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AMC RECALL PAPERS: OBSTETRICS &

GYNAECOLOGY

2005
While doing hysterectomy in lithotomy position WOF nerve is prone to injury--a) Pudendal nerve
b) Sciatic nerve
c) Common peroneal nerve
Ans: Standard textbooks of gynaecology mention about stretch injury of the sciatic nerve
and its peroneal branch as complications following vaginal hysterectomy.

A woman is challenged with combined oestrogen & progesterone, but does not get
withdrawal bleeding. Which organ is most likely to be affected?
a) Overies
b) Uterus
c) Pituitary
d) Hypothalamus
e) Fallopian tubes
Ans: Uterus.
The most appropriate OCP for a 24-year-old woman taking phenytoin is?
a) Microgynon 30
b) Microgynon 50
c) Diane 35
d) Clomiphene
e) Oestrogen 85 micrograms
Ans: Microgynon 50.
(JM p.960, LJ p.250)

A 20-year-old female presents to you with amenorrhoea. On ultrasound, a cyst(1.8 x

1.3 x 1.0 cm) is found on the right overy. What is the most appropriate management?

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a) Laproscopy to find cytology

b) Repeat ultrasound in 4 weeks time ***
c) Do nothing
d) OCP
e) Oophorectomy
Ans: cysts less than 7 cm are given around 6 to 7 weeks of time for follow up, if more
than 7cm go for laparotomy. Functional ovary less likely to be malignant. Kaplan Obs. p.

(Kaplan Obs and Gynac)

Regarding oxytocin, which of the following is true?
a) Has an anitdiurectic effect
b) It is a steroid
c) It is produced by the posterior pituitary
d) It has an action on most of the involuntary muscles
e) It causes milk production
Ans: Oxytocin is a nonapeptide produced from Post Pituitary along with vasopressin.
Mainly act on myometrium in therapeutic doses which is mediated by intracellular
influx of calcium and synthesis of PG.

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Oxytocin is responsible for milk ejection reflex but not milk production.
Oxytocin in higher doses shows ADH like action upon kidney leading to decrease urine
output.
In normal therapeutic doses doesnt effect BP but higer doses cause brief fall in BP (KDT
p.319-320).
A female, 17 weeks pregnant, has acute right iliac fossa pain. Which of the following is
the least likely cause of the pain?
a) Pyelonephritis
b) Red degeneration of a fibroid
c) Ectopic pregnancy
d) Acute appendicitis
e) Torsion of an ovarian cyst
Ans: C. Ectopic Pregnancy.
(353 Across: AIPG Book)
Depo provera can cause all the following, except?
a) Mild hypertension
b) Amenorrhoea after the 3rd injection
c) Fertility problems for 6-12 months after stopping the treatment
d) Menstrual irregularities
e) Weight gain
Ans: Hypertension
What are the potential side effects of Amenorrhea (eventually occurs in
taking DMPA?
Most women within 1 year of
(consistent use); irregular bleeding
(spotting); decreased bone density
(fully reversed once DMPA is
stopped); acne; headache;
depression
There is no evidence to date that DMPA leads to weight gain
Weight gain: May be up to 2-3 kg over a year on Depo Provera.
http://www.rxlist.com/depo-provera-drug.htm

An 8-week gestation primigravida, presented with slight vaginal bleeding. You will do
an ultrasound examination for all of the following, except?
a) To see if the sac is within the uterus or not

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b) To see if the foetus is alive or dead

c) To check for any congenital anomalies
d) To look for a clot inside the uterus
e) To look for the position of the placenta
Ans: C (Deja Review)

