1 Embryology
A Mesonephric ducts D Sinovaginal bulbs G Genital swellings
B Paramesonephric duct E Genital tubercle H Genital ridge
C Mullerian system F Genital folds
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Develop(s) into the lower portion of the vagina.
2 Form(s) the ovary.
3 Develop(s) into the labia minora.
4 Develop(s) into the labia majora.
2 Anatomy and physiology
A Aorta D Vena cava G Paraaortic nodes
B Internal iliac vein E Superficial inguinal and H External iliac vein
femoral nodes
C Renal vein F Obturator, internal and
external iliac nodes
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Lymphatic drainage of the ovary.
2 Lymphatic drainage of the lower vagina and vulva.
3 Lymphatic drainage of the upper vagina and cervix.
4 Venous drainage from the left ovarian vein.Extended matching questions 59
3 Normal and abnormal sexual development and puberty
A Cloacal cells D Testosterone G SRY region
B 17-Hydroxyprogesterone E Dihydrotestosterone H Sertoli cells
C Wolffian duct F Leydig cells
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 This is responsible for the production of TDF.
2 These cells are responsible for the production of Mullerian inhibitor.
3 These cells are responsible for the production of testosterone.
4 This is the hormone responsible for the development of the vas deferens, epididymis and seminal vesicles.
4 Disorders of the menstrual cycle
A Adenomyosis D Malignancy of the cervix G Endometrial malignancy
B Stress incontinence E Fibroids H Uterine prolapse
C Endometrial polyp F Pelvic inflammatory disease
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Intermenstrual bleeding.
2 Postcoital bleeding.
3 Postmenopausal bleeding.
4 Painful periods.
5 Disorders of the menstrual cycle
Surgical treatments
A Transcervical resection C Microwave ablation F Myomectomy
of the endometrium D Endometrial curettage G Abdominal hysterectomy
B Vaginal hysterectomy E Manchester repair H Mirena
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 A procedure for the investigation of menorrhagia but not a treatment.
2 An outpatient procedure that destroys the endometrium and fibroids up to 4 cm in diameter.
3 A procedure for women with fibroids who want to retain their fertility.
4 A definitive treatment for menorrhagia refractive to other treatments, if the uterus is not enlarged and ovarian conservation is required.
Medical treatments
A Cyclical progestogens D Antifibrinolytics G Danazol
B Combined oral E Antiprostaglandins H Gestrinone
contraceptive pill F Gonadotrophin-releasing
C LNG-IUS hormone analogues
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.60 Gynaecology
1 The 5-year prolonged exposure of the endometrium to progestogen to cause thinning of the endometrium
and lighter menses.
2 This reduces production of prostaglandin E2 and reduces loss by up to 25 per cent.
3 This is to be taken from days 5 to 26 in anovulatory dysfunctional uterine bleeding; it regulates the cycle and
promotes secretory endometrium in the second half of the cycle.
4 This promotes coagulation and reduces menstrual loss by 40 per cent.
6 Infertility
A Clomid D Azoospermia G Androgen-secreting tumour
B Anovulation E Polycystic ovary syndrome H Puregon
C Oligospermia F Chlamydia
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 This is associated with a raised free androgen index, low sex hormone-binding globulin and raised testosterone.
2 The commonest cause of tubal disease in the Western world.
3 The only treatment is donor insemination.
4 An oral treatment for anovulation.
7 Disorders of early pregnancy
A Threatened miscarriage D Ectopic pregnancy G Choriocarcinoma
B Missed miscarriage E Hydatidiform mole H Septic miscarriage
C Incomplete miscarriage F Heterotropic pregnancy
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 The proliferation of trophoblastic tissue with or without embryonic tissue.
2 The partial expulsion of products of conception with products of conception seen 65 mm in diameter on
ultrasound scan.
3 Bleeding in pregnancy 24 weeks’ gestation with fetal heart visible on ultrasound scan and closed cervical os.
4 Light bleeding, pelvic pain, shoulder tip pain, 6 weeks’ gestation, empty uterus on ultrasound and fluid in
pouch of Douglas.
8 Benign diseases of the cervix
A Squamous metaplasia D Severe dyskaryosis G Glandular atypia
B Columnar epithelium E Borderline nuclear change H Arias–Stella change
C Moderate dyskaryosis F Mild dyskaryosis
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 CIN1 2 CIN2 3 CIN3 4 CGIN
9 Benign diseases of the uterus
A Leiomyosarcoma D Adenomyosis G Brenner’s tumour
B Pedunculated leiomyoma E Red degeneration H Calcified degeneration
C Hyaline degeneration F EndometriosisExtended matching questions 61
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 This occurs as a result of disruption of blood supply (typically pregnancy-related).
2 Necrosis and cystic formation due to outgrowth of blood supply.
3 Fibroid change that is usually a postmenopausal manifestation.
4 Malignant change that accounts for less than 1 per cent of fibroids.
10 Endometriosis and adenomyosis
A Transcervical resection of the endometrium E Medical therapy, such as the combined oral
B Laser ablation to endometrial deposits contraceptive pill
C Hydrothermal ablation F Vaginal hysterectomy
D Total abdominal hysterectomy and bilateral G No treatment is indicated
salpingo-oophorectomy H Surgical drainage and postoperative
gonadotrophin-releasing hormone (GnRH)
antagonist treatment
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Treatment for minimal endometriosis to improve chances of conception in patient with infertility.
