Prometric Sara

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1- Thin prep at 6 weeks pregnant revealed SSC, by speculum nothing seen ?

micro invasive carcinoma of


cervix, next step… ?colposcopy and punch biopsy

2- Rh D negative mother, husband Rh D positive, when to give Rhogam.. at 28 weeks and after delivery if
baby is positive, provided Coomb’s test is negative

3- Most accurate parameter for measuring the fetal weight.. AC

4- Bleeding that is mainly from fetal side.. Vasa previa

5- Measure of incidence/ occurance of an event, per year, expressed as rate (does not recall the Q)..
options were Odds ratio, and Pearl index.. I chose Pearl, seemed closer for me

6- Most common cause of postcoital/ intermenstrual bleeding in young women.. ?Endometrial polyp.. ?
Cervical polyp (no infection/ PID option was there)

7- Amount of bone lost sufficient to be diagnosed by x-ray.. 30-40% or 40-50%

8- Young lady/ girl with Glactorrhea, high prolactin, no pituitary tumor, next step… medical or expectant

9- Girl with amenorrhea, secondary sexual characteristics present, O/E all normal but no uterus and
there is a pelvic kidney, she wants a biological child, solution?.. Gestational surrogacy

10- Irregular periods, hirsutism, not willing to get pregnant now.. low dose COCP

11- Folic acid prevent recurrence of NTD by.. 72%

12- About anatomy, which is correct.. The pyramidalis is a small triangular muscle, anterior to the rectus
abdominis muscle, and contained in the rectus sheath.

13- Androgenic effect is by.. free testosterone

14- Young lady, had 2 previous pap smears normal now the result is LISL most important next step.. ?
HPV DNA testing ?colposcopy ?repeat thin prep after…

15- Scenario for patient with endometriosis best diagnostic method.. laparoscopy

16- Cx Ca stage ?2B ?1B2, best management.. ?chemotherapy and radiotherapy ?radiotherapy alone

17- Postmenopausal lady had bleeding, found to have ovarian cyst/ mass, underwent TAH+ BSO, HPE
report: complex endometrial hyperplasia, and Rt ovarian thecoma, what is next step.. ?routine follow up

18- Counseling epilepsy patient what is correct about medication.. ?the answer is sodium valproate
carries 4-8% risk of congenital malformation, and is dose dependent

19- Most common cause of failure of OCPs.. incorrect use

20- TAS for pregnant lady showed placenta previa, to confirm the diagnosis you need to do.. TVS
21- ACOG recommendation for prevention of preterm labour what is true.. vaginal progesterone with
micronized progesterone is recommended for prevention of preterm labour

22- ?Primi in labour, cervix fully dilated, ?ROT, head at 1+ station, ?deceleration, how to deliver.. ?
kielland forceps

23- Patient with ?secondary amenorrhea.. ?PCOS (I don’t recall), how you will manage.. Progesterone
2.5mg or 5mg for 5 or 10 days.. there were 4 options

24- About anatomy, which is correct.. ?sensory innervation of the upper vaginal from S2-4

25- Bleeding with placenta previa is least with.. long cervix 3 cm

26- Counseling for episiotomy.. ?no evidence it will protect perineum something longterm,, not sure
what was the Q&A

27- Lady with HTN found to have simple endometrial hyperplasia, her father has Ca colon, mother ?Ca
endometrium, what is next step.. ?LNG-IUS ?hysterectomy

28- Indication of Colposcopic examination.. High grade squamous intraepithelial neoplasia in 27 years
old

29- Patient 332 weeks pregnant with vaginal bleeding you use US for.. exclusion of placenta previa

30- Risk of ectopic pregnancy after sterilization.. there were percentages that I don’t recall, I read in the
net that one third of ladies who fall pregnant after an ectopic will have ectopic pregnancy

31- PID in ladies with IUCD mostly due to/ pathogen mostly linked to pelvic infection in ladies with
IUCD.. ?Actinomyces israelii

