1. Mrs. John 37-years, para 4+0 complaints of irritating vaginal discharge after taking a course of cephalosporin last week. Speculum examination revealed thick curdy white vaginal discharge with red and excoriated vulva. What is the likely diagnosis?
a. Vulvo-vaginal candidiasis
b. Trichomoniasis
c. Bacterial vaginosis
d. Gonorrhoea
e. Chlamydia
Explanation: Antibiotic use predisposes to candidiasis (curdy discharge + vulvar excoriation).
2. A 30 years old woman presented with menorrhagia for last one year. On ultrasound examination there is uterine fibroid of 3cm. Her Hb is 5 g/dL. The treatment option for her:
a. GnRH agonist
b. Progesterone receptor modulator
c. COC pills
d. Levonorgestrel intrauterine system (LNG-IUS)
e. Correction anaemia and hysteroscopy guided transcervical resection of fibroid
Explanation: Severe anemia (Hb=5) requires iron correction + surgical resection.
3. A 70-years-old woman presented with post-menopausal bleeding. The commonest cause of post-menopausal bleeding is:
a. Atrophic vaginitis
b. Carcinoma cervix
c. Endometrial carcinoma
d. Endometrial hyperplasia
e. Endometrial polyps
Explanation: Atrophic vaginitis is the most common benign cause.
4. The main risk factor for causing cervical cancer:
a. Cigarette smoking
b. Multiparty
c. Age 50 years
d. Human papilloma infection
e. Herpes simples type II infection
Explanation: HPV (especially types 16/18) causes >90% of cervical cancers.
5. A 20-years old woman is referred to Gynaecology clinic having had amenorrhea for the last 6 months and negative pregnancy test. She had recently noticed an increased growth of hair on the face & chin and chemistry of hormonal assays show high level of hydroxy progesterone. What is the like diagnosis?
a. Adrenal adenoma
b. Adrenal carcinoma
c. Cushing syndrome
d. Polycystic ovary syndrome
e. Late onset congenital adrenal hyperplasia
Explanation: Elevated 17-OH progesterone indicates 21-hydroxylase deficiency (CAH).
6.
A.
B.
C.
D.
Explanation: [Left blank as per original PDF]
7. 16-years old girl is referred to gynaecology clinic by her general practitioner with primary amenorrhea. She gave history of excessive weight gain and lethargy; secondary sexual characteristics are normal on clinical examination. Investigation reveals raised serum thyroid stimulating hormone (TSH) and prolactin levels. What is likely cause?
a. Pituitary Prolactinoma
b. Hypothyroidism
c. Hyperprolactinemia
d. Androgen insensitivity syndrome
e. Gonadal dysgenesis
Explanation: Elevated TSH confirms hypothyroidism (can cause hyperprolactinemia).
8. A 30-years old woman attends early pregnancy antenatal clinic at six-week pregnancy according to LMP with heavy vaginal bleeding and crampy lower abdominal pian. An ultrasound scan is performed which shows an empty uterus, normal ovaries with serum βHCG report of 1200 IU/L. Test is repeated after 48 hours later, serum βHCG levels is 400U/L. What is the likely diagnosis?
a. Missed Miscarriage
b. Incomplete miscarriage
c. Complete miscarriage
d. Ectopic pregnancy
e. Molar pregnancy
Explanation: Declining β-hCG + empty uterus suggests resolving ectopic.
9. 47-years old woman presented with history of dyspareunia, itching and sourness. On examination there is skin with fissuring and loss of anatomy of vulva. How will you confirm your diagnosis?
a. Biopsy—Dx. Lichen sclerosis
b. Colposcopy
c. Vaginal swab
d. On clinical examination
e. Pap smear
Explanation: Biopsy confirms lichen sclerosus (thinned epidermis + fissuring).
10.
A.
B.
C.
D.
Explanation: [Left blank as per original PDF]
11. Ischemic heart disease which contraceptive will be avoided
A. COCP
B. LNG-IUS
C. Barrier methods
D. Progestin-only pills
Explanation: COCP increases thrombotic risk in cardiovascular disease.
