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Saudi Board exam 2015

These answers are mine ,they may be right ,may be wrong.

1- Primigravida , term in labor ,exhausted from contractions with pudendal

block.on examination the head is below ischial spine occipital anterior. you are
planning for instrumental delivery.pt is not satisfied with the pudendal
block.what will you give her?
a-IV Meripidine
b-spinal block
c-repeat the pudendal nerve block
d-Lidocaine infiltration for the perineum

2-15 years old girl Tanner stage II ,with primary amenorrhea. she have grown
5cm taller in the last month .what will you do?
a-skull x-ray
b-reassurrance
c-GnRH agonist
d-???

3-7years old,bone age 9 years old, Tanner stage III, with vaginal bleeding.what
will you give her?
a-GnRH agonist
b-OCP
c-Estrogen
d-no treatment

4-Achild with 15*15cm solid smooth ovarian tumor, is most probably:

a-Dermoid cyst
b-Germ cell ovarian tumor
c-?
d-?

5-Laboratory and clinical findings with clear cell ovarian tumor are:
a-Hypernatremia and hypotension
b-hyperglycemia and
c-Hyperkalemia and pyrexia
d-?
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6-Heparin physiological mechanism to reduce coagulopathy:
a-increase platelet function
b-increase platelet count
c-increase fibrin degradation product
d-block fibrinogen consumption

7- Patient has twin pregnancy, with absent fetal movements, diagnosed as IUFD
for twins at 30 weeks.what is your management?
a-Emergency C/S NOW
b-IOL now
c-Heparin to decrease the coagulopathy
d-Reassurance

8-Best diagnostic test to monitor hypothyroidism in pregnancy:

a-TSH
b-T3
c-T4

9-Patient has epilepsy 10 weeks pregnant asking about risk of epilepsy

treatment on the baby.
how will you council this patient?
a-Risk is minimal ,continue the medications
b-stop the medications
c-Epileptic attacks are increasing in pregnancy

10-Advanced ovarian cancer patient is writing her WILL consent(), Refusing

to take any further chemotherapy ,this is called:
a-Autonomy
b-Beneficience
c-Malefficience
d-Justice

11-37 years old married since 3 years with dyspareunia, dysmenorrhea,on

pelvic exam nodular uterosacral ligament was felt, on barrier contraception
what is the treatment?
a-she must get pregnant immediately
b-GnRH agonists for 6 months
c-OCP
d-Danzol
e-no enough data in the question, we need to know the diagnosis first

12-Best method to diagnose endometriosis:

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a-laparoscopy
b-hystroscopy
c-?
d?

13-Adenomyosis is defined as:

a-stromal endometrial glands invading the myometrium
b-___
c-___
d-___

14- Perforation during curettage of an

incomplete abortion after using this
instrument->

what is your action?

a- Keep the patient 24 hours for observation
b-laparoscopy
c-Hystroscopy
d-?
e-?

15-Case scenario, patient pregnant 34 weeks, with biophysical profile 2/10,

oligohydraminos, IUGR
what is your action?
a-immediate C/S
b-IOL
c-repeat BPP after 2 weeks
d-?

16-Pregnant 20 weeks,polyhydraminoa, IUGR.Best thing to do:

a-Karyotyping

17-Best treatment of hirsutism in PCO patient:

a-OCP
b-Spironolacton (not sure)
c-?
d-?
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18-Treatment for pregnant patient suspected H1N1:
a- oseltmavir
b-zanamivir
c-?
d-?

19- commonest cause for thrombosis:

a-Factor V Leiden
b-antithrombin III
C-?
d-?

20-Lupus anticoagulant detection by:

a-___
b-___
c-___
d-___

21-patient 16 weeks pregnant complaining of nausea and vomiting ,heart burn

since 6 months.no benefit from treatment.Best management:
a-Omeprazole
b-stomach PH test
c-upper gastrointestinal tract endoscopy
d-?

22-treatment for hyperemesis gravidarum:

a-Pyremedin/Dyhydramine
b-exercise and diet
c-?
d-?

23-The disease that get worse with pregnancy:

a-Rheumatoid arthritis
b-Gout
c-SLE
d-?

24-Risk for SLE:

a-thrombosis and VTE
b-Thrombocytopenia
c-?
d-?
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25-Pregnant patient at 8 months with BP:140/90, with nausea vomiting

,epigastric pain and jaundice.
diagnosis:
a-Acute fatty liver in pregnancy
b-Acute hepatitis
c-preeclampsia

26-Best diagnostic tool for PE:

a-spiral CT scan
b-VQ scan
c- ABG
d-?

27- Case scenario for avery ill pregnant patient with acute
pyelonephritis,admiited on IV antibiotics and IV fluids.After 5 hours from
admission , pt developed dyspnea,hypotension (BP:90/50), O2 saturation 88%.
what is your diagnosis?
a-Pulmonary edema
b-Drug induced
c-Sepsis lung injury
d-?

