100 picture osce in obstetrics and gynaecology

100 picture test OSCE for medical students

1. OBSTERICS AND GYNAECOLOGY PICTURE TEST OSCE 2 Dr Okechukwu A. Ugwu 10/29/2018 1 Okechukwu A. Ugwu

2. NUVARING A. Its contains ethinyl estradiol and the etonogestrel. T B. The ring is placed within 5 days of menses onset and, after 3 weeks of use, is removed for 1 week to allow withdrawal bleeding. T C. It contains ethinyl estradiol and the progestin norelgestromin. F D. Transdermal patch and vaginal ring produce metabolic changes, side effects, and efficacy rates comparable to those with COC pills. T E. It may be removed during intercourse but should be replaced within 3 hours to maintain efficacy. T

3. If imaging fails to locate a translocated implant, etonogestrel blood level determination can help verify that the implant is indeed in situ. T B. implant is ideally inserted within 5 days of menses onset. T C. For transitioning methods, an implant is placed on the day of the first placebo combination oral contraceptive (COC) pill. T D. implant may be inserted before discharge following delivery or abortion. T E. Fertility is restored rapidly following removal of implant contraception. T

4. Contraceptive Sponge A. Sponge is an over-the-counter, one-size-fits-all device.T B. can be inserted up to 36 hours prior to intercourse. F 24hours C. while in place, it provides contraception regardless of coital frequency. T D. should remain in place for 24 hours after intercourse. F 6hours E. Impregnated with Nonoxynol-9.T

5. Question 22: Regarding the picture on display: This prevents nosocomial infection. T An accoucher must wear this all the time to prevent infection. F *** The hospital attendant is expected to wear this all the time. F The scrub-nurse should also wear this. T It is not necessary for theatre cleaner to wear this. T 10/29/2018 5 Okechukwu A. Ugwu

6. Question 12: Observe the picture: The pathology demonstrated is commoner among women within the reproductive age group. F Weakness of the broad ligaments leads to this pathology. F This condition may be associated with stress incontinence T The condition is readily amenable to pessary insertion. F Colposuspension is one of the surgical methods of correction. F 10/29/2018 6 Okechukwu A. Ugwu

7. Question 14: Concerning the instrument shown: It is used during Caesarean section F It is used during vaginal Hysterectomy F Its used for destructive operation F The cervix should be fully dilated before it is used F Injury to the ureters may follow the use of this instrumentF 10/29/2018 7 Okechukwu A. Ugwu

8. Question 16: This is a laparoscopic view of the pelvis in a patient with pelvic inflammatory disease. Fitz-Curtis-Hugh syndrome is a complication of this condition. T Bacterial vaginosis is a known aetiological factor. F Characteristic findings at laparoscopy are diagnostic. T Long term sequelae include preterm delivery. F Pelvic abscess results from secondary invasion by anaerobic organisms. T 10/29/2018 8 Okechukwu A. Ugwu

9. Question 20: The instrument shown is used in a particular gynaecological procedure. It is indicated in the evaluation of uterine malformations. T It is indicated in the evaluation of uterine perforations.F It is usually performed in the mid-luteal phase of the menstrual cycle. F It is contraindicated in the presence of a pelvic mass. F It must be performed under general anaesthesia. F 10/29/2018 9 Okechukwu A. Ugwu

10. Question 19:Regarding destructive operations: Craniotomy is indicated in obstructed labour with a life fetus. F Cleidotomy is the division of one or both clavicles. T Simpson’s perforator is used for decapitation. F Willet’s forceps are used during craniotomy. F Blond-Heidler saw may be hooked over the iliac crest in breech presentation to give an excellent purchase. F 10/29/2018 10 Okechukwu A. Ugwu

11. Question 21: Concerning the condition being treated with this intervention Genital tract laceration is the commonest cause of the condition. F The condition is the commonest cause of maternal mortality. T This intervention impedes access to the genital tract. F Access to anaesthesia may influence outcome of management of this condition. T This intervention can be employed at any level of care. T 10/29/2018 11 Okechukwu A. Ugwu

