Obs and Gyn 6th year Final exam / 2012

1) organic causes of menorrhagia include all of the following except: a. PCOS b. endometrial hyperplasia c. endometrial cancer d. copper releasing IUCD e. fibroid 2)About Contraception failure rates, all true except : a. POP 2% b. COC 1% c. depo-provera 1% d. implanon 1% e. mirena 0.5% Cant recall the % :/:/.. check the lec.. 3) About lower uterine segment .. one is true: a. bladder is posterior b. covered by loose vesciral peritoneum (not sure) c. round ligament from its upper part d. crossed by the ureters e. inferior epigastric artery are lateral to it 4) Monozygotic twins .. all true except : a. mainly diamniotic b. increased risk of C/S c. more congenital heart disease d. are 1/3 of all twins 5) About female sterilization .. all are true except :

a. is absolutely contraindicated if <28 yrs old b. needs a consent from the husband 6) regarding C-section, all of the following are true except : a. midline incision is more painful than the lower segment transverse b. bladder injury is more common than uretric injury Something else!! 7) All are fertility sparing treatment for fibroid except: a. LHRH analogue b. myomectomy c. Uterine artery embolisation d. COC e. mifepristone (RU 486) 8) female with pap smear the result is LSIL , next step : a. Colposcopy b. Referral in 6 months 9) Couple, infertility , tall male with small testes. Semen analysis: oligospermia, next step: a. Karyotype b. Fsh level c. Prolactine 10) About recurrent miscarriages all are true except : a. screening for toxoplasmosis is recommended b. screening for lupus anticoagulant is recommended c. can be associated with PA d. progesterone is recommended in unexplained cases 11) All of the following can decrease effect of COCP except:

a. Phenytoin b. Amoxicillin c. Gastroenteritis d. Rifampicin e. Valproic acid 12) GA: 37 wks, asymptomatic placenta previa anterior, 1 cm above cervix edge, the patient is at risk off all except: a. PPH b. NICU admission due to RDS c. Severe neonatal anemia d. C/S Clue cells are seen in : a. bacterial vaginosis Case: ovarian tumor bilateral 5*5 cm , CA 125 = 500. Modality of Rx: a. Chemotherapy then surgery b. Total hystrectomy with bilateral salpingo oopherectomy with omentectomy. About gestational DM .. all are true except: a. OGTT is not needed after puerperium b. macrosomia incidence is 10% c. a fasting glucose of 7.2 at 24 weeks is diagnostic for DM d. postprandial glucose level > 8 necessitate start insulin All of the following are relatively contraindicated in pregnancy except: a. Tetracycline b. carbimazole c. Cox-2 inhibitor d. carbamazepine

e. warfarin No idea shu azdhm!!

All are symptoms of fibroid except: a. mennoraghia b. IMB c. abdominal distension d. pressure symptoms e. infertility one of the following is suggestive of stress incontinence: a. leakage of urine on sneezing all are worrying sign in late pregnancy except: a. white vaginal discharge b. watery vaginal discharge c. generalized itching d. abdominal pain e. fever PCB in all of the following exept: a. cervicitis b. cervical polyp c. cervical cancer d. cervical carinoma in situ e. ectropion ASCUS: a. 10% progress to invasive disease all are surgery for prolapse except: a. anterior colporaphy

b. colposusspension c. colpopexy d. Manchester all can be detected by US in third trimester except: a. turner b. fetal demise c. fetal anemia about ANC ... one is true : a. booking visit is preferred in 11-14 weeks b. detailed anomaly scan is done at 22-24 weeks c. at 36 weeks presentation should be confirmed heparin .. one is false : -monitored by aPTT -contraindicated in lactation laproscopy is useful in all the following except : a. endometrial polypectomy b. subtotal hysterectomy c. salpengectomy d. oopherectomy about cervical incompetence .. all are true except: a. cerclage done at 11 weeks b. can be congenital c. diagnosed by US d. previous cone bx or surgery is a risk factor First step in shoulder dysticia : a. Episiotomy b. McRobert (legs up)

c. suprapubic pressure all are risk factors for cord prolapse except: a. ECV b. prematurity c. oligohydramnios d. AROM One is false about ectopic: a. can be excluded if BHCG test is -ve b. almost always patients have a period of ammenorhea or irregular bleeding c. aria stella is characteristic d. 50% of pts have +ve urine pregnancy test This Q is not accurate!!.. I cant recall :/