A 25-year-old female presents with galactorrhoea and amenorrhoea, CT scan shows

the presence of pituitary adenoma, 3 mm in diameter, and 1.6 mm from the optic
chiasma, with no visual disturbances. Prolactin level is high (4250). What is the most
appropriate management?
a) Trans-sphenoidal surgery
b) Phenothiazine
c) Bromocriptine
d) Clomiphene
e) OCP
Ans: The dopamine agonist, bromocriptine mesylate, is often the initial drug of choice. It
lowers the prolactin level in 70-100% of patients. Agents other than bromocriptine have
been used (eg, cabergoline, quinagolide). (Notes Hyper PRL)
Therapy should be continued for approximately 12-24 months (depending on the
degree of symptoms or tumor size) and then withdrawn if prolactin levels have
returned to the normal range. After withdrawal, approximately one sixth of
patients maintain normal prolactin levels (emedicine: Topic Hyperprolectinemia)

A primigravida, 14 weeks gestation, is found to have proteinuria (+++), BP 150/95

mmHg and swelling. What is true?
a) She has pre-eclampsia(24 wks)
b) She has UTI
c) She will not be carry on with the pregnancy
d) Renal hypertension
e) Pre-existing renal disease
Ans: Pre existing renal ds.

In a postmenopausal woman, what is the least likely cause of greenish foul smelling
vaginal discharge? ***
a) Trichomonas vaginalis- long standing cases discharge is greenish and frothy

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b) Gardnerella vaginalis strong fishy smell, grayish discharge

c) Chlamydia may be mucopurulent
d) Foreign body
e) Cervical carcinoma
Ans: E.
What is true regarding carpal tunnel syndrome in pregnancy? ***
a) Relieved by use of splint with hand in extended position
b) Causes severe pain in the thenar eminence position
c) Rarely requires surgery
d) Diuretics should be given
e) Becomes better as gestation progresses
Ans: C.
Splint in Nutral position (JM: Pregnancy Complication)
The mainstay of treatment for carpal tunnel syndrome (CTS) is rest, wrist immobilization
with a splint, and nonsteroidal anti-inflammatory drugs (NSAIDs).
Corticosteroid injections, oral steroids, and diuretics are other treatment modalities that
have been used.
A volar splint should be placed in neutral position because flexion and extension of the
wrist increases carpal intracanal pressure.
Definitive therapy consists of surgical release of the transverse carpal ligament.
http://emedicine.medscape.com/article/822792-treatment

A woman comes to you 2 years after her menopause asking for something to relieve
her postmenopausal syndromes. You decide to give her combined HRT. You explain to
her that all of the following are the effects of progesterone, except?
a) She will have pre-menstrual like symptoms
b) She will have withdrawal bleeding every month
c) Progesterone will oppose the action of oestrogen on the endometrium
d) Progesterone will potentiate the action of oestrogen in increasing HDL***
e) Progesterone will augment the action of oestrogen for prevention of osteoporosis
Ans: D.
(Deja Review: 216)
There is no effect of estrogen and progesterone on Lipid profile.

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Which of the following is not true, for a woman having antenatal care?
a) Presence of Anti-Rho means that the baby can have permanent heart block
b) A platelet count of 100,000 is a risk for developing intracranial bleed in the infant
c) The presence of ANA could cause growth retardation of the foetus
d) ?
Ans: A.
Permanent heart block is seen in SLE (emedicine)

Which of the following occurs in pregnancy by progesterone?

a) No renal changes
b) Dilatation of the ureters & calyces
c) Dilatation of the calyces only
d) Dilatation of the ureter only
e) Reduce incidence of infection
Ans: D.
Increased Vasico uterine reflex to cause infection.
(Deja p.230)

Which of the following CTG patterns indicates foetal distress?

a) Acceleration with foetal movements
b) Early decelerations with uterine contractions
c) Decelerations when the foetus is sleeping
d) Accelerations on sound stimulation
e) A beat to beat variability< 5 beats/min
Ans: C.
Decelerations are always bad.

Regarding administration of anti-D gamma globulin in Rh -ve women, which of the

following is true?
a) It is a form of active immunization Passive immunization
b) Administration in the 2nd trimester of pregnancy has been shown to decrease
autoimmunization in the mother 28th week 300ug of IG
c) It increase the risk of HIV transmission Not always
d) It should be given within 24 hours of the delivery-2nd it should be given within 72 hrs
of deliver
e) It is not necessary to give it in cases of ABO incompatibility-1st

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Ans: E. not necessary.

