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SMLE - OB-GYN
| A 40-year-old primigravida with previous DVT — appropriate management? | A. Aspirin | B. Heparin | C. Enoxaparin | D. No anticoagulation | D. No anticoagulation |
| A 29-year-old G4 P3 at 12 weeks with BP 150/95 mmHg, trace protein. Best therapy? | A. Methyldopa | B. Atenolol | C. Captopril | D. Losartan | A. Methyldopa |
| During a difficult forceps delivery, the blade crushed the left facial nerve. Expected defect? | A. Inability to close left eyelid | B. Reduced blood supply to ear | C. Loss of facial sensation | D. Loss of anterior tongue taste | A. Inability to close left eyelid |
| A 34-year-old G4 P3 at 32 weeks with tonic-clonic convulsions. Best drug to control seizures? | A. Magnesium sulfate | B. Hydralazine | C. Phenytoin | D. Diazepam | A. Magnesium sulfate |
| A 27-year-old primigravida abnormal GTT. Next step? | A. Random glucose | B. HbA1c | C. Adjust diet | D. Repeat GTT | C. Adjust diet |
| A 35-year-old G2 P1 at 30 weeks with uncontrolled gestational diabetes on diet. Best medication? | A. Pioglitazone | B. Metformin | C. Glyburide | D. Insulin | D. Insulin |
| A 35-year-old woman on prolactinemia treatment. When is pituitary imaging indicated? | A. Prolactin twice normal | B. Persistent galactorrhea | C. Blurred vision | D. Pregnancy | B. Persistent galactorrhea |
| A 40-year-old woman on tamoxifen has thickened endometrium. Next step? | A. Endometrial sampling | B. CA-125 | C. Pelvic CT | D. FSH/LH | A. Endometrial sampling |
| A 24-year-old obese woman with irregular menses, acne, hirsutism, ↑LH/↓FSH. Diagnosis? | A. Turner | B. Exogenous obesity | C. Premature ovarian failure | D. PCOS | D. Polycystic ovary syndrome |
| A 25-year-old breastfeeding mother with fever and painful right breast. Pathogen? | A. E. coli | B. Staph aureus | C. H. influenzae | D. β-hemolytic strep | B. Staphylococcus aureus |
| A 22-year-old woman with ovarian cysts, hirsutism, insulin resistance. Diagnosis? | A. Gynecomastia | B. Kallmann | C. Klinefelter | D. Stein-Leventhal syndrome | D. Stein-Leventhal syndrome |
| A 28-year-old HCV-treated woman, pregnant, asks about breastfeeding. When contraindicated? | A. Lack of vaccines | B. Neonatal thrush | C. Maternal anemia | D. Cracked nipples | D. Cracked nipples |
| A 22-year-old woman with normal exam but pre-menstrual breast tenderness. Screening test? | A. Breast ultrasound | B. Pap smear | C. HPV test | D. GBS culture | B. Papanicolaou smear |
| A 30-year-old 10-weeks pregnant with hyperemesis and ketonuria. Finding confirms diagnosis? | A. Leukocytes | B. Glucose | C. Ketones | D. Protein | C. Ketones |
| A 25-year-old 10 days postpartum, red tender breast lump, fever 39 °C. Diagnosis? | A. Fibrocystic disease | B. Inflammatory carcinoma | C. Puerperal sepsis | D. Breast abscess | D. Breast abscess |
| A 35-year-old woman with greenish-yellow purulent vaginal discharge and spotted rash lesions. Diagnosis? | A. Candidiasis | B. Bacterial vaginosis | C. Atrophic vaginitis | D. Trichomoniasis | D. Vaginal trichomoniasis |
| A 65-year-old postmenopausal woman with vaginal bleeding. Essential investigation? | A. MRI | B. Ultrasound | C. Endometrial biopsy | D. Tumor markers | C. Endometrial biopsy |
| A 67-year-old woman with lichen sclerosus, new vulvar mass. Histopathology finding? | A. Adenosquamous carcinoma | B. Squamous cell carcinoma | C. Adenocarcinoma | D. Melanoma | B. Squamous cell carcinoma |
| A 29-year-old woman with thin grayish fishy vaginal discharge, pH 5.5. Treatment? | A. Metronidazole | B. Fluconazole | C. Tetracycline | D. Doxycycline | A. Metronidazole |
| A 57-year-old menopausal woman with endometrial hyperplasia + atypia. Best treatment? | A. Myomectomy | B. Progesterone | C. Embolization | D. Total hysterectomy | D. Total abdominal hysterectomy |
| A 55-year-old woman with urinary leakage before reaching bathroom. First step in evaluation? | A. Cystoscopy | B. IV pyelogram | C. Urethral pressure profile | D. Urine analysis and culture | D. Urine analysis and culture |
| A postpartum 3 months woman with fecal incontinence + vaginal flatus. Diagnosis? | A. Hemorrhoids | B. Puerperal sepsis | C. Perineal tear | D. Rectovaginal fistula | D. Recto-vaginal fistula |
| A 60-year-old ASC-US twice after estrogen therapy. Next investigation? | A. Repeat Pap 6 months | B. Endometrial biopsy | C. HPV test | D. Colposcopy | D. Colposcopy |
| A 25-year-old woman with painless 3 cm cystic labial mass 7 o’clock. Diagnosis? | A. Bartholin cyst | B. Vulvar myoma | C. Vaginal adenosis | D. Skene duct cyst | A. Bartholin cyst |
| A 33-year-old woman with thick odorless white cottage-cheese discharge after antibiotics. Diagnosis? | A. Chlamydia | B. Candidiasis | C. Gardnerella | D. Trichomoniasis | B. Candidiasis |
| A 48-year-old woman with recurrent curd-like discharge, yeast on microscopy. Associated condition? | A. Sarcoidosis | B. Tuberculosis | C. Diabetes mellitus | D. Lupus erythematosus | C. Diabetes mellitus |
| A 56-year-old postmenopausal woman with pea-sized labial lump, bleeding discharge. Diagnosis? | A. Bartholin cyst | B. Cystic adenosis | C. Bartholin gland carcinoma | D. Vulvar SCC | D. Squamous cell carcinoma of vulva |
| A 21-year-old woman with diffuse abdominal pain, dyspareunia, cervical tenderness. Diagnosis? | A. PID | B. Cholecystitis | C. Appendicitis | D. Cervicitis | A. Pelvic inflammatory disease |
| A 23-year-old woman with watery brown discharge after IUD insertion. Diagnosis? | A. Uterine rupture | B. Bacterial vaginosis | C. Twisted ovarian mass | D. PID | D. Pelvic inflammatory disease |
| A 21-year-old woman with thick white curdy discharge, pseudohyphae, pH 4.0. Diagnosis? | A. Trichomoniasis | B. Bacterial vaginosis | C. Physiologic discharge | D. Vulvovaginal candidiasis | D. Vulvovaginal candidiasis |
| A young woman unresponsive to ceftriaxone for PID. Likely pathogen? | A. Adenovirus | B. Herpes virus | C. Neisseria gonorrhea | D. Chlamydia trachomatis | D. Chlamydia trachomatis |
| A 34-year-old woman Pap ASC-US, history of HPV warts. First step? | A. Repeat Pap | B. Hysterectomy | C. Colposcopy | D. HPV testing | D. HPV testing |
| A woman with cyclic pelvic pain before menses. Diagnostic method for endometriosis? | A. MRI | B. Diagnostic laparoscopy | C. Biopsy | D. Ultrasound | B. Diagnostic laparoscopy |
| A 67-year-old woman with vaginal atrophy and burning, negative wet prep. Initial treatment? | A. Steroid cream | B. Metronidazole gel | C. Vinegar douche | D. Estrogen vaginal cream | D. Estrogen vaginal cream |
| A 16-year-old girl with primary amenorrhea, normal breast, absent uterus. Diagnosis? | A. Turner syndrome | B. Kallmann syndrome | C. Androgen insensitivity | D. Asherman syndrome | C. Androgen insensitivity syndrome |
| A 28-year-old woman with secondary amenorrhea, history of D&C. Diagnosis? | A. PCOS | B. Turner syndrome | C. Asherman syndrome | D. Hypothalamic amenorrhea | C. Asherman syndrome |
| A 22-year-old woman with amenorrhea, galactorrhea, negative pregnancy test. Diagnosis? | A. Pituitary tumor | B. PCOS | C. Ovarian failure | D. Hypothalamic dysfunction | A. Pituitary tumor (prolactinoma) |
| A 30-year-old woman with infertility and hirsutism, LH:FSH = 3:1. Diagnosis? | A. PCOS | B. Cushing | C. Hypothyroidism | D. Adrenal tumor | A. Polycystic ovary syndrome |
| A 27-year-old woman with hirsutism and clitoromegaly. Cause? | A. PCOS | B. Adrenal tumor | C. Cushing | D. Ovarian failure | B. Adrenal tumor |
| A 35-year-old woman with heavy menses and irregular cycles. Most likely cause? | A. Anovulation | B. Endometriosis | C. Adenomyosis | D. Fibroids | A. Anovulation |
| A 30-year-old woman with heavy menses, firm enlarged uterus. Diagnosis? | A. Adenomyosis | B. Leiomyoma | C. Fibroid polyp | D. Endometrial carcinoma | B. Leiomyoma |
| A 42-year-old woman with dysmenorrhea, heavy bleeding, uniformly enlarged uterus. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroids | D. Polyp | B. Adenomyosis |
| A 35-year-old woman with cyclic pelvic pain, infertility, nodular uterosacral ligament. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. Fibroid | A. Endometriosis |
| A 45-year-old woman with hot flashes, irregular menses, FSH ↑. Diagnosis? | A. Hypothyroidism | B. Premature ovarian failure | C. Menopause | D. Hyperprolactinemia | C. Menopause |
| A 50-year-old postmenopausal woman with vaginal bleeding. Next step? | A. Pap smear | B. Endometrial biopsy | C. CT scan | D. Hysteroscopy | B. Endometrial biopsy |
| A 40-year-old woman with postcoital bleeding. Investigation? | A. Pap smear | B. TVS | C. Endometrial biopsy | D. Hysteroscopy | A. Pap smear |
| A 28-year-old pregnant woman with painless vaginal bleeding, soft uterus, no pain. Diagnosis? | A. Placenta previa | B. Abruption placenta | C. Vasa previa | D. Cervical polyp | A. Placenta previa |
| A 28-year-old woman at 34 weeks with painful vaginal bleeding, tender uterus. Diagnosis? | A. Placenta previa | B. Abruption placentae | C. Uterine rupture | D. Vasa previa | B. Abruptio placentae |
| A 30-year-old primigravida with gush of fluid at 34 weeks. Test to confirm? | A. Nitrazine test | B. Pap smear | C. Biophysical profile | D. CTG | A. Nitrazine test |
| A 32-year-old woman with PROM, fever, uterine tenderness. Diagnosis? | A. Endometritis | B. Chorioamnionitis | C. Sepsis | D. UTI | B. Chorioamnionitis |
| A 29-year-old woman with fever, uterine tenderness 3 days postpartum. Diagnosis? | A. Endometritis | B. Mastitis | C. Septic abortion | D. Retained placenta | A. Endometritis |
| A 24-year-old woman at 36 weeks with headache, blurred vision, BP 160/110, 3+ proteinuria. Diagnosis? | A. Gestational HTN | B. Chronic HTN | C. Pre-eclampsia | D. Eclampsia | C. Pre-eclampsia |
| A 30-year-old woman with preeclampsia, seizure, unconscious. Diagnosis? | A. Stroke | B. Epilepsy | C. Eclampsia | D. Hypertensive crisis | C. Eclampsia |
| A 25-year-old woman at 32 weeks, BP 170/110, urine protein 4+. Next step? | A. Deliver immediately | B. Antihypertensives and magnesium sulfate | C. Observe | D. Steroids only | B. Start magnesium sulfate and control BP |
| A 35-year-old G2P1 with GDM on insulin, at 38 weeks. Next step? | A. Induce labor | B. Cesarean | C. Wait till 41 weeks | D. Stop insulin | A. Induce labor at 38 weeks |
| A 28-year-old woman with pruritus and jaundice in pregnancy. Diagnosis? | A. Viral hepatitis | B. Intrahepatic cholestasis | C. Acute fatty liver | D. Preeclampsia | B. Intrahepatic cholestasis of pregnancy |
| A 25-year-old G2P1 with previous C-section, at 39 weeks, wants VBAC. Contraindication? | A. Transverse lie | B. One previous C-section | C. Term pregnancy | D. Vertex presentation | A. Transverse lie |
| A 25-year-old woman at 10 weeks with vaginal bleeding, open os. Diagnosis? | A. Threatened abortion | B. Inevitable abortion | C. Incomplete abortion | D. Missed abortion | B. Inevitable abortion |
| A 30-year-old woman 14 weeks, vaginal bleeding, closed os, fetal heart present. Diagnosis? | A. Threatened abortion | B. Inevitable abortion | C. Missed abortion | D. Complete abortion | A. Threatened abortion |
| A 26-year-old woman with positive pregnancy test, spotting, adnexal tenderness. Diagnosis? | A. Ovarian cyst | B. Ectopic pregnancy | C. Threatened abortion | D. Appendicitis | B. Ectopic pregnancy |
| A 28-year-old woman with ectopic pregnancy, BP 80/50. Management? | A. Methotrexate | B. Salpingostomy | C. Laparotomy | D. Observation | C. Emergency laparotomy |
| A 24-year-old woman with missed abortion, mild bleeding. Best management? | A. Expectant | B. Surgical evacuation | C. Misoprostol | D. Oxytocin | B. Surgical evacuation |
| A 30-year-old woman 10 weeks with multiple vesicular structures on ultrasound. Diagnosis? | A. Missed abortion | B. Molar pregnancy | C. Multiple gestation | D. Twin pregnancy | B. Hydatidiform mole |
| A 32-year-old woman post-molar evacuation, hCG plateau for 6 weeks. Diagnosis? | A. Complete mole | B. Invasive mole | C. Choriocarcinoma | D. Normal regression | B. Invasive mole |
| A 30-year-old woman with molar pregnancy, after evacuation follow-up test? | A. hCG weekly | B. CT abdomen | C. MRI pelvis | D. Ultrasound | A. Weekly serum hCG |
