MRCOG Part 2 Revision Course – FREE Trial Questions

Course Description

Pre-recorded MRCOG Part 2 video lectures
New lectures added monthly
Lecture content focused on topics that candidates find difficult or perform poorly at in the MRCOG Part 2 examination
Extensive up-to-date MRCOG Part 1 revision question bank
Over 1000 questions in SBA format
Question answers provided with learning points to help revision
Revise by Module / Category or as practice exam
Can be used to revise whenever convenient – any time, any location, at your own pace

Time limit: 0

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Question 1 of 27

1. Question

A 39 year old woman has a total laparoscopic hysterectomy and bilateral salping-oophorectomy for Stage IV endometriosis.The procedure is complicated by significant adhesions requiring extensive adhesiolysis of the pelvic side wall. Postoperatively, she reports significant abdominal pain and distension and a CT Urogram confirms transection of the lower third of the right ureter. What is the most appropriate procedure for repair?

Boari flap
Correct Incorrect Correct answer

Psoas hitch
Correct Incorrect Correct answer

Trans–uretero-ureterostomy
Correct Incorrect Correct answer

Uretero-neocystostomy
Correct Incorrect Correct answer

Uretero-ureterostomy
Correct Incorrect Correct answer

Correct

Incorrect

Question 2 of 27

2. Question

A 30 year old woman is referred from screening with a higher chance combined screening result at 12 weeks gestation. The nuchal translucency is 6mm with a combined screening result of 1 in 5 for Trisomy 21 and 1 in 140 for Trisomy 13/18. What is the next most appropriate investigation?

Amniocentesis
Correct Incorrect Correct answer

Chorionic villous sampling
Correct Incorrect Correct answer

Non-invasive prenatal testing
Correct Incorrect Correct answer

Fetal anatomy scan at 16 weeks
Correct Incorrect Correct answer

Fetal echocardiography at 16 weeks
Correct Incorrect Correct answer

Correct

Incorrect

Question 3 of 27

3. Question

A 34 year old woman with a metallic mitral valve replacement contacts the maternal medicine antenatal clinic with a positive pregnancy test at approximately 6 weeks gestation by LMP. Pre-pregnancy, she was taking 6mg of warfarin once daily. What is the most appropriate management?

Change to therapeutic low molecular weight heparin between week 6 and 12 then restart warfarin in second trimester
Correct Incorrect Correct answer

Change to therapeutic low molecular weight heparin between week 6 and 28 then restart warfarin in third trimester
Correct Incorrect Correct answer

Change to therapeutic low molecular weight heparin from week 6 onwards
Correct Incorrect Correct answer

Continue warfarin at current dosage
Correct Incorrect Correct answer

Continue warfarin at lower dosage
Correct Incorrect Correct answer

Correct

Incorrect

Question 4 of 27

4. Question

A 30 year old woman is booked for a planned Caesarean birth at 37 weeks gestation in her first pregnancy due to her medical history of Marfan’s syndrome with aortic root dilation of 48mm. What is the most appropriate first line uterotonic?

Carboprost
Correct Incorrect Correct answer

Ergometrine
Correct Incorrect Correct answer

Misoprostol
Correct Incorrect Correct answer

Oxytocin bolus
Correct Incorrect Correct answer

Oxytocin infusion
Correct Incorrect Correct answer

Correct

Incorrect

Question 5 of 27

5. Question

Which of the following assisted vaginal births should be conducted in theatre?

Para 0, induction of labour for gestational diabetes, maternal BMI 29, estimated fetal weight 3.8kg, effective epidural analgesia, cervix fully dilated, prolonged second stage >2 hours, 0/5ths fetal head palpable per abdomen, station at +1, LOA position <45 degrees
Correct Incorrect Correct answer

Para 0, induction of labour for gestational diabetes, maternal BMI 29, estimated fetal weight 3.8kg, no regional analgesia, cervix fully dilated, prolonged second stage >2 hours, 0/5ths fetal head palpable per abdomen, station at +2, LOA position <45 degrees
Correct Incorrect Correct answer

