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Question 1

Which organism most commonly causes septic shock in Gynaecology?

a. E Coli
b. Bacteroides
c. Beta Haemolytic Streptococcus
d. Staphylococcus
e. Clostridium

Answer 1

a. E Coli

Question 2

Acyclovir can be used in which of the following conditions?

a. CMV
b. Parvovirus
c. Varicella pneumonia
d. HIV
e. Recurrent herpes simplex

Answer 2

c. Varicella pneumonia

Question 3

All of the following are characteristic features of toxic shock syndrome EXCEPT:

a. Temperature > 39 degrees celsius
b. Multi-system involvement
c. Staph aureus on blood culture
d. Diffuse erythematous rash
e. Staph aureus on vaginal swab

Answer 3

c. Staph Aureus on Blood Culture

Question 4

Which of the following combinations is correct?
a. Syphilis is satisfactorily treated with Erythromycin
b. Ampicillin to treat PID in a 16 year old
c. Lindane to treat molluscum contagiosum
d. Sulphonamides to treat granuloma
inginale

Answer 4

d. Sulphonamides to treat granuloma

inginale

Question 5

Which infective organisms will not be treated by gentamycin and metronidazole:

a. Gram -ve aerobes
b. Anaerobes
c. Gram +ve anaerobes + aerobes
d. Trichomonas

Answer 5

c. Gram +ve anaerobes + aerobes

Question 6

What is the most important aspect of managing necrotising fasciitis:

a. Surgical debridement
b. Antibiotics
c. Hyperbaric Oxygen

Answer 6

a. Surgical Debridement

Question 7

A 23 year old Somali woman at 16 weeks gestation presents with night sweats, weight loss and cough. Her HIV serology is negative. A CXR shows an apical lung lesion. The most appropriate management for her is:

a. Erythromycin
b. Cotrimazole
c. Isoniazid
d. Streptomycin

Answer 7

c. Isoniazid

Question 8

A patient has had an IUCD insitu for two years. On routine PAP smear, actinomycosis was detected. Pelvic examination was normal. What is the next most appropriate treatment ?

a. Keep the IUCD in place and treat her with oral Penicillin
b. Remove the IUCD and treat her with oral Penicillin for 2 weeks. Reinsert another IUCD afterward
c. Remove the IUCD and treat her with oral Penicillin for 2 weeks. IUCD will be contraindicated for her in the future.
d. Remove the IUCD and no further treatment is needed
e. No treatment is needed if asymptomatic

Answer 8

e. No treatment is needed if asymptomatic

Question 9

Which of the following is the least effective antibiotic against Bacteroides fragilis?

a. Cefotaxime
b. Clindamycin
c. Chloramphenicol
d. Gentamicin
e. Metronidazole

Answer 9

d. Gentamycin

Question 10

When is the highest attack rate of vaginal candidiasis:

a. 1st trimester
b. 2nd trimester
c. 3rd trimester
d. After vaginal delivery
e. Postmenopausally

Answer 10

c. 3rd trimester

Question 11

All of the following are true for treatment of candida, EXCEPT:

a. Oral fluconazole
b. Oral itraconazole
c. Oral terzole

Answer 11

c. Oral terzole

Question 12

A woman with PID has a temperature of 39 degrees celsius and bilateral adnexal tenderness. Her swabs are positive for Chlamydia. The best treatment for her is:

a. IM Cefoxitin + PO doxycycline
b. PO Doxycycline
c. IV Cefoxitin + PO Doxycycline
d. IV Clindamycin
e. IV Penicillin + PO Doxycycline

Answer 12

c. IV Cefoxitin + PO Doxycycline

Question 13

A 26 year old woman at 26 weeks gestation presents with vaginal discharge and chlamydia on swabs. The most appropriate treatment for her is:

a. Penicillin
b. Cephalosporin
c. Doxycycline
d. Erythromycin
e. Metronidazole

Answer 13

d. Erythromycin

Question 14

A woman at 8 weeks gestation is diagnosed with Chlamydia infection on endocervical swab. The most appropriate management would be:

a. No treatment needed
b. Oral Doxycycline
c. Oral Erythromycin
d. Oral Penicillin
e. No treatment needed now but repeat swabs at 28 weeks

