Mock test-2(SBA+EMQ)Module part-2

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A 37-year-old woman, para 1 is referred to gynaecology clinic as a 2 weeks’
wait in view of abdominal swelling and pelvic pressure. An ultrasound scan
attached with GP referral shows a large uterus (uterine size of 20 × 10 cm)
with multiple fbroids. She wishes to have uterine artery embolisation.
Which of the following is not an absolute contraindication for uterine
artery embolisation?

Which one of the following statements is correct in assessing statistical

3) A 24-year-old woman who is a third gravida attends the antenatal clinic with her third trimester ultrasound report at 37  weeks gestation requesting delivery by Caesarean

section. Her previous two pregnancies were spontaneous miscarriages at 8 and 10 week

gestations, respectively. She  underwent surgical terminations and had received

anti-D both times. Her indirect Coombs test has been negative. She is noted to have

polyhydramnios with an AFI of 20. Fetal umbilical and middle cerebral artery Doppler

study is within normal limits. No other obvious anomalies were noted



A correlation study shows that there is a statistically signifcant positive
correlation between body mass index (BMI) and average blood loss at the time
of caesarean section. Pearson’s r is 0.4 and p value is 0.01.
How much of the variation in blood loss can be accounted for by the BMI

5) A 34-year-old woman starts to develop severe pruritus on her limbs and trunk

at 34 weeks of gestation. On examination, there is evidence of scratching but

no rash. She is afebrile and her urine is dark. LFTs are abnormal with an alanine

transaminase (ALT) level of 451 U/l with normal bile acids. Standard liver

serological screening is normal.


. A 28 yr woman with sickle cell disease is 16 weeks pregnant. She has been taking folic acid
since beginning of her pregnancy, now she has been advised to obtain a substance that is
prophylactic measure which she has not received in the last 12 months.

7) A49-year-old woman presents with haematuria. She has recently been diagnosedwith

ovarian cancer and has received two cycles of chemotherapy. Cystoscopyreveals

haemorrhagic cystitis.

8) A  33-year-old primigravida attends the DAU at 33  weeks gestation complaining of

abdominal pain and leaking vaginal. On examination, she is noted to have regular

uterine contractions with partially effaced cervix.


9) One of the following is a recognised cause of gynaecomastia:
10) 30 years old pregnant lady history of schizophrenia on olanzapine, what could be the side effect of Olanzapine  on pregnancy

11) A40-year-old woman has recently been diagnosed with ovarian cancer and has received

two cycles of chemotherapy. She presents with decreased urine output,

tingling in the lower limbs and is hard of hearing followingcompletion of the

second cycle. Her blood results show high creatinine and low magnesium.

Of the following statements about hyperthyroidism in pregnancy, select the correct
A 28-year-old teacher was given varicella-zoster immunoglobulin G (VZIG)
afer a signifcant exposure to chickenpox at 24 weeks’ gestation, as she was
found to be seronegative on her booking bloods.
How long should she be considered potentially infectious afer exposure to
Which of the following statements best describes the role of serum ferritin in

15) A 38-year-old second gravida with previous normal delivery at term presents at 26 weeks

gestation with leaking vaginal. She denies any pain or bleeding and examination shows a

soft non-tender uterus with no cervical changes. Pooling of liquor is seen in the posterior

fornix. Her antenatal period was otherwise normal and anomaly scan was also normal.

16) A 35-year-old woman presented with a offensive frothy vaginal discharge

On speculum examination, the cervix was red, punctate and inflamed.

The wet mount shows the mobile organism.

What is a likely diagnosis in her case?



. A 38-year-old multiparous woman is admitted to the antenatal ward for an elective
Caesarean section for breech presentation. She had a pulmonary embolism during this
pregnancy and has been on a therapeutic dose of LMWH (90 mg twice daily) for the last 3
months. She took her last dose just before coming into the ward

A 29-year-old woman attends antenatal clinic at 28 weeks of gestation. She
gives a history of syphilis 2 years ago. She has recently been diagnosed with
late syphilis and now advised to have a cerebrospinal fuid (CSF) examination
Te indications for CSF examination include all of the following except for
which one?