Para 0, induction of labour for post-dates, effective epidural analgesia, fetal heart rate 70bpm for 8 minutes with no recovery to baseline, cervix fully dilated, 0/5ths fetal head palpable per abdomen, station at +2, LOT position
Correct Incorrect Correct answer

Para 1, induction of labour for post-dates, effective epidural analgesia, fetal heart rate 70bpm for 8 minutes with no recovery to baseline, cervix fully dilated, 0/5ths fetal head palpable per abdomen, station at +2, LOT position
Correct Incorrect Correct answer

Para 1, induction of labour for gestational diabetes, estimated fetal weight 4.4kg, fetal heart rate 70bpm for 8 minutes with no recovery to baseline, effective epidural analgesia, cervix fully dilated, 0/5ths fetal head palpable per abdomen, station at +1, LOT position
Correct Incorrect Correct answer

Correct

Incorrect

Question 6 of 27

6. Question

A primiparous woman presents in spontaneous labout at 31 weeks gestation and rapidly has a spontaneous vaginal delivery. The baby is born in poor condition with no respiratory effort and a heart rate of 90 beats per minute. What is the most appropriate next step in neonatal resuscitation?

Give five inflation breaths with 30% oxygen at 25cm H2O pressure
Correct Incorrect Correct answer

Give five inflation breaths with 30% oxygen at 30cm H2O pressure
Correct Incorrect Correct answer

Give five inflation breaths with 25% oxygen at 25cm H2O pressure
Correct Incorrect Correct answer

Give five inflation breaths with air at 25cm H2O pressure
Correct Incorrect Correct answer

Give five inflation breaths with air at 30cm H2O pressure
Correct Incorrect Correct answer

Correct

Incorrect

Question 7 of 27

7. Question

A 23 year old presents with secondary amenorrhoea for 6 months. She is nulliparous with a BMI of 31 and her periods have been irregular for the last three years with cycles varying between 2 and 4 months apart. A urinary pregnancy test is negative. Her past medical history includes irritable bowel syndrome for which she takes regular antispamodics and metoclopramide. Her blood test results are shown below:

FSH – 10.5                           (1.0-11.0 IU/L)

LH – 8.5                                 (0.5-14.5 IU/L)

Testosterone – 1.8        (0.8-3.1 nmol/L)

Prolactin – 996                (90-520 mu/L)

TSH – 2.1                              (0.5-7.0 mu/L)

Free T4 – 20                        (11-23 pmol/L)

What is the next most appropriate investigation?

CT Head
Correct Incorrect Correct answer

MRI Head
Correct Incorrect Correct answer

MRI Pituitary
Correct Incorrect Correct answer

Pituitary hormone profile
Correct Incorrect Correct answer

Repeat prolactin levels in 4-6 weeks
Correct Incorrect Correct answer

Correct

Incorrect

Question 8 of 27

8. Question

A 24-year old woman contacts the sexual health clinic for contraceptive advice. She uses the combined hormonal transdermal patch and has just noticed that the patch she applied yesterday has become detached. She is unsure when the patch came off and has had unprotected sexual intercourse in the last 24 hours. What is the most appropriate advice?

Apply a new patch and no additional precautions are required
Correct Incorrect Correct answer

Apply a new patch and use condoms for seven days
Correct Incorrect Correct answer

Apply a new patch and use emergency contraception
Correct Incorrect Correct answer

Apply a new patch, use emergency contraception and use condoms for seven days
Correct Incorrect Correct answer

Use emergency contraception and change to a different contraceptive method
Correct Incorrect Correct answer

Correct

Incorrect

Question 9 of 27

9. Question

A 31 year old nulliparous woman presents with abdominal pain, irregular periods and bloating. Pelvic ultrasound shows a 5cm solid complex ovarian mass and laboratory testing confirms high alpha-fetoprotein (aFP) levels. Staging CT scan is suggestive of regional lymph node involvement. She wishes to conserve her fertility. What is the most appropriate management?

