1. Regarding incidence of choriocarcinomas, mostly they follow:
A) A miscarriage
B) An apparently normal pregnancy
C) An ectopic pregnancy
D) Complete hydatidiform mole
E) Partial hydatidiform mole
Explanation: Choriocarcinoma most commonly follows a complete hydatidiform mole.
2. What is the first line pharmacological treatment for ovulation induction in a woman with Polycystic ovary syndrome (PCO)?
A) Anastrozole
B) Clomiphene
C) Letrozole
D) Recombinant FSH
E) Tamoxifen
Explanation: Letrozole is now recommended as the first-line agent for ovulation induction in PCOS because it yields higher live-birth rates and lower multiple-pregnancy risk than clomiphene.
3. An obese multiparous woman with previous history of difficult vaginal delivery present with incontinence of urine on coughing and straining. The obstetric risk factor for her problem is due to:
A) Stretching/damage to pelvic floor muscles
B) Stretching/damage to pudendal nerve
C) Avulsion of pelvic floor muscle from their insertion on pelvic side wall
D) A combination of stretching/damage to pelvic floor muscles, pudendal nerve and avulsion of pelvic floor muscle from their insertion on pelvic side wall
E) Obesity
Explanation: Stress urinary incontinence after difficult vaginal delivery is multifactorial—muscle, nerve and attachment damage together create sphincter weakness.
4. A 35-years old Para 3+0 underwent Large Loop Excision of Transformation Zone (LLETZ) for CIN 3. Which of following is the 'test of care' in her case?
A) Cervical cytology in 3 months
B) Cervical cytology in 6 months
C) Colposcopy
D) High risk HPV test
E) High risk HPV test and cytological assessment after 6 months
Explanation: Combined high-risk HPV testing and cytology at 6 months is the recommended ‘test of cure’ after treatment for CIN 3.
5. 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 visible sign of female puberty.
6. A 38-years old abuse multiparous presents with heavy menstrual bleeding. You are suspecting endometrial Polyp as an underlying cause of her complain. The appropriate test for diagnosis is:
A) Hysteroscopic directed endometrial biopsy
B) Transvaginal ultrasound
C) Transabdominal ultrasound
D) MRI
E) Diagnostic D & C
Explanation: Direct visualisation and biopsy by hysteroscopy is the gold-standard method for diagnosing an endometrial polyp.
7. 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: The levonorgestrel-releasing intrauterine system is effective, long-acting, non-oestrogenic and suitable for obese, hypertensive women.
8. 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: In teenagers, the majority of ovarian tumours are germ-cell derived (e.g. dermoid cysts).
9. 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 oligo-asthenospermia (<15 million/ml) is best managed with IVF combined with intracytoplasmic sperm injection.
10. The absolute contraindication combined oral contraceptive pills is:
A) Diabetes mellitus
B) Ischemic heart disease
C) Smoking
D) Hyperprolactinemia
E) Migraine
Explanation: Existing ischaemic heart disease is a WHO category 4 condition—COCs are absolutely contraindicated.
11. While treating anovulation, clomiphene citrate should be administrated in which of the following phase of menstrual cycle?
A) Early follicular phase
B) Mid follicular phase
C) Late follicular phase
D) Mid luteal phase
E) During menstruation
Explanation: Clomiphene is taken from day 2–5 of the cycle, i.e. early follicular phase.
12. 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: Fractional dilatation and curettage provides histology from both endocervix and endometrium, giving the definitive diagnosis.
13. A 35 years old woman Para 4+0 with heavy menstrual bleeding not responding to medical treatment on clinical examination uterus is slightly larger than normal and she has been advised for endometrial ablation. The procedure aims at destruction of endometrial lining of uterus involving:
A) Superficial 1/3
B) Superficial 2/3
C) Basal 1/34
D) Whole thickness
E) In patchy areas
Explanation: Endometrial ablation removes or destroys the functional endometrium down to the basal layer, preventing regeneration.
