, family history of non-polyposis colorectal cancer,
obesity, nulliparity, failure of medical treatment of this AUB, significant intermestrual
bleeding, TVU showed endometrial thickness > 5 mm).
N.B: Methods of endometrial biopsy (office endometrial biopsy which is the best) or
(D&C) or (Hysteroscpe).
N.B: any women with postmenopausal bleeding, should be undergo TVU, then: if
endometrial thickness more than 5 mm so endometrial biopsy, if 5 mm or less so
repeat TVU after period of time.

4. 43 year old she has 3 children the first child was by C -section the other 2
were vaginal birth, now she is pregnant (36 weeks) comes with Rupture of
membrane, by us placenta previa, AFI 4 cm,CX is 2 cm 50% effaced.
What is the Absolute CI for ECV?
A. previous CS
B. her age
C. US result
N.B: C/I of ECV are US results of oligo or polyhydramnios + placenta previa +
previous C-S. N.B: CI of instrumental vaginal delivery is cephalopelvic
disproportion.

5. 31 year old pregnant ( 37 weeks ) ROM in labor on exam breech

presentation , CTG reactive PV CX 2 cm , 50% effaced , mid anterior Cx.
Management?
A.CS
B oxytocin C.vagprostaglandin
D. IV abx
N.B: Breech presentation is one of the indication of C-S.
 6. 15 yrs female not menstruating yet at clinic by her parents ,she is short stature , short
neck , hypertensive. Most appropriate diagnosis?
A.Turner
B.down
C.TFS
D.normal variant
N.B: HTN + short stature + webbed neck + primary amenorrhea = Turner.
N.B: Conditions associated with turner syndrome; hypothyroidism + Coarctation of aorta.

7. 39 weeks pregnant her BP - 150/90, urine analysis normal, no headache,

no vision changes, no epigastric pain , her previous BP was below
110/70. What is dx?
A- Preeclampsia
B- Eclampsia
C- Gestational hypertension
D- superimposed HTN
N.B: Hihg BP after 20 weeks of gestation + proteinuria = Pre-eclampsia.
N.B: Hihg BP after 20 weeks of gestation + no proteinuria = Gestational HTN.

8. Pregnant women has hard lump at epigastrium , FHS is heard at umbilicus

what is Fetal presentation?
A- Face
B- Brow
C- Breech
D- OP

9. Someone has gallbladder stones came complaining of yellowish discoloration

and epigastric pain, his labs ALT, AT, ALP , bilirubin , amylase are high.
What is next step?
A. US.
B. CT
C. ERCP
N.B: Pt is a known case of gallstones so no need to do US.
N.B: The case is CBD stone, next step is ERCP cuz both diagnostic and therapeutic.
 10. Pregnant women not complaining of anything , her urine analysis shows
nitrate, leucocytes, then culture revealed 50.000 organisms what is the dx?
A- Cystitis
B- Pyelonephritis
C- asymptomatic bacteriuria
N.B: She must be treated.

11. Pregnant women during vaginal delivery , what can make her has fourth degree
perineal tear ?
A- unrestrained legs and squatting position
B- unrestrained legs and sitting on chair
C- restrained legs and use of forceps and other metallic instrument.

12. 42 weeks + 3 days pregnant women bishop score 8 CTG reactive , No CPD how to
mange?
A- Expectant
B- CS
C- IOL
D- decide after one week
N.B: Bioshop above 4 = Go for induction
N.B: If she was 39 or 40 weeks the answer will be CS

13. CTG ( 3 contraction without deceleration ) what is your dx?

A. head compression
B. cord compression
C. C.uteruplacental insufficiency.
D. none of the above

14. 34 weeks pregnant doses not feel her baby movement, she goes to the doctor and did
CTG was reactive, what is your management?
A. urgent CS.
B. Bpp
C. refer for admission
D.Reassure.

15. women got pregnant after trying 10 years, now she is 10 week pregnant, she
has abdomen pain and vaginal bleed, she went to the ER , the dr said the
was not fetal heart sound and this is abortion ( they were shocked ) what the
doctor should do ?
A- Sympathy
B- Admission after evacuation as post-partum care
C- Search for cause of abortion
 16. protin +2, ketonuria, glucose high, pregnant 37 wks + 8 days, management?
A- Labor
induction.
B- CS

17. treatment of chlymedia:

A- azithromycin
B- doxycycline.
Azithromycin cuz it takes 1g once daily rather than doxycycline who taken twice daily

18. pregnant 2nd trimester -> high BhCG, indicate what?

A- normal pregnancy
B- complete …?
C- Down
N.B: High BhCG in 1st trimester = Molar pregnancy.
N.B: High BhCG in 2nd trimester = Down syndrome

19. post-menopausal flushing mechanism?

A- Vasodilation
B- High FSH
C- Vasoconstriction
N.B: to confirm ndiagnosis of menopause (elderly with hot flushes + night sweats) = FSH
N.B: pathophysiology of flushing in menopause = low estrogen leads to vasodilatation
(Consultant Obe/Gyn).

20. hormonal replacement therapy. We should know if she have uterus or post
hysterectomy. You must know does she have uterus or already removed to assess
her for endometrial cancer risk
(if post hysterectomy and now need HRT so give Estrogen
only HRT) (if intact uterus and now need HRT so give
Combined HRT)

21. how to diagnose recovery from preeclampsia

A- BP
B- protinurea 3 tests
C- protinurea 5 test

22. hypertensive lady controlled in pregnancy may complicated by

A- abnormal fetal presentation
B- abnormal placenta
C- Preterm labor
N.B: Preeclampsia is a risk factor for preterm labor, but here the scenario is only controlled HTN so I
think it is B (Obe/Gyne consultant).
23. pic of vulva and papule
A- reassurance
B- More investigation
We should investigate for STDs

24. smoking + pregnancy … ->IUGR

25. pic or discerption -> cauliflower -> condyloma accuminata

26. CTG, deceleration Late -> placenta insufficiency, Early -> head compression,
Variable -> cord compression

27. seizure pregnancy is prevented by

A- Mg sulfate
28. vaccine contraindicated in pregnancy. MMR, Varicella
29. When to start education about breast feeding?
A-2nd trimester.
B-3rd trimester
C-after delivery
D-before pregnancy

30. Pt had retained placenta and has bleeding what type of PPH?
A-primary. B- secondary

31. Pt in labor, dilatation 5cm since 2 hour, effacement 100, station 0. Management?
A-observe√
B-give oxytocin
 32. Case of PPH. What to give?
A-oxytocin.(First drug to be given).√
B-ergot
C-carboprost

33. . Pt female has history of recurrent PPH. What to do?

A-active management of 3rd stage of labor.√

34. Pt had a previous C-S. Now pregnant at 36 weeks with abdominal pain. Vitals:
hypotensive, tachycardia. Dx?
A-uterine rupture
B-abruptio placenta.√
N.B: Hypotension + tachycardia are signs of abruption of the placenta.