| A 32-year-old woman with high β-hCG, multiple snowstorm pattern. Diagnosis? | A. Partial mole | B. Complete mole | C. Multiple gestation | D. Ectopic pregnancy | B. Complete hydatidiform mole |
| A 35-year-old woman with postpartum heavy bleeding, boggy uterus. Diagnosis? | A. Retained placenta | B. Uterine atony | C. Laceration | D. Coagulopathy | B. Uterine atony |
| A 30-year-old woman with firm uterus, heavy bleeding, vaginal tear. Diagnosis? | A. Uterine rupture | B. Laceration | C. Placenta accreta | D. Uterine inversion | B. Vaginal laceration |
| A 26-year-old woman with prolonged labor, sudden pain, fetal bradycardia. Diagnosis? | A. Placenta previa | B. Abruption | C. Uterine rupture | D. Cord prolapse | C. Uterine rupture |
| A 32-year-old woman after delivery, inverted uterus. Management? | A. Replace uterus manually | B. Hysterectomy | C. Uterotonics | D. Oxytocin | A. Manual replacement of uterus |
| A 29-year-old woman 2 days postpartum, red tender breast, fever 39 °C. Organism? | A. Staph aureus | B. Strep pyogenes | C. E. coli | D. Pseudomonas | A. Staph aureus |
| A 28-year-old woman with postpartum psychosis. Management? | A. Hospitalization | B. Antidepressants | C. ECT | D. Family support | A. Hospitalization and antipsychotics |
| A 23-year-old woman with green vaginal discharge, strawberry cervix. Diagnosis? | A. Candida | B. Trichomonas | C. Bacterial vaginosis | D. Chlamydia | B. Trichomonas vaginalis |
| A 26-year-old woman with clue cells on wet mount, pH >4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Gonorrhea | B. Bacterial vaginosis |
| A 28-year-old woman with yellow discharge, intracellular diplococci on smear. Diagnosis? | A. Gonorrhea | B. Chlamydia | C. BV | D. Candida | A. Gonorrhea |
| A 23-year-old woman with cervicitis, Giemsa stain shows inclusion bodies. Diagnosis? | A. BV | B. Candida | C. Gonorrhea | D. Chlamydia | D. Chlamydia trachomatis |
| A 25-year-old woman with painful vesicles on vulva. Diagnosis? | A. HPV | B. HSV | C. Trichomonas | D. Candida | B. Herpes simplex virus |
| A 26-year-old woman with cauliflower-like genital warts. Diagnosis? | A. HSV | B. HPV | C. BV | D. Chlamydia | B. Human papillomavirus infection |
| A 30-year-old woman with painless genital ulcer and firm nodes. Diagnosis? | A. Syphilis | B. Chancroid | C. Lymphogranuloma venereum | D. HSV | A. Primary syphilis |
| A 27-year-old woman with painful genital ulcer and tender inguinal nodes. Diagnosis? | A. Syphilis | B. Chancroid | C. LGV | D. HSV | B. Chancroid |
| A 28-year-old woman with multiple shallow painful ulcers, grouped vesicles. Diagnosis? | A. HSV | B. Chancroid | C. LGV | D. Syphilis | A. Herpes simplex virus |
| A 30-year-old woman with bubo and groove sign. Diagnosis? | A. HSV | B. LGV | C. Syphilis | D. Chancroid | B. Lymphogranuloma venereum |
| A 40-year-old woman with hot flashes and mood changes, FSH high, LH high. Diagnosis? | A. Hypothyroidism | B. Premature menopause | C. PCOS | D. Addison’s | B. Premature menopause |
| A 48-year-old woman with heavy bleeding, uterus 12-week size. Investigation? | A. US pelvis | B. Hysteroscopy | C. MRI | D. CT | A. Ultrasound pelvis |
| A 35-year-old woman with severe pelvic pain during menstruation, infertility, tender nodules in posterior fornix. Diagnosis? | A. PID | B. Endometriosis | C. Adenomyosis | D. Fibroid | B. Endometriosis |
| A 45-year-old woman with cyclic menorrhagia, boggy uterus. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroid | D. Endometrial polyp | B. Adenomyosis |
| A 30-year-old woman with infertility, bilateral adnexal masses, chocolate cysts. Diagnosis? | A. Endometriosis | B. Fibroid | C. PID | D. Ovarian tumor | A. Endometriosis |
| A 45-year-old woman with painless postmenopausal bleeding, thickened endometrium on ultrasound. Next step? | A. D&C | B. MRI pelvis | C. TVS | D. Biopsy | D. Endometrial biopsy |
| A 32-year-old woman on OCP presents with mild right lower abdominal pain, ovarian cyst on ultrasound. Likely type? | A. Dermoid cyst | B. Follicular cyst | C. Endometrioma | D. Serous cystadenoma | B. Follicular cyst |
| A 25-year-old woman with right ovarian cyst containing hair and teeth. Diagnosis? | A. Dermoid cyst | B. Endometrioma | C. Serous cystadenoma | D. Mucinous cystadenoma | A. Dermoid cyst (Mature teratoma) |
| A 30-year-old woman with cystic ovarian mass, thick capsule, bilateral. Likely diagnosis? | A. Mucinous cystadenoma | B. Serous cystadenoma | C. Dermoid cyst | D. Endometrioma | B. Serous cystadenoma |
| A 40-year-old woman with multilocular mucin-filled ovarian cyst. Diagnosis? | A. Mucinous cystadenoma | B. Serous cystadenoma | C. Endometrioma | D. Dermoid cyst | A. Mucinous cystadenoma |
| A 35-year-old woman with virilization and solid ovarian mass. Diagnosis? | A. Granulosa cell tumor | B. Sertoli-Leydig tumor | C. Theca cell tumor | D. Dysgerminoma | B. Sertoli-Leydig tumor |
| A 40-year-old woman with endometrial hyperplasia and adnexal mass. Likely tumor? | A. Dysgerminoma | B. Granulosa cell tumor | C. Yolk sac tumor | D. Serous cystadenoma | B. Granulosa cell tumor |
| A 20-year-old woman with right adnexal mass, elevated LDH. Diagnosis? | A. Dysgerminoma | B. Yolk sac tumor | C. Choriocarcinoma | D. Teratoma | A. Dysgerminoma |
| A 25-year-old woman with adnexal mass, AFP high. Diagnosis? | A. Dysgerminoma | B. Yolk sac tumor | C. Choriocarcinoma | D. Teratoma | B. Yolk sac tumor |
| A 22-year-old woman with adnexal mass, β-hCG elevated, not pregnant. Diagnosis? | A. Dysgerminoma | B. Yolk sac tumor | C. Choriocarcinoma | D. Teratoma | C. Choriocarcinoma |
| A 60-year-old woman with bilateral ovarian masses, ascites, pleural effusion. Diagnosis? | A. Krukenberg tumor | B. Serous carcinoma | C. Mucinous cystadenoma | D. Fibroma | A. Krukenberg tumor |
| A 45-year-old woman with ovarian fibroma, ascites, pleural effusion. Diagnosis? | A. Krukenberg | B. Meigs syndrome | C. Serous carcinoma | D. Brenner tumor | B. Meigs syndrome |
| A 50-year-old woman with postmenopausal bleeding and adnexal mass. Tumor marker? | A. CA 19-9 | B. CA 125 | C. AFP | D. β-hCG | B. CA-125 |
| A 28-year-old woman with recurrent UTIs, dysuria, sterile urine culture. Likely cause? | A. Interstitial cystitis | B. Nephrolithiasis | C. Pyelonephritis | D. Urethritis | A. Interstitial cystitis |
| A 25-year-old woman with stress incontinence. Initial management? | A. Surgery | B. Kegel exercises | C. Catheterization | D. Anticholinergics | B. Pelvic floor (Kegel) exercises |
| A 45-year-old woman with continuous dribbling urine after hysterectomy. Diagnosis? | A. Stress incontinence | B. Urge incontinence | C. Vesicovaginal fistula | D. Overflow incontinence | C. Vesicovaginal fistula |
| A 30-year-old woman with sudden urge to void, can’t reach toilet. Diagnosis? | A. Stress incontinence | B. Urge incontinence | C. Overflow incontinence | D. Fistula | B. Urge incontinence |
| A 60-year-old woman with loss of urine with cough or sneeze. Diagnosis? | A. Stress incontinence | B. Overflow incontinence | C. Urge incontinence | D. Functional | A. Stress incontinence |
| A 70-year-old woman with continuous leakage and post-void residual >300 mL. Diagnosis? | A. Stress | B. Urge | C. Overflow | D. Fistula | C. Overflow incontinence |
| A 55-year-old woman with cystocele, dragging sensation. Treatment? | A. Pelvic floor exercises | B. Ring pessary | C. Hysterectomy | D. Kegel only | B. Ring pessary |
| A 50-year-old woman with second-degree uterine prolapse, doesn’t want surgery. Treatment? | A. Pessary | B. Pelvic exercises | C. Estrogen cream | D. Repair | A. Pessary |
| A 45-year-old woman with foul vaginal discharge after delivery, tender uterus. Diagnosis? | A. PID | B. Endometritis | C. Retained products | D. UTI | B. Endometritis |
| A 25-year-old woman with incomplete abortion, heavy bleeding, open os. Management? | A. Expectant | B. Surgical evacuation | C. Methotrexate | D. Observe | B. Surgical evacuation |
| A 26-year-old woman at 35 weeks, painless vaginal bleeding, no pain, normal fetal HR. Diagnosis? | A. Placenta previa | B. Abruption | C. Vasa previa | D. Uterine rupture | A. Placenta previa |
| A 32-year-old woman at 36 weeks with abdominal pain, bleeding, tender uterus, fetal distress. Diagnosis? | A. Placenta previa | B. Abruptio placentae | C. Uterine rupture | D. Cord prolapse | B. Abruptio placentae |
| A 29-year-old woman at 39 weeks, previous cesarean, severe pain, absent fetal heart. Diagnosis? | A. Abruption | B. Uterine rupture | C. Placenta previa | D. Cord prolapse | B. Uterine rupture |
| A 35-year-old woman after delivery with hypotension and no response to fluids. Diagnosis? | A. PPH | B. Sheehan syndrome | C. DIC | D. Retained placenta | B. Sheehan syndrome |
| A 28-year-old woman postpartum, failure of lactation, amenorrhea. Diagnosis? | A. Sheehan | B. Pituitary tumor | C. PCOS | D. Thyroiditis | A. Sheehan syndrome |
| A 30-year-old woman with retained placenta, hemorrhage, hypotension. Next step? | A. Manual removal | B. Oxytocin | C. D&C | D. Observation | A. Manual removal of placenta |
| A 32-year-old woman with PPH, uterus not contracting. Next management? | A. Oxytocin | B. Misoprostol | C. Ergometrine | D. All | D. All uterotonics |
| A 27-year-old woman after delivery, perineal tear to anal sphincter. Degree? | A. 1st | B. 2nd | C. 3rd | D. 4th | C. Third-degree tear |
| A 30-year-old woman with third-degree tear. Management? | A. Repair sphincter | B. Observation | C. Ligation | D. Antibiotics only | A. Surgical repair under anesthesia |
| A 25-year-old woman postpartum with fever, tender uterus, foul lochia. Diagnosis? | A. Endometritis | B. Retained products | C. Sepsis | D. UTI | A. Endometritis |
| A 24-year-old woman with previous molar pregnancy, now high hCG and lung metastases. Diagnosis? | A. Invasive mole | B. Choriocarcinoma | C. Complete mole | D. Partial mole | B. Choriocarcinoma |
| A 30-year-old woman with choriocarcinoma. Best treatment? | A. Methotrexate | B. Surgery | C. Radiotherapy | D. Observation | A. Methotrexate chemotherapy |
| A 32-year-old woman with complete mole, hCG plateau for 8 weeks. Diagnosis? | A. Invasive mole | B. Choriocarcinoma | C. Normal regression | D. Partial mole | A. Invasive mole |
| A 30-year-old woman post-molar evacuation, hCG rises again. Diagnosis? | A. Choriocarcinoma | B. Invasive mole | C. Normal regression | D. Partial mole | A. Choriocarcinoma |
| A 25-year-old woman with molar pregnancy. Best contraceptive for follow-up? | A. OCP | B. IUCD | C. Barrier | D. None | A. Oral contraceptive pills |
| A 30-year-old woman with twins, discordant growth, oligohydramnios in one sac. Diagnosis? | A. TTTS | B. Discordant twins | C. Fetal anomaly | D. Placenta previa | A. Twin-to-twin transfusion syndrome |
| A 28-year-old woman with fundal height > expected, high hCG, polyhydramnios. Likely? | A. Twin pregnancy | B. Anemia | C. IUGR | D. Oligohydramnios | A. Twin pregnancy |
| A 26-year-old woman with previous stillbirth, now Rh-negative. Next step? | A. Rh antibody screen | B. Coombs test | C. RhIg at 28 weeks | D. All | D. All of the above |
| A 25-year-old Rh-negative woman, 32 weeks, indirect Coombs positive. Management? | A. RhIg | B. No action | C. Monitor titers | D. Induce | C. Monitor antibody titers |
| A 26-year-old Rh-negative woman delivered Rh-positive baby, no prior RhIg. Next step? | A. Nothing | B. RhIg within 72 hours | C. RhIg at 6 weeks | D. Observe | B. Give Rh immunoglobulin within 72 hours |
| A 22-year-old woman, 30 weeks pregnant, reports decreased fetal movement. Next step? | A. Ultrasound | B. Non-stress test | C. CTG | D. Kick count | B. Non-stress test |
| A 32-year-old woman, 38 weeks, reactive non-stress test. Interpretation? | A. Normal fetus | B. Fetal distress | C. Hypoxia | D. Preterm labor | A. Normal fetal status |
| A 28-year-old woman, 39 weeks, decelerations and decreased variability on CTG. Management? | A. Reposition mother | B. Oxygen | C. Stop oxytocin | D. All | D. All of the above |
| A 25-year-old woman at 36 weeks, fundal height small. Investigation? | A. Ultrasound Doppler | B. CTG | C. NST | D. Biophysical profile | A. Doppler ultrasound for IUGR |
| A 30-year-old woman, IUGR, abnormal Doppler with absent end-diastolic flow. Next step? | A. Continue monitoring | B. Immediate delivery | C. Increase nutrition | D. Reassure | B. Immediate delivery |
