EBCOG Part 1 – Mega Mock EMQ – Paper A

Option List:
A. 20%
B. 10%
C. 66.6%
D. 90%
E. 52.9%
F. 50%
G. 100%
H. 25%
I. 33%
J. 40%
K. 16%
L. 18%
M. 4%
N. 81%

Lead in: A diagnostic accuracy study of a new TVS USG to diagnose premature labour in women reveals following data. Out of 200 women with premature labour 40 were detected positive by TVS USG and out of 200 without premature labour 180 were detected negative by TVS USG.

1. What is the sensitivity of the new test?

2. What is the specificity of new test?

3. What is the PPV of new test?

4. What is the NPV of new test?

Option List:
A. 5%
B. 15%
C. 95%
D. 85%
E. 100%
F. 11%
G. 10%
H. 115%
I. 105%
J. 68%
K. 99%
L. 97%
M. 33.33%
N. 66.66%

Lead in: A new study showed that low dose FSH treatment improves clinical pregnancy. The probability that this was due to chance was 0.05. And the probability of telling there is no improvement when there is improvement in reality is 0.15.

5. What is the p vale?

6. What is the power?

Option List:
A. 100%
B. 50%
C. 3%
D. 33.3
E. 97%
F. 5%
G. 80%
H. 68%
I. 95%
J. 25%
K. 75%
L. 10%
M. 70%
N. 4%

Lead in: A randomized clinical trial that tested the efficacy of low dose Aspirin in several thousand men with high risk of CVD, but no previous history of coronary heart disease, over a 5-year period. There were 100 “events” in the 3,000 men in the intervention arm, and 200 “events” in the 3,000 men in the placebo arm.

7. The relative risk in the above study is?

8. The relative risk reduction in the above study is?

9. What is the Absolute risk reduction in the above study?

10. The number needed to treat in the above study is?

Option List:
A. Synchronous learning
B. Asynchronous learning
C. Blended learning
D. Formative assessment
E. Summative assessment
F. Formative as well as summative
G. Lectures
H. Snowballing
I. Peer coaching
J. Schema activation
K. Schema reinforcement
L. Simple procedural hierarchy
M. Complex procedure hierarchy
N. Doughnut round

Lead in: The above are T-L and assessment methods. Below are certain scenarios given, choose correct options

11. Mock examination, OSCE station, Case based discussion are which type of assessment?

12. Learning partly by offline real time classes and partly by virtual online training is called as

13. A program is designed to teach all its part through online webinars. Yet the students can interact with the teacher online

14. In a correspondence course all the materials are delivered to home and the student has to read and learn all by himself

For each of the following clinical scenario, choose the single most appropriate option. Each option may be used once, more than once or not at all.

Option List:
A. Abdominal ultrasound scan
B. Anterior colporrhaphy
C. Anticholinergics
D. Bulking agents
E. Colposuspension
F. Desmopressin
G. Detrusor myomectomy
H. Intravesical Botox injections
I. Intravesical hyaluronic acid
J. Pelvic and abdominal ultrasound scan
K. Pessary
L. Physiotherapy
M. Physiotherapy, bladder training
N. Standard cystometry
O. Tape procedure
P. Urodynamic

15. A 40-yr old multiparous woman was referred by her GP due to prolapse and mixed urinary incontinence. On examination she has a grade 1 cystocele and rectocele (POPQ classification). No stress incontinence is demonstrable. Her bladder diary is suggestive of frequency and urgency. What is the most appropriate initial management option?

16. A 55-yr old woman has been diagnosed with interstitial cystitis. Oral therapy has been unhelpful. What is the next available management option?

17. A 60-yr old woman who underwent TVT-O two years ago has attended for follow-up with recurrent stress incontinence. Conservative management has failed and clinically stress incontinence is demonstrable. She is now requesting further surgical treatment. What is the next line of management?

18. A 49-yr old woman with 3 children born by vaginal delivery presents with leaking on exercise, coughing and sneezing with occasional urgency. She has tried pelvic floor exercise with little improvement in her symptoms and seeks definitive treatment. On examination there is minimal prolapse and urinalysis is clear.

19. A 73-yr old woman presents with symptoms of urgency and urge incontinence. She states her abdomen feels more bloated and she cannot do the top button of her trousers up any more. Urinalysis is clear.

For each mechanism of action described below, choose the single most appropriate drug from the list of options above. Each option maybe used once, more than once, or not at all.