19) A 23-year-old woman with two previous normal deliveries attends the antenatal clinic at

37 weeks gestation with backache. Her current pregnancy is a dichorionic diamniotic twin

gestation with no comorbidities. Both fetuses show normal growth pattern in cephalic

presentation. Her Bishop score is 5. An elective induction is due at 38 weeks gestation.

20) An HIV-positive woman presents with spontaneous rupture of membranes at

term. What is the threshold parameter to recommend induction of labour

A 35-year-old para 1 woman is in established labour with strong, regular
contractions and a cervical dilatation of 4 cm. She is requesting stronger pain
relief as Entonox is making her feel sick and is not very efective. She does
not want an epidural and is asking about the alternative options. You have
counselled her about the opioid analgesics in detail.
Which one of the following statements is true with regards to the opioid

A 20-year-old woman attends the sexual health clinic with symptoms of
frothy, yellow vaginal discharge and associated lower abdominal pain. Te
organism can be seen when a drop of saline is added to the vaginal discharge
placed on the slide.
What is the most likely diagnosis?

23) Possible sources of error in noninvasive prenatal testing for fetal aneuploidies include:
24) Young girl 18 year old, presented to GP with normal breast development clitoromeghaly, labial fusion, what is the diagnosis

A 38-year-old primigravida at 36 weeks’ gestation with dichorionic diamniotic
twin pregnancy was diagnosed with acute fatty liver of pregnancy. She was
stabilised and delivered by caesarean section.
What is the risk of recurrence in subsequent pregnancies?

26) A 38-year-old woman presents with urinary leakage on coughing and sneezing. She has

completed her family. She has had two normal deliveries. She also admits that she has

difficulty holding on due to urinary urgency and frequents the toilet at least seven times

a day but not at night. Anticholinergics have not been helpful so far

27) A 40-year-old woman attends the gynaecology clinic with a history of leakage of

urine on coughing or sneezing following the birth of her last child 2 years ago. A

urine dipstick is negative. A decision is made to commence a course of supervised

pelvic floor muscle training.


. A 23-year-old university student presents to the gynaecology OPD with prolonged
bleeding lasting for 8 days during her period, although not particularly heavy. On
questioning, she admits to having intermenstrual and post-coital bleeding intermittently.
She uses the combined oral contraceptive pill for contraception.

A 30-year-old para 5 woman at 36 weeks’ gestation was brought in by
ambulance with abdominal pain and heavy per vaginal bleeding. Her pulse
was 120 bpm, blood pressure 100/60 mm Hg, respiration rate 20/min, O2
saturation 96% on room air, and temperature 37°C. Te placenta was reported
as anterior high on previous scans. On examination abdomen is tender and
the CTG recording is abnormal. She does not understand or speak English, but
her sister who speaks English was with her. Immediate resuscitation measures
were commenced and a decision for an emergency caesarean section was made
by yourself.
What is the most appropriate statement in this clinical situation with
regards to obtaining consent from this non-English speaker?

30) A 49-year-old menopausal diabetic woman presents with vulval soreness and pruritus, and a non-offensive thick white vaginal discharge.

She gives a history of at least three past similar episodes over the last 12 months and suffers from superficial dyspareunia. On examination, there is erythema and some fissuring of the vulval skin


. Pregnant patient in second trimester with thalassemia major, did not come for preconceptional
counselling. On liver ferriscan was found to have high iron overload.


