STUDY MODE TRIAL Show session ID Load progressSave Session Correct0Incorrect0Skipped0 Welcome to your Demo Study 2 - MRCOG 2 Name Email 1. A 48 years female had IVF dichorionic twins. what pregnancy outcome is she at risk of ? CS IOL Still birth IUGR Pre-eclampsia None 2. How many pregnant women needed level 3 care in COVID pandemic between March 2020 to May 2020? 30% 20% 15% 10% 5% None 3. G2P1 Placenta previa major , gestational age 29-weeks, history of bleeding, now slight, no uterine contraction. Management should include which of the following ? Regular follow-up Admission and observation Reassurance Elective LSCS at 34 weeks Category 2 LSCS None 4. When is the latest time in pregnancy when smoking should be stopped before for same pregnancy risk as non-smokers? Stop smoking prior to 12 weeks As soon as possible Stop smoking prior to 10 weeks Stop smoking prior to 8 weeks Stop smoking prior to 15 weeks None 5. Which type of surgery is associated with higher incidence of ureteric Injuries? Laparoscopic abdominal hysterectomy Laparoscopic assisted vaginal hysterectomy Total abdominal hysterectomy Vaginal hysterectomy Incidence is comparable in all options None 6. A 30-year-old woman presented to Ambulatory Care with pain and swelling of her left leg, which had been present for 2 days. She is smoker and have history vaginal delivery ended by PPH 10 days ago. On examination her weight 91 kg and BMI 35 and there was obvious swelling of her left leg compared with the right. A Doppler ultrasound scan confirmed a proximal deep vein thrombosis. What is the correct treatment in this case? Enoxaparin: 60 mg twice daily or 90 mg once daily Enoxaparin: 100 mg twice daily or 150 mg once daily Dalteparin: 6000 iu twice daily or 12 000 iu once daily Dalteparin: 5000 iu twice daily or 10 000 iu once daily Tinzaparin: 170 units/kg once daily None 7. During laparoscopic hysterectomy , A diathermy injury to the small bowel occured but it was superficial. What to do? Take stitches Reassure Admit under observation Remove segment and anastomosis Wedge resection None 8. A lady 6 weeks miscarriage underwent expectant management. At 14 days no bleeding or pain per abdomen. What will you do? TVS after 1 week. Serum B-hcag. TVS at that time Continue expectant for further 1to 2 weeks. Start induction of abortion None 9. A 33-year-old woman presented to the emergency department with a five-day history of low abdominal pain. A pregnancy test and ultrasonography led to the diagnosis of a tubal ectopic pregnancy and she received medical treatment (methotrexate). Serum B-HCG as follow 750, 685,590 in days 1, 4 ,7 . How to follow up? Second dose of methotrexate 50 mg/m2 Repeat TVS & methotrexate 50 mg/m2 Serum b-Hcg in day 10 Repeat b-hCG weekly No further follow up needed None 10. How to follow B-HCG in expectant management of ectopic if it is falling? Weekly 2 Weekly 48 hours, US weekly US every 2weeks None 11. Pregnant woman 9 weeks gestation presenting with vomiting PUQE score 13, urine ketones +2 , vomiting not stopped by common management. What next? Give IV fluids and discharge Admit for inpatient management Ambulatory Day care Add prednisolone and discharge Therapeutic termination of pregnancy None 12. Which of the following is an indication for cervical length monitoring ? History of abdominal trauma Antiphospholipid sydrome (APS) Previous first trimester miscarriage Previous preterm birth up to 34 weeks. Family history of recurrent pregnancy loss None 13. A 13-year-old girl with solid ovarian tumor on left ovary. right ovary normal. B-HCG and CA-125 was normal, AFP and LDH are both raised. Diagnosis is mostly which of the following? Immature teratoma Dysgerminoma Yolk sac tumour Mature teratoma Seminoma None 14. A 45 years old woman with endometriosis. her family is complete and she wishes to contemplate the operation. Management should include which of the following? CHC Cystectomy Subtotal hysterectomy Laparoscopic excision Hysterectomy with bilateral oophorectomy None 15. A