SMLE Obstetrics and Gynaecology 6

Question 1

A 35-year-old woman with a BMI of 40 and PCOS has been trying to conceive for 2 years. She has irregular cycles and anovulation. What is the most appropriate first step?

Accepted Answer

Weight loss and lifestyle modification

Answer

In vitro fertilisation (IVF)

Answer

Clomiphene citrate

Answer

Gonadotropin injections

Question 2

A woman at 30 weeks gestation presents with severe pre-eclampsia. Corticosteroids have been administered. Despite antihypertensive therapy, her condition is deteriorating with HELLP syndrome. What is the definitive treatment?

Accepted Answer

Delivery of the fetus and placenta

Answer

Continue expectant management until term

Answer

Increase antihypertensive doses

Answer

Plasma exchange

Question 3

A 50-year-old woman presents with postmenopausal bleeding. Endometrial biopsy shows complex atypical hyperplasia. What is the recommended management?

Accepted Answer

Total hysterectomy with bilateral salpingo-oophorectomy

Answer

Observation and repeat biopsy in 6 months

Answer

Progestin therapy alone

Answer

Endometrial ablation

Question 4

A primigravida at 37 weeks presents with a frank breech presentation confirmed by ultrasound. She desires vaginal delivery. What is the recommended approach?

Accepted Answer

External cephalic version (ECV) attempt

Answer

Vaginal breech delivery

Answer

Immediate caesarean section

Answer

Wait for spontaneous version

Question 5

A woman undergoes cervical screening. HPV testing is positive for high-risk HPV types 16 and 18, but cytology is normal. What is the recommended follow-up?

Accepted Answer

Immediate colposcopy

Answer

Repeat co-testing in 12 months

Answer

No follow-up needed

Answer

Hysterectomy

Question 6

What is the most appropriate contraceptive method for a breastfeeding mother at 6 weeks postpartum?

Accepted Answer

Both B and C are appropriate

Answer

Combined oral contraceptive pill

Answer

Progestogen-only pill

Answer

Copper intrauterine device