A 48-year-old woman undergoes laparoscopic hysterectomy and bilateral
salpingo-oophorectomy, pelvic lymphadenectomy, peritoneal washings and
bowel adhesiolysis for International Federation of Gynecology and Obstetrics
(FIGO) stage Ib, high-grade serous endometrial cancer. Her blood loss was
1000 mL. A peritoneal pelvic drain is inserted. Her observations are stable and
she is apyrexial. Her abdominal drain is straw-coloured fuid and is 500 mL on
day 2. Her haemoglobin (HB) is 9 gm% and serum creatinine is 75. Drain fuid
creatinine is reported as 90.
What is the diagnosis in her case?

33) A 21-year-old woman who suffers with alcohol dependence attends the gynaecology clinic complaining of a persistent watery vaginal discharge.

There is no history of irritation or pruritus. She smokes ten cigarettes a day. On vaginal examination, there is an offensive fishy-smelling vaginal discharge.


.A 13-year-old girl is brought to the gynaecology OPD by her mother. Her mother is
concerned that she has not had her periods regularly. She attained menarche at 12 years
and had been having periods once in 2 months or sometimes 3 months. She has a
normal BMI and plays sport regularly.

35) In MCDA twin pregnancy monitoring to detect TTTS starts at which week.

.A 40-year-old woman who has recently come from Turkey presents with intermenstrual
bleeding. She has not had any investigations so far


A43-year-old multiparous woman presents to the EPAU at 12weeks' gestation with mild
vaginal bleeding. She gives a history of unprovoked deep venous thrombosis (DVT) 1year prior
to this pregnancy and was treated with warfarin for 6 months. Currently, the GP has started her
on aspirin in view of a previous history of pre- eclampsia

38) A  22-year-old third gravida presents at 29-week gestation with leaking vaginal. On

examination, she is found to have regular uterine contractions, and her fetus is felt in

the transverse position. Cervix is found to be 4 cm dilated.


39) A 28-year-old woman presents to the antenatal clinic at 32 weeks gestation with loss

of fetal movements for the past 2  days. Her antenatal period was uneventful except

fetal bilateral pelviectasis at 20-week anomaly scan, which was reported to be normal

on a subsequent ultrasound scan. Clinical examination is normal, but an obstetric

ultrasound reveals fetal demise.

40) Covid 19 in pregnancy guideline recommends a Fetal Growth Scan in?

41) Which vaccine to give in pregnancy?

42) A 41-year-old woman presents with a long history of probable recurrent urinary tract

infections and has been treated with presumptive antibiotics when she lived abroad.

She has severe pain in the bladder area and also urinary urgency but no leaks. She also

reports occasional haematuria that resolves spontaneously. Serial urine cultures have

always been negative, including for fungus and atypical bacteria.

A 36-year-old woman with known hypothyroidism has been taking
levothyroxine 100 micrograms once a day. Her most recent thyroid function
tests performed 3 months ago were normal with a thyrotropin (TSH) of
2.5 mU/L. She has come to the early pregnancy unit with abdominal pain and
a positive pregnancy test. Transvaginal ultrasound confrmed an intrauterine
How would you advise with regards to her levothyroxine dosage?

44) A  24-year-old woman in her second pregnancy was referred from the radiology

department following an ultrasound at 24  weeks gestation. She  was diagnosed with

monochorionic diamniotic twin gestation earlier. Her ultrasound study today showed

fetal demise of one twin and a well-grown second twin. Counselling has been offered

and initial blood tests have been sent

A 48-year-old woman undergoes laparoscopic hysterectomy and bilateral
salpingo-oophorectomy, pelvic lymphadenectomy, bowel and pelvic
adhesiolysis and peritoneal washings for grade 3 endometrial cancer. While
dissecting the pelvic side wall, the consultant notices right ureteric injury
close to the bladder edge. Te urologist on call has been called for opinion and
What would be recommended management for her surgically?