CT abdomin done for cholecystitis that yielded an incidental finding of ovarian cyst which was not properly visualized, which of the following should be your next step ? RMI MRI TVS TAS CT with contrast None 16. A lady with a skin lesion on vulva and scalp not responding to topical steroids and she's diabetic, which of the following is most likely? Lichen sclerosis Fungal infection Lichen planus Eczema Vulval psoriasis None 17. Vulval itching not Responding to topical steroids. what should be your next step ? Estrogen therapy Ultra-potent topical steroid Take biopsy and start tacrolimus Take biopsy Podophyllin Tri-chloro-acetic acid imiquimod None 18. 22 years old female with high testosterone and 17 hydroxy progesterone. Most likely diagnosis is? Cushing syndrome PCOS Hirsutism Congenial adrenal hyperplasia (CAH) Sertoli-leydig cell tumor None 19. Which indicator predicts disease among who actually has the disease ? Sensitivity Specifity Positive predictive value Negative predictive value Positive likelihood ratio Negative likelihood ratio None 20. With LNG IUS common complication is irregular bleeding, less common complication is amenorrhea, rare complication is perforation. In explaining potential unwanted outcome, what does "Uncommon” mean? 1 in 100 1 in 1000 1 in 10000 1 in 100000 1 in 10 None 21. Hospital collects data of all water birth deliveries of 3 years duration to identify effectiveness of analgesia, which assessment method should be used? Audit Risk management RCT Appraisal Reflection None 22. A woman admitted in ward with medically induced abortion. Patient complained of pain per abdomen. ST 3 refused to review case because of religious belief he can’t do abortion. In this time ST 1 was busy in maternity ward. Consultant on the way and expected to arrive in 30 minutes , which of the following is most appropriate ? Wait for consultant Wait ST1 Request senior midwife to give analgesia. Inform consultant and request senior midwife to give analgesia. Inform consultant and request ST3 to give analgesia. None 23. MRCOG grade A recommendation is which of the following? Case reports Cohort studies Meta-analysis Case control Expert opinion None 24. To find the relationship between maternal BMI & fetal birth weight , which of the following tests should be used ? Multiple regression logistic regression Pearson correlation Spearman correlation Man-whitney None 25. To look for the different outcomes of pregnancy in relation to BMI , which of the following tests should be used ? Multiple regression logistic regression Pearson correlation Spearman correlation Man-whitney None 26. National alerts are received by whom? Clinical director Deaneary Heads of departments Medical director Head nurse None 27. A student in clinic discussing a breech case with consultant, which of the following is this ? OSAT Audit DSL Mini CEX CBD None 28. Donation of embryos for research purposes requires which of the following? Verbal consent Written consent No consent Consent from both parents Legal advice Advance directive Consent from both parents and court order None 29. We want to find the relationship between umbilical artery doppler & pre-eclampsia, after other factors like age, parity, BMI are taken into consideration, which of the following tests should be used ? Multiple regression logistic regression Pearson correlation Spearman correlation Man-whitney None 30. Patient had IVF pregnancy had grade 4 placenta previa came in labour, baby transverse lie and placenta anterior low-lying. What's your management? Classical CS Lower uterine segment CS Admit for observation Internal podalic version Caesarean hysterectomy None 31. A 36 years elective CS, she received 2 units blood transfusion, her weight 91 kg and she is smoker. What your advice for VTE prophylaxis? 