1
Q
Under the National Immunisation Program (NIP), the following vaccines are free for pregnant women:
A
- Influenza
- Pertussis (dTpa)
- RSV (Respiratory Syncytial Virus)
2
Q
A complete miscarriage can be diagnosed when
A
- Bleeding and pain have settled, and
- Ultrasound: empty uterus with endometrial thickness <15mm.
3
Q
An appropriate second-line treatment for heavy menstrual bleeding when medical management has failed and fertility is no longer desired.
A
Endometrial ablation
4
Q
IF painful genital ulcers with undermined edges, a grey or purulent base, and tender inguinal lymphadenopathy (usually unilateral). The incubation period is typically 4-7 day THINK
A
chancroid
5
Q
chancroid CAUSATIVE ORGANISM
A
Haemophilus ducreyi
6
Q
chancroid management
A
Azithromycin 1g as a single oral dose is the first-line
7
Q
ovarian hyperstimulation syndrome (OHSS)
A
a serious complication of fertility treatment.
The timing (two weeks post-IVF)
- positive pregnancy test-
- Abdominal pain, dyspnoea, ascites, and pleural effusions are characteristic.
Laboratory findings: haemoconcentration, hypoalbuminaemia, and electrolyte disturbances
8
Q
typically presents in the second or third trimester with intensely pruritic vesiculobullous eruptions
A
Pemphigoid gestationis
9
Q
Vasa previa management
A
Elective caesarean section before the onset of labor
10
Q
A crown-rump length <7mm without cardiac activity requires:
A
repeat ultrasound in 7 days before confirming pregnancy loss
11
Q
Missed miscarriage diagnosis
A
- No embryonic cardiac activity with crown-rump length ≥7mm
- In the absence of an embryo: mean gestational sac diameter is ≥25mm with no yolk sac or embryo.
12
Q
first-line treatment for eclampsia to prevent further seizures
A
Magnesium sulfate
13
Q
Signs of magnesium toxicity include
A
- Absent deep tendon reflexes
- Respiratory depression
- Decreased urine output
14
Q
The antidote for magnesium toxicity
A
Calcium gluconate
15
Q
Preterm labour is defined as
A
- regular uterine contractions with cervical changes between 20 and 36+6 weeks of gestation.
16
Q
Tests useful in assessing the risk of preterm birth within the next seven days.
A
Partosure/Actim Partus
17
Q
Groups considered high risk, requiring referral to a specialist for an EARLY colposcopic assessment after two positive results with HPV (not 16/18):
A
- Aged 50+ years
- Aboriginal and/or Torres Strait Islander
- Overdue for screening by at least 2 years at initial screen
18
Q
The average rate of cervical dilation in active labour
A
- 0.5-1 cm per hour for nulliparous women and
- 1-2 cm per hour for multiparous women.
19
Q
primary infertility
A
The inability to conceive after 12 months of regular unprotected intercourse
20
Q
day 21 progesterone level confirms
A
ovulation
21
Q
CT imaging in pregnancy is appropriate when:
A
(1) the clinical indication is urgent,
(2) alternative imaging modalities are inadequate or unavailable,
3) The information will directly impact clinical management.
22
Q
first-line medication for treatment of severe nausea and vomiting in pregnancy that has resulted in dehydration
A
intramuscular promethazine and intravenous ondansetron
23
Q
Antiphospholipid syndrome in pregnancy MANAGEMENT
A
aspirin + Enoxaparin (ow molecular weight heparin)
24
Q
first-line antibiotic for intrapartum group B streptococcus prophylaxis in women with preterm pre-labour rupture of membranes.
A
Intravenous benzylpenicillin
25
appropriate management for incomplete miscarriage + haemodynamic instability
Dilation and curettage
26
Preferred method for induction of labour in women with ruptured membranes at term who are not in labour.
Oxytocin infusion within 24 hours
27
the gold standard for diagnosing endometriosis.
Histological examination of biopsied tissue
28
Incomplete miscarriage
- heavy vaginal bleeding with tissue passage +
- ultrasound evidence of retained products of conception.
29
missed miscarriage
- minimal or no bleeding, and
- ultrasound with non-viable intrauterine pregnancy with a gestational sac.
30
threatened miscarriage
- vaginal bleeding with a closed cervix and
- a viable intrauterine pregnancy on US
31
inevitable miscarriage
- miscarriage is in progress but no products of conception have yet been passed.