12. A woman aged 34 years and her 32-year-old partner have had 8 years’ infertility and have attended a fertility clinic. The woman has been shown to have a normal hormone profile with normal ovarian reserve and the TVUSS is normal. A HyCoSy has demonstrated tubal patency. The SFA has shown a sperm count of 6 million/ml and motility of 20%. What should they be advised is the most suitable treatment?
a. IVF and ICSI.
b. IUI.
c. PGD.
d. Ovulation induction.
e. IVF alone
Explanation: Severe oligoasthenospermia (count <10 icsi.="" million="" ml="" requires="" span="">
13. A 38-year-old para 4, Lecturer having BMI 35, BP 160/100 requests for long term contraception, the best choice for her is?
a. Contraceptive intrauterine Device
b. Contraceptive Implant
c. Depo-Provera Injection
d. COCs
e. LNG-IUS
Explanation: LNG-IUS is safe in obesity + hypertension (no estrogen).
14. Puberty is the process of reproductive and sexual development and maturation that changes a child into an adult. First physical sign of puberty is:
a. Pubic hair growth
b. Axillary hair growth
c. Growth spurt
d. Breast budding
e. Menstruation
Explanation: Thelarche (breast budding) is the earliest pubertal sign.
15. A 50-year-old nulli parous obese woman present with heave menstrual bleeding. Endometrial carcinoma is best diagnosed by:
a. Transvaginal ultrasound
b. Magnetic resonance imaging
c. CT scan
d. Fractional curettage
e. Hysteroscopically guided endometrial biopsy
Explanation: Hysteroscopic biopsy allows direct visualization + sampling.
16. Ovarian follicular reserve, FSH LH can be best measured at
a. Early follicular phase
b. Mid follicular phase
c. Late follicular phase
d. Mid luteal phase
e. During menstruation
Explanation: Day 2-5 FSH reflects ovarian reserve most accurately.
17. The most appropriate treatment ruptured ectopic pregnancy:
a. Methotrexate injection
b. Immediate laparotomy and salpingectomy
c. Expectant management
d. Laparotomy and tubal repair
e. Hysterectomy
Explanation: Ruptured ectopic requires emergency surgery.
18. A multiparous woman presents with chronic pelvic pain (CPP) refractory to medical treatment. What is the gold standard investigation to diagnose CPP?
a. Pelvic ultrasound
b. TVUSS
c. Laparoscopy
d. CT scan
e. MRI
Explanation: Laparoscopy allows direct visualization of pelvic structures.
19. A 7-year-old girl is brought you for precocious puberty. The frequently found cause Central precocious puberty (CPP) is:
a. Craniopharyngioma
b. Hydrocephalus
c. Hypothalamic hamartoma
d. Idiopathic
e. McCune-Albright syndrome
Explanation: 90% of CPP in girls is idiopathic.
20. A young 18-year-old woman presented in with ultrasound report that reveals ovarian cyst of 8 x 6cm size. The most common ovarian tumour in this age group is:
a. Inflammatory ovarian cyst
b. Germ cell tumour
c. Serous cystadenoma
d. Sex cord stromal tumour
e. Mucinous cystadenoma
Explanation: Germ cell tumors (e.g., teratomas) dominate in young women.
21. 20-years old para 0+1 came with complain of 10 weeks gestational amenorrhea and bleeding P/V with passage of clots for 02 hours. O/E BP is 90/60 mmHg, pulse is 100 beats/min, cervical os is open, RPOCs felt. What is the appropriate treatment of this case?
a. Do U/S pelvis
b. Give misoprostol tablet
c. Perform MVA—surgical termination up to 14 weeks
d. Do evacuation-- surgical termination after 14 weeks
e. Start syntocinon infusion
Explanation: Open os + RPOCs + bleeding = incomplete miscarriage → MVA.
22. 45-years old woman presents with irregular heavy vaginal bleeding. Ultrasound reveals enlarged uterus with endometrial thickness of 1.8 cm and right adnexal mass of 8x8 cm. A provisional diagnosis of granulosa cell tumor is made. She should have, following tumor marker to support the diagnosis:
a. Serum inhibin
b. CA-125
c. Alpha fetoprotein
d. Beta HCG
e. TSH
Explanation: Granulosa cell tumors secrete inhibin.
23. women with discharge, in examination strawberry cervix is there .
A. Trichomonas Vaginalis
B. Bacterial vaginosis
C. Candida
D. Gonorrhea
Explanation: Strawberry cervix is pathognomonic for trichomoniasis.