35. Yellowish greenish vaginal discharge increase with intercourse Dx?

A-trichomonasvaginitis.√
B-bacterial vaginosis.

36. Pt had menopause at age of 40. She is at increased risk of?

A- increase risk for osteoporosis.√

37. 22 weeks of gestation , os dilated 1.5 cm. Dx?

A-cervical incompetence

38. 1st trimester ,Os closed , mild spotting. Type of abortion?

Threatened abortion.

39. 1st trimester, Os closed and speculum revealed heavy bleeding.

Type of abortion?
- Threatened abortion.
40. Ectopic pregnancy treated with salpingostomy, what next?
A-no follow up needed.
B-follow up Bhcg after a week and till zero.

41. Management of late deceleration?

A- change position.

42. vaccine can pregnant take? A-influenza

43. Pap smear? A-3 years continue

44. Pt 40 years old what to tell about pap smear?

A-5 years
B-3 consecutive neg results no need for further

45. a pt with history of Ocp use wat is associated with it?

A- Anemia.
B- history of fatigue
C- C history of DVT

46. ECV contraindicated in?

A- AFI less than 22
B- Cord length greater than 36 or 38mm
C- Placenta Previa

47. a pic of ultrasound showing chocolate cyst (endometrioma)?

A associated with increased risk of infertility
 48. beta hcg positive but on ultrasound no gestational sac seen? A- extrauterine
pregnancy.

49. Gestational diabetes. A normal pregnancy associated with diabetogenic condition due to
A- progesterone
B- same as above due to estrogen
C- due to FSH

50. SVD with 800ml blood loss visible to eye

A- prim PPH
B- SEC PPH

51. best presentation for NVD in case of twins:

A- breechcephalic
B- cephalicbreech
C- cephaliccephalic
D- breechbreech
- The best is : cephalic cephalic , also its the most common in twins pregnancy

52. scenario of complete molar pregnancy.

53. a pt with IUFD
A- tell the pt
B- tell her husband
C- tell her relatives
54. consent in case of IUFD to b taken from
A- husband
B- wife
C- relatives
55. a pt with IUFD
A- console the couple and ask them for follow up visit after few days B- let the mother spend
some time with her dead child
- MISSING OPTIONS

56. HTN in pregnancy what you suspect? IUGR

 57. 15years old female c/o amonerrhea, htn, short neck and the parents below the
level what the diagnosis?
A- tuner syndrome
B- hypothyroidism
C- familial

58. 40 weeks of gestation primigravida presents with hypoxia, drowsiness and

agitation for 6 hours, LL edema (Long scenario with blood tests). What does
she have?
A- Amniotic Emboli
B- PE

59. PTs with Post-delivery bleeding and she have asthma, what’s CI in her case to
stop bleeding?
A. Oxytocin
B. Misprostol (prostaglandins).
C. carboprost
Hemabate( carboprost) is PGF2 Alpha which can cause or aggravate bronchospasm

Note:Ergometrine is absolute contraindicated in HTN

Note: Ergometrine is relative contraindicated in asthma
Note: Carboprost (hemabate) is contraindicated in asthma

60. female patient with fibroid wants to keep fertility what is the ttt?
A. laproscopic hestrectomy
B. laproscopic myeomectomy
C. laparotomy myeomectomy
D. laparotomy hestrectomy.

61. Multiple questions of female with right lower quadrant pain some came with
+ve pregnancy and some with -ve what is the diagnosis?
Choices were the same as I could remember.
A. Acute appendicitis
B. ovarian torsion
C. ectopic pregnancy
62. Question clearly states ectopic pregnancy 6 weeks aminohrea what is ttt?
A- methotrexate
B- laparoscopic surgery

Depends on BHCG:
If less than 5000 metho , If more than
5000 lab Less than 3,5 give metho
-Laparoscopic is the best diagnostic and therapeutic-

63. Pregnant during labour CTG showing contractions and decealration of heart rate of
fetua she was given analgesia and oxytocin what is causing the deceleration?
A- oxytocin
B- Anesthesia
Bc it causes tense uterine contraction and reduces blood transported to fetus

64. Almost same question but different CTG showing no change in heart
rate of fetus during contraction, what’s the cause?
A- oxytocin.
B- Anesthesia
C- Analgesia
These 2 depend on CTG picture to determine type of deceleration I had 3
ctgs
One early ...head compression
One late ... anesthesia induced maternal hypotension lead to placentsl
hypoperfusion and fetal distress
One was normal ctg no deceleration normal variability.

65. Multiple question on Vaginal discharge ttt and diagnosis (trachoma, viginosis, and
chlymedia)?

66. Questions about hyperemesis and high BHCG (80 thousand) what is your
diagnosis?
A.partialmolar pregnancy

67. what is the age recommended for screening by pap smear for married women?
A- 20-24
B- 26-30
C- 30-35
D- 36-40
68. pt LMP since 8 week with rt abd pain: Ectopic pregnancy

69. pt with irregular menses LMP since 6week first test: Pregnancy test

70. pt with galctohrea and orregular menses first test:

A- prolactine
B- LH
C- Progesteone

71. pt a symptomatic with 5 cm serous fibroid ttt:

A- myomectomy
B- hysterectomy
C- follow up

72. fetus with head up flexed knee and hip and flexed hand
A- frank breech
B- complete breec

73. 6 year girl with vulvar itching and bleeding what you think:
A- foreign body
B- sexual abuse
74. pt with vaginal itching and bad smell the microscopic is flatellaprazite
A- trichominosis
B- BV

75. pt pregnant come with severe bleeding and component in cervix what next
management:
A- iv fluid and D&C
B- expectant management
Explanation: this is a case of incomplete miscarriage.

76. pregnant with precalmpsia what ttt:

A- methyldopa
B- hydrlazine
C- nitrubrosside
Explanation mild go with A , if it’s sever go with B

77. pt with irregular menses and acne and hair in face her wt 60kg:
A- Pcos
B- Hypothyroidism.

78. Postmenopausal came to take hormonal replacement therapy the Dr said no

evidence to take HRT, but she is insisted for HRT What is your action?
A- Refer to another gynecologist
B- Refuse
C- consult another gynecologist
D- consult hospital committee

79. (55 years old) female her last mammogram was normal when she will do the next
after?
A- 1 year
B- 2year
C- 3-year
D- 4 year

80. 27 years old female she did Pap smears before 3 years it was normal what is your
advice for her?
A- Reassurance
B- no pap test
C- pap test with cytology

81. female with the result of cervical biopsy by microscopic is ASCUS what next?
A- Coloscpy
B- PV examination.

82. female at 38 week with UTI what is ttt?

