1. The document discusses various topics in obstetrics and gynecology including delayed ureteric injury, cervical cancer screening procedures, instruments used in labor and delivery, and ovarian tumors. 2. It provides true/false questions and explanations about procedures, instruments, conditions, and their clinical presentations. 3. The document serves as an image-based test covering obstetrics and gynecology topics for medical students and residents.

1. OBSTETRICS PICTURE TEST
DrOkechukwuA.Ugwu

2. Features of delayed ureteric injury
Prolonged ileus T
Watery vaginal discharge T
Prolonged high output from drains
T
Fever/sepsis. T
Persistent flank/ abdominal pain T
Flank mass T
Elevated creatinine or BUN T
11/13/2017 Okechukwu A. Ugwu 2

3. The procedure shown
a) The patient should lie in the left
lateral position F
b) The tip of the spatula is
introduced into the cervical canal
and the instrument rotated
through 180 degrees F
c) A cytobrush can be used in place
of Ayre’s spatula T
d) Samples taken are immediately
fixed with 70% alcohol F
e) The cervix is painted with Lugol’s
iodine prior to sample collection
F
11/13/2017 3Okechukwu A. Ugwu

4. About what is shown
a) It is useful in the management of
cervical stenosis F
b) It is an absorbable tape F
c) It is usually removed at
gestational age of 36 weeks F
d) It should be removed when there
are preterm contractions F
e) When its use is indicated, it is
inserted after the second missed
period F
11/13/2017 4Okechukwu A. Ugwu

5. About this instrument and its use
a. This instrument is called the
Mayo’s scissors. F
b. The procedure must be carried out
on all primigravid women. F
c. Its use can lead to a 3rd degree
perineal tear T
d. Dysmenorrhea is a late
complication of its use F
e. The midline incision is easier to
repair than the medio-lateral type T
11/13/2017 5Okechukwu A. Ugwu

6. 1. Also known as pathological
retraction ring T
2. Formed between thinned out
upper segment and lower
segment F
3. Contractions wane off with time
in primigravid women T
4. Electrolytes derangement is
common T
5. Increased risk of PPH T
11/13/2017 6Okechukwu Ugwu

7. 6. Spermatozoa must be
immobilized before injection. T
7. Inverted microscopy is utilized T
8. When indicated, male
karyotyping should be done. T
9. ‘OAT’ syndrome is a
contraindication. F
10. Holding pipette provides gentle
sunction. T
11/13/2017 7Okechukwu Ugwu

8. 11. Commoner in multipara T
12. Usually symptomatic F
13. Intermenstrual bleeding is a
recognized symptom T
14. Recurrence rate of about 3% F
15. Monsel paste has a role in
controlling bleeding post-avulsion T
11/13/2017 8Okechukwu Ugwu

9. 16. HPV is a double stranded DNA
virus. T
17. Smoking doubles risk of Ca
cervix T
18. Risk due to COCP falls to
baseline in 10 years after stopping.
T
19. Presence of nodal involvement
increases mortality by 30% stage for
stage. F
20. Pregnancy does not adversely
affect outcome. T
11/13/2017 9Okechukwu Ugwu

10. 21. Cervical length of less 25mm at
24wks in a primigravida is an
indication F
22. Outcome is the same as no
intervention in multiple gestation. F
23. Removal of Shirodkar type
requires anaesthesia T
24. Immediate removal following
PPROM optimisises outcome. F
25. Recent evidence supports
laparoscopic over laparotomy for
abdominal cerclage F
11/13/2017 10Okechukwu Ugwu

11. 26. Rupture of this type may be catastrophic
T
27. Typically ruptures around 11weeks. F
28. Progesterone assay could help localize
gestation. F
29. Wedge resection is the management of
choice. T
30. Total removal of the ipsilateral tube is
recommended. T
11/13/2017 11Okechukwu Ugwu

12. 31. Provides illumination and
magnification T
32. 3 consecutive inadequate pap
smear samples is an indication T
33. Ablative technique may be used
for glandular disease. F
34. CCI has a maximum score of 10
T
35. It is unsatisfactory when the
endocervical canal is not visualised
F
11/13/2017 12Okechukwu Ugwu

13. 36. Incidence of 0.2% T
37. Delivery by extension F
38. Presenting diameter is 9.5cm T
39. Anterior neck mass is the most
common course. F
40. Mentoposerior is better
delivered by CS. T
11/13/2017 13Okechukwu Ugwu

14. 41. Cost effective investigation T
42. This is risk factor for ectopic
gestation T
43. Live birth rate is reduced by 35%
in patients with this condition
undergoing IVF-ET FALSE
44. Salpingectomy or proximal
occlusion is indicated. T
45. NNT in IVF patients undergoing
treatment for this condition is 6. T
11/13/2017 14Okechukwu Ugwu