Neoadjuvant BEP (bleomycin, etoposide, cisplatin) chemotherapy
Correct Incorrect Correct answer

Neoadjuvant BEP (bleomycin, etoposide, cisplatin) chemotherapy with subsequent surgical resection
Correct Incorrect Correct answer

Neoadjuvant carboplatin chemotherapy with subsequent surgical resection
Correct Incorrect Correct answer

Surgical resection with adjuvant BEP (bleomycin, etoposide, cisplatin) chemotherapy
Correct Incorrect Correct answer

Surgical resection with adjuvant carboplatin chemotherapy
Correct Incorrect Correct answer

Correct

Incorrect

Question 10 of 27

10. Question

A 70-year-old woman presents with urinary frequency, urgency, nocturia and incontinence. She has reduced her caffeine intake, restricts her fluids in the evening and has had bladder retraining as well as supervised pelvic floor exercises. Whilst there has been some improvement of her symptoms, she still finds them quite troublesome, and they are affecting her quality of live. Her medical history includes glaucoma and hypertension for which she takes latanoprost and amlodipine. What treatment should now be considered?

Darifenacin
Correct Incorrect Correct answer

Duloxetine
Correct Incorrect Correct answer

Mirabegron
Correct Incorrect Correct answer

Oxybutinin
Correct Incorrect Correct answer

Trospium
Correct Incorrect Correct answer

Correct

Incorrect

Question 11 of 27

11. Question

A 34 year old woman is referred to her local early pregnancy unit at 8 weeks gestation following symptoms of vaginal bleeding with mild cramping pain having had one previous Caesarean section. The ultrasound findings are of an empty uterine cavity and closed empty cervical canal with a gestational sac in the niche of the previous Caesarean section scar that extrudes towards the bladder with absent overlying myometrium with negative sliding sign and evidence of trophoblastic circulation on Colour Doppler flow. Within the gestational sac, a viable embryo with fetal cardiac activity is seen. What is the most likely diagnosis?

Cervical pregnancy
Correct Incorrect Correct answer

Interstitial pregnancy
Correct Incorrect Correct answer

Type 1 Caesarean scar pregnancy
Correct Incorrect Correct answer

Type 2 Caesarean scar pregnancy
Correct Incorrect Correct answer

Viable intra-uterine pregnancy
Correct Incorrect Correct answer

Correct

Incorrect

Question 12 of 27

12. Question

A 30 year old woman woman contacts the Maternity Assessment unit at 28 weeks gestation as she is concerned because her nephew has developed chicken pox yesterday and she was looking after him when the rash appeared. Her community midwife has requested urgent serum serology for Varicella Zoster IgG from her antenatal booking bloods and the laboratory calls to report that the patient is non-immune. What is the most appropriate management?

Offer prophylactic Varicella-Zoster immunoglobulin (VZIG) immediately
Correct Incorrect Correct answer

Offer prophylactic Varicella-Zoster immunoglobulin (VZIG) after 10 days
Correct Incorrect Correct answer

Offer prophylactic Varicella-Zoster immunoglobulin (VZIG) if the patient develops chickenpox
Correct Incorrect Correct answer

Repeat serum serology immediately for varicella-zoster immunoglobulins
Correct Incorrect Correct answer

Repeat serum serology in 48 hours for varicella-zoster immunoglobulins
Correct Incorrect Correct answer

Correct

Incorrect

Question 13 of 27

13. Question

A 38 year old black African woman has an induction of labour at 37 weeks for Type 2 diabetes and gestational hypertension medicated with oral nifedipine 10mg BD. She has a spontaneous vaginal birth and her blood pressure on Day 1 and Day 2 postnatally is normal. She is reviewed in the community on Day 5 and noted to have a blood pressure of 155/98 mmHg.   She is otherwise clinically well and is asymptomatic. She is not breastfeeding and does not plan to start. What is the most appropriate treatment option?

Repeat blood pressure measurement in 24 hours
Correct Incorrect Correct answer

Restart treatment with nifedipine
Correct Incorrect Correct answer

Start treatment with amlodipine
Correct Incorrect Correct answer

Start treatment with enalapril
Correct Incorrect Correct answer

Start treatment with losartan
Correct Incorrect Correct answer

Correct

Incorrect

Question 14 of 27

14. Question

For each clinical scenario described below, choose the single most appropriate management option from the above list. Each option may be used once, more than once or not at all.