A. Nitrufurtonin
B. cephalxin

83. female after uterus prolapse surgery have the urine from vagina what is dx?
A- ureterovaginal fistula.
B- urethrovaginal fistula
C- vesicovaginal fistula
84. pregant lady in labor with active regular contractions every 3 mins and cervix
dilated 5 cm. After 4 hrs still the same, and CTG shows grade 1 heart activity.
What will u do?
A- Oxytocin
B- instrumntal delivery
C- CS

85. gyn explain to the pt that HRT will not help her menpousal symptoms at this
stage but the pt insist to have it what should he do?
- Refuse to give her

86. CTG shows late deceleration what is the cause?

A- Head compression
B- Cord compression ?
C- Placental insufficiency

87. pt with bleeding, US showed fibroid and pt wish to maintain her

infertility how to manage?
- Lap myomectomy

88. pt with several weeks of amenorrhea came with PV bl and BHCG was positive os
close What is the Dx?
A- Threatened bortion

89. pt with incomplete abortion and some tissue presented at os. What is the
Management?
- IVF and D&C

90. pt at 22 wks has abdominal pain then feel decrease of fetal movement and feel
SOB, …etc what is the dx?
A- Amniotic fluid embolism. B-Septic shock

91. pregnant lady with elevated BP and significant edema nothing was mentioned
about proteinuria .How to mange?
A- Diuretics
92. Clinical scenario of (painless genital ulcer + skin rash). What is the dx?
A- Secondary syphilis.

93. Young lady with presentation looks like DVT and amenorrhea for several wks ,
PT -ve What is the important q to ask?
A- History OCP.

94. Pt with sudden acute pain us showed mass in ovary what is the dx?
A- Ruptured of ovarian cyst.
B- Ovarian torsion.

95. Ectopic pregnancy 6 wks less than 3.5 cm pt stable with mild pl mx?
A- Serial BHCG.
B- Methotrexate.
C- Laparoscopic.
D- Expectant mx.

96. Pt with ectopic bhcg 200+ treated with methotrexate came in few week with
sever pain and bhcg 6000 what to do?
Explanation: If stable = laparoscopy , unstable = laparotomy.

97. Delayed puberty 15 yrsshort , some problem with hair line, elevated blood
pressure, short and I think constipation. Dx?
A- Turner syndrome. B- Hypothyroidism.

98. Infertility and cysts in ovary what is the problem?

A- Ovulation.
B- Endometrial.
C- Cervix.
99. Case of Pregnancy, did D&C, after 1 year got amenorrhea , what the diagnosis ?
- Asherman syndrome

100.pregnant with mild bleeding, Us: placenta previa. Mx: CS

 101.fetus with breach presentation flexing hip and knees:
A- Frank breech.
B- Complete breech
C- Incomplete breech

102.smoker with fetal desmia cries that her smoking killed her fetus
A- Tell her…
B- Say the cause not yet clear

103.10 wks pregnant with cholecystitis when to do surgery?

A- Now. B- 1st tri. C- 2nd. D- After delivery.

104.after delivery and complete placenta delivery

A- Uterus massage.
B- 20-unit oxytocin
- first uterine massage, if no response give oxytocin
- Oxytocin given after delivery of anterior shoulder

105.2nd degree laceration and another in the vaginal wall u cant suture due to the perfuse
bleeding from above
A- 10 ut oxytocin.
B- Prostaglandin
C- Explore the uterus and examine it

106.Pregnant wants to quit smoking best way

A- CBT
B- Nicotine replacement
C- Buprine

107.what is the age recommended for screening by pap smear for married women?
a. 20-24
b. 26-30
c. 30-35
d. 36-40
Explanation:
Pap smear screening start at age 21 an after 3 years of marriage

108.pt LMP since 8 week with rt abd pain

- Ectopic pregnancy
109.pt with galactorrhea and irregular menses first test
a. prolactine
b. LH
c. Progesterone

110.pt a symptomatic with 5 cm serous fibroid ttt

A- myomectomy
B- hysterectomy
C- follow up.

111.Women diabetic controlled developed dysuria and frequency urine analysis

nitrate, creatinine high. Which drug is contraindicated?
A- Amoxicillin
B- Septrin
C- Ciprofloxacin
D- Pipracilintazopactam

112.Woman with vaginal discharge offensive fishy odor revealed clue test d.d
A-Bacterial vaginosis
B-Trichomonas vaginosis

113.Female with scanty vaginal bleeding she noticed that postcoital. what’s your
action?
A-Pelvicus
B-CBC
C-assess the vagina and cervix

114.A 30 year old female has recently given birth. She presents with a sudden onset of
shortness of breath. What would you expect to see in the x-ray? (not sure)
A- Cardiomegaly
B- Increase in mediastinal width
C- Lobar infiltrate
D- Pleural effusion

115.case of a female came after 3 months of delivery, saying she used to suffer with
low mood, irritability during the first 2 weeks of delivery but symptoms resolved
now completely….what condition did she suffer from…?
A- postpartum psychosis
B- pp blues
C- pp depression
D- pp hallucinations

116.Unmarried young lady, 20 yr old, with bilateral abdominal pain, she is a

waitress at a resort, very vague sexual history, no bleeding, no significant and
examination….no fever, missed last month periods. diagnosis?
A- ovarian torsion
B- salpingitis
C- ruptured ectopic pregnancy
D- endometritis and adnexal masses
- Bilateral = generalized = rupture ectopic causes perotinitis
117.overall deaths percentage due to post part hemorrhage:
A- 15%
B- 25%
C- 20%
D- 10%

118.A female patient came to the clinic complaining of a mass on a vagina she has a
history of repeated unprotected intercourse with multiple partners, upon
examination. she has a wart in the vagina, the causative agent is:
A- Herpes simples
B- Neisseria Gonorrhoea
C- Treponemma pallidum
D- Molluscum contagiosum

119.female pt with small papule on genital area with central pitting, h/o unprotected sexual
intercourse with multiple partners.
A- Herpes simples
B- Neisseria Gonorrhoea
C- Treponemma pallidum
D- Molluscum contagiosum

120.inhibition of which of the following is the primary action of oral contraceptives?

A- Decrease estrogen to prevent the ovulation

B- Decrease GTRH spur at the mid cycle
C- Increase prolactin
D- Suppressing the release of gonadotropins
E- Spermatozoa and thickening cervical mucusa

121.Urge incontinence principle management?

A- Medical
B- Surgical
C- Medical and surgical
D- Bladder training and physio

122.Pregnant, 10 weeks with HTN never went to doctor before (chronic HTN) what is the
complication?
- Pre-eclampsia ( if IUGR in the choices , choese it)

123.(Long Case)... IUGR , witch one of the following can be the cause? Oligohydramnios

124.q about menopause had fibroid before 4 years 4x3 cm come now with bleeding and
in US the fibroid size 7.6 and endometrial thickness 6 (normal <4) what is the cause?

- Endometrial cancer

125.Urge incontinence ttt?

A- Kegel exercise
B- antibiotic incide,
C- surgery

126.10 weeks pregnant come with weight loss 2 kg +fatigue + appetite +

vomiting after each meal what is the. cause of these symptoms?
A- H. Pylori
B- hyperemesis gravidarum
127.Ig can cross placenta? Ig G

128.Abnormal pap smear insignificant result with colposcopy, next?

