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Chapter 1: The menstrual cycle and vaginal bleeding 1c. Laparoscopy. 2a. Selective serotonin reuptake inhibitors. !d. Webneck. d.

Levonorgestrel intrauterine system.

"c. Absence of any $c. If the FS %d. Long'term is

signs of pubertal development. #d. Turners syndrome. !"# I$%L& clomiphene can be given to induce ovulation.

oestrogen%progesterone substitution is contraindicated in case of ovarian failure. &c. Ten follicles (usually )*+# mm in diameter, arranged peripherally 1'b. -erform an adrenal stimulation

around a dense core of ovarian stroma. test. 11d. .varian ultrasound.

12a. A strong progestogen and acts by

androgen receptor blockade. Chapter 2: (aginal discharge 1e. White vaginal discharge may occur /ith candida infection. infection is also kno/n as moniliasis. Chapter : )e*ually transmitted infections 1a. An increase in vaginal discharge indicates the presence of an ST1. 2Sticky eyes in the neonate may be caused by a chlamydia infection. ulcer of the vulva can be caused by use of steroid cream. 2c. a. An 2b. 0andida

Chapter !: +ower abdominal pain 1b. 0hronic abdominal pain& by definition& has been present for at least 3 /eeks. 2a. 4inety'five per cent occur in the fallopian tube5 2b. -I1 is the

most important factor in the aetiology.

Chapter ": Contraception 1c. -revious pulmonary embolus. All of the above. 2b. Irregular bleeding. a. I$1s. !e.

"b. A /oman /ho under/ent the procedure at the time of a

caesarean section.

Chapter #: ,ealth education before and during pregnancy 1c. Folic acid reduces the incidence of anencephaly in pregnancy. Smoking reduces the chance of conception. 2a.

d. 4uchal translucency !a. -atients /ith

ultrasound is more accurate if combined /ith a blood test.

thalassaemia minor are at risk of having a fetus /ith thalassaemia ma6or. "b. 0ystic fibrosis is more common in people from northern 7urope.

Chapter $: -ntenatal care 1d. 8overnment organisations provide +9 months maternity leave. Thyroid function test (TFTs,. c. :ost cases of 1o/n syndrome are 2d.

detectable by first'trimester screening /ith nuchal translucency ultrasound. !d. An ectopic pregnancy. "b. The /oman should have a transvaginal #d. It is most commonly due to

ultrasound scan and ;uantitative 08. sporadic chromosomal abnormality.

$c. Antenatal care in the second

trimester aims to identify and manage any obstetric or medical problems that develop during this time. %d. :aternal serum screening may be offered to &c. <lood pressure measurement.

assess the risk of 1o/n syndrome.

Chapter %: The fetus 1a. er dates may have been incorrect. associated /ith maternal preeclampsia. 2c. Intrauterine gro/th restriction is e. A =>'year'old /oman /ith !a. Amniotic fluid

diabetes mellitus is at risk of having all of the above.

volume reflects uterine perfusion and the processes of fetal s/allo/ing& fetal cardiac function and renal function. "e. All of the above.

Chapter &: .edical disorders in pregnancy 1a. True. 2a. True. a. True. !a. False. "a. False. #a. True. $a. False. %a. True. &a. False. 1'a. False. 11a. False. 12a. False. 1b. True. 2b. True. b. False. !b. False. "b. False. #b. True. $b. True. %b. True. &b. False. 1'b. False. 11b. True. 12b. True. 1c. True. 2c. True. c. False. !c. False. "c. True. #c. False. $c. True. %c. True. &c. True. 1d. False. 2d. False. d. False. !d. True. "d. False. #d. False. $d. False. %d. False. &d. False. 1e. True. 2e. True. e. False. !e. False. "e. False. #e. True. $e. True. %e. True. &e. False. 1'e. False. 11e. False. 12e. False.

1'c. True. 11c. True. 12c. True.

1'd. False. 11d. False. 12d. True.

Chapter 1': /nfections in pregnancy 1b. A /oman /ho consults her doctor after discovering that she /as immunised against rubella = /eeks after conceiving should be offered reassurance. 2d. A /oman /ho is <eAg positive should have a program

of hepatitis < immune globulin and active hepatitis < vaccination /ithin +9 hours of birth to minimise the risk of vertical transmission of hepatitis <. $rinary tract infections in pregnancy are common because urinary stasis is increased in pregnancy. e.

Chapter 11: 0reterm birth 1a. True. 2a. True. a. True. !a. True. 1b. True. 2b. False. 2b. False. 2b. False. 1c. False. 2c. False. 2c. False. 2c. True. 1d. True. 2d. False. 2d. True 2d. True. 1e. True 2e. False. 2e. False. 2e. True.

Chapter 12: .aternal and perinatal mortality 1a. -ulmonary embolism5 1c. aemorrhage5 1d. -reeclampsia. 2b.

-rematurity5 2c. $ne?plained intrauterine death.

Chapter 1 : +abour and delivery 1c. 0ardiac output& blood pressure and catecholamine secretion all rise. 7pidural analgesia may be associated /ith a lo/'grade maternal pyre?ia. d. The average duration of second stage of labour for the nullipara /ithout an epidural is 3# minutes. !b. :aternal morale deteriorates after 3 hours "a. Action and alert lines on #b. 2a.

and rapidly declines after +9 hours in labour.

the partogram provide visual cues for abnormal progress of labour.

