NATIONAL MCQ AT BENIN 2008

GROUP 1

1 Concerning missed abortion

a, The gestation is termed missed abortion if the
diagnosis of incomplete or inevitable abortion is
excludedT
b, Blighted ovum is a form of missed abortion T
c, Most cases of spontaneous abortions are preceded by
missed abortion T
d, Frequency rises significantly in women over 45 years T
e, DIC is common with early diagnosis and treatment F

2,A 33 year old multipara with USS features suggestive of

missed abortion
a, Serial ultrasonography is unnecessary if USS reveals
loss of previously documented heart activity. T
b, Crown rump length greater than 5 mm without cardiac
activity is strongly suggestive
c, Mean gestational sac diameter greater than 8mm and
no yolk sac suggests blighted ovumT
d,Mean gestational sac diameter greater than 10mm with
absence of embryo suggest blighted ovum F
e, Coagulation studies are generally not indicated prior to
evacuation of the uterus. T

3 Options of treatment in missed abortion include

A, Success rate of 400 - 800ug of intravaginal misoprostol
ranges between 70-90% T
B Expectant management is an option T
C Risk of gynaecological infection following medical and
surgical management
is 2-3 % T
D Combination of misoprostol and mifepristone can be
used. T
E Surgical evacuation is the standard of care T

4 Following treatment of missed abortion

A, Documented Rh sataus is not important F
B Risk of Rh alloimmunisation is minimal therefore
administration of anti D globulin is not necessary.F
C Retained products of conception is more common after
medical treatment compared with surgical evacuation T
D 80 – 90% of patients who have a single spontaneous
abortion subsequently deliver a viable fetus in next
pregnancy T
E Parental karyotyping is unnecessary in patients with a
missed abortion and 2 or more other consecutive early
pregnancy losses F

5 Concerning Myasthenia Gravis in pregnancy

A It is always exercebated in pregnancy F
B, Pregnancy is contraindicated in patients with known
disease F
C, Screening for other autoimmune disorders is helpful T
D,MgSo4 can be used if benefits outweigh the risks F
E Depolarising anaesthesia must always be avoided T

6 Aethiopathogenesis of ovaritis
A, N gonorrhoea is never implicated F
B, N gonorrhoea and C trachomatis are mostly implicated
T
C Pathogenesis involved are rarely isolated in ovarian
tissue T
D, High risk sexual behaviour is not implicated F
E May be associated with gynaecological malignancy in
post menopausal women.T

7 Concerning Ovaritis
A Most commonly occur in women < 25 years T
B, Tubo-ovarian abscess is not a known complication of
neglected cases F
C Out patient treatment is required for pregnant women
F
D Treatment with doxycycline up to 14 days is necessary T
E Though diagnosis is usually made clinically, laparoscopy
is the definitive test T

8 Concerning chronic pelvic pain, the following are known

causes.
A, Chronic endometritis T
B, Ectopic pregnancy F
C, Nerve entrapment syndrome T
D,Inflammatory bowel disease T
E, Corpus luteum hematoma F
9 Concerning recent advances in the management of
myomas, the following are true or false.
A, Laparoscopic myomectomy is unfashoionable F
B,Similar cumulative pregnancy rate is found in women
with unexplained infertility using laparoscopic versus
abdominal myomectomy T
C, Laparoscopic myomectomy is superior to abdominal
myomectomy in terms of birth rate in a woman with
unexplained infertitility F
D, Hysterescopy recession has limited role for intramural
myomas T
E Improved fertility rate is seen after removal of
submucosal fibroid hysteroscopically T

10 The following are true or false concerning

myomectomy
A, Intravaginal misoprostol 400ug 1 hour before surgery
increases post op Hb level T
B Vaginal preparation is sensible T
C, Operating time is shortened using GNRH analogue in
laparoscopic myomectomy T
D Pre operative bowel preparation is not necessary T
E, Lower incidence of vertical incision following GNRH
analogue preoperatively T

11 The presence of uterine fibroid with pregnancy can

result into the following disorder
A, fetal malpresentation T
B Preterm labour T
C Intrauterine growth restriction T
D, Erythrocytosis T
E Fetal macrosomia F

12 The following increases the risk of developing myoma

A, Diet high in red meat ham T
B Diet high in intake of green vegetables F
C Cigarette smoking F
D Occur in 20-40% of reproductive aged women T
E Infertility suppresses its growth F

13 Concerning PID, risk factors include

A, young age at first intercourse T
B, Multiple sexual partners T
C, IUCD insertion T
D Tobacco smoking T
E , None of above F

14 In PID
A Abnormal vaginal discharge is present in approximately
75% of cases T
B, Unanticipated vaginal bleeding coexist in about 40% of
cases T
C, Temperature higher than 38 degree centigrade
manifest late in clinical course T
D Pain is present in more than 90% of documented cases.
T
E None of above

15 The following organisms have been implicated in PID

A Peptococcus specie T
B Hemophilus influenza T
C Gardnerella vaginalis T
D Streptococcus agalactia
E None of the above

16 Menorrhagia
A, Is defined as menstrual loss of 40 – 120mls F
B, Is synonymous with metrorrhagia F
C Is commoner with ovulatory cycles compared with
anovulatory cycles F
D, May be indistinguishable with DUB T
E Is a common cause of gynaecologic consultation in our
environment T

17 Menorrhagia can result from

A, increased platelet activity F
B low platelet concentration T
C Hyperthyroidism T
D, May complicate renal failure T
E Increased fibrinolytic activity protects against
development of menorrhagiaF

18 With respect to m,enorrhagia, the following are

untrue.
A, Menorrhagia may occur after withdrawing hormonal
contraceptives F
B, Menorrhagia in younger women are likely to be
organic in origin T
C Menorrhagia associated with regular cycles are likely to
be organic F
D May result from Gonococcal pelvic infection F
E In the presence of uniformly enlarged uterus,
endometrial cancer very likely F

19 Essentilal investigations in mgt of menorrhagia

include
A, pregnancy test T
B Thyroid function test T
C Endometrial biopsy in patient below 30 years T
D Hysteroscopy T
E Ultra sound scan T

20 Concerning dysmenorrhoea
A Primary dysmenorrhoea is menstrual pain associated
with microscopic pelvic pathology F
B It typically occurs in the first few years after menarche
and affect 38% of post pubescent females.
C,Its pathogenesis is due to prostaglandin F2 alpha T
D A six fold increase in endometrial prostaglandin occurs
from the follicular phase to the luteal phase F
E Leukotriens heightens the sensitivity of pains in the
uterus true T
21, Concerning Bacteria vaginosis
A Use of metronidazole is contraindicated F
B, Douching is mgt option F
C May cause tuibal factor infertility T
D Use of IUCD is a risk factor T
E Premature rupture of membrane is a sequalae

22 Concerning bacterial vaginosis

A Gardnerella vaginalis is implicated T
B It is a known synergistic poly microbial infection T
C,Staph aureus is a common aetiologic agent F
D Vaginal P.H is decreased F
E Commoner in men F

23 Concerning Bacterial vaginosis

A Vaginal discharge is usually odourless F
B Clue cells may be essential in diagnosis T
C The Whiff test may be positive in up to 70% T
D Potassium chloride is used in whiff test F
E Surgery is the main stay of treatment

24 Concerning imperforate hymen, the following are

correct
A, Hydrocolpos T
B, Mucocolpos T
C Diagnosed in early childhood F
D Mixed vulvovaginitis T
E Hematocolpos T
25 The following are contraindications to vaginal
hysterectomy except
A, Previous pelvic surgery F
B, Ovarian malignancies F
C, Uterine size greater than 280g F
D, Stage 1A Ca cervix T
E, PID F

26 Concerning Hysterectomy
A, Intraoperative blood loss in laparoscopically assisted
vag hysterectomy is not significantly different fro that
following total abd hysterectomy T
B The operating time for Laparoscopically assist vag
hysterectomy is shorter than vaginal hysterectomy F
C The post operative pain is the same within the first 24
hours in the 2 groups T
D From the 2nd post operative day laparoscopic assist.
Vaginal hysterectomy patients require significantly more
analgesics than patients wuth vaginal hysterectomy T
E All of the above F

