EBCOG Part 2 Randome Practice Questions – Paper C

For each of the following clinical scenario, choose the single most appropriate treatment. Each option may be used once, more than once or not at all.
Options list
A. AMH
B. Bromocriptine
C. Clomiphene
D. Endometrial ablation
E. FSH stimulation
F. Laparoscopic ovarian suspension
G. Laparoscopic tubal reconstructive surgery
H. LHRH agonist
I. Oocyte cryopreservation
J. Ovarian endometrioma excision
K. Ovarian endometrioma fenestration
L. Reassurance
M. Removal of polyp at hysteroscopy
N. Unilateral salpingectomy

1. A 35-yr old woman with primary infertility for 30 months has right-sided hydrosalpinx. She is now on the waiting list for IVF.

2. A 30-yr old woman with primary infertility of four years duration, diagnosed with bilateral ovarian endometrioma, each approximately 6cm in diameter.

3. A 38-yr old woman with primary infertility of 36 months duration, waiting for IVF, had an USG showing multiple endometrial polyps.

4. A 25-yr old multiparous woman who has undergone pelvic radiation.

5. A 22-yr old nulliparous woman with a BMI 16, diagnosed with hypogonadotrophic

6. A 30-yr old woman with confirmed ovulatory cycles with raised prolactin of 760 (normal <360 mIU/L). She does not complain of headaches or nipple discharge.

7. A 42-yr old woman with primary infertility of 8 yrs duration had a failed stimulated IVF cycle. What investigation prior to her next IVF cycle should be performed?

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.
Options list
A. Bladder damage
B. Chronic constipation
C. Dehydration
D. Diabetic ketoacidosis
E. Fluid overload
F. Intra-peritoneal haemorrhage
G. Ovarian pregnancy
H. Pelvic haematoma
I. Post-operative pelvic sepsis
J. Post-operative pneumonia
K. Pulmonary embolism
L. Torsion of the ovarian cyst
M. Tubal ectopic pregnancy
N. Ureteric injury
O. Uterine perforation and fluid overload
P. Vesico-vaginal fistula

8. A 40-yr old woman has a difficult abdominal hysterectomy and bilateral salpingo- oophorectomy for severe endometriosis. She was administered with estradiol implant following hysterectomy. She comes for review appointment 4 weeks later and tells you that she is wearing pads and feels ‘as if she has lost control of her bladder’.

9. A 45-yr old woman with a BMI of 40 had a laparoscopic-assisted hysterectomy for multiple uterine fibroids. She had a spinal block along with a general anaesthetic. 12 hours later, her pelvic drain remains clear, her pulse is 110 bpm, pO2 92, and she is feeling very uncomfortable, with a distended and tender abdomen.

10. A 35-yr old woman had an abdominal hysterectomy and bilateral salpingo-oophorectomy for severe pelvic inflammatory disease and menorrhagia. 24 hours later, she complains of severe left flank pain, which is not response to analgesics. Her urine output is satisfactory bit pink in colour and BP is stable. The fluid in her drain is pink sero-sanguinous, approximately 500ml in total.

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.
Options list
A. Acute abdomen
B. Acute appendicitis
C. Acute pelvic inflammatory disease
D. Acute renal failure
E. Acute torsion of ovary
F. Bowel injury at egg collection
G. Critical OHSS
H. Intra-peritoneal bleeding
I. Mild OHSS
J. Moderate OHSS
K. Pulmonary embolism
L. Ruptured ectopic
M. Severe OHSS

11. A 28-yr old woman, with a BMI of 34, is a known case of polycystic ovarian syndrome. She is being treated with clomiphene citrate regimen of 50mg dose. She is complaining of a bloated abdomen and feels uncomfortable as a result.

12. A 34-yr old woman, with a BMI 32, underwent an embryo transfer 5 days ago. She has now been admitted to the acute medical ward with nausea, vomiting, and moderate abdominal pain.

13. A 24-yr old woman, with a BMI 24, has a high AMH and had embryo transfer 3 days ago. She has been admitted to the acute gynaecology ward with clinical ascites and reduced renal output.

14. A 35-yr old woman who had an embryo transfer 8 days ago is now complaining of bloated feeling and increase in weight of 2kg. She had a pelvic USS scan reporting an ovarian size >12 cm2.

15. A 22-yr old woman who is a known case of polycystic ovarian syndrome with a history of OHSS is in her first IVF cycle, recently undergoing her second treatment cycle. She is day 12 post-embryo transfer. She is complaining of nausea and sudden onset of right-sided abdominal pain following intercourse.

For each of the following clinical scenario, choose the single most likely diagnosis from the listed provided. Each option may be used once, more than once or not at all.
Options list
A. Benign intracranial hypertension
B. Cerebral venous thrombosis
C. Cluster-type headache
D. Epilepsy
E. Menstrual-related migraine
F. Migraine with aura
G. Migraine without aura
H. PE
I. Pseudo-seizure
J. SAH
K. Tension headache
L. Thrombocytopenic purpura

16. A 24-yr old primigravid woman who is 24 weeks pregnant complains of a pulsating, right- sided headache for 48hrs. This is associated with nausea and vomiting. She also complaints of seeing ‘flickering lights’.

17. A 32-yr old multiparous woman who is 20 weeks pregnant complaints of a pressing bilateral headache for more than 10 days.

18. A 20-yr old primigravid woman who is 18 weeks pregnant complains of sharp, left-sided headache, particularly around the eye. This is associated with a red eye and runny nose.

19. A 17-yr old woman has a history of heavy menstrual bleeding since menarche. She complains of a left-sided headache, particularly 2-3 days before her periods.

20. A 38-yr old multiparous woman at 36 weeks of pregnant presents with history of headaches, vomiting, and photophobia. Her examination had signs of raised ICP.