- The cervix is open or dilated, but expulsion has not occurred
32
complete miscarriage
occurs when all products of conception have been expelled.
33
the most sensitive single parameter for diagnosing intrauterine growth restriction is:
Serial measurements of fetal abdominal circumference
34
IF products of conception are trapped in the cervical os + Hypotentsion THINK
Cervical shock
Immediate removal of products from the cervical os is essential to reverse cervical shock
35
A diaphragm must remain in place for how long after intercourse to ensure contraceptive effectiveness?
at least 6 hours
36
Methods of induction preferred for vaginal birth after caesarean (VBAC)
- Mechanical methods of induction: cervical ripening balloon catheter
due to lower risk of uterine rupture
37
Post-treatment surveillance following treatment for a high-grade cervical lesion:
(as of the 2025 Cervical Screening Guideline Updates).
*HPV PCR at 12 months post-treatment*
- If (-): annual HPV testing should be repeated for a second year.
- If both tests are negative: routine five-yearly cervical screening.
38
Ground glass appearance on transvaginal ultrasound is characteristic of
endometriomas
39
Hormone replacement therapy for women who have had a hysterectomy
oestrogen-only
there is no need for progesterone protection of the endometrium
40
the most appropriate next investigation as unicornuate uterus is associated with ipsilateral renal agenesis in up to 40% of cases
Renal tract ultrasound
41
the first-line investigation for suspected deep vein thrombosis in pregnancy
Compression ultrasound
42
Initial management of lactational mastitis includes
- Continued breastfeeding
- Cold packs,
- NSAIDs
43
first-line antibiotic for lactational mastitis.
Flucloxacillin
44
a low-lying placenta is defined as
a placental edge ≤20 mm from the internal cervical os.
45
The management of a low-lying placenta
follow-up ultrasound at 32 weeks gestation
46
Placenta praevia is defined as
placenta covering the internal os of the cervix in the third trimester.
47
The management of a placenta previa
- follow-up at 36 weeks
- Present immediately if any vaginal bleeding occurs.
48
non-invasive prenatal testing (NIPT) identifies:
- Common chromosomal abnormalities like trisomy 21, 18, and 13,
NIPT has excellent sensitivity and specificity but, cannot detect structural or anatomical abnormalities (US)
49
The most appropriate panel of tumour markers for suspected germ cell tumours.
'Lactate dehydrogenase, alpha-fetoprotein, beta-human chorionic gonadotropin
50
The correct range for normal fetal heart rate variability on a CTG.
6-25 beats per minute
51
Large Loop Excision of the Transformation Zone (LLETZ) most significant long-term risk
cervical incompetence in future pregnancies
52
uterine hyperstimulation
- more than five contractions in 10 minutes,
- contractions lasting longer than two minutes
- or contractions occurring prior to the return to baseline tone
53
Dose of folic acid supplementation that should be given to women with epilepsy planning pregnancy or who are pregnant
High-dose folic acid supplementation (5 mg daily)
54
the recommended first-line treatment for chlamydial infection in pregnancy.
Single dose azithromycin 1g
55
Endometrial thickness that requires further investigation.
>4mm
56
Reaction characterised by fever, headache, myalgia, and often a worsening of skin lesions. Symptoms typically develop in patients receiving treatment for syphilis and other spirochetal infections within 6-12 hours (up to 24h)
Jarisch-Herxheimer reaction (JHR)
The reaction is usually self-limiting and resolves within 24-48 hours.
HR is not an allergic response to penicillin, but rather a result of rapid killing of spirochetes and subsequent release of inflammatory mediators.
57
Management of the Jarisch-Herxheimer reaction
Supportive, including antipyretics and reassurance.
58
Urge incontinence is characterised by
sudden urge to void with or without urinary leakage, often due to detrusor overactivity
59
Urge incontinence First-line management
- First-line : lifestyle changes, bladder training and pelvic floor exercises
60
Urge incontinence management when conservative measures fail
Oral oxybutynin
Anticholinergic medications
61
Rotterdam criteria
requires two out of three of the following:
1. oligo/anovulation,
2. clinical or biochemical hyperandrogenism,
3. polycystic ovarian morphology
62
A Krukenberg tumour
is a metastatic ovarian tumour characterised by mucin-producing signet-ring cells.