A young woman, pregnant for 14 weeks, uterine size corresponding to 16 weeks, now
presents with bleeding and passing out grape like material through a dilated cervix.
Which of the following is the best follow up?
a) weekly monitoring of urine HCG, until it comes to normal level
b) Ultrasound
c) Chest X ray for metastasis
d) Check placenta for signs of malignancy
e) Observation & reassurance
Ans: A.
Weekly Until 3 consecutive tests become Negative for HCG (Deja Review: Complication
of Pregnancy: Topic H Mole)
A 32-years woman became pregnant. She had 5 pregnancies before, of which she lost
3 spontaneously between 8-10 weeks & 2 were stopped by intervention at 12 weeks.
What is the most likely cause?
a) Cervical incompetence
b) Chromosomal abnormalities
c) Hormonal imbalance
d) Ovarian tumor
e) Valvo vaginitis
Ans: B.

All of the following are true about neural tube defect, except?
a) Decrease in alpha fetoprotein
b) Polyhydramnios
c) Folic acid prophylaxis can decrease the risk of neural tube defects
d) There is a 4% chance of neural tube defect in the 2nd pregnancy
e) Can be detected by amnio centesis
Ans: A.
Recurrence risk of giving birth to a second child with a neural tube defect varies with
incidence. Investigators found the risk of having an additional affected birth after an
anencephalic or spina bifida birth to be approximately 10.4% in Belfast but only about
4.12% in London. The risk in the United States is 1-3%.

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Of all the suspected teratogens, carbamazepine, valproic acid, and folate deficiency
have been most strongly tied to the development of neural tube defects. In humans,
carbamazepine and valproic acid have been definitively identified as teratogens.
Valproic acid is a known folate antagonist and its association with neural tube defects
may be through that action. A woman taking valproic acid during pregnancy has an
estimated risk of 1-2% of having a child with a neural tube defect. Therefore, women
taking antiepileptic drugs during pregnancy are advised to undergo routine prenatal
screening with AFP.
The first step in prenatal screening is measuring the maternal serum AFP at 15-20
weeks' gestation. A patient-specific risk is then calculated based on gestational age and
AFP level. For example, at 20 weeks' gestation, a maternal serum AFP concentration
higher than1000 ng/mL would be indicative of an open neural tube defect. Normal AFP
concentration in the maternal serum is usually lower than500 ng/mL.
If AFP level is <4.0 MOM in relatively early pregnancy 2 nd test is recommended. If
values are high USG and Amniocentesis are recommended.
In patients in whom a question persists, amniotic AFP can be obtained. It is a
significantly more accurate test, especially at 15-20 weeks' gestation, and detects
approximately 98% of all open neural tube defects, although this method is not the
preferred screening test. Amniotic fluid acetylcholinesterase levels add an increased
degree of resolution.
Detection of a neural tube defect with fetal ultrasonography in the hands of a skilled
ultrasonographer is usually 98% specific (nuchal translucency at 11 to 13 weeks). Falsepositive findings can result from multiple pregnancies or inaccurate fetal dating.
However, closed neural tube defects can sometimes remain undetected, especially in
cases of skin-covered lipomyelomeningoceles and meningoceles, in which the AFP levels
may also be normal. These closed neural tube defects comprise about 10% or more of
total neural tube defects discovered. A skilled ultrasonographer can detect these lesions
with almost 95% sensitivity.
Most common neural tube defects are: Anencephaly and Spina bifida.(emedicine)

A partial list of the fetal anomalies that are associated with elevated AFP levels is as follows:

Anencephaly
Spina bifida cystica
Encephalocele (leaking)
Conjoined twins
Omphalocele
Turner syndrome

Gastroschisis
Exstrophy of the cloaca
Oligohydramnios
Sacrococcygeal teratoma
Polycystic kidneys
Fetal death

