MULTIPLE CHOICE QUESTIONS

1.Endometriosis is the presence and growth of tissue similar to endometrium outside the uterus.
From the following identify which statements IS falce

A Endometriotic lesions occur in 1–20% of all women, the majority of which present
symptomatically and are diagnosed with the condition.

B As well as occurring throughout the pelvis, the umbilicus, abdominal wound scars, the vagina,
bladder, rectum and lungs may be involved.

C Endometriosis in the pelvis is probably a result of retrograde menstruation.

D More distant foci may result from mechanical, lymphatic or blood-borne spread.

2. Symptoms of endometriosis – which are falce?

A Dysmenorrhoea

B Chronic pelvic pain

C Superficial dyspareunia

E Dyschezia

3. Concerning the management of endometriosis, which IS FALCE?

A In more than 50% of women the disease regresses or does not progress.

B Asymptomatic endometriosis requires treatment.

C A trial of hormonal treatment may be used as an alternative to laparoscopy in the diagnosis of
endometriosis.

D In expert hands, symptomatic improvement following surgery is seen in 50% of patients.

E Excision of ovarian endometrioma cysts improves fertility compared to cyst drainage alone.
4. Answer true to the following statements on the subject of chronic pelvic pain.

A Chronic pelvic pain (CPP) is defined as intermittent or constant pain in the lower abdomen or pelvis
of at least 6 months, occurring exclusively with menstruation or intercourse.

B Postmenopausal pain is rare (and more likely to be due to malignancy).

C Depression and sleep disorder are uncommon concomitantly with CPP.

D Laparoscopy may have a role in developing a woman's beliefs about her pain, even if the findings
are normal and repeated invasive investigations are unproductive.

E Women with cyclical pain should be offered a therapeutic trial using the COCP or a GnRH agonist
for a period of 6–12 months before having a diagnostic laparoscopy if the pain is unresolved.

F None of the above.

5. Please identify which of the following IS FALCE with regard to pubertal development.

A Pregnancy is not possible until regular menstruation occurs.

B Adrenarche is the beginning of breast development.

C Menarche, or onset of menstruation, is the first manifestation of puberty in the female.

D Development of a menstrual cycle is dependent upon GnRH pulses increasing in amplitude and
frequency.

E In a Western population, the onset of menstruation occurs, on average, by age 13.

F None of the above.

6. The following statements refer to heavy menstrual bleeding (HMB). Which IS FALCE?

A Clinically, HMB can be defined as excessive menstrual blood loss that interferes with a woman's
physical, emotional, social or material quality of life.
 B It is necessary to demonstrate that a woman loses >80 mL/menstrual cycle to diagnose HMB.

C Endometrial and cervical malignancy are common causes of HMB.

D Thyroid disease, haemostatic disorders and use of anticoagulant medication should be considered.

E First-line medical treatment (NICE recommended) is the levonorgestrel intrauterine system.

F None of the above.

7. Regarding gynaecological operations, which of the following statements is falce?

A A Pfannenstiel or transverse incision is the most common abdominal incision used for caesarean
section.

B Complications of hysteroscopic surgery include uterine perforation and fluid overload.

C A hysteroscope is used to assess macroscopic pelvic disease and determine tubal patency.

D Advantages of laparoscopy are better visualization of tissues, less tissue handling, less infection,
reduced hospital stay and faster postoperative recovery with less pain.

E Complications of laparoscopic surgery are uncommon and require only minor surgery to correct.

F None of the above.

8. True complications of hysterectomy include:

A 1 in 100 000 mortality

B Haemorrhage, bladder or ureteric injury

C VTE

D Chest infection

E Long-term complications includomg premature ovarian failure and subsequent menopause

 F None of the above

9. Identify the factors which put patients at high risk of thromboprophylaxis.

A Cancer surgery

B Minor surgery or major surgery <30 min

C History of DVT or thrombophilia

D Surgery >30 min

E A and C

F B and D

Well done, you have selected the right answer.

A and C are true. Surgery, without other risk factors, and gross varicose veins are a moderate risk factor
for VTE. Three or more moderate risk factors equate to high risk.

10.At which point in the menstrual cycle is a women most fertile?

1Days 1-5

2.Days 9-16
3.Days 17-21
4.Days 22-28

11.In a normal 28 day menstrual cycle when would you expect the LH surge to occur?
1.Days 8-10
2.Days 11-13
3.Days 14-16
4.Days 17-19

12.Which hormone is the corpus luteum responsible for producing?

1.Oestrogen
2.Progesterone
3.Follicle Stimulating Hormone
4.Luteinizing hormone

13.Where is gonadotrophin-releasing hormone produced?

1.Anterior pituitary
2.Posterior pituitary
3.Hypothalamus
4.Adrenal glands
14Most commonest cause of early miscarriage
-Chromosomal abnormality
-Cervicalincompetence
-Infections
-Autoimmune diseases

15.Commonest type of ectopic pregnancy

Abdominal pregnancy
Tubal pregnancy
Ovarian pregnancy
Corneal pregnancy

16.Best investigation to diagnose ectopic pregnancy

USG
Urine pregnancy test
Laparascopy
Hysterectomy
17.What is true for EUGONADOTROPIC AMENORRHEA.
congenital anomalies of the uterus
acquired anomalies of the uterus
ovaries are functional, producing normal levels of estrogen and progesterone
all is falce
all is true
18.Classification of myomas according to location does not iclude
Intramural
Submucous
subserous.
subtubal

19.Patterns of abnormal bleeding does not iclude

Intermenstrual bleeding
Menorrhagia (hypermenorrhea)
Metrorrhagia.
Polymenorrhea
Oligomenorrhea
Algodismenorrhea

20.What is felce for Sex hormone binding globulin (SHBG)

 There is an inverse relationship between SHBG and the percentage of
free testosterone
 decreases, the percentage of free testosterone
 when SHBG increases,the percentage of free testosterone decreases.
 Increases free estrogins
21 What is true -Decrease in plasm SHBG( Sex hormone binding globulin) in:

 Obesity
 Increased androgen production
 Corticosteroid therapy
 Hypothyroidism
  Estrogen therapy

22. What is true-.Increase in plasma SHBG ( Sex hormone binding globulin)

with:

 Estrogen therapy
 Pregnancy
 Hyporthyroidism
 Cirrhosis

23.What is falce& Endometriosis is often associated with:

 Crippling dysmenorrhea
 Severe dyspareunia
 Chronic pelvic pain
 Infertility
 Herpes simplex



24. Wich is not categories of spontaneous abortion
Medical abortion
Inevitable abortion
Complete or incomplete abortion
Missed abortion
Recurrent abortion