1. A 22 year old woman comes with complains of irregular menstruation . She has recently gained weight too and her BMI is 32 . On scan , following image is seen .What is your next advise ?

2. A midwife calls you to see a the CTG of a woman in labour . What is the cause of the changes seen in the CTG ?

3. A 26 years old 8 weeks pregnant pregnant woman comes to A& E with complaints bleeding p/v associated with passage of some clots and tissue . She has been diagnosed with complete abortion.What is your next advise ?

4. A woman at 32 weeks gestation complaints of itching in hands and legs which is particularly worse at night . She was given cetrizine but had no improvement. Her serum bilirubin is mildly raised . Which of the following drugs can benefit her in this situation?

5. A 26 years old woman comes to you with complain of bloated ness and breast pain and low mood every month just menses . What is your diagnosis ?

6. A 34 years old woman presents in A & E with complaints of pain abdomen and vomiting . She is undergoing IVF treatment . She had got HCG injection 5 days back and Oocyte collection 3 days back . On examination ascites was found . What is the diagnosis of her condition ?

7. A 55 years old post menopausal woman visits you with the complaint of bloating , heaving in lower abdomen .Transvaginal scan done shows bilateral ovarian mass with solid areas on scan and CA 125 of 200. What is her RMI score?

8. A woman in labour is receiving oxytocin to augment labour . Suddenly midwife realises that the woman is getting contractions very frequent consequently causing changes in CTG. She stops the oxytocin immediately and calls you . Your consultant has asked you to oxytocin antagonist. Which of the following will you give her ?

9. A 32 years old nulliparous woman has been diagnosed with breast cancer . She underwent surgery and is not having any metastatic disease . What will be your advise ?

10. A 26 weeks nulliparous women comes to you with complains of fever and rash .She never had chicken pox before . She tells that one of her colleagues had recently been diagnosed with chicken pox. Which of the following medicine would you advise in this condition ?

11. The accompanying picture is brought by Ms.Shelly.She wants to know .What is the structure marked by the arrow?

12. A 50 year old lady underwent TAH for heavy menstrual bleeding not responding to medical management.24 hours in the post op period there was abdominal distension & peristalsis was not heard.The consultant asked for the result of serum electrolytes.Which electrolyte imbalance can lead to a picture of paralytic ileus?

13. you are reviewing the results of 75 gm oral glucose tolerance test of a multi at 24 weeks of gestation which shows glucose levels as follows-fasting 6.2, 2 hours 7.7. How will you counsel the woman?

14. A 40 years old primi came to A & E 4 days after undergoing an emergency CS. She came from home with shortness of breath and leg swelling. ECG, XRC ABG all normal. what will you do next?

15. You have started COCPs for contraception in a normotensive pt what advise will you give regarding follow up to check the blood pressure?

16. You are the ST 5 in the contraception clinic .A 35 years old lady has come in to know more about Implanon.She specifically wants to know how Implanon works.What will you tell her?

17. A primi at 39 weeks of pregnancy comes to the labour room with pain in abdomen & leaking since 1 hour.While going thru her hand held notes you notice that she had GBS bacteriuria at 28 weeks which was treated with antibiotics.Which antibiotic will you offer her now for IAP?

18. A primi with 38 weeks pregnancy comes to labour room with history of labour like pain & leaking vaginal fluids since 3-4 hrs.On exam -Temperature-39 degrees,Pulse 110/min,BP-90/60mmHg.CTG shows baseline fetal heart rate of 189 bpm & there are mild occasional uterine contractions.Vaginal exam showed cervix to be 5 cm dilated,membranes absent & liquor was clear.What is the most appropriate management for this lady?

19. Filshie clips for laparoscopic female sterilization made up of which material?

20. A couple with history of subfertility for past 2 years came to the infertility clinic for investigations & treatment. Investigations of the female partner were within normal limits. The semen analysis showed azoospermia & semen volume of 0.5 ml. The male partner gives a history of testing positive for the cystic fibrosis gene. What could be the likely cause for the azoospermia & low semen volume?