| A 24-year-old primigravida with headache, visual disturbances, BP 170/110, urine +++. Diagnosis? | A. Gestational HTN | B. Preeclampsia | C. Eclampsia | D. Chronic HTN | C. Eclampsia |
| A 26-year-old pregnant woman, BP 160/100, no proteinuria. Diagnosis? | A. Chronic HTN | B. Gestational HTN | C. Preeclampsia | D. Eclampsia | B. Gestational hypertension |
| A 28-year-old woman with pregnancy-induced HTN, seizures. Drug of choice? | A. Diazepam | B. Phenytoin | C. Magnesium sulfate | D. Phenobarbital | C. Magnesium sulfate |
| A 30-year-old woman with eclampsia, RR 10/min, absent reflexes. Next step? | A. Stop MgSO₄ | B. Continue same dose | C. Increase dose | D. Give calcium gluconate | A. Stop MgSO₄ and give calcium gluconate |
| A 25-year-old woman at 30 weeks, itching palms and soles, bile acids high. Diagnosis? | A. Viral hepatitis | B. Intrahepatic cholestasis | C. Fatty liver | D. HELLP | B. Intrahepatic cholestasis of pregnancy |
| A 29-year-old woman with epigastric pain, jaundice, hypoglycemia, late pregnancy. Diagnosis? | A. Preeclampsia | B. HELLP | C. Acute fatty liver | D. Cholestasis | C. Acute fatty liver of pregnancy |
| A 35-year-old woman with preeclampsia, low platelets, high AST/ALT. Diagnosis? | A. DIC | B. HELLP syndrome | C. Acute fatty liver | D. Sepsis | B. HELLP syndrome |
| A 27-year-old woman, preeclampsia, severe headache, visual loss, hyperreflexia. Next step? | A. Deliver | B. Labetalol | C. MgSO₄ | D. All | D. All (stabilize and deliver) |
| A 22-year-old woman with UTI at 28 weeks. Safe antibiotic? | A. Ciprofloxacin | B. Ampicillin | C. Tetracycline | D. Sulfonamide | B. Ampicillin |
| A 30-year-old woman with asymptomatic bacteriuria in pregnancy. Management? | A. No treatment | B. Treat with antibiotics | C. Repeat culture | D. Observe | B. Treat with antibiotics |
| A 28-year-old woman with pyelonephritis in pregnancy. Management? | A. IV antibiotics | B. Oral antibiotics | C. Observation | D. Surgery | A. IV antibiotics |
| A 25-year-old woman with GDM, random glucose 12 mmol/L. Next step? | A. Diet | B. Oral agents | C. Insulin | D. Observe | C. Start insulin therapy |
| A 26-year-old woman at 10 weeks, fasting glucose 7.0 mmol/L. Diagnosis? | A. Gestational DM | B. Type 2 DM | C. Type 1 DM | D. Impaired fasting glucose | B. Type 2 diabetes mellitus (pre-existing) |
| A 30-year-old woman with polyhydramnios, macrosomia, fetal distress. Cause? | A. Preeclampsia | B. GDM | C. Rhesus isoimmunization | D. Twin pregnancy | B. Gestational diabetes |
| A 40-year-old woman with GDM, controlled on diet. Best fetal assessment? | A. NST weekly | B. Ultrasound growth | C. Kick count | D. All | D. All of the above |
| A 22-year-old woman with preterm labor at 30 weeks. Tocolytic? | A. Oxytocin | B. Nifedipine | C. Ergometrine | D. Methylergometrine | B. Nifedipine |
| A 28-year-old woman with preterm labor. Drug to accelerate lung maturity? | A. Oxytocin | B. Betamethasone | C. MgSO₄ | D. Misoprostol | B. Betamethasone |
| A 24-year-old woman, PROM at 32 weeks, afebrile. Management? | A. Expectant | B. Induce labor | C. Cesarean | D. Antibiotics only | A. Expectant management with antibiotics |
| A 29-year-old woman at 39 weeks, ruptured membranes 24 h ago, afebrile. Next step? | A. Induce labor | B. Expect | C. C-section | D. Reassure | A. Induce labor |
| A 28-year-old woman with cord visible at introitus, fetal bradycardia. Management? | A. Push cord in | B. Elevate presenting part | C. C-section | D. All | D. All of the above immediately |
| A 30-year-old woman with shoulder dystocia. First maneuver? | A. Suprapubic pressure | B. Fundal pressure | C. Woods screw | D. McRoberts | D. McRoberts maneuver |
| A 25-year-old woman with cord around neck, fetal distress. Best step? | A. Cut cord | B. Slip over head | C. Continue labor | D. Push back | B. Slip cord over the head gently |
| A 30-year-old woman, PPH after delivery. Uterus firm. Cause? | A. Atony | B. Trauma | C. Coagulopathy | D. Retained placenta | B. Genital tract trauma |
| A 32-year-old woman, PPH, uterus boggy. First step? | A. Massage uterus | B. Call help | C. Oxytocin | D. All | A. Uterine massage |
| A 28-year-old woman, PPH unresponsive to uterotonics. Next step? | A. Bakri balloon | B. Ligation | C. Hysterectomy | D. All sequentially | A. Balloon tamponade |
| A 30-year-old woman with DIC after abruption. Lab findings? | A. ↑PT/↓fibrinogen | B. ↓PT/↑fibrinogen | C. Normal PT | D. ↑Platelets | A. Increased PT, decreased fibrinogen |
| A 26-year-old woman post-cesarean, sudden dyspnea, hypotension, DIC. Diagnosis? | A. PE | B. AFE | C. Sepsis | D. MI | B. Amniotic fluid embolism |
| A 25-year-old woman, 3 days postpartum, painful leg swelling. Diagnosis? | A. DVT | B. Cellulitis | C. Lymphedema | D. Thrombophlebitis | A. Deep vein thrombosis |
| A 32-year-old woman with severe perineal pain, fever, foul lochia. Diagnosis? | A. Endometritis | B. Necrotizing fasciitis | C. Vaginitis | D. Retained products | B. Necrotizing fasciitis |
| A 24-year-old woman postpartum with perineal infection, crepitus. Management? | A. Debridement | B. Antibiotics only | C. Observe | D. Dressing | A. Surgical debridement |
| A 25-year-old woman with fever, tender leg vein postpartum. Diagnosis? | A. Superficial thrombophlebitis | B. DVT | C. Cellulitis | D. Lymphedema | A. Superficial thrombophlebitis |
| A 28-year-old woman postpartum, chest pain, tachypnea, hypoxia. Diagnosis? | A. MI | B. PE | C. AFE | D. Pneumonia | B. Pulmonary embolism |
| A 26-year-old woman with cesarean wound discharge, fever. Management? | A. Open wound | B. Antibiotics | C. Debridement | D. All | D. All of the above |
| A 32-year-old woman with mastitis, fluctuant mass. Next step? | A. Continue feeding | B. Stop feeding | C. Incision and drainage | D. Change breast | C. Incision and drainage |
| A 23-year-old woman breastfeeding with cracked nipples, mastitis. Organism? | A. Staph aureus | B. Strep | C. E. coli | D. Candida | A. Staphylococcus aureus |
| A 22-year-old woman with PPH and hematuria after delivery. Cause? | A. Uterine rupture | B. Bladder injury | C. Urethral tear | D. Vaginal tear | B. Bladder injury |
| A 30-year-old woman post-delivery, unable to void urine. Cause? | A. Bladder atony | B. UTI | C. Retention | D. Perineal edema | A. Bladder atony |
| A 24-year-old woman with postpartum depression, crying, insomnia. Management? | A. Supportive | B. Antidepressants | C. ECT | D. Hospitalize | A. Supportive reassurance |
| A 26-year-old woman with postpartum psychosis, hallucinations. Management? | A. Hospitalize | B. ECT | C. Antipsychotics | D. All | D. All (urgent hospitalization and treatment) |
| A 30-year-old woman, 6 weeks postpartum, fever, tender uterus, foul discharge. Diagnosis? | A. Endometritis | B. Retained products | C. Sepsis | D. PID | A. Endometritis |
| A 25-year-old woman, postpartum, excessive bleeding, failure to lactate. Diagnosis? | A. Sheehan | B. DIC | C. Retained placenta | D. Sepsis | A. Sheehan syndrome |
| A 30-year-old woman with infertility and bilateral hydrosalpinx. Cause? | A. PID | B. Endometriosis | C. TB | D. Fibroid | A. Pelvic inflammatory disease |
| A 28-year-old woman with pelvic pain, fever, adnexal tenderness. Diagnosis? | A. Endometriosis | B. PID | C. Ectopic | D. Ovarian cyst | B. Pelvic inflammatory disease |
| A 25-year-old woman with PID, unresponsive to ceftriaxone. Organism? | A. Gonorrhea | B. Chlamydia | C. Trichomonas | D. Candida | B. Chlamydia trachomatis |
| A 22-year-old woman with lower abdominal pain, vaginal discharge, and fever. Treatment? | A. Ceftriaxone + doxycycline | B. Ampicillin + gentamicin | C. Azithromycin | D. Ciprofloxacin | A. Ceftriaxone and doxycycline |
| A 26-year-old woman with salpingitis. Common complication? | A. Ectopic pregnancy | B. Infertility | C. Chronic pain | D. All | D. All of the above |
| A 28-year-old woman, tubo-ovarian abscess. Management? | A. IV antibiotics | B. Surgery | C. Drainage | D. Observe | A. IV broad-spectrum antibiotics |
| A 24-year-old woman with infertility, dysmenorrhea, dyspareunia. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. PCOS | A. Endometriosis |
| A 30-year-old woman with cyclic pelvic pain and infertility. Gold standard diagnosis? | A. Ultrasound | B. MRI | C. Laparoscopy | D. CT | C. Diagnostic laparoscopy |
| A 28-year-old woman with retroverted uterus, painful periods, infertility. Diagnosis? | A. Adenomyosis | B. PID | C. Endometriosis | D. PCOS | C. Endometriosis |
| A 35-year-old woman with uterine tenderness, heavy periods, enlarged uterus. Diagnosis? | A. Adenomyosis | B. Fibroid | C. Endometriosis | D. PID | A. Adenomyosis |
| A 40-year-old woman with irregular bleeding, intermenstrual spotting. Investigation? | A. TVS | B. Endometrial biopsy | C. Pap smear | D. MRI | B. Endometrial biopsy |
| A 45-year-old woman with menorrhagia and intermenstrual bleeding. Common cause? | A. Fibroid | B. Adenomyosis | C. Polyp | D. Endometrial carcinoma | A. Uterine fibroid |
| A 32-year-old woman with heavy bleeding and fibroid uterus. Medical treatment? | A. GnRH agonist | B. OCP | C. NSAIDs | D. All | D. All of the above |
| A 40-year-old woman with infertility, multiple fibroids, anemia. Best treatment? | A. Myomectomy | B. Hysterectomy | C. Embolization | D. Observe | A. Myomectomy |
| A 50-year-old postmenopausal woman with fibroid. Management? | A. Observe | B. Hysterectomy | C. Myomectomy | D. GnRH | B. Hysterectomy |
| A 35-year-old woman with infertility and anovulation. Best initial test? | A. Serum progesterone (Day 21) | B. FSH/LH | C. Estradiol | D. Prolactin | A. Serum progesterone on day 21 |
| A 28-year-old woman with galactorrhea, amenorrhea, normal TSH. Investigation? | A. MRI pituitary | B. Prolactin | C. β-hCG | D. FSH | B. Serum prolactin |
| A 27-year-old woman with prolactinoma on bromocriptine, pregnant. Management? | A. Stop drug | B. Continue same | C. Increase dose | D. Switch to cabergoline | A. Stop bromocriptine during pregnancy |
| A 26-year-old woman with infertility, normal tubes, normal sperm, anovulation. Management? | A. Clomiphene | B. FSH | C. IVF | D. Surgery | A. Clomiphene citrate |
| A 30-year-old woman with failure to conceive after 2 years, normal ovulation, patent tubes, normal semen. Diagnosis? | A. Unexplained infertility | B. Endometriosis | C. Tubal block | D. PCOS | A. Unexplained infertility |
| A 29-year-old woman with recurrent pregnancy loss, anticardiolipin antibodies positive. Diagnosis? | A. Lupus | B. Antiphospholipid syndrome | C. Thrombophilia | D. Factor V Leiden | B. Antiphospholipid syndrome |
| A 30-year-old woman with antiphospholipid syndrome. Management? | A. Aspirin + heparin | B. Warfarin | C. Clopidogrel | D. Steroids | A. Aspirin and heparin |
| A 33-year-old woman with infertility, tubal blockage. Next step? | A. IVF | B. Clomiphene | C. IUI | D. Myomectomy | A. In vitro fertilization |
| A 35-year-old woman with amenorrhea, hot flashes, FSH high. Diagnosis? | A. Hypothalamic | B. Pituitary | C. Ovarian failure | D. Thyroid | C. Premature ovarian failure |
| A 22-year-old woman with delayed puberty, anosmia, low FSH/LH. Diagnosis? | A. Turner | B. Kallmann | C. PCOS | D. Sheehan | B. Kallmann syndrome |
| A 16-year-old girl with primary amenorrhea, webbed neck, short stature. Diagnosis? | A. Klinefelter | B. Turner | C. Kallmann | D. AIS | B. Turner syndrome |
| A 17-year-old girl with primary amenorrhea, normal breast, absent uterus. Diagnosis? | A. AIS | B. MRKH | C. Turner | D. PCOS | B. Müllerian agenesis (MRKH) |
| A 25-year-old woman with secondary amenorrhea after D&C. Diagnosis? | A. PCOS | B. Asherman | C. Sheehan | D. Hypothyroidism | B. Asherman syndrome |
| A 28-year-old woman with heavy periods, infertility, and fibroid uterus. Diagnosis? | A. Submucous fibroid | B. Endometriosis | C. Adenomyosis | D. Polyp | A. Submucous fibroid |
| A 45-year-old woman with heavy periods, pelvic fullness. Best imaging? | A. TVS | B. MRI | C. CT | D. X-ray | A. Transvaginal ultrasound |
| A 48-year-old woman with fibroid uterus and anemia, not fit for surgery. Management? | A. GnRH agonist | B. Myomectomy | C. Embolization | D. Observe | A. GnRH agonist therapy |
| A 32-year-old woman with ovarian cyst, 5 cm, simple, no symptoms. Management? | A. Observe | B. Surgery | C. Chemotherapy | D. Aspiration | A. Observe |