27 The following are complications of

hysterectomy except
A Damage to the major blood vessels F
B, Urinary tract infection F
C Atelectesis F
D Loss of ovarian function F
E Thromboembolism F
28 Concerning primary dysmenorrhoea
A, Significant amount of leukotriens are present in the
endometrioum of women with primary
dysmenorrhoea T
B, Vasopressin may be involved in myometrial
hypersensitivity T
C Vasopressin role in the endometrium is not related to
prostaglandin synthesis and release F
D A neuronal hypothesis has been found for the
pathogenesis of primary dysmenorrhoea T
E Type C pain neurons are stimulated by aerobic
metabolites generated by ischaemic endometrium F

29 In Secondary dysmenorrhoea, the following are

involved in pathogenesis
A, Pelvic congestion syndrome T
B, Allen - Masters syndrome T
C Vasopressin F
D Leukotriens F
E Prostaglandin F2 beta F

30 Regarding Uterine inversion

A, O’Sullivan technique is a treatment option T

B Strassman operation is recommended F

C, Haultain operation is a vaginal procedure F
D Huntington trans abdominal procedure may be used
T
E Parenteral uterotonics are useful T
31 Regarding Uterine prolapse
A, Incidence of uterine prolapse during pregnancy is
accurately known F
B, May not be realated to multiparity T
C The aetiology in pregnancy is multifactorial T
D May present with paradoxical urinary tract
symptoms T
E None of the above F

32 The following is not associated with uterine

inversion
A, Tirial of vaginal birth after caesarean section F
B Crede maneuver F
C, Fundal implantation of the placenta F
D Chromni endometritis F
E None of the above T,
 BENIN 2008 UPDATE
GROUP 2

1. Menopause;
a. Climacteric is cessation of menses after 12 months
F
b. Menopause is associated with increased level of
FSH, LH and inhibin F
c. Raloxifene is a selective oestrogen receptor
modulator and acts on oestrogen receptors in the
bone to increase resorption. F
d. Osteoporosis affects trabecular bones more than
cortical bones in post menopausal women T
e. Osteoporosis is worse in whites than in blacks. T
f.
2. Concerning menopause
a. The most common perimenopausal or post
menopausal symptom that makes women to
present in the hospital is vasomotor symptom and
occurs in 15% of women. F
b. Post menopausal women may have symptoms
suggestive of urinary tract infection without
positive urine culture. T
c. Hormone replacement therapy is contraindicated
in women with history of venous thrombosis. T
d. The average age of menopause is 50 – 51 years. T
e. The age of physiologic menopause can be lowered
by autoimmune disorders and living at high
altitude. T
3. Regarding the structure and genetics of LH, the
following are untrue:
a. LH is a glycoprotein dimmer composed of 2
glycosylated covalently linked subunits. T
b. the alpha subunit is encoded on the long arm of
chromosome 6. F
c. The beta subunit is 121 amino acids and is
encoded on the short arm of chromosome 19. T
d. The alpha subunits of FSH, TSH, and hCG are
biologically identical to alpha subunits of LH. F
e. The half life of LH is 20 minutes. F
f. the Beta subunit is unique and determines LH
immunologic and biologic activity. F
4. Kallmann Syndrome:
 a. was first described by Franz Hosef Kallmann in
1940. F
b. may occur sporadically or be genetically
transmitted. T
c. occurs only in the females. F
d. results from congenital absence of GnRH
producing neurons in the pituitary. F
e. may present with micropenis in the males. T
5. The following are associated with hyperprolactinemia,
except
a. hypothyroidism. F
b. chronic renal disease. F
c. Oestrogen therapy. F
d. metoclopramide. F
e.cimetidine. F
6. Causes of primary ovarian insufficiency;
a. abnormal karyotype. T
b. sarcoidosis. F
c. pure gonadal dysgenesis. T
d. 17-20 desmolase deficiency. T
e. Sheehan’s syndrome. F
7. Gonadotrophin releasing hormone pulse generator:
a. located on the supraoptic nucleus of the
hypothalamus. F
b. requires appropriate central nervous system
signals to function properly. T
c. failure of the pulse generator results in primary
ovarian insufficiency. F
 d. stress and anxiety can disrupts normal pulse
generator function. T
e. stimulates the pituitary gland to secrete
gonadotrophins. T
8. Concerning primary ovarian insufficiency:
a. spontaneous remission could occur. T
b. ovarian biopsy is mandatory for its treatment. F
c. occurs in patients more than 40 years. F
d. use of prednisolone or dexamethasone to restore
ovarian function carries a risk of osteonecrosis.T
e. occurs when the hypothalamus and pituitary fail
to provide appropriate gonadotrophin
stimulation. T
9. Concerning GnRH,
a. it is a neurohormone central to the initiation of
the reproductive hormone cascade. T
b. pulsatile secretion of GnRH from the
hypothalamus is the key in establishing
normal gonadal function. T
c. Isolated GnRH deficiency can be distinguished by
only partial lack of GnRH induced pulse. F
d. it is confined almost entirely to the portal blood
supply of the pituitary and direct sampling in
humans is not possible. T
e. much of the information known about GnRH has
come from animal studies. T
10. Concerning GnRh receptors,
a. it is a G-protein coupled receptor. T
b. it activates phospholipsase D. F
 c. it mobilizes intracellular potassium. F
d. mutations in this receptor have been described in
families with hypogonadotrophic
hypogonadism. T
e. GnRH receptor mutations present with partial
gonadotrophin deficiency. F
11. In adult onset GnRH deficiency:
a. adult onset idiopathic hypogonadrophic
hypogonadism recently has been reported in
males. T
b. normal puberty is followed by an increase libido
and infertility. F
c. testicular size is nearly normal.T
d. the biochemical profile includes a pulsatile LH
secretion and low serum testosterone. T
e. in only 20% of cases, there is normal restoration of
the reproduction axis with exogenous GnRH. F
12. Features of PCOS include:
a. dysfunctional uterine bleeding and infertility.T
b. obesity is present in nearly half of all women with
PCOS. T
c. obstructive sleep apnoea. T
d. acanthosis nigricans is not a feature. F
e. approximately 60% have type 2 DM. F
13. Concerning management of PCOS:
a. diet improves endocrine- metabolic parameters
markedly after 4-12 weeks. T
b. oral contraception is not a modality of treatment
of treatment. F
 c. Efflornithine and spironolactone are drugs used in
the treatment of hirsutism. T
d. laparoscopic laser drilling and multiple biopsies
are effective surgical methods. T
e. metformin may be used in pregnancy. T
14. About endometriosis,
a. incidence increases with maternal age. T
b. incidence increases with high parity. F
c. a genetic link seems probable. T
d. it is associated with ovulatory disorders such as
luteal phase deficiency, oligo-ovulation and luteinised
unruptured follicle. T
e. classic endometriosis appears as black pigment.T
15. True or false
a. In endometriosis, the rate of fallopian tube
damage increases for the first and second
episodes of pelvic inflammatory disease by 34% and
54% respectively. T
b. asthenospermia associated with varicocoele is
treated with varicocelectomy or
embolization of the spermatic vein. T
c. oligospermia is the most frequent cause of male
infertility. T
d. absolute contra-indication to laparoscopy is bowel
obstruction, cardiopulmonary disease or
shock due to internal bleeding. T
e. Leuprolide acetate is a GnRH agonist. T
16. Advanced maternal age leads to increase in the
following:
 a. miscarriage. T
b. fertility. F
c. hypertensive disease of pregnancy. T
d. congenital malformations. T
e. all of the above. F
17. Concerning the fallopian tubes,
a. they are seromuscular paired tubular organs that
run medially from the ovaries to the cornua of
the uterus. T
b. they are situated towards the lower margin of the
broad ligament. F
c. they average 6.0cm in length. F
d. they receive their blood supply from the tubal
branches of the uterine and ovarian arteries. T
e. they receive their sensory, autonomic and
vasomotor nerve fibres from the uterine and
superior hypogastric plexus. F
18. Concerning the diagnosis of luteal phase deficiency;
a. endometrial biopsy should be performed on the
12th day of a 14 day luteal phase. T
b. Ultrasound measurement of endometrial
thickness is effective in the prediction of luteal
phase deficiency. F
c. the endometrial biopsy result lacks behind the
date of actual endometrial sampling by 3
days or more. T
d. biopsy performed in two consecutive cycles has
more sensitivity than single cycle biopsy. T
 e. fundal biopsy samples yield better results
compared to samples taken from the lower
uterine segment. T
19. Treatment of luteal phase deficiency;
a. bromocriptine and levothyroxine are useful in
patients with hyperprolactinaemia and
hypothyroidism respectively. T
b. vaginal progesterone supplementation is
advocated in women without
hyperprolactinaemia and hypothyroidism. T
c. oral and intramuscular progesterone are superior
to vaginal suppository or gel. F
d. clomiphene citrate does not correct luteal phase
deficiency. F
e. A repeat endometrial biopsy is not indicated
following treatment of luteal phase defect. F
20. Luteal phase deficiency
a. diagnostic workup requires inpatient
hospitalization for effective evaluation. F
b. antibiotics prophylaxis is indicated before
endometrial biopsy. F
c. uterine perforation is a common complication of
endometrial biopsy. F
d. the prior administration NSAID before
endometrial biopsy alleviates uterine
cramping. T
e. all diagnostic testing and treatment can be
performed at the out-patient setting. T
21. Relative contraindications to tubal reconstructive
surgery:
a. hydrosalpinx with a diameter of more than 3cm. F
b. age 38-39 years. T
c. abnormal uterine cavity. F
d. decreased ovarian reserve. F
e. mild male factor infertility. T
22. Microsurgical tubal reconstruction does not involve:
a. pinpoint haemostasis. F
b. atraumatic instrumentation. F
c. intermittent irrigation to prevent desiccation. T
d. magnification. F
e. does not involve micro suturing. F
23. True or false
a. ectopic pregnancy rate following tubal
reconstruction is 2-3 %. F
b. age and financial status are considered before
tubal reconstructive surgery. T
c. risk of subsequent infertility is 50% after 3
episodes of P.I.D. F
d. greater than 3cm length hydrosalpinx is associated
with poor prognosis. T
e. pregnancy rate up to 90% has been reported with
tubes longer than 4cm. F
24. Concerning postpartum thyroiditis:
a. affects 4-10% of women. T
b. it is an acute immune thyroid disease. T
c. occurs during the first year after delivery. T
d. presents with transient thyrotoxicosis. T
 e. none of the above. F
25. Uncontrolled hyperthyroidism in second half of
pregnancy causes:
a miscarriage. T
b preterm delivery. T
c. congestive heart failure. T
d thyroid storm. T
e placenta abruption. T
26. Cardiovascular findings in hyperthyroidism include:
a. wide pulse pressure. T
b. sinus bradycardia. F
c. atrial fibrillation. T
d. systolic murmurs. T
e cardiac failure. T
27. Concerning thyroid storm,
a. patient should be admitted in intensive care unit.
T
b. may be triggered by stress. T
c. propranolol is contraindicated. F
d. dexamethasone is contraindicated. F
e. none of the above. F
28. Assisted reproductive technologies
a. first successful human IVF attempt was in 1980
and resulted in birth of Louise Brown. F
b. IVF indications have departed from the narrow
scope of tubal infertility. T
c. IVF consists of retrieving a pre ovulatory oocyte
from the ovary and fertilizing with sperm in
the laboratory. T
 d. the pioneering work of Edwards and Steptoe has
been duplicated worldwide. T
e. IVF is now recognized as an established treatment
for infertility. T