A 45-year-old woman presents to GP with abdominal bloating. A blood test
was performed for Ca125 which measures 1000 units/mL. She is referred to
rapid access clinic (gynaecological oncology). A CT scan (chest, abdomen and
pelvis) reveals a large abdominal mass possibly flled with mucin. Te fndings
are suggestive of mucinous carcinoma. She undergoes staging laparotomy
which reveals pre-operative rupture of the cyst with ascites and mucinous
substance flling the abdomen. Te histology is reported as mucinous
carcinoma of the lef ovary with rupture of cyst.
What is the International Federation of Gynecology and Obstetrics (FIGO)
stage in her case?

47) 34 weeks SROM HIV positive not in labour , on HAART viral load <43
Which one of the following statements is correct with regards to the
statistical tests?

A 40-year-old para 2 woman is referred to the gynaecology clinic for
menorrhagia. She has an outpatient hysteroscopy and Pipelle biopsy which
is normal. She has tried Mirena but this has not reduced her bleeding. She
undergoes a NovaSure endometrial ablation.
Which one of the following expectations might not be met?


Ms XY is 30/40 weeks pregnant. Her recent MSU sample confi rms the presence of
signifi cant GBS bacteriuria (>105 CFU/ml) sensitive to cephalexin. However, she is
asymptomatic for a UTI. Which of the following treatment options are best suited to

51) A 23-year-old woman presents with ongoing pruritus that has worsened from

12 weeks of pregnancy.

Her blood results are:

Albumin 32 g/l

Serum alkaline phosphatase 320 U/l

Serum ALT 35 U/l

Serum bilirubin 20 μmol/l

γ-Glutamyl transferase 40 U/l

Anti-nuclear antibodies Negative

Anti-mitochondrial antibodies Positive

Anti-smooth muscle antibodies Negative

Lupus anticoagulant Negative


52) A 26-year-old woman attends the gynaecology emergency services complaining

of painful blisters and ulceration on her vulva for last 2 days.

She has dysuria and vaginal discharge. On examination, there is bilateral tender inguinal lymphadenitis.

53) An 18-year-old primigravida attends the day assessment unit at 36  weeks gestation

with loss of fetal movements. She  was diagnosed with obstetric cholestasis and was

started on ursodeoxycholic acid 3 weeks ago. Ultrasound confirms intrauterine fetal

demise. She and her partner are counselled and initial blood tests are done. She opts for

immediate obstetric management.

A 38-year-old nulliparous woman with moderate chronic renal failure
comes to the preconception clinic as she wishes to have a baby. She had
renal transplantation 3 years ago and her recent creatinine is around 130
with estimated glomerular fltration rate (GFR) of approximately 45. She
is currently taking prednisolone, mycophenolate, angiotensin-converting
enzyme (ACE) inhibitors and aspirin. You have advised her to stop
mycophenolate and to start another immunosuppressant.
Which one of the immunosuppressant drugs would be contraindicated in
55) Diabetic mother, during pregnancy was taking insulin now shifted back to prepregnancy medicine that was metformin. Baby was alright after birth but 2 hrs after birth poor suckling became lethargic. What is the cause of baby’s condition

56) An HIV-positive woman who presented late for antenatal care at 34 weeks of

gestation is now in labour. What would be the threshold parameter for offering

intrapartum intravenous zidovudine therapy?



A nulliparous woman at 40 + 2 gestation was admitted in spontaneous labour
and progressed satisfactorily to full dilatation 2 hours ago. On reassessment
there is no change in the descent with the vertex at −1 station, the position is
occipitoanterior with absent membranes, no caput or moulding. Epidural is
efective, contractions are three in 10 minutes and the CTG is normal.
What is the most appropriate management?