An 18 year old nulliparous woman presents with lower abdominal pain and vaginal spotting. Her last menstrual period was 6 weeks ago and she has a positive urinary pregnancy test. Transvaginal ultrasound shows a retroverted uterus with empty uterine cavity. A small gestational sac measuring 21mm in diameter is seen below the internal cervical os but there is no evidence of a yolk sac or fetal pole. There is blood flow seen on Colour Doppler around the gestational sac and sliding sign is absent. The ovaries appear normal with a corpus luteum seen on the left ovary and there is no free fluid in the Pouch of Douglas.

Conservative Management
Correct Incorrect Correct answer

CT scan
Correct Incorrect Correct answer

Laparoscopy +/- proceed
Correct Incorrect Correct answer

Laparotomy +/- proceed
Correct Incorrect Correct answer

Medical management with prostaglandins
Correct Incorrect Correct answer

Medical management with methotrexate
Correct Incorrect Correct answer

MRI scan
Correct Incorrect Correct answer

No action
Correct Incorrect Correct answer

Urine pregnancy test in two weeks
Correct Incorrect Correct answer

Serum beta human chorionic gonadotrophin levels in 48 hours
Correct Incorrect Correct answer

Serum beta human chorionic gonadotrophin levels in 7 days
Correct Incorrect Correct answer

Serum progesterone levels
Correct Incorrect Correct answer

Surgical Evacuation of Uterus
Correct Incorrect Correct answer

Transabdominal ultrasound scan in 14 days
Correct Incorrect Correct answer

Transvaginal ultrasound scan in 7-10 days
Correct Incorrect Correct answer

Correct

Incorrect

Question 15 of 27

15. Question

For each clinical scenario described below, choose the single most appropriate management option from the above list. Each option may be used once, more than once or not at all.

A 50 year old women presents with a sensation of a vaginal lump on coughing. She is Para 3, having had three previous vaginal births. She has no other significant medical or surgical history. She has tried pelvic floor muscle training without significant benefit and wishes to have definitive treatment. On examination, her BMI is 24 and POP-Q assessment showed:

Abdominal sacrocolpopexy
Correct Incorrect Correct answer

Anterior colporrhaphy
Correct Incorrect Correct answer

Autologous rectus fascial sling
Correct Incorrect Correct answer

Colpocleisis
Correct Incorrect Correct answer

Colposuspension
Correct Incorrect Correct answer

High uterosacral ligament suspension
Correct Incorrect Correct answer

Laparoscopic sacrocolpopexy
Correct Incorrect Correct answer

Manchester repair
Correct Incorrect Correct answer

McCall culdoplasty
Correct Incorrect Correct answer

Pelvic floor muscle training
Correct Incorrect Correct answer

Posterior colporrhaphy
Correct Incorrect Correct answer

Sacrospinous fixation
Correct Incorrect Correct answer

Vaginal ring pessary
Correct Incorrect Correct answer

Vaginal shelf pessary
Correct Incorrect Correct answer

Correct

Incorrect

Question 16 of 27

16. Question

For each clinical scenario described below, choose the single most appropriate management option from the above list. Each option may be used once, more than once or not at all.

A 62-year-old woman presents with a bleeding ulcerated anterior right vulval lesion. On examination, there is a 1.5 cm vulval tumour confined to the vulva and wedge biopsy confirms a histological diagnosis of vulval squamous cell carcinoma with stromal invasion of 0.8 mm. There is no evidence of lymph node involvement or distant metastasis on MRI.

Adjuvant chemoradiotherapy
Correct Incorrect Correct answer

Anterior vulvectomy
Correct Incorrect Correct answer

Bilateral inguinofemoral lymphadenectomy
Correct Incorrect Correct answer

Ipsilateral inguinofemoral lymphadenectomy
Correct Incorrect Correct answer

Neoadjuvant chemoradiotherapy
Correct Incorrect Correct answer

Palliative care
Correct Incorrect Correct answer

Pelvic exenteration
Correct Incorrect Correct answer

Posterior vulvectomy
Correct Incorrect Correct answer

Primary chemoradiotherapy
Correct Incorrect Correct answer

Radical local excision with sentinel lymph node biopsy
Correct Incorrect Correct answer

Radical vulvectomy
Correct Incorrect Correct answer

Sentinel lymph node biopsy
Correct Incorrect Correct answer

Wide local excision without lymphadenectomy
Correct Incorrect Correct answer

Correct

Incorrect

Question 17 of 27

17. Question

For each clinical scenario described below, choose the single most appropriate diagnostic test from the above list. Each option may be used once, more than once or not at all.