29. Clomiphene citrate

a. A clomiphene only protocol consists if 10 days
treatment with doses of 150-200mg, starting on
the second day of menstruation. F
b. When the follicle reaches about 10mm, LH must
be measured 3-4hours to detect a premature LH
surge. F
c. The major advantage of clomiphene citrate is its
high cost and ovarian hyperstimulation
syndrome. F
d. The major advantage of clomiphene citrate is its
high oocyte yield and low cancellation rate. F
e. The ovarian response to clomiphene citrate is
monitored using MRI and CT scan. F
30. Micro manipulative insemination techniques do
not include:
a. Zona drilling. F
b. Zygote Intrafallopian tube transfer (ZIFT). T
c. Subzonal sperm injection. (SUZI). F
d. Intracytoplasmic sperm injection. (ICSI). F
e. Gamete Intrafallopian tube transfer (GIFT). T
31. Premature ovarian failure (POF)
a. Intermittent ovarian function is a feature. T
 b. Is equivalent to menopause. F
c. Pregnancy may occur. T
d. Is characterized by elevated serum
gonadotrophin. T
e. Hyperoestrogenism is a characteristic feature. F
32. Concerning premature ovarian failure:
a. Deletions of the critical regions of the short arm
of the X chromosome have been implicated. T
b. Deletions of the long arm of X chromosome
may be contributory. T
c. FSH and LH receptor genes abnormalities have
been implicated. T
d. Autoimmune oophoritis is a common condition
that affects more than 50% of women who
present with spontaneous premature ovarian
failure. F
e. May be found in 10-28% of women with
primary amenorrhea. T
33. Premature ovarian failure:
a. Is synonymous with primary ovarian
insufficiency. T
b. May be found in 4-18% of women with
secondary amenorrhea. T
c. Commonly a disease of women of 50 years and
above. F
d. Commonly presents with sweats, dry skin,
decreased libido and dyspareunia. T
 e. HRT, fertility restoration and psychological well
being of the patient are core issues in
management. T

GROUP 3

1. The following are non-biodegradable 2nd generation

implants
a. Norplant 2
b. Implanon
c. Uniplant
d. S-T 1435
e. All of the above

2. Removal of a non-biodegradable may be

accomplished by any of the following surgical
techniques
a. The standard method
b. The “U” technique
c. The pop-out method
d. Emroy technique
e. None of the above

3. The following statements are true

a. The Yuzpe regimen is made up of 400 mg ethnyl
oestradiol and 2.0 mg of levonogestrel and should be
given within 72hrs of intercourse for emergency
contraception.
b. The Norplant consists of 6 capsules each containing
36mg of levonogestrel and will release 60µg/ day in
the 5 years of its use.
c. Implanon rod contains 67mg of 3-ketodesogestrel
which is released at 30µg/day and is effective for 3
years.
d. ST-1435 is a single implant system with an efficacy
for one and half years
e. RU-486 is a non-competitive inhibitor of
progesterone and can be used for emergency
contraception up to 5 weeks post exposure.

4. On combined oral contraceptive (COC)

a. Commonly used COC contains ethnyl oestradiol
b. 1st generation COC contains less than 50ug estradioll
c. 2nd generation COC contains 50ug or more of estriol
d. 3rd generation contains gestodene
e. failure rate is 0.1 – 3 per 100women yrs

5. Progestrone only pills

a. contains 0.3 – 0.6mg of nor-ethindrone
b. contains 0.03- 0.0375mg levo-norgestrel
c. good options for breastfeeding mothers
d. are taken continuously with no hormone free
interval b/w cycles
e. failure rate 0.3-4/100 women yrs

6. Jadelle
a. is non-biodegradable
b. has 2 rods containing 36mg levonogestrel
c. inserted subdermally
d. Duration of action is 5yrs
e. Contraceptive protection is similar to Norplant

7. Recommended post-coital contraceptives includes

a. Danazol
b. Combined oral contraceptives
c. Vaginal Douching
d. Oestrogen-only pill
e. Gonadotropin-releasing hormone analogues

8. Concerning contraceptives
a. Intrauterine contraceptive devices inhibit
capacitation
b. Injectable contraceptives reduce endometrial
thickness
c. Combined oral contraceptives have no effect on
cervical mucus
d. Injectable contraceptives cause irregular bleeding
e. Injectable contraceptives cause amenorrhoea

9. The following are false regarding contraceptives

a. Depomedroxy-progesterone acetate is given at a
dose of 200mg every 3 months.
b. Norigynon should not be used if the woman is
35years
c. Implanon contains 3-ketoDesogestrel
d. IUCD’s are contra-indicated in pelvic infections
 e. Vaginal approach can be used to effect tubal
sterilisation.

10. Effects of Depomedroxy progesterone acetate

(Depo-provera) include the following
a. Some delay in the return to normal in a glucose
tolerance test
b. May increase duration of lactation
c. Significant increase in blood pressure
d. Marked effect on coagulation system
e. No significant effect have been demonstrated on
liver and lipid metabolism

11. Use of Depo provera is assoc with a reduction in

the incidence or severity of the following except
a.. benign breast tumor
b. malignant breast tumors
c. endometrial cancer
d. seizure in women with epilepsy
e ovarian cancer.

12. With respect to surgical sterilization methods

a. In the Pomeroy method, the ampulla is the preffered
site of excision because of ease of re-anastomosis in
future
b. Sterilisation performed in the immediate post partum
is accompanied with a high incidence of regret.
c. The laparoscopic approach is not contraindicated in
patients with diaphragmatic hernia.
d. Cardiac arrhythmia is a known complication following
hypercarbia from pneumoperitoneum in laparoscopy.
e. Hysteroscopic insertion of microinserts for tubal
occlusion may be done as an office procedure under
general anaesthesia.