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Urinary tract obstruction

http://emedicine.medscape.com/article/979902-overview

A 19-year old primigravida, 38 weeks gestation, with hyper-reflexia, hypertention and

oedema, might be expected to have elevated blood levels of all of the following,
except?
a) Platelets
b) Uric acid
c) Creatinine
d) SGOT
e) BUN
Ans: Platelets.
(Deja Review p.305)
JM p.1053 read Guidelines for Urgent referral or admission in Hospital.
Which of the following is an absolute contraindication for OCP use?
a) Migraine with hemiplegic aura
b) Smoking
c) Varicose veins
d) Diabetes mellitus
e) Gall bladder disease
Ans: A.
(JM p.961)
All of the following are used in dysmennorhoea, except?
a) D & C
b) Progesterone
c) Mefnamic acid
d) OCP
e) Bromocriptine
Ans: Bromocriptine
(JM p.998)

A 62-years-old female complaints of bleeding per vagina. After examination and

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investigation, endometrial hyperplasia was found and a solid mass (5 cm in diameter)

was found in one of the ovaries. Possible diagnosis is?
a) Teratoma
b) Ovarian ca
c) Fibroma
d) Granulosa cell tumor
Ans: D. 10% cases associated with endometrial ca.
(LJ p.308)
Association (Across 353)
A pregnant woman, 34 weeks-gestational age, presents with antepartum
haemorrhage. You diagnose abruptio placenta. All of the following are possibly seen,
except?
a) Tense & tender uterus
b) BP of 180/110 mmHg
c) Shock out of proportion with the bleeding
d) Foetal head mobile above the pelvic brim
e) Dead foetus
Ans: D.
Fetaus cannot be palpated due to tense and tender uterus.
(Dutta p.248)
OCPs mainly affect which site?
a) Hypothalamus
b) Pituitary
c) Ovaries
d) Endometrium
e) Cervical mucous
Ans: Hypothalamus
POP effect the cervical mucus.
On clinical examination, how do you differentiate an ovarian tumor from ascitis?
a) Dullness in the periphery & central tympanetic note, on percussion
b) Tympanetic note in the periphery & central dullness, on percussion
c) Shifting dullness
d) Decreased bowel sounds
e) Fluid thrill
Ans: B.

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A 26-years old primi, 152 cm tall, with vertex presentation, head at 0 station, cervix
effaced completely and dilated to 4 cm, with intact membranes at 37 weeks. What is
the most approprate management? ***
a) Lower segment caesarean section
b) Oxytocin to induce labour
c) Ultrasound to detect foetal abnormalities
d) X-ray pelvimetry
e) Trial labour
Ans: E.
A 24-year old woman came with secondary amenorrhoea & was diagnosed to have
Poly Cystic Ovarian Syndrome. WOF is true about her conditions-a) Immediate laparoscopic removal of cysts Testosteronne-increase LH:FSH-increase
b) FSH:LH ratio will be 3:1 LH-increase Insulineincrease)
c) Increase androstenedione also Testosterone LJ-223
d) 17-hydroxy Progesterone will be normal
e) USG will show echo density over the affected part of the ovariesEchofree
Ans: C.
LH is elevated LH:FSH=3:1
Andrstenedione and DHEA elevated
(Dutta p.422)
In a twin pregnancy, after delivery of the first twin, you do all of the following, except?
a) Vaginal examination
b) External version if the second twin is breech
c) Oxytocin infusion if contractions dont start
d) Check foetal heart rate
e) Check lie of the second twin
Ans: B
(LJ p.175)
Regarding uterine rupture after previous Lower segment Ceasarian Section WOF is
most likely indication?
a) Incidense is increased by 5%
b) Increase with prostaglandin induction
c) Increase with oxytocin augmentation
Ans: C.
LSCS chances of rapture is less than 0.5%.