14. A 50 years old woman has undergone laparotomy for ovarian cancer. At laparotomy tumour is limited to one ovary, no external tumour, capsule is intact, no ascites. According to International Federation of Gynaecology & Obstetrics (FIGO) staging of ovarian cancer it is:
A) Stage 1a
B) Stage 1b
C) Stage 1C
D) Stage 2a
E) Stage 2b
Explanation: Stage IA is tumour confined to one ovary with intact capsule and no surface involvement or ascites.
15. A 65 years old diabetic, hypertensive woman presents with a first episode of postmenopausal bleeding. What is appropriate first line investigation of post-menopausal bleeding?
A) Dilatation and endometrium curettage to assess endometrium
B) Pipelle biopsy
C) Hysteroscopically guided endometrial biopsy
D) Saline infusion sonography
E) Transvaginal ultrasound to assess the endometrial thickness
Explanation: TVUS is non-invasive, quick and can reliably detect an endometrial thickness >4 mm that warrants biopsy.
16. 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: A haemodynamically unstable, ruptured ectopic pregnancy requires immediate salpingectomy to control bleeding.
17. Young couple diagnosed as having unexplained infertility trying to conceive for 03 years. What treatment would you recommended?
A) Conservative management
B) Ovulation induction with clomiphene
C) Ovulation induction with letrozole
D) Intracytoplasmic sperm injection (ICSI)
E) Invitro fertilization (IVF)
Explanation: After 3 years of unexplained infertility, NICE guidelines recommend moving directly to IVF.
18. Gravida 4, Para 3+0 attends early pregnancy clinic with amenorrhea of 10 weeks, nausea, vomiting and vaginal bleeding. An ultrasound scan is performed that show molar pregnancy. What is the optimal method of emptying the uterus?
A) Mifepristone
B) Misoprostol (PGE)
C) PGE
D) Oxytocin
E) Suction curettage
Explanation: Suction evacuation with oxytocin cover is the preferred method for complete removal and bleeding control in molar pregnancy.
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: Most cases of central precocious puberty in girls are idiopathic with no identifiable CNS lesion.
20. 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: Diagnostic laparoscopy allows direct visualisation of pelvic pathology and remains the gold standard for chronic pelvic pain.
21. A 30-year-old nulliparous obese woman with hirsutism presented at clinic for infertility, the most confirmative test to diagnosis of PCO is:
A) Symptoms of androgenism
B) Serum endocrinology
C) Ultrasound features
D) Assessment of BMI
E) Gallway hirsutism scoring
Explanation: The presence of >=12 peripherally arranged follicles or increased ovarian volume on ultrasound is a key diagnostic criterion.
22. A 35-year-old woman presents in OPD with excessive greyishwhite vaginal discharge, high vaginal swab taken. ‘Clue cells’ on wet mount are suggestive of:
A) Syphilis
B) Bacterial vaginosis
C) Trichomoniasis
D) Gonorrhoea
E) Candidiasis
Explanation: Clue cells—vaginal epithelial cells studded with bacteria—are pathognomonic of bacterial vaginosis.
23. While a woman is ao danazol therapy for endometriosis, the most common & distressing side effects are
A) Nausea & vomiting
B) Abdominal ballottement
C) Breast tenderness
D) Weight gain, acne & greasy hair
E) Headache & bone pains
Explanation: Danazol’s androgenic effects—weight gain, oily skin, acne and hirsutism—are often the most troublesome.
24. Which one of the following is NOT associated with polycystic ovarian disease?
A) Always overweight
B) Hirsutism and acne
C) Elevated androgen levels
D) Insulin resistance
E) Increased SHBG levels
Explanation: Many but not all women with PCOS are overweight; lean PCOS is well recognised.
25. Which one of the following primary malignancies, metastasise to ovary?
A) Stomach
B) Bone
C) Thyroid
D) Lung
E) Brain
Explanation: Krukenberg tumours classically arise from a primary gastric carcinoma and involve the ovaries bilaterally.
