Obstetrics and Gynaecology for Finals, DRCOG and MRCOG

A Revision Guide

Janice Rymer, Norman Smith

• Publisher: CRC Press
• Year: 2017
• eBook ISBN: 9781315343181
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

This examination and revision guide comprehensively tests knowledge at all levels in obstetrics and gynaecology. The wide-ranging sample questions have detailed answers to provide proper explanation and aid understanding, and the variety of question formats prepares students for all possibilities in the examination. The best of five question format is ideal for DRCOG candidates, the EMQs prepare the MRCOG candidates, and the MCQs will test both DRCOG and MRCOG candidates. The book is also highly recommended for undergraduates preparing for their finals, who will welcome the sample best of fives and EMQs now that essays and short answer questions are becoming a thing of the past.

1

Multiple-choice questions: Paper 1

1 Natural menopause:

1. may occur under the age of 30
2. is associated with an increase in HDL cholesterol
3. accelerates bone loss
4. causes an increase in the karyopyknotic index (KPI)
5. occurs at an average age of 54 in the UK.

2 Secondary amenorrhoea may be due to:

1. thyrotoxicosis
2. virilising ovarian tumour
3. imperforate hymen
4. Asherman’s syndrome
5. endometriosis.

3 Regarding human fertility.

1. Fertilisation usually occurs five to seven days before implantation.
2. Subfertility is common following mumps in women.
3. An adverse male factor is detectable in about 30% of couples with low fertility.
4. Hyperstimulation syndrome may occur as a complication of clomid therapy.
5. Testicular biopsy may be used in the investigation of azoospermia.

4 Sterilisation:

1. in men has a failure rate of about 1 in 300 cases
2. prevents pregnancy in a similar order of magnitude to the Mirena levonorgestrel intrauterine system
3. when it fails can be associated with an ectopic pregnancy
4. in women decreases menstrual loss
5. in women can be successfully reversed if clips were used for the original operation in >80% of cases.

5 Regarding thromboembolic disease.

1. There is a greater risk in a multiple than in a singleton pregnancy.
2. Heparin should not be given in the first trimester.
3. Warfarin increases the likelihood of fetal haemorrhage.
4. In pregnancy heparin therapy can cause maternal osteoporosis.
5. The risk is increased in women who are blood group O.

6 Monozygotic twins:

1. are less common than dizygotic twins
2. are commonly familial
3. may be reliably distinguished from dizygotic twins by the naked-eye examination of the fetal membranes and placentae
4. have a higher incidence of placenta praevia than singleton pregnancies
5. are associated with acute polyhydramnios.

7 Spina bifida:

1. is associated with raised maternal serum a-fetoprotein (AFP) levels
2. can be diagnosed by ultrasound scan during the third trimester
3. is inherited as an autosomal recessive
4. is associated with dilated cerebral ventricles
5. screening may be tested with maternal serum.

8 In development of the female genital tract:

1. the fallopian tubes are derived from the Müllerian ducts
2. the external genitalia can be recognised as male or female by the 16th week of fetal life
3. failure of fusion of the Müllerian ducts results in a double uterus
4. the upper third of the vagina is formed from the cloaca
5. Wolffian ducts degenerate in the absence of a Y chromosome.

9 In human genetics:

1. an XO genotype is associated with male somatotype
2. the total number of chromosomes in both males and females is 48
3. chromatin-positive cells (Barr body present) are characteristic of normal women
4. first-trimester chorionic villus sampling is associated with a fetal loss of 1%
5. the Y chromosome determines the development of the ovary.

10 In the normal cervix:

1. the canal is lined by the transitional epithelium
2. the mucus is scanty at the time of ovulation
3. the level of the squamo-columnar junction varies at different phases of reproductive life
4. keratinised stratified epithelium is found over the vaginal aspects of the cervix
5. the squamo-columnar junction is usually visible on speculum examination after menopause.

11 In the fetal skull:

1. the biparietal diameter is approximately 9.5 cm at the term
2. the lambdoidal suture runs between the frontal and parietal bones
3. the bregma is the area lying between the parietal and occipital bones
4. the sub-occipito bregmatic diameter is the engaging diameter when the head is fully flexed in a vertex presentation
5. the occiput is the denominator in a vertex presentation.

12 In the fetal circulatory system:

1. blood flows from the fetus to the placenta in the umbilical arteries
2. the ductus arteriosus closes during labour
3. placental circulation starts at about one week after implantation
4. the heart becomes a four-chamber organ at about seven weeks’ gestational age
5. reversed end diastolic flow in the umbilical artery is associated with fetal hypoxia.

13 The following hormones are secreted within the posterior lobe of the human pituitary gland:

1. oxytocin
2. thyroid-stimulating hormone
3. luteinising hormone
4. adrenocorticotrophin
5. prolactin.

14 Regarding ovum and spermatozoa.

1. The spermatozoa are responsible for approximately 10% of the volume of the ejaculate.
2. The fertilised ovum can be fertilised up to four days after ovulation.
3. Human spermatozoa are capable of fertilising an oocyte when aspirated from the testis.
4. Human spermatozoa when mature have undergone a reduction division of their nucleus.
5. The fertilised ovum implants at the 16 cell stage

15 Regarding miscarriage.

1. If recurrent, it can be associated with parental chromosomal translocation.
2. If recurrent, it can be associated with sickle cell trait.
3. The clinical diagnosis of incomplete miscarriage is assisted by digital examination of the cervical canal.
4. Cervical incompetence causes recurrent first-trimester miscarriage.
5. Missed miscarriage should be suspected if the uterine size is greater than expected for gestational age.

16 Circulatory changes in a healthy woman during a normal pregnancy ...

Table of contents

• Cover Page
• Half title
• Title Page
• Copyright Page
• Contents
• Preface
• About the authors
• Acknowledgements
• 1 Multiple-choice questions: Paper 1
• 2 Multiple-choice questions: Paper 2
• 3 Multiple-choice questions: Paper 3
• 4 Multiple-choice questions: Paper 4
• 5 Single best answers: obstetrics
• 6 Single best answers: gynaecology
• 7 Extended matching questions: obstetrics
• 8 Extended matching questions: gynaecology
• Index