Acquire MCQs

Question 1

What artery should be ligated in order to remove the omentum
a. Middle colic artery
b. Omental branch of abdominal aortic artery
c. Left colic artery
d. Gastroepiploic artery

Answer 1

d. Gastroepiploic artery

Question 2

Which of the following statements is true regarding third trimester idiopathic oligohydramnios confirmed on ultrasound?

a. the use of AFI of less than 5 cm rather than SDP of less than 2 cm for diagnosis improves perinatal outcome
b. Amnioinfusion should be performed regularly until term
c. Isolated oligohydramnios is associated with worse perinatal outcomes
d. the earlier the diagnosis in the 3rd trimester the worse the perinatal outcomes

Answer 2

d. the earlier the diagnosis in the 3rd trimester the worse the perinatal outcomes

Question 3

A previously normotensive 42 year old woman is on the COCP. she has a diastolic pressure reading 95 mmHg at review for repeat script.
What would be her best initial management?

a. Continue with COCP, begin anti-hypertensive treatment and review
b. Continue with COCP and perform renal function testing and review
c. Cease COCP and review
d. Continue with COCP and recheck the blood pressure

Answer 3

d. Continue with COCP and recheck the blood pressure

Question 4

A 32 year old woman who has been infertile for four years has just completed the diagnostic phase of her infertility evaluation. Mid-luteal progesterone, semen analysis and hysterosalpingogram are all normal. A recent laparoscopy indicated moderate endometriosis without adhesions (stage III). Medical therapy for her endometriosis is recommended by another gynaecologist. the patient presents to the clinic with a list of questions concerning the proposed therapy.
You advise her that:

a. The availability of new medications has made medical therapy for endometriosis superior to operative therapy in terms of post-treatment pregnancy rates
b. The degree of ovarian suppression (hypo-oestrogenism) achieved by treatment with GnRH agonists is greater than that achieved with danazol
c. Danazol (danocrine) is most effective when administered as a single daily dose
d. Medical therapy will defer pregnancy and is not recommended in the setting of infertility

Answer 4

d. Medical therapy will defer pregnancy and is not recommended in the setting of infertility

Question 5

Which of the following is LEAST true of vulval melanoma?

a.The majority of melanoma cases are postmenopausal
b. Melanoma represents approximately 2% of all vulval malignancies.
c. Occur more frequently on the labia majora than labia minora.
d. 5-year survival with subcutaneous penetration is approximately 20%

Answer 5

c. Occur more frequently on the labia majora than labia minora.

Question 6

During placental development:

a.
a complete feto-placental circulation is established by 5-6 weeks post-conception.

b.
endovascular migration by cytotrophoblasts proceeds in two episodes that are completed by 8-10 weeks gestation.

c.
fetal blood flows to the placenta through paired umbilical arteries and a vein, and reaches an average flow rate of 350-400ml/min.

d.
utero-placental blood flow increases to 200-250ml/min at term.

Answer 6

a.
a complete feto-placental circulation is established by 5-6 weeks post-conception.

Question 7

Which of the following disorders does NOT have autosomal dominant inheritance?

a.
Achondroplasia

b.
Huntington’s chorea

c.
Tay-Sachs disease

d.
Von Recklinghausen’s disease (neurofibromatosis)

Answer 7

c.
Tay-Sachs disease

Question 8

The appropriate initial treatment of pulmonary thromboembolism is:

a.
low molecular weight heparin (LMWH) 1mg/kg BD subcutaneous injection.

b.
low molecular weight heparin (LMWH) 1.5mg/kg BD subcutaneous injection.

c.
unfractionated heparin 5000 units BD subcutaneous injection.

d.
unfractionated heparin 10,000 units IV followed by IV infusion.

Answer 8

a.
low molecular weight heparin (LMWH) 1mg/kg BD subcutaneous injection.

Question 9

A woman G3P2 at 35 weeks gestation, has confirmed preterm pre-labour rupture of membranes. In the context of the PPROMT trial which of the following outcomes would be most likely if she was managed expectantly?

a.
Higher risk of Caesarean section

b.
Higher risk of antepartum haemorrhage

c.
Lower risk of intrapartum fever

d.
Shorter hospital stay

Answer 9

b.
Higher risk of antepartum haemorrhage

Question 10

A 17-year-old patient having a laparotomy for a ruptured right ectopic pregnancy has a 10cm cyst of the right ovary and a normal appearing left ovary. Regarding the right ovarian cyst, what is the most appropriate surgical procedure?

a.
Right ovarian cystectomy

b.
Aspirate the cyst only

c.
Right salpingo-oophorectomy

d.
Cystectomy with wedge resection of the left ovary

Answer 10

a.
Right ovarian cystectomy

Question 11

You are the on-call registrar for Obstetrics. A patient has delivered her 5th baby but has not delivered the placenta yet. You receive an urgent call to the delivery suite and on arrival you diagnose acute inversion of the uterus. The patient is in shock.
What is the most appropriate first management step?

a.
Give Terbutaline 0.25mg subcutaneous/intravenous

b.
Attempt to remove the placenta

c.
Attempt to reposition the uterus

d.
Take the patient immediately to theatre

Answer 11

c.
Attempt to reposition the uterus

Question 12

A 31-year-old HIV positive woman near term is on anti-retroviral therapy. Her viral load is undetectable and there is no fetal complication. She wants to have a vaginal birth rather than a caesarean section.
After explaining the risk, what is the next most appropriate step?

a.
Contact the hospital lawyers for court orders for a caesarean section.

b.
Respect the patient’s decision as the risk of transmission is low.

c.
Perform the caesarean section at 38 weeks or if in labour.

d.
Contact Psychiatry to evaluate the patient’s decision.