26. The risk factor associated with ovarian cancer is:
A) Combined oral contraceptive pills
B) Early menopause
C) Late menarche
D) Infertility
E) Multiparity
Explanation: Infertility is a risk factor for ovarian cancer due to prolonged ovulation without pregnancy-related protective hormonal changes. Multiparity and COCPs reduce risk.
27. A 52 years old woman presents with history of night sweats, palpitation, anxiety and mood changes. What is the likely cause?
A) Hyperthyroidism
B) Hypothyroidism
C) Diabetes mellitus
D) Climacteric symptoms
E) Anxiety
Explanation: Night sweats, palpitations, and mood changes are classic climacteric (menopausal transition) symptoms due to estrogen fluctuations.
28. A 20 years old unmarried girl is diagnosed to have bicornuate uterus. The gynaecological problems she can have in future:
A) Miscarriage
B) Ectopic pregnancy
C) Dysmenorrhoea
D) Sub-fertility
E) All of the above
Explanation: Bicornuate uterus increases risk of miscarriage (due to reduced uterine space), ectopic pregnancy (abnormal tubal implantation), dysmenorrhea (abnormal contractions), and subfertility.
29. The main risk factor for causing cervical cancer:
A) Cigarette smoking
B) Multiparity
C) Age 50 years
D) Human papilloma infection
E) Herpes simples type II infection
Explanation: Persistent high-risk HPV (especially types 16/18) is the primary cause of cervical cancer, accounting for >90% of cases.
30. 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 5g/dL) requires urgent correction. Hysteroscopic resection is definitive for symptomatic submucosal fibroids causing menorrhagia.
31. 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 1a vulval cancer (tumor ≤2cm confined to vulva/perineum) is treated with wide local excision (1cm margins) to preserve function.
32. A 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: Lichen sclerosus is confirmed by biopsy showing epidermal thinning and dermal collagen homogenization. Clinical features (itchy, pale, fissured vulva) are suggestive but not diagnostic.
33. 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 pain. 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 4001U/L. What is the likely diagnosis?
A) Missed Miscarriage
B) Incomplete miscarriage
C) Complete miscarriage
D) Ectopic pregnancy
E) Molar pregnancy
Explanation: Rising βhCG (>35% in 48h) with empty uterus and bleeding suggests ectopic pregnancy. Molar pregnancy would show abnormally high βhCG and uterine findings.
34. A 38-years old nulliparous woman presented with heavy menstrual bleeding for last 06 months. Examination reveals firm mass in the lower abdomen, what is the most likely cause?
A) Adenomyosis
B) Endometriosis
C) Full bladder
D) Ovarian tumour
E) Fibroid
Explanation: Fibroids (leiomyomas) commonly cause heavy menstrual bleeding and a palpable, firm abdominal mass in reproductive-aged women.
35. A 55-years old teacher attends gynae clinic with complains of lack of sleep due to night sweats and hot flushes leading to tiredness, exhaustion, poor performance at work. She is otherwise healthy but has a past history of DVT 10 years ago following an accident. Her LMP was two years ago. She requests HRT. A suitable option is:
A) Oral estrogen
B) Transdermal estrogen
C) Oral estrogen progesterone combination
D) Vaginal estrogen containing rings
E) Transdermal estrogen and progesterone
Explanation: Transdermal estrogen (patch/gel) is preferred in women with DVT history as it avoids first-pass liver metabolism, reducing thrombotic risk compared to oral HRT.
36. A 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: Hypothyroidism causes elevated TRH, which stimulates both TSH and prolactin secretion. Weight gain, lethargy, and amenorrhea are classic features.
37. 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 (due to estrogen deficiency) is the most common benign cause. Endometrial carcinoma is the most serious cause (ruled out first).
38. 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 (cephalosporins) disrupts vaginal flora, predisposing to Candida overgrowth. Curdy discharge and vulvar excoriation are pathognomonic.