Cone biopsy

129. weeks pregnant came with breech presentation what is your next step?
Flu 36 weeks -ECV

130.Pregnant in her 38 week and 2 weeks ago she was admitted and ECV was done for
her. Currently the fetus position is in linear (or lateral not sure) with amniotic fluid
index 12. What’s the contraindication for ECV in her condition?
- fetal position

131.40 year female primigravida with Hx & DVT. RX?

A- Heparin B- Enoxaparin

132.Female with vaginal discharge + nucleic acid amplification test (+ve), Dx?
- Gonorrhea

133.Female come with grayish vaginal discharge + PH Dx, bacterial vaginosis what is ttt?
A- Oral metronidazole

134.Mom just eat polished rice, what is the deficiency?

- Vit . B1

135.Pregnant female 10 weeks came with vaginal blew + abdominal pain on

examination gartational age 11 -12 weeks , what is the cause ?
A- Molar pregnant
B- incomplete abortion
*Bc fundal hight is more than the actual geatational age

136.Female has painful period she use NSAID she want stronger medication what to advice
her?
- Exercise and relaxation.

137.Safe in pregnancy with DM?

A- Metformin
B- Insulin

138.Pregnant BP 160/110 at the end of pregnancy, what is the next step ?

- Mg so (Missing informations)

139.Pregnant with pre-eclampsia mild 140/40 with abdominal pain .platelet and,
uricaerd what indicate severity?
- Abdominal pain

140. Pregnant in her 37 week fainted and complain of sever abd pain no bleeding
pb 80/50 HR120 WHat is the diagnosis?
A- pulmonary empolism.
B- abruptio placentae.

141. couple seeking infertility clinic after 3 months what is ur advise?

- try more
142. pte with breast cancer and fibroid on tamoxfin develop vaginal bleeding US show
fibroid 8cm and hypoechogenic area. what is the diagnosis?
A- endometrial cancer.
B- lyomyosarcoma.
C- overian cancer.

143. 65 years old femal presented with vaginal bleeding and abd pain Ca125 very
high what u wll do?
A- biobsy.
B- antibiotic.
C- admit.
144. pregnant lady with recurrent pain known case of gallstone what wll do?
A- open surgery in the second trimester
B- belter laparoscopy in 2nd trimester.
C- surgery after delivery.

145. pregnant lady complains of foul-smelling vaginal discharge what u wll give?
A- Amoxicillin
B- Cephalexin
C- Metronidazole.

146. bacterial vaginosis treatment? Metronidazole.

147. pt with placental abrubon BP 80/40 , what u wll do?
A- us
B- admission for SC
C- maximum response team and multidisciplinary plan.

148. pt with ectopic pregnancy what is best question before managment of the pt?
A- accessability to hospital.
B- previous surgery.

149. Snow storm on US? Complete mole.

150. Pregnant complain of painful vaginal bleeding is it

A- Placenta abruptio
B- placenta previa

151. Pregnant at 20 week complain of vaginal bleeding os closed ultra sound no fetus
A- complete abortion

152. Pregnant with bleeding os open: inevitable

153. Bleeding with os closed threatened: bed rest ttt

154. Magnisium sulfate given to HTN pregnant to: A. prevent the attack eclampsia.

155. Fishy smell: bacterial vaginsois.

156. Patients with sx of BV: What’s the test:

A- gram stain
157. Gray white discharge....
A. Trichomanias

158. Case of Trichmonisis what’s the dx,and what’s the treatment? Metro
159. You are seeing a 78 yrs old lady in clinic. She looks sick had signification weight
loss and feels tired all the time. She has pelvic mass. What the the most appropriate
screening test to confirm the diagnosis:
A- US
B- Colposcopy
C- Ca-125
Colpo for cervical cancer
Endometrial biopsy for endometrial cancer US then surgical biopsy for Ovarian cancer

160. Pregnant lady in her first trimester, she was exposed to rubella 3 days ago, what
you’re going to do:
A- Nothing
B- MMR
C- Terminate the pregnancy
D- Rubella Igg

161. Case 7 yrs has pubic hair no breast development: normal 8.

premature adrenarche

162. First trimester miscarriage at 5 week with history of 2nd trimester abortion twice
duo to cervical incompetence, cause now:
A- Cervical incompetence->2nd
B- Chromosomal abnormality ->1st ->11week

163. Fibroid commonest in: african race

164. After stopping the OCP, pt sll have amenorrhea for 6 months, gain 5 kg, feel
tired. labs show elevated glucose
A- Hypothyroidism
B- Cushing syndrome
Estrogen increases cortisol binding globulin,
165. case female pregnant Still born at 38 wks everything normal then discharge but
after 3 days come back with bleeding from every site injection Which best
investigation? DIC
A- Hemoglobin electrophoresis B- Fibrin product.

166. placenta previa and she has contractions, what to do? Cs

167. clinical scenario about overian tube torsion: Sudden severe lower abdominal pain
+ tenderness ^

168. questions about ectopic pregnancy, diagnosis and management

169.clinical scenario about molar pregnancy, asking which type

170.US of pregnant shows breech position, both legs and hip flexed, asking about breech
Complete breech

171.Pregnent has abruptio placente what is the acid base balance of fetus Asphyxia..
A- Res acidosis..
B- Metabolic acidosis
Pethidine cause mixed acidosis
Placenta abruption metabolic acido
Pre eclampsia res acidosis
 172.Magnisum sulphate the aim in using it in pre-eclampsia.? To prevent convulsion

173.Patient 14 week pregnant. with hypertension? Essential hypertension

174.K/c of cervical incompitance came for antenatal care. When to do surgery?

- 12 to 14 weeks

175.Screening of cervical CA. To which age group? cervical 21

176.Salpingiotomy done for tubal pregnancy. After 6 weeks. Bhcg high . What's to
do?
- If symptomatic - laparoscopic salpingectomy
- If Asymptotic – methotrexate

177.Uterus Compress inferior Vena cava will cause?

A- Hypotension
N.B: This is a case of IVC syndrome ''aortocaval compression syndrome'' in which the
utrerus in late pregnancy when pregnant women lies on her back will compress IVC
and aorta resulting in maternal hypotension.
Aortocaval compression is thought to be the cause of supine hypotensive syndrome.
Supine hypotensive syndrome is characterized by pallor, tachycardia, sweating, nausea
and hypotension and dizziness and occurs when a pregnant woman lies on her back
and resolves when she is turned on her side. Medical management of supine
hypotensive syndrome can include turning the patient to the left recumbent position (so
the uterus is not sitting on the IVC) and administrering IVF.

178.Pregnant lady with late deceleration and bleeding?

A-Placenta abruption

179.Pregnant with massive bleeding from abruptio placentae. Treatment to save her
life?
A- admitted to ICU with obstetric team
B- Admitted with different spacilized team
C- 2 peripheral IV cannula and blood transfusion
N.B: The initial most important step in Abrupto is immediate resuscitation at ER to
stabilize patient.

