SMLE Obstetrics and Gynaecology 2

Question 1

A 32-year-old woman at 28 weeks gestation presents with painless vaginal bleeding. Ultrasound shows the placenta completely covering the internal cervical os. What is the diagnosis?

Accepted Answer

Placenta praevia (major/complete)

Answer

Placental abruption

Answer

Vasa praevia

Answer

Cervical ectropion

Question 2

A woman presents with a positive pregnancy test, vaginal bleeding, and an adnexal mass. Serum beta-hCG is 2,500 mIU/mL but transvaginal ultrasound shows an empty uterus. What is the most likely diagnosis?

Accepted Answer

Ectopic pregnancy

Answer

Threatened miscarriage

Answer

Complete miscarriage

Answer

Gestational trophoblastic disease

Question 3

What is the recommended screening test for gestational diabetes mellitus (GDM) according to SCFHS and Saudi guidelines?

Accepted Answer

75g OGTT at 24-28 weeks gestation

Answer

Random blood glucose at booking

Answer

HbA1c at 24-28 weeks gestation

Answer

Fasting glucose at 12 weeks gestation

Question 4

A 35-year-old multiparous woman has an atonic uterus after delivery with estimated blood loss of 1,500 mL. Uterine massage and oxytocin have been administered. What is the next pharmacological step?

Accepted Answer

Methylergonovine (Methergine)

Answer

Tranexamic acid

Answer

Factor VIIa

Answer

Repeat oxytocin only

Question 5

A 22-year-old woman presents with lower abdominal pain, fever, purulent vaginal discharge, and cervical motion tenderness. What is the most likely diagnosis?

Accepted Answer

Pelvic inflammatory disease (PID)

Answer

Appendicitis

Answer

Ovarian torsion

Answer

Endometriosis

Question 6

A 40-year-old woman presents with heavy menstrual bleeding, pelvic pressure, and an enlarged, irregular uterus. Ultrasound shows multiple well-circumscribed, hypoechoic masses within the myometrium. What is the most likely diagnosis?

Accepted Answer

Uterine leiomyomas (fibroids)

Answer

Endometrial carcinoma

Answer

Adenomyosis

Answer

Endometrial polyps