39. A 40-year-old lady para 4+0 presents with the symptoms of severe dysmenorrhea and dyspareunia. Diagnostic laparoscopy confirmed severe endometriosis. Most suitable option to completely cure symptoms is:
A) Danazol
B) GnRH agonists
C) Hysterectomy + BSO
D) Laparoscopic removal of endometriosis
E) Nonsteroidal anti-inflammatory drug
Explanation: Hysterectomy with bilateral salpingo-oophorectomy (BSO) is definitive for severe endometriosis in women who have completed childbearing, as it eliminates estrogen-driven disease.
40. A known diabetic woman presents vaginal discharge and intense itching. She is likely to have:
A) Bacterial vaginosis
B) Vulvo vaginal candidiasis
C) Trichomoniasis
D) Gonorrhoea
E) Chlamydial infection
Explanation: Diabetics are prone to candidiasis due to glucose-rich vaginal secretions promoting yeast overgrowth. Itching and discharge are hallmark symptoms.
41. A 30-years old unmarried obese woman BMI of 30kg/m² presents in OPD with irregular menstrual cycle and excessive facial hair growth. What is the first line treatment?
A) Combined oral contraceptive pills
B) Progesterone only pill (POP)
C) Cyproterone acetate
D) Metformin
E) GnRH analogues
Explanation: COCPs are the first-line treatment in PCOS for cycle regulation and androgen control.
42. A 49-years old woman has not menstruated for last 10 months and has night sweats and hot flushes. 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
E) Elevated serum DHAE
Explanation: Elevated FSH and LH levels indicate ovarian failure, confirming menopause.
43. An 18-year-old girl is brought in OPD for the complaints of not menstruating yet. On examination she is 04-feet 02-inches tall with webbed neck and wide carrying angle. Best diagnostic tool in her case is:
A) CT scan
B) Hormonal assays
C) Karyotyping
D) MRI
E) Ultrasound
Explanation: The clinical features suggest Turner syndrome (45,X), confirmed by karyotyping.
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: Sub-septate uterus is the most common Müllerian anomaly causing recurrent miscarriages.
45. A 43-year-old woman undergoes a suction & curettage for miscarriage and the histopathology report confirms a partial mole. The next line management is:
A) Registration with recognised centre
B) Registration and follow up with serial hCG measurement
C) Serial hCG measurement
D) Start the COCP
E) Prescribe methotrexate
Explanation: Partial moles require hCG monitoring to detect persistent trophoblastic disease.
46. A 25-year-old multigravida is admitted in emergency in a state of shock. She had a history of 06 weeks amenorrhoea and severe lower abdominal pain. The diagnosis is consistent with:
A) Appendicitis
B) Ectopic pregnancy
C) Endometriosis
D) Ruptured corpus luteum cyst
E) Salpingitis
Explanation: Amenorrhea + shock + abdominal pain strongly suggests ruptured ectopic pregnancy.
47. A 35 years old woman has come to gynaecology clinic complaining of heavy menstrual bleeding. On examination uterus is bulky. The appropriate imaging modality for further investigation is:
A) Abdominal ultrasound scan
B) TVUSS (Transvaginal ultrasound)
C) CT scan
D) MRI
E) Hysterosalpingogram (HSG)
Explanation: TVUSS is the first-line imaging for evaluating heavy menstrual bleeding and uterine bulk (e.g., fibroids).
48. A 20-years old woman is suffering from premenstrual syndrome (PMS). The aetiology appears to be related to cyclical ovarian activity and the effects of oestradiol and progesterone on certain neurotransmitters. Which of the following neurotransmitter is considered to have a key role?
A) Adrenaline
B) Nor-adrenaline
C) Dopamine
D) Serotonin
E) Acetyl choline
Explanation: Serotonin dysregulation is central to PMS pathophysiology; SSRIs are used for treatment.
49. Feature characteristically associated with imperforated hymen in a 16-year-old girl include:
A) Acute retention of the urine
B) Absence of secondary sexual characteristics
C) Hirsutism
D) Short stature
E) Present with secondary amenorrhea.