180. 24 yrs primigravida. Maried 6 months ago, hx of iregular menses, at ER

complaining lower Abd pain, scanty vag. Bleeding, by us uterus empety, rt
adnexal mass 2,5cm, bhcg 2500, bp:120/70, P:78 RR 14. Management:
A- Surgical
B- Medical
C- medical plus surgical
N.B: Medical ttt by Methotrexate is indicated in stable ectopic with size less than 3.5 cm.

181.Vaccine should be give preconception?

A- rubella B-Varicella
N.B: Vaccines given in preconception care are; HBV vaccine, MMR, tetanus and Diphtheria.

182.Pergnant have HCV with cracked nipple , which of the following is

contraindicated to breast feeding?
A- HCV
B- cracked nipple
N.B: HCV is not CI for breastfeeding except if there is eroded or cracked nipple.
 183.Couple came to OBGYN clinic, need to check infertility, what to assess first?
A- start abdominal ex
B- vaginal inspection
C- general appearance
D- PV
N.B: General appearance of the couple might help you to reach diagnosis, for example:
*Hirsutism on the female supports PCOS, Lymphadenopathy or parotid enlargement in male
supports mumps orchitis.

184.34 years P4G3 GA 32 she is not came to ANC visit never, what the cause?
A- visit is expensive
B- Ignorance
C- scaring from visit

185. Smoker risk to pregnant

A- low birth wt for fetus
B- respiratory problem of the baby
C- preterm baby

186. after delivery by 2 months, female came with urine leak from vagina
during urination. Dx?
A. urethrovaginal fistula
B. vesicovaginal fistula

187. 42 years with 2ndry dysmenorrhea and heavy menses, on pv u found

symmetrical uterine enlargement. Dx?
A. endometritis
B. adenomyosis
C. endometrial cancer

188. female with SCC on pap smear. What to do?

A. chemo
B. hysterectomy
C. radio
D. colposcopy

189. Pregnant, now bp 140/90, platelets 90, hx of previously severe preeclampsia.

What indication here of severe preeclampsia?
A. bp
B. platelets
C. uterine contractions
190.female with severe preeclampsia. What to give?
A. methyldopa
B. nitropr
C. hydralazine
Mild > methyldopa, Sever > hydralazine

191. Hep+ve mother asking about breast feeding?

A. Continues breastfeeding

192. What is the more important thing to check before instrumental delivery?
A. Breach
B. placenta abruption
C. head pelvic disproportion
193. Pregnant lady with 6cm and 80 effacement , ruptured members and head
station+1, what is the labor stage?
- Second
194. 24 yrs primigravida. Married 6 months ago, hx of irregular menses, at ER
complaining lower Abd pain, scanty vag.Bleeding, by us uterus empty, rt adnexal
mass 2,5 cm, bhcg 2500, bp 120/70, P 78 RR 14. Management:
A. surgical
B. medical
C. medical plus surgical

195. 18 yrs primagrvida, married 6 months ago, Hx of irregular menses, at ER

complaining lower Abd pain, bloody vag discharge, us and urinalysis
normal, bp 120/70, P 78, RR14, Next step
A. pregnancy test
B. duplex us
C. ct angio
D. laparotomy

196. 56yes postmenopausal her pap smear hx was normal except one month ago
revealed ASCUs, then given local estrogen for one month then pap smear.
Repeated reveale dintra epithelia lesion. Next step is:
A. conization
B. hysterectomy
C. colposcopy

197. 31yrs 37wks ROM in labor examination reveled breach presentation, ctg
reactive PV CX 2 cm , 50 % effaced, mid anterior CX, your management:
A. CS
B. oxytocin
C. Vag.Prostaglandin
D. iv antibiotics

198. Case of vaginal infection ( Candida + bacterial vaginosis + trichomonas vaginalis)

199.Female 41 yrs want to get pregnant, lab done (high LH, high FSH) More prone to what?
A- endometrial cancer
B- osteoporosis
C- ovarian cancer
High FSH indicates ovarian failure > menopause > low estrogen > osteoporosis

200. Female on tamoxifen, Lead to what? Endometrial carcinoma

201.Female after delivered present with unable to breast fed her baby and no milk at all.
diagnosis? Sheehan syndrome

202.Pt c/o of bleeding and she at 8wk gestational age on ex os closed and there is brownish
color appear during pv, the abdomen is soft, not tender or guarding and she denies
passage of few tissue By u/s you found gestational age 7wks what is diagnosis
A- molor pregnancy
B- threatened abortion
C- ectopic pregnancy
Threatened abortion Products of conception intact, intrauterine bleeding, no
dilation of cervix
203. case of cervical carcinoma and ask about the investigation? (read about
endometrial carcinoma and cervical carcinoma)

204. picture of CTG and ask about diagnosis (there is variable deceleration)
A- cord compression B- placental insufficiency

205. Long scenario the conclusion is pregnant ( ectopic, life in rural area ) her
husband travel in another country, she is complain severe pain and her neighbor
going with him to hospital, the vital sign is normal, the mass 2cm BHcg Lower
than 5000?
A- methotrexate
B- surgery because the distance
C- vital signs

206. Pregnant came to ER in her 18 weeks, comes with bleeding, cervix is open
and some products passed out?
A- therenated
B- missed
C- Incomplete

207. girl came to ER with child abuse, what the prove of abuse?
A- hymen injury at 6clock

208. How to do a Pap smear

From transformation Zone (endocervix)

209. Cancer in the labia majora >>>.SCC

210.pregnant lady, G4p3 ,35yo, 34GA came complaining of bleeding 2hours ago, what
question will you ask next?
A- Intercourse
B- Is she satisfied with her family

211. A female with abdominal pain and last menses 2months back,what is your
next step?
Pregnancy test

212. After how many months you will start call a couple infertile?
12 months
213. During-instrumental delivery, the doctor crushed the left (Ithink styelohioid) what
will be affected?
Left led closure,hearing loss,loss of taste anterior2/3, loss sensation of left side

214. Very heavy periods and infertility.

Endometriosis
Endometriosis + infertility TX> laproscopy

215. Probability of turner syndrome in next pregnancy.

A- 30 B- 40 C- 50 D- 60

216. What prevents uterus from prolapse?

A- Round
B- broad
C- uterosacral ligament

217. Case 7yrs has pubic hair no breast development? premature adrenarche

218. with lower abd pain o/px mass, lower abdomen tenderness mainly RIF with fullness,
pregnancy test negative?
A- acute cystitis
B- ovarian torsion
C- rupture cyst
D- appendicitis

219. Ectopic pregnancy, 3cm no cardiac activity minimal free fluid in pouch, beta
HCG:3500 BP 90/60 her home 80km from near hospital. What is the
contraindication of methotrexate
A- hcg and us finding
B- vital signs
C- distance of her home to the hospital
220. trichomonas treatment?
Metronidazole

221.The mother refused the cs that is will save the baby.