Option List:
A. Amitryptyline
B. Botulinum toxin
C. Darifenacin
D. Desmopressin
E. Duloxetine
F. Fesoterodin:e
G. Oxybutynin
H. Tolterodine
I. Trospfum chloride
J. Propiverine HCl
K. Dobutamfne
L. Drospirenone
M. Desogestrel
N. Digoxin
O. Fexofenadine

20.  Selective serotonin and noradrenergic reuptake inhibitor

21. Anti cholinergic plus muscuIotrophic plus local anaesthetic

22. Anti cholinergic plus calcium channel blocker

23. Competitive muscarinic receptor antagonist which is a prodrug

24. Uroselective, M3muscarinic acetylcholine receptor antagonist

Option List:
A. Pelvic Floor Exercise
B. Pessary
C. High uterosacral ligament suspension
D. Colpocleisis
E. Abdominal sacrocolpoplexy
F. Laparoscopic sacrocolpopexy
G. Ilio-coccygeal fixation
H. Vagunal mesh kits
I. McCall culdoplasty
J. Sacrospinous fixation

25.  An 80 year old lady is suffering from vaginal vault prolapse for 14 years. She has been using pessaries for a long time but has been suffering from bleeding, ulceration and intractable pain and discomfort.

26. A 56 year old woman is worried about sexual dysfunction following surgery for vault prolapse.

27. A 60 year old woman has recurrence of vault prolapse following previous surgery for the same indication.

28. During vaginal hysterectomy on a 62 year old woman with utero vaginal prolapse, the vaginal vault is found to be at the introitus.

29. A 56 year old woman is having vaginal hysterectomy for utero vaginal prolapse. She is keen to have additional procedure to prevent vault prolapse in the future.

Option List:
A. Ilioinguinal nerve
B. Iliohypogastric nerve
C. Femoral nerve
D. Obturator nerve
E. Pudendal nerve
F. Genito femoral nerve
G. Common peroneal nerve
H. Tibial nerve
I. Ulnar nerve
J. Radial nerve
K. Upper nerve root injury of brachial pleus
L. Lower nerve root injury of brachial plexus
M. Radial nerve injury
N. Ulnar nerve injury

Choose the most appropriate nerve injury for the given clinical scenario from the options. The options may be used once, more than once or not at all.

30. 27 year old Primiparous woman had a difficult labour. An outlet forceps delivery was done and following delivery, there was shoulder dystocia, for which MCRoberts manoeuvre was performed and successfully delivered a male baby. Following the delivery, the woman complained of difficulty in climbing stairs and also paraesthesia over the anterior and medial aspect of the thigh. What is the nerve that is suspected to have sustained the injury

31. 30 year old obese woman underwent emergency caesarean section. At the end of the procedure, it was found that her arm was hyperextended accidentally during the procedure. During the post operative period the woman complained of muscles weakness and on examination found to have a Erb’s palsy. What is the nerve that is suspected to have injury that has resulted in this deformity?

32. 3. 39 year old woman underwent a paravaginal defect repair following which she complained of paraesthesia of the upper medial thigh with no difficulty in walking. The nerve that is suspected to have injured is?

33. 4. 26 year old woman underwent second stage caesarean section through a pfannensteil incision. There was difficulty in delivering the baby, but otherwise uneventful. During the postnatal review, she complained of numbness over the mons pubis, labia majora. The nerve that is suspected to have an injury is ?

Option List :
A. Wound infection
B. Pneumonia
C. Urinary tract infection
D. Pulmonary embolism
E. Gastritis
F. Infected vault haematoma
G. Vault haematoma
H. Bowel injury
I. Post operative dehydration
J. Intraabdominal bleeding
K. Atelectasis
L. Urinary tract injury
M. Deep vein thrombosis

Choose the most appropriate diagnosis for the scenario given. Each option may be used once or more than once or not at all

34. 51 year old multiparous woman underwent an total abdominal hysterectomy with bilateral salping oophorectomy for huge fibroid uterus under general anaesthesia. Her BMI was 30, with no other co-morbidities. She smokes around 10 cigerrette a day. She is receiving antibiotics and appropriate thromboprophylaxis. Post-operatively, the woman was complaining of cough, fever, tachcardia and difficulty in breathing. The chest radiography is given below. what is the most likely diagnosis?

35. 54 yearold Mrs. Roberts,P2L2 both delivered by caesarean section underwent radical hysterectomy. Postoperative recovery was slow and she was complaining of reduced urine output and suprapubic pain. She was afebrile with mild tachycardia and diffuse abdominal pain. The most likely diagnosis is?

36. 55 year old multiparous woman underwent an vaginal hysterectomy for stage 3 uterine prolapse. she was discharged home and presented with complaints of bleeding per vaginum for the past 2 days and mild fever for the past one day with no other signs and symptoms of bowel or bladder problems. What is the most likely diagnosis?

Option List:
A. No intervention needed
B. Diagnostic laparoscopy
C. Intravenous broad spectrum antibiotics
D. Catheterisation for 14 days
E. CT guided drainage
F. Intravenous fluids
G. Return to theatre for exploratory laparotomy
H. Oral antibiotics for 10 days
I. Repair of bladder
J. Peritoneal lavage

Choose the most appropriate option from the list of options given below. Each option may be used once or more than once or not at all

37. Mrs. Richie, 43 year old underwent myomectomy for menorrhagia. In the ward, she was found to have increasing pulse gradually, and her bloodpressure is dropping. Her RR is 24/min. she is been complaining of pain and is receiving the maximum dose of analgesics. Her abdomen feels distended and tender.

