Gynaecology & Obstetrics Question Bank

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1. Causes of first trimester abortion

The most common cause of first-trimester abortion is chromosomal abnormalities of the conceptus. Cervical incompetence causes mid-trimester loss, and the other options are less common first-trimester causes.

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2. The commonest cause for infertility

Male factor is keyed here as the commonest single cause of infertility, contributing to a large proportion of cases (often around 30-40%). [REVIEW: anovulation and tubal factors are also major causes; the relative ranking varies by population - keyed answer is male factor]

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3. The following are factors affecting the choice of methotrexate as a choice of treatment for ectopic pregnancy, EXCEPT

Factors determining suitability for methotrexate treatment of ectopic pregnancy include the absence of cardiac activity, tubal integrity (unruptured) and the beta-hCG level. The patient's PARITY is NOT a determining factor, so it is the EXCEPTION.

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4. Multiple pregnancy increases

The incidence of (dizygotic) multiple pregnancy increases with advancing maternal age, along with parity, heredity and ovulation induction. It is more common in black than white populations, and ovarian diathermy reduces (not increases) multiples.

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5. All the following are possible of premature labor, EXCEPT

Causes of premature labor include polyhydramnios (overdistension), perinatal infection and uterine anomalies (bicornuate uterus). Anencephaly causes polyhydramnios but is keyed as not itself a typical preterm labor cause, so it is the EXCEPTION.

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6. The most common cause of uterine size-date disproportion:

The most common cause of uterine size-date discrepancy is an inaccurate last menstrual period date. Polyhydramnios, molar and multiple pregnancy are less common causes.

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7. The most common cause of ectopic pregnancy is:

The most common cause/risk factor for ectopic pregnancy is a history of pelvic inflammatory disease (salpingitis), which damages the tube and impairs ovum transport.

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8. Antepartum hemorrhage: Which is true?

Antepartum hemorrhage can be caused by cervical carcinoma (a local lesion). It refers to bleeding after 24 weeks (not any stage), vaginal examination is avoided until previa is excluded, and not all cases require cesarean section.

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9. Accurate diagnosis of hydatiform mole can be made by

Hydatidiform mole is accurately diagnosed by ultrasound, which shows the characteristic vesicular ('snowstorm') pattern with no fetus. Elevated hCG is supportive but not specific by itself.

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10. A 25-year-old primigravida with 8 weeks threatened abortion, ultrasound would most likely reveal.

In a viable 8-week threatened abortion, ultrasound would most likely reveal an intact intrauterine gestational sac with a fetus and fetal heart motion, indicating ongoing viability.