12. Question 23: This partograph depicts: A normal labour F A prolonged active phase of labour T*** An obstructed labour F*** Adequate uterine contractions F Fetal distress T 10/29/2018 12 Okechukwu A. Ugwu

13. Question 25: Concerning the instrument on display: It must be used with the patient under anaesthesia. T It may be indicated in the management of hydatidiform mode. T Autoclaving is the preferred method of sterilization. F It is used only by physicians. F Its primary mechanism is by mechanical curettage. F 10/29/2018 13 Okechukwu A. Ugwu

14. Question 27: The instruments depicted: a. Are used during laparoscopic procedures F b. Are used for insertion of Implanon capsules. T c. Are used for intravenous infusion. F d. Are used for fine needle aspiration and cytology. F e. Are used for insertion of Norplant/Jadelle capsules T 10/29/2018 14 Okechukwu A. Ugwu

15. Question 26: During this procedure: a. The cervix should be exposed with a Sim’s speculum. F b. An Ayre’s spatula is used to obtain a sample. T c. The tip of the spatula should be rotated through 90 once. F d. The material obtained should be stained with haematoxylin and eosin. T e. The patient should lie in the left lateral position .F 10/29/2018 15 Okechukwu A. Ugwu

16. QUESTION 4: REGARDING THIS INSTRUMENT: It is called a Uterine Sound T It is more appropriately called a Hegar’s Dilator used for dilatation and curettage (D&C) F It is used to measure the depth of the uterine cavity during D&C T It is also used for evacuation of retained products of conception (ERPC) F Careless use of this instrument can cause uterine perforation T

17. Question 28: This picture depicts : An ultrasound scan of the pelvis. F A hystero-salpingogram. T Normal vagina and uterus. T Bilateral patent Fallopian tubes. F Presence of pelvic adhesions. 10/29/2018 17 Okechukwu A. Ugwu

18. Question 29: This is the gross appearance of a cervical squamous cell carcinoma that is still limited to the cervix This is likely to be stage 2A. F The predisposing factors include bacterial vaginosis infection. F Treatment for the stage of the lesion demonstrated does not require additional radiotherapy. T The lesion demonstrated is amenable to cone biopsy. F This is the commonest histological type. T 10/29/2018 18 Okechukwu A. Ugwu

19. Question 30: The picture depicted here: a. Represents a major degree of placenta praevia. F b. A patient with this condition should be allowed a short trial of labour. F c. Cord prolapse is usually a major complication of this condition. F d. It is always complicated by post-partum haemorrhage. F e. The patient with this condition should be delivered by elective Caesarean section. T 10/29/2018 19 Okechukwu A. Ugwu

20. QUESTION 1: REGARDING THE INSTRUMENT DISPLAYED: a. The instrument is used for retracting the vagina during VVF repair T b. The instrument is utilised for retracting the bladder during VVF repair F c. The instrument helps prevent VVF F d. The instrument is used for retracing the Rectus sheath. F e. It is a self retaining retractor. T** 10/29/2018 20 Okechukwu A. Ugwu

21. Question 8: Concerning the use of the instrument on display. Conditions to be fulfilled include a suitable presentation like mento -posterior F Conditions to be fulfilled include the membranes being intact. F Indications include cephalo -pelvic disproportion. F This instrument can be used for rotation. F It can be applied to brow presentation. F

22. Question 12 – Look at the instrument on display a . The instrument is used in retracting the vagina during VVF repair F b. The instrument is utilised in retracting the bladder during VVF repair F c. The instrument helps prevent VVF F d. The instrument is used in retracing the Rectus sheath. F e. It is a self retaining retractor. F 10/29/2018 22 Okechukwu A. Ugwu

23. QUESTION 20: REGARDING THE INSTRUMENT ON DISPLAY It is called a Green Armitage . T It is more appropriately called a haemostatic Doyen’s forceps. F It is used as haemostatic forceps during Caesarean Section. T Its use can cause uterine rupture. F Its use can cause a Vesico -Vaginal Fistula. F 10/29/2018 23 Okechukwu A. Ugwu