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Classic CS rapture chances is 5%. (LJ p.184)

Which of the following cancer is most common to metastasize to bone ?

a) Prostate Cancer [ Murtagh-GP:247 B-P-L: Breast-Prostate-Lung]
b) Stomach Cancer
c) Breast Cancer
d) Lung Cancer
e) Cerebral Cancer
Ans: breast.
Prostate ca never goes to brain parenchyma but involve skull.
(JM p.243)
Regarding contraception, all of the following are correct except- ***
a) It is absolutely contraindicated in women with migrainous aura [GP-961]
b) It should not be prescribed for a patient with DVT
c) If patient is on 20 microgram there is no need to stop pre-operatively
d) 50 microgram should only be started if 30 microgram causes irregular bleeding
Ans:
A 26 yrs old young lady with 10 weeks of amenorrhoea. WOF test will affect her
management after the diagnosis of her pregnancy?
a) Varicella Antibody
b) HIV
c) Glucose Challenge test
Ans: B
(Dj p.369)
(Dj p.267) vericella.
WOF is not true regarding neural tube defectsa) Decrease alpha feto protein
b) Folate intake can decrease the incidence
c) Can be detected by amniocentesis
d) Socioeconomic factor is an important factor
Ans: A. see above discussion.

ps

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2006
AOF are used in BISHOP Score , Excepta.Cervical length
b.Cervical dilatation
c.Position relation to ischial spine
d.Moulding of the head
e.Cervical effacement
Ans: D.
Remember the mnemonic C P E D S
Question on repeated abortion.A female with H/O 2 abortion.

At what level OCP works?

a.Cervix
b. Hypothalamus ***
c.Uterus
Ans: B
Anti D immunisation.WOF is truea. Not required in B-ve baby
b. To be useful must be given within 24 hours of delivery of the baby (With in 72 hrs of
delivery)
c. If given during second trimester can reduce the risk of autoimmunization
d. Is not required if there is associated ABO incompatibility
e. Is an active immunization
Ans: d. ABO incompatibility decreases the risk of autoimmunization. Kaplan Obs p.70

The time of ovulation is accurately diagnosed by WOF?

a.Serial LH surge
b.Urinary LH
c.Regular basal body temp.
d.Estimation of progesteronein mid luteal phase
Ans: Urinary LH.
An LH urine test detects a rise in lutenizing hormone (LH). Such a rise, or surge, signals the
ovary to release the egg. This at-home test is often used by women to help predict
ovulation.
http://www.nlm.nih.gov/medlineplus/ency/article/007062.htm

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An 18 yr old girl comes to you for your advice regarding Contraceptives as she is going to
start her sexual relationship.WOF you will prescribe:
a. OCP
b.IUCD
c.Condom
d. Low dose progesterone
Ans: C (JM Family Planning)
A 45 yr old lady complains of irregular menstrual bleeding. She has been treated for CIN-II
previously and a Pap smear done 6 months ago was fond normal.WOF is the most
appropriate investigation for her?
a. Colposcopy
b. USG to detect endometrial thickness
c. Cone biopsy
d. Endometrial curettage
e. Repeat Papsmear
Ans: E. Repeat Pap smear***
Coloposcopy should be done when the pap smear is Abnormal, and after treatment of CIN
lesion the followup pap smear should be done every 3 to 6 months for 2 years.
Dj Review 131, JM Cervical Carcinoma
A 29 yr old lady comes to you with obesity, irregular cycles and hirsutism. What will help
you to Dx her conditiona.Increased FSH : increased LH
b.Incrased LH: increased FSH (Dx-Polycystic Ovarian Synd.)
c.Increased Prolactine level
Ans: B. LH: FSH ratio is 3:1.
A 32 yr old primi in her 33 weeks of gestation informs you that her babys movement
suddenly become decrease for the last 28 hrs. Before that her pregnancy was going
normal without any problem.WOF would be your management to combat the concern:
a.USG [October03]
b. Do Cardiotopography(CTG)
c.Fetal Scalp pH
d.Immediate delivery of the baby
Ans: B.