7arly amniotomy allo/s visualisation of the li;uor and augments labour5 #d. The most likely reason for slo/ progress in a nulliparous labour is inefficient uterine action5 #e. .ne'to'one care in labour has been sho/n to reduce the

duration of labour.

$c. :edical conditions affecting the mothers ability to %c. The membranes must be &b. The

push are an indication for a forceps delivery.

ruptured before an instrumental delivery can be performed.

ventouse re;uires less analgesia at delivery and is associated /ith less pain postpartum. 1'a. The pregnancy could be at "9 /eeks gestation5 1'b. The

pregnancy may not be post'dated. The risks of prolonged pregnancy and induction of labour should be discussed /ith the /oman5 1'e. 0onservative management may be considered& /ith close surveillance until spontaneous onset of labour. 11a. 0ervical ripening /ith prostaglandin may be re;uired

for a cervi? /ith a <ishop score of =5 11c. Amniotomy is an effective method of inducing labour5 11d. $terine rupture is a risk associated /ith induction of labour5 11e. 7lectronic fetal monitoring is recommended for /omen on o?ytocin infusion. 12a. 4aegeles rule gives an e?pected date of delivery of

#).++.#"5 12c. The first ultrasound e?amination supports Stephanies menstrual dates5 12e. Stephanie should be offered urgent induction of labour if undelivered on the +#.++.#". Chapter 1!: )pecific obstetric emergencies 1d. painless vaginal bleed. 2b. vaginal e?amination. c. -rimary -- is

still a ma6or cause of maternal mortality.

!c. @isk reduction can be achieved "d. The management of

by the routine use of prophylactic o?ytocic agents.

established primary postpartum haemorrhage consists of initial assessment and treatment follo/ed by more directed interventions. dystocia is more common in mothers /ith diabetes. a higher risk of cord prolapse. #b. Shoulder

$b. It is associated /ith

Chapter 1": The newborn 1c. A neonate is premature if born at =9 /eeks gestation. infants are susceptible to hypothermia. Chapter 1#: 1outine management of the puerperium 1c. Increased levels of prolactin and /ithdra/al of progesterone post'delivery. 2e. -alpation of the descent of the uterine fundus. a. In a subse;uent 2e. -remature

pregnancy& it is important to attend early antenatal care and discuss mode of delivery /ith the obstetrician. !c. :aternal morbidity rates are the same for "c. $terine tenderness& purulent %e. All of the above.

vaginal birth as for caesarean delivery. lochia and fever. #d. -rimiparity.

$b. Anal sphincter.

&e. All of the above.

1'e. 7ncouragement to keep the area clean and report

to the doctor if there is any pain& increasing odour or discharge from the site. Chapter 1$: The psychological e*perience of pregnancy 1b. The incidence of depression is >#A higher in the third trimester than in the early postpartum period. 2e. All of the above. e. All of the above.

!a. It can be used in the antenatal period as /ell as the postnatal period5 !b. It has high specificity and sensitivity. serotonin reuptake inhibitors. "e. All of the above. #a. Selective

Chapter 1%: /nfertility 1d. )#A. above. Chapter 1&: 2nplanned pregnancy and termination 1e. :ental health reasons. 2e. :ost /omen bleed for at least a /eek 2c. @educed oocyte ;uality. c. :otilityB "#A. !e. All of the

follo/ing termination. termination.

c. -rostaglandins are commonly employed to induce

Chapter 2': 3enital prolapse 1e. A vaginal pessary may satisfactorily treat this problem. unlikely to manage this problem satisfactorily. 2c. A pessary is

d. Women /ith posterior

vaginal /all prolapse may have to place a finger in the vagina to assist /ith bo/el evacuation. Chapter 21: /ncontinence 1a. It occurs /ith a sudden increase in intra'abdominal pressure. 2d. She should have urodynamic studies performed.

Chapter 22: The menopause and beyond 1d. 0ombined continuous oestrogen and continuous progestogen. Irregular bleeding. d. -hytoestrogens. 2a.

!d. The /oman should be referred

for specialist for evaluation. atrophic changes. #d.

"b. The bleeding is likely to be due to vaginal

ysteroscopy and endometrial sampling are probably

the best diagnostic tests for postmenopausal bleeding. Chapter 2 : 0rinciples of operative gynaecology 1a. Anaesthetic assessment. consent5 2f. All of the above. Chapter 2!: 0rinciples of oncology 1d. An abnormal finding does not necessarily imply the need for a histological diagnosis. 2a. A /oman has had three pregnancies from 2b. Surgical risk assessment5 2c. Informed

three different partners. cancer.

e. It causes fe/er deaths than ovarian

!d. @egular screening programs can eradicate cervical cancer

more effectively than any other cancer of the female reproductive tract. "c. They are nulliparous. #a. It has been sho/n to reduce mortality $c. All

from breast cancer in screened populations by around 9#A.

/omen over "# years of age and others selectively according to risk factors. %c. <y any effective cytological or histological test. &c. They

/ill have decreased disease'related morbidity by selective treatment based on individual findings at staging. previously. 1'a. had a molar pregnancy 12d. .bstetric

11d. It can occur after normal childbirth.

ultrasound sho/s a normal fetus and a placenta. occurs in both ovaries. 1!e. .mentum.

1 c. It fre;uently

1"d. Fe/ malignant tumours

arise from the ovarian stroma.

Chapter 2": 4omen and society 1c. Abortion /ithout the parents consent is illegal in a girl under +3 years of age. 2b. They are more likely to be smokers than older

/omen5 2c. They are more likely to come from a disrupted family.