1. The document discusses various obstetrics and gynecology topics including delayed ureteric injury, cervical cancer screening procedures, instruments used in labor and delivery, and ovarian tumors. 2. Key points covered include signs of delayed ureteric injury, techniques for cervical cytology sample collection, how to properly apply and remove an anti-shock garment, and pathognomonic findings associated with different types of ovarian tumors. 3. Multiple choice questions are provided throughout testing knowledge of procedures, instruments, and conditions discussed.

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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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22. Mechanism of Ureteric injury
• Crushing T
• Laceration T
• Ligation with sutures T
• Ischaemia/devasculrisation T
• Segmental resection T
• Transection T
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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
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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
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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
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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
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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
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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
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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
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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
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