| A 45-year-old woman with adnexal mass, solid, fixed, ascites. Next step? | A. CA-125 | B. US | C. Laparotomy | D. Biopsy | A. CA-125 tumor marker |
| A 50-year-old woman with bilateral ovarian masses, ascites. Likely diagnosis? | A. Ovarian carcinoma | B. Serous cystadenoma | C. Endometrioma | D. Teratoma | A. Ovarian carcinoma |
| A 55-year-old woman with ovarian cancer. Most common histologic type? | A. Serous cystadenocarcinoma | B. Mucinous | C. Endometrioid | D. Brenner | A. Serous cystadenocarcinoma |
| A 30-year-old woman with large ovarian cyst, papillary projections, ascites. Diagnosis? | A. Malignant tumor | B. Benign cyst | C. Endometrioma | D. Teratoma | A. Malignant epithelial ovarian tumor |
| A 25-year-old woman with dysgerminoma. Marker? | A. LDH | B. AFP | C. β-hCG | D. CA-125 | A. LDH |
| A 28-year-old woman with yolk sac tumor. Marker? | A. LDH | B. AFP | C. β-hCG | D. CA-125 | B. AFP |
| A 24-year-old woman with choriocarcinoma. Marker? | A. LDH | B. AFP | C. β-hCG | D. CA-125 | C. β-hCG |
| A 50-year-old woman with granulosa cell tumor. Marker? | A. Inhibin | B. LDH | C. AFP | D. β-hCG | A. Inhibin |
| A 60-year-old woman with adnexal mass, ascites, omental cake. Diagnosis? | A. Ovarian carcinoma | B. Krukenberg tumor | C. Fibroma | D. Serous cystadenoma | A. Ovarian carcinoma |
| A 40-year-old woman with mucinous ovarian tumor and pseudomyxoma peritonei. Diagnosis? | A. Mucinous cystadenoma | B. Mucinous carcinoma | C. Serous carcinoma | D. Krukenberg tumor | B. Mucinous cystadenocarcinoma |
| A 25-year-old woman with dermoid cyst. Complication? | A. Torsion | B. Rupture | C. Malignant change | D. All | D. All of the above |
| A 28-year-old woman with acute lower abdominal pain, ovarian cyst on ultrasound. Likely complication? | A. Torsion | B. Rupture | C. Infection | D. Hemorrhage | A. Ovarian torsion |
| A 32-year-old woman with ovarian torsion. Best management? | A. Laparoscopy detorsion | B. Laparotomy | C. Observe | D. Aspiration | A. Laparoscopic detorsion |
| A 30-year-old woman with right adnexal pain, ovarian cyst, mild fever. Diagnosis? | A. Endometrioma | B. PID | C. Tubo-ovarian abscess | D. Corpus luteum cyst | C. Tubo-ovarian abscess |
| A 27-year-old woman with tubo-ovarian abscess unresponsive to antibiotics. Next step? | A. Drainage | B. Observe | C. Continue same | D. Hysterectomy | A. Surgical drainage |
| A 30-year-old woman with recurrent miscarriage, uterine septum found on imaging. Management? | A. Hysterectomy | B. Septal resection | C. IVF | D. Hormone therapy | B. Hysteroscopic septal resection |
| A 25-year-old woman with infertility, hysterosalpingogram shows bilateral block at fimbrial end. Cause? | A. PID | B. Endometriosis | C. TB | D. Adhesions | C. Genital tuberculosis |
| A 28-year-old woman with infertility and positive chlamydia IgG. Likely cause? | A. Ovulatory | B. Tubal | C. Uterine | D. Cervical | B. Tubal factor infertility |
| A 32-year-old woman with infertility, progesterone low on day 21. Diagnosis? | A. Anovulation | B. Luteal insufficiency | C. PCOS | D. Ovarian failure | A. Anovulation |
| A 30-year-old woman with PCOS. Best drug for ovulation induction? | A. Clomiphene | B. FSH | C. GnRH | D. Bromocriptine | A. Clomiphene citrate |
| A 28-year-old woman with infertility and hyperprolactinemia. Drug of choice? | A. Bromocriptine | B. Cabergoline | C. Pergolide | D. Dopamine | A. Bromocriptine |
| A 35-year-old woman with recurrent miscarriage, antiphospholipid antibodies. Treatment? | A. Low-dose aspirin | B. Heparin | C. Both | D. Steroids | C. Aspirin + heparin |
| A 26-year-old woman with infertility and normal investigation. Next management? | A. Expectant | B. Clomiphene | C. IUI | D. IVF | C. Intrauterine insemination |
| A 34-year-old woman with tubal block. Management? | A. Clomiphene | B. HSG | C. IVF | D. IUI | C. In-vitro fertilization |
| A 30-year-old woman with luteal phase defect. Treatment? | A. Progesterone | B. Clomiphene | C. Estrogen | D. GnRH | A. Progesterone support |
| A 28-year-old woman with premature ovarian failure. Hormone profile? | A. FSH↑ LH↑ E2↓ | B. FSH↓ LH↓ | C. FSH normal | D. FSH↑ E2↑ | A. High FSH & LH, low estrogen |
| A 27-year-old woman with Kallmann syndrome. Finding? | A. Anosmia | B. Galactorrhea | C. Hirsutism | D. Amenorrhea with high FSH | A. Anosmia |
| A 16-year-old girl with amenorrhea, normal breast, absent uterus. Diagnosis? | A. AIS | B. MRKH | C. Turner | D. Kallmann | B. Müllerian agenesis (MRKH) |
| A 17-year-old girl with tall stature, sparse pubic hair, 46 XY. Diagnosis? | A. Klinefelter | B. AIS | C. Turner | D. MRKH | B. Androgen insensitivity syndrome |
| A 30-year-old woman with cyclic pelvic pain, tender nodules posterior fornix. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. PID | D. Fibroid | B. Endometriosis |
| A 40-year-old woman with heavy periods, boggy uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. PID | A. Adenomyosis |
| A 45-year-old woman with heavy bleeding, enlarged irregular uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial carcinoma | D. Polyp | A. Uterine fibroid |
| A 30-year-old woman with submucous fibroid, menorrhagia. Treatment? | A. Hysteroscopic resection | B. Myomectomy | C. Hysterectomy | D. Embolization | A. Hysteroscopic myomectomy |
| A 50-year-old postmenopausal woman with fibroid. Management? | A. Observe | B. Hysterectomy | C. GnRH | D. Myomectomy | B. Hysterectomy |
| A 35-year-old woman with 3 cm endometrial polyp. Management? | A. Polypectomy | B. Observe | C. Hysterectomy | D. Curettage | A. Hysteroscopic polypectomy |
| A 45-year-old woman with postcoital bleeding, contact bleeding on exam. Diagnosis? | A. Cervical cancer | B. Polyp | C. PID | D. Ectropion | A. Cervical carcinoma |
| A 30-year-old woman with abnormal Pap (HSIL). Next step? | A. Repeat Pap | B. Colposcopy | C. Hysterectomy | D. HPV test | B. Colposcopy |
| A 28-year-old woman Pap = ASC-US, HPV positive. Management? | A. Colposcopy | B. Repeat Pap | C. Biopsy | D. Hysterectomy | A. Colposcopy |
| A 32-year-old woman Pap = LSIL, HPV negative. Management? | A. Repeat Pap in 6 mo | B. Colposcopy | C. Cone | D. LEEP | A. Repeat cytology in 6 months |
| A 35-year-old woman Pap = HSIL, biopsy CIN 3. Treatment? | A. Cryotherapy | B. LEEP | C. Hysterectomy | D. Observe | B. LEEP or cone excision |
| A 40-year-old woman post-cone biopsy with negative margins. Follow-up? | A. Pap at 6 mo | B. Yearly | C. No follow-up | D. HPV test only | A. Pap smear in 6 months |
| A 55-year-old woman with postmenopausal bleeding. Investigation? | A. TVS | B. Endometrial biopsy | C. Pap smear | D. Hysteroscopy | B. Endometrial biopsy |
| A 60-year-old woman with endometrial thickness > 10 mm. Diagnosis? | A. Carcinoma | B. Hyperplasia | C. Polyp | D. Atrophy | B. Endometrial hyperplasia |
| A 58-year-old woman with atypical endometrial hyperplasia. Management? | A. Hysterectomy | B. Progesterone | C. Observe | D. D&C | A. Total abdominal hysterectomy |
| A 25-year-old woman with greenish vaginal discharge, pH > 4.5, motile protozoa. Diagnosis? | A. BV | B. Candida | C. Trichomonas | D. Gonorrhea | C. Trichomonas vaginalis infection |
| A 27-year-old woman with thin gray discharge, fishy odor, clue cells. Diagnosis? | A. BV | B. Candida | C. Trichomonas | D. Chlamydia | A. Bacterial vaginosis |
| A 26-year-old woman with thick white curdy discharge, itching. Diagnosis? | A. BV | B. Candida | C. Trichomonas | D. Gonorrhea | B. Vulvovaginal candidiasis |
| A 23-year-old woman with painful vesicular genital lesions. Diagnosis? | A. HSV | B. HPV | C. Syphilis | D. LGV | A. Herpes simplex virus infection |
| A 25-year-old woman with painless ulcer, firm lymphadenopathy. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis |
| A 26-year-old woman with painful ulcer, soft base, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. HSV | D. LGV | A. Chancroid |
| A 28-year-old woman with groove sign, bubo, lymphadenopathy. Diagnosis? | A. LGV | B. HSV | C. Chancroid | D. Syphilis | A. Lymphogranuloma venereum |
| A 30-year-old woman with cauliflower-like genital warts. Diagnosis? | A. HPV | B. HSV | C. Syphilis | D. Trichomonas | A. Human papillomavirus infection |
| A 45-year-old woman with postmenopausal vulvar itching, white plaques. Diagnosis? | A. Lichen sclerosus | B. Psoriasis | C. Candidiasis | D. VIN | A. Lichen sclerosus |
| A 55-year-old woman with lichen sclerosus develops mass. Likely malignancy? | A. SCC | B. Adeno | C. Melanoma | D. Sarcoma | A. Vulvar squamous cell carcinoma |
| A 30-year-old woman with vulvar pain, 3 cm cystic swelling at 4 o’clock. Diagnosis? | A. Bartholin cyst | B. Skene duct cyst | C. Gartner cyst | D. Lipoma | A. Bartholin gland cyst |
| A 33-year-old woman with recurrent Bartholin abscess. Treatment? | A. Word catheter | B. Incision only | C. Hysterectomy | D. Antibiotic only | A. Word catheter insertion |
| A 25-year-old woman with firm, fixed vulvar mass, age > 40. Concern? | A. Carcinoma | B. Fibroid | C. Lipoma | D. Abscess | A. Bartholin gland carcinoma |
| A 60-year-old woman with postmenopausal bleeding and enlarged uterus. Diagnosis? | A. Endometrial carcinoma | B. Cervical cancer | C. Fibroid | D. Polyp | A. Endometrial carcinoma |
| A 55-year-old woman with endometrial cancer, stage IA. Management? | A. Total hysterectomy + BSO | B. Radiotherapy | C. Chemotherapy | D. Observe | A. Total abdominal hysterectomy with bilateral salpingo-oophorectomy |
| A 60-year-old woman with endometrial carcinoma, deep myometrial invasion. Add therapy? | A. Radiotherapy | B. Chemotherapy | C. Both | D. None | A. Post-operative radiotherapy |
| A 50-year-old woman with postcoital bleeding, ulcerated cervix. Diagnosis? | A. Cervical cancer | B. Polyp | C. Endometrial carcinoma | D. PID | A. Cervical carcinoma |
| A 35-year-old woman Pap = HSIL, biopsy = CIN III. Treatment? | A. Cryotherapy | B. LEEP | C. Conization | D. Hysterectomy | B. LEEP or cone excision |
| A 40-year-old woman with invasive cervical carcinoma, confined to cervix. Stage? | A. IA | B. IB | C. IIA | D. IIB | B. Stage IB |
| A 42-year-old woman cervical cancer extending to upper vagina. Stage? | A. I | B. IIA | C. IIB | D. III | B. Stage IIA |
| A 50-year-old woman cervical cancer with parametrial invasion. Stage? | A. IIA | B. IIB | C. III | D. IVA | B. Stage IIB |
| A 55-year-old woman cervical carcinoma with pelvic wall involvement. Stage? | A. II | B. III | C. IVA | D. IVB | B. Stage III |
| A 60-year-old woman cervical carcinoma invading bladder mucosa. Stage? | A. III | B. IVA | C. IVB | D. IIIB | B. Stage IVA |
| A 45-year-old woman cervical carcinoma with distant lung metastases. Stage? | A. III | B. IVA | C. IVB | D. IIB | C. Stage IVB |
| A 50-year-old woman stage IIB cervical carcinoma. Treatment? | A. Radical hysterectomy | B. Radiotherapy + chemo | C. Cone biopsy | D. Observe | B. Combined chemoradiation |
| A 35-year-old woman stage IA1 cervical carcinoma. Treatment? | A. Conization | B. Hysterectomy | C. Radiotherapy | D. Chemo | A. Conization |
| A 28-year-old woman with carcinoma in situ of cervix. Treatment? | A. LEEP | B. Cone biopsy | C. Hysterectomy | D. Observe | A. Excision (LEEP/cone) |
| A 60-year-old woman with cervical carcinoma. Most common histologic type? | A. Squamous cell | B. Adeno | C. Small cell | D. Clear cell | A. Squamous cell carcinoma |
| A 40-year-old woman with cervical cancer. Main risk factor? | A. HPV 16 & 18 | B. HSV | C. EBV | D. CMV | A. High-risk HPV 16 and 18 infection |
| A 25-year-old woman with genital warts. Prevention? | A. HPV vaccine | B. Pap smear | C. Condoms only | D. Antibiotics | A. HPV vaccination |
| A 30-year-old woman with vaginal bleeding after intercourse. Screening test? | A. Pap smear | B. Biopsy | C. HPV | D. Ultrasound | A. Pap smear |
| A 45-year-old woman with persistent watery vaginal discharge, negative Pap. Diagnosis? | A. Vaginal carcinoma | B. Cervical polyp | C. Endometrial cancer | D. Fibroid | A. Primary vaginal carcinoma |
| A 65-year-old woman with vulvar itching, ulcerated lesion. Diagnosis? | A. Vulvar carcinoma | B. VIN | C. Lichen planus | D. Psoriasis | A. Vulvar squamous cell carcinoma |
| A 40-year-old woman with Paget’s disease of vulva. Histology finding? | A. Adenocarcinoma cells | B. Squamous cells | C. Melanocytes | D. Lymphocytes | A. Adenocarcinoma cells in epidermis |
