1. This document contains multiple choice questions about obstetrics and gynecology instruments, procedures, and conditions. 2. It addresses topics like risk factors for ureteric injury during surgery, features of delayed ureteric injury post-operatively, and characteristics of different obstetric instruments and their appropriate usage. 3. The questions test knowledge about prevention of complications, identifying high-risk patients, and selecting the best management approach in different clinical scenarios.

1. OSCE Picture test in
Obstetrics and Gynaecology
Dr. Okechukwu A. Ugwu

2. . About this instrument
a) It can be used for hindwater rupture of membrane F
b) Its use is associated with cord prolapse T
c) Its use is associated with foetal injury T
d) It can cause uterine hyperstimulation F
e) Its use is contraindicated in retroviral positive patients F

3. Prevention of ureteric injury
1. Generous surgical exposure T
2. Meticulous surgical technique T
3. IdentifIcation of Risk factors T
4. Ureteric stenting T
5. Pre operative IVU not necessary F

4. About this instrument
a) It is a high cavity forceps F
b) It is a non-rotational forceps and so can be used in the correction of
asynclitism F
c) It has a sliding lock T
d) The cervix should be at least 8cm dilated for its use F
e) It causes more maternal injury compared to the vacuum extractor T

5. Concerning this
a) It is a permanent measure of management F
b) Pregnancy is a contraindication F
c) It should be changed every 6 months F
d) It can be complicated by vaginal infection T
e) If it fails, surgery is indicated T

6. About the condition depicted below
a) It is common in postmenopausal women F
b) Cystic degeneration usually precedes hyaline degeneration F
c) The intraligamentary form can cause polycythaemia T
d) GnRH antagonists are useful in its management T
e) Iron deficiency anaemia secondary to chronic blood loss is an indication
for surgical management. **T

7. 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

8. About the
Instrument
1. They are indicated in maternal
exhaustion. -T
2. Bladder must be empty but the
catheter bulb need not deflated-F
3. Associated with more maternal
worries about the baby compared
to Vacuum. -F
4. Associated with lower APGAR scores
compared to vacuum.-F
5. Ideal traction of 30-45 lb.-T

9. 6. Cervarix offers protection-F
7. May contain oncogenic subtypes of
HPV-T
8. Contraception is mandatory while
using podophyllin-T
9. Neonatal laryngeal papilomatosis is a
recognized potential problem.-T
10. Histology is necessary for diagnosis-
F

10. Concerning this instrument,
a. It is used in fistula repair T
b. Cusco’s speculum can be used in
its place F
c. Its use requires one assistant T
d. Its use requires more than one
assistant F
e. Autoclaving is contraindicated F

11. About this instrument
a) A tourniquet can be used in its place. T
b) It is useful in vaginal hysterectomy F
c) It is used in clamping the isthmus of the fallopian tubes F
d) It helps reduce blood loss during surgery T
e) It can be left in place for at least 2 hours F

12. Concerning the use of this instrument:
a. It is used to reduce the bisacromial diameter and allow for vaginal
delivery F
b. Cervix need not be fully dilated in experienced hands T
c. It is employed in the commonest type of destructive surgery. T
d. Continuous bladder drainage is essential after its use T
e. At least 2/5th of the fetal head must have gone into the maternal pelvis
if its use is indicated F

13. Concerning the picture shown and
intrapartum monitoring
a. The duration between two vertical lines on a
partograph is half hour. T
b. In the primigravida, the cervix dilates at a rate
of at least 1 cm/hr in the active phase T
c. The alert line is parallel and 4hours to the right
of the action line F
d. Vaginal examination is done four hourly. T
e. Plastic Pinnard stethoscope is better than the
metallic one in monitoring fetal heart rate. T

14. Concerning the picture shown
a. Birth weight of 1400gram is an indication for Caeserian delivery. T
b. Engagement of the presenting part in the pelvis is not a contraindication
for external cephalic version. F
c. High parity is a predisposing factor T
d. Lovset manouvre is used to deliver the head F
e. Kielland’s forceps can be used in the delivery of the aftercoming head F