32- Which parameter is used for early detection of bleeding postpartum (don’t remember the stem
exactly).. tachycardia or hypotension.. or urine output

33- Primi 40 weeks with rupture of membrane for 6hours, no contraction, speculum exam Cx 2cm next
step.. Augmentation with oxytocin

34- Follow up lady with osteopenia by DEXA every.. ?24months/ two years

35- MRI evidence of creta.. ?sth mentioned about subserosal layer thickness
from RCOG these are the answers: ● uterine bulging ● heterogeneous signal intensity within the
placenta ?this was there in the options ● dark intraplacental bands on T2-weighted imaging

36- Early disturbed ectopic pregnancy/ The most common site for rupture of ectopic pregnancy?..
isthmus

37- Cause of jaundice in the baby after 6hrs from delivery.. ?should be pathological, there were mny
options
38- lady with musculunization.. androgen secreting tumor

39- Young lady, hirsutism, ?secondary amenorrhea, ultrasound/MRI show ovarian tumor with
characteristic specular calcification.. ?Dysgerminoma.. ?Arrhenoblastoma.. ?Hilus cell tumor

40- Concerning loop electro surgical excision than cervical conization.. cost effective office based
procedure

41- Intraabdominal portion of Umbilical vien becomes what after the delivery.. Ligamentum teres

42- Patient ?senario, needs hormonal profile Ix, what time to give blood ?Prolactine ?17-OH
progesterone.. ?1000hrs

43- Double bubble sign seen in.. Duodenal atresia

44- Normal female feels first urge to void at the volume of.. ?200-250 ml

45- Antenatal screening tests done from 11-14 weeks of gestation.. maternal age, NT, B-hCG, PAPP-A

46- Who from the following more readily suffer from urge incontinence?.. ?old lady, seems to become
more common as we age

47- Newborn with microcephaly, intracranial calcification, & HSM, most likely diagnosis.. ?toxoplasmosis
?Rubella

48- 70 year old with post menopausal bleeding ?cervix healthy most likely cause.. atrophic vaginitis

49- PG, 35 weeks came for regular antenatal folow up, USG revealed
oligohyramnios most likely cause.. PPROM

50- Pregnant woman with UTI which is the best antibiotics to be given if she has
no allergy?.. Nitrofurantoin

51- Scenario of fibroid asking cumulative incidence.. ?60%

52- P3 had PPH then secondary amenorrhea, labs written, what is the diagnosis..
Sheehan syndrome

53- Breakthrough bleeding occurs most commonly with.. ?OCPs

54- Pseudomyxoma peritonii with which ovarian tumor.. mucinous cystadenoma

55- 39 year old with irregular bleeding for 6 months, next step.. ?endometrial
aspiration ?trial of progesterone

56- Patient with Endometriosis stage I, suffers from moderate dysmenorrhea,


Mx.. ?Diclofenac sodium
57- Which factor increase in pregnancy.. ?factor VIII – from the net: Although
many of the coagulation factors are increased during pregnancy, none are quite
to the extent of factor VII and fibrinogen.

58- Adolescent with amenorrhea, 17-OH progesterone high, with stimulation test
increased, Rx?.. ?Dexamethasone

59- Adolescent with features of Cushing, what is the confirmatory test..


from the net: The diagnosis of Cushing disease can be efficiently confirmed by
first establishing a diagnosis of Cushing syndrome via elevated 11 p.m. salivary
cortisol levels. Confirmatory tests include 24-hour UFC levels and/or low-dose
dexamethasone suppression tests
so high cortisone suppression test is wring : (

60- Lady with previous preterm labour and one spontaneous complete
miscarriage now pregnant, USG showed IUGS corresponding to 7 weeks with no
yolk sac, what is the diagnosis.. ?anembryonic pregnancy/ blighted ovum

61- Daily release of progesterone from the implant.. ?numbers in mcg ?changes
with the time during the day

62- Pregnant with fibroid.. observation anticipating probable vaginal delivery

63- Pregnant with fibroid.. ?rarely cause obstructed labour

64- A 17 year old, P1, with HMB, what is the best Rx?.. ?Tranexamic acid ?
Progesterone ?LNG-IUS

65- Scenario of tubo-ovarian ?abscess, what is the Mx.. ?IV antibiotics ?


