CONTENT
Acknowledgements vii
Commonly used abbreviations ix
SECTION 1 OBSTETRICS
CHAPTER 1 Extended Matching Questions 3
Answers 18
CHAPTER 2 Multiple Choice Questions 29
Answers 40
CHAPTER 3 Single Best Answer Questions 51
Answers 57
CHAPTER 4 Short Answer Questions 62
CHAPTER 5 Objective Structured Clinical Examination Questions 76
Answers 82
SECTION 2 GYNAECOLOGY
CHAPTER 6 Extended Matching Questions 91
Answers 98
CHAPTER 7 Multiple Choice Questions 103
Answers 110
CHAPTER 8 Single Best Answer Questions 116
Answers 120
CHAPTER 9 Short Answer Questions 122
CHAPTER 10 Objective Structured Clinical Examination Questions 133
Answers 144
CHAPTER 1
EXTENDED MATCHING
QUESTIONS
, QUESTiONS ....................................................................... 3 The clinical management of hypertension in
Pre-existing maternal conditions ........................................ 3 pregnancy ..................................................... 10
Gravidity/parity............................................................... 4 Features of abnormal placentation ............................ 10
Maternal and perinatal mortality: the confidential Late miscarriage .................................................. 10
enquiry ............................................................ 4 Risk factors for preterm labour .................................. 11
Standards in maternity care ............................................... 4 Diagnosis and management of preterm delivery ...........11
Physiological changes in pregnancy: uterus and Drugs used in pregnancy ..................................... 12
cervix ............................................................... 5 Shortness of breath in pregnancy .............................. 12
Haematological changes in pregnancy .............................. 5 Perinatal infection (1)........................................... 12
Normal fetal development: the fetal heart ....................... 5 Perinatal infection (2)........................................... 13
Normal fetal development: the urinary tract .................... 5 Mechanism of labour ........................................... 13
Antenatal care..................................................................... 6 Stages of labour .................................................. 13
NiCE guidelines on routine antenatal care ......................... 6 interventions in the second stage .............................. 14
Antenatal imaging and assessment of fetal well-being ... 6 Complications of Caesarean section.............................14
Ultrasound measurements .................................................. 7 Obstetric emergencies (1) ................................... 14
Prenatal diagnosis .............................................................. 7 Obstetric emergencies (2) ................................... 15
Modes of prenatal testing ............................................... 7 Postpartum pyrexia ............................................. 15
Antepartum haemorrhage ................................................... 7 Postpartum contraception.................................... 16
Fetal malpresentations ....................................................... 8 Psychiatric disorders in pregnancy and the
Thromboprophylaxis ...................................................... 8 puerperium .................................................... 16
Common problems of pregnancy ....................................... 9 Neonatology ........................................................ 16
Twins and higher order multiple gestations .................... 9 Neonatal care ...................................................... 17
Management of multiple pregnancy ................................... 9 Neonatal screening ............................................. 17
ANSWERS ................................................................. 18
QUESTIONS
1 Pre-existing maternal conditions
A Diabetes E Factor V Leiden deficiency I Crohn’s disease
B Hypertension F HIV J Mitral valve stenosis
C Epilepsy G Asthma K Myasthenia gravis
D Vitiligo H Smoking L Glomerulonephritis
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Reduces intrauterine growth in a dose-dependent manner.
2 Increases risk of venous thromboembolism (VTE) in the puerperium.
3 Increased frequency of episodes during pregnancy.
4 Risk of fetal macrosomia if condition not well controlled.
5 Maternal muscle fatigue in labour.
6 Requires prophylactic antibiotics for instrumental delivery.
,4 Obstetrics
2 Gravidity/parity
A G1 P0 E G2 P1 I G1 P1
B G4 P2 F G1 P2 J G3 P1
C G0 P0 G G6 P0 K G4 P3
D G3 P3 H G5 P2 L G2 P0
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 A woman currently pregnant who has had a previous term delivery.
2 A woman not currently pregnant who has had one previous termination, one early miscarriage and one still-
birth at 36/40.
3 A woman who attends for pre-conception counselling, never having been pregnant.
4 A woman currently pregnant with twins who has had one previous early miscarriage.
5 A woman not currently pregnant who previously had a twin delivery at 28/40.
3 Maternal and perinatal mortality: the confidential enquiry
A Maternal death D Maternal mortality rate G Stillbirth
B Direct maternal death E Perinatal death H None of the above
C Indirect maternal death F Perinatal mortality rate
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Death of a woman while pregnant, or within 42 days of termination of pregnancy, from any cause related to,
or aggravated by, the pregnancy or its management, but not from accidental or incidental death.
2 The number of stillbirths and early neonatal deaths per 1000 live births and stillbirths.
3 Fetal death occurring between 20 + 0 weeks and 23 + 6 weeks. If the gestation is not certain all births of at
least 300 g are reported.
4 Death resulting from previous existing disease, or disease that developed during pregnancy and which was
not due to direct obstetric cause, but which was aggravated by the effects of pregnancy that are due to direct
or indirect maternal causes.
