PLAB PLAB Obstetrics & Gynecology

Question 1

A 28-year-old woman at 32 weeks gestation presents with sudden-onset severe headache, visual disturbances, and BP of 160/110 mmHg. What is the most likely diagnosis?

Accepted Answer

Pre-eclampsia

Answer

Pre-eclampsia is defined by hypertension (≥140/90 mmHg) with proteinuria or end-organ dysfunction after 20 weeks gestation, and severe features include BP ≥160/110 mmHg with neurological symptoms.

Question 2

Which medication is first-line for cervical ripening and labor induction in a patient with an unfavorable cervix at term?

Accepted Answer

Dinoprostone (prostaglandin E2)

Answer

Dinoprostone (prostaglandin E2) gel or insert is the standard first-line agent for cervical ripening in patients with an unfavorable Bishop score at term.

Question 3

A 35-year-old woman presents with sudden severe lower abdominal pain, shoulder tip pain, and a positive urine pregnancy test. Ultrasound shows no intrauterine pregnancy. What is the most likely diagnosis?

Accepted Answer

Ruptured ectopic pregnancy

Answer

Ruptured ectopic pregnancy classically presents with acute abdominal pain, peritoneal irritation causing referred shoulder tip pain (diaphragmatic irritation from hemoperitoneum), and a positive pregnancy test without intrauterine pregnancy on ultrasound.

Question 4

Which investigation is most useful to confirm ovarian torsion in a woman presenting with acute unilateral pelvic pain?

Accepted Answer

Transvaginal ultrasound with Doppler

Answer

Transvaginal ultrasound with Doppler flow studies is the first-line investigation for suspected ovarian torsion, assessing ovarian morphology and blood flow, though absence of flow is not always present.

Question 5

A primigravida at 38 weeks presents with mild contractions and her cervix is 4 cm dilated, fully effaced, with the fetal head at 0 station. What stage of labor is she in?

Accepted Answer

Active phase of first stage

Answer

The active phase of the first stage of labor begins at 6 cm dilation in most modern guidelines, but reaching 4 cm effaced with regular contractions is transitioning into active labor; cervical dilation ≥6 cm with contractions defines active phase per ACOG 2014 guidelines.

PLAB - Professional and Linguistic Assessments Board Practice Test

PLAB - Professional and Linguistic Assessments Board Practice Test

PLAB PLAB Obstetrics & Gynecology