21. Which of the following is considered 1st line treatment for Menorrhagia according to NICE?

22. A 28 year old women presents at 30 weeks complaining of intense itching particularly on the hands and feet that is worse in the evenings. She has taken cetirizine but this hasn’t settled her symptoms. Examination is unremarkable with no rash. What is the likely diagnosis

23. A 27 year old women presents with a history of vaginal spotting and cramping abdominal pain. She has an 8 week history of amenorrhoea. On examination urine pregnancy test is positive and the cervix is closed. What is the likely diagnosis?

24. A 16 year old girl has been referred as she has amenorrhoea. She reports never having periods. Her mother and 2 sisters menarche was at age 12. On examination you note the patient is 152cm tall and BMI 29.0 and secondary sexual characteristics are not developed. Her FSH is elevated. Prolactin is normal. What is the suspected diagnosis?

25. You are seeing the CTG of a primi 25 years of age ,who is 6 cm dilated.The CTG shows baseline heart rate 155,no accelerations,baseline variability 8,variable decelerations for 120 mins.What is the type of CTG.?

26. What is the speed of the CTG paper in UK?

27. In a partogram,,what does the arrow indicate?(left arrow)

28. What is your interpretation of the following urodynamic graph?

29. A G2P1 with 1 previous normal delivery comes to labour suite at 39 weeks of pregnancy with spontaneous rupture of membranes. CTG is as shown below—maternal PR-80/min, baseline FHR 120/min & liquor is clear cervix is 2 cm dilated. After 2 hrs she is 4 cm dilated & CTG again shows baseline FHR of 120/min. maternal contractions are reduced. What should be the management?.

30. A primi at 41 weeks gestation is induced using dinoprostone pessary.A few hours later she starts getting contractions.Regarding the CTG ,what is the most appropriate management?

31. A 30 years old G2P1Ao with 39 weeks pregnancy.She has SROM of membranes at home 24 hrs ago.Came to labour room with abdominal pain x 4 hrs.She is febrile,Pulse rate 92/min,BP-100/70. There I uterine tenderness & foul smelling lochia.cervix is 5 cm dilated.CTG shows baseline fetal heart rate 162/min,reduced variability.What is the best management option for this pt?

32. Amniotomy was done for a primi at 5 cm dilatation.2 hours later she is 5 cm & contracting 2 in 10.What is your further action?

33. A primi with a low risk pregnancy at 40 weeks in spontaneous labour.she has a history of leaking clear fluid vaginally for 2 hours.on exam her observations are normal.she is having regular painful contractions 3 in 10 mins & cervical dilatation is 4 cm.CTG was performed due to concerns about FHR on auscultation.The CTG shows a baseline fetal heart rate of 140-150 beats /min & no other non reassuring or abnormal features.What will be the next appropriate step?

34. How would classify a CTG with following features—baseline 120/min,variability 9 /min,decelerations with </= 60 beats drop from baseline ,lasting </= 60 seconds for over 90 minutes .

35. A 25 year old primi has had an uncomplicated pregnancy. she reports to labour room at 39 weeks gestation .She has clear fluid draining vaginally for past 2 hours & uterine contractions are strong,4 in 10 mins. The fetus is in cephalic presentation. Vaginal exam reveals an uneffaced cervix 5 cm dilated. The head is at -1 station, without any caput or moulding. Which of the following is the most appropriate method to monitor the fetus in labour?

36. The filling cystometry trace of a woman with c/o urinary urgency ,frequency & nocturia is as below.She has no urge or stress urinary incontinence.What is the most likely diagnosis?

37. How would you describe the following semen analysis report-volume>3ml,total sperm count-20 million,sperm conc-10 million/ml,pH>7.2,overall motility-15%,normal forms-1% .?

38. A pregnant woman with a BMI of 35 underwent a 2 hr 75gm OGTT at 24 weeks of gestation.According to NICE guidelines what results confirm a diagnosis of GDM?