. A40-year-old multiparous woman presents to the obstetric day assessment unit at 28
weeks' gestation with reduced fetal movements [normal cardiotocograph (CTG)}.Her notes
indicate that she had DVT at 20weeks' gestation during her current pregnancy and is on 80 mg
LMWH twice daily. Her booking blood results were normal. However, her recent blood test
reveals a platelet count of 60 x 109/L

Which antibiotics should be given to prevent early onset neonatal GBS disease to
women who have accepted intrapartum antibiotic prophylaxis (IAP) and are mildly allergic
to benzylpenicillin?
A 20-year-old woman was brought to A&E with a history of sexual assault
4 days ago. Te perpetrator had forced her to have vaginal intercourse (used
condom) and also performed digital anal penetration. You are the doctor in
A&E who is now collecting the samples for forensic medical examination.
All the following samples are indicated for forensic medical examination
except which one?
A 20-year-old primigravida with 30 weeks gestation has presented in the casualty
with preterm labour pains. She has history of productive cough and fever since 15
days. She has a BMI of 19 and was diagnosed with gestational diabetes at 20 weeks.
She has had a poor gestational weight gain. It is true to say that in this condition:

62) A40-year-old woman presents with palpitations, numbness and tinglingin

the legs, and alopecia involving allbody hair.She has recently been diagnosed

with ovarian cancer and hasreceived three cycles of chemotherapy. Clinical

examination reveals pulse of 180bpm and normal blood pressure. She is booked

for debulking surgery in 10days.


Te following conditions except one manifest only when the individual is
homozygous for the mutant allele. Which one is the exception?

64) A 72-year-old woman presents to the GP with presence of blood in her urine over the

last 2 months. She has no fever or any other systemic symptoms. Routine urinalysis

shows blood 3+. She feels quite well and has been brought to the GP reluctantly by her

persuasive daughter. The patient apologises for being an encumbrance.

A nulliparous woman had a thrombophilia screen requested by her GP
because of the family history of VTE in her mother and sister.
Which one of the thrombophilia defects is associated with the highest risk
of VTE in pregnancy?
A 40-year-old woman has been trying to conceive for the last 2 years but has
not been successful. She had one failed IVF cycle and is going for a second
cycle of IVF treatment.
Which of the following will not reduce the success rate of IVF

.A 54-year-old woman presents with spotting of blood vaginally on wiping over the last
few weeks on and off. She went through the menopause 3 years ago and is otherwise well.

She is more active since her recent knee replacement surgery. Her Pap smear
2 years ago was normal as were her other smears.

68) A 29-year-old primigravida is being reviewed at term +10 in the consultant antenatal clinic.

Her BMI is 28. She  perceives movements well and admission CTG is normal. Vaginal

examination shows a Bishop score of 3 and has had a stretch and sweep by her midwife.


A 30-year-old woman with a previous history of caesarean section and
multiple uterine fbroids had a repeat elective caesarean section due to breech
presentation. She had massive postpartum haemorrhage (PPH) secondary to
uterine atony with an estimated blood loss of 3 L. She is RhD-negative and had
transfusion of the group specifc packed red cells, reinfusion of the salvaged
red cells from the cell saver and also fresh frozen plasma (FFP), cryoprecipitate
and platelets. Te cord blood group was confrmed as RhD-negative.
Anti-D prophylaxis should be administered in which one of the options,
if she had the following blood products transfused?

A 14-year-old girl was having a suction termination of pregnancy (TOP).
She did not want her mother to know. Her mother asks you about why her
daughter is in the hospital.
Te options in the girl’s case include the following except for which one?


Pregnant patient with thalassemia major who had history of splenectomy. Her platelet count
is > 600x 10*


A 30-year-old para 1 woman with a body mass index (BMI) of 38 and family
history of diabetes attends antenatal clinic at 28 weeks’ gestation. She was
diagnosed with gestational diabetes 2 days ago when her glucose tolerance
test was abnormal with a fasting glucose of 7.0 mmol/L and a 2-hour plasma
glucose of 8.9 mmol/L.
What is the most appropriate intervention in managing her gestational

