EBCOG P1 – Random Practice Ques – Paper B (SBA)

1. A 25-year-old woman who is known to have beta thalssaemia trait is due to marry someone form the same ethnic background. Which of the following is correct?

A. If her fiancé is screen positive, there is a 50% chance that the fetus will suffer from beta thalssaemia major
B. Parenteral iron can be used for treatment
C. She will not suffer from anaemia
D. Thalassaemia major is associated with cardiac failure
E. Thalassaemia major is not life-threatening

2.Upon attending an emergency buzzer call-out on the labour ward, you find a woman with cord prolapse. Which one of the following is a risk factor for umbilical cord prolapse?

A. 3 cm fundal subserosal fibroid
B. Meconium liquor
C. Placenta praevia
D. Primigravid woman
E. Transverse presentation

3. You are reviewing a 36-year-old woman who has undergone a surgical evacuation for a molar pregnancy. Which one of the following forms part of the FIGO scoring system for gestational trophoblastic disease (GTD)?

A. Heavy bleeding at the time of surgical evacuation
B. Parity
C. Pregnancy gestation
D. Previous history of childhood malignancy
E. Tumour size

A 24-year-old woman presents with a mild fever, feeling unwell with joint pain. She is 36 weeks pregnant and diagnosed to have human parvovirus B19 infection. What is the rate of vertical transmission at this gestation?

A. 10%
B. 20%
C. 30%
D. 50%
E. 70%

A 56-year-old postmenopausal woman is referred to clinic with a six-month history of bloating. Ultrasound reveals a 7 cm multilocular unilateral ovarian cyst with solid areas. There is no ascites. CA125 is 55. What is her RMI?

A. 110
B. 220
C. 330
D. 440
E. 500

You are asked to review the ultrasound results for a 42-year-old primigravida woman at 12 weeks gestation. The result suggests a high risk of trisomy 21. Which of the following is correct regarding the aetiology of trisomy 21?

A. 10% of babies with Down’s syndrome are born with cardiac anomalies
B. About 45% of cases are due to meiotic nondisjunction
C. After two affected fetuses the recurrence rate is almost 30%
D. If the father carries a Robertosonian translocation affecting chromosome 21, the recurrence risk of 10%
E. Recurrence rate is affected by maternal age

A 35-year-old woman presents with nonspecific abdominal pain; ultrasound scan showed a 5-mm echogenic focus polyp in the uterine cavity. Both ovaries appear normal. She has normal regular withdrawal bleeding with the combined oral contraceptive pill and tells you her pain has resolved with the pill. What would your management plan be?

A. Endometrial biopsy
B. Follow-up hysteroscopy in six months to access any change
C. Hysteroscopic resection of the polyp
D. Reassure and discharge to GP
E. Repeat ultrasound in six months

During investigation of lower urinary tract symptoms, videourodynamics would be preferred to conventional urodynamics in which of the following scenarios?

A. Clinical suspicion of detrusor overactivity
B. Mixed symptoms (frequency, urgency, and stress incontinence)
C. Previously unsuccessful incontinence surgery
D. Symptoms unresponsive to conservative therapy
E. Voiding difficulties

You see an anxious 26-year-old primigravid woman in antenatal clinic. She asks you about the benefits of breastfeeding. Which of the following is correct?

A. Breastfeeding should be initiated within one hour of birth to maximize success
B. Colostrum has high levels of carbohydrates
C. Colostrum is especially rich in IgE
D. Colostrum is produced in small quantities after the birth of the baby
E. In the UK about 10% of mothers are still breastfeeding at six months

10. A 35-year-old woman is diagnosed to have hypothalamic hypogonadism. She would like to conceive. What treatment would you administer to stimulate ovulation?

A. Clomiphene
B. Gonadotrophin therapy
C. Metformin
D. Ovarian drilling
E. Pulsatile gonadotrophin-releasing hormone

11. A 36-year-old woman presents after being exposed to a five-year-old child who develops chickenpox. She cannot remember having chickenpox. Which of the following is correct?

A. More than 90% of the UK antenatal population are seropositive for varicella zoster IgG
B. Pneumonia occurs in up to 20% of pregnant women with chickenpox
C. The risk of spontaneous miscarriage is increased if chickenpox occurs in the first trimester
D. Routine immunization to varicella is advised in pregnancy
E. Varicella zoster immunoglobulin should be given as soon as clinical signs of chickenpox have developed

12.An emergency caesarean section was performed on a 25-year-old woman for worsening pre-eclampsia with failed induction of labour at 36 weeks gestation. Four hours after the caesarean section, her blood pressure was 180/95 mmHg, urine output around 15 ml/hour. What is your management plan?

A. Administer a loading dose of 1 g magnesium sulphate followed by infusion
B. Administer an immediate fluid challenge
C. Administer intravenous frusemide 10-20 mg
D. Prescribe intravenous antihypertensive treatment
E. Prescribe oral antihypertensive treatment

13. A 34-year-old woman in her second pregnancy presents with a one-day history of headache and vomiting at 24 weeks gestation. She describes the headache as being on the left side only, pulsating and severe in intensity. She is unable to perform her activities of daily living, as this aggravates the pain. Lying in a dark room limits the pain. All observation and examination are normal. What is the diagnosis?

A. Cerebral venous thrombosis
B. Idiopathic intracranial hypertension
C. Migraine
D. Pituitary tumour
E. Subarachnoid haemorrhage

14.You are asked to review a 22-year-old woman in her first pregnancy because she has type 4 female genital mutilation. Which of the following does this include?