60 mg enoxaparin for 10 days postpartum 60 mg enoxaparin for 6 weeks postpartum 80 mg enoxaparin for 6 weeks postpartum Ambulation and avoid dehydration. No need for VTE prophylaxis None 32. A primigravid in the second stage of labour, the vacuum popped off twice with descent from 0 to+2 . Choose the most appropriate for situation ? Observe Try ventouse again Seek senior opinion Forceps CS None 33. What is the preferrable position should the woman be in for delivery during a vaginal breech birth? Trendlenberg position Semi-supine position Semi-recumbent position Left lateral Upright position None 34. A woman with Breech presentation & intact fore-water opting for vaginal delivery for which epidural analgesia is used. O/E : cervix dilated 3 cm , breech at +1 station contractions are 2 every 10 min. what would be the most appropriate action ? Expextant management LSCS Augment by syntocinon ARM Breech extraction None 35. Twin pregnancy at 36 weeks first cephalic, second was breech. what should be the mode of delivery? Induction of labour at 37 weeks Category 1 LSCS Category 2 LSCS Induction of labour now Allow vaginal delivery None 36. Patient in labour with uterine hyperstimulation. Next step should be which of the following? Maternal resuscitation Terbutaline Steroids Magnesium sulfate Analgesia None 37. Patient had 3rd degree perineal tear, now pregnant and has no complain of any faecal incontinence or urgency but on endoanal scan found to have anorectal defect. Patient keen on vaginal delivery, what's your advice? Offer IOL at 39 weeks & episiotomy Offer SC at 39 weeks Counsel the patient about the risk Emergency CS Wait for spontaneous labour & warm compression Normal onset of labour with perineal massage Wait for spontaneous labour and give perineal protection Offer IOL at 40 weeks & perineal protection None 38. Position/Rotation of fetal head while application of outlet forceps should be which of the following ? Deflexed occipito posterior Deflexed occipito transverse Deflexed occipito anterior Flexed occipito transverse Flexed occipito posterior None 39. Patient pregnant 37 weeks had EOGBS in last pregnancy and had nausea and vomiting during penicillin administration. What’s the most appropriate for her ? Antibiotics during labour Antibiotics now and during labour Benzyl penicillin 3 gm IV loading dose then 1.5 mg every 4 hourly until delivery No antibiotics prophylaxis Clindamycin 15 gm loading dose n then 750mg 8 hourly until delivery Vancomycin 1 gm every 12 hourly No bacteriological screening None 40. Patient complains of fecal incontinence after 3rd degree perineal tear came in labour. How will you manage? Offer IOL at 39 weeks & episiotomy Offer CS at 39 weeks Counsel the patient about the risk LSCS Wait for spontaneous labour & warm compression Normal onset of labour with perineal massage Wait for spontaneous labour and give perineal protection Offer IOL at 40 weeks & perineal protection None 41. A 42 years pregnant , dichorionic diamniotic twins (DADC) at 36 weeks. What is the most common complication ? Pre-eclampsia Caesarian section Neonatal admission Pre-term labour Post-partum hemorrage None 42. Obstetric anal sphincter injuries (OASIS) is more likely with which of the following? Kiwi delivery Rotational forceps Rubin maneouvre Traction forceps in occipito-anterior position Traction forceps in occipito-posterior position Vaginal breech delivery Vaginal disimpaction of the fetal head Ventouse delivery None 43. Subgaleal haematoma is a recognised complication of which of the following? Kiwi delivery Rotational forceps Rubin maneouvre Traction forceps in occipito-anterior position Traction forceps in occipito-posterior position Vaginal breech delivery Vaginal disimpaction of the fetal head Ventouse delivery None 44. Patient had 3rd degree perineal tear, now pregnant and has fecal incontinence , Your management should include which of the following ? Offer IOL at 39 weeks & episiotomy Offer CS at 39 weeks Counsel the patient about the risk Emergency CS Wait for spontaneous labour & warm compression Normal onset of labour with perineal massage Wait for spontaneous labour and give perineal protection Offer IOL at 40 weeks & perineal protection None 45. Pregnant woman with ulcerative colitis and has bloody diarrhea, fever, pain, gets psychotic episodes with steroids. Your management? Metronidazole Hydrocortisone Sulfasalazine Azathioprine Prednisone None 46. Pregnant woman with SLE, she has rash, arthritis, glomerulonephritis. What is the best drug for situation? Metronidazole Prednisolone Hydrocortisone Azathioprine Sulfasalazine None 47. Pregnant woman with diabetic retinopathy. At which gestational age will screening for retinal assessment be? At 12-15 weeks At 10-12 weeks At 16-20 weeks At 20-24 weeks At 24-28 weeks None 48. 