A 25-year-old woman attends the emergency department with a history of
lef-sided severe abdominal pain for the last 24 hours. A clinical diagnosis of
suspected ovarian torsion is made as there is marked tenderness as well as
guarding on abdominal palpation. An ultrasound scan reveals a large ovarian
dermoid cyst on the lef side (9 × 7 × 8 cm) with absent blood fow. Bloods
reveal leucocytosis and raised C-reactive protein. A laparotomy is performed
in view of clinical suspicions of ovarian torsion.
Intra-operative fndings reveal the following:
• Normal right ovary
• Torsion of ovarian pedicle × 3 loops (lef ovary)
• Lef ovary appears non-viable
• Normal fallopian tubes and uterus
• Normal rest of pelvis and abdomen with no ascites
Her surgical management includes which one of the following?
What percentage of the cardiac output is received by the gravid uterus at term

75) A 30-year-old primigravida presents with loss of fetal movements for the past 2 days

at 30 weeks gestation. She also recollects having dark urine for the past 2 weeks. On

examination she is found to be icteric, dehydrated and tachycardic. Ultrasound

examination, confirms fetal demise and blood analysis shows severely deranged liver

enzymes with INR of 3.0. Vaginal examination shows a very unfavourable cervix


A 26-year-old woman is referred to colposcopy clinic for severe dyskaryosis.
Colposcopy reveals a tumour on the cervix. Cervical biopsy is reported
as squamous cell carcinoma of cervix. She has been booked for radical
Which of these instruments is used to identify and release the ureter in the
ureteric tunnel in radical hysterectomy?


You are seeing a 30-year-old nulliparous woman in the antenatal clinic at
12 weeks’ gestation with a family history of Duchenne muscular dystrophy.
She is a known carrier and keen to know the likelihood of her children being
What is the likelihood of her children being afected?

Ms XY is 38-year-old G5P4 with a BMI of 32. She presents to the consultant-led
ANC at 28 weeks with a fetal growth scan, which is normal. She is otherwise fi t and
well. She takes routine pregnancy supplements.
In terms of VTE prophylaxis, which of the following is best suited to her?

79) A  26-year-old woman presents to the delivery suite with painful contractions and

vaginal bleeding. She is currently 35 weeks pregnant and abdominal examination shows

a tense uterus with an uneffaced cervix and vaginal bleeding


29 yr old woman with sickle cell disease is 14 weeks pregnant. She ia seen by midwife to
discuss her booking blood tests. She is rubella immune, HIV negative, Syphillis negative and her Hb is
8.4 gm/dl.

81) . A20-year-old woman had medical treatment for an ectopic pregnancy 15 days ago.She

has been told not to get pregnant for at least 1month following this injection because the

drug has an antifolate action.


82) A 27-year-old woman presents with abdominal cramps and vaginal bleeding at term

+2 days in her second pregnancy. Her blood group is rhesus negative and was given

anti-D after her first delivery. Further tests confirm placental abruption and fetal

demise. She looks pale with a PR of 100 bpm, and her BP is 100/60 mmHG. Her Bishop

score is 3. Immediate intravenous access is obtained and blood tests are sent.

83) Placenta low-lying at 20wk chances to shift in upper segment

84) A 30-year-old woman presents to the gynaecology outpatient department (OPD) with a

6-month history of urinary urgency – frequency but no urge incontinence or nocturia.

The GP letter states that the urinalysis done last fortnight reported negative.

84) A 30-year-old woman presents to the gynaecology outpatient department (OPD) with a

6-month history of urinary urgency – frequency but no urge incontinence or nocturia.

The GP letter states that the urinalysis done last fortnight reported negative.


A 33-year-old multiparous woman is reviewed by the senior house officer in the postnatal
ward. She had a Caesarean section for failure to progress and has been using an epidural for
pain relief for the last 4 hours following Caesarean section. The midwife has just given her the
first dose of prophylactic LMWH postnatally

86) A20-year-old woman is having treatment for a high-risk gestational trophoblastic disease.

