Gynaecology MCQs for AMC Part 1 Exam

ByAMC Wise

Gynaecology, a vital branch of medical science, explores the health and well-being of the female reproductive system. Our carefully curated MCQs aim to test and enhance your knowledge of gynaecological conditions, procedures, and principles tested in the Part 1 of Australian Medical Council (AMC) CAT MCQ exam.

Whether you are a medical student, or an International Medical Graduate (IMG) getting ready for the AMC MCQ exam, these questions will challenge your understanding and will help you to ace your Part 1 exam.

Question 3001

A 32-year-old woman presents to the emergency department with vaginal bleeding and severe abdominal pain. She is six weeks pregnant according to her last menstrual period. On physical examination, her uterus appears larger than expected for her gestational age, and she reports passing grape-like clusters of tissue with the bleeding. Her serum beta-hCG levels are significantly elevated. What is the most likely diagnosis of this patient?

  • A) Ectopic pregnancy
  • B) Incomplete miscarriage
  • C) Molar pregnancy
  • D) Placental abruption
  • E) Cervical polyp

Answer: C) Molar pregnancy.

In this clinical scenario, the patient presents with vaginal bleeding, severe abdominal pain, a larger-than-expected uterus for her gestational age, and the passage of grape-like clusters of tissue. These findings are highly suggestive of a molar pregnancy, specifically a complete molar pregnancy.

Molar pregnancies result from abnormal fertilization of an egg, leading to the proliferation of trophoblastic tissue. This tissue gives rise to characteristic cystic structures resembling grape clusters, known as “hydatidiform moles.”

Patients with molar pregnancies typically have significantly elevated hCG levels. It’s crucial to diagnose and manage molar pregnancies promptly as they are associated with a risk of complications, including malignant transformation into choriocarcinoma.

Question 3002

A 28-year-old woman presents to the gynecology clinic with complaints of irregular menstrual cycles, hirsutism, and acne. She mentions difficulty losing weight despite regular exercise and a healthy diet. On examination, you observe bilateral enlarged ovaries on pelvic ultrasound, with the appearance of multiple small follicles. Her bloodwork reveals elevated levels of luteinizing hormone (LH). What is the most likely diagnosis?

  • A) Polycystic Ovary Syndrome (PCOS)
  • B) Endometriosis
  • C) Premature Ovarian Failure
  • D) Ovarian Tumor
  • E) Hypothyroidism

Answer: A) Polycystic Ovary Syndrome (PCOS)

PCOS is a common endocrine disorder characterized by irregular menstrual cycles, hyperandrogenism (excessive male hormone levels), and polycystic ovaries on ultrasound. Women with PCOS may experience symptoms such as hirsutism, acne, and difficulty losing weight despite efforts. Elevated levels of luteinizing hormone (LH) and insulin resistance are common features. Diagnosis is based on clinical and laboratory findings, and management often involves lifestyle modifications, hormonal therapy, and addressing associated metabolic concerns. Early recognition and intervention are crucial to prevent long-term complications such as infertility and metabolic syndrome.

Question 3003

A 45-year-old woman presents to the gynecology clinic with complaints of a bulging sensation in her vagina, particularly during bowel movements. She reports a history of difficulty passing stool and a feeling of incomplete evacuation. On physical examination, you note a protrusion of the rectal wall into the posterior vaginal wall during straining. What is the most likely diagnosis?

  • A) Uterine Prolapse
  • B) Cystocele
  • C) Enterocele
  • D) Rectocele
  • E) Vesicovaginal Fistula

Answer: D) Rectocele

A rectocele occurs when the rectal wall protrudes into the posterior vaginal wall, creating a bulge. This condition is often associated with symptoms such as a sensation of rectal fullness, difficulty with bowel movements, and a feeling of incomplete evacuation. On examination, a rectocele may be observed during straining. It is important to differentiate rectoceles from other pelvic organ prolapses to guide appropriate management. Treatment options may include pelvic floor exercises, lifestyle modifications, and in some cases, surgical intervention.

Question 3004

A 35-year-old woman presents to the gynecology clinic with complaints of heavy menstrual bleeding, pelvic pressure, and frequent urination. On pelvic examination, you palpate a firm, irregularly shaped mass that is consistent with the size of a 12-week gestation. Ultrasound confirms the presence of multiple uterine masses. What is the most likely diagnosis?

  • A) Endometriosis
  • B) Ovarian cysts
  • C) Uterine Fibroids
  • D) Pelvic inflammatory disease
  • E) Adenomyosis

Answer: C) Uterine Fibroids

Uterine fibroids, also known as leiomyomas or myomas, are noncancerous growths of the uterus that often appear during childbearing years. They can cause various symptoms, including heavy menstrual bleeding, pelvic pressure or pain, and increased urinary frequency. On pelvic examination, you may feel enlarged, firm masses in the uterus. Ultrasound is a common diagnostic tool to confirm the presence of uterine fibroids.

Question 3005

A 28-year-old woman presents to the gynecology clinic with complaints of pelvic pain, especially during menstruation, and pain during intercourse. She describes the pain as progressively worsening over the past few months. On pelvic examination, you note tender nodules in the posterior vaginal fornix. She has a regular menstrual cycle, and a recent pelvic ultrasound shows the presence of chocolate cysts. What is the most likely diagnosis?