24. A 65-year-old woman has presented with postmenopausal bleeding for one month. She is diagnosed as a case of carcinoma endometrium stage-I. The best treatment option for her is..
A. Total abdominal hysterectomy with bilateral salpingooophorectomy
B. Radiation therapy
C. Chemotherapy
D. Hormonal therapy
Explanation: TAH+BSO is standard for Stage I endometrial cancer.
25. .The well-established aetiology for carcinoma of cervix is:
A. HPV infection
B. Herpes simplex
C. Smoking
D. Early coitarche
Explanation: HPV (types 16/18) causes >90% of cervical cancers.
26. A 14-years old girl presents with primary amenorrhea, short stature, webbed neck. She is diagnosed as "Turner's syndrome". The karyotype of this syndrome is:
a. 46XX
b. 46XY
c. 45X0
d. 47XXX
e. 47XXY
Explanation: Turner syndrome = 45,X (monosomy X).
27. A 33-years old patient has been diagnosed as having adenomyosis. Which of the following symptoms is most consistent with this diagnosis?
a. Infertility
b. Secondary dysmenorrhea
c. Mood swings
d. Painful defecation
e. Dyspareunia
Explanation: Adenomyosis causes progressive dysmenorrhea + menorrhagia.
28. Commonest etiological factor for early miscarriage is likely to be:
A. Chromosomal abnormalities
B. Uterine anomalies
C. Infections
D. Endocrine disorders
Explanation: 50-70% of early miscarriages are due to fetal aneuploidy.
29. Which of the following types of fibroids causes an excessive bleeding?
a. Cervical
b. Broad ligament
c. Sub-mucosal
d. Subserosal
e. Transmural
Explanation: Submucosal fibroids distort the endometrial cavity.
30. 55-year-old para 6 + 0 presents with utero-vaginal prolapse. The most likely cause of weakness of:
a. Pubocervical fascia
b. Round & ovarian ligaments
c. Perineal body
d. Rectovaginal fascia
e. Uterosacral and cardinal ligaments
Explanation: Uterosacral/cardinal ligament laxity causes uterine prolapse.
31. Pre mature ovarian failure is defined as total failure of ovaries in a woman under the age of:
a. 30 years
b. 32 years
c. 35 years
d. 37 years
e. 40 years
Explanation: POF = menopause before age 40 with FSH >40 IU/L.
32. A 30-year-old woman attends gynae clinic. Her first-degree relatives had ovarian cancer and she is found to be BRCA (Breast ovarian cancer syndrome) mutation carrier. She is at of risk of developing ovarian cancer particularly
a. Clear cell carcinoma
b. Mucinous carcinoma
c. High grade serous cancer
d. Granulosa call tumour
e. Dysgerminoma
Explanation: BRCA mutations predispose to high-grade serous carcinoma.
33. A 42-year-old woman came in OPD with complaints of leakage of urine on coughing, sneezing and household work. What is the type of incontinence?
a. Urge incontinence
b. Mixed incontinence
c. Stress incontinence
d. Overactive bladder
e. Vesico vaginal fistula
Explanation: Leakage with increased abdominal pressure = stress incontinence.
34. Cervical cancer is a rare outcome of Human papilloma virus (HPV) infection. Out of several HPV types, which types have highest oncogenic potential:
a. 6
b. 11
c. 16 and 18
d. 41
e. 44
Explanation: HPV-16/18 cause 70% of cervical cancers (high-risk).
35. Evaluating tubal factor in woman with infertility and mild endometriosis, the most likely problem is:
a. Peri-tubal fine adhesions
b. Altered tubal motility
c. Occlusion of tubal lumen
d. Destruction of tubal ciliary function of epithelium
e. Adjacent endometrioma of ovary
Explanation: Mild endometriosis causes adhesions impairing tubal mobility.
36. Ureter is at risk of injury during hysterectomy due to its close relationship with:
a. Uterine artery
b. Internal iliac artery
c. Cervix
d. Vault of vagina
e. Uterine artery, Cervix and vault of vagina
Explanation: Ureter crosses under uterine artery ("water under bridge").
37. young girl of 18-year age came with primary amenorrhea due to absent uterus ovaries are normal in appearance. She has normal secondary sexual characteristics.
A. MayerRokitansky, Kuster Hauser (MRKH) syndrome
B. Androgen insensitivity syndrome
C. Turner syndrome
D. PCOS
Explanation: MRKH = Müllerian agenesis (absent uterus, normal ovaries).