28-commonest cause of death in advanced ovarian cancer:

a-uremia
b-thromboembolism
c-Bowel obstruction

29-pregnant with pedal edema, hypoalbuminuria, increase in creatinine level 60

, protein in urine 4000
Diagnosis:
a-Nephrotic syndrome
b-Glomerulonephritis
c-chronic renal failure
d-preeclampsia

30-Commonest cause for IUGR:

a-Hypertension

31-To repair a paravaginal defect, we approximate pubocervical fascia with:

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a-pericervical fibrotic
b-pelvic fascia
c-levator Ani fascia
d-?

32-Pregnant patient with CMV, asking about the risk of having a severely
affected baby is:
a-10%
b-20%
c-50%

33-Mallory Weis is:

a-oesophageal tear

34-Peutz-Jeghers syndrome is happening with:

a-squamous cell carcinoma
b-ovarian sarcoma
c-sex cord
d-Adenoma Malgum

35-Patient postmenopausal with severe vasomotor symptoms,had recently

DVT, does not want medroxyprogesterone acetate.you will give:
a-Vitamin E
b-Raloxifen
c-clonidine
d-?

36-Patient her mother has breast cancer and her sister .you will council
a-Genetic screening
b-?
c-?
d-?

37-Patient her mother has ovarian cancer ,she can decrease her risk of having
an ovarian cancer by:
a-pelvic exam
b-CA 125
c-OCP
d-?

38-Histopatholgy after ERPOC showed trophoblastic tissue in myometrium:

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a-Hydatiform mole
b-choriocarcinoma stage II
c- Nitabuch layer

39- 3 recurrent miscarriges ,incidence of having alive birth without treatment :

a-20%
b-40%
c-60%
d-80%

40-Reversed umbilical Doppler velocimetery at ? weeks

.Best management:
a-IOL and delivery
b-Repeat the scan weekly
c-Biophysical profile

41-Best method for checking Lupus anticoagulant

a-partial thromboplastin time
b-Dilute Russells viper venom time

42-Obese patient ,DM type I on insulin, term pregnancy, polyhydraminos, cord

prolapse went for emergency cesarean section.the most common complication
of genera anaesthesia:
a-inability for intubation
b-anaesthesia agent side effects
c-awareness during cesarean

43-pregnant patient with sudden severe onset of Rt lower abdominal pain

,elevated WBC,fever.
Diagnosis:
a-Appenicitis
b-Adenexal torsion

44-Patient has previous IUFD at 33 weeks now she is 28 weeks .what will you
do?
a- U/S at 38 weeks
b-U/S after 2 weeks
c-C/S now
d-Steroids
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45-Ist line of treatment for acute severe hypertension in pregnancy
a-labetalol
b-Hydralazine
c-Nitroglycerin
d-Nifidipine

46-repair for ureteric injury at midway of .

a-end to end anastomosis and stent
b-?
c-?

47-commonest complication after total abdominal hysterectomy is:

a-bladder dysfunction

48-If patient with anti-D sensitization, the first sign to appear in the fetus is:
a-Skin edema
b-ascitis
c-?
d-?

49-pregnant with vaginal bleeding ,? weeks, no leaking,intact membranes ,CTG

reassuring ,U/S showed anterior placenta no translucency
a-vasa previa
b-placental angioma
c-accretta
d-abruption

50-Patient has no cycles since 3 months, high prolactin,nipple discharge

a-pregnancy
b- pituitary adenoma

51-Commonest site for melanoma

a-labia Minora
b-labia Majora
c-Clitoris

52-To diagnose birth asphyxia

a-bad CTG in 2nd stage
b-PH<7
c- Apgar 7 in 5 minutes

53- prognosis of
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54-Best mangement is drainage in :

a-intact Tubo-ovarian abscess
b-persistant mass even after IV antibiotics
c-

55-Male infertility ,Azoospermia volume 2 ml, WBC 6/HPF

Best management:
a-PESA?
b-TESE
c-Testicular biopsy

56-Aminocentesis in twins
a-single needle inserted in one sac then to other sac
b-each sac is aspirated separately through twice insertion with indigo carmine
injection 1st sac

57-Best diagnosis for cevical incompetence:

a-History
b-Parity
c-U/S

58-Prognosis of vulval carcinoma depends on:

a-Lymph nodes involvement

59-Prognosis of endometrial carcinoma depends on:

a- cellular atypia

60-Pagets disease of vulva ?2cm, no cutaneous or subcutaneous induration .