13.The following are true about hysteroscopic

miroinserts.
a. It is contraindicated in patients with active pelvic
inflammatory disease and can be done within 3 weeks of
delivery or pregnancy termination.
b. It is best done few days after menstruation else a Urine
HCG test is necessary before an insertion.
c. A Papanicolaou test should be performed within 6
months of the procedure.
d. Screening for Chlamydia and Gonorrhoea are
necessary.
e. Ultrasound is rarely required before the procedure.

14. With respect to types of surgical sterilization.

a. BTL is best done following vaginal delivery within 72
hours.
b. Minilaparotomy is defined as a laparotomy with an
incision size smaller than 5cm.
c. The advantages of laparoscopy include small incisions,
rapid recovery and the use of local anaesthesia.
d. A major cause of failure in minilaparotomy is the
inadvertent ligation of the round ligament.
e. All of the above are true.
15. Consent for sterilization can be obtained in the
following patients.
a. patients younger than 21 years.
b. patients in labour.
c. patients under the influence of alcohol or drugs.
d. Mentally incompetent.
e. All of the above are false.
16. The following are true.
a. In the Pomeroy method, the mid portion of the
Fallopian tube are tied at 2 portions with an absorbable
suture without creating a loop.
b. In the Parkland technique each leg of a loop is tied
separately thereby reducing subsequent recanalization.
c. In the Parkland technique, the mesosalpinx is tied
along with tube.
d. In the Uchida technique, the proximal end is left
exposed while the distal end is buried in the broad
ligament.
e. The Irving technique is designed to be used in
conjuction with caesarean delivery.

17. In laparoscopic approaches to sterilization.

a. Electordessiccation technique is preferable when the
tube is oedemaotus or thickened.
b. Bipolar current is safer than unipolar because tissue
destruction is less.
c. Haemotosalpinx may be a complication for those who
had bipolar sterilization and subsequently had
endometrial ablation for menorrhagia.
d. In monopolar circuits, the current passes through the
entire patient to complete the circuit.
e. Patients presenting with an acute abdomen after a
surgery using monopolar current may have suffered
thermal injury to the bowel.

18. In the mechanical occlusive devices.

a. The Falope ring is a non-reactive silicone rubber and
can be identified radiographycally by the incooperated
barium.
b. In the Hulka-clemens technique virtually none of the
blood vessels of the tube is destroyed.
c. The Filshie clip incorporates titanium with a silicone
rubber lining that expands to maintain blockage of the
tubal lumen.
d. Migration of the clip in both the Filshie and Hulka
techniques can occur but are usually asymptomatic and
of little clinical significance.
e. All of the above are true.

19. The following are true about Essure.

a. It takes approximately 3 months for complete tubal
occlusion after the Essure microinserts.
b. To confirm proper placement of the device 5-8 coils of
the 24 coils must be visible in the uterine cavity.
c. Alternative forms of contraception are advised for 3
months to avoid pregnancy.
d. An HSG is necessary to confirm bilateral tubal occlusion
after insertion.
e. Perforation of the fallopian tube is a complication.

20. Risk factors for patients regret after sterilization are.

a. young age
b. Low parity
c. single parent status
d. unstable relationship
e. All of the above.

21. Non contraceptive benefits of sterilization include

a. protection against ovarian cancer
b. protection against pelvic inflammatory disease
c. protection against sexually transmitted disease
d. protection against breast cancer
e. all of the above
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

T T F T T T T T T T F F F T F F T T T T T

T T F F T F T T T T T T T T F T T T T T T

F T T F T T F F F F F F T F F F T T T T F

F T T T T T F T F F F T T T F F T T T T F

F F F T T T F T F T F F F F T T T T T T F

Group 4 Questions

(1) Concerning folate supplements

a. Should commence before pregnancy
b. Reccomended for anaemia only.
c. Reccomended dose is 1mg daily.
d. Folate deficiency causes increased mean cell
volume.
e. Deficiency is detected by schilling test.
TFFTF

(2) Concerning sickle cell haemoglobinopathy,

a. HbS results from substition of thiamine for
adenine in Beta globin gene
 b. Valine is substituted for glutamic acid in beta
globin chain
c. Commoner among the Caucasians
d. Limited to the black race
e. Variants include HbS- Memphis
TTFFT

(3) Concerning anaemia and drugs in pregnancy

a. Chloramphenicol causes haemolytic anaemia
b. Fava beans and naphthalene cause oxidant
induced haemolysis
c. Metothrexate may cause megaloblastic
anaemia
d. Any drug may precipitate anaemia in pregnancy
e. Drugs that may cause anaemia should never be
prescribed in pregnancy
FTTFF

(4) An infant birth weight is not affected by the following

except;
a. Mothers pre pregnancy BMI
b. Weight gain in pregnancy
c. The father’s weight
d. All of the above
e. None of the above
TTFFF
(5) The following are complication of obesity in
pregnancy
a. Meconium aspiration
b. Early neonatal death
c. Late neonatal death
d. Eclampsia
e. Pre-Eclampsia
TTFTT

(6) Concerning maternal weight gain pregnancy,

a. Women with pre-pregnancy BMI < 19.5 kg/m2
should gain 12.5 – 18 kg throughout pregnancy
b. Women with pre-pregnancy BMI of between
19.5kg/m2 and 25kg /m2 should gain a total weight
of between 11.5 and 16.0 kg in pregnancy
c. Women with pre-pregnancy BMI of >30kg/m2
should gain a total of 7-11.5kg during pregnancy
d. Weight gain in 2nd trimester is more critical.
e. All of the above.
TTTTT

(7) Normal diet in pregnancy should comprise the

following except
a. 20% protein.
b. 30% fat.
c. 50% carbohydrate
d. 40% carbohydrate
 e. 20% fat
FFFTT

(8) As regards fetal macrosomia

a. Hindal height measurment in an accurate way of
estimating fetal size
b. Diabetes mellitus that is poorly controlled in
pregnancy is the greatest risk factor
c. Neonatal evalaution for hypoglycaemia,
polycythaemia, hyperbilirubinaemia and elctrolyte
abnormalites in indicated in all mascrosomic
newborms.
d. Dedinitive diagnosis can be made with
utltrasonographic measurment of fetal weight
e. In diabetic patients, maternal diet alone alter
rates of macronomia
FTTFF

(9) As regards fetal macrosomia,

a. It is pathognomonic of poor glucose control
 b.It accounts for 3-10% of posterm deliveries
c. it is predictive of shoulder dystocia as a
complication when considered as a single risk factor
d. Female infants are more likely to be affected than
male
e. it occurs in 40% of pregnancies complicated by
type I diabetes mellitus
FTFFT

(10) The following are implicated in pathophysiology of

fetal macrosomia
a. Poorly controlled diabetes
b. Maternal obesity
c. Excessive maternal weight gain
d. Maternal hyperisulinemia
e. Insulin like growth factor
TTTFT

(11) Concerning preterm labour

a. the exact mechanism (s) are known with certainty
b. Decidal haemorhage is a risk factor
c. Cervical incompetence is a cause
d. Bacterial vaginosis may be responsible
 e.Maternal pyrexia may be implicated
FTTTT

(12) The following are used to predict preterum labour

except
a. Home uterine activity monitoring
b.Maternal salivary estradiol
c. Fetal fibronectin (FFN)
d. Presence of bacterial vaginosis
e. Cervical lenght assesment
F TFFF

(13) Concerning fetal fibronectin testing

a. It is a polypeptide
b. It is present in the extracellular substance of the
decidual only
c. Its synthesis and release is decreased by the
mechanical and inflammtory events
d. It is normally absent in vaginal secretions up to 20
weeks
e. Negative FFN is helpful in predicting women who
are destined to deliver preterum
FFFFF
(14) The following are contraindicated to tocolytics in
preterm labour
a. Fetal growth restriction
b. Oligohydramnios
c. Variable deceleration that are repetitive
d. Suspected or confirmed intraminiotic infection
e. Reversed diastolic flow upon doppler examination
of umbilical flow
TTTTT

(15)Concerning seizure disorder in pregnancy,

a. Hepatic metabolism of antiepileptic drugs
reduces
b. Hepatic metabolism of antiepileptic drugs
increases
c. Estrogen has antiepileptic effect
d. Progesterone is epileptogenic
e. Fewer seizures occurs during the follicullar phase
of the menstrual cycle
FTFFF