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A 38 yr old primi of 39 weeks pregnancy admitted in Labour Unit with the onset of regular
uterine contraction, her cervix is 8 cm dilated, fully effaced, station +1, initially fetal heart
rate was 155 but after a while on the progress of labour fetal heart beats suddenly falls
from 155 to 80 per minute; otherwise normal in respect of mothers general condition.
What would be your next step of Mx: ***
a.Fetal scalp pH
b.Cardiotopography
c.Vaginal examination to exclude any cord prolapse
d.Emergency delivery by C/S
e.Percutaneous umbilical sampling
Ans: D
What is the best medication to give as Postcoital Contraception ?
a.OCP
b.Levonogestrol within 72 hrs,and second dose 12 hrs after the first one.
Ans: B. JM 964
Failure rates: JM 960.
A lady recently married comes to you with vaginal infection(cystitis).This is 3rd episode.
Most appropriate Ix- ****
a. Vaginal swab
b. Husbands urethral swab
c. Colposcopy
Ans: ..
A female comes to you for infertility. Her LH increased, FSH increased, Oestradiol
decreased. Rx:
a.Clomiphen citrate
b.Give her Oestrogen daily
c.IVF
Ans: Premature Ovarian Failure. B.
HRT is the treatment initially.
http://members.medscape.com/article/255974-treatment

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A young obese 24 yr old female with hirsutism, oligomenorrhoea and irregular periods,
was found to have endometrial hyperplasia(benign)on curettage.AOF are appropriate
treatments, Excepta. Progesterone from 14 to 21 day of each cycle
b. Diane35
c. Clomiphene citrate
d. OCP
e. Oestrogen alone
Ans: E.
A baby with Downs syndrome is born to a couple who definitely refuse to take the child
home after failure to convince them.The most appropriate course of action:
Arrange temporary foster care
Ans: Arrange temporary foster care (Annotated Multiple Choice Question)
A multigravida presents at 37 weeks gestation, not in labour, with a breech presentation
and ruptured membranes. What should you do initially? ***
a. Immediately C/S
b. Vaginal examination
Ans:

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2007
A woman came at 17 weeks of pg with lab reports showing that there is a 1:50 chance of
getting a Down's syn baby. She does not want a Down baby. She is asking for your
management. What do you do?
A. terminate
B. do amniocentasis
C. do usg to exclude Down's
D. reassure
Ans: C.
Best way to measure the EDD?
A. 8 wk clinical ex
B. 8 wk USG
C. 18 wk Clinical ex
D. 18 wk USG?
E. Late trimester uterine height
Ans: 8 weeks USG (Annotated Multiple Choice Questions).

A woman came G2P1 with prevoius delivery of a 4200 gm baby at 42 wks with shoulder
dystocia. What do you do this time? ***
A. Induce at 38 wks
B. Induce prematurely
C. do x-ray pelvimetry at term
D. CS
Ans: A.
Dj 386
Regarding soulder dystocia, which is correct?
A. It is not assoc. with maternal DM
B. Arrest occurs at pelvic inlet
C. Increased possibility if epidual anaesthesia given
D. Most cases can be resolved by hyperflexing the fetal thighs onto the abdomen.
E. Erb's palsy (C8-T1) is a complication

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Ans:
All i know is the root value for Erb's palsy given was wrong.
An 18 yo girl came to you for contraceptive advice. she has decided to commence on
sexual activity but has not yet chosen her partner. What advice do you give her?
A. CoC
B. IUCD
C. CoC + Condom
D. barrier methods
Ans: C

A mother of two child comes to you for contraceptive advice. You prescribe microgynon
30. She again comes and tells you that she experiences bleeding twice a month. One with
2 days duration and another for 5 days. What will be your next step?
Increase the dose of Estrogen.
The best method of diagnosing the exact date of gestation.