24. Question 38: The following are to be noted with this picture A This patient is likely to be immuno – compromised T B Excision is an option of treatment T C Vulval cancer can result from this condition T D This condition cannot occur in patient with HIV F E This may be caused by a virus F 10/29/2018 24 Okechukwu A. Ugwu

25. : Question 39: Carefully look at this picture: A Biopsy is necessary for a 60-year old with this condition T B Ward-catheter can be used for treatmentT C Antibiotics is the main treatment hereF D This is due a sexually trans mitted diseaseT E This can be a complication of episiotomy T 10/29/2018 25 Okechukwu A. Ugwu

26. Question 40: The following are to be noted with this picture: A This patient has bilateral ovarian cystsT B The uterus looks normal T C This condition may be benign T D This patient cannot be pregnant againF E One of the complications of this condition is bleeding T 10/29/2018 26 Okechukwu A. Ugwu

27. A. Both pictures are for same procedure T B. There is an advantage of A over B in terms of outcome F C. A is more invasive than BF D. They are used for Pap smear T E. The result is interpreted as CIN1 to CIN111 F 10/29/2018 27 Okechukwu A. Ugwu

28. Question 42: Observe this picture A This can be caused by a virus T B This can be a complication of episiotomy T C This patient will require plastic surgery T D She will require immediate surgery F E Gynetresia is a possible complication T 10/29/2018 28 Okechukwu A. Ugwu

29. Question 43: Picture shows a vulva with extensive ulcer This woman most probably has vulval malignancy. T She is likely aged 35-40 years, the peak age incidence for vulval malignancy. F This lesion could be a syphylitic chancre F This lesion is easily amenable to cure by simple vulvectomy F Radiotherapy is the most suitable modality of treatment for this woman’s condition F 10/29/2018 29 Okechukwu A. Ugwu

30. Question 2: Look at the picture: The patient with the pathology shown would have presented with menorrhagia . T Infertility would have been one of her presentation. T Post-operatively, subsequent pregnancies should be delivered by Caesarean section because the endometrium was breached. T Laparoscopic surgery is a management option in this patient. T If menorrhagia was a presenting complaint, there is a certainty that if would resolve after this surgery. F

31. Question 2: Look at the picture: a. The patient with the pathology shown would have presented with menorrhagia . T b. Infertility would have been one of her presentation. T c. Post-operatively, subsequent pregnancies should be delivered by Caesarean section because the endometrium was breached. F d. Laparoscopic surgery is a management option in this patient. T e. If menorrhagia was a presenting complaint, there is a certainty that if would resolve after T this surgery. 10/29/2018 31 Okechukwu A. Ugwu

32. Question 1: The instrument on display is a sonicaid, commonly used in obstetric practice ; Will detect fetal heart decelerations.F Is used every 15 minutes in 2 nd stage of labour.F It is more effective in polyhydramnios.F It is indicated in patients with twin gestation only.F Is more useful in breech presentations than cephalic presentations.F 10/29/2018 32 Okechukwu A. Ugwu

33. Question 2: Look at the picture: The patient with the pathology shown would have presented with menorrhagia because of the number of nodules removed. Infertility would have been one of her presentations because of the fatty degeneration observed. Post-operatively, subsequent pregnancies should be delivered by Caesarean section because the endometrium was breached. Laparoscopic surgery is a management option in this patient. If menorrhagia was a presenting complaint, there is a certainty that if would resolve after this surgery. 10/29/2018 33 Okechukwu A. Ugwu

34. Question 3: This partograph depicts: A normal labour A prolonged active phase of labour An obstructed labour Adequate uterine contractions Fetal distress 10/29/2018 34 Okechukwu A. Ugwu

35. Question 4. The picture shown below belongs to a 25 year old with 2 years History of inability to get pregnant Previous termination of pregnancy is a likely cause T This procedure was performed during mensesF It is performed under conscious sedationF Air embolism is a likely complicationT Hysteroscopy should be done to further evaluate the findings shownF 10/29/2018 35 Okechukwu A. Ugwu