A- Refer the pt
B- Repect her wish
C- Take the husband concent
D- Do vaginal delevary
E- Do cs against her wish

222. The type of estrogen that abundant by humans:

A- Estriodol
B- Estriol
C- Estrogen
D- Estrone
Estriol in pregnancy
Estrone in postmenopause
Estradiol in childbearing age

223. Female pt with her husband for fertility counselling. BMI and All labs are
good, Regular menses. Your advice:
A- Keep physicaly active
B- Eat less fast food
C- Include 2 portion of vegetables and grains

224. Lady came her husband started HBV treatment , she is negative what to
advice about sexual relation
A- Tell her to use condom
B- To have normal intercourse
225.

226.
227.

228.

229. CTG one variable deceleration about pt primigraveda cervix 5cm and the fatus
is in station 0 with cephalic presenting part and this state for 4 hours even the
oxytocin had been taken what is the management for this pt?
A- stop oxytocin
B- immediate CS
C- follow up
D- instrumental delivery

230. pt came G3P1102 in the 32th week with abdominal pain and vaginal
bleeding CTG done which show late deceleration what the acid-base status of
the baby now?
A- Asphyxia
B- respiratory acidosis
C- metabolic acidosis
D- IUGR
231. this diagram for the menstrual cycle what happens in the ovulation phase? Peak of LH

232. 14-year-old develop scanty pubic hair and darkness of the axillary region in
which stage depend on tanner staging?
A- I. B – II. C- III D- IV.

233. Which ONE of the following is a contraindication to thrombolysis?

A- age over 75 years
B- the presence of atrial fibrillation
C- asthma
D- pregnancy
E- background diabetic retinopathy

234. postmenopausal symptom how to reach diagnosis? FSH

235. female after delivered present with unable to breast fed her baby and no milk
at all wt diagnosis? Sheehan syndrome

236. pt with 37 gastation with high albumin creatinine ratio and high blood
pressure
Pre- eclampsia

237. pt late trimester pregnancy and bp160/110 with blurred vision and
epigastric pain.
A- Hydralazin
B- NA nitroprusside
C- Methyl dopa

238. .pt pregnant with abd pain and On exam funds large than date and tender.
Concealed hge

239. pregnant with sever abd pain and on exam baby normal and utrus 2 week
large than date and tender. No v bleeding.
A- Red degeneration of fibroid
B- Abruption placenta

240. pt pregnant late fall from stair complain of dark v bleeding and and pain
contraction 3 to 4 per 10 min.
A- Abruption
B- Laten stage of labour

241. pt married with abd pain and drowsiness on exam abd tender but no
gaurdining with sloughs bowl sound
A- Ectopic
B- Rupture overain syct

242. Case scenario of female patient gets menopaused (cycles stopped). Then she
developed dysfunctional uterine bleeding for the last 3 months. TVUS found
endometriosis (Jnadi think this is endometrial thickness not endometriosis) with
thickness about mm 19. What to offer for this woman?
A- Ablation of endometriosis
B- Total abdominal hysterectomy- best management –
C- Laparoscopic hysterectomy
 -If ask next step, do Endometrial biopsy-

243. Case scenario of female patient menopausal now 58 years old. She
developed dysfunctional uterine bleeding for the last 2 months. TVU found
multiple endometriosis. What to offer for this women?
A- Ablation of endometriosis
B- Total abdominal hysterectomy- if old pt-
C- Laparoscopic hysterectomy

244.Female patient diagnosed as a case of ovarian cancer. What is the most

important tumor marker for follow up?
A- C125 B- AFP

245. 36 week pregnant with history of smoking came complaining of vaginal

bleeding with uterine tenderness. Diagnosis?
A- Abruptio placenta
B- Placentaprevia
C- Vasaprevia
D- Placenta accrete
VB + tenderness + smoking history-

246. Contraindications of ECV? Placenta previa

247.Pregnant women at 15 weeks presented with nausea and headache. On exam

the BP was high "168/100", otherwise healthy. Dx?
A- Preeclampsia
B- Gestational HTN
C- Pregnancy induced HTN
D- chronic HTN
248. Pregnant women at 22 weeks presented with nausea and headache. On exam the
BP was high "168/100", otherwise healthy without protein in urine. Dx?
A- Preeclampsia
B- Gestational HTN
C- Pregnancy induced HTN

249.pregnant women at 22 weeks presented with nausea and headache. On exam the
BP was high "168/100", otherwise healthy without protein in urine. TTT?
A- Hydralazine-
B- Methyl dopa
C- Nigedipine
D- Nitrates

250.A young female complaining of abdominal pain that increased with cycles, stay
for 5 days, first 2 days of cycle she missed school due severe pain (dysmenorrhea).
First next step in TTT?
NSAID is the best for primary dysmenorrhea

251.Women with PCOS, not planning to get pregnant soon. TTT?

A- Metformin
B- COCP
C- Progesterone only pills

252. Contraindicated vaccine in pregnancy?

A- HPV!!!
B- Zoster!!!
C- Pneumococcal!!!
D- Influenza!!!

253.Case of bacterial vaginosis.

254.Case of trichomonas vaginitis.

255. Postmenopausal women come to take HRT. You said she didn't need it. She
insisted to take it. What to do?
A- Prescribe HRT to her
B- Don't give it
C- Consult Hospital authority
D- Refer to another Gynecologist
256. Pregnant 36 weeks with HTN and plasma protein is high. Dx?
A- Preeclampsia
B- Eclampsia
C- Gestational HTN

257. 48 years old female came with abnormal uterine bleeding. TVU shows subserous
fibroid and endometrial thickness is 14 mm. Dx?
A- Fibrosarcoma
B- Myosarcoma
C- Fibromyoma

258. 31 years old female did pap smear annually in last 5 years and was negative.
Recommend pap smear in future?
A- Annually
B- Every 2 years
C- Every 3 years

259. During instrumental delivery there was an injury to stylomastoid foreamin.

What will happen to baby?
A- incomplete eye closure!!!
B- Bell’s palsy

260.Case of PCOS, normal FSH, high LH, testosterone high. What investigation to do
next?
A- Glucose and lipid
B- Thyroid function.

261. Case about 21 years old primigravida with 2 years history of infertility now
came with spotting of blood (threatened abortion case). Nex step?
A- Confirm pregnancy by BhcG
B- Pelvic US
C- Ask about cause of infertility
Depend on real sentence in exam if not mention that she confirm pregnancy before chose
A If mention that did urine test and was positive go for B

262.Elderly female came with dysuria and frequency. What investigation you will do?
A- Urine analysis
B- CT abdomen
C- Something invasive.

263. 36 weeks pregnant lady has features of abrupto placenta, severe bleeding,
hypotensive, tachycardic and anemia. What to do to safe live?
A- ICU admission and multiteam work
B- Insert 2 large bore peripheral cannulas and blood transfusion
C- Delivery room

264. Woman come to clinic with history of multiple abortions, now she is 11 week
pregnant, what is the best predector of complication in pregnancy?
A- Abdominal pai
B- Vaginal bleeding
C- Other options
265.Women pregnant 34+2 weeks had cesarean section past pregnancy due to non-
reassuring fetal monitoring, present now for external cephalic version, US
amniotic fluid index 14, responsive CTG. What would be absolute
contraindication for ecv?
A- Previous cs
B- CTG results
C- US findings

266. 30 y old women comes with painless vaginal mass under urethral orifice that
bleeds when touched, picture wad provided. What is the diagnosis?
A- Bartholin abscess (wrong option)
B- Other option can't remember.