Laparotomy and drainage

66- Staging and prognosis of vulvar cancer, no nodal involvement in the senario
67- P1, 28 weeks pregnant with polyhydramnios, SFH=40cm, normal fetal growth
and blood sugar, fetus breech, what is the bad effect ?of polyhydramnios on the
mother.. ?Abruption ?Cesarean section

68- What is an absolute contraindication for HRT.. ?active liver disease ?previous
h/o VTE

69- Statistical Q, Prevalence of GDM.. total affected/ total number from 2x2 table

70- Lady in menopausal transition, gets 2-3 attacks of hot flushes/ day, what is
the best treatment.. ?lifestyle changes advice ?estrogen for short time ?SSRI

71- P3, previous 3LSCS now pregnant and diagnosed with previa, risk of previa
next pregnancy?

72- Composition of FFP

73- Most common outcome after endometrial ablation.. ?amenorrhea ?occasional


vaginal spotting/ bleeding

74- What is secreted by the mature corpus luteum?.. ?estrogen and progesterone

75- Cause of ovarian cyst development while being on implantable


contraceptive ?direct effect on the ovay

From the net: If follicular development occurs, atresia of the follicle is sometimes delayed, and the
follicle may continue to grow beyond the size it would attain in a normal cycle. Generally, these enlarged
follicles disappear spontaneously. Rarely, they can require surgery.

76- What causes the decrease in FSH in the C.C. challenge test?.. ?Estrogen ?
Inhibin
The CCCT involves a cycle day 3 blood test measuring follicle stimulating
hormone (FSH) and estrogen followed by two clomiphene pills per day (cycle
days 5-9) and finally a repeat measurement of FSH on cycle day 10. A high FSH
may indicate decreased ovarian reserve or fewer remaining quality eggs. Women
40-41 typically require an FSH < 15 on either cycle day 3 or 10 to pass the CCCT.
Women 42 and older, dependent on their specific insurance provider, require an
FSH < 12-15.

77- Bartholin abscess, Mx.. ?drainage ?marsupialization

78- Paracetamol over dose in pregnancy, Mx..


72 hour oral protocol —
The 72 hour oral (PO) dosing protocol for N-acetylcysteine treatment has been used successfully for
more than 30 years, and consists of the following:
• A loading dose o f 140 mg/ kg PO, followed by • A dose of 70 mg/kg PO every four hours for a total of
17 doses.

79- Medicine that reduce the bleeding by decreasing fibrinolysis (unsure about
the stem).. Tranexamic acid

80- Lady with h/o recurrent miscarriage, BPD photo shown, what is the Dx.. ?
Holoprosoncephaly, ?microcephaly ???ventriculomegaly

81- Case of Gestational HTN otherwise stable, when to deliver.. ?40 weeks

82- PET with favorable cervix, Mx.. IOL

83- ?Tocolysis question, and Ritodrine was mentioned by its trade name Yutopar

84- Ovarian cyst with pain, and vomiting 3 days, O/E tenderness, Mx.. immediate
laparoscopy

85- Infertility couple, he has low sperm quality, and she has endometriosis,
Mx.. ?ICSI

86- Elective cerclage is performed from?.. 12 to 16 weeks

87- Two conditions look alike?.. MRKH/ Mullerian agenesis AND AIS

88- POI with bone pain what is the Mx.. ?estrogen

89- POI high FSH what is the next Ix.. ?Karyotype ?anti-ovarian antibodies

90- Old lady with postmenopausal bleeding found to have ovarian mass, what is
the likely diagnosis.. ?thecoma ?granulosa cell tumor

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