Semester exam 2018

Common cause of hemosalpinx?

Clue cell in which infection?
Infant of 3 days with vaginal bleeding.
Reassurance

Copper IUD failure rate?

Effect on menstrual cycle?contraindicated
Use as emergency contraceptive within ___days?
5 days

3 day-old baby with jaundice at 25th hour of his life.investigation?

Indirect coombs?

Cu IUD ospe

Identify
Failure rate
Can be used as emergency contraception for how many days
Contraindicated in

Ans :
Copper
0.8%
5 days
Abnormality in structure

Cryptorchidism ospe. BASIS PIC

Diabetic mothers have macrosomic babies except in:

Diabetic embryopathy
Retinopathy

Cryptorchidism related ospe

1. Accompanied with hypospadias
2. Placement in scrotal sac doesn't guarantee fertility
3. Histological changes begin as early as 2 years of age
4. Transabdominal phase is controlled by mullerian inhibiting hormone
Labia majora develops from:
phallus
Genital folds
Genital swellings

Alfa fetonprotein and a1 antitrypsin is seen in

Embryonal carcinoma
Yolk sac cancer

Basal cell carcinom of ______ prognosis by some American scale is based on

Histologic grade
Lymph invasion
Lymphovascular invasion
Epithelium of prostate cancer
Columnar/cuboidal

Leydig cells secrete testo under stimulation of?

Gene mutation in mucinous carcinoma?
Lh
kras mutation

Complication of giving baby O2 for more than 28 days

Brochopulmonary dyplasia?

Treatment for endometriosis?

A patient has maculopapular rash on his palms and soles with genital involvement. Swab
from the genital area taken. Most appropriate investigation for it is?
Most appropriate investigation?
Dark field Microscopy

24 WK size uterus irregular margins, firm with heavy bleeding and dysmenorrhea?

80 year old female case of prolapse third degree. Positive for hep C and coagulation not
normal.
Treatment?
Ring pessary
Shelf pessary
Hysterectomy

A baby born at 33wk with 1.9kg with OFC 28cm and length 40cm. Diagnosis?

Preterm child with symmetrical IUGR.

Common cause of maternal mortality in pakistan

Infection
Hemorrhage
Malaria

increase in physiological size of a child is called...

Growth

Size of OVARY in PCOS- doubles.

Oral contraceptives can be used in?

Vaginal bleeding
Fibroids
Ovarian cysts

Lady presents 24 hrs after giving birth to baby. Doesn't know her LMP. How will you
calculate the gestational age
Ofc
Ballard scoring

A nulliparous lady with dysmenorrhea, dyspareunia, subfertility for 7 years. She was
diagnosed as case of severe endometriosis
Best rx for her?
Danazol tablets
IVF

ospe on cryptorchidism...

20 yr old with complaint of something coming out of the vagina upon straining. This
problem started after she had a delivery. Cervix is inside the introitus at examination. No
urinary or bowel symptoms. An egg shaped swelling is seen to come from the anterior wall
at straining. Diagnosis?
Bartholin's cyst
Gartner's cyst
Cystocele

Female with lump in lower outer quadrant of breast. Shiny skin. No nipple retractable.
Serosanguinous nipple discharge. Dx?
Phyllodes? OR Carcinoma?
Testosterone is formed under the action of?
LH
FSH
LH and estrogen
Kid diagnosed with constitutional growth problem. What can you expect to happen

1. Very short height and obesity

2. Normal height and weight
3.Short height and normal weight.

oral contraceptive which can be used in first six months after delivery...
Progestin only pills.

Estrogen ones CI in breast feeding

A lady presents with dysmenorrhea and menorrhagia. Localised hypoechoic areas seen in
the myometrium. Diagnosis?
Adenomyosis
Fibroid

But there were two questions.

One had 24 weeks uterus and other had 14 weeks uterus.
Answer for 24 is Adenomysosis I guess and that for 14 is fibroid may be

The first question which stated about irregular margins etc was fibroid.

The other question hypoechoic areas etc was adenomyosis

Treatment of fibroid would be localized myometrium resection.

And after TAH salpingoophorectomy give HRT or primose oil?
Bro the patient had severe dysmenorrhea in the first case. Fibroids don't present with
dysmenorrhea. It would be Adenomysosis for the first.
Yes but u/s finding was more consistent with fibroid because it causes irregular
enlargment whereas adenomyosis cause uniform globular enlargement as mentioned in the
other question

Girl with mood swings and lack of concentration. Diagnosed with premenstrual syndrome.
What's the best way to start treatment

1. Ssris
2. Cut down tea, coffee, alcohol
3.Stress management
4.Cognitive behavioural therapy..

Ospe on Copper IUCD

Failure rate?
Absolute contraindication?
Emergency contraception for how long?
ANS: 0.8
Uterine deformity
5 days.
One more question on effect of menestraution- dysmennorhea and HMB

Asthenozoospermia
Icsi
Gift
Iui
Ivf

Gestational sac present. No fetal pole. Dx

Missed miscarriage

26 year-old lady with BP 140/90 .method of contraception?

Intrauterine device
COCP
POP

Risk after LLETZ?

Pretrerm
Cervical dystocia

Treatment for advanced ovarian ca?

Radical hysterectomy with bilateral salpingoophorectomy
Laparotomy and debulking surgery

A lady comes with 8 weeks amenorrhea. With complaint of vaginal spotting and mild pain.
Diagnosis?