267. Case of pregnant women with UTI, culture was done and result was E.coli
sensitive for TMP/SMX and ceprofloxacin and nitrofurantoin, and asking what is
the best drug to give?
A- Cipro
B- TMP/SMX
C- Nitrofurantoin

268. pld after menorrhea – confirm pregnancy

269. child bearing age with acute abdomen- r/o pregnancy

270. Case of endometrial cancer. What’s the mx? TAH + BSO

271. Pregnant wants to quit smoking best way?

A- CBT
B- Nicotine replacement
C- Buprine

272. Pregnent has abruptio placente what is the acid base balance of fetus Asphyxia
A- Res acidosis..
B- Metabolic acidosis
note: Pethidine cause mixed acidosis
Placenta abruptio metabolic acidosis
Pre-eclampsia respiratory acidosis
273. Picture about variable decelation in ctg what is the cause.. Abruptio or cord
prolapse. note:
Late de= Placenta insufficiency
Early de= head
Virable: cord

274. A woman with a history of breast cancer. Which of the following is medically
contraindicated for this woman?
A- Condoms
B- Copper containing intrauterine device
C- Laparoscopic tubal ligation
D- Progestin-only contraceptive pills

275. Vaccines contraindicated in pregnancy? A. Varicella

276.Vaccines given in pregnancy? A. Influenza

277.Case about abrupto placenta.

278. Case about type of abortion.

279.Case of Endometrial hyperplasia:

A. Biopsy

280.Case of PMB and US shows endometrial thickness of 14 mm. I think asking what
is the management?
A. Hysterectomy

281.Case of hyperprolactiemia.

282.TTT of trichomonas vaginalis (greenish vaginal discharge, flagellated organism).

A. Metronidazole
283. Pt with multiple repeated contractions and sluggished fetal heart rate response
on CTG. Mother was given epidural analgesia, given oxytocin to induce labor,
given MgSO4 due preeclampsia. What is the cause of this CTG?
A- Oxytocin
B- Analgesia
C- MgSO4

284.Case about pregnant in 13 weeks with vaginal bleeding. US picture given of a

uterus and a sac contains something. Closed internal os. What is the type of
abortion?
A- Unembryonic sac
B- Missed
C- Threatened

285.Most common infection associated with IUCD is?

A- Actinomyces

286.Pregnant 37wks came to the clinic for follow up BP140/90 no headache,invest on

proteinuria. what is the dx?
A- Pre-eclampsia
B- Chronic HTN
C- Gestational HTN

287.When you will do screening for GDM in weeks?

A-14.
B-24
C-34.

288. Pt 34 years developed PPH S.V.D they give Oxytocin and do massage but not
stopped what you will do?
A- Hysterectomy.
B- Ligation of uterine artery.
Treatment of PPH:
-Uterine massage
-Nipple massage
-oxytocin ( increase contraction ) *para ventricular* and also vasopressin!!
IM 10 after 2-5 min
IV 20
IV. 40
-methergine 0.2 IM “every 2-4 hrs - contraindicated in HTN “
Carboprost! Prostaglandin f2 alpha 0.25 IM every 15 mins maximum is 8!! “
Contraindicated in asthma “
Side effects = diarrhea
 Mesoprastole = prostaglandin E1 per rectal = illegal abortion !! ( but different rout
sublingual )
Side effect = postparypyrxia
403 D
-Surgical
-B linch stitch
- Ligation ( uterine artery from anterior internal iliac artery )
-Immobilization
-Last hysterectomy

289. Post menopausal came to take HRT but doctor said no need according to the
condition but she is insisted for HRT. What is your action?
A- Refer to another gynecologist.
B- Refuse.
C- Respect and give her HRT.

290.Pregnant 10 weeks presented with vaginal bleeding. On exam cervix is closed what is
the diagnosis?
A- Incomplete abortion.
B- Missed.
C- Threatend
*Bleeding: threatened
Brown discharge: missed

291.1st puberty sign in female?

A- Adrenarche
B- Thelarche.
C- Pubarache.
D- Menarche.

292. In which position 4th degree perineal tear occurs? Squatting

293. Endometriosis case.

294. 40yr.old woman asking about ca cx screening, pap smear when to do and asking
for ur advice...
A- no need now
B- can be done 1 year starting from now.
C- can be done every 5 year from now
D- if 3 negative, no need to further test for screening.

295.What is the drug of choice for eclamptic sezure?

A- Phenytoin
B- Diazepam.
C- Magnesium Sulfate

296.Most common labor complication in new born?

A- clavicle fracture...
B- shoulder dislocation
C- femur fracture

297. Pregnant, 16 weeks, discovered to be RH –ve, what to do next?

A- Ultrasound
B- amniocentesis
C- IV RH antibodies...
298. Patient in 3rd trimester have high blood blood glucose despite close observation
What is the suspect cause?
A- neonate hyperglycemia
B- neonate hypoglycemia
C- mother hyper…
D- mother hypoglycemia

299. Stillbirth in KSA is 24 weeks

300.treatment of premenstrual syndrome:

301.Most common affect (behavioral) symptom in premenstrual dysphoric disorder?

A- Irritability
B- Mood swings
C- Depression
D- Anxiety
*PMDS >> irritability
PMS >> mood liability or swings

302. Patient who had hysterectomy and hot flush after the surgery management?
Transdermal Estrogen only

303.Gonerrea case. And another Q about test

a) Gram stain shows Gram-negative intracellular diplococci
304. painful vesicles in labia and cervix: HSV

305. couple presented to infertility clinic. The man is working in battery manufacturing:
Lead

306. vaccine cI in pregnancy

A- HBV
B- MMR
C- Rubella
D- Haemophilus influenza

307. First trimester with Vaginal bleeding. Fetal parts felt in the internal os open.
Diagnosis?
Investable abortion

308.First trimester vaginal bleeding. Internal os closed. Diagnosis?

threatened abortion

309. Short female, with htn, wide neck, dx? Turner's Syndrome✔

310. G 11 weeks, pregnant patient wants to quit smoking, what’ll you do? CBT

311.Postcoital bleeding: Endometriosis.

*the most responsible organ for postcoital bleeding is the cervix.