| A 60-year-old woman with pelvic mass, ascites, CA-125 elevated. Diagnosis? | A. Ovarian carcinoma | B. Endometrial | C. Cervical | D. GI tumor | A. Ovarian carcinoma |
| A 55-year-old woman with bilateral adnexal masses. Histology shows serous papillae. Diagnosis? | A. Serous cystadenocarcinoma | B. Mucinous | C. Endometrioid | D. Brenner | A. Serous cystadenocarcinoma |
| A 45-year-old woman with ovarian tumor and endometrial hyperplasia. Diagnosis? | A. Granulosa cell tumor | B. Dysgerminoma | C. Thecoma | D. Serous carcinoma | A. Estrogen-secreting granulosa cell tumor |
| A 25-year-old woman with right ovarian mass and elevated LDH. Diagnosis? | A. Dysgerminoma | B. Yolk-sac | C. Teratoma | D. Choriocarcinoma | A. Dysgerminoma |
| A 23-year-old woman with ovarian mass, AFP elevated. Diagnosis? | A. Yolk-sac tumor | B. Dysgerminoma | C. Choriocarcinoma | D. Teratoma | A. Yolk-sac tumor |
| A 27-year-old woman with ovarian mass, β-hCG elevated, not pregnant. Diagnosis? | A. Choriocarcinoma | B. Dysgerminoma | C. Endometrioid | D. Teratoma | A. Choriocarcinoma |
| A 30-year-old woman with ovarian fibroma, ascites, pleural effusion. Diagnosis? | A. Meigs syndrome | B. Krukenberg | C. Brenner | D. Serous | A. Meigs syndrome |
| A 50-year-old woman with bilateral mucinous ovarian tumors, signet-ring cells. Diagnosis? | A. Krukenberg tumor | B. Meigs | C. Brenner | D. Teratoma | A. Krukenberg metastasis |
| A 55-year-old woman with ovarian carcinoma. Tumor marker? | A. CA-125 | B. AFP | C. β-hCG | D. LDH | A. CA-125 |
| A 40-year-old woman with mucinous cystadenoma. Complication? | A. Pseudomyxoma peritonei | B. Rupture | C. Torsion | D. All | D. All of the above |
| A 30-year-old woman with dermoid cyst. Histology shows? | A. Ectodermal tissue | B. Endodermal | C. Mesodermal | D. None | A. Ectodermal derivatives (hair, teeth) |
| A 35-year-old woman with postmenopausal bleeding, thickened endometrium. Next step? | A. Endometrial biopsy | B. TVS | C. Pap smear | D. D&C | A. Endometrial biopsy |
| A 60-year-old woman with adnexal mass, omental cake. Diagnosis? | A. Ovarian carcinoma | B. Endometrial | C. Cervical | D. GI metastasis | A. Advanced ovarian carcinoma |
| A 25-year-old woman with molar pregnancy. Follow-up test? | A. Weekly β-hCG | B. Ultrasound | C. CA-125 | D. FSH | A. Serial weekly β-hCG until negative |
| A 28-year-old woman with molar pregnancy, high hCG after evacuation. Diagnosis? | A. Invasive mole | B. Choriocarcinoma | C. Normal regression | D. Partial mole | A. Invasive mole |
| A 30-year-old woman with molar pregnancy and metastasis to lung. Diagnosis? | A. Choriocarcinoma | B. Invasive mole | C. Complete mole | D. Partial mole | A. Choriocarcinoma |
| A 32-year-old woman with choriocarcinoma, no metastasis. Treatment? | A. Methotrexate | B. Surgery | C. Radiation | D. Observe | A. Methotrexate chemotherapy |
| A 35-year-old woman with hydatidiform mole. Chromosome type? | A. 46 XX paternal | B. 69 XXX | C. 46 XY maternal | D. 47 XXY | A. Diploid 46 XX paternal origin (complete mole) |
| A 28-year-old woman with partial mole. Karyotype? | A. 69 XXY | B. 46 XX | C. 46 XY | D. 45 XO | A. Triploid 69 XXY (partial mole) |
| A 25-year-old woman post-mole evacuation, contraception recommended. Duration? | A. 6 months | B. 12 months | C. 3 months | D. None | B. Avoid pregnancy ≥ 12 months |
| A 27-year-old woman with complete mole, snowstorm USG. Diagnosis confirmed by? | A. β-hCG | B. Biopsy | C. CT | D. MRI | A. Very high β-hCG |
| A 25-year-old woman with choriocarcinoma, metastasis to lungs. Management? | A. Chemotherapy | B. Surgery | C. Radiation | D. Observe | A. Chemotherapy (methotrexate-based) |
| A 25-year-old woman presents with amenorrhea for 6 weeks and positive pregnancy test. Next step? | A. Ultrasound | B. β-hCG | C. Pelvic exam | D. Wait and repeat test | A. Transvaginal ultrasound to confirm intrauterine pregnancy |
| A 30-year-old pregnant woman with vaginal bleeding, closed cervix. Diagnosis? | A. Threatened abortion | B. Inevitable | C. Incomplete | D. Missed | A. Threatened abortion |
| A 32-year-old woman with vaginal bleeding, open cervix, products seen. Diagnosis? | A. Incomplete abortion | B. Inevitable | C. Threatened | D. Missed | A. Incomplete abortion |
| A 35-year-old woman with absent fetal heart, closed cervix, retained products. Diagnosis? | A. Missed abortion | B. Complete | C. Inevitable | D. Threatened | A. Missed abortion |
| A 40-year-old woman with repeated pregnancy loss at 8–10 weeks. Cause? | A. Luteal phase defect | B. Cervical incompetence | C. Infection | D. Thrombosis | A. Luteal phase defect |
| A 25-year-old woman with amenorrhea, lower abdominal pain, shoulder pain, and positive pregnancy test. Diagnosis? | A. Ectopic pregnancy | B. Abortion | C. PID | D. Ovarian cyst | A. Ruptured ectopic pregnancy |
| A 30-year-old woman with ectopic pregnancy, hemodynamically stable. Management? | A. Methotrexate | B. Laparotomy | C. Observation | D. D&C | A. Medical management with methotrexate |
| A 32-year-old G2P1 with vaginal bleeding, uterus larger than gestational age, snowstorm on US. Diagnosis? | A. Molar pregnancy | B. Missed abortion | C. Twin pregnancy | D. Fibroid | A. Hydatidiform mole |
| A 28-year-old post-evacuation of mole, β-hCG remains high. Diagnosis? | A. Choriocarcinoma | B. Twin | C. Persistent mole | D. Ectopic | A. Gestational trophoblastic neoplasia (choriocarcinoma) |
| A 24-year-old with hyperemesis, hypertension, uterus > gestational age. Diagnosis? | A. Molar pregnancy | B. Ectopic | C. Missed abortion | D. Pre-eclampsia | A. Hydatidiform mole |
| A 26-year-old at 30 weeks with BP 160/110, proteinuria, edema. Diagnosis? | A. Pre-eclampsia | B. Eclampsia | C. Chronic HTN | D. Gestational HTN | A. Severe pre-eclampsia |
| A 27-year-old woman with convulsions, hypertension, and proteinuria. Diagnosis? | A. Eclampsia | B. Epilepsy | C. Pre-eclampsia | D. Stroke | A. Eclampsia |
| A 28-year-old woman with pre-eclampsia. Drug for seizure prophylaxis? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Midazolam | A. Magnesium sulfate |
| A 32-year-old primigravida with BP 150/95 after 20 weeks, no proteinuria. Diagnosis? | A. Gestational hypertension | B. Chronic | C. Pre-eclampsia | D. Eclampsia | A. Gestational hypertension |
| A 35-year-old woman with painless vaginal bleeding at 32 weeks. Diagnosis? | A. Placenta previa | B. Abruption | C. Vasa previa | D. Preterm labor | A. Placenta previa |
| A 28-year-old at 34 weeks with painful bleeding, tender uterus. Diagnosis? | A. Placental abruption | B. Placenta previa | C. Rupture | D. Preterm labor | A. Placental abruption |
| A 29-year-old woman in labor with vaginal bleeding, fetal distress, and loss of station. Diagnosis? | A. Uterine rupture | B. Abruption | C. Placenta previa | D. Cord prolapse | A. Uterine rupture |
| A 30-year-old woman with cord visible at introitus, fetal bradycardia. Diagnosis? | A. Cord prolapse | B. Uterine rupture | C. Abruption | D. Placenta previa | A. Umbilical cord prolapse |
| A 28-year-old woman with preterm labor, no cervical dilation, irregular contractions. Diagnosis? | A. False labor | B. True labor | C. Placenta previa | D. Abruption | A. False labor |
| A 30-year-old at 39 weeks with regular contractions and cervical dilation. Diagnosis? | A. True labor | B. False labor | C. Abruption | D. Placenta previa | A. True labor |
| A 25-year-old primigravida at 40 weeks with prolonged labor, fetal distress. Management? | A. Emergency C-section | B. Induction | C. Observe | D. Forceps | A. Emergency cesarean section |
| A 30-year-old with head not descending, caput formation, molding. Diagnosis? | A. Cephalopelvic disproportion | B. Malpresentation | C. Obstructed labor | D. Prolonged labor | A. Cephalopelvic disproportion |
| A 25-year-old with retained placenta after 30 minutes, bleeding. Management? | A. Manual removal | B. Oxytocin | C. Wait | D. Massage | A. Manual removal of placenta |
| A 32-year-old woman with postpartum hemorrhage due to uterine atony. Management? | A. Uterine massage + oxytocin | B. Manual removal | C. Antibiotic | D. Surgery | A. Massage and uterotonic agents |
| A 28-year-old woman with postpartum hemorrhage not controlled by drugs. Next step? | A. Uterine artery ligation | B. Hysterectomy | C. Balloon tamponade | D. Observe | C. Balloon tamponade or surgical ligation if refractory |
| A 35-year-old woman with fever, foul lochia after delivery. Diagnosis? | A. Puerperal sepsis | B. Endometriosis | C. UTI | D. Mastitis | A. Puerperal sepsis |
| A 25-year-old woman with painful breast swelling during lactation. Diagnosis? | A. Mastitis | B. Abscess | C. Galactocele | D. Carcinoma | A. Lactational mastitis |
| A 28-year-old lactating woman with fluctuant tender lump, pus. Diagnosis? | A. Breast abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma | A. Breast abscess |
| A 26-year-old woman with excessive bleeding, uterus large after delivery. Diagnosis? | A. Retained products | B. Uterine atony | C. Trauma | D. Coagulopathy | A. Retained products of conception |
| A 30-year-old woman with tender uterus, foul-smelling lochia, fever. Diagnosis? | A. Endometritis | B. Mastitis | C. Retained placenta | D. Wound infection | A. Puerperal endometritis |
| A 29-year-old woman 3 months postpartum with inability to breastfeed, amenorrhea. Diagnosis? | A. Sheehan syndrome | B. PPH | C. Asherman | D. Pituitary adenoma | A. Sheehan’s syndrome (pituitary necrosis) |
| A 35-year-old woman with infertility, amenorrhea after D&C. Diagnosis? | A. Asherman syndrome | B. PCOS | C. Pituitary failure | D. Sheehan | A. Intrauterine adhesions (Asherman) |
| A 25-year-old woman with secondary amenorrhea, galactorrhea, headache. Diagnosis? | A. Prolactinoma | B. PCOS | C. Sheehan | D. Hypothyroidism | A. Pituitary prolactinoma |
| A 30-year-old woman with irregular menses, hirsutism, obesity, infertility. Diagnosis? | A. PCOS | B. Hypothyroidism | C. Hyperprolactinemia | D. CAH | A. Polycystic ovary syndrome |
| A 26-year-old woman with dysmenorrhea, dyspareunia, infertility. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. Fibroid | A. Endometriosis |
| A 35-year-old woman with heavy painful menses, enlarged tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. PID | A. Adenomyosis |
| A 40-year-old woman with heavy painless bleeding, irregular enlargement of uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial cancer | D. DUB | A. Uterine fibroids (leiomyoma) |
| A 30-year-old woman with irregular menses, acne, hirsutism, and infertility. Diagnosis? | A. PCOS | B. Cushing | C. CAH | D. Thyroid disorder | A. Polycystic ovary syndrome |
| A 25-year-old woman with amenorrhea, low FSH/LH, normal prolactin. Diagnosis? | A. Hypothalamic amenorrhea | B. PCOS | C. Premature ovarian failure | D. Sheehan | A. Hypothalamic amenorrhea |
| A 35-year-old woman with hot flashes, amenorrhea, high FSH/LH. Diagnosis? | A. Premature ovarian failure | B. Sheehan | C. PCOS | D. Hypothyroid | A. Premature ovarian failure |
| A 28-year-old woman with primary infertility, regular cycles, open tubes. Next step? | A. Semen analysis | B. Ovulation test | C. HSG | D. Laparoscopy | A. Semen analysis (first-line test in infertility) |
| A 32-year-old woman with secondary infertility, HSG shows tubal block. Management? | A. IVF | B. Clomiphene | C. IUI | D. Ovarian drilling | A. In vitro fertilization |
| A 25-year-old woman with vaginal discharge, “strawberry cervix.” Organism? | A. Trichomonas | B. Candida | C. Gardnerella | D. Chlamydia | A. Trichomonas vaginalis |
| A 30-year-old woman with curdy white vaginal discharge, itching. Diagnosis? | A. Candidiasis | B. Trichomonas | C. BV | D. Chlamydia | A. Vulvovaginal candidiasis |
| A 28-year-old woman with thin fishy discharge, clue cells on microscopy. Diagnosis? | A. Bacterial vaginosis | B. Trichomonas | C. Candida | D. Gonorrhea | A. Bacterial vaginosis (Gardnerella vaginalis) |
| A 24-year-old woman with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Candida | D. Trichomonas | A. Pelvic inflammatory disease |
| A 26-year-old woman with lower abdominal pain, fever, adnexal tenderness. Diagnosis? | A. PID | B. Ectopic | C. Ovarian torsion | D. Endometriosis | A. Pelvic inflammatory disease |