Answer 14

c. Oral Erythromycin

Question 15

With respect to Chlamydia, which of the following is most correct:

a. The cervix usually looks injected
b. In a population of low prevalence the immunofluorescence test will have a 50% false positive result.
c. 50% of females with chlamydia will develop PID.
d. <1% of women in Australia

Answer 15

a. The cervix usually looks injected

Question 16

The incidence of foetal infection after maternal seroconversion of Cytomegalovirus infection in pregnancy is approximately:

a. 95%
b. 80%
c. 50%
d. 20%
e. 5%

Answer 16

c. 50%

Question 17

Concerning CMV in pregnancy, which of the following is most correct?

a. Most babies are symptomatic at birth
b. CMV is the most common viral transmitted infection in pregnancy
c. IgG antibodies can be detected in the cord blood
d. Is passed on in uncooked meat

Answer 17

b. CMV is the most common viral transmitted infection in pregnancy

Question 18

A woman with known gardnerella vaginal infection is to have a vaginal hysterectomy. Which antibiotic would be most cost effective for pre-operative prophylaxis?

a. Ceftriaxone
b. Piperacillin
c. Cephazolin
d. Chloramphenical
e. Clindamycin and C gentamycin

Answer 18

c. Cephazolin

Question 19

With respect to Group B Streptococcus, the following are true EXCEPT:

a. The rate of colonization is 15- 25%
b. 5-10% of women become positive at term if they had a negative low vaginal swab at 28 weeks gestation
c. 5% of infants develop serious infection
d. The gastrointestinal tract contains the largest pool

Answer 19

c. 5% of infants develop serious infection

Question 20

With respect to Group B Streptococcus, which of the following is the most correct?

a. 50% mothers have it at term
b. Infection in the foetus is rare in an asymptomatic mother
c. Antibiotics at the end of pregnancy will eradicate infection in the mother
d. If found at high vaginal swab at 27 weeks with PPROM need to give ampicillin and deliver the baby

Answer 20

b. Infection in the foetus is rare in an asymptomatic mother

Question 21

Which is the most common site for colonisation with GBS?

a. lower vagina
b. cervix
c. urethra
d. lower GIT

Answer 21

d. lower GIT

Question 22

A primigravid woman is at 34 weeks gestation. The midwife looking after her informs you that the low vaginal swab has grown GBS. What is the most appropriate management?

a. Give a 7 day course of penicillin
b. Give the neonate IV penicillin after birth
c. Give IV ampicillin in labour
d. No treatment is needed

Answer 22

c. Give IV ampicillin in labour

Question 23

A 37 year old woman has had a total abdominal hysterectomy for microinvasive carcinoma of the cervix. She believes the man she slept with 2 weeks ago has developed gonorrhoea. The best way to establish if she has gonorrhoea is:

a. Culture urethra
b. Culture vaginal vault
c. Culture rectum
d. Gram stain of vaginal secretions.
e. Gonozyme assay

Answer 23

a. Culture urethra

Question 24

A patient is suspected of having hepatitis B. Serology demonstrates a positive Hepatitis B core antibody, but surface antibody and antigen are negative. This means:

a. The patient is a chronic carrier
b. The surface antibody will rise soon
c. The patient probably did not have hepatitis B
d. Cross reaction with Hepatitis A
e. The patient is highly infective

Answer 24

b. The surface antibody will rise soon

Question 25

Which of the following is LEAST true of HIV? a. After acquiring the virus, the median time to development of clinical AIDS is 10 years. b. Opportunistic infections commonly develop when the CD4 count falls below 200 x 106 per Litre. c. Antiviral chemotherapy lowers the risk of mother to child transmission of HIV to approximately one-third of the risk without chemotherapy. d. High viral load (>10,000 copies/ml), low CD4 count (<400 x 106/l) and more than 4 hours ruptured membranes all double the risk of mother to child transmission of HIV. e. With all available E initiatives, the incidence of mother to child transmission of HIV should be reduced to approximately 5%.