At 12 weeks gestation ... a gestational sac found using abdominal US.. CRL = 7mm ... and no heart beat found .. your next step : a. repeat US after 1 week b. terminate pregnancy (missed abortion) c. serial B-HCG first sign of uterine Dehiscence is : a. tachycaria b. hypotension c. fetal distress d. abnormal abdominal shape Amniotic fluid embolus .. all true except: a. managed by heparin and FFP b. usually with coagulation disorder

c. very serious condition d. treatment is supportive in nature Again this stem is not accurate!! about STD .. all true except : a. gonorrhea can cause infertility b. HIV patient must be deliverd vaginaly c. primary herpes can be associated with lymphadenopathy d. syphilis in third trimester should be treated with penicillin e. trichomonas is and STD HRT .. all are true except: a. increase risk of colon cancer b. causes endometrial hyperplasia c. subdermal patches have less SE d. local estrogen is more effective for atrophic vaginitis e. protects from osteoporosis All are matched except : a. POP - Wt loss b. danazol - hoarseness of voice c. COC - headache d. mirena spotting about endometrial CA.. one is true : a. serous papillary type is the commonest b. serous papillary has worse prognosis than endometriod Molar .. one is false : a. grape like vesicles b. malignant sequele can be avoided c. in complete mole .. no fetal parts

d. 50% chance of persistant GTN about HPV vaccine .. one is true : a. not effective in males b. can be used in treatment of HPV 16 ,18 related CIN II, III c. single dose at 12 years old d. protect against 70 % of cervical CA About Kielland forceps true except: a. Has cephalic curvature b. Has pelvic curvature c. Has an english lock d. Used for rotation All causing 2nd amenorrhea except: a. Meyer-rokitansky b. Ashermans syndrome c. Pcos All causing 2nd amenorrhea except: a. Transverse vaginal septum About candidal infection all are true except: a. vaginal discharge b. ph less than 5 c. +ve WIFF test d. occurs in immune compromise postdate complication except : 1- shoulder dystocia 2- hyperbiluribinemia 3- placenta insufficient 4- oligohyramnios

5-prolonged labor The definitive treatment for Endometriosis : a. Hysterectomy b. Hysterectomy & Bilateral Salpengoopherictomy c. Myomectomy All of these require US to Dx except : a. Threatened Abortion b. Missed Abortion c. Inevitable Abortion

Unexplained infertility one is false : a. diagnostic test is ovarian ultrasound .. cant remember the rest of the choices :/ all are routinely done pre- operatively except : - chest X-ray -CBC all done in case of urinary incontinence except : - urine analysis -pelvic U/S -KFT -urodynamic all routinely done in ANC except : - PTT one is associated with fetal acidosis : -amniotic fluid index = 5 -reversed end diastolic flow in umbilical artery doppler

-HR of 110 primi gravida fully dilated for 1 hr , u accept these findings except : - semi- flexed -ROP - station 0 - caput - moulding No idea shu bedhm!!

about Rh -isoimmunisation one is false : - anti D given within 72 hrs ,for Rh positive woman . Endometriosis can be a cause of all the following except : - infertility -amenorrhea -dymenorrhea one is true about breech presentation: -it carries higher mortality than cephalic whatever the mode of delivery -post-maturity is a known risk factor Elevated A feto-prtn in all of the following conditions except: a. down syndrome

True about stored blood: a. Deficient in 2,3 DPG Not an absolute indication for CS delivery: -2 previous CS -cord prolapse

-cord presentation -second twin mal-presentation About ovarian cancer,one of the folowing is wrong: a. Dysgerminoma is more common in older age/menopouse woman About primary amenorrehea, what is wrong: -Brain MRI must be done -Pelvic u/s is essential -karyotyping is a must if FSH and LH are low - TSH can be done Not sure..

Not detected in first trimester by U/S a. microcaphaly

Not true in fibroid a. 2 % will transform into sarcoma

a 22 years old primigraveda GA 30 weeks her BP 150/90 one of the following is true : -serum uric acid is elevated - you have to repeat BP after 6 hour rest - this is pregnancy induced hypertension In DIC all increase except : 1- fibronogin 2-Aptt

3-PT A 40 years old female has a heavy menses what is the best contraceptive method : - mirena -OCP -progesteron minipills. All of the following are vaginal procedures except : - tubal ligation Something about amenorrhea all of the following is true except : - Rokitansky syndrome karyotype is 46 XY about endometrial CA all are true except : - 5 year survival rate in early stages is 30 % about PAP smear all are true except : - HSIL is usually caused by HPV 6 , 11

One of the following is not of the acute management of preeclampsia : - haydralazine -labetolol - nifipedine - benzodiazepines - methyldopa Methotraxate is not used if: a. sac less than 40 mm b. fetal heart activity is detected

Q about a baby with meconium stained liquor at the onset of labor, what to do: -if the fetal heart rate was active only observe - deliver immediately by CS - it is an indication for fetal heart monitoring

All of the followings can be used in the treatment of stress incontinence except: a. Pelvic exercise b. Colposuspension c. TVT d. Toilet training

Q about uterine involution Q about granulosa cell tumor of the ovary Q about Magnesium sulfate Q about the methods of detecting ovulation (same in the lec) Q about HMG in the treatment of infertility Q about the treatment of GTN and the follow up period