38. Ms. Betsy, 50 year old underwent vaginal hysterectomy and a anterior vaginal wall repair for pelvic organ prolapse. she had an uneventful recovery and was discharged home with the patient recovery aid provided. In the postoperative period, on day 9 she developed, spiking temperatures, abdominal pain with diarrhoea. What is the immediate management option?

39. Mrs. Nancy, 36 years underwent diagnostic laparoscopy as a part of infertility, while placing a suprapubic port, there was a bladder injury through the space of retzius alone. What is the best management option?

Option List:
A. 80 days
B. 80-90 days
C. 90-120 days
D. 60-90 days
E. 7-14 days
F. 180-210 days
G. Will not get absorbed
H. More than 210 days

Choose the most appropriate option from the list of options given above. Each option may be used once or more than once or not at all

40. You have closed the episiotomy wound and in what time do you expect the suture to get absorbed?

Option List:
A. Palmer’s point
B. Vertical incision at the base of the umbilicus
C. Infraumbilical prt
D. Supraumbilical port
E. Hasson’s technique
F. Right Paraumbilical port

Choose the most appropriate laparoscopic entry method for the clinical scenario given. The option may be used once or more than once or not at all.

41. A 29-year-old para 2 woman with previous 2 caesarean sections presents with severe left-sided lower abdominal pain and a positive urine pregnancy test. She gives history of splenectomy at the age of 14. Her pulse rate is 90 bpm and BP of 100/60. Her BMI is 35 kg/m2. A transvaginal ultrasound scan shows an empty uterine cavity and 4 cm complex left adnexal mass with free fluid in the pouch of Douglas. The ultrasound appearances are highly suggestive of an ectopic pregnancy and a plan of laparoscopic salpingectomy is made. Veress needle insertion was attempted twice which failed. What is your next step to achieve laparoscopic entry?

42. 19 year old girl with a BMI of 17 presented with history of sudden severe abdominal pain and vomiting. On evaluation found to have a ovarian cyst of 6 cms with a suspicion of torsion. The best way to have a laparoscopic entry is by?

43. 36 year old women with a BMI of 24 is has undergone IVF. She is now awaiting Embryo transfer. She is found to have a left hydrosalpinx of 6.1X2.3 cm and hence posted for laparoscopic removal of the hydrosalpinx. The most appropriate laparoscopic entry is by?

44. 50 year old woman is posted for total laparoscopic hysterectomy for adenomyosis. She has had previous 2 caesarean section both were done by midline vertical incisions. The best appropriate site of entry for laparoscopic hysterectomy is?

Option List:
A. Pfannensteil incision
B. Mouchel incision
C. Joel-Cohen incision
D. Maylard incision
E. Kustners incision
F. Vertical midline incision
G. Cherneys incision
H. Gridiron incision

Choose the most appropriate incision from the list of options for the given clinical scenario. Each option may be used once or more than once or not at all.

45. A 47 year old woman has been planned for total abdominal hysterectomy for a normal sized uterus. She has had previous 3 cesarean sections. The consultant has planned for an incision which involoves all layers of the abdominal wall transversely 6cm above the symphysis pubis

46. 34 year old woman who is a primi gravida is undergoing cesearean section for breech presentation following an unsuccessful ECV. A transverse incision was made on the skin 3 cm below the Anterior superior iliac spine. The subcutaneous layer and the fascia are opened at the midline by knife and the separated by blunt dissection. What is the incision called as?

47. 43 year old woman is posted for a large 26 cm ovarian cyst extending upto the xiphisterum which on further imaging diagnosed to be Dermoid cyst. The recommended incision would be

48. 19 year old girl is been diagnosed with acute appendicitis. What is the preferred incision for her?

Option List:
A. Cervical preparation with 200 mcg misoprostal
B. Oral opiates
C. Cervical preparation with 400 mcg of misoprostol
D. Paracervical block
E. Oral mifepristone
F. Topical local anaesthetic to ectocervix
G. Intravenous anaesthetic
H. No cervical preparation
I. I.V 0.25 mg fentanyl + atropine and 2 mg midazolam
J. No cervical anaesthesia required

For the clinical scenarios given, choose the most appropriate pre-operative anaesthetic plan for performing outpatient hysteroscopy. Each option may be used once, more than once or not at all.

49. 37 years old nulliparous woman is posted for office hysteroscopy for the removal of lost IUCD. The pelvic ultrasound was normal except that the IUCD is seen in the uterine cavity

50. 41 years old multiparous woman had presented with abnormal uterine bleeding. Pelvic ultrasound revealed a 2 cm endometrial polyp. She is otherwise fit and healthy. She does not wish to have a general anaesthesia