15. 46. This is a pneumatic anti-shock
garment. F
47. One size fits all F
48. Made of Neoprene T
49. Segments 4, 5 and 6 should be
applied by only one person. T
50. It is a definitive treatment. F
11/13/2017 15Okechukwu Ugwu

16. 51. Time consuming T
52. 10-15cm long T
53. Preferred in Misgav-Ladach
technique F
54. Utilizes blunt dissection F
55. Has cosmetic appeal T
11/13/2017 16Okechukwu Ugwu

17. 56. Two thirds of patients bleed PV T
57. Transvaginal USS is
contraindicated F
58. Bleeding is mainly maternal T
59. Hospital admission yields better
outcome than being at home F
60. Risk of morbidly adherent
placenta in cases of 3 previous CS
and Placenta previa is 45%. T
11/13/2017 17Okechukwu Ugwu

18. 61. Routinely done for primigravida F
62. This type bleeds less T
63. Restrictive used increases
anterior perineal traumaT
64. May have a role in management
of fetal distress T
65. The technique with best
outcome is unknown T
11/13/2017 18Okechukwu Ugwu

19. 66. Should be inserted between Day
1-5. T
67. Levels of hormones in the blood
return to normal in a week. T
68. Biodegradable. F
69. Failure rate of 2 in 1000 F
70. Discontinuation rate of 15-25%
F
11/13/2017 19Okechukwu Ugwu

20. 11/13/2017 Okechukwu Ugwu 20

21. Concerning this instrument and its use
a. It is used in a minimally invasive
procedure T
b. Intestinal obstruction is a
contraindication for its use F
c. The procedure can be performed
under general anaesthesia T
d. It is useful in the diagnosis of
uterine perforation F
e. It is contraindicated in the
treatment of endometriosis F
11/13/2017 21Okechukwu A. Ugwu

22. Mechanism of Ureteric injury
• Crushing T
• Laceration T
• Ligation with sutures T
• Ischaemia/devasculrisation T
• Segmental resection T
• Transection T
11/13/2017 Okechukwu A. Ugwu 22

23. Regarding this lesion
a) It is caused by herpes simplex
virus F
b) Similar lesions may be found
on the vagina, cervix and
uterus F
c) They are generally painless T
d) Spontaneous healing occurs
within 3 weeks F
e) Pregnancy can make the
lesions large T
11/13/2017 23Okechukwu A. Ugwu

24. This instrument
a) It is useful in the management of
ante-partum haemorrhage F
b) A systolic blood pressure of
90mmHg is an indication for its
use T
c) When weaning a patient off it, it
is removed in the reverse order
i.e from no 5 to no 1 F
d) A pulse rate of 60/min is an
indication for its use F
e) It can be employed at every level
of care T
11/13/2017 24Okechukwu A. Ugwu

25. Concerning this picture
a) It is used for emergency
contraception F
b) The duration of use is 10 years
F
c) It can cause amenorrhoea T
d) It can be used as part of a
hormone replacement therapy
regimen T
e) It contains oestrogen and
progestin F
11/13/2017 25Okechukwu A. Ugwu

26. About the procedure shown
a) It is an endoscopic procedure T
b) It facilitates directed biopsy T
c) Areas of CIN appear white when
the cervix is painted with Lugol’s
iodine during this procedure F
d) It can be used to assess vascular
patterns on the cervix T
e) The instrument used is a
monocular microscope F
11/13/2017 26Okechukwu A. Ugwu

27. • BILATERAL in 10-15% of cases T
• Malignant change occurs in 0.5-
2% of cases T
• Most common malignant
transformation is squamous cell
tumour
• Lining epithelium is columnar
epithelium F
11/13/2017 Okechukwu A. Ugwu 27

28. CONCERNING OVARIAN TUMOURS
• Skin, Teeth and cartillage-
Teratoma T
• Psammoma bodies- Serous
epithelial Tumours T
• Pseudomyxoma peritonei-
Mucinous tumours T
• Rienke’s Crystal- Hilus cell
tumour T
11/13/2017 Okechukwu A. Ugwu 28

29. Ovarian Tumours
• Call Exner Bodies- Granulosa cell
tumour T
• Walthard Cell nest- Brenner
Tumour T
• Signet Ring-Krukuberg tumour T
• Hobnail Cell- Clear cell tumour T
• Schiller Duval Bodies-
Endodermal sinus tumour T
11/13/2017 Okechukwu A. Ugwu 29

30. DERMOID CYST
• Most common benign tumour of
the ovary T
• Most common neoplasm
diagnosed during pregnancy T
• Most common germ cell tumour
T
• Commonest tumour to undergo
torsion T
11/13/2017 Okechukwu A. Ugwu 30