Answer 25

e. With all available E initiatives, the incidence of mother to child transmission of HIV should be reduced to approximately 5%.

Question 26

A 16 year old primigravida is HIV positive on western blot at 28 weeks gestation. The risk of transmission to the foetus is: a. 0% b. 10% c. 30% d. 60% e. 80%

Answer 26

c. 30%

Question 27

What is the transmission rate to the fetus if the mother is HTLV III positive? a. 0% b. 10% c. 30% d. 50% e. 100%

Answer 27

c. 30%

Question 28

All of the following are true of HIV, EXCEPT: a. More risk from intercourse with an infected female than with an infected male b. HIV positive women may develop symptoms in pregnancy c. The virus has been shown to be carried in breast milk d. First presentation may be with pneumocystis carinii

Answer 28

a. More risk from intercourse with an infected female than with an infected male

Question 29

All of the following are immunological tests for HIV EXCEPT: a. Western Blot b. ELISA c. PCR

Answer 29

c. PCR

Question 30

The cure rate for vulval condyloma with podophyllin is closest to? a. 10% b. 20% c. 50% d. 70% e. 90%

Answer 30

d. 70%

Question 31

A patient has been treated for vulval warts. She was given 6 cycles of podophyllin then tried trichloroacetic acid for 4 weeks without response. What is the next line of management? a. 5 FU b. CO2 laser c. Surgical excision d. Vulvectomy e. Cryotherapy

Answer 31

e. Cryotherapy

Question 32

All of the following with respect to HPV on the cervix are true EXCEPT: a. Sometimes associated with carcinoma b. Intracytoplasmic reproduction is associated with koilocytosis c. HPV dysplasiais not a true premalignant condition d. HPV 16 causes benign cervical condylomata e. Fragments of HPV D have been isolated on DNA testing in cervical carcinoma

Answer 32

d. HPV 16 causes benign cervical condylomata

Question 33

All of the following are true of HPV EXCEPT: a. Types 31 and 35 are associated with cervical cancer b. Types 16 and 18 are associated with VIN c. Type 16 is associated with benign condylomata

Answer 33

c. Type 16 is associated with benign condylomata

Question 34

A healthy, 24 year old G0P0 is using an IUCD for contraception. She has some vaginal warts. Her only sexual partner of 2 years has no obvious penile warts. She wants to know where they came from. What would you tell her? a. Secondary to irritation from the strings of the IUCD b. Transferred from other parts of her body by her hands. c. Wart virus has been dormant in dorsal root ganglia d. Partner probably has non apparent penile warts. e. It does not matter where they come from, it will not affect her management

Answer 34

e. It does not matter where they come from, it will not affect her management

Question 35

What is the approximate likelihood of recurrence within 6 months after a primary genital herpes simplex? a. 10% b. 25% c. 50% d. 75% e. 90%

Answer 35

d. 75%

Question 36

Which of the following is NOT true of genital HSV (herpes simplex virus) infection? a. Prior infection with HSV-1 does not significantly reduce the risk of acquiring HSV2 infection in pregnancy. b. Approximately 1% of those with recurrent attacks have asymptomatic secretion at the time of delivery. c. Approximately 2% of those with a clinical recurrence at the time of delivery will have an infected neonate. d. Approximately 3% of those with asymptomatic viral shedding at the time of delivery will have an infected neonate.

Answer 36

a. Prior infection with HSV-1 does not significantly reduce the risk of acquiring HSV2 infection in pregnancy.

Question 37

All of the following about Herpes simplex are true EXCEPT: a. Infection with HSV1 imparts some immunity against HSV2 b. Treatment with acyclovir significantly reduces recrudescence c. Genital herpes is mostly due to HSV2 d. There is increased HSV antibody in carcinoma of the cervix e. Recrudescence usually occurs in the 1st 6 months

Answer 37

d. There is increased HSV antibody in carcinoma of the cervix