38. GnRH agonists being peptide in nature need not to be administered by:
a. Intra muscular injection
b. Slow-release depot-formulation
c. Intra nasal sprays
d. Oral route
e. Sub-dermal patches
Explanation: GnRH agonists are destroyed by gut enzymes (cannot be oral).
39. A 30-years old Para 2+0 visits family planning clinic. After evaluation and counselling, she is motivated for combined oral contraceptive pill. The principal mechanism of action of this drug is mediated by:
a. Negative feedback effect on pituitary
b. Negative food back effect on hypothalamus
c. Effects on cervical mucus
d. Effects on tubal motility
e. Effects on endometrial receptivity
Explanation: COCP suppresses FSH/LH via pituitary feedback.
40. 55 year old female had bleeding problem diagnoss intra mural fibroids best option for treatment
A. myomectomy
B. Hysterectomy
C. Uterine artery embolization
D. Medical management
Explanation: Myomectomy preserves fertility for intramural fibroids.
41. A 35-years old woman present with confirmed diagnosis of over active bladder syndrome (OAB). It refers to combination of:
a. Frequency and burning micturition
b. Frequency and urgency of micturition
c. Frequency, dysuria and urge incontinence
d. Frequency, urgency and/or urge incontinence
e. Frequency and dysuria
Explanation: OAB = urgency + frequency ± urge incontinence.
42. 42-year-old woman para 6 presents with complains of severe progressive dysmenorrhea and menorrhagia. Pelvic examination demonstrates a tender enlarged uterus, diagnoss:
A. Adenomyosis
B. Endometriosis
C. Fibroids
D. PID
Explanation: Tender, globular uterus = adenomyosis.
43. An 80-years old, para 8+2 female came with the complaint of something coming out of vagina for last 5 years and no other associated complains. She is known case of cirrhosis of liver and hypertension. On pelvic examination there is moderate cystocele, mild rectocele and 2nd degree cervical descent. The most appropriate treatment option is:
a. Anterior colporrhaphy
b. Lee Fort operation
c. Manchester repair
d. Ring pessary insertion
e. Vaginal hysterectomy
Explanation: LeFort colpocleisis is ideal for elderly with comorbidities.
44. A 25-year-old woman para 0+4 comes in OPD for consultation. The commonest uterine malformation responsible for recurrent abortions is:
a. Uterus bicornis bicollis
b. Sub-septate uterus
c. Uni-cornuate uterus
d. Uterus didelphys
e. Rudimentary horn
Explanation: Subseptate uterus has highest miscarriage risk.
45. A 25-year-old woman para 0+4 comes in OPD for consultation. The commonest uterine malformation responsible for recurrent abortions is:
a. Uterus bicornis bicollis
b. Sub-septate uterus
c. Uni-cornuate uterus
d. Uterus didelphys
e. Rudimentary horn
Explanation: Duplicate of Q44 - subseptate uterus.
46. Which one of the following hormone assays suggests the diagnosis of menopause:
A. Elevated serum FSH and LH
B. Elevated serum prolactin
C. Elevated serum T3 and T4
D. Elevated serum beta-hCG
Explanation: FSH >25 IU/L confirms menopause.
47. A 70-year-old lady is diagnosed with stage 1a vulval cancer. Best treatment modality for her is:
a. Chemotherapy
b. Radiotherapy
c. Radical vulvectomy
d. Radio + chemotherapy
e. Wide local excision
Explanation: Stage Ia (microinvasion) requires local excision only.
48. The most appropriate treatment ruptured ectopic pregnancy:
A. Methotrexate injection
B. Immediate laparotomy and salpingectomy
C. Expectant management
D. Laparoscopic tubal repair
Explanation: Ruptured ectopic = surgical emergency.
49. Female patient 28 yrs old. Just got married. She developed painful blisters and ulcers on external genitalia.. few months back her husband suffered from similar illness. On examination painful ulcers, marigins not elevated. No lymphadenopathy. .. HSV
A. Herpes simplex virus
B. Syphilis
C. Chancroid
D. Behcet's disease
Explanation: Painful ulcers + partner history = HSV.
50.
A.
B.
C.
D.
Explanation: [Left blank as per original PDF]
Report Card
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