15. Concerning uterine incisions during
Caesarean delivery
a. A is associated with less likelihood of adhesion formation to bowel or omentum T
b. A is more commonly used than B T
c. B allows for easy entry into the uterus when there is fibroid in the lower segment T
d. B is associated with less likelihood of subsequent uterine rupture during pregnancy F
e. A is indicated in the presence of carcinoma of the cervix F
A
B

16. Multiple gestation
a. Cleavage of zygote on day 9 after fertilization produces the picture
shown F
b. The intertwin membrane is made up of 2 layers of amnion with no
chorionic layer F
c. Inheritance as autosomal recessive trait is recognised F
d. There is a risk of twin to twin transfusion F
e. Caeserian delivery is indicated if the presentation of the first twin is
vertex and the second twin non-vertex F

17. Concerning this picture
a. This is a complication of external cephalic
version T
b. Coagulation failure is a complication T
c. Foetal parts will be easily outlined on
palpation.F
d. The uterus will have a hard wooden
consistency on palpation T
e. Caeserian section should be performed if
the fetus is dead on presentation. F

18. 11. Used by 2% of Nigerian women.-T
12. Failure rate of ideal use is 2%.-F
13. Use associated with deep vein
thrombosis but not myocardial
infarction in obese women.-F
14. Increased risk of rheumatoid
arthritis.-F
15. Risk of Stroke is increased in women
with migraine but lower in those with
aura.-F

19. 16. Outer ring needs to be held prior to
penetration.-T
17. Can be noisy and cumbersome-T
18. More likely to rupture than male
condom.-F
19. Contains spermicide-F
20. Failure rate of 5% with ideal use.-T

20. 21. Sensitivity of 96%-F
22. Liquid based type make diagnosis of
HPV and Chlamydia possible-T
23. Abnormality found in 10% of all
samples-T
24. False negative result may be up to
70%-F
25. Nationwide programme has
reduced incidence of Ca. Cervix by 95%-
F

21. 26. This is a Karman syringe- F
27. Volume of syringe is 50cc- F 60CC
28. 5-10mm cannula for 9-12weeks-F
29. Provides sunction pressure of about
640mmHg-T
30. Can be used for menstrual
regulation.-T

22. 31. Size and rate of growth influenced by
sexual stimulation.- T
32. N. gonorrhoeae and Chlamydia
Trachomatis are most often isolated in
the abscesses-F -E.coli
33. Word Catheter has a role in
management.-T
34. Silver Nitrate ablation may be used
in treatment. -T
35. Biopsy is mandatory in patients
under 40years-F

23. 36. Postdatism and malpresentation
may be complication-T
37. Oligohydramnios often associated-F
38. Defect results from malformation
around day 35 of embryonic life.-F 25
39. Late neonatal death is common.-F
EARLY
40. Folic acid supplementation may
reduce incidence.-T

24. 41. Monoclonal in origin-T
42. Red degeneration is the commonest
form of degeneration-F
43. Only submucous type has been
shown to be linked with infertility-F
44. Uterine artery embolization not
recommended for women who wish to
preserve fertility. -T
45. Recurrence after myomectomy is
about 20%.-F 10-15

25. 46. About 80% of patients are above
55years –F 65
47. Commonest site is labia minor-F
48. Two-thirds occur in women with
Lichen sclerosis-T
49. 4-8% of squamous cell type linked
with Paget disease.-F <1%
50. Stage 3 has 5-year survival rate of
about 75%.-T

26. 51. Bilateral in about 25%-F
52. Stroma ovarii if parathyroid tissue is
demonstrated.-F
53. Immature variant accounts for 20%
of all ovarian malignancy in females less
than 20 years-T
54. Immature variant are commonly
bilateral-F
55. Squamous cell carcinoma is the most
common histology of malignant
transformation in mature variant.-T

27. 56. Flexion point is 3cm from anterior
fontanelle-F
57. Negative pressure of 600mmHg is
recommended-T
58. Use associated with increase risk of
shoulder dystocia-T
59. Retinal haemorrhage commoner in
forceps than in this instrument.-F
60. May be used during Caesarean
section.-T