(16)Concerning infants delivered by epileptic mothers,

a. There is 4 fold increase in cleft palate
b. There is 8 fold increase in cardiac anomalies
 c. There is an increase in rate of neural tube defect
in mothers using carbamazepine or valproic acid.
d. Spontaneous haemorrhage may suggest
inhibition of clotting factors II, IV, IX and X.
e. Options b and c only
TFTFF

(17)The following are component of ”Fetal hydantoin

Syndrome”except
a. Craniofacial anomalies
b. Lowset ear
c. Developmental delay
d. Proximal digital hypoplasia
e. Epicanthal fold
FFFTF

(18)In preconceptional management of a women with

epilepsy,
a. Attempt should be made to increase
pharmacotherapy to polytherapy
b. In women who are seizure free for 6–12 months
attempt complete withdrawal of
pharmacotherapy
c. Taper dosages of antiepileptic drugs to the lowest
possible dose
d. Genetic counselling should be considered
e. Supplement of diet with folate at 0.4mg/day.
(19) F F T T F Concerning the umbilical cord
 a. Average is lenght 55cm
b. About 20% have cord lenght < 30cm
c. Average diameter is 5cm
d. May be absent
e. Lenght may be determined prenatally by scan
TFFTF

(20)Abnormalties of the cord,

a. Cord abnormalties affect arteries more than
vein
b. False knots are of clinical significance
c. Vasa praevia has mortalities of up to 50%
d. Prenatally diagnosed vasa praevia should have
caesarean section
e. Ultrasound diagnosis of velamentous cord
insertion has specificity of 100%
TFTTT

(21)Abnormalties of the cord,

a. Nuchal cord is a frequent cause of fetal demise
b.Cord prolapse occurs in 2% of all deliveries
c. All cases of cord prolapse is treated by caesarean
section
d.All of the above
e. None of the above
FFFFT

22. Concerning genilal herpes virus simplex infection

 A)2% of women acquire genital HVS during
pregnancy
B) More than 75% of women with primary HVS
infection are asymptomatic
C) Primary HVS infection is associated with the
absence of IgG antibodies
D)HVS does not cause genital herpes infection
E) All of the above
TTTFF
23. Concerning perinatal transmission of HVS
A)Postnatal transmission accounts for most vertical
transmission
B) Neonatal transmission rate is highest among
women who are sero-negative
C) Rates of transmission is highest for HSV-1 than
HSV-2
D)Caeserean section is not protective against
neonatal infection in women with active genital
lesions
E) Neonatal infection is not associated with
neurologic morbidities such as microcephaly
FTTFF

24. Complications of Neonatal HSV infection

includes
A) microcephaly
B) micropthalmia,
C) intracranial calcifications
D)chorioretinitis
E) All of th above

TTTTT

25. Causes of IUGR includes

A) Trisomy 18
B) Cytomegalovirus infection
C) Foetal alcohol syndrome
D) Maternal smoking
E) Placenta previa

TTTTT

26. Long term sequelae of IUGR includes

A) Obesity
B) Hypertension
C) Type 2 diabetes mellitus
D) Hypercholesterolemia
E) Cardiovascular disease

TTTTT
27. IUGR is associated with
A) Increased AFI
B) Birth asphyxia
C) Hypoglycemia
D) Hypothemia
E) Meconium aspiration syndrome

FTTTT

28. In pre-eclampsia
A) Clonus is a neuromuscular sign of irritability that
usually reflect severity
B) Retinal edema typically resolves after pregnancy
and resolution of hypertension
C) Hypertension prior to 20 weeks is almost always
due to chronic hypertension
D) Interpregnancy interval less than 2 yrs or more
than 10 yrs is a risk factor
E) Triploidy is not a risk factor

TTTTF

29. Blood pressure

A) Should be measured in sitting position
B) Women should be allowed to sit quietly for 5-10
minutes
C) Korotkoff sounds 1 and IV should be used
D) Increased gap exists between Korotkoff sounds 1
and V in 5% of women
E) If taken in supine position, leads to increased BP

TTFTF

30) In pre-eclampsia
A) Hb level > 13g/dl suggests haemoconcentration
B) Urine protein 2 should be quantified with 24 hr
urine
C) 1 urine protein is acceptable
D) Spot urine specimen for protein: creatinine ratio
is not a screening tool for abnormal protein
E) Serum uric acid 6mg/dl is abnormal and is a
sensitive marker of tuberlar dysfunction

TTTFT
31) The following conditions are associated with
mean fetal weight increase
A) Diabetes mellitus
B) Increased altitude
C) Increased maternal height
D) Maternal obesity
F) Cigarette smoking
TFTTF
32) Modifiable factors that directly affect birth
weight include
A) Gestational age at delivery
B) Parity
C) Fetal sex
D) Pre pregnancy weight
E) Pregnancy weight gain

TFFTT

33. Concerning ultrasonographic fetal biometry; the

following parameters are useful in estimating fetal
weight
A) Amniontic fluid index
B) Femur length
C) Head circumference
D) Placenta size and maturity
E) Abdominal circumference

FTTFT

34. Indications for pre-implantation genetic

diagnosis include
A) Women 30yrs or older
B) Women with recurrent pregnancy losses
C) Couples with repeated IVF failures
D) Men with moderate oligospermia
E) Couples with a family history of inheritable
genetic disease

FTTFT

35. Pre-implantation diagnosis may include the

following procedures
A) Polar body biopsy
B) Single cell extraction 48 hrs after fertilization
C) Polymerase chain reaction
D) Flourescence in-situ hybridization
E) Comparative genomic hybridization

TFTTT

36. Concerning pre-implantation genetic diagnosis ;

the following are true
A) The diagnostic methodology for a new disease is
quick, though expensive
B) Damage to embryo may accidentally occur during
removal of cell
C) All chromosomal abnormalities can be diagnosed
using PGD
D) A single cell can be screened for multiple genetic
conditions
E) Fertile patients must undergo IVF to produce
suitable embryo

FTFFT

37. The following can cause a false positive

pregnancy test
A) Rheumatoid factor
B) Anti animal immunoglobulin antibodies
C) Human leuteinizing hormone
D) Heterophile antibodies
E) Binding antibodies

TTTTT

38. Concerning Trans abdominal USS and Trans

vaginal USS
A) Fetal pole is seen on Trans vaginal USS when
gestational sac diameter is 18mm
B) Fetal pole is seen on Trans abdominal USS when
gestational sac diameter is > 25mm
C) Observing a gestational sac larger than 10 mm
without a yolk sac is rare
 D) A double desidual ring can be seen at 5.5-6 wks
gestation
E) Dianasis of pregnancy can be made earlier with a
Trans abdominal USS in conjuction with a β-Hcg

TTTTF
39. Environmental effects on pregnancy includes
A) Environmental toxins are most devastating within
gestational window
B) Fetal X-ray exposure does not manifest in later
years
C) Radiation exposure in diagnostic range is
significantly associated with increasing incidence of
congenital malformations
D) In-utero exposure to high levels of manganese is
associated with increased incidence of club foot and
still birth in the baby
E) Women who had exposure to diethyl stilbesterol
in-utero, typically develop vaginal cancer

TFFTT
40. Drug use in pregnancy
A) Warfarin is preferred agent in pregnancy
B) ACE inhibitors are contraindicated in pregnancy
C) Folate deficiency is associated with cleft palate
and spinal bifida
D) The recommended daily supplement of folic acid
in a woman with previous birth of a neural tube
defect banby is 0.4mg/dl
E) Cocaine is teratogenic

FTTFF

41. The following statements are true

A) Hypervitaminosis A causes embryopathy
B) Teratogenic effects associated with the use of
thalidomide include phocomelia but not external ear
defect
C) Diethyl stilbesterol in-utero exposed males have
decreased fertility
D) Phenytoin fetal anticonvulsants syndrome
includes microcephaly, developmental delays but
not hypoplasia of mid face and finger
E) Carbamazepine is pratective against spinal bifida

TFFFF
42. Concerning thrombocytopenia in pregnancy
A) Platelets have a lifespan of 10 days in the
peripheral circulation
B) Thrombocytopenia is encountered in 7-8% of all
pregnancies
C) Platelet reaction is characterized by release of Von
Willebrand factor, adenosine-S, and serotonine
D) Platelet counts are slightly lower during
pregnancy due to accelerated destruction, leading to
younger, larger cells
E) Most reports of sponteneous bleeding associated
with thrombocytopenia have occured in individuals
diagnosed with leukemia

TTTTT
43. The aetiological classification of classification for
thrombocytopenia includes
A) Increased destruction
B) Decreased production
C) Sequestration
D) All of the above
E) None of the above

TTTTF
44. The following include maternal treatment of
idiopathic thrombocytopenia
A) Steroids
B) Intravenous immune globulin
C) Anti-D immunoglobulin in Rh-positive non
splenectomised women
D) Splenectomy in the 1st and 2nd trimester when
idiopathic thrombocytopenia is severe and
unresponsive to steroids or Intravenous immune
globulin
E) Platelet transfusion for life –threatening
haemorrhage

FFFFF

45. Twin –Twin Transfusion syndrome

A) Occurs in the same sex twins only
B) occurs in monochorionic twins only
C) occurs in monozygotic twins only
D) All of the above
E) None of the above

TTTTF

46. In Twin –Twin Transfusion syndrome.

A) Hyperbilirubinaemia is a feature of the donor
twin.
B) Hypoglycaemia may be present in either twin.
C) Thrombocytopaenia may be present in either
twin.
D) Renal dysfunction may be present in either twin.
E) None of the above.

