PLAB 1 Obstetrics and Gynaecology

Question 1

A 28-year-old woman at 32 weeks' gestation presents with painless bright red vaginal bleeding. On examination, the uterus is soft and non-tender. What is the most likely diagnosis?

Accepted Answer

Placenta praevia

Answer

Placental abruption

Answer

Cervical ectropion

Answer

Uterine rupture

Question 2

A 30-year-old primigravida at 34 weeks' gestation has a blood pressure of 165/110 mmHg, proteinuria of 3+, and complains of a severe headache and visual disturbances. What is the most appropriate immediate management?

Accepted Answer

Admit, commence IV magnesium sulphate and IV labetalol, and plan urgent delivery

Answer

Discharge with oral antihypertensives and GP follow-up

Answer

Prescribe bed rest at home and recheck BP in 1 week

Answer

Start oral methyldopa and review in the antenatal clinic next week

Question 3

A 25-year-old woman presents at 7 weeks' gestation with vaginal bleeding and left iliac fossa pain. Her serum beta-hCG is 1,500 IU/L and transvaginal ultrasound shows an empty uterus. What is the most likely diagnosis?

Accepted Answer

Ectopic pregnancy

Answer

Complete miscarriage

Answer

Molar pregnancy

Answer

Threatened miscarriage

Question 4

According to NICE guidelines, what is the recommended method of induction of labour when the cervix is unfavourable (Bishop score <6)?

Accepted Answer

Vaginal prostaglandin E2 (dinoprostone) or oral misoprostol to ripen the cervix

Answer

Immediate ARM (artificial rupture of membranes)

Answer

Emergency caesarean section

Answer

IV oxytocin infusion

Question 5

A 35-year-old woman presents with post-menopausal bleeding. She is on no hormone replacement therapy. What is the most appropriate initial investigation?

Accepted Answer

Transvaginal ultrasound to assess endometrial thickness

Answer

Cervical smear

Answer

CT abdomen and pelvis

Answer

Serum CA-125

Question 6

During labour, a CTG shows late decelerations with reduced variability. What does this pattern most likely indicate?

Accepted Answer

Uteroplacental insufficiency causing fetal hypoxia

Answer

Normal fetal response to contractions

Answer

Fetal head compression

Answer

Umbilical cord compression

A 28-year-old woman at 32 weeks' gestation presents with painless bright red vaginal bleeding.On examination, the uterus is soft and non-tender.What is the most likely diagnosis?

A 28-year-old woman at 32 weeks' gestation presents with painless bright red vaginal bleeding.
On examination, the uterus is soft and non-tender.
What is the most likely diagnosis?