A 20 year old woman presents to her local sexual health clinic with symptoms of profuse vaginal discharge which she describes as offensive. On examination, there is profuse frothy yellow offensive vaginal discharge and there is a strawberry cervix appearance with small punctate haemorrhages with ulceration.

Endocervical swab + culture
Correct Incorrect Correct answer

Endocervical swab + microscopy
Correct Incorrect Correct answer

Endocervical swab + nucleic acid amplification test (NAAT)
Correct Incorrect Correct answer

First catch urine + culture
Correct Incorrect Correct answer

First catch urine + microscopy
Correct Incorrect Correct answer

First catch urine + nucleic acid amplification test (NAAT)
Correct Incorrect Correct answer

High vaginal swab + culture
Correct Incorrect Correct answer

High vaginal swab + microscopy
Correct Incorrect Correct answer

High vaginal swab + nucleic acid amplification test (NAAT)
Correct Incorrect Correct answer

Urethral swab + culture
Correct Incorrect Correct answer

Urethral swab + microscopy
Correct Incorrect Correct answer

Urethral swab + nucleic acid amplification test (NAAT)
Correct Incorrect Correct answer

Vulvo-vaginal swab + culture
Correct Incorrect Correct answer

Vulvo-vaginal swab + microscopy
Correct Incorrect Correct answer

Vulvo-vaginal swab + nucleic acid amplification test (NAAT)
Correct Incorrect Correct answer

Rectal swab + culture
Correct Incorrect Correct answer

Rectal swab + microscopy
Correct Incorrect Correct answer

Rectal swab + nucleic acid amplification test (NAAT)
Correct Incorrect Correct answer

Correct

Incorrect

Question 18 of 27

18. Question

For each clinical scenario described below, choose the single most appropriate management option from the above list. Each option may be used once, more than once or not at all.

A 69-year-old woman presents with postmenopausal bleeding. Transvaginal ultrasound reveals an endometrial thickness of 14 mm. A biopsy confirms endometrial hyperplasia without atypia. She has no significant medical history and has a BMI of 24.

Annual endometrial surveillance
Correct Incorrect Correct answer

Conservative management
Correct Incorrect Correct answer

Continuous progestogen medroxyprogesterone acetate 5 mg daily
Correct Incorrect Correct answer

Continuous progestogen medroxyprogesterone acetate 10 mg daily
Correct Incorrect Correct answer

Continuous progestogen norethisterone 5 mg daily
Correct Incorrect Correct answer

Continuous progestogen norethisterone 10 mg daily
Correct Incorrect Correct answer

Endometrial ablation
Correct Incorrect Correct answer

Hysteroscopy and Endometrial biopsy
Correct Incorrect Correct answer

Levonorgestrel Intrauterine System + Endometrial biopsy in 3 months
Correct Incorrect Correct answer

Levonorgestrel Intrauterine System + Endometrial biopsy in 6 months
Correct Incorrect Correct answer

Levonorgestrel Intrauterine System
Correct Incorrect Correct answer

Subtotal hysterectomy
Correct Incorrect Correct answer

Total abdominal hysterectomy
Correct Incorrect Correct answer

Total abdominal hysterectomy and bilateral salpingo-oophorectomy
Correct Incorrect Correct answer

Total laparoscopic hysterectomy and bilateral salpingo-oophorectomy
Correct Incorrect Correct answer

Ultrasound scan
Correct Incorrect Correct answer

Correct

Incorrect

Question 19 of 27

19. Question

For each clinical scenario described below, choose the single most appropriate management option from the above list. Each option may be used once, more than once or not at all.