39. A 17-year-old girl presents with a 12 hour history of lower abdominal pain. She had unprotected intercourse a week ago, which was 6 days after her last period. Her pulse is 110 beats per minute, her blood pressure is 110/70 mmHg, her temperature 37.8°C and she is tender over her lower abdomen, especially in the right iliac fossa where there is rebound tenderness. There is cervical excitation. Her Hb is 137g/l (normal 115–165) and her white cell count 17.6 x 10*9/l (normal 4–11). What is the most likely diagnosis?

40. Which of the following is the commonest congenital infection is caused by Chlamydia trachomatis?

41. Which molecule of the HIV has the ability to bind and enter in host cell?

42. Which of the following sexually transmitted disease (STD) is caused by Haemophilus ducreyi?

43. Which of the following is a most common protozoan causing zoonotic infection presenting with cerebral calcification and chorioretinitis as main features?

44. Antenatal screening of a 25-year-old patient is suggestive of hepatitis B infection. The results of her serology are as follows: HBsAg Positive, HBeAg negative, Anti-HBeAb positive, Anti-HBsAb Negative, Total anti-HBc Positive (IgM anti-core Ab negative, IgG anti-core Ab positive). Which of the following is most likely to represent her hepatitis B status?

45. 34-year-old woman has just returned to the UK following missionary work in the northern parts of South America. She is delighted to be pregnant and presents for booking at 12 weeks of gestation. After counselling she agrees to have routine blood investigations including screening for syphilis. The results are returned as follows:
• Venereal Disease Research Laboratory (VDRL) test REACTIVE
• Treponema pallidum particle agglutination (TP-PA) test NON-REACTIVE
• Fluorescent treponemal antibody absorption (FTA-Abs) test NON-REACTIVE
What is the most likely appropriate interpretation of these results?

46. Which of the following laboratory techniques is used to amplify very small amounts of DNA?

47. Pseudomonas aeruginosa is an opportunistic pathogen which is responsible for causing hospital-acquired infections like localised lesions (infections of wounds and bedsores, eye infections and urinary infections following catheterisation), septicaemia and infections of the gastrointestinal tract, CNS and musculoskeletal system. It particularly causes infection in patients with severe burns, patients with cancer and patients who are immunosuppressed. How does Pseudomonas aeruginosa appear on MacConkey agar?

48. A G2P1L1 28-year-old pregnant woman had flu like symptoms, backache, myalgia and malaise at 20 weeks of her pregnancy. Her elder child is 4 years old attends nursery. She delivered a baby with respiratory depression, jaundice & hepatosplenomegaly. Which of the following infection is the most likely cause?

49. A 22-year-old sexually active woman attends gynaecology clinic with green or yellow discharge, which is profuse, smells fishy, and accompanied by itching or irritation. The microscopy has isolated following organism. Identify the cause of her symptoms?

50. A 36-year-old primigravida having O negative blood group, underwent amniocentesis due to screen positive for Down’s syndrome. Which of the following test is used to detect feto-maternal haemorrhage?

51. Which type of epithelial cell lines the cervix exterior to the transformation zone?

52. Which of the following is the most common histology type that constitutes vulvar cancers?

53. Which ovarian tumor is associated with Meig’s syndrome?

54. Which of the following neoplasms of the female genital tract occur in an 18-year-old girl whose mother was treated with diethylstilbestrol during the pregnancy ?

55. A 45 year old woman has been diagnosed with the BRCA 1 gene positive. What is her lifetime risk of ovarian cancer?

56. Psammoma bodies are a histologic feature of ovarian papillary serous cystadenoma. ‘ Psammoma bodies’ are composed of-

57. Most common type of degeneration in fibroid

58. Which type of necrosis is seen in the heart after an acute myocardial infarction?

59. A 60-year-old lady presents with erythematous erosive lichen planus on the vulva. Which type of cancer is likely associated with lichen planus ?

60. A 55 year old lady presented me with the history of painful menses. After hysterectomy, Cut section of hysterectomy specimen of a Uniformly enlarged uterus. The histopathological evaluation of the uterus shows the endometrial tissue found within the myometrium in continuum with the endometrium. Which of the following conditions best describes this histopathological finding?

61. Major stages of shock are:

62. Features of down syndrome is:

63. Which of the following is characteristic of the cellular changes seen in dysplasia?

64. You have just clerked in a patient on the labor ward who has SLE. What type of hypersensitivity reaction is SLE an example of?