20 weeks pregnant with generalized tonic clinic seizure for first time. Investigation to do? CT scan MRI FBC, RFT, LFT EMG EEG None 49. Post-partum patient on labetalol, but still high BP and she is breast feeding. What's the management? Nifedipine Aldomet Enalapril Verapamil Hydrochlorothiazide None 50. Which of the following is a predictor for Perinatal mortality? Birthweight according to GA Maternal age Mode of delivery Fetal weight Paternal age None 51. What of the following used for screening of thalassemia in the UK? 70 Q and blood index FOQ and HPLC HPLC GAD 2 EPDS None 52. A 34 years old patient , she is a known case of diabetes millitus and she came to your clinic because she's planning to get pregnant. What’s your advice regarding blood glucose control? Fasting 4-8 permeable 5-7 mmol/l 2 hours postprandial. 6.7 mmol/l Fasting 5-7 permeable 4-7 mmol/l 2 hours postprandial 8.9 mmol/l None 53. A 30 years old female, primigravida, BMI 39, Complains of headache , fundoscopy was done showing papillaedema, choose the most appropriate next step ? MRI CT scan US Lumbar puncture None of the above None 54. Woman undergone IVF and conceived , risk of thrombosis is highest during which of the following? First trimester Second trimester Third trimester Postpartum Second half of pregnancy 1st half of pregnancy None 55. Primigravid at 30 weeks gestation, no past medical or surgical history, BMI is 24kg/m, blood pressure is 110/70, developed Ml. most common cause for Ml in pregnancy is which of the following ? Atherosclerosis Ischemic heart disease Coronary artery dissection Thrombosis Coronary artery rupture Embolization None 56. Pregnant woman at 32 weeks of gestation, she presents to emergency department with fits. She had past history of preeclampsia. Patient on a loading dose of magnesium sulphate and fits recur. What should be your next step? Increase infusion dose 1.5 gm/hr Diazepam IV Further dose of 2-4 g IV Lorazepam IV EMCS None 57. A pregnant woman with DM type 1 presents to ANC clinic at 12 weeks. How to manage? 75-150 mg of aspirin daily from 12 weeks until the birth of the baby 75-150 mg of aspirin daily from 36 weeks until the birth of the baby 75-150 mg of aspirin daily from 34 weeks until the birth of the baby 75-150 mg of aspirin daily from 24 weeks until the birth of the baby 75-150 mg of aspirin daily from 18 weeks until the birth of the baby None 58. Most common cause of maternal collapse in UK? Epilepsy Hemorrhage DM Sepsis Pulmonary embolism Coronary dissection None 59. Jehovah's Withess woman during caesarean section she developed postpartum hemorrhage and IOCS [intra-operative cell salvage] is used, she is Rh negative. Which dose of anti-D to be given? 250 IU 500 IU 1500 IU immunoglobulin 1500 IU followed by Keilhauer test No need for anti D None 60. 35 years old PG, her BMI is 29, underwent LSCS for breech at term, no medical or surgical complications. What should be recommended for her VTE prophylaxis ? Ambulation and avoid dehydration LMWH for 5 days LMWH for 10 days LMWH for 6 weeks no additional measures neede None 61. Anti-K auto-antibodies were detected in a pregnant woman at 29 weeks of gestation. What's next? Measured every 4 weeks until delivery Measured every 3 weeks until delivery Measured every 2 weeks until delivery Measured weekly until delivery Measured twice weekly until delivery No need for extra monitoring None 62. Which of the following is used for assessment in clinically significant maternal anti D antibodies? Umbilical artery Doppler Fetal blood sampling (FBS) MCA Doppler Uterine artery Doppler Ductus venosus Doppler None 63. 