A woman in her second pregnancy opts to have a planned Caesarean birth. Her first child was born by forceps complicated by shoulder dystocia and the baby sustained a brachial plexus injury which required surgery and extensive physiotherapy. She has a booking BMI of 39 and develops gestational diabetes during pregnancy which requires insulin treatment. She is readmitted on Day 6 postpartum with extensive erythema around the Caesarean section wound which spreads rapidly. She has excruciating pain over the wound requiring intravenous morphine and the pain is elicited beyond the margins of the superficial erythema. She is treated with intravenous flucloxacillin but continues to deteriorate.

Co-amoxiclav
Correct Incorrect Correct answer

Ceftriaxone
Correct Incorrect Correct answer

Clarithromycin
Correct Incorrect Correct answer

Clindamycin
Correct Incorrect Correct answer

Erythromycin
Correct Incorrect Correct answer

Flucloxacillin
Correct Incorrect Correct answer

Gentamicin
Correct Incorrect Correct answer

Intravenous immunoglobulin (IVIG)
Correct Incorrect Correct answer

Meropenem
Correct Incorrect Correct answer

Metronidazole
Correct Incorrect Correct answer

No antibiotics required
Correct Incorrect Correct answer

Phenoxymethylpenicillin
Correct Incorrect Correct answer

Piperacillin-tazobactam
Correct Incorrect Correct answer

Suction evacuation of uterus
Correct Incorrect Correct answer

Surgical debridement
Correct Incorrect Correct answer

Teicoplanin
Correct Incorrect Correct answer

Vancomycin
Correct Incorrect Correct answer

Correct

Incorrect

Question 20 of 27

20. Question

For each clinical scenario described below, choose the single most appropriate management option from the above list. Each option may be used once, more than once or not at all.

A woman in her first pregnancy attends in spontaneous labour at 30 weeks gestation and requests epidural analgesia which is sited and is effective. During the second stage of labour, the CTG is abnormal with repetitive late decelerations. On vaginal examination, the presenting part is at station 0 with occipito-posterior fetal position.

Category 1 emergency Caesarean section
Correct Incorrect Correct answer

Category 2 emergency Caesarean section
Correct Incorrect Correct answer

Category 3 emergency Caesarean section
Correct Incorrect Correct answer

Category 4 emergency Caesarean section
Correct Incorrect Correct answer

Direct traction forceps
Correct Incorrect Correct answer

External cephalic version
Correct Incorrect Correct answer

Internal podalic version
Correct Incorrect Correct answer

Rotational forceps
Correct Incorrect Correct answer

Spontaneous vaginal delivery
Correct Incorrect Correct answer

Vaginal breech delivery
Correct Incorrect Correct answer

Ventouse
Correct Incorrect Correct answer

Correct

Incorrect

Question 21 of 27

21. Question

For each clinical scenario described below, choose the single most appropriate analgesia option from the above list. Each option may be used once, more than once or not at all.

A woman in spontaneous labour at 40 weeks gestation requests rapid onset effective pharmacological analgesia for the duration of her labour. She has a history of immune thrombocytopenia and her platelets on admission are 70.

Acupuncture
Correct Incorrect Correct answer

Aromatherapy
Correct Incorrect Correct answer

Biofeedback
Correct Incorrect Correct answer

Birthing ball
Correct Incorrect Correct answer

Combined spinal-epidural
Correct Incorrect Correct answer

Continuous one-to-one support
Correct Incorrect Correct answer

Epidural
Correct Incorrect Correct answer

General anaesthesia
Correct Incorrect Correct answer

Hypnosis
Correct Incorrect Correct answer

Music
Correct Incorrect Correct answer

Nitrous oxide
Correct Incorrect Correct answer

Non-opioid analgesics
Correct Incorrect Correct answer

Opioids
Correct Incorrect Correct answer

Remifentanil patient-controlled analgesia
Correct Incorrect Correct answer

Spinal
Correct Incorrect Correct answer

Sterile water injections
Correct Incorrect Correct answer

Transcutaneous electrical nerve stimulation
Correct Incorrect Correct answer

Water immersion
Correct Incorrect Correct answer

Correct

Incorrect

Question 22 of 27

22. Question

For each clinical scenario described below, choose the single most appropriate investigation from the above list. Each option may be used once, more than once or not at all.