A pregnant lady presents at 26 weeks with hydrops fetalis. Which investigation will help
you in the management:
a.coombs test
b.IgM and Ig G for parvovirus
Ans: A.
Treatment for mastalgia
a.danasol
b progesterone
c.ocp
Ans: C.
(JM Breast Pain)
Which if the most important factor for osteoporosis in women
a.Menopause in 40 years
b.BMI <20 C.?
Ans: BMI <20 (JM Menopause and osteoporosis)

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A 17 year old girl presented with amenorrhea. Her height and physical appearance are
normal for her age. What will be the cause
a. mullerian agenesis
b.ovarian agenesis
c.ovarian dysgenesis
c.pituitary failure
d.hypothalamic dysfunction
Ans: A.
(Long question and choices) the time interval between onset of growth spurt and
menarche

CTG for 30 min given heart rate 145, baseline variability 5bpm, no acceleration, no
decelerations,
a.normal
b.abnormality due to fetal sleep
c.abnormal and requires immediate cs.
d. abnormal and scalp ph.
e.some abnormality present and requires close observation.
Ans: ..
A long question about when to start folic acid and how long to take it to prevent neural
tube defect.
Most accurate method of diagnosing downs syndrome
a.maternal serum examination at 16 weeks
b.maternal seum and nuchal thickness at 11 weeks
c?
Ans: ..
What is the most important adverse effect of GA over epidural anaesthesia in normal
labour?
a.maternal hypotention
b.thiopentone has direct respiratory depressant action on foetus
c.increase bleeding
Ans:

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2009
16w pregnant primi, C/o, vomiting, Tenderness and guarding over RIF, no fever No
bleeding, Increased when straining
a. A Apendicitis
b. Salphingitis
c. PID
Ans: .

36w Pregnant mother, with 2 children given birth at 39w previously. She wants to deliver
bcos herusbund is going for interstate the next day. Her cx 2cm long, not dlated. What is
your advice?
a. Do induction next day
b. Do a LSCS
c. Decline her request and ask her to wait till spont onset.
Ans:

Woman with bloody nipple discharge, what is the most probable diagnosis?
a. Duct papiloma
b. Abcess
c. Breast CA
Ans: A (JM Breast)

A lady 6 months post purtum presented with depressed mood and tearfulness. She said
that, she is having a feeling to through her baby in to the wall and fear that she will do so.
For that reason she always asks her husband to be around and never leave her and baby
alone. What is the condition?
a. Delusions
b. Obsession
c.

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Ans: Obsession
A 16 years girl presented with an endometrioma of ovary, size 7cm. what is the
management?
a. Laparoscopy and removal
b. Follow up after 6 weeks
c. Reassurance
Ans: Laparoscopy and removal (Kaplan Obs)

A lady presented with amenorrhea of few months with galactorrhoea, no symptoms of

Virilisation.What is the diagnosis?
a. Prolactinoma
Ans: Prolactinoma

A girl of 16 years of age comes to you with her boy friend who is only 15 years of age. She
was asking for OCPs. What should be you action?
a. Refuse to give
b. Counsel and give OCPs
c. Telephone her mother
Ans: Counsel and give OCP

A 85 years old lady presented with vaginal prolapse, 3rd degree. What is the
management?
a. Pessary
b. Surgery
Ans: .

A lady 2 days post purtum asked you that she does not want to feed her baby. What is the
first step to stop breast milk?
a. Tight fitting bra and stop stimulating nipple
b. Bromocriptine
Ans: Tight fitting bra and stop stimulating nipple (JM Post Purtum Complication)

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Sonia is a 24 year old secretary , One week after delivery of a healthy baby, she
presented to you as a GP with 4 cm Breast Abscess, what is your management
a)
b)
c)
d)
e)

flucloxacillin 500mg qid

Repeated aspiration or mini incision and drainage combined with antibiotic therapy.
Repeated aspiration or mini incision and drainage only, stop breadfeed
Swab culture.
A trial flucloxacillin 500mg qid before incision of abscess

Ans: B
Inappropriate antibiotics continue to be prescribed for breast infection. Optimal
management of breast abscesses consists of repeated aspiration or mini incision and
drainage combined with appropriate antibiotic therapy.
Avoid breast feeding in the affected side until symptoms relieved.(JM)

ps