65. Which immunoglobulin has no known function, but is present on the surface of B lymphocytes? It may function as an antigen receptor.

66. A young girl has had repeated infections with Candida albicans and respiratory viruses since the time she was 3 months old. As part of the clinical evaluation of her immune status, her responses to routine immunization procedures should be tested. In this evaluation, the use of which of the following vaccines is contraindicated?

67. Which immunoglobulin exists as a dimer and is found in secretions such as saliva?

68. Concerning complement, which of the following statement is true?

69. All antiepileptic drugs can cause birth defects in the fetus. The anti-epileptic which is thought to be safest in pregnancy is

70. 60 year old lady with overactive bladder symptoms was prescribed Oxybutynin to control her symptoms.Which of the following symptom would you expect to see in her after she starts taking the drug?

71. What is the mechanism of action of dabigatran which is a drug used as an anticoagulant?

72. The anti-epileptic whose levels invariably fall during pregnancy is

73. A 23-year-old woman is newly diagnosed with thyrotoxicosis. She is 20 weeks pregnant. Which medication will be the most appropriate treatment?

74. A 20 year old girl who was 20 weeks pregnant came with complaints of vaginal itching. Examination & investigations indicated she had vaginal candidial infection. What is the best management you would offer to her?

75. Patients who are on combination ART are at a high risk of developing the following complications & should be monitored for all of the following in pregnancy except:

76. Mrs Sara, 25 years old has come to the clinic with a report of her urine culture & sensitivity. The urine culture shows growth with E.coli which is sensitive to penicillin, cefuroxime & nitrofurantoin. The patient has severe allergy to penicillin. What will you advise her about taking cefuroxime to treat the UTI?

77. Among all the drugs used in treatment of HIV which of the following is considered to be the drug of choice for treating women during pregnancy to prevent vertical transmission?

78. Ciprofloxacin is a quinolone antibiotic. What is its mode of action?

79. Which of the following normal physiological changes seen in pregnancy are associated with a slower drug metabolism?

80. A 17-year-old girl discovers she is pregnant despite taking the oral contraceptive pill. She has recently been prescribed a new medication by her general practitioner. Which of the following drugs is most likely to have interacted with the efficacy of her contraception?

81. A 25-year-old nulliparous woman, with a lifelong history of tonic clonic seizures, sees her neurologist as she wishes to start a family. In addition to her current anticonvulsant therapy which additional drug is now required?

82. A 23-year old woman is 8 weeks pregnant. She has persistent itchy, thick, white vaginal discharge. A high vaginal swab has identified the presence of yeast species. She has already tried topical clotrimazole cream which has provided no relief of her symptoms. Which is the most appropriate treatment for vaginal candidiasis unresponsive to clotrimazole cream?

83. Characteristics of labetalol are:

84. What is the SI unit for the activity of radioactive decay?

85. The standard chest X-ray is equivalent to what duration of natural background radiation

86. A 60-year-old woman with stage IIB cervical cancer is currently undergoing radiotherapy by impact of gamma-emitting isotopes on her vagina. This type of therapy is best described by which of the following terms?

87. What type of Laser is Neodymium: YAG laser?

88. Which one of the following imaging techniques gives maximum radiation exposure to the patient during checking tubal patency?

89. Which imaging modality would you be choosing to check growing thyroid nodule in pregnancy ?

90. What is the SI Unit of magnetic field ?

91. What is the threshold for ultrasound frequency ?

92. The difference between the peak and the base line of ultrasound wave is called?

93. A 14-year-old girl is treated with radiotherapy. Which of following tissues is most radioresistant?

94. What is the contrast dye used in MRI scans?

95. What is the principle of DEXA scanning to assess bone mineral density?

96. What is the best description of the Doppler effect?

97. What is the dose of radiation to breast tissue while doing CTPA?

98. What frequency is used for trans-vaginal ultrasound?

99. Which type of electrosurgical circuits is safest in theatres?

100. The following key enzymes and metabolic pathway are matched well except-