She has just finished her second cycle of chemotherapy. 1week later she

presents with feeling unwell with motor weakness, double vision and sore throat

Clinical examination reveals lower limb power of 3/5 and lateral rectus palsy of

right eye, and blood results show myelosuppression.



A 30-year-old woman who delivered 8 hours ago gives a history of previous thrombophilia.
Her mode of delivery was Caesarean section for a prolonged second stage of labour. She had a
massive postpartum haemorrhage and her current haemoglobin level is 80 gL. The midwife
comes to you to inform you about the minimal soakage of the Caesarean section wound

88) Birth in water pool is avoided in

89) A 27-year-old woman is reviewed in the antenatal clinic at 36 weeks in her

first pregnancy. She has HIV and is on highly active antiretroviral treatment

(HAART). What is the threshold parameter for which delivery by elective

caesarean section would be recommended?

90) A  20-year-old primigravida attends the day assessment unit at 23  weeks gestation

with increased vaginal discharge and abdominal discomfort. Abdominal examination

confirms a soft non-tender uterus, and vaginal examination reveals a soft cervix with no

bleeding or draining. Transvaginal scan shows a cervix of 1.5 cm length

91) A 30-year-old woman in her third pregnancy arrives unbooked from Mumbai

at 28 weeks of gestation. She begins to feel unwell at 32 weeks of gestation and

develops jaundice, severe fatigue and nausea. She rapidly develops fulminant

hepatic failure and encephalopathy. She is transferred to a liver unit, but dies,



A para 1 woman at 33 weeks’ gestation presents with preterm premature
rupture of membranes (PPROM). She had a recurrence of genital herpes
3 days ago. On examination PPROM was confrmed, and the genital lesions
are healing.
What is the most appropriate management option?


A para 4 woman with all previous normal vaginal deliveries and a big baby has
just delivered spontaneously. She has consented for the active management of
the third stage of labour and oxytocics were given at birth.
Active management of the third stage of labour reduces the risk of PPH by
what proportion?

Ms XY is a primigravida who is 30 weeks pregnant. She presents to A + E with
acute onset of shortness of breath and chest pain. She has just travelled via a long
haul fl ight (12 h) to the UK.
Which of the following investigations is not appropriate in the investigation of a
suspected pulmonary embolus in pregnancy?

95) A 23-year-old university student complains of persistent purulent vaginal discharge.

On vaginal examination, there is contact bleeding from the cervix.

Microscopy of a Gram-stained endocervical swab specimen showed monomorphic

Gram-negative diplococci within polymorphonuclear leucocytes.


A 33 yr old woman with sickle cell disease presents to preconception clinic. She would like to
become pregnant and her partner has been already tested for sickle cell disease and negative. The
woman is taking a no of medications, and is advised to stop a perticular drug 3 months before

97) A 23-year-old primigravida at 38 weeks gestation complains of reduced fetal movements

for the past 2 days. Her antenatal course was uneventful and her current observations

are within normal limits. Further evaluation shows normal estimated fetal weight on

ultrasound with marked oligohydramnios and normal UA and MCA Doppler study.

She denies any vaginal discharge. Vaginal examination shows a Bishop score of 5 and

membrane sweep has been done.


A 43-year-old woman gravid 1 para 0 is referred to the antenatal clinic for
booking. Her dating scan at 13 weeks shows increased nuchal thickness.
Chorionic villus sampling (CVS) results show trisomy 21.
Which one of the following is not associated with Down syndrome?


For gestational age assessment of the fetus in early pregnancy, it is recommended
that crown rump length be used for dating. Once the CRL exceeds 84 mm, it is rec-
ommended that dating be based on measurement of:


9.An 18-year-old girl presents to the gynaecology clinic with severe mood swings and delay
for a week before the onset of her period. She also feels drained due to heavy bleeding
during her periods. This affects her relationship with her boyfriend with whom she is in a
stable cohabiting relationship. It also affects her University performance as a new student.

Your score is