Explanation: Hematocolpos due to imperforate hymen can compress the urethra, causing urinary retention.
50. The most common defective gene in breast/ovarian tumour families is:
A) BRCA-1 gene—80%
B) BRCA-2 gene—15%
C) DNA repair gene
D) RNA messenger gene
E) Mitochondria gene
Explanation: BRCA-1 mutations account for the majority of hereditary breast/ovarian cancers.
51. 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 likely diagnosis?
A) Adrenal adenoma
B) Adrenal carcinoma
C) Cushing syndrome
D) Polycystic ovary syndrome
E) Late onset congenital adrenal hyperplasia
Explanation: Elevated 17-hydroxyprogesterone suggests 21-hydroxylase deficiency (CAH).
52. A 35-year-old lady para 3+0 came at clinic for something coming out of vagina for 2 years. On examination she has second degree utero-vaginal prolapse. Now she is interested in treatment with preservation of fertility. What surgical procedure will be better for her?
A) Anterior colporrhaphy
B) Amputation of cervix
C) Sacro hysteropexy
D) Manchester repair
E) No need of surgery
Explanation: Manchester repair (Fothergill’s operation) preserves fertility while correcting prolapse.
53. Patients who have been started on hormone replacement therapy, should be counselled that the following symptoms will appear on start of HRT, EXCEPT:
A) Breast tenderness
B) Nipple sensitivity
C) Appetite rise
D) Weight loss
E) Calf cramps
Explanation: HRT may cause weight gain (not loss) due to fluid retention.
54. A 30-years old woman present in gynae clinic with discomfort in left iliac fossa. Ultrasound shows 4 cm simple cyst in left ovary. What other investigation is required?
A) Alpha feto-protein
B) CA 125
C) Beta hCG
D) LDH
E) No investigation required
Explanation: Simple cysts <5 cm in premenopausal women are typically benign and need no further tests.
55. With continuous long-term use of GnRH agonist; One of the distressing side effects is:
A) Menopausal symptoms
B) Sexual dysfunction
C) Osteoporosis (Reduced bone mineral density; BMD)
D) Alteration in lipid profile
E) Alteration in liver function tests
Explanation: GnRH agonists cause hypoestrogenism, leading to bone loss over time.
56. A 30-year-old woman presented with history of 09-weeks of amenorrhea, ultrasound report shows empty uterus. The most likely diagnosis is:
A) Missed abortion
B) Threatened abortion
C) Ectopic pregnancy
D) Incomplete abortion
E) Induced abortion
Explanation: An empty uterus with positive pregnancy test and amenorrhea suggests ectopic pregnancy until proven otherwise.
57. A 55 years old woman presented with postmenopausal bleeding. Hysteroscopy guided endometrial biopsy was performed and histopathology shows moderately differentiated adenocarcinoma. Appropriate staging investigation to determine the extent of tumour spread to myometrium is:
A) Trans-abdominal ultrasound
B) CT scan pelvis and abdomen—to detect lymph node metastasis
C) PET scan
D) Laparoscopy
E) MRI scan of pelvis
Explanation: MRI pelvis is the best imaging modality to assess myometrial invasion in endometrial cancer.
58. Laparoscopy enables the accomplishment all of following surgical procedures, EXCEPT:
A) Lysis of pelvic adhesions
B) Lysis of intra-uterine adhesions
C) Draining of endometrioma
D) Ovarian cystectomy
E) Tubal ligation
Explanation: Intra-uterine adhesions are treated via hysteroscopy, not laparoscopy.
59. Germ cell tumour originate from:
A) Extra embryonic tissue
B) Embryonic tissue
C) Epithelial cells
D) Mesothelial cells
E) Toti potential germ cells
Explanation: Germ cell tumors arise from primordial germ cells of the ovary.