FTTTF

47.The following are correctly matched.

A) Brain ischaemia----------------Donor twin.
B) Brain ischaemia----------------Recipient twin.
C) Cerebral palsy------------------- Donor twin.
D) Cerebral palsy------------------ Recipient twin.
E) Microcephaly------------------- Recipient twin.

TTTTT

48. Folate supplements

A) Should commence before pregnancy.
B) Recommended for anaemia only.
C) Recommended dose is 1mg daily.
D) Folate deficiency causes increased mean cell
volume.
E) Deficiency is detected by sickling test.

TFFFF
49. Sickle cell haemoglobinopathy
A) Hb-S results from substitition of thymine for
adenine in -globin gene.
B) Valine is substituted for glutamic acid in β-
globulin chain
C) Commoner among the caucasians
D) Is limited to the black race
E) Variants include heamoglobin S-memphis

FTFFT

50. Anaemia and drugs in pregnancy

A) Chloramphenicol causes haemolytic anaemia
B) Fava beans and naphtalene causes oxidant
induced haemolysis
C) Methotrexate may cause megaloblastic anaemia
D) Any drug may precipitate anaemia in pregnancy
E) Drugs that may cause anaemia should never be
prescribed in pregnancy

FTTFF

51. In early pregnancy loss

A) Mild uterine cramping invalidates the diagnosis of
threatened abortion in a 19 wk gestation with
vaginal bleeding and a closed cervical os
B) Approximately 70-80% of threatened abortion will
terminate before viability
C) Almost always there is gross rupture of the
membranes in inevitable abortion
D) Complete abortion is more likely to occur at 6-14
wks of pregnancy
E) Monosomy accounts for most of the abnormal
karyotypes responsible for spontaneous abortion

FFFFF

52. The following are true

A) The descriminatory value of β-hcG for which a
normal intrauterine pregnancy should be seen on
TVS is 6500 mIU/ml
B) β-hcG values that levels off or falls before 10 wks
gestation is diagnostic of ectopic pregnancy
C) Progesterone level of less than 5 ng/ml is often
asociated with viable pregnancy
D) The imaging technique of choice in early
pregnancy is MRI
E) Ultrasound findings of scalp edema in IUFD IS
CALLED Spalding sign

FFFFF
 53. Which of the following is true in early
pregnancy?
A) Bed rest is of proven effectiveness in the
management of threatened abortion
B) DIC often complicates dead conceptus of 2-3 wks
C) Intramuscular progesterone is the drug of choice
and preferred route of administration in luteal phase
deficiency
D) Patient should be observed bfor 24hrs before
discharge after undergoing suction curretage
E) After 1 previous miscarriage rate of spontaneous
abortion in the subsequent pregnancy is about 50%

FFFFF

GROUP 5 QUESTIONS
1. Concerning diagnosis of ovarian cancer, the
following are correct;
a. Presence of ovarian cancer can be confirmed
clinically.
b. Ultrasonography is the most useful initial
investigation.
c. Positron emission tomography( PET) scanning have
an established role in the diagnosis of primary
ovarian malignancy.
d. Tumour markers such as CA-125 are good
discriminators of benign lesions from malignant
lesions in perimenopausal women.
e. Tumour markers have better accuracy in
postmenopausal women.

2. Predisposing factors of ovarian cancer

a. Never seen in teenagers.
b. Epithelial ovarian cancers most commonly occur in
black women.
c. Ovulation induction agents have been proven to
increase risk.
d. Women with family history of breast cancer have an
increased risk of epithelial ovarian cancer.
e. 5%-10% of cases of ovarian cancer occur in
individuals with a family history of the disease.

3. The following statements about epithelial ovarian

cancers are true;
a. Tubal ligation increases risk.
b. Bilateral oophorectomy reduces risk of epithelial
ovarian cancer and prevents carcinoma of the
peritoneum.
c. Oral contraceptives taken for about 5years reduces
risk by about 50%.
d. Known carriers of BRCA-1 and BRCA-11 mutations
will benefit from bilateral oophorectomy as soon as
childbearing is complete.
e. Transvaginal ultrasound scan plays a role in its
prevention.

4. Concerning gynaecologic tumour markers

a. CA 125 can assist in determining a patient’s
prognosis.
b. CA 125 can be used to screen high risk population
for the presence of ovarian cancer.
c. CA 125 is 100% specific for the diagnosis of ovarian
cancer.
d. Currently tumour markers are primarily used to
assess tumour response to treatment and check for
recurrence.
e. Most endodermal sinus tumours of the ovary
express alpha fetoprotein.

5. The following are gynaecologic tumour markers of

therapeutic significance except;
a. CA 125
b. Beta hCG
c. Carcinoembryonic antigen (CEA)
d. Prostatic surface antigen (PSA)
e. Alpha fetoprotein

6. Increased levels of hCG occur in patients with

a. Choricarcinoma
b. Embryonal carcinomas
c. Mixed cell tumours
d. Epithelial ovarian cancers
e. Leiomyomas

7. Concerning cervical carcinoma;

a. Most common malignancy in women worldwide.
b. Bladder mucosa involvement is stage 111b disease.
c. Radical hysterectomy and bilateral pelvic
lymphadenectomy is appropriate for stage 11b
disease.
d. Worldwide, about 500,000 new cases are diagnosed
annually.
e. Clinical staging protocols fail to demonstrate pelvic
lymph node involvement in 20%-50% of cases.

8. HPV and cervical cancer;

a. High risk HPV types are found in 50%-80% of CIN
lesions and less than 50% of invasive cancer.
b. Low risk HPV genome is found integrated into the
host cellular DNA.
c. HPV 6 is found less in invasive cancer than in LGSIL.
d. All of the above are true.
e. All are false.

9. In carcinoma of the cervix,

a. Chemotherapy with cyclophosphamide is effective
for stage 1Vb.
b. Screening with pap smear decreases death rate by
90%.
c. False negative rate of pap smear is 10%.
d. Gardasil is a HPV vaccine and given in two doses to
prevent cervical cancer.
e. Gardasil is a quadrivalent vaccine and can prevent
condyloma accuminata.

10. Malignant lesions of the fallopian tube;

a. Comprises 5% of all gynaecologic cancers.
b. Incidence increases with age but peaks at 60-
66years.
c. Exact aetiology is known in only 30% of cases.
d. BRCA germ line mutation is associated with it.
e. None of the above is true.

11. Malignant lesions of the fallopian tube and

broad ligament.
a. Fallopian tube malignancy usually starts as
dysplasia or carcinoma in-situ.
b. Broad ligament malignancies are associated with
endometriosis.
c. Broad ligament malignancy commonly simulates
appendicitis.
d. Absence of fimbriated end closure in stage 1
disease is a poor prognostic factor.
e. All of the above are true.
12. Malignant lesions of the fallopian tube.
a. Surgical care include selective pelvic and para
aortic lymphadenectomy
b. HSG is a useful investigation.
c. Abnormal vaginal bleeding as a presenting
symptom is a good prognostic factor.
d. Radiotherapy is the main stay of treatment.
e. All of the above are false.

13. The following symptoms are associated with

vulval disorders;
a. Pruritus
b. Vulvodynia
c. Superficial dyspareunia
d. Visible skin lesion
e. None of the above.