36. Question 5: This is the gross appearance of a cervical squamous cell carcinoma that is still limited to the cervix This is likely to be stage 2A. Bacterial vaginosis is not a predisposing factor Treatment for the stage of the lesion demonstrated does not require additional radiotherapy. The lesion demonstrated is not amenable to Loop Electrosurgical Operation . This is the commonest histological type. 10/29/2018 36 Okechukwu A. Ugwu

37. Question 6: The object shown below: It is utilized in cervical ripening when there is intrauterine fetal deathT Oral administration is used for induction of labourT Rectal administration is used for post partum haemorrhageT Its use may cause DICF It should not be used in patients on anti-shock garmentF 10/29/2018 37 Okechukwu A. Ugwu

38. Question 7:Concerning the picture below The patient is well positioned for the examinationT The examiner is on the proper side of the patientT The patient is sufficiently exposed for the examinationT The position of the fetus is being determinedF The lie of the fetus is being determinedT 10/29/2018 38 Okechukwu A. Ugwu

39. Question 8: This is a result obtained from a patient at 32 weeks gestation. This patient is likely to have had a previous still birth from cord prolapse .F This result demonstrate glucose intolerance in this patient.F Dietary control is sufficient for this patient.F Metformin may be used in the post-partum period in this patient.T This patient will require only insulin therapy. F 10/29/2018 39 Okechukwu A. Ugwu

40. Question 9:Concerning the picture below Being HIV positive is a contraindicationF Conditions to be fulfilled include the membranes being intactF Indications include cephalo-pelvic disproportionF This instrument can not be used for rotationF It can be applied to brow presentation.F 10/29/2018 40 Okechukwu A. Ugwu

41. Question 10: Concerning the use of the instrument on display. Conditions to be fulfilled include a suitable presentation like mento -posterior Conditions to be fulfilled include the membranes being intact. Indications include cephalo -pelvic disproportion. This instrument can be used for rotation. It can be applied to brow presentation.

42. Question 4 This chart is an ECG traceF This is a Partogram chartF This is a cardiotocogram traceT This trace shows a uterine contraction that may be a Braxton Hicks contraction There is evidence of Fetal distress on the trace 10/29/2018 42 Okechukwu A. Ugwu

43. Question 5: Concerning the picture below The baby is probably breech at deliveryF The baby was likely delivered by caesarean sectionT The baby may have presented with the faceT The baby probably had forceps deliveryT The baby is a product of destructive operationF 10/29/2018 43 Okechukwu A. Ugwu

44. Question 9: The result shown is for a 25 year old primigravida at 36 weeks gestational age. She should be admitted for urgent induction of labourT Use of misopristol is contraindicatedF She should have an elective Caesarean sectionT Fetal scalp pH is particularly useful in her intrapartum monitoringF The baby requires anti-retroviral therapyT CD4 count =13/mm 3 Viral Load = 6,585copies/ml 10/29/2018 44 Okechukwu A. Ugwu

45. Question 10: The patient below is a 45 yr old lady with 6/12 history of progressive Abdominal distension ECG is essential in her evaluationT Chest X ray is not required if there are no respiratory symptomsF Optimum treatment requires both surgery and chemotherapyT Ascites is rarely associated at this ageF Prognosis is not related to the size of the massT 10/29/2018 45 Okechukwu A. Ugwu

46. DERMOID CYST Most common benign tumour of the ovary T Most common neoplasm diagnosed during pregnancy T Most common germ cell tumour T Commonest tumour to undergo torsion T 10/29/2018 Okechukwu A. Ugwu 46

47. Ovarian Tumours Call Exner Bodies- Granulosa cell tumour T Walthard Cell nest- Brenner Tumour T Signet Ring- Krukuberg tumour T Hobnail Cell- Clear cell tumour T Schiller Duval Bodies- Endodermal sinus tumour T 10/29/2018 Okechukwu A. Ugwu 47