60. A young woman is worried about excessive vaginal discharge and post coital bleeding. Diagnosis of cervical ectropion is made, this refers to a:
A) Stratified squamous keratinize epithelium covering ectocervix
B) Stratified squamous non-keratinized epithelium covering ectocervix
C) A disruption of lining epithelium
D) Columnar epithelium covering the area surrounding external cervical os
E) Cuboidal epithelium covering ectocervix
Explanation: Cervical ectropion occurs when columnar epithelium from the endocervical canal is present on the ectocervix.
61. A multiparous woman presents with progressive dysmenorrhoea and dyspareunia, she undergoes laparoscopy and is diagnosed as having pelvic inflammatory disease (PID). PID is considered as a complication of:
A) Gonorrhoea
B) Chlamydial infection
C) Mycoplasma genitalium
D) Trichomoniasis
E) Bacterial vaginosis
Explanation: PID is most commonly caused by Neisseria gonorrhoeae and Chlamydia trachomatis.
62. Which form of long-acting reversible contraception (LARC) is associated with delay in return of fertility?
A) Nexplanon
B) Copper T
C) Progesterone only injectable (Depot MedroxyProgesterone Acetate)
D) LNG IUS
E) Jadelle
Explanation: DMPA is associated with delayed return to fertility (average 10 months after discontinuation).
63. Factors that increase the risk for carcinoma endometrium:
A) Multiparity
B) Combined oral contraceptive pill
C) Smoking
D) Late menopause
E) Progesterone
Explanation: Late menopause increases endometrial cancer risk due to prolonged estrogen exposure without progesterone opposition.
64. The commonest problem observed in adolescent girls with PCO's is:
A) Acne
B) Hirsutism
C) Obesity
D) Polymenorrhoea
E) Menorrhagia
Explanation: Irregular menstrual cycles (polymenorrhea/oligomenorrhea) are the most common presentation of PCOS in adolescents due to anovulation.
65. A couple having been trying to conceive for last 2 years husband's semen analysis is normal, wife stopped COCP 2 years ago. She was taking this for dysmenorrhea and has noticed that her period pain is getting progressively worse since stopping the COCP but are regular every 28 days. Serum FSH, LH and day 21 progesterone are within normal limits. The physical examination of both partners is unremarkable. Your advice will be:
A) Pelvic ultrasound
B) Laparoscopy and dye test
C) Hysterosalpingo-contrast ultrasonography
D) Hysterosalpingogram
E) Hysteroscopy
Explanation: Progressive secondary dysmenorrhea suggests endometriosis. Laparoscopy with dye test is the gold standard for diagnosis and evaluation of tubal patency.
66. The hypothalamic pituitary ovarian axis is functionally completed during:
A) Early half of fetal life
B) Late half of fetal life
C) Immediately after birth
D) Just before puberty
E) At puberty
Explanation: The HPO axis becomes fully functional at puberty when GnRH secretion achieves its adult pulsatile pattern.
67. 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: In elderly patients with medical comorbidities, conservative management with pessary is preferred over surgical repair.
68. Unsafe abortion is a major consequence of unintended pregnancies, which can be prevented through an effective contraception backup method. Hence women deserve second chance to prevent an unintended pregnancy. One of the effective methods of emergency contraception (EC) is:
A) Levonorgestrel (LNG 1.5mg)
B) Ulipristal acetate 30mg
C) LNG-IUS
D) Cu-IUD
E) High dose COCP
Explanation: All options except C and E are WHO-approved EC methods. Cu-IUD is most effective (99%), LNG and UPA pills work up to 120/72h respectively.
69. A 42-year-old woman para 6 presents with complains of severe progressive dysmenorrhea and menorrhagia. Pelvic examination demonstrates a tender enlarged uterus. The likely diagnosis of this case is:
A) Endometriosis
B) Pelvic inflammatory disease
C) Adenomyosis
D) Fibroid uterus
E) Myohyperplasia
Explanation: The triad of multiparity, secondary dysmenorrhea, and uniformly enlarged tender uterus is classic for adenomyosis.
Report Card
Total Questions Attempted: 0
Correct Answers: 0
Wrong Answers: 0
Percentage: 0%