Answer 12

b.
Respect the patient’s decision as the risk of transmission is low.

Question 13

What effect does an electrosurgical waveform have if it is high-current, low voltage and elevates the tissue temperature rapidly (> 100˚ C) to produce vaporisation?

a.
Cutting

b.
Desiccation

c.
Coagulation

d.
Fulguration

Answer 13

a.
Cutting

Question 14

A 36-year-old, primigravid woman at 16 weeks of gestation, has received genetic counselling and has chosen to proceed with prenatal diagnosis as there has been unusually slow growth of the fetus since the 12 week scan.
Which of the following is most correct?

a.
Amniocentesis is indicated because it is too late for chorionic villus sampling (CVS).

b.
CVS may indicate a cause for the growth restriction, not apparent with amniocentesis as placenta mosaicism is a potential cause.

c.
The risk of miscarriage associated with amniocentesis is 1:600 if performed by a maternal fetal medicine subspecialist.

d.
CVS is unhelpful in this situation because of potential karyotypic disparity between fetus and trophoblast.

Answer 14

b.
CVS may indicate a cause for the growth restriction, not apparent with amniocentesis as placenta mosaicism is a potential cause.

Question 15

A 21-year-old anxious and distressed nulliparous woman presents requesting a vaginal repair as her boyfriend commented that she had a lax vaginal wall and is putting pressure on her to have a reconstruction/repair. The gynaecological examination was normal.
What is the most appropriate initial option?

a.
Perform the procedure after explaining risks and consequences

b.
Explain to the woman that there is no medical indication for surgery

c.
Provide psychosexual counselling to the couple

d.
Recommend pelvic floor physiotherapy

Answer 15

b.
Explain to the woman that there is no medical indication for surgery

Question 16

Which of the following statements concerning stillbirth is INCORRECT?

a.
The rate of stillbirth is increased with a true knot in the cord.

b.
In each week of pregnancy between 26 weeks and 40 weeks, the rate of stillbirth is approximately 0.03%.

c.
Between 41 weeks and 41 weeks and 6 days, the rate of stillbirth is approximately the same as between 38 weeks and 38 weeks and 6 days.

d.
Approximately 1/500 women will have a stillbirth at or beyond 38 weeks gestation.

Answer 16

c.
Between 41 weeks and 41 weeks and 6 days, the rate of stillbirth is approximately the same as between 38 weeks and 38 weeks and 6 days.

Question 17

In developed countries fetal hypothyroidism is most likely to result when the mother has:

a.
carbamazepine overdose.

b.
Graves’ disease treated with thyroidectomy

c.
autoimmune thyroiditis.

d.
iodine deficiency.

Answer 17

c.
autoimmune thyroiditis.

Question 18

Which organism is responsible for Donovanosis?

a.
Haemophilus ducreyi

b.
Corynebacterium donovaniae

c.
Gardnerella vaginalis

d.
Klebsiella granulomatis

Answer 18

d.
Klebsiella granulomatis

Question 19

A 65-year-old woman has recovered from a Colles’ fracture. A recent bone scan reports decreased bone density. Her decreased bone mass is principally due to:

a.
decreased intestinal calcium absorption.

b.
decreased osteoblastic activity.

c.
decreased Vitamin D levels.

d.
increased osteoclastic activity.

Answer 19

d.
increased osteoclastic activity.

Question 20

A 53-year-old postmenopausal woman has been reading about Tibolone and would prefer to use it rather than oestrogen/progestogen therapy (Menopause Replacement Therapy-MRT).
You tell her that Tibolone:

a.
has a reduced incidence of vaginal bleeding compared with combined MRT.

b.
decreases the risk for endometrial cancer compared with placebo.

c.
has less risk for breast cancer recurrence than placebo.

d.
is as effective as bioequivalent doses of combined MRT in reducing the frequency of vasomotor symptoms.

Answer 20

a.
has a reduced incidence of vaginal bleeding compared with combined MRT.

Question 21

In which of the following scenarios would you have legally fulfilled your duty of care as a medical practitioner?

a.
You are on a flight travelling between Brisbane and Auckland. A passenger in first class has collapsed and a call has been made for assistance from any doctors on board. You do not respond.

b.
You perform an emergency caesarean section on one of your private patients due to fetal distress in labour. Her next pregnancy is complicated by a caesarean scar pregnancy and uterine rupture. You had discussed possible complications with her prior to her initial surgery but had not mentioned this rare but serious complication

c.
One of your regular patients has high grade abnormalities detected on her routine cervical screening. You arrange a referral for colposcopy but you receive a note from the hospital that your patient did not attend. You try to contact her by telephone but her number has been disconnected. You take no further action.

d.
A woman arrives at your practice before the clinic opens carrying a sick infant. She is not one of your patients. She asks you if you are a doctor and you reply that you are not.

Answer 21

b.
You perform an emergency caesarean section on one of your private patients due to fetal distress in labour. Her next pregnancy is complicated by a caesarean scar pregnancy and uterine rupture. You had discussed possible complications with her prior to her initial surgery but had not mentioned this rare but serious complication

Question 22

A hepatitis B screening test is positive for antibody to core protein but negative for surface antigen and antibody.
This indicates that:

a.
the patient is a chronic carrier.

b.
the patient has a high rate of infectivity.

c.
the patient has probably never had hepatitis B.

d.
the surface antibody will probably become positive soon.

Answer 22

d.
the surface antibody will probably become positive soon.

Question 23

Which of these congenital malformations is most likely to be associated with maternal diabetes mellitus?

a.
Isolated ventricular septal defect

b.
Duodenal atresia

c.
Gastroschisis

d.
Posterior urethral valves

Answer 23

a.
Isolated ventricular septal defect