48. CONCERNING OVARIAN TUMOURS Skin, Teeth and cartillage - Teratoma T Psammoma bodies- Serous epithelial Tumours T Pseudomyxoma peritonei - Mucinous tumours T Rienke’s Crystal- Hilus cell tumour T 10/29/2018 Okechukwu A. Ugwu 48

49. BILATERAL in 10-15% of cases T Malignant change occurs in 0.5-2% of cases T Most common malignant transformation is squamous cell tumour Lining epithelium is columnar epithelium F 10/29/2018 Okechukwu A. Ugwu 49

50. About the procedure shown It is an endoscopic procedure T It facilitates directed biopsy T Areas of CIN appear white when the cervix is painted with Lugol’s iodine during this procedure F It can be used to assess vascular patterns on the cervix T The instrument used is a monocular microscope F 10/29/2018 50 Okechukwu A. Ugwu

51. Concerning this picture It is used for emergency contraception F The duration of use is 10 years F It can cause amenorrhoea T It can be used as part of a hormone replacement therapy regimen T It contains oestrogen and progestin F 10/29/2018 51 Okechukwu A. Ugwu

52. This instrument It is useful in the management of ante-partum haemorrhage F A systolic blood pressure of 90mmHg is an indication for its use T When weaning a patient off it, it is removed in the reverse order i.e from no 5 to no 1 F A pulse rate of 60/min is an indication for its use F It can be employed at every level of care T 10/29/2018 52 Okechukwu A. Ugwu

53. Regarding this lesion It is caused by herpes simplex virus F Similar lesions may be found on the vagina, cervix and uterus F They are generally painless T Spontaneous healing occurs within 3 weeks F Pregnancy can make the lesions large T 10/29/2018 53 Okechukwu A. Ugwu

54. Mechanism of Ureteric injury Crushing T Laceration T Ligation with sutures T Ischaemia/ devasculrisation T Segmental resection T Transection T 10/29/2018 Okechukwu A. Ugwu 54

55. Concerning this instrument and its use a. It is used in a minimally invasive procedure T b. Intestinal obstruction is a contraindication for its use F c. The procedure can be performed under general anaesthesia T d. It is useful in the diagnosis of uterine perforation F e. It is contraindicated in the treatment of endometriosis F 10/29/2018 55 Okechukwu A. Ugwu

56. About this instrument and its use a. This instrument is called the Mayo’s scissors. F b. The procedure must be carried out on all primigravid women. F c. Its use can lead to a 3rd degree perineal tear T d. Dysmenorrhea is a late complication of its use F e. The midline incision is easier to repair than the medio -lateral type T 10/29/2018 56 Okechukwu A. Ugwu

57. About what is shown It is useful in the management of cervical stenosis F It is an absorbable tape F It is usually removed at gestational age of 36 weeks F It should be removed when there are preterm contractions F When its use is indicated, it is inserted after the second missed period F 10/29/2018 57 Okechukwu A. Ugwu

58. The procedure shown The patient should lie in the left lateral position F The tip of the spatula is introduced into the cervical canal and the instrument rotated through 180 degrees F A cytobrush can be used in place of Ayre’s spatula T Samples taken are immediately fixed with 70% alcohol F The cervix is painted with Lugol’s iodine prior to sample collection F 10/29/2018 58 Okechukwu A. Ugwu

59. Features of delayed ureteric injury Prolonged ileus T Watery vaginal discharge T Prolonged high output from drains T Fever/sepsis. T Persistent flank/ abdominal pain T Flank mass T Elevated creatinine or BUN T 10/29/2018 Okechukwu A. Ugwu 59

60. About the condition depicted below It is common in postmenopausal women F Cystic degeneration usually precedes hyaline degeneration F The intraligamentary form can cause polycythaemia T GnRH antagonists are useful in its management T Iron deficiency anaemia secondary to chronic blood loss is an indication for surgical management. **T 10/29/2018 60 Okechukwu A. Ugwu

61. Concerning this It is a permanent measure of management F Pregnancy is a contraindication F It should be changed every 6 months F It can be complicated by vaginal infection T If it fails, surgery is indicated T 10/29/2018 61 Okechukwu A. Ugwu