A 36 year old woman is referred to maternal medicine clinic at 23 weeks gestation in her second pregnancy with persistent hyperkalaemia and hyponatraemia. She previously had an uncomplicated first pregnancy and vaginal birth at term. In this current pregnancy, she has had hyperemesis gravidarum throughout pregnancy and has struggled with symptomatic low blood pressure and occasional episodes of hypoglycaemia.

Adrenal autoantibodies
Correct Incorrect Correct answer

Home blood pressure monitoring
Correct Incorrect Correct answer

Low-dose dexamethasone suppression test
Correct Incorrect Correct answer

Morning serum cortisol and plasma ACTH levels
Correct Incorrect Correct answer

Morning serum 17α-hydroxyprogesterone levels
Correct Incorrect Correct answer

Night serum cortisol level
Correct Incorrect Correct answer

Night salivary cortisol level
Correct Incorrect Correct answer

Oral glucose tolerance test
Correct Incorrect Correct answer

Serum aldosterone-to-renin ratio
Correct Incorrect Correct answer

Serum free androgen index
Correct Incorrect Correct answer

Serum plasma free metanephrines
Correct Incorrect Correct answer

Serum renin level
Correct Incorrect Correct answer

Short Synacthen stimulation test
Correct Incorrect Correct answer

Soluble fLt / PLGF ratio
Correct Incorrect Correct answer

Urinary free cortisol (UFC)
Correct Incorrect Correct answer

Urinary protein creatininine ratio
Correct Incorrect Correct answer

24-hour urine collection for plasma free metanephrines
Correct Incorrect Correct answer

Correct

Incorrect

Question 23 of 27

23. Question

For each clinical scenario described below, choose the single most appropriate management option from the above list. Each option may be used once, more than once or not at all.

A new screening test for gestational diabetes has been evaluated in a population of 1000 women. The test correctly identifies 120 of 150 women with gestational diabetes (true positives) and incorrectly labels 50 women without the disease as having gestational diabetes (false positives). What is the positive predictive value (PPV) of this test?

Approximately 20%
Correct Incorrect Correct answer

Approximately 25%
Correct Incorrect Correct answer

Approximately 30%
Correct Incorrect Correct answer

Approximately 35%
Correct Incorrect Correct answer

Approximately 40%
Correct Incorrect Correct answer

Approximately 45%
Correct Incorrect Correct answer

Approximately 50%
Correct Incorrect Correct answer

Approximately 55%
Correct Incorrect Correct answer

Approximately 60%
Correct Incorrect Correct answer

Approximately 65%
Correct Incorrect Correct answer

Approximately 70%
Correct Incorrect Correct answer

Approximately 75%
Correct Incorrect Correct answer

Approximately 80%
Correct Incorrect Correct answer

Approximately 85%
Correct Incorrect Correct answer

Approximately 90%
Correct Incorrect Correct answer

Correct

Incorrect

Question 24 of 27

24. Question

A 28 year old woman and her 32 year old partner are seen in fertility clinic with a three year history of primary subfertility. The results of their infertility investigations are shown below:

Female Investigations

BMI: 23

Menstrual cycle: regular, 28 days

Day-21 Serum Progesterone:

FSH: 6.5 mIU/ml

LH 7.4 IU/L

Pelvic ultrasound: normal appearances of uterus and ovaries

Hysterosalpingogram: both tubes appear patent

Male Investigations

BMI: 25

Semen analysis on two occasions 3 months apart: azoospermia

FSH: 0.2 IU/L

LH: 0.1 IU/L

Testosterone: 8 nmol/L

What is the most appropriate management option?

Corticosteroids for 3 months followed by repeat semen analysis
Correct Incorrect Correct answer

Gonadotrophins for 3 months followed by repeat semen analysis
Correct Incorrect Correct answer

Letrozole for 3 months followed by repeat semen analysis
Correct Incorrect Correct answer

No treatment
Correct Incorrect Correct answer

Testosterone injections for 3 months followed by repeat semen analysis
Correct Incorrect Correct answer

Correct

Incorrect

Question 25 of 27

25. Question

For each scenario described below, choose the single most appropriate management option. Each option may be used once, more than once or not at all.