312. endometriosis relief pain with cycle? Yes

313. Tetanus in pregnancy.

314. pregnant in her 37 week faint and complain of sever abd pain no pleedin pb
80/50 HR120 WHat os diagnosis?
A- pulmonary empolism
B- abruptio placente

315. pte with breast cancer and fibroid on tamoxfin develop vaginal bleeding US
show fibroid 8cm and hypoechogenic area what is diagnosis?
A- endometrial cancer
B- lyomyo sarcoma
C- overian cancer
316.pt with ectopic pregnancy what is pest question before management of the pte?
A- accessability to hospital
B- previous surgery

317. Patients with sx of BV: What’s the test: gram stain

318. Pregnant lady in her first trimester, she was exposed to rubella 3 days ago, what
you’re going to do?
A- Nothing
B- MMR
C- Terminate the pregnancy
D- Rubella Ig

319.A pregnant woman with high BP 140/90 and had severe pre-eclampsia in the past
but has both lower Abdominal pain and back pain with Uricemia. No proteinuria,
in the question
Which shows she has severe pre-eclampsia?
A- BP
B- Abdominal pain
C- Back pain
D- Uricemia

320. Clue cells in vaginal discharge indicates?

A- Attophic vaginitis
B- Bacterial vaginosis
C- Candida vaginitis
D- Trichomonas vaginitis

321. Female pt married has greenish-yellowish discharges with vaginal itching and
bad smell the microscopic is flatella prazite what is the dx? Trichomonas

322.Previous scar CS with USS findings of low lying placenta and AFI 4. Ask about
the absolute contraindication for ECV?
A- US findings
B- other options

323. Pregnant with rupture of membrane at 34weeks presented to ER what to do

first?
A- start antibiotics
B- start steroid

324. Case of PV bleeding at low lying placenta at 34weeks, no ac ve bleeding but

brownish discharge on vaginal exam. Ask about what you will do?
A- admission and observe
B- Discharge home

C- Delivery

325. Case scenario of DVT. Asked about what to

Strat?
A- Heparin
B- Enoxaparin
C- Warfarin
326. Rape case. Asked about expected site of vaginal injury?
A. 8 o'clock
B. 6o’clock
C. 3o'clock

327.Multipara 7 with incontenance and vaginal pouch, what is dx?

- Prolapse

328. Cervical incompetence 2qs:

1- It’s the most common cause of 2nd trimester miscarriage.
2- Ttt by cerclage 12-14 weeks and removed at 36 weeks.

329. most common organism do tubal block? Chlamydia

330. contraindication to EVC? Bicornate uterus

331. Usual screening by mammogram every how many years?

mammogram screening
Starting from the age of 40
40-54: annually
55 and older: every 2 years
^ American Cancer Society -Guidelines
332.Female came to clinic with hx of post coital bleeding, and you do examination
with speculum you found mass in cervix (picture of mass) what the approach for
her?
A- Excesional the mass
B- Take biopsy
C- Check the Ca 125
D- Reassurance
333. Pregnant lady and her kid started to go to school, she is afraid that he will affect
her what vaccine she should take?
- Influenza

334. Picture of anus with Cauliflower, for lady who had multiples unprotected sex:
condylomata.

335. Female with fever and Supra public pain with vaginal discharge?
A- Acute Cervictiitis
B- Acute Salpingitis
C- Vaginal problem
D- Vulva problem

336. pregnant lady have Nuchal translucency +ve > what complication the fetus will
have?
- cardiac anomaly

337. Female not controlled pass of urine during cough or laugh and has suprapubic
pulge.
- vasicocele

338. Pregnant fear that her son may transfer an infection from his school Which
vaccine to give?
- Influenza
339. Preganat c/o sever abd pain and uterine cotractions she was given 6mg Mg
sulfate and the e contractions become normal then decrease the dose to 4mg Then
complained of shortness of breath What to do?
A- give her Ca gluconate
B- Stop Mg sulfate
C- measure serum Mg sulfate D. fluid
** after stop Mg sulfate give the Ca gluconate

340. pregnant during ANC do 50gm glucose test and find high glucose level She is
more liable to which type if infection?
A- Candida
B- Trichomonus
C- bacterial vaginitis
D- atrophic vaginintis
341.pregnant c/o genital wart What to do?
A- cryo..
B- electro..
C- injection by......
**Cryotherapy (cryosurgery) destroys genital warts by freezing them with liquid
nitrogen and it’s safe for pregnancy

342. pregnant in early 2nd trimester c/o painful cx bleeding what to do?
A- pap smear
B- colposcopy
C- biopsy
D- Transvaginal US
* Threatend abortion, Transvaginal US

343. CTG shows cord compression? Variable declaration

344. vaginal discharge, flagellate? Trichomonas

345. Trichomonas, and ask about ttt? metronidazole

346. Fishy odor, dx? Bacterial vaginosis

347. Valval itchy for 1 year, dx?

348. post menopause Bleeding? cancer

349. tender uterus? adenomysis

350. Female in reproductive age, come by an ambulance (RTA) What 1st thing u have
to do?
- check for pregnancy

351. Atrophic vaginitis: Clincally

** definition: dryness of the vagina that occur in postmenopausal women due to low
estrogen production
Features: vaginal spotting (mild bleeding every 4-5 days), vaginal soreness, burning,
dryness, redness, thin vagina with few or non fold, pH alkalosis > 5, periodic petechiae
Treatment: topical vaginal estrogen
352. Ectopic pregnancy 1- 3 cm and bhcg 2600
- medical treatment (methotrexate)

353.Ectopic pregnancy with peritonitis what is the the next step?

A- Laparotomy
B- Medical treatment

354.Patient with severe pre-eclampsia with proteinuria, low platelets, abdominal pain
and high URAC acid What of the following indicate the poorer outcome:
A- high proteins
B- low playlets
C- Abdominal pain
D- High uric acid

355. patient with signs and symptoms of polycystic ovary syndrome and asking about
diagnosis: but they mentioned the other name which is Stein–Leventhal syndrome

356. what is the action of metformin in treatment of polycystic ovarian syndrome?

- reduce insulin resistance

357.The first stage breast milk (colostrum):

- Has high percentage of protein

358.Pap smear: Every 3 years

359. 55 years old with normal mammography when to repeat after:

A- 1 year
B- 2 years
C- 3 years

360. 28 years old female with normal pap smear 3 years old what to do?
A- Nothing
B- Pap smear with cytology

361. When does ovulation happen:

A- peak of LH
B- Peak of FSH
C- Peak of progesterone
D- 21 days after peak of deoxyprogetrone

362. What is the prominent estrogen during pregnancy?

A- Estradiol
B- Estriol
C- Estetrol
**estriol in pregnancy
Estrone in postmenopause
Estradiol in childbearing age

363. Patient with nervousness irritability and severe premenstrual symptoms what to
give:
A- intradermal progestogen patch
B- SSRIs
C- Progesterone only pills
D- Other contraceptive methods other than the OCP
364.Quad test for Down syndrome in pregnancy:
- High Bhcg, low estradiol, low alpha fetoprotein, high inhibin A

365.Many qs about valvular lesion.

366.Pregnant lady in week 13 GA, came with bleeding and suspected she have an infection
what test you do?
A- Pap smear
B- Biopsy
C- Colposcopy
D- Something invasive.
367.pte came in er with vaginal b. by ex diagnosed as abruptio, what to do to save her
life?
A- transfere 2 pack rbc
B- take investigation
C- Call rapid response team of multi specialties.

368.adnexal mass, how to differentiate if it's benign ovarian cyst not malignant?
bilateral