4 Standards in maternity care
A Royal College of Obstetricians E National Childbirth I Maternity Services Liaison
and Gynaecologists Trust Committee
B Clinical Negligence Scheme for F National Institute for Health J Confidential Enquiry into
Trusts and Clinical Excellence Maternal and Child Health
C The Cochrane Library G World Health Organization K National Screening Committee
D Maternity Matters H National Library for Health L National Health Service
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Publishes national guidelines on all aspects of clinical care, including obstetric practice.
2 National consumer group representing the views of women on maternity care.
3 Sets standards for provision of care, training and revalidation of obstetric doctors in the UK.
4 An insurance scheme to help hospital Trusts fund ligation claims and manage risk.
5 Unifies and progresses standards for screening across the UK.
, Extended matching questions 5
5 Physiological changes in pregnancy: uterus and cervix
A Oestradiol E Collagenase H Adrenocorticotrophic hormone
B Prostaglandins F Prolactin (ACTH)
C Progesterone G Human chorionic I Oxytocin
D Cortisol gonadotrophin (HCG)
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Levels approximately x15 higher in third trimester than in non-pregnant state.
2 Induces the process of cervical remodelling.
3 Regulates local uterine blood flow through endothelial effects.
4 Utilized in triple test.
5 Released from posterior pituitary gland.
6 Haematological changes in pregnancy
A Haematocrit D Plasma folate concentration G Fibrinogen
B Bilirubin E White blood cells H Alkaline phosphatase
C Triglycerides F Tissue plasminogen activator I Lactate dehydrogenase
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Levels rise through pregnancy due to increased production of placental isoform.
2 Falls in pregnancy due to dilutional effect.
3 Increased by 50 per cent in pregnancy, contributing to hypercoagulable state.
4 Routine supplementation advised during pregnancy due to fall in level.
7 Normal fetal development: the fetal heart
A The ductus venosus E Right atrium I Umbilical artery
B The ductus arteriosus F Mitral valve J Atrial septum
C Foramen ovale G Tricuspid valve K Intraventricular septum
D Left atrium H Umbilical vein L None of the above
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Location of the patent foramen ovale.
2 Vessel that carries oxygenated blood from the placenta and, in adult life, forms part of the falciform
ligament.
3 Connects the pulmonary artery to the descending aorta.
4 Vessel that shunts blood away from the liver.
8 Normal fetal development: the urinary tract
A Mesonephric duct D Collecting duct system G Nephronic units
B Glomeruli E Ectoderm H Renal agenesis
C Ureteric bud F Mesoderm I Pronephros
Acknowledgements vii
Commonly used abbreviations ix
SECTION 1 OBSTETRICS
CHAPTER 1 Extended Matching Questions 3
Answers 18
CHAPTER 2 Multiple Choice Questions 29
Answers 40
CHAPTER 3 Single Best Answer Questions 51
Answers 57
CHAPTER 4 Short Answer Questions 62
CHAPTER 5 Objective Structured Clinical Examination Questions 76
Answers 82
SECTION 2 GYNAECOLOGY
CHAPTER 6 Extended Matching Questions 91
Answers 98
CHAPTER 7 Multiple Choice Questions 103
Answers 110
CHAPTER 8 Single Best Answer Questions 116
Answers 120
CHAPTER 9 Short Answer Questions 122
CHAPTER 10 Objective Structured Clinical Examination Questions 133
Answers 144
CHAPTER 1
EXTENDED MATCHING
QUESTIONS
, QUESTiONS ....................................................................... 3 The clinical management of hypertension in
Pre-existing maternal conditions ........................................ 3 pregnancy ..................................................... 10
Gravidity/parity............................................................... 4 Features of abnormal placentation ............................ 10
Maternal and perinatal mortality: the confidential Late miscarriage .................................................. 10
enquiry ............................................................ 4 Risk factors for preterm labour .................................. 11
Standards in maternity care ............................................... 4 Diagnosis and management of preterm delivery ...........11
Physiological changes in pregnancy: uterus and Drugs used in pregnancy ..................................... 12
cervix ............................................................... 5 Shortness of breath in pregnancy .............................. 12
Haematological changes in pregnancy .............................. 5 Perinatal infection (1)........................................... 12
Normal fetal development: the fetal heart ....................... 5 Perinatal infection (2)........................................... 13
Normal fetal development: the urinary tract .................... 5 Mechanism of labour ........................................... 13
Antenatal care..................................................................... 6 Stages of labour .................................................. 13
NiCE guidelines on routine antenatal care ......................... 6 interventions in the second stage .............................. 14
Antenatal imaging and assessment of fetal well-being ... 6 Complications of Caesarean section.............................14
Ultrasound measurements .................................................. 7 Obstetric emergencies (1) ................................... 14
Prenatal diagnosis .............................................................. 7 Obstetric emergencies (2) ................................... 15
Modes of prenatal testing ............................................... 7 Postpartum pyrexia ............................................. 15
Antepartum haemorrhage ................................................... 7 Postpartum contraception.................................... 16
Fetal malpresentations ....................................................... 8 Psychiatric disorders in pregnancy and the
Thromboprophylaxis ...................................................... 8 puerperium .................................................... 16
Common problems of pregnancy ....................................... 9 Neonatology ........................................................ 16
Twins and higher order multiple gestations .................... 9 Neonatal care ...................................................... 17
Management of multiple pregnancy ................................... 9 Neonatal screening ............................................. 17
ANSWERS ................................................................. 18
QUESTIONS
1 Pre-existing maternal conditions
A Diabetes E Factor V Leiden deficiency I Crohn’s disease
B Hypertension F HIV J Mitral valve stenosis
C Epilepsy G Asthma K Myasthenia gravis
D Vitiligo H Smoking L Glomerulonephritis
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Reduces intrauterine growth in a dose-dependent manner.
