Basic Gyn , Endocrinology , General Gyn , Basic Obst , Bleeding in early & late pregnancy , PIH , Normal & Abnormal labor , malpresentations ,CPD , Complications of 3rd stage , Obstetric trauma

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The uterine artery arises from which of the following?

1 point

Aorta.

Ovarian artery

Common iliac artery.

Internal iliac artery.

External iliac artery.

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Which one of the following constitutes a main support to keep the uterus in place:

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Ovarian ligament.

Round ligament.

Mackenrodt’s ligament.

Broad ligament.

Infundibulo-pelvic ligament.

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Choose the correct statement regarding the lower uterine segment during pregnancy:

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It develops from the uterine isthmus.

It starts to develop in the 3rd trimester.

It has a well-developed thick muscle wall.

It is covered by adherent visceral peritoneum.

Contracts and retracts during labor.

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In a normal human menstrual cycle, choose the correct statement about corpus luteum:

1 point

If pregnancy occurs, it persists till labor.

Remains active for 3-4 weeks.

It is maintained by L.H.

Secretes mainly estrogen.

It produces HPL.

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A 44 year old female P4+1 with complete vesicular mole, has a uterine size of 20 weeks gestation as confirmed by ultrasound. Choose the most appropriate treatment for her:

1 point

A course of Chemotherapy should be given first.

Dilatation and curettage.

Medical abortion

Hysterectomy.

Hysterotomy.

Clear selection

Which of the following is considered a warning symptom in pregnancy?

1 point

Gush of fluid per vagina.

Increased fetal movements.

Breast tenderness.

Nausea and vomiting.

Heart burn.

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A 35yrs old woman presented with her husband with delayed conception for 7 months. Semen analysis of the husband revealed a sperm count of 1000/ml. Analysis was repeated after 6 months of medical treatment and the count was 1100/ml. History and clinical examination of the wife revealed no abnormality. What is the best management of this case?

1 point

Wait until 1 year of continuous marital life.

Ovulation monitoring and advice the husband to continue medical treatment.

Refer the husband for testicular biopsy.

Refer the couple for intrauterine insemination.

Refer the couple for intra-cytoplasmic sperm injection.

Clear selection

cervical mucus is characterized by:

1 point

Unlike endometrium, has a fixed pattern unrelated to hormonal changes.

Increased bacterial colonization in follicular phase.

Profuse amount in midcycle.

Decreased viscosity in luteal phase.

More watery during pregnancy

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Recurrent pregnancy loss could be due to all of the following Except:

1 point

Genetic and chromosomal abnormalities.

Antiphospholipid syndrome.

Subserous uterine myoma.

Septate uterus.

Cervical incompetence.

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As regard induction of ovulation by Clomiphene citrate:

1 point

Decreases cervical mucus sperm receptivity.

Effective in cases with Sheehan syndrome.

Risk of having a malformed fetus is doubled.

The treatment of choice in adolescent girls with anovulation.

Human chorionic gonadotropins should be given to ensure ovulation.

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Cervical incompetence is characterized by one of the following:

1 point

Abortions usually occur in 2st trimester.

Commonly associated with blighted ovum.

Abortions are usually preceded by bleeding.

Fetal death occurs before abortion.

Cervix is around 3.5 cm in length.

Clear selection

An 8 weeks gestation PG, suddenly felt lower abdominal colic followed by minimal vaginal bleeding after sexual intercourse. PV revealed a closed cervix and ultrasound confirmed a living intrauterine fetus. What is the most appropriate management?

1 point

Immediate hysterotomy.

Medical abortion.

Surgical evacuation.

Expectant treatment.

Cervical cerclage.

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Crypto menorrhea is caused by one of the following pathologies:

1 point

Complete Mullerian agenesis.

Androgen insensitivity syndrome.

Transverse vaginal septum.

Complete Asherman syndrome.

Congenital adrenal hyperplasia.

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A 39-year-old G3 P3 complains of severe, secondary dysmenorrhea and menorrhagia. Pelvic examination demonstrates a tender, diffusely enlarged uterus with no adnexal tenderness. Endometrial biopsy shows secretory endometrium. Which of the following is the most likely diagnosis?

1 point

Leiomyoma.

Endometritis

Adenomyosis.

Endometriosis.

Uterine sarcoma.

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Indications for surgical removal of myoma include:

1 point

Uterine size less than 10 weeks.

Intramural fibroid of 2 cm.

Non pedunculated subserous myoma of 3cm size.

Small submucus polyp in infertile cases.

Evidence of cystic degeneration on ultrasound.

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As regard management of 2nd stage of normal labor;

1 point

Fundal pressure is mandatory to help fetal head expulsion.

Bearing down is discouraged.

Episiotomy is routinely done in primipara.

Head is allowed to extend after crowning.

After head delivery, anterior shoulder is delivered first.

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Failure of long rotation in occipito-posterior malposition with deep transverse arrest of head during labor may be due to:

1 point

Strong uterine contractions.

Well flexed fetal head.

Gynecoid pelvis.

Early rupture of membranes.

Rigid perineum

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A 23 years PG, at 36 weeks gestation came to the ER with severe headache, blurring of vision and hyperreflexia. Her BP was 160/110, urine test for albumin was +++. Choose the most appropriate management:

1 point

Rest, analgesics and recheck after few days.

Oral antihypertensive and reevaluate after 1 week.

Ultrasound and Doppler indices will determine time of termination.

IV Diuretics for rapid control of hypertension.

IV.Mgso4 infusion and urgent termination.

Clear selection

A 30 years old primipara, known to have a rheumatic mitral stenosis attended to ER during the first stage of labor. Choose the most appropriate statement regarding the management:

1 point

Caesarean section should be performed.

Profuse I.V fluids should be pushed in 1st stage to ensure proper nutrition.

Antibiotics should be avoided.

Instrumental delivery is routinely done to shorten 2nd stage.

Ergometrine should be avoided during 3rd stage.

Clear selection

During the menopause:

1 point

FSH & LH increase.

Hot flushes occur more in obese women.

Osteoporosis causes bone aches.

HDL and LDL decrease.

Dyspareunia is inhibited by tranquilizers.

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