62. About this instrument It is a high cavity forceps F It is a non-rotational forceps and so can be used in the correction of asynclitism F It has a sliding lock T The cervix should be at least 8cm dilated for its use F It causes more maternal injury compared to the vacuum extractor T 10/29/2018 62 Okechukwu A. Ugwu

63. Prevention of ureteric injury Generous surgical exposure T Meticulous surgical technique T IdentifIcation of Risk factors T Ureteric stenting T Pre operative IVU not necessary F 10/29/2018 Okechukwu A. Ugwu 63

64. . About this instrument It can be used for hindwater rupture of membrane F Its use is associated with cord prolapse T Its use is associated with foetal injury T It can cause uterine hyperstimulation F Its use is contraindicated in retroviral positive patients F 10/29/2018 64 Okechukwu A. Ugwu

65. Concerning this picture This is a complication of external cephalic version T Coagulation failure is a complication T Foetal parts will be easily outlined on palpation.F The uterus will have a h ard wooden consistency on palpation T Caeserian section should be performed if the fetus is dead on presentation. F 10/29/2018 65 Okechukwu A. Ugwu

66. Multiple gestation Cleavage of zygote on day 9 after fertilization produces the picture shown F The intertwin membrane is made up of 2 layers of amnion with no chorionic layer F Inheritance as autosomal recessive trait is recognised F There is a risk of twin to twin transfusion F Caeserian delivery is indicated if the presentation of the first twin is vertex and the second twin non-vertex F 10/29/2018 66 Okechukwu A. Ugwu

67. Concerning uterine incisions during Caesarean delivery A is associated with less likelihood of adhesion formation to bowel or omentum T A is more commonly used than B T B allows for easy entry into the uterus when there is fibroid in the lower segment T B is associated with less likelihood of subsequent uterine rupture during pregnancy F A is indicated in the presence of carcinoma of the cervix F A B 10/29/2018 67 Okechukwu A. Ugwu

68. Concerning the picture shown a. Birth weight of 1400gram is an indication for Caeserian delivery. T b. Engagement of the presenting part in the pelvis is not a contraindication for external cephalic version. F c. High parity is a predisposing factor T d. Lovset manouvre is used to deliver the head F e. Kielland’s forceps can be used in the delivery of the aftercoming head F 10/29/2018 68 Okechukwu A. Ugwu

69. Concerning the picture shown and intrapartum monitoring The duration between two vertical lines on a partograph is half hour. T In the primigravida , the cervix dilates at a rate of at least 1 cm/hr in the active phase T The alert line is parallel and 4hours to the right of the action line F Vaginal examination is done four hourly. T Plastic Pinnard stethoscope is better than the metallic one in monitoring fetal heart rate. T 10/29/2018 69 Okechukwu A. Ugwu

70. Concerning the use of this instrument: a. It is used to reduce the bisacromial diameter and allow for vaginal delivery F b. Cervix need not be fully dilated in experienced hands T c. It is employed in the commonest type of destructive surgery. T d. Continuous bladder drainage is essential after its use T e. At least 2/5th of the fetal head must have gone into the maternal pelvis if its use is indicated F 10/29/2018 70 Okechukwu A. Ugwu

71. About this instrument A tourniquet can be used in its place. T It is useful in vaginal hysterectomy F It is used in clamping the isthmus of the fallopian tubes F It helps reduce blood loss during surgery T It can be left in place for at least 2 hours F 10/29/2018 71 Okechukwu A. Ugwu

72. Concerning this instrument, It is used in fistula repair T Cusco’s speculum can be used in its place F Its use requires one assistant T Its use requires more than one assistant F Autoclaving is contraindicated F 10/29/2018 72 Okechukwu A. Ugwu

73. DERMOID CYST Most common benign tumour of the ovary T Most common neoplasm diagnosed during pregnancy T Most common germ cell tumour T Commonest tumour to undergo torsion T 10/29/2018 Okechukwu A. Ugwu 73

