AMC MCQ Obstetrics and Gynaecology 3 — Questions and Answers
Question 1: A 45-year-old reports heavy menstrual bleeding with a bulky, irregular uterus on examination. What is the most likely diagnosis?
- Endometrial carcinoma
- Uterine fibroids (Correct answer)
- Ovarian cyst
- Ectopic pregnancy
Correct answer: Uterine fibroids
A bulky, irregularly enlarged uterus with menorrhagia is most consistent with uterine fibroids.
Question 2: A 24-year-old with 6 weeks amenorrhoea presents with left iliac fossa pain and a positive pregnancy test, but no intrauterine sac on transvaginal ultrasound. What must be excluded?
- Threatened miscarriage
- Ectopic pregnancy (Correct answer)
- Molar pregnancy
- Ovulation pain
Correct answer: Ectopic pregnancy
A positive test with an empty uterus and adnexal pain mandates exclusion of ectopic pregnancy.
Question 3: Which organism is the most common cause of pelvic inflammatory disease in young sexually active women?
- Escherichia coli
- Chlamydia trachomatis (Correct answer)
- Candida albicans
- Gardnerella vaginalis
Correct answer: Chlamydia trachomatis
Chlamydia trachomatis is the leading cause of PID, often asymptomatic until complications arise.
Question 4: A postmenopausal woman presents with vaginal bleeding. What is the most important investigation?
- Cervical smear
- Transvaginal ultrasound and endometrial sampling (Correct answer)
- Pregnancy test
- Vaginal pH testing
Correct answer: Transvaginal ultrasound and endometrial sampling
Postmenopausal bleeding requires endometrial assessment to exclude endometrial carcinoma.
Question 5: What is the first-line investigation for suspected polycystic ovary syndrome alongside clinical features?
- CT abdomen
- Pelvic ultrasound and hormonal profile (Correct answer)
- Endometrial biopsy
- Laparoscopy
Correct answer: Pelvic ultrasound and hormonal profile
PCOS diagnosis uses the Rotterdam criteria, supported by pelvic ultrasound and hormonal testing.
Question 6: A woman on the combined oral contraceptive pill develops a unilateral swollen, painful calf. What is the priority action?
- Reassure and continue the pill
- Stop the pill and investigate for DVT (Correct answer)
- Increase the pill dose
- Switch to a higher oestrogen pill
Correct answer: Stop the pill and investigate for DVT
Combined oral contraceptives increase venous thromboembolism risk, so suspected DVT requires stopping the pill and urgent investigation.
Question 7: Which test is used in the antenatal screening combined test for trisomy 21?
- Maternal blood glucose
- Nuchal translucency with PAPP-A and beta-hCG (Correct answer)
- Amniotic fluid index
- Cervical length measurement
Correct answer: Nuchal translucency with PAPP-A and beta-hCG
The first-trimester combined test uses nuchal translucency, PAPP-A and free beta-hCG to estimate Down syndrome risk.
AMC MCQ Obstetrics and Gynaecology 3
A 45-year-old reports heavy menstrual bleeding with a bulky, irregular uterus on examination.
What is the most likely diagnosis?