| A 35-year-old woman with adnexal mass, twisting pain, vomiting. Diagnosis? | A. Ovarian torsion | B. Ectopic | C. PID | D. Fibroid | A. Ovarian torsion |
| A 30-year-old woman with sudden unilateral lower abdominal pain mid-cycle. Diagnosis? | A. Mittelschmerz | B. Ectopic | C. Ovarian torsion | D. PID | A. Mittelschmerz (ovulation pain) |
| A 40-year-old woman with cyclic pelvic pain, dyspareunia, infertility. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PID | D. Fibroid | A. Endometriosis |
| A 45-year-old woman with heavy painful menses, tender bulky uterus. Diagnosis? | A. Adenomyosis | B. Fibroid | C. Endometriosis | D. DUB | A. Adenomyosis |
| A 35-year-old woman with menorrhagia, irregularly enlarged uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Uterine fibroid (leiomyoma) |
| A 45-year-old woman with intermenstrual bleeding, endometrial thickness > 12 mm. Diagnosis? | A. Endometrial hyperplasia | B. Cancer | C. Polyp | D. DUB | A. Endometrial hyperplasia |
| A 55-year-old postmenopausal woman with vaginal bleeding. Next step? | A. Endometrial biopsy | B. Pap smear | C. US | D. Hysteroscopy | A. Endometrial sampling to rule out malignancy |
| A 60-year-old woman with vulvar itching, white patches, loss of architecture. Diagnosis? | A. Lichen sclerosus | B. Lichen planus | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus (atrophic vulvitis) |
| A 35-year-old woman with post-coital bleeding, friable cervix. Next step? | A. Pap smear | B. HPV test | C. Colposcopy | D. Biopsy | A. Pap smear for screening |
| A 40-year-old woman with abnormal Pap smear showing HSIL. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV vaccine | D. Observe | A. Colposcopy with directed biopsy |
| A 30-year-old woman with ASC-US Pap smear. Next step? | A. HPV testing | B. Colposcopy | C. Repeat Pap in 6 months | D. Cone biopsy | A. HPV testing for triage |
| A 28-year-old woman with multiple painful vesicles on vulva. Diagnosis? | A. HSV infection | B. HPV | C. Syphilis | D. Chancroid | A. Genital herpes (HSV type 2) |
| A 26-year-old woman with painless genital ulcer, indurated edges. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis (chancre) |
| A 24-year-old woman with painful ulcer, ragged edges, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. HSV | D. LGV | A. Chancroid (Haemophilus ducreyi) |
| A 30-year-old woman with painless ulcer, later buboes. Diagnosis? | A. Lymphogranuloma venereum | B. Chancroid | C. Syphilis | D. HSV | A. LGV (Chlamydia L1-L3) |
| A 25-year-old woman with cauliflower-like growth on vulva. Diagnosis? | A. Genital warts | B. Syphilis | C. Chancroid | D. HSV | A. Condyloma acuminata (HPV 6, 11) |
| A 50-year-old woman with abdominal mass, ascites, CA-125 elevated. Diagnosis? | A. Ovarian cancer | B. Fibroid | C. Endometrial CA | D. Cyst | A. Epithelial ovarian carcinoma |
| A 55-year-old woman with postmenopausal bleeding, high CA-125. Diagnosis? | A. Ovarian CA | B. Endometrial CA | C. Cervical CA | D. Vaginal CA | A. Ovarian carcinoma |
| A 45-year-old woman with contact bleeding, foul discharge, ulcerative cervix. Diagnosis? | A. Cervical cancer | B. Endometrial CA | C. PID | D. Erosion | A. Cervical carcinoma |
| A 60-year-old woman with vaginal bleeding, enlarged uterus, high estrogen history. Diagnosis? | A. Endometrial carcinoma | B. Cervical CA | C. Ovarian CA | D. Vaginal CA | A. Endometrial adenocarcinoma |
| A 55-year-old woman with vulvar mass, itching, ulcer. Diagnosis? | A. Vulvar carcinoma | B. Bartholin cyst | C. Lichen planus | D. Condyloma | A. Squamous cell carcinoma of vulva |
| A 40-year-old woman with post-coital bleeding, Pap smear normal. Next step? | A. Colposcopy | B. Repeat Pap | C. HPV test | D. Observe | A. Colposcopic evaluation |
| A 30-year-old woman wanting contraception, also for dysmenorrhea. Choice? | A. Combined OCP | B. Barrier | C. Copper IUD | D. DMPA | A. Combined oral contraceptive pills |
| A 25-year-old postpartum woman breastfeeding, wants contraception. Choice? | A. Progestin-only pill | B. Combined OCP | C. Copper IUD | D. Barrier | A. Progestin-only (minipill) |
| A 28-year-old woman G3P3 wants permanent contraception. Method? | A. Tubal ligation | B. Cu-T | C. Vasectomy | D. Implant | A. Tubal ligation |
| A 30-year-old man wants permanent contraception. Method? | A. Vasectomy | B. Condom | C. Implant | D. Pill | A. Vasectomy |
| A 25-year-old woman with heavy menstrual bleeding, normal uterus on US. Diagnosis? | A. DUB | B. Fibroid | C. Adenomyosis | D. Polyp | A. Dysfunctional uterine bleeding (anovulatory) |
| A 35-year-old woman with infertility, chocolate cysts on ovary. Diagnosis? | A. Endometriosis | B. PCOS | C. Fibroid | D. Adenomyosis | A. Endometriosis |
| A 30-year-old woman with vaginal itching, curdy discharge, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Chlamydia | A. Candidiasis |
| A 25-year-old woman with primary amenorrhea, normal breast, absent uterus. Diagnosis? | A. Mayer-Rokitansky syndrome | B. Androgen insensitivity | C. Turner | D. Hypogonadism | A. Müllerian agenesis (Mayer-Rokitansky-Küster-Hauser syndrome) |
| A 18-year-old girl with primary amenorrhea, tall, scanty hair, testes palpable. Diagnosis? | A. Androgen insensitivity | B. MRKH | C. CAH | D. Turner | A. Androgen insensitivity (testicular feminization) |
| A 16-year-old girl with short stature, webbed neck, streak gonads. Diagnosis? | A. Turner syndrome | B. Klinefelter | C. CAH | D. MRKH | A. Turner syndrome (45,XO) |
| A 22-year-old woman with ambiguous genitalia, high 17-hydroxyprogesterone. Diagnosis? | A. Congenital adrenal hyperplasia | B. Androgen insensitivity | C. PCOS | D. Turner | A. CAH (21-hydroxylase deficiency) |
| A 25-year-old with secondary amenorrhea, hot flushes, high FSH/LH. Diagnosis? | A. Premature ovarian failure | B. PCOS | C. Hypothyroid | D. Sheehan | A. Premature ovarian insufficiency |
| A 30-year-old with oligomenorrhea, hirsutism, obesity, normal prolactin. Diagnosis? | A. PCOS | B. Cushing | C. CAH | D. Thyroid | A. Polycystic ovary syndrome |
| A 28-year-old woman with galactorrhea, amenorrhea, high prolactin. Diagnosis? | A. Prolactinoma | B. Sheehan | C. PCOS | D. Hypothyroid | A. Pituitary prolactinoma |
| A 35-year-old woman with infertility, hysterosalpingogram shows bilateral block. Next step? | A. IVF | B. IUI | C. Clomiphene | D. Ovarian drilling | A. IVF (in-vitro fertilization) |
| A 25-year-old with mid-cycle pain, normal exam. Diagnosis? | A. Mittelschmerz | B. Ovarian torsion | C. PID | D. Ectopic | A. Mittelschmerz |
| A 28-year-old woman with tender unilateral mass, fever, adnexal tenderness. Diagnosis? | A. PID | B. Ovarian torsion | C. Endometrioma | D. Ectopic | A. Pelvic inflammatory disease |
| A 30-year-old woman with sudden severe pelvic pain, vomiting, adnexal mass. Diagnosis? | A. Ovarian torsion | B. Ectopic | C. PID | D. Endometriosis | A. Ovarian torsion |
| A 35-year-old woman with chocolate cysts on ovary, infertility. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. PCOS | D. Fibroid | A. Endometriosis |
| A 40-year-old with heavy bleeding, enlarged irregular uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Leiomyoma (uterine fibroid) |
| A 45-year-old with heavy menses, uniformly enlarged tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. PID | A. Adenomyosis |
| A 28-year-old with thin fishy discharge, clue cells. Diagnosis? | A. Bacterial vaginosis | B. Trichomonas | C. Candida | D. Gonorrhea | A. Bacterial vaginosis |
| A 25-year-old with curdy white discharge, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Chlamydia | A. Vulvovaginal candidiasis |
| A 27-year-old with frothy green discharge, strawberry cervix. Diagnosis? | A. Trichomonas | B. BV | C. Candida | D. Gonorrhea | A. Trichomonas vaginalis infection |
| A 22-year-old with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Trichomonas | D. Candida | A. Pelvic inflammatory disease |
| A 30-year-old woman with post-coital bleeding, friable cervix. Next step? | A. Pap smear | B. Colposcopy | C. Biopsy | D. HPV test | A. Pap smear |
| A 45-year-old with abnormal Pap showing HSIL. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV vaccine | D. Observe | A. Colposcopy with directed biopsy |
| A 30-year-old with ASC-US Pap result. Next step? | A. HPV test | B. Repeat Pap | C. Colposcopy | D. Cone biopsy | A. High-risk HPV testing |
| A 40-year-old with ulcerative cervix, contact bleeding. Diagnosis? | A. Cervical cancer | B. Erosion | C. Polyp | D. PID | A. Cervical carcinoma |
| A 55-year-old with postmenopausal bleeding, CA-125 normal. Diagnosis? | A. Endometrial cancer | B. Ovarian CA | C. Cervical CA | D. DUB | A. Endometrial adenocarcinoma |
| A 50-year-old with abdominal mass, ascites, CA-125 elevated. Diagnosis? | A. Ovarian carcinoma | B. Fibroid | C. Endometrial CA | D. Cyst | A. Epithelial ovarian cancer |
| A 60-year-old with vulvar itching, white patches, loss of architecture. Diagnosis? | A. Lichen sclerosus | B. Vulvar CA | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with vulvar ulcer, bleeding, hard edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Infection | D. Bartholin cyst | A. Squamous cell carcinoma of vulva |
| A 28-year-old woman with cauliflower-like growth on vulva. Diagnosis? | A. Genital warts (HPV 6, 11) | B. Syphilis | C. HSV | D. Chancroid | A. Condyloma acuminata |
| A 30-year-old woman on combined OCP for 3 years, comes with HTN and migraine. Next step? | A. Stop COC | B. Continue | C. Switch to Cu-T | D. Add DMPA | A. Discontinue OCP and switch to non-estrogen method |
| A 25-year-old breastfeeding mother wants contraception. Choice? | A. Progestin-only pill | B. COC | C. IUD | D. Barrier | A. Progestin-only (minipill) |
| A 30-year-old woman with IUD, missed period, abdominal pain. Diagnosis? | A. Ectopic pregnancy | B. Molar | C. Threatened | D. Missed | A. Ectopic pregnancy |
| A 27-year-old with pre-eclampsia. Drug for seizure prophylaxis? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Phenobarbital | A. Magnesium sulfate |
| A 29-year-old with postpartum bleeding uncontrolled by oxytocin. Next step? | A. Balloon tamponade | B. Hysterectomy | C. Uterine massage | D. Uterine artery ligation | A. Balloon tamponade or surgical ligation if needed |
| A 30-year-old with retained placenta after delivery. Next step? | A. Manual removal | B. Oxytocin | C. Massage | D. Observe | A. Manual removal of placenta |
| A 32-year-old postpartum woman with amenorrhea, inability to breastfeed. Diagnosis? | A. Sheehan syndrome | B. Asherman | C. PCOS | D. Prolactinoma | A. Pituitary necrosis (Sheehan’s syndrome) |
| A 25-year-old primigravida at 39 weeks presents with regular contractions and cervical dilation. Diagnosis? | A. True labor | B. False labor | C. Placenta previa | D. Preterm labor | A. True labor |
| A 28-year-old woman at 36 weeks with irregular contractions and no cervical change. Diagnosis? | A. False labor | B. True labor | C. Abruption | D. Preterm labor | A. False labor |
| A 32-year-old woman with painful contractions and cervix dilated at 30 weeks. Diagnosis? | A. Preterm labor | B. False labor | C. Threatened abortion | D. Incompetent cervix | A. Preterm labor |
| A 29-year-old woman with history of second-trimester losses, painless dilation. Diagnosis? | A. Cervical incompetence | B. Preterm labor | C. Abruption | D. Threatened abortion | A. Cervical incompetence |
| A 28-year-old woman at 28 weeks with BP 150/100, proteinuria, edema. Diagnosis? | A. Pre-eclampsia | B. Gestational HTN | C. Eclampsia | D. Chronic HTN | A. Pre-eclampsia |
| A 30-year-old woman with seizures, hypertension, and proteinuria. Diagnosis? | A. Eclampsia | B. Pre-eclampsia | C. Epilepsy | D. Stroke | A. Eclampsia |
| A 32-year-old woman with eclampsia. Drug of choice? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Midazolam | A. Magnesium sulfate |
| A 35-year-old woman with BP 160/110 and headache at 34 weeks. Management? | A. Hospitalize + magnesium + delivery | B. Observe | C. Delay delivery | D. Antihypertensive only | A. Control BP, magnesium sulfate, plan delivery |
| A 26-year-old at 33 weeks with painless vaginal bleeding, soft uterus. Diagnosis? | A. Placenta previa | B. Abruption | C. Vasa previa | D. Preterm labor | A. Placenta previa |