14. In endometrial carcinoma

a. Treatment is only surgical
b. Primary radiotherapy has a role
c. Only palliative radiotherapy has a role
d. Adjuvant radiotherapy is controversial
e. Adjuvant radiotherapy improves 5year survival

15. In the treatment of cervical cancer stage 1b²,

a. Primary radical hysterectomy with adjuvant
chemoradiation is an option of treatment
b. Primary chemoradiation is a viable choice
 c. Regardless of mode of treatment, relapse rate is
high
d. Cyclophosphamide can be used in
chemoradiation
e. In brachytherapy, point B is 3cm lateral to the
midline

16. Radiotherapy in gynaecology may be associated

with the following;
a. Chronic haemorrhagic cystis
b. Intestinal obstruction
c. Ureteral stricture
d. Diarrhoea
e. Haemoptysis

17. Concerning vulva carcinomas;

a. account for 3-5% of all female genital tumours
b. 2-3 times more frequent in developed than
developing countries
c. the peak age incidence is 35-45 years
d. oncogenic HPV is a risk factor
e long term pruritus, lump or mass in the vulva
are present in most patients with
invasive vulva carcinoma

18. Metastasis in vulva carcinoma

a. lymph node involvement is directly related to the
depth and size of the primary lesion
 b. multifocal lesions are very common
c. unilateral lesions are common particularly in post
menopausal women
d. clinical evaluation of possible inguinal lymph node
metastasis is very precise
e. lesions less than 1mm with no nodal metastasis is
equivalent to stage 1a FIGO disease

19 . Which of the following is true of complete mole

a. contains no fetal tissue
b. 99% of 46XY
c. 10% of 46XX
d. homozygous account for 80% of complete moles
e. heterozygous account for 20% of complete moles

20 Which of the following is not true of partial mole

a fetal tissue is often present
b. fetal erythrocytes and vessels in the villi are
common findings
c. the chromosomal complement is 69XXX or 69XXY
d. this results from fertilization of a haploid ovum
e. tetraploidy may be encountered

21 Which of the following is true of hydatidiform mole

a. more common in the extremes of reproductive age
b. women in their early teenage or perimenopausal
years are most at risk
c. women older than 35years have a two fold
increased risk
 d. women older than 40years, experience a 7fold
increase in risk compared to younger women
e. parity does not affect the risk

22. Concerning granulosa cell tumors

a. are the most common oestrogen producing
neoplasms in female
b. very rarely occur in juvenile and adult male testis
c. is the most common sex cord stromal tumor in the
testis
d. pelvic mass is the most consistent finding on pelvic
and rectal examination in patients of all ages
e. a multifocal aetiology has been postulated

23. Mullerian Inhibiting Substance(MIS)

a. is produced exclusively by granulosa cells in post
natal females
b. is produced both prenatally and postnatally by the
sertoli cells in the male testis
c. may be a marker of ovarian reserve
d. typically disappears from the serum after
menopause and bilateral oophorectomy
e. may also be elevated in women with sertoli-leydig
cell tumors of the ovary

24. On microscopic examination of granulosa cell

tumors
a. microfollicular is the most common pattern
b. contains characteristic call-exner bodies
 c. are composed of granulosa cells, theca cells and
fibroblast in varying amounts and combinations
d. the poorly differentiated group is composed of
microfollicular, macrofollicular, trabecular and insular
patterns
e. the well differentiated group include diffuse and
watered-silk or gyriform patterns

25. Meig's syndrome is associated with the following

a. benign ovarian tumor
b. ascites
c. plural effusion
d. fibroma
e. uterine fibroid

26. The following are components of Pseudomeig's

syndrome
a. fibroma
b. pleural effusion
c. ascites
d. mature teratoma
e. struma ovarii

27. Atypical Meig's syndrome

a. relatively common
b. ascites is a component
c. plural effusion is a component
d. ascites resolve after removal of the pelvic mass
e. ascites persist after removal of the pelvic mass
28. Dysgerminoma accounts for what percentage of all
ovarian cancers
a. 5%
b. 10%
c. 15%
d. 20%
e. 25%

29. The 5 year survival rate if dysgerminoma is

confined to the ovary only is:
a. 70%
b. 62%
c. 40%
d. 96%
e. 20%

30. The following are characteristics of dysgerminoma

a. the mean age is 22years
b. the absence of an elevated AFP or beta hCG
excludes the diagnosis
c. staging of dysgerminoma is only by surgical method
d. chemotherapy is usually the adjuvant therapy of
choice
e. not all dysgeminomas are malignant.
 ANSWERS GROUP 5 QUESTIONS

1. FTFFT
2. FFFTT
3. FFTTT
4. TTFTT
5. FFFTF
6. TTTFF
7. FFFTT
8. FFFFT
9. FTFFT
10. FTFTF
11. TTFTF
12. TTTFF
13. TTTTF
14. FTFTF
15. TTTFF
16. TTTTF
17. TFFTT
18. FFTFT
19. TFFTT
20. FFFFF
21. TTTTF
22. TTFTT
23. TTTTT
24. TTTFF
25. TTTTF
 26. FTTTT
27. FFTFF
28. TFFFF
29. FFFTF
30. TFTTF

Group 6
1) The diagnosis of Post partum hemorrhage can be made
following the delivery of a fetus beyond the gestational
age of
a)24weeks
b) 32weeks
c) 40weeks
d) all of the above
e) None of the above
2)The following factors contribute to a less favourable
outcome of PPH:
a)Lack of experienced obstetrician
b)non availability of drugs
c)Lack of blood transfusion services
d) Lack of anaesthetic services
e)operating capabilities

3)The most common cause of PPH in this environment is:

a) Cervical laceration
b) Vasa praevia
C) Retained placenta
d)All of the above
e)none of the above

4) Routine care in the postpartum period includes the

following:
a)Monitoring maternal vital signs
b) Observation of vaginal blood loss
c) Monitoring uterine size and tone
d) Periodically massaging the uterus to express clots
e)All of the above

5) The following are not true of Placental praevia

a) A leading cause of third trimester bleeding
b) Occurs in 0.5% of pregnancies
c) Previous Caesarean Section scar is a risk factor
d) It is more prevalent in the blacks
e)Common in multi parous women

6) The following characterized bleeding due to placenta

praevia
a)Painless bleeding
b)Bright red bleeding
c) Board like rigidity
d)May coexist with abruption in 10% of cases
e) is usually fatal

7) Management of ante partum hemorrhage due to

placenta praevia
a) Patient should be delivered immediately irrespective of
gestational age.
b) Patient should not be given Salbutamol
c)McAffe recommends aggressive management
d) Minor praevia should be delivered by Spontaneous
Vaginal Delivery
e)Uterine incision for major placenta praevia should be
‘classical’ to ensure good materno fetal outcome

8) Complications in third stage of labour includes the

following except:
a)Placenta Acreta
b) Uterine inversion
c) Retained placenta
d) Post partum haemorrhage
e) Placent Praevia

9) Mathew Duncan’s method of Placental delivery

a) is delivery of the cord insertion and fetal surface of the
placenta
b) is delivery of the leading edge of the placenta and the
maternal surface first
c)is the same as Schultz method
d) a and c are correct
e) all of the above.

10) Concerning Uterine Exploration:

a) Recommended following vaginal birth after Caesarean
section.
b) No longer recommended for normal delivery
c) The Procedure is uncomfortable
d) Increases the risk of endometritis
e)None of the above

11) Recommended Methods of placental delivery

includes the following:
a)Schultz Method
b)Mathews Duncan method
c)Crede’s manouvre
d)Controlled cord traction
e)all of the above

12) The distension media utilized during hysteroscopy

include the following except:
a)Carbon monoxide
b)50% Mannitol
c)4.9% Glycerine
d)30% Sorbitol
e)Dextran 70
13) Acceptable angle of viewing during hysteroscopy are
a)00
b)120
c)150
d)300
e)700

14) Contraindications to hysteroscopy include the

following except:
a)Acute Cervicitis
b) Acute Uterine infection
c) Uterine size greater than 10cm
d)all of the above
e) None of the above.

15) Prolonged second stage of labour is associated with

the following except:
a)Maternal age
b) Gestational age
c) Maternal race
d)Parity
e)Obesity

16)Braxton- Hick’s Contractions

a) Increases in frequency with increasing intensity.
b) Increases with change in activity
c) Can lead to cervical changes
d) Occurs several times in a minute
e) Unchanged with ambulation.

17) Repeated use of Non steroidal Anti inflammatory

Drugs in the third trimester:
a) is very safe
b) Can cause Polyhydramnios
c)Can cause oligohydramnios
d) can cause renal affectation
e) Can cause early closure of fetal ductus arteriosus in
utero.