17-year-old girl presented with urinary retention ,Midwife noted her urethra is narrow and a cut mark near clitoris. What will be your urgent management? Suprapupic catheter De-infibulation Inform police Inform social cervices Inform police and social services None 64. Patient's LMP was 3 weeks ago and IUCD inserted in that period, she started holiday 2 weeks ago and during the whole holiday she was sexually active, but she can't feel the thread of IUCD, O/E : the thread not seen , last intercourse was 4 days ago, she's worried to get pregnant. US showed no IUCD intrauterine . What emergency contraception is most suitable for her? CU-IUD Levonorgestrel 1.5 mg CHC Ulipristal acetate 30 mg Pregnancy test and reassure None 65. When to start OCP in a postpartum breastfeeding woman? 3-5 weeks 5-6 week 6 weeks -6 months 6 - 12 months 2-4 weeks None 66. Donovan bodies are characteristic of which of the following? Lymphogranuloma venereum Leptospirosis Homophiles ducryi Streptococcus group Granuloma inguinale None 67. Which contraception method has the least failure rate with typical and perfect use? LNS-IUS Implant CHC DMPA POP None 68. A 15 years old girl presenting with primary amenorrhea with ataxia and cataract in both eyes? Stein Leventhal syndrome Swyer syndrome Down syndrome Turner syndrome Heriditary galactosemia None 69. A woman with PCOS resistant to 6 cycles 150mg clomiphene citrate. Labs show higher LH and androgen level. Next treatment should be which of the following? IVF GnRH therapy Laparoscopic ovarian drilling Another 6-cycle clomiphene clomiphene citrate & metformin None 70. 30 years old SLE patient came for councelling. which drug has to be stopped before pregnancy ? Sulfasalazine Cyclophosphamide Azathioprine Hydroxychloroquine Steroid None 71. A lady came to outpatient clinic , she's diagnosed as bladder pain syndrome. She's anxious and said that symptoms cause poor quality of life. Your management should be which of the following ? Intravesical hyaluronic acid Intravesical lidocaine Amitriptyline Intravesical heparin Fluoxetine None 72. A patient with bladder pain syndrome which affects her quality of life and anxious. What is the first line treatment? Acupuncture Cimetidine Cyclophosphamide Amitriptyline Intra-vesical DMSO None 73. Patient with suspected Vesicovaginal fistula (VVF). How to be diagnosed? MRI CT urogram Cysto-urethroscopy Color Doppler ultrasonography Examination under anaesthesia None 74. Patient has urgency, frequency and urge incontinence. Overactive bladder was diagnosed and not responding to anticholinergic medicines, next step ? Urodynamic study Posterior tibial nerve neuromodulation Botulinum toxin injection Augmentation cystoplasty Sacral nerve stimulation None 75. A 55 years old female has vaginal prolapse with uterine descent stage 2 to 3. failure of pessary. She refused abdominal hysterectomy. What's your management? Anterior repair Pessary Vaginal hysterectomy TAH PFMT None 76. Regarding the instrument in the picture , which of the following is represented by label D ? Cap which is removed to allow the radioactive source to drain out Vaginal ring Rectal ring Cap which is removed to allow the radioactive source to pass down Lateral uterine tube Central uterine tube Rectal retractor Rectal forceps None 77. Which of the following represents the most likely diagnosis of ultrasound picture below ? Blood in Pouch of Douglas Ovarian hyperstimulation Ectopic pregnancy Haemorrhagic cyst Hydrosalpinx Free fluid in POD None 78. US picture shows adenexal mass with history of IUCD for 10 years? Endometriotic cyst Actinomycetes Hemorrhagic cyst Ectopic pregnancy Ovarian tumour None You’ve already answered some of the questions! Would you like to continue with quiz or restart it from beginning? Time's up MRCOG 2 mock trial View MRCOG 2 question bank