| A 30-year-old at 36 weeks with painful bleeding, tender uterus, fetal distress. Diagnosis? | A. Placental abruption | B. Placenta previa | C. Uterine rupture | D. Cord prolapse | A. Abruptio placentae |
| A 29-year-old in labor with sudden pain, loss of fetal station, maternal shock. Diagnosis? | A. Uterine rupture | B. Abruption | C. Cord prolapse | D. Placenta previa | A. Uterine rupture |
| A 28-year-old with visible umbilical cord at introitus, fetal bradycardia. Diagnosis? | A. Cord prolapse | B. Uterine rupture | C. Abruption | D. Placenta previa | A. Umbilical cord prolapse |
| A 30-year-old with retained placenta and bleeding 30 min after delivery. Management? | A. Manual removal | B. Wait | C. Massage | D. Oxytocin | A. Manual removal of placenta |
| A 32-year-old woman with postpartum hemorrhage, uterus soft. Diagnosis? | A. Uterine atony | B. Trauma | C. Retained placenta | D. Coagulopathy | A. Uterine atony |
| A 35-year-old woman with postpartum hemorrhage unresponsive to uterotonics. Next step? | A. Balloon tamponade | B. Uterine artery ligation | C. Hysterectomy | D. Observe | A. Balloon tamponade or surgical ligation if needed |
| A 25-year-old woman with fever, foul-smelling lochia after delivery. Diagnosis? | A. Puerperal sepsis | B. Endometritis | C. UTI | D. Mastitis | A. Puerperal sepsis |
| A 28-year-old woman postpartum with tender uterus, foul lochia, fever. Diagnosis? | A. Endometritis | B. Mastitis | C. Retained placenta | D. Wound infection | A. Puerperal endometritis |
| A 27-year-old woman 2 weeks postpartum with painful breast swelling. Diagnosis? | A. Lactational mastitis | B. Abscess | C. Galactocele | D. Fibrocystic | A. Mastitis |
| A 28-year-old lactating woman with fluctuant tender lump and pus. Diagnosis? | A. Breast abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma | A. Breast abscess |
| A 29-year-old woman 3 months postpartum with failure to lactate, amenorrhea. Diagnosis? | A. Sheehan syndrome | B. Asherman | C. PCOS | D. Hypothyroid | A. Pituitary necrosis (Sheehan’s syndrome) |
| A 32-year-old woman with infertility, amenorrhea after D&C. Diagnosis? | A. Asherman syndrome | B. PCOS | C. Sheehan | D. Hyperprolactinemia | A. Intrauterine adhesions (Asherman) |
| A 25-year-old woman with galactorrhea, amenorrhea, headache. Diagnosis? | A. Prolactinoma | B. PCOS | C. Sheehan | D. Hypothyroidism | A. Pituitary prolactinoma |
| A 30-year-old woman with irregular cycles, obesity, hirsutism. Diagnosis? | A. PCOS | B. Hypothyroidism | C. Cushing | D. CAH | A. Polycystic ovary syndrome |
| A 28-year-old woman with infertility, chocolate cyst on ovary. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroid | D. PID | A. Endometriosis |
| A 35-year-old woman with heavy bleeding, bulky tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. DUB | A. Adenomyosis |
| A 40-year-old woman with irregular heavy bleeding, enlarged irregular uterus. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Leiomyoma (fibroid) |
| A 55-year-old woman with postmenopausal bleeding. Next step? | A. Endometrial biopsy | B. Pap smear | C. USG | D. Observe | A. Endometrial sampling |
| A 45-year-old woman with post-coital bleeding, friable cervix. Next step? | A. Pap smear | B. Colposcopy | C. HPV test | D. Biopsy | A. Pap smear |
| A 50-year-old with Pap smear HSIL. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV vaccine | D. Observe | A. Colposcopy with biopsy |
| A 35-year-old woman with intermenstrual bleeding, endometrial thickness 14 mm. Diagnosis? | A. Endometrial hyperplasia | B. Endometrial cancer | C. DUB | D. Polyp | A. Endometrial hyperplasia |
| A 60-year-old woman with vulvar itching, white patches, loss of vulvar architecture. Diagnosis? | A. Lichen sclerosus | B. Vulvar CA | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with vulvar ulcer, indurated edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Infection | D. Bartholin cyst | A. Squamous cell carcinoma |
| A 25-year-old woman with cauliflower-like growth, HPV 6 and 11. Diagnosis? | A. Condyloma acuminata | B. HSV | C. Syphilis | D. Chancroid | A. Genital warts |
| A 40-year-old woman on OCP, comes with HTN and migraine. Next step? | A. Stop OCP | B. Continue | C. Switch to Cu-T | D. DMPA | A. Stop OCP and change to non-estrogen method |
| A 26-year-old breastfeeding woman seeking contraception. Best choice? | A. Progestin-only pill | B. Combined OCP | C. Cu-T | D. Condom | A. Progestin-only (minipill) |
| A 30-year-old woman wants long-term reversible contraception. Option? | A. Copper IUD | B. Barrier | C. Pill | D. Injection | A. Copper IUD |
| A 30-year-old woman with IUD and missed period. Next step? | A. Pregnancy test | B. Remove IUD | C. USG | D. Observe | A. Urine pregnancy test to rule out ectopic |
| A 25-year-old woman wants permanent contraception. Option? | A. Tubal ligation | B. Cu-T | C. Vasectomy | D. Implant | A. Tubal ligation |
| A 35-year-old man wants permanent contraception. Option? | A. Vasectomy | B. Condom | C. Implant | D. Pill | A. Vasectomy |
| A 30-year-old primigravida with breech presentation at 37 weeks. Next step? | A. External cephalic version | B. C-section | C. Wait | D. Induce labor | A. Attempt external cephalic version at 37 weeks if no contraindication |
| A 28-year-old woman with transverse lie in labor. Management? | A. Cesarean section | B. Version | C. Forceps | D. Observe | A. Cesarean section |
| A 25-year-old at 32 weeks with multiple pregnancies, uterine size larger than expected. Diagnosis? | A. Twin pregnancy | B. Molar | C. Polyhydramnios | D. Fibroid | A. Twin gestation |
| A 29-year-old with polyhydramnios. Associated fetal anomaly? | A. Esophageal atresia | B. Renal agenesis | C. Cardiac defect | D. Anencephaly | A. Esophageal atresia or anencephaly |
| A 30-year-old woman with oligohydramnios. Associated condition? | A. Renal agenesis | B. TEF | C. Anencephaly | D. Cardiac defect | A. Bilateral renal agenesis |
| A 27-year-old G2P1 with macrosomia, polyhydramnios, glucose intolerance. Diagnosis? | A. Gestational diabetes | B. PIH | C. Pre-eclampsia | D. Twin | A. Gestational diabetes mellitus |
| A 32-year-old diabetic pregnant woman with large baby, shoulder dystocia. Complication? | A. Brachial plexus injury | B. Uterine rupture | C. Cord prolapse | D. Placenta previa | A. Erb’s palsy (brachial plexus injury) |
| A 25-year-old woman in labor with excessive bleeding after delivery, soft uterus. Diagnosis? | A. Uterine atony | B. Retained placenta | C. Trauma | D. Coagulopathy | A. Uterine atony |
| A 35-year-old with postpartum bleeding, uterus firm, laceration present. Diagnosis? | A. Genital tract trauma | B. Atony | C. Retained placenta | D. DIC | A. Genital tract laceration |
| A 30-year-old woman with postpartum hemorrhage not responding to uterotonics. Next step? | A. Balloon tamponade | B. Uterine artery ligation | C. Hysterectomy | D. Observe | A. Balloon tamponade, if fails → surgical ligation |
| A 29-year-old woman with persistent postpartum bleeding, uterus well-contracted. Diagnosis? | A. Retained products | B. Atony | C. Trauma | D. Coagulopathy | A. Retained products of conception |
| A 27-year-old woman with fever, foul lochia, uterine tenderness. Diagnosis? | A. Puerperal endometritis | B. Mastitis | C. Retained placenta | D. Sepsis | A. Postpartum endometritis |
| A 25-year-old postpartum woman with painful breast lump, erythema, fever. Diagnosis? | A. Mastitis | B. Abscess | C. Fibroadenoma | D. Cancer | A. Lactational mastitis |
| A 30-year-old woman with breast abscess, fluctuance, pus. Management? | A. Incision and drainage | B. Antibiotics only | C. Observe | D. Needle aspirate | A. Surgical drainage + antibiotics |
| A 32-year-old with postpartum inability to lactate and amenorrhea. Diagnosis? | A. Sheehan syndrome | B. PCOS | C. Asherman | D. Hypothyroidism | A. Pituitary necrosis (Sheehan’s) |
| A 29-year-old with secondary amenorrhea, infertility after D&C. Diagnosis? | A. Asherman syndrome | B. PCOS | C. Sheehan | D. Prolactinoma | A. Asherman syndrome (intrauterine adhesions) |
| A 24-year-old woman with primary amenorrhea, normal breasts, absent uterus. Diagnosis? | A. MRKH | B. Androgen insensitivity | C. Turner | D. Hypothalamic | A. Müllerian agenesis (MRKH) |
| A 18-year-old girl with tall stature, sparse hair, testes palpable. Diagnosis? | A. Androgen insensitivity | B. Turner | C. MRKH | D. CAH | A. Testicular feminization syndrome |
| A 16-year-old with short stature, webbed neck, streak gonads. Diagnosis? | A. Turner | B. MRKH | C. CAH | D. Hypogonadism | A. Turner syndrome |
| A 26-year-old with infertility, high FSH/LH, low estrogen. Diagnosis? | A. Premature ovarian failure | B. PCOS | C. Hypothalamic | D. Sheehan | A. Premature ovarian failure |
| A 30-year-old woman with hirsutism, obesity, anovulation. Diagnosis? | A. PCOS | B. CAH | C. Cushing | D. Thyroid | A. Polycystic ovary syndrome |
| A 35-year-old woman with hot flashes, FSH > 40, LH high. Diagnosis? | A. Premature ovarian failure | B. Menopause | C. PCOS | D. Hypogonadism | A. Premature ovarian insufficiency |
| A 50-year-old woman with vaginal dryness, hot flashes, and amenorrhea. Diagnosis? | A. Menopause | B. Premature ovarian failure | C. Hypothyroidism | D. PCOS | A. Menopause |
| A 55-year-old postmenopausal woman with vaginal bleeding. First step? | A. Endometrial biopsy | B. Pap smear | C. USG | D. Observe | A. Endometrial sampling to rule out malignancy |
| A 45-year-old woman with irregular bleeding, thick endometrium. Diagnosis? | A. Endometrial hyperplasia | B. Cancer | C. DUB | D. Polyp | A. Endometrial hyperplasia |
| A 60-year-old woman with postmenopausal bleeding, high estrogen exposure. Diagnosis? | A. Endometrial carcinoma | B. Cervical CA | C. Ovarian CA | D. Vaginal CA | A. Endometrial adenocarcinoma |
| A 45-year-old woman with contact bleeding, foul discharge, ulcerated cervix. Diagnosis? | A. Cervical cancer | B. PID | C. Erosion | D. Polyp | A. Cervical carcinoma |
| A 50-year-old woman with postmenopausal bleeding, mass in ovary, CA-125 elevated. Diagnosis? | A. Ovarian carcinoma | B. Fibroid | C. Endometrial CA | D. Cyst | A. Epithelial ovarian carcinoma |
| A 60-year-old woman with vulvar itching, white patch, lichenified skin. Diagnosis? | A. Lichen sclerosus | B. Vulvar CA | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with ulcerated vulvar mass, indurated edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Bartholin cyst | D. HSV | A. Squamous cell carcinoma of vulva |
| A 30-year-old woman with cauliflower-like genital growth. Diagnosis? | A. HPV condyloma | B. HSV | C. Syphilis | D. Chancroid | A. Condyloma acuminata (HPV 6, 11) |
| A 28-year-old with painful vesicular genital lesions. Diagnosis? | A. HSV infection | B. Syphilis | C. Chancroid | D. LGV | A. Genital herpes simplex infection |
| A 26-year-old with painless ulcer, indurated edges, serous discharge. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis (chancre) |
| A 24-year-old with painful ulcer, ragged edges, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. LGV | D. HSV | A. Chancroid (H. ducreyi) |
| A 30-year-old with painless ulcer, then inguinal buboes. Diagnosis? | A. Lymphogranuloma venereum | B. Chancroid | C. Syphilis | D. HSV | A. LGV (C. trachomatis L1-L3) |
| A 25-year-old woman with dysuria, vaginal discharge, clue cells. Diagnosis? | A. Bacterial vaginosis | B. Candida | C. Trichomonas | D. Chlamydia | A. Bacterial vaginosis |
| A 27-year-old woman with thick curdy discharge, intense itching, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Gonorrhea | A. Vulvovaginal candidiasis |
| A 30-year-old with frothy discharge, strawberry cervix, motile organisms on wet mount. Diagnosis? | A. Trichomonas | B. BV | C. Candida | D. HSV | A. Trichomonas vaginalis |
| A 26-year-old woman with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Candida | D. Trichomonas | A. Pelvic inflammatory disease |
| A 25-year-old woman with positive pregnancy test, abdominal pain, shock. Diagnosis? | A. Ruptured ectopic pregnancy | B. Miscarriage | C. Ovarian cyst | D. PID | A. Ruptured tubal pregnancy |
| A 30-year-old woman with amenorrhea, spotting, β-hCG ↑, empty uterus on US. Diagnosis? | A. Ectopic pregnancy | B. Threatened abortion | C. Molar | D. Normal | A. Unruptured ectopic pregnancy |