2 Definitive treatment for Stage IV endometriosis, obliterated rectovaginal septum and bilateral endometriomata.
3 Asymptomatic endometriosis found on routine laparoscopy for sterilization.
4 Symptomatic endometriosis in a 23-year-old woman who wants children but is currently not contemplating
pregnancy.
11 Benign diseases of the ovary
A A fibroma D Endometroid tumour G Brenner’s tumour
B Serous cystadenoma E Clear cell tumour H Mucinous cystadenoma
C A teratoma F A granulosa cell tumour
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 A unilocular cyst with papillous processes usually occurring unilaterally.
2 A large unilateral multiloculated cyst lined by columnar epithelium and complicated with pseudomyxoma
peritonii.
3 A large cyst usually containing unclotted blood with a ground-grass appearance on ultrasound.
4 This has a solid appearance with islands of transitional epithelium in dense fibrotic stroma.
12 Malignant disease of the uterus and cervix
A Subtotal abdominal hysterectomy E Pelvic exenteration
B Cold coagulation F Bilateral salpingo-oophorectomy
C Wertheim’s hysterectomy G Palliative treatment
D LLETZ (large loop excision of the transformation zone) H Wertheim’s hysterectomy and radiotherapy62 Gynaecology
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 CIN2.
2 Ectopy.
3 Stage 1B cervical cancer.
4 Stage 2 cervical cancer.
13 Carcinoma of the ovary and Fallopian tube
A Laser laparoscopy E Unilateral salpingo-oophorectomy and
B Vaginal hysterectomy peritoneal washings
C Total abdominal hysterectomy (TAH), bilateral F TCRE
salpingo-oophorectomy (BSO) and omentectomy G Wertheim’s hysterectomy
D Subtotal hysterectomy H Debulking surgery and subsequent carboplatin
or cisplatin/aclitaxel chemotherapy
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Stage 1B ovarian cancer.
2 Stage 3 epithelioid tumour.
3 Unilateral borderline tumour.
4 Endometriosis.
14 Infections in gynaecology
A Candida D Trichomoniasis G Human immunodeficiency
virus (HIV)
B Chlamydia E Herpes H Gonorrhoea
C Bacterial vaginosis F Syphilis
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 A sexually transmitted disease typified by genital ulcers and painful vesicles.
2 A non-sexually transmitted infection typified by itchy sore vagina with a white ‘curdy’ discharge.
3 A non-sexually transmitted disease typified by an offensive fishy discharge.
4 A sexually transmitted disease typified by Gram-negative diplococci, and colonizing columnar and cuboidal
epithelium; 50 per cent are found asymptomatically.
15 Urogynaecology
A Urodynamic stress incontinence D Bladder diverticulum G Detrusor overactivity
B Normal bladder function E Sensory urgency H Detrusor–sphincter dyssynergia
C Poor detrusor contraction F Urethral obstruction
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Detrusor pressure rise 15 cm of water during filling associated with urgency.
2 A voiding detrusor pressure 10 cm of water and flow rate of 5 mL per second.
3 Leakage on coughing in the absence of detrusor contraction.
4 Voiding detrusor pressure 70 cm of water and peak flow rate 5 mL second.Extended matching questions 63
16 Uterovaginal prolapse
A Anterior repair D Posterior repair G Ring pessary
B Shelf pessary E Vaginal hysterectomy H Manchester repair
C Sacrospinous fixation F Sacrocolpopexy
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 The treatment for vault prolapse in a frail elderly woman who would not be suitable for surgery.
2 The historical treatment for prolapse involving amputation of the cervical stump and plication of the
uterosacral and cardinal ligaments.
3 The treatment of choice for a cystocele with no history of incontinence but poor voiding in a 50-year-old, sexually active woman.
4 Operation of choice for the treatment of vault prolapse in an elderly woman with multiple previous abdominal surgery who is not sexually active.
17 The menopause
A Tibolone D Norplant G Vagifem
B Medroxyprogesterone acetate E Conjugated equine H Implanon
oestrogen
C Transdermal patch containing F Echinacea
50 μg of oestrogen
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 An oral hormone replacement therapy (HRT) preparation that is converted to oestrone by hepatic enzymes
resulting in a plasma oestradiol (E2)/oestrone ration of 1:2.
2 A lipid-soluble preparation maintaining an E2/oestrone ratio of 2:1, which is similar to pre-menopausal
physiological status.
3 A HRT with mild androgenic side effects, which may have a beneficial effect on low libido.
4 An essential part of HRT to reduce the risk of endometrial hyperplasia in women with a uterus.
18 Common gynaecological procedures and medico-legal aspects of gynaecology
Surgical complications
A TCRE D Posterior repair G Abdominal hysterectomy
B Tension-free vaginal tape (TVT) E Cystoscopy for extensive endometriosis
C Vaginal hysterectomy F Laparoscopy H Flexible hysteroscopy
For each description below, choose the SINGLE most appropriate answer from the above list of options. Each
option may be used once, more than once, or not at all.
1 Gas embolism.
2 Ureteric injury.
3 Damage to the bladder.
4 Uterine perforation.
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