DRCOG – Free Trial Questions

A 30 year old woman attends her GP at 28 weeks gestation as she is concerned because her husband has developed shingles around his left eye.  She does not recall having had chicken pox herself as a child.  What is the most appropriate management?

Which of the following vaccinations is contra-indicated in pregnancy?

A 24-year old woman calls her GP for contraceptive advice.She is taking the combined oral contraceptive pill and has forgotten to take her last two pills.  She is currently on Day 5 of her pill packet and has had unprotected sexual intercourse in the last 24 hours.  What is the most appropriate advice?

A 20 year old woman presents to her local sexual health clinic with symptoms of profuse vaginal discharge which she describes as offensive. On examination, there is profuse frothy yellow offensive vaginal discharge and there is a strawberry cervix appearance with small punctate haemorrhages with ulceration. What is the most likely causative organism?

The total number of healthy, immature eggs in the ovariesdecreases as a woman ages, which can lower fertility. For a woman seeking to undergo in vitro fertilisation, which test would give the best prediction of her response to gonadotrophins?

A 30-year-old woman presents to your fertility clinic with her partner with a history of secondary infertility. She had a miscarriage 5 years ago and has been trying to conceive since. She has oligomenorrhea. Early follicular gonadotrophin levels were normal. Given the irregularity of her cycles, ovulation could not be demonstrated biochemically. Her ultrasound scan had shown a normal size anteverted uterus and shown ovaries with over 20 follicles on the right ovary with an ovarian volume of 11ml. The left ovary could not be clearly seen. HyCosy examination has demonstrated patent fallopian tubes. Her BMI is 28. She has no other medical issues. The semen analysis of her partner was normal. What is the first line pharmacological treatment for her?

A 20 year old primigravida attends her GP at 7 weeks gestation with persistent nausea and vomiting for the last week.Clinically, she appears dehydrated but has not lost any weight.  She asks if there are any medications to alleviate her symptoms.  What is the most appropriate antiemetic regimen?

A 40 year old woman presents to her GP after having a miscarriage.She is Gravida 4, Para 0 and has previously been seen in a specialist recurrent miscarriage clinic.  All her investigations have been normal, including a thrombophilia screen, pelvic ultrasound and karyotype.  She requests some new treatment that she has read about online as she is desperate to avoid having a further miscarriage.  Which of the following has been shown to have benefit in unexplained recurrent miscarriage?

A 71 year old woman presents to her GP with a single episode of post-menopausal bleeding. She is very worried as her sister has recently died of endometrial cancer.  She is otherwise fit and well with a normal BMI and no significant past medical history.  Abdominal and speculum examination is unremarkable.  Her GP arranges a transvaginal pelvic ultrasound scan which shows a normal size anterverted uterus with a 12mm endometrial polyp arising at the fundus of the uterus with endometrial thickness of 3mm.  What is the next most appropriate management?

A 40 year old woman has a total abdominal hysterectomy and bilateral salpingo-oophorectomy for Type 2 endometrial cancer and subsequently develops debilitating menopausal symptoms. What is the most appropriate management option?

A 60 year old woman presents to her GP with severe vulval itching and soreness. On examination, there are pale white atrophic areas of the vulva and fusion of the labia minora in the midline but no involvement of the vaginal mucosa.  What is the most appropriate management?

A 28 year old attends her GP with secondary amenorrhoea for 6 months. She is nulliparous with a BMI of 24 and her periods have always been regular previously. A urinary pregnancy test is negative but she reports that she has been experiencing some hot flushes in the last few months.  Her GP arranges blood tests and the results are shown below:

FSH – 45                      (1.0-11.0 IU/L)

LH – 30                        (0.5-14.5 IU/L)

Oestradiol – 80           (70-510 pmol/L)

Testosterone – 1.8      (0.8-3.1 nmol/L)

Prolactin – 401            (90-520 mu/L)

TSH – 2.1                     (0.5-7.0 mu/L)

Free T4 – 20                (11-23 pmol/L)

What is the next most appropriate investigation?

A woman has an emergency Caesarean section for presumed fetal compromise and the baby is born in poor condition. At  birth and one minute of age, the baby has a heart rate of 120bpm but makes no respiratory effort and is pale and does not move spontaneously or in response to stimulation.  At five minutes of age after successful resuscitation, the baby has a heart rate of 150bpm, is pink and moving and is crying weakly both spontaneously and in response to stimulation.  What Apgar scoring should be documented in the postnatal notes?

A woman has a vaginal delivery and sustains a perineal tear. On examination, the injury affects the skin and perineal muscles and more than 50% of the external anal sphincter is torn.  What classification of perineal tear is this?