  • A) Pelvic Inflammatory Disease
  • B) Ovarian Cysts
  • C) Uterine Fibroids
  • D) Adenomyosis
  • E) Endometriosis

Answer: E) Endometriosis

Endometriosis is a condition where tissue similar to the lining of the uterus (endometrium) grows outside the uterus. Common symptoms include pelvic pain, dysmenorrhea (painful menstruation), and dyspareunia (painful intercourse). On pelvic examination, tender nodules or masses may be felt, and imaging studies, such as ultrasound or MRI, can aid in the diagnosis. In this case, the presence of chocolate cysts on ultrasound, along with the described symptoms, is consistent with the diagnosis of endometriosis. Early recognition and management are crucial in addressing symptoms and preventing complications.

Question 3006

A 55-year-old woman presents to her gynecologist with postmenopausal bleeding and pelvic pain. She reports a history of irregular menstrual cycles before menopause. On pelvic examination, there is an enlarged uterus with an irregular contour. Transvaginal ultrasound reveals increased endometrial thickness. What is the most likely diagnosis?

  • A) Ovarian cyst
  • B) Cervical polyp
  • C) Uterine fibroids
  • D) Endometrial hyperplasia
  • E) Endometrial Cancer

Answer: E) Endometrial Cancer

Endometrial cancer often presents with postmenopausal bleeding and pelvic pain. Risk factors include obesity, hormonal imbalance, and a history of irregular menstrual cycles. Transvaginal ultrasound and endometrial biopsy are commonly used for diagnosis. Early detection and appropriate management are crucial for improving outcomes in endometrial cancer.

Question 3007

A 28-year-old woman presents with a sudden onset of severe lower abdominal pain left side, accompanied by nausea and vomiting. She has a history of irregular menstrual cycles. On pelvic examination, there is tenderness in the lower abdomen, and an adnexal mass is palpable. What is the most likely diagnosis?

  • A) Ectopic pregnancy
  • B) Ovarian cyst rupture
  • C) Mittelschmerz
  • D) Ovarian torsion
  • E) Pelvic inflammatory disease

Answer: D) Ovarian torsion

Ovarian torsion occurs when the ovary twists on its ligamentous supports, leading to compromised blood flow and severe abdominal pain. Symptoms include sudden onset of pain, nausea, and vomiting. On pelvic examination, there may be tenderness and an adnexal mass. Prompt diagnosis and surgical intervention are essential to prevent ovarian damage and preserve fertility.

Question 3008

A 24-year-old sexually active woman presents with a complaint of a malodorous, frothy, greenish-yellow vaginal discharge. She reports itching and discomfort in the genital area. On pelvic examination, the vulva is erythematous, and the cervix appears “strawberry-like.” What is the most likely diagnosis?

  • A) Bacterial vaginosis
  • B) Candidiasis
  • C) Trichomoniasis
  • D) Gonorrhea
  • E) Chlamydia

Answer: C) Trichomoniasis

Trichomoniasis is a sexually transmitted infection caused by the protozoan parasite Trichomonas vaginalis. It commonly presents with a malodorous, frothy, greenish-yellow vaginal discharge, along with itching and vulvar discomfort. On pelvic examination, characteristic findings include vulvar erythema and a “strawberry-like” appearance of the cervix. Diagnosis is confirmed through microscopic examination of vaginal secretions. Prompt treatment with antibiotics is essential to alleviate symptoms and prevent complications.

Question 3009

A 28-year-old woman presents to the emergency department with severe lower abdominal pain and vaginal bleeding. She reports a positive pregnancy test and a history of amenorrhea for the past 6 weeks. On examination, she appears pale, and abdominal tenderness is noted on the right side. Transvaginal ultrasound reveals an adnexal mass without an intrauterine gestational sac. What is the most likely diagnosis?

  • A) Ovarian cyst rupture
  • B) Appendicitis
  • C) Pelvic inflammatory disease (PID)
  • D) Threatened miscarriage
  • E) Ectopic pregnancy

Answer: E) Ectopic pregnancy

Ectopic pregnancy occurs when the fertilized egg implants outside the uterine cavity, commonly in the fallopian tubes. The presentation often includes lower abdominal pain, vaginal bleeding, and a positive pregnancy test. In this scenario, the presence of an adnexal mass on ultrasound, absence of an intrauterine gestational sac, and right-sided abdominal tenderness are indicative of an ectopic pregnancy. Early recognition and intervention are crucial to prevent complications such as rupture and significant bleeding.

Question 3010

A 22-year-old sexually active woman presents with lower abdominal pain and an increase in vaginal discharge. She reports discomfort during urination. On pelvic examination, there is cervical motion tenderness and purulent cervical discharge. Gram stain of the discharge reveals intracellular gram-negative diplococci. What is the most likely diagnosis?

  • A) Bacterial vaginosis
  • B) Candidiasis
  • C) Trichomoniasis
  • D) Gonorrhea
  • E) Chlamydia

Answer: D) Gonorrhea

Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. Symptoms in women may include lower abdominal pain, increased vaginal discharge, and discomfort during urination. On pelvic examination, findings may include cervical motion tenderness and purulent cervical discharge. Gram stain revealing intracellular gram-negative diplococci further supports the diagnosis. Prompt treatment with antibiotics is essential to prevent complications and reduce the spread of infection.

References

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