74. Ovarian Tumours Call Exner Bodies- Granulosa cell tumour T Walthard Cell nest- Brenner Tumour T Signet Ring- Krukuberg tumour T Hobnail Cell- Clear cell tumour T Schiller Duval Bodies- Endodermal sinus tumour T 10/29/2018 Okechukwu A. Ugwu 74

75. CONCERNING OVARIAN TUMOURS Skin, Teeth and cartillage - Teratoma T Psammoma bodies- Serous epithelial Tumours T Pseudomyxoma peritonei - Mucinous tumours T Rienke’s Crystal- Hilus cell tumour T 10/29/2018 Okechukwu A. Ugwu 75

76. BILATERAL in 10-15% of cases T Malignant change occurs in 0.5-2% of cases T Most common malignant transformation is squamous cell tumour Lining epithelium is columnar epithelium F 10/29/2018 Okechukwu A. Ugwu 76

77. About the procedure shown It is an endoscopic procedure T It facilitates directed biopsy T Areas of CIN appear white when the cervix is painted with Lugol’s iodine during this procedure F It can be used to assess vascular patterns on the cervix T The instrument used is a monocular microscope F 10/29/2018 77 Okechukwu A. Ugwu

78. Concerning this picture It is used for emergency contraception F The duration of use is 10 years F It can cause amenorrhoea T It can be used as part of a hormone replacement therapy regimen T It contains oestrogen and progestin F 10/29/2018 78 Okechukwu A. Ugwu

79. This instrument It is useful in the management of ante-partum haemorrhage F A systolic blood pressure of 90mmHg is an indication for its use T When weaning a patient off it, it is removed in the reverse order i.e from no 5 to no 1 F A pulse rate of 60/min is an indication for its use F It can be employed at every level of care T 10/29/2018 79 Okechukwu A. Ugwu

80. Regarding this lesion It is caused by herpes simplex virus F Similar lesions may be found on the vagina, cervix and uterus F They are generally painless T Spontaneous healing occurs within 3 weeks F Pregnancy can make the lesions large T 10/29/2018 80 Okechukwu A. Ugwu

81. Mechanism of Ureteric injury Crushing T Laceration T Ligation with sutures T Ischaemia/ devasculrisation T Segmental resection T Transection T 10/29/2018 Okechukwu A. Ugwu 81

82. Concerning this instrument and its use a. It is used in a minimally invasive procedure T b. Intestinal obstruction is a contraindication for its use F c. The procedure can be performed under general anaesthesia T d. It is useful in the diagnosis of uterine perforation F e. It is contraindicated in the treatment of endometriosis F 10/29/2018 82 Okechukwu A. Ugwu

83. 66 . Should be inserted between Day 1-5. T 67. Levels of hormones in the blood return to normal in a week. T 68. Biodegradable. F 69. Failure rate of 2 in 1000 F 70. Discontinuation rate of 15-25% F 10/29/2018 83 Okechukwu Ugwu

84. 61. Routinely done for primigravida F 62. This type bleeds less T 63. Restrictive used increases anterior perineal traumaT 64. May have a role in management of fetal distress T 65. The technique with best outcome is unknown T 10/29/2018 84 Okechukwu Ugwu

85. 56. Two thirds of patients bleed PV T 57. Transvaginal USS is contraindicated F 58. Bleeding is mainly maternal T 59. Hospital admission yields better outcome than being at home F 60. Risk of morbidly adherent placenta in cases of 3 previous CS and Placenta previa is 45%. T 10/29/2018 85 Okechukwu Ugwu

86. 51. Time consuming T 52. 10-15cm long T 53. Preferred in Misgav-Ladach technique F 54. Utilizes blunt dissection F 55. Has cosmetic appeal T 10/29/2018 86 Okechukwu Ugwu

87. 46. This is a pneumatic anti-shock garment. F 47. One size fits all F 48. Made of Neoprene T 49. Segments 4, 5 and 6 should be applied by only one person. T 50. It is a definitive treatment. F 10/29/2018 87 Okechukwu Ugwu