2 Increases risk of venous thromboembolism (VTE) in the puerperium.
3 Increased frequency of episodes during pregnancy.
4 Risk of fetal macrosomia if condition not well controlled.
5 Maternal muscle fatigue in labour.
6 Requires prophylactic antibiotics for instrumental delivery.
,4 Obstetrics
2 Gravidity/parity
A G1 P0 E G2 P1 I G1 P1
B G4 P2 F G1 P2 J G3 P1
C G0 P0 G G6 P0 K G4 P3
D G3 P3 H G5 P2 L G2 P0
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 A woman currently pregnant who has had a previous term delivery.
2 A woman not currently pregnant who has had one previous termination, one early miscarriage and one still-
birth at 36/40.
3 A woman who attends for pre-conception counselling, never having been pregnant.
4 A woman currently pregnant with twins who has had one previous early miscarriage.
5 A woman not currently pregnant who previously had a twin delivery at 28/40.
3 Maternal and perinatal mortality: the confidential enquiry
A Maternal death D Maternal mortality rate G Stillbirth
B Direct maternal death E Perinatal death H None of the above
C Indirect maternal death F Perinatal mortality rate
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Death of a woman while pregnant, or within 42 days of termination of pregnancy, from any cause related to,
or aggravated by, the pregnancy or its management, but not from accidental or incidental death.
2 The number of stillbirths and early neonatal deaths per 1000 live births and stillbirths.
3 Fetal death occurring between 20 + 0 weeks and 23 + 6 weeks. If the gestation is not certain all births of at
least 300 g are reported.
4 Death resulting from previous existing disease, or disease that developed during pregnancy and which was
not due to direct obstetric cause, but which was aggravated by the effects of pregnancy that are due to direct
or indirect maternal causes.
4 Standards in maternity care
A Royal College of Obstetricians E National Childbirth I Maternity Services Liaison
and Gynaecologists Trust Committee
B Clinical Negligence Scheme for F National Institute for Health J Confidential Enquiry into
Trusts and Clinical Excellence Maternal and Child Health
C The Cochrane Library G World Health Organization K National Screening Committee
D Maternity Matters H National Library for Health L National Health Service
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Publishes national guidelines on all aspects of clinical care, including obstetric practice.
2 National consumer group representing the views of women on maternity care.
3 Sets standards for provision of care, training and revalidation of obstetric doctors in the UK.
4 An insurance scheme to help hospital Trusts fund ligation claims and manage risk.
5 Unifies and progresses standards for screening across the UK.
, Extended matching questions 5
5 Physiological changes in pregnancy: uterus and cervix
A Oestradiol E Collagenase H Adrenocorticotrophic hormone
B Prostaglandins F Prolactin (ACTH)
C Progesterone G Human chorionic I Oxytocin
D Cortisol gonadotrophin (HCG)
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Levels approximately x15 higher in third trimester than in non-pregnant state.
2 Induces the process of cervical remodelling.
3 Regulates local uterine blood flow through endothelial effects.
4 Utilized in triple test.
5 Released from posterior pituitary gland.
6 Haematological changes in pregnancy
A Haematocrit D Plasma folate concentration G Fibrinogen
B Bilirubin E White blood cells H Alkaline phosphatase
C Triglycerides F Tissue plasminogen activator I Lactate dehydrogenase
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Levels rise through pregnancy due to increased production of placental isoform.
2 Falls in pregnancy due to dilutional effect.
3 Increased by 50 per cent in pregnancy, contributing to hypercoagulable state.
4 Routine supplementation advised during pregnancy due to fall in level.
7 Normal fetal development: the fetal heart
A The ductus venosus E Right atrium I Umbilical artery
B The ductus arteriosus F Mitral valve J Atrial septum
C Foramen ovale G Tricuspid valve K Intraventricular septum
D Left atrium H Umbilical vein L None of the above
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Location of the patent foramen ovale.
2 Vessel that carries oxygenated blood from the placenta and, in adult life, forms part of the falciform
ligament.
3 Connects the pulmonary artery to the descending aorta.
4 Vessel that shunts blood away from the liver.
8 Normal fetal development: the urinary tract
A Mesonephric duct D Collecting duct system G Nephronic units
B Glomeruli E Ectoderm H Renal agenesis
C Ureteric bud F Mesoderm I Pronephros