A 52-year-old woman presents with severe hot flushes and night sweats affecting her quality of life. She has a BMI of 34 kg/m² and she has a medical history of previous ER positive breast cancer for which she takes ongoing adjuvant tamoxifen treatment.

Clonidine
Correct Incorrect Correct answer

Continuous combined oral HRT containing 1 mg of estradiol
Correct Incorrect Correct answer

Continuous combined oral HRT containing 2 mg of estradiol
Correct Incorrect Correct answer

Continuous combined HRT with transdermal estradiol
Correct Incorrect Correct answer

Combined sequential oral HRT containing 1 mg of estradiol
Correct Incorrect Correct answer

Combined sequential oral HRT containing 2 mg of estradiol
Correct Incorrect Correct answer

Estrogen only 1 mg oral HRT, without progestogen
Correct Incorrect Correct answer

Estrogen only 2 mg oral HRT, without progestogen
Correct Incorrect Correct answer

Menopause-specific cognitive behavioural therapy (CBT)
Correct Incorrect Correct answer

Oral ospemifene
Correct Incorrect Correct answer

Selective serotonin reuptake inhibitors (SSRIs)
Correct Incorrect Correct answer

Sequential HRT with transdermal estradiol
Correct Incorrect Correct answer

Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Correct Incorrect Correct answer

Tibolone
Correct Incorrect Correct answer

Transdermal estradiol only HRT, without progestogen
Correct Incorrect Correct answer

Vaginal prasterone
Correct Incorrect Correct answer

Vaginal oestrogen
Correct Incorrect Correct answer

Vaginal laser treatment
Correct Incorrect Correct answer

Vaginal moisturiser and lubricant
Correct Incorrect Correct answer

Correct

Incorrect

Question 26 of 27

26. Question

For each scenario described below, choose the single most appropriate management option:

A 28-year-old woman with polycystic ovary syndrome (PCOS) is undergoing IVF with a GnRH antagonist fixed protocol. Her AMH is 40 pmol/L, and ultrasound reveals 25 antral follicles per ovary. Serum oestradiol is rising rapidly.

Clomiphene citrate cycle
Correct Incorrect Correct answer

Double embryo transfer
Correct Incorrect Correct answer

Freeze-all strategy
Correct Incorrect Correct answer

GnRH agonist long protocol
Correct Incorrect Correct answer

GnRH agonist short protocol
Correct Incorrect Correct answer

GnRH agonist trigger
Correct Incorrect Correct answer

GnRH antagonist protocol
Correct Incorrect Correct answer

hCG trigger
Correct Incorrect Correct answer

Letrozole stimulation
Correct Incorrect Correct answer

Mild stimulation protocol
Correct Incorrect Correct answer

Natural cycle IVF
Correct Incorrect Correct answer

Progesterone-primed protocol
Correct Incorrect Correct answer

Single embryo transfer
Correct Incorrect Correct answer

Correct

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Question 27 of 27

27. Question

For each scenario described below, choose the single most appropriate management option:

A 19-year-old woman presents with a second episode of sudden-onset left iliac fossa pain and vomiting within six months. She previously underwent laparoscopic detorsion for left ovarian torsion with a normal-appearing ovary and no cysts. This time, transvaginal ultrasound again shows an enlarged left ovary with peripheral follicles, and Doppler flow is reduced. She is haemodynamically stable and not pregnant.

CT Abdomen / Pelvis
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Diagnostic laparoscopy
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Laparoscopic detorsion
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Laparoscopic detorsion with oophorectomy
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Laparoscopic detorsion with oophoropexy
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Laparoscopic detorsion with ovarian cystectomy
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Laparoscopic unilateral salpingo-oophorectomy
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MRI Abdomen / Pelvis
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Percutaneous cyst drainage
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Staging laparotomy and unilateral salpingo-oophorectomy
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Transvaginal cyst drainage
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Correct

Incorrect