88. 41. Cost effective investigation T 42. This is risk factor for ectopic gestation T 43. Live birth rate is reduced by 35% in patients with this condition undergoing IVF-ET FALSE 44. Salpingectomy or proximal occlusion is indicated. T 45. NNT in IVF patients undergoing treatment for this condition is 6. T 10/29/2018 88 Okechukwu Ugwu

89. 36 . Incidence of 0.2% T 37. Delivery by extension F 38. Presenting diameter is 9.5cm T 39. Anterior neck mass is the most common course. F 40. Mentoposerior is better delivered by CS. T 10/29/2018 89 Okechukwu Ugwu

90. 31. Provides illumination and magnification T 32. 3 consecutive inadequate pap smear samples is an indication T 33. Ablative technique may be used for glandular disease. F 34. CCI has a maximum score of 10 T 35. It is unsatisfactory when the endocervical canal is not visualised F 10/29/2018 90 Okechukwu Ugwu

91. 26. Rupture of this type may be catastrophic T 27. Typically ruptures around 11weeks. F 28. Progesterone assay could help localize gestation. F 29. Wedge resection is the management of choice. T 30. Total removal of the ipsilateral tube is recommended. T 10/29/2018 91 Okechukwu Ugwu

92. 21. Cervical length of less 25mm at 24wks in a primigravida is an indication F 22. Outcome is the same as no intervention in multiple gestation. F 23. Removal of Shirodkar type requires anaesthesia T 24. Immediate removal following PPROM optimisises outcome. F 25. Recent evidence supports laparoscopic over laparotomy for abdominal cerclage F 10/29/2018 92 Okechukwu Ugwu

93. 16. HPV is a double stranded DNA virus. T 17. Smoking doubles risk of Ca cervix T 18. Risk due to COCP falls to baseline in 10 years after stopping. T 19. Presence of nodal involvement increases mortality by 30% stage for stage. F 20. Pregnancy does not adversely affect outcome. T 10/29/2018 93 Okechukwu Ugwu

94. 11. Commoner in multipara T 12. Usually symptomatic F 13. Intermenstrual bleeding is a recognized symptom T 14. Recurrence rate of about 3% F 15. Monsel paste has a role in controlling bleeding post-avulsion T 10/29/2018 94 Okechukwu Ugwu

95. Also known as pathological retraction ring T Formed between thinned out upper segment and lower segment F Contractions wane off with time in primigravid women T Electrolytes derangement is common T Increased risk of PPH T 10/29/2018 95 Okechukwu Ugwu

96. 6. Spermatozoa must be immobilized before injection. T 7. Inverted microscopy is utilized T 8. When indicated, male karyotyping should be done. T 9. ‘OAT’ syndrome is a contraindication. F 10. Holding pipette provides gentle sunction . T 10/29/2018 96 Okechukwu Ugwu

97. About this instrument and its use a. This instrument is called the Mayo’s scissors. F b. The procedure must be carried out on all primigravid women. F c. Its use can lead to a 3rd degree perineal tear T d. Dysmenorrhea is a late complication of its use F e. The midline incision is easier to repair than the medio -lateral type T 10/29/2018 97 Okechukwu A. Ugwu

98. About what is shown It is useful in the management of cervical stenosis F It is an absorbable tape F It is usually removed at gestational age of 36 weeks F It should be removed when there are preterm contractions F When its use is indicated, it is inserted after the second missed period F 10/29/2018 98 Okechukwu A. Ugwu

99. The procedure shown The patient should lie in the left lateral position F The tip of the spatula is introduced into the cervical canal and the instrument rotated through 180 degrees F A cytobrush can be used in place of Ayre’s spatula T Samples taken are immediately fixed with 70% alcohol F The cervix is painted with Lugol’s iodine prior to sample collection F 10/29/2018 99 Okechukwu A. Ugwu

100. Features of delayed ureteric injury Prolonged ileus T Watery vaginal discharge T Prolonged high output from drains T Fever/sepsis. T Persistent flank/ abdominal pain T Flank mass T Elevated creatinine or BUN T 10/29/2018 Okechukwu A. Ugwu 100