It most commonly originates from a primary gastrointestinal adenocarcinoma, especially the stomach
63
IF painless, beefy-red ulcers that gradually enlarge and spread.
Donovanosis
64
donovanosis (granuloma inguinale), is caused by
the bacterium Klebsiella granulomatis
65
Donovanosis management
Azithromycin
66
Diagnosis of donovanosis is confirmed by
visualising characteristic Donovan bodies on tissue smear or biopsy
67
preferred method for pregnancy termination between 9-14 weeks of gestation
Surgical termination
68
IF primary amenorrhoea and a blind-ending vagina, 46,XY karyotype and elevated testosterone levels. THINK
Complete androgen insensitivity syndrome
69
IF primary amenorrhoea WITH normal secondary sexual characteristics and a normal hormonal profile. + blind-ending vaginal pouch with normal external genitalia adn 46,XX THINK
Mullerian agenesis,
also known as Mayer-Rokitansky-Küster-Hauser syndrome
70
IF (45,X0) + short stature, delayed puberty, and absent secondary sexual characteristics THINK.
Turner syndrome
71
Complete molar pregnancy occurs when
an empty ovum is fertilised by a sperm that duplicates its chromosomes, resulting in 46XX chromosomes all of paternal origin.
72
normal fetal baseline heart rate on cardiotocography (CTG) is
110-160 beats per minute
73
DSM-5 criteria for perinatal depression requires:
A. Five or more of the following symptoms that have been present for two weeks consistently (every or almost every day) and are a change from previous functioning. (One of these symptoms must be either Depressed mood or Loss of interest/pleasure).
Depressed mood
Loss of interest/pleasure
Weight loss or weight gain or appetite changes
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Problems with concentration or making decisions
Recurrent thoughts of death
B. These symptoms cause an impairment in functioning for the individual or clinically significant distress
C. These symptoms cannot be better explained by another medical condition or by another psychiatric diagnosis
74
Difference between Baby blues and perinatal depression
- Perinatal depression is characterised by persistent low mood, sleep disturbance, and fatigue lasting more than two weeks postpartum.
- Baby blues typically resolves within 10 days of birth, while perinatal depression persists and significantly impacts functioning.
75
IF headache and features of raised intracranial pressure during pregnancy OR Headache with multiple cranial nerve palsies and seizures THINK
Cerebral venous thrombosis
76
gestational diabetes mellitus is diagnosed when any one of the following thresholds is met:
- fasting plasma glucose ≥ 5.3–6.9 mmol/L
- 1‐hour plasma glucose ≥ 10.6 mmol/L
- 2-hour plasma glucose ≥ 9.0–11.0 mmol/L
77
the single best biomarker for the detection of primary ovarian malignancy
CA125
78
Reactive arthritis typically presents with
the triad of
1. arthritis,
2.conjunctivitis, and
3. urethritis,
often 1-4 weeks after a chlamydial infection.
"can't see, can't pee, can't climb a tree,"
79
The preferred diagnostic method for identifying the underlying chlamydial infection in reactive arthritis:
Nucleic acid amplification testing (NAAT) of urine or genital swabs
P.S. in symptomatic people with a cervix, endocervical swabs are generally more reliable and are the recommended site of testing.
80
Medical TOP (Termination of pregnancy) at <63 days
can be done through outpatient misoprostol and mifepristone therapy
81
Surgical option for TOP up to 14 weeks of gestation
Suction dilation and curettage
82
Medical TOP in a pregnancy greater than 63 days (9+0/40)
Inpatient misoprostol and mifepristone
83
IF postmenopausal women with pruritus, dyspareunia, and dysuria and atrophic patches and architectural changes of the vulva THINK
vulval lichen sclerosus (LS)
84
IF patient presents with symptoms of cervicitis (vaginal discharge, spotting, and deep dyspareunia) but initial testing for common sexually transmitted infections (STIs) has been negative, the most appropriate next step is
to perform an endocervical swab for Mycoplasma genitalium (M. genitalium)
85
first-line antidepressants in pregnancy, though continuing a medication that has been effective is usually preferable to switching
Sertraline and citalopram are generally preferred
though continuing a medication that has been effective is usually preferable to switching
86
An acceleration on CTG is defined as
a transient increase in fetal heart rate of 15 beats per minute or more above the baseline, lasting for 15 seconds or more.
AMC MCQ
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