A. Genital piercing
B. Infibulation
C. Partial removal of the clitoris
D. Removal of the clitoris and prepuce
E. Total removal of the clitoris

15 .When counseling a recently postmenopausal woman with unpleasant vasomotor

symptoms wishing to take hormone replacement therapy (HRT), it is important to discuss

fully the risks and benefits of HRT. As part of the discussion she should be informed the

following, except:

A. Improvement of lower genital tract symptoms
B. Increase in the risk of venous thromboembolic disease
C. Prevention of painless vertebral osteoporotic fracture
D. Protection from Alzheimer’s disease
E. Reduction in the risk of colonic cancer

16. A 28-year-old hyperthyroid woman with a 6 cm left ovarian mass undergoes a left salpingo-oophorectomy. Following the operation, she experiences symptoms of hypothyroidism and consequently is recommended to stop her antithyroid medication. What type of ovarian tumour does she have?

A. Brenner’s tumour
B. Granulosa cell tumour
C. Immature malignant teratoma
D. Sertoli-Leydig tumour
E. Struma ovarii

17.A 57-year-old woman who has had two children presents with the sensation of ‘something coming down’ with no urinary symptoms. She complains of chronic constipation. On examination, she has stage 2-3 posterior vaginal wall prolapse with no associated uterine descent. The anterior vaginal wall is well supported. What is the most appropriate treatment?

A. Paravaginal wall repair
B. Pelvic floor exercises
C. Posterior vaginal wall repair
D. Posterior vaginal wall repair with mesh
E. Shelf pessary

18.A 24-year-old nulliparous woman presents with headaches and milky discharge from her breasts. She also complains of vomiting, for which she is taking medication. What is the most likely physiological cause?

A. Breastfeeding
B. Caesarean section
C. Chronic renal failure
D. Metoclopramide
E. PCOS

19.Which of the following has an association with endometrial cancer?

A. Bilateral salpingo-oophrectomy (BSO)
B. BRCA2
C. Granulosa cell tumours
D. HER-2 receptor agonist
E. High SHBG (sex hormone binding globulin)

20.You review a 65-year-old woman with known urinary urgency and prescribe oxybutynin. Which class of drug is this?

A. Antimuscarinic
B. Calcium channel inhibitor
C. Cox inhibitor
D. Dopamine agonist
E. Loop diuretic

21.You are pre-assessing a 49-year-old woman who is due to undergo a radical hysterectomy for endometrial carcinoma. On discussing the risk of fistulae formation, she asks you when this is likely to present clinically.

A. Within 24 hours of the operation
B. Within 48 hours of the operation
C. Within the first five days post-operatively
D. Between five and fourteen days post-operatively
E. After four weeks post-operatively

22. You review the blood results of a 26-year-old woman being investigated for recurrent pregnancy loss. The results show a haemolytic anaemia, low C4 level, and neutrophil 2 x 109/L. What is the most likely diagnosis?

A. Acute myeloid leukaemia
B. Antiphospholipid syndrome
C. HIV
D. Immune thrombotic thrombocytopaenia
E. Systemic lupus erythematosus

23.You review a 17-year-old woman who requests emergency contraception after four episodes of unprotected sexual intercourse over the last five days. She is asthmatic, with an admission to ITU last year. Which method of contraception is the most appropriate to prescribe?

A. Copper intrauterine device
B. Levonorgestrel pill
C. Mirena coil
D. Progesterone-only pill
E. Ulipristal acetate

24. A 34-year-old woman is being consented for a caesarean section for placenta praevia. She has had a previous caesarean section. What is her chance of emergency hysterectomy?

A. Up to 11 in 1000 women
B. Up to 27 in 1000 women
C. Up to 7 in 100 women
D. Up to 11 in 100 women
E. Up to 27 in 100 women

25.A 40-year-old woman who has a 20 pack-year history of smoking and a BMI of 35 presents with menorrhagia and dysmenorrhea. What is the most appropriate form of medical management?

A. Aspirin
B. Combined oral contraceptive pill
C. Gonadotrophin-releasing hormone analogues
D. Ibuprofen
E. Mirena intrauterine system

26.You are preparing a presentation on malignancy in pregnancy. What is the most common malignancy associated with pregnancy?

A. Bowel cancer
B. Breast cancer
C. Cervical cancer
D. Ovarian cancer
E. Thyroid cancer

27.A 22-year-old woman presents with new-onset hirsutism. Her BMI is 19 and a pelvic ultrasound is normal. You note her testosterone level is 3 ng/ml, and her dehydroepiandrosterone sulphate level is also high. What is your diagnosis?

A. Acromegaly
B. Adrenal tumour
C. Cushing syndrome
D. Ovarian Sertoli cell tumour
E. Prolactinoma

28.A 37-year-old woman presents at 13 weeks gestation, concerned about the risk of trisomy She is keen to pursue an amniocentesis as soon as possible as she has been told it is more accurate than chorionic villus sampling. Which of the following is a risk if amniocentesis is done before 14 weeks of gestation?

A. Fetal talipes
B. Increased risk of preterm labour
C. Intrauterine growth restriction
D. Oligohydramnios
E. Placental mosaicism

29.You review a 23-year-old woman with cystic fibrosis for pre-conceptual counseling. Which of the following is correct regarding pregnancy in women with cystic fibrosis?

A. The average life expectancy of women with cystic fibrosis in the UK is 55 years
B. Fertility is reduced by approximately 30%
C. The risk of miscarriage is unchanged when compared to the general population
D. There is a higher incidence of congenital malformations
E. There is an association with fetal growth restriction

30. You are called by the midwife to review a woman who presents with constant lower abdominal pain and fresh bleeding at 35+5 weeks gestation in her second pregnancy. Which of the following risk factors is most predictive of placental abruption?

A. Advanced maternal age
B. Obesity
C. Pre-eclampsia
D. Previous history of placental abruption
E. Smoking