18) Concerning Lochia in the puerperium:

a) The order of lochia discharge are rubra, alba and
serosa
b)The lochia serosa is yellowish in colour

c)The lochia serosa is brownish red in colour

d) Each woman has her own pattern with various phases

of lochia lasting for different length of time
e )The period of time the lochia can last varies although it
averages 12 weeks with a waxing and waning amount
of flow and colour
19) The breast feeding mother (mother who breast fed
her infant)
a) Has a longer period of amenorrhoea and anovulation
than a mother who chooses to bottle feed
b) The delay in return to normal ovarian function is not
caused by suppression of ovulation due to elevation of
prolactin.
c) 1\2 to 3\4 of women who breast fed return to having
spontaneous menstrual period within 36 weeks of
delivery
d) The mother who does not breast feed may ovulate as
early as 27 days after delivery
e)The changes to the breast that prepare the body for
breastfeeding occurs only during the peurperium

20 )Endometritis

a) Is an ascending polymicrobial infection, the

causative agent usually being normal vaginal flora or
enteric bacteria
 b) Can be caused by Chlamydia Trachomatis

c) Intravenous antibiotics is not essential in the

treatment
d) A patient with endometritis typically has low
temperature of 37 degrees centigrade, bradycardia
with absence of fundal tenderness

e) Known risk factors include young age, twin

delivery ,preexisting infection or colonization of
lower genital tract

21) Post term pregnancy

a) Reported frequency is approximately 3- 12 percent

b) The most frequent risk factor of post term

pregnancy is prior post term pregnancy
c) Paternal genetic factors influences the rate of post
term pregnancy
d) Inducing labour without documenting lung maturity
may be advised when there is risk of adverse
outcome from an underlying condition.

e) Is diagnosed at 41wks +6 days.

22) The following are agents for cervical ripening:

a) PGEI.
b) PGF2alpha.
c) PGE2.
d) Foleys balloon catheter.
e) Membrane sweeping.

23) Fetal risks of post-term pregnancy are:

a) Macrosomia,Dismaturity syndrome,Cephalopelvic
disproportion.
b) 70% have dismaturity syndrome.
c) Perinatal mortality increases approaches between 40
and 41weeks.
d) all are false.
e) all are true.

24) In Perimortem Caesarean Delivery:

a) Only the life of the fetus can be saved
b) The life of both the mother and the fetus can be saved.
c) The procedure is recommended only after all other
resuscitative measures had failed
d) The procedure might improve a mother’s chance of
survival during a collapse.
e) After Post Mortem Caesarean Deliveries, there may be
unexpected maternal recoveries.

25) The following are true concerning term pregnancies:

a)A decrease of 50% occurs in stroke volume and cardiac
Output in a pregnant woman who lies supine
b)A 20% reduction in functional residual capacity occurs.
c)Delivery of the near term fetus provides a 30%-80%
improvement in cardiac output.
d)All of the above
e)None of the above.

26)The following Statements concerning perimortem

caesarean Delivery are correct:
a)A midline abdominal Incision remains the appropriate
choice for perimortem Caesarean Delivery.
b)Maternal resuscitation efforts should not be
interrupted to allow more room for the surgical
intervention team.
c)The closed loop of cord may sit for up to 90 minutes
without significant deterioration of the gas values.
d) Surgical Closure should not be undertaken based on
maternal circumstances.
e) The rules of “dirty” surgery do not apply.

27 )Concerning Complications of instrumental Deliveries:

a)Ecchymoses and scalp lacerations occur commonly
when the process of vacuum Extraction is beyond
30minutes.
b) There is evidence to suggest that there is a slight
increase in long term scholastic performance and
neurologic status in babies delivered by Spontaneous
Vaginal delivery as compared with instrumental delivery
c) There is a 6% decrease in anal sphincter injury when
Vacuum extraction is used as compared to forceps.
d) Facial nerve palsies are more common following
vacuum extraction than forceps delivery
e)Infants delivered by vacuum extraction have a
significantly higher rate of convulsions and central
nervous system depression as against infants delivered
spontaneously.

28) Contraindication to Vacuum extraction includes:

a) Prematurity is a relative contraindication
b) Known or suspected fetal coagulation defect
c) Inadequate trial of labour
d) During caesarean section
e) Prior failed forceps delivery

29) Concerning Vacuum extraction:

a)Number of tractions must be limited to 4 at all times
b) Informed consent is mandatory before vacuum
extraction even if the presenting part is at station 0+2
c) Soft or flexible cups of the vacuum extractor have a
higher incidence of failure than rigid vacuum cups.
d) Trial of instrumental delivery is an option in certain
circumstances and it is best done in the operating
theatre.
E) Antibiotics is of essence after normal vacuum
extraction.
30) A properly conducted vacuum extraction procedure
depends on :
a)Accuracy of the cup application
b) Degree of effort used for traction
c) Vector of traction
d)fetal cranial station at the time of application
e)Appropriate skill of accoucheur

31) Indications for vacuum extraction includes the

following:
a)Prolonged second stage of labour is not an absolute
indication .
b)Cerebrovascular accident
c)Dense Epidural analgesia
d)Cord prolapse with full cervical dilatation at station 0 -1
e)Abruptio placenta with life fetus at cervical dilatation of
7cm in the hands of an experienced obstetrician.

32) The following definitions are correct:

a)Tetany is contraction lasting more than 40minutes
b)Hyperstimulation is uterine contractions of more than 5
in 10 minutes
c)Tachysystole is uterine contractions greater than 6
contractions in 10 minutes
d)none of the above is true
e)all the above is true
33) The following are not risk factors for uterine rupture:
a)Multiparity
b) Fetal macrosomia
c) Induction of labour
d)Previous successful vaginal delivery
e) Prolonged inter pregnancy interval after previous
caesarean section.

34) The following are true of uterine rupture

A) Uterine rupture occurring after a previous caesarean
section runs a more severe course than uterine rupture in
an unscarred uterus
b) Epidural anaesthesia may mask or delay diagnosis
c) Prolonged decelerations is the commonest sign
d) Abdominal pain is a reliable and common early
symptom.
e) External tocodynamometry in monitoring patients is
associated with worse fetomaternal outcome than
intrauterine pressure catheter.

35) Vaginal Birth After caesarean section (VBAC):

a) Previous Vaginal delivery improves success rate
b) There is no evidence based significant risk of uterine
rupture between spontaneous trial of labour and
induction of labour after previous caesarean section.
c)Patients with 2 or more previous caesarean deliveries
have a 5- fold increased risk of uterine rupture during the
process of VBAC than patient with 1 previous caesarean
section.
d) Spontaneous labour in patients with previous classical
scar is associated with a risk of uterine rupture of less
than 1%.
e) Classical uterine scar predisposes to preterm labour.

ANSWERS TO GROUP 6
QUESTIONS
1.a=T b=T c=T d=T e=F
2. a=T, b=T, c=T, d=T, e=F
3. a=F, b=F, c=F, d=F, e=T
4. all are TRUE
5. a=T, b=F, c=F, d=T, e=F
6. a=T, b=T, c=F, d=T, e=F
7. all are FALSE
8. a=T, b=F, c=F, d=F, e=T
9. a=F, b=T, c=F, d=F, e=F
10. a=F, b=T, c=T, d=T, e=F
11. a=F, b=F, c=F, d=T, e=F
12. a=T, b=T, c=T, d=T, e=F
13.all are TRUE
14. a=F, b=F, c=F, d=F, e=T
15.all are FALSE
16.all are FALSE
17. a=F, b=F, c=T , d=T, e=T
18. a=F, b=F, c=T, d=T, e=F.
19. a=T, b=F, c=T, d=T, e=F.
20. a=T, b=T, c=F, d=F, e=T.
21. a=T, b=F, c=F, d=T, e=F
22. a=T, b=F, c=T, d=T, e=T
23. a=T, b=F, c=F, d=F, e=F
24a=F b=T C=T d=T e=T
25 a=F b=T C=T d=F e=F
26 a=T b=T C=F d=F e=F
27 a=T b=F c= T d= F e=T
28 a=T b= T c= T d= F e= T
29 a=T b=T C=T d=T e=F
30 a=T b=T c=T d=T e=T
31) a=T b=T c=T d=F e=F
32) a=F b=T c=F d=F e=F
33) a=F b=F c=F d=T e=T
34) a=F b=F c=T d=F e=F
35) a=T b=F c=T d=T e=T