| A 26-year-old with uterus larger than dates, β-hCG ↑↑, snowstorm US. Diagnosis? | A. Hydatidiform mole | B. Twins | C. Abortion | D. Fibroid | A. Molar pregnancy |
| A 25-year-old after molar evacuation, β-hCG remains high. Diagnosis? | A. Choriocarcinoma | B. Persistent mole | C. Ectopic | D. Normal | A. Gestational trophoblastic neoplasia |
| A 28-year-old with hyperemesis and BP 160/100 at 12 weeks. Diagnosis? | A. Molar pregnancy | B. Pre-eclampsia | C. Ectopic | D. Twins | A. Hydatidiform mole |
| A 25-year-old woman with amenorrhea 6 weeks and positive pregnancy test. Next step? | A. Ultrasound | B. β-hCG | C. Pelvic exam | D. Wait and repeat test | A. Transvaginal ultrasound to confirm intrauterine pregnancy |
| A 30-year-old with vaginal bleeding, cervix closed. Diagnosis? | A. Threatened abortion | B. Inevitable | C. Incomplete | D. Missed | A. Threatened abortion |
| A 32-year-old with open cervix, products in cervical canal. Diagnosis? | A. Incomplete abortion | B. Inevitable | C. Threatened | D. Missed | A. Incomplete abortion |
| A 35-year-old woman with retained fetal tissue and no FHR. Diagnosis? | A. Missed abortion | B. Complete | C. Inevitable | D. Threatened | A. Missed abortion |
| A 40-year-old woman with ≥ 3 pregnancy losses at 8–10 weeks. Cause? | A. Luteal-phase defect | B. Cervical incompetence | C. Infection | D. Thrombophilia | A. Luteal-phase deficiency |
| A 26-year-old with amenorrhea, abdominal pain, shoulder pain, +β-hCG. Diagnosis? | A. Ectopic pregnancy | B. Abortion | C. PID | D. Cyst | A. Ruptured ectopic pregnancy |
| A 30-year-old stable ectopic pregnancy. Treatment? | A. Methotrexate | B. Laparotomy | C. D&C | D. Observe | A. Medical methotrexate therapy |
| A 32-year-old with uterus > dates, β-hCG high, snow-storm US. Diagnosis? | A. Molar pregnancy | B. Missed abortion | C. Twin | D. Fibroid | A. Hydatidiform mole |
| A 28-year-old post-molar evacuation, β-hCG remains elevated. Diagnosis? | A. Choriocarcinoma | B. Persistent mole | C. Ectopic | D. Normal | A. Gestational trophoblastic neoplasia |
| A 24-year-old with hyperemesis, HTN, uterus > dates. Diagnosis? | A. Molar pregnancy | B. Ectopic | C. Abortion | D. Twins | A. Hydatidiform mole |
| A 26-year-old G1P0 at 32 weeks with BP 150/100 and proteinuria. Diagnosis? | A. Pre-eclampsia | B. Gestational HTN | C. Eclampsia | D. Chronic HTN | A. Pre-eclampsia |
| A 27-year-old woman with seizures, HTN, proteinuria. Diagnosis? | A. Eclampsia | B. Pre-eclampsia | C. Epilepsy | D. Stroke | A. Eclampsia |
| A 30-year-old with pre-eclampsia. Drug for seizure prophylaxis? | A. Magnesium sulfate | B. Diazepam | C. Phenytoin | D. Phenobarbital | A. Magnesium sulfate |
| A 33-year-old primigravida at 36 weeks with BP 160/110, protein +, edema. Diagnosis? | A. Severe pre-eclampsia | B. Mild | C. Chronic HTN | D. Gestational HTN | A. Severe pre-eclampsia |
| A 32-year-old primigravida with BP 140/90 after 20 weeks, no proteinuria. Diagnosis? | A. Gestational hypertension | B. Chronic HTN | C. Pre-eclampsia | D. Eclampsia | A. Gestational hypertension |
| A 35-year-old woman at 32 weeks with painless bleeding, non-tender uterus. Diagnosis? | A. Placenta previa | B. Abruption | C. Rupture | D. Vasa previa | A. Placenta previa |
| A 28-year-old at 34 weeks with painful bleeding, tender uterus. Diagnosis? | A. Placental abruption | B. Placenta previa | C. Rupture | D. Cord prolapse | A. Abruptio placentae |
| A 29-year-old in labor with sudden pain, loss of station, shock. Diagnosis? | A. Uterine rupture | B. Abruption | C. Placenta previa | D. Cord prolapse | A. Uterine rupture |
| A 30-year-old in labor with cord visible at introitus, fetal bradycardia. Diagnosis? | A. Cord prolapse | B. Uterine rupture | C. Abruption | D. Previa | A. Umbilical cord prolapse |
| A 28-year-old at 30 weeks with regular contractions, cervix unchanged. Diagnosis? | A. False labor | B. True labor | C. Preterm | D. Threatened | A. False labor |
| A 30-year-old at term with regular painful contractions, cervical dilation. Diagnosis? | A. True labor | B. False labor | C. Abruption | D. Previa | A. True labor |
| A 25-year-old in labor with head not descending, caput and molding. Diagnosis? | A. Cephalopelvic disproportion | B. Malpresentation | C. Prolonged labor | D. Obstruction | A. Cephalopelvic disproportion |
| A 27-year-old woman with prolonged labor, fetal distress. Management? | A. Emergency C-section | B. Forceps | C. Observe | D. Induce | A. Emergency cesarean section |
| A 30-year-old with bleeding 30 min post-delivery, placenta retained. Next step? | A. Manual removal | B. Oxytocin | C. Massage | D. Observe | A. Manual removal of placenta |
| A 32-year-old with postpartum hemorrhage, soft boggy uterus. Diagnosis? | A. Uterine atony | B. Retained products | C. Trauma | D. Coagulopathy | A. Uterine atony |
| A 35-year-old with PPH not controlled by oxytocin. Next step? | A. Balloon tamponade | B. Uterine artery ligation | C. Hysterectomy | D. Observe | A. Balloon tamponade (then ligation if fails) |
| A 25-year-old with fever, foul lochia after delivery. Diagnosis? | A. Puerperal sepsis | B. Endometritis | C. UTI | D. Mastitis | A. Puerperal sepsis |
| A 28-year-old postpartum woman with tender uterus, foul discharge. Diagnosis? | A. Endometritis | B. Mastitis | C. Retained products | D. Wound infection | A. Puerperal endometritis |
| A 27-year-old woman 2 weeks postpartum with painful breast swelling. Diagnosis? | A. Mastitis | B. Abscess | C. Galactocele | D. Fibrocystic | A. Lactational mastitis |
| A 28-year-old lactating woman with fluctuant tender lump, pus. Diagnosis? | A. Breast abscess | B. Mastitis | C. Fibrocystic | D. Carcinoma | A. Breast abscess |
| A 29-year-old woman 3 months postpartum with failure to lactate, amenorrhea. Diagnosis? | A. Sheehan syndrome | B. Asherman | C. PCOS | D. Pituitary adenoma | A. Pituitary necrosis (Sheehan’s syndrome) |
| A 32-year-old woman with amenorrhea, galactorrhea, headache, and visual defect. Diagnosis? | A. Prolactinoma | B. PCOS | C. Sheehan | D. Hypothyroid | A. Pituitary prolactinoma |
| A 30-year-old woman with irregular menses, hirsutism, obesity, infertility. Diagnosis? | A. PCOS | B. Cushing | C. CAH | D. Hypothyroidism | A. Polycystic ovary syndrome |
| A 28-year-old woman with infertility and chocolate cyst on ovary. Diagnosis? | A. Endometriosis | B. Adenomyosis | C. Fibroid | D. PID | A. Endometriosis |
| A 35-year-old woman with heavy painful menses and bulky tender uterus. Diagnosis? | A. Adenomyosis | B. Endometriosis | C. Fibroid | D. DUB | A. Adenomyosis |
| A 40-year-old woman with heavy painless bleeding and irregular uterine enlargement. Diagnosis? | A. Fibroid | B. Adenomyosis | C. Endometrial CA | D. Polyp | A. Uterine fibroid (leiomyoma) |
| A 25-year-old woman with secondary amenorrhea, infertility after D&C. Diagnosis? | A. Asherman syndrome | B. Sheehan | C. PCOS | D. Premature ovarian failure | A. Intrauterine adhesions (Asherman’s syndrome) |
| A 30-year-old woman with secondary amenorrhea, hot flashes, high FSH/LH. Diagnosis? | A. Premature ovarian failure | B. PCOS | C. Hypothyroid | D. Sheehan | A. Premature ovarian insufficiency |
| A 35-year-old woman with infertility, bilateral tubal block on HSG. Next step? | A. IVF | B. Clomiphene | C. IUI | D. Ovarian drilling | A. In vitro fertilization |
| A 25-year-old woman with primary infertility, regular cycles, open tubes. Next step? | A. Semen analysis | B. Ovulation test | C. HSG | D. Laparoscopy | A. Husband semen analysis (first-line test) |
| A 30-year-old woman with strawberry cervix and green frothy discharge. Organism? | A. Trichomonas | B. Candida | C. Gardnerella | D. Chlamydia | A. Trichomonas vaginalis |
| A 25-year-old woman with curdy white discharge, itching, pH < 4.5. Diagnosis? | A. Candida | B. BV | C. Trichomonas | D. Gonorrhea | A. Vulvovaginal candidiasis |
| A 28-year-old woman with thin fishy discharge, clue cells on microscopy. Diagnosis? | A. Bacterial vaginosis | B. Trichomonas | C. Candida | D. Chlamydia | A. Gardnerella vaginalis (bacterial vaginosis) |
| A 24-year-old woman with mucopurulent discharge, cervical motion tenderness. Diagnosis? | A. PID | B. BV | C. Candida | D. Trichomonas | A. Pelvic inflammatory disease |
| A 30-year-old woman with severe lower abdominal pain, adnexal tenderness, fever. Diagnosis? | A. PID | B. Ovarian torsion | C. Endometriosis | D. Ectopic | A. Acute pelvic inflammatory disease |
| A 35-year-old woman with adnexal mass, twisting pain, vomiting. Diagnosis? | A. Ovarian torsion | B. PID | C. Cyst rupture | D. Ectopic | A. Ovarian torsion |
| A 28-year-old woman with mid-cycle pelvic pain, normal US. Diagnosis? | A. Mittelschmerz | B. PID | C. Ovarian torsion | D. Endometriosis | A. Ovulation (Mittelschmerz) |
| A 45-year-old woman with postcoital bleeding and friable cervix. Next step? | A. Pap smear | B. Colposcopy | C. Biopsy | D. HPV test | A. Pap smear for cervical screening |
| A 40-year-old woman with HSIL on Pap smear. Next step? | A. Colposcopy and biopsy | B. Repeat Pap | C. HPV test | D. Observe | A. Colposcopy with directed biopsy |
| A 30-year-old woman with ASC-US on Pap smear. Next step? | A. HPV testing | B. Colposcopy | C. Repeat Pap | D. Cone biopsy | A. High-risk HPV testing |
| A 45-year-old woman with contact bleeding, ulcerated cervix, foul discharge. Diagnosis? | A. Cervical cancer | B. Erosion | C. PID | D. Polyp | A. Cervical carcinoma |
| A 55-year-old postmenopausal woman with bleeding. Next step? | A. Endometrial biopsy | B. Pap smear | C. USG | D. Observe | A. Endometrial sampling |
| A 40-year-old woman with heavy menstrual bleeding, thickened endometrium. Diagnosis? | A. Endometrial hyperplasia | B. Endometrial cancer | C. DUB | D. Polyp | A. Endometrial hyperplasia |
| A 60-year-old woman with vaginal bleeding, high estrogen exposure. Diagnosis? | A. Endometrial carcinoma | B. Cervical CA | C. Ovarian CA | D. Vulvar CA | A. Endometrial adenocarcinoma |
| A 50-year-old woman with abdominal mass, ascites, CA-125 ↑. Diagnosis? | A. Ovarian carcinoma | B. Fibroid | C. Endometrial CA | D. PID | A. Epithelial ovarian carcinoma |
| A 60-year-old woman with vulvar itching, white patch, loss of architecture. Diagnosis? | A. Lichen sclerosus | B. Lichen planus | C. Atrophic vaginitis | D. Candida | A. Lichen sclerosus |
| A 65-year-old woman with ulcerated vulvar mass, indurated edges. Diagnosis? | A. Vulvar carcinoma | B. Lichen planus | C. Infection | D. Cyst | A. Squamous cell carcinoma of vulva |
| A 25-year-old woman with cauliflower-like genital growth. Diagnosis? | A. Condyloma acuminata | B. HSV | C. Syphilis | D. Chancroid | A. HPV genital warts (types 6, 11) |
| A 28-year-old woman with painful vesicular genital lesions. Diagnosis? | A. HSV | B. Syphilis | C. Chancroid | D. LGV | A. Genital herpes (HSV-2) |
| A 26-year-old woman with painless genital ulcer, indurated edges. Diagnosis? | A. Syphilis | B. Chancroid | C. HSV | D. LGV | A. Primary syphilis (chancre) |
| A 24-year-old woman with painful ulcer, ragged edges, tender nodes. Diagnosis? | A. Chancroid | B. Syphilis | C. HSV | D. LGV | A. Chancroid (Haemophilus ducreyi) |
| A 30-year-old woman with painless ulcer followed by buboes. Diagnosis? | A. Lymphogranuloma venereum | B. Chancroid | C. Syphilis | D. HSV | A. LGV (Chlamydia trachomatis L1–L3) |
| A 30-year-old woman on OCP develops migraine and HTN. Next step? | A. Stop OCP | B. Continue | C. Switch to Cu-T | D. Barrier | A. Discontinue OCP and switch to non-estrogen method |
| A 25-year-old breastfeeding mother seeking contraception. Best choice? | A. Progestin-only pill | B. Combined OCP | C. Cu-T | D. Barrier | A. Progestin-only (minipill) |
| A 30-year-old woman wanting long-term reversible contraception. Choice? | A. Copper IUD | B. Barrier | C. Pills | D. Injection | A. Copper T IUD |
| A 25-year-old woman requesting permanent contraception. Option? | A. Tubal ligation | B. Cu-T | C. Vasectomy | D. Implant | A. Tubal ligation |
| A 30-year-old man requesting permanent contraception. Option? | A. Vasectomy | B. Condom | C. Implant | D. Pill | A. Vasectomy |
| A 35-year-old woman with heavy menstrual bleeding, normal uterus. Diagnosis? | A. DUB | B. Fibroid | C. Adenomyosis | D. Polyp | A. Dysfunctional uterine bleeding (anovulatory) |
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