Type 2 endometrial cancer is associated with

Thin physique

A school teacher comes with complaint of abdominal pain since last night at day 14 of the
menstrual cycle. Diagnosis?
Torsion of ovarian cyst
Mittel Schmirz syndrome

Female comes with tender abdomen. What will you do before examining her.
Ask her the site of pain?
Signs of peritonitis
Female presented in opd with vomiting and tender abdomen. Had some gynecological
procedure at local clinic
Peritonitis
Perforated uterus
Intestinal obstruction

Plasma volume in pregnancy increases by

40 %
50 %

A very long scenerio. Gist of which is that she had complete mole which was removed.
What do you test in followup?
Beta hcg

Incomplete mole. You will find

69XXY
69XYY

Well defined cell boundaries, centrally placed nucleus. Tumor grows in sheets or cords and
is seperated by scant fibrous stroma.
Dysgerminoma

Hpv affects
Tp53 and RB

Baby with respiratory distress syndrome. RR 80 HR 150. Treatment?

Oxygen
Surfactant therapy

What complication will occur if kept on oxygen for more than 28 days.
Pneumonia
Bronchiolitis
Bronchopulmonary dysplasia

Female with primary dysmenorrhoea. Treatment?

Nsaids…

Female had hysterectomy. Still there is prolapse from vagina

Vault prolapse

Per vaginal examination is contraindicated in

Placenta praevia
Psammoma bodies IS SEEN IN ?

Birth weight in developing countries.

2.5 to 3.5 kg

A qno on features of androgen insensitivity or Rokitansky syndrome?

Short stature, wide carrying angle, amenorrhea. What will you do next.
Chromosomal analysis
Amenorrhea. Prolactin levels are high. What will you do next to confirm diagnosis
MRI pituitary fosaa

Female has a baby who is 8 years old. One miscarriage 5 years back. Now amenorrhea. All i
remember is fsh was high. Dx?

Premature ovarian insufficiency

Glandular and stromal growth in which phase?

Proliferative.

phase of *menstrual cycle

But these changes are of endometrium 🙈

One question was tortuos glands,spiral arteries.

Answer: Luteal phase. (Corresponds with secretory phase of uterus)
Other question was straight foward. Which hormone responsible for secretory phase?
Progesterone.

Girl presented in opd with irregular menstrual cycle and excessive hair growth. Dx
Pcos

CIN immunostain?
Ki67, p16

Ovarian cyst lead to serous epithelial neoplasia?

cortical inculsion cyst

Theca leutin cells in pcos produce?

Androstenedione??

Obese women with pcos bmi > 30.. 1st treatment or advice?
Weight reduction
Clomiphene
IMNCI classification of a child with 3 days fever and diarrhea. No restlessness, irritability,
no sunken eyes.

Female with blurred vision and general edema and raised BP

Pre eclampsia?

Mother RH negative. 2nd baby is RH positive. Antibodies are formed against

IgG
IgM
IgA
IgB
Manage

Was there any question about how does adenocarcinoma of endometrium occurs?
Ans: atypical endometrial hyperplasia?

Pap smear shows moderate dysplasia. What will you do next

Colposcopy and biopsy

Cone biopsy

Another morphology question from which the only thing i remember is 'spindle shaped
cells'
Leiomyoma
Leiomyosarcoma

*nuclear pleomorphism, 10 mitosis, necrosis too ?

Leiomyosarcoma

Female with hot flushes after hysterectomy i guess. Tx?

HRT

A female presented with some findings of ovarian cancer. Her sister died 4 yrs back due to
breast cancer. Most important question of history?
Family history of ovarian/breast Ca

A woman comes with a history of something coming down from the vagina and hx of post
coital bleeding. On examination 4x4 mass is seen attached to the cervix. Diagnosis?
Cervical polyp
Pervaginal examination is contraindicated in
Placenta previa
Labour…

What about the ospe on jaudice?

What investigation?
Indirect coombs
Peripheral smear
..
Cause?
Biliary atresia
Rh disease
Treatment?
Transfusion
Phototherapy

There was a case with microspherocytes in peripheral blood film of baby. Diagnostic test?
Osmotic fragility test

Thin yellow offensive smelly discharge. Clue cells. Which infection?

gardnerella

A young woman 8 weeks pregnant comes with a cystic mass in the right lower abdomen.
She wants it removed thinking it may affect her pregnancy. When is the right time to
remove the cyst?
12 wks
9 wks
27 wks

52 year old female with PMB which tumor?

Granuloss

another long scenerio. Right adnexal mas. Cx is soft. Shifting dullness. Uterus is enlarged.
And some other stuff too. 🙈 🙈
This was ectopic I think. The lady had some amenorrhea too.

A lady with large shiny isolated swelling with no skin involvement?

A 24 year old girl mein 2cm mobile mass in breast?

fibroadenoma since it wasn't cystic

a lady with left upper quadrant lump..

Fetal complication if mother has diabetes.

Polycythemia
Hyperglycaemia
Hypercalcaemia

Surgery requires cutting of uterine artery. Which structure needs to be protected. 😅

Ureter

Dark field microscopy since it was treponema pallidum

Most common cause of hematosalpinx ?

Ectopic preg

TALIB-E-DUA:
Syed Faizan Ali (D’20)