Best mangement:
a-Wide local incision
b-Radical vulvectomy
C-5-flurouracil

61-Least to cause infective endocarditis:

a-VSD
b-Fallot
c-ASD
d-Mitral regurge
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62-Endodermal
a-primitive yolk sac

63-Case scenario, Patient with 1ry amenorrhea, Pubic hair and breasts are
present
increased testosterone, decrease DHEA
Due to:
a-5 alpha reductase deficiency
b-17 keto-steroid
c-21 hydroxylase deficiency
d-11 beta hydroxylase deficiency

64-Percentage of prevention of NTDs in fortified food with folic acid

a-10-20

65-Patient with FSH :2 and very high LH:1500, and delayed cycle nice 3 months
a-PCO

66-Case scenario ,patient with prolonged labor, forceps delivery developed foot
drop
the cause is:
a-improper position
b-instrumental delivery

67-Serious skin disease in pregnancy:

a-pemphigoid
b-Impetigo herptiformis
c-PUPP

68-To prevent neonatal hepatitis B infection due to maternal infection:

a-HBIG

69-Regarding HIV in neonates

a-Breast feeding risk of transmission>20%
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b-no need for treatment

70-30 weeks pregnant ,history of recurrent attacks of genital herpes

came with leaking,PPROM, active lesions of herpes,what is your management?
a-C/S now
b-IOL now
c-antiviral treatment now
d-antiviral treatment at 34 weeks

71-Multigravida,twin pregnancy with Ist cephalic ,2nd breech.

The best way to deliver the 2nd twin is:
a-C/S
b-external cephalic version
c-breech extraction
d-spontanous delivery

72-young patient ,nulligravida, underwent unilateral salpingoophrectomy due to

dysgerminoma.what else will you do?
a-pelvic lymphadenectomy
b-TAHBSO
c-infracolic omentectomy
d-contralateral ovarian biopsy

73-percentage for a leiomyoma to develop cancer:

a-1%

74-Patient 6 weeks pregnant with history of previous unilateral salpingostomy

for a previous ectopic pregnancy.
the patient is worried to have an extra uterine pregnancy.
the highest probability is to have:
a-normal pregnancy
b-ectopic
c-miscarrige

75-cervical lesion in cervical lip 4 cm in size , 3 cm right uterosacral

involvement, 4 cm upper vaginal involvement,what is the stage?:
a-stage II b

76-cervical lesion 4mm depth, 7mm widest spread. stage:

a-Stage IA2
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77-definition of stuck twin is:
a- donor twin bleeds into the circulation of a recipient twin. The donor twin
become anemic, hypovolemic and looses amniotic fluid in twin twin transfusion
syndrome

78-Ahealthy patient had asherman syndrome and secondary amenorrhea

,underwent hystroscoy and adhesolysis,
Best treatment of secondary amenorrhea is:
a-30 mcg estradiol+ progestin
b-50 mcg estradiol+progestin
c-Depoprovera
d-GnRH agonist

79-28 years old, young patient diagnosed as acute myeloid leukaemia received
chemotherapy 6 months ago, 2ry amenorrhea .FSH 50.
Best mangement:
a-OCP
b-conjugated equine oestrogen
c-GnRH

80-Breast abscess treatment after 5 weeks postpartum is:

a-Ice packs
b-expression
c-antibiotics
d-?Incision and drainage

81- Wound gapping ,no fascial gap, no infection

Treatment is:
a-wet dressing

82-Cancer thyroid diagnosed at 14 weeks pregnant .Best management:

a-Delivery at term then surgery
b-Delivery at 34 weeks
c-Surgery and expectant management

83-Patient with severe postpartum depression.Best indicator is:

a-Previous history of depression

84-Old patient with 2 cm vulvar lesion .Best management is:

a-excisional biopsy

85-Ipsilateral lymph node affection is in :

a-clitoris
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b-perineum
c-urethera
d-middle part of labia majora

86- patient with pap smear showed atypical glandular cells of unknown origin .
Best management:
a-colposcopy ,biopsy and endometrial biopsy
b-repeat smear in 6months

87-patient 24 weeks ,fundal level is 27weeks,normal ultrasound findings.

By these informations you can rule out:
a-Potter
b-Down
c-Congenital heart disease
d-Tracheosphageal fistula

88-patient with ovarian cancer had chemotherapy developed numbness in

hands and feet due to:
a-Cisplatin
b-Carboplatinum
c-Doxorubicin

89-Patient on IV antibiotics with persistent fever since 5 days post operative

Diagnosis:
a-Embolism
b-pelvic septic thrombophilibitis
c-Infection ,so continue on IV antibiotics

90-37 years old patient ,Nullipara,wants strongly to conceive.Endometrial

biopsy showed adenocarcinoma stage I
management:
a-Progestin
b-Hystrectomy
c-High dose progestin + endometrial biopsy every 3 months

91-patient in labor,vaginal exam showed:4cm dilated cervix , fully effaced, best

management:
a-Folys catheter
b-Amniotomy
c-Oxytocin
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92-26 years old ,smoker received HPV vaccine, Pap smear showed ASCUS.
Mangement:
a-Repeat Pap smear in 3-6 months
b-conization
c-LEEP
d-Colposcopy and biopsy

93-32 years old, pap smear showed ASCUS, with intermittent pv bleeding.
What will you do?
a-LEEP
b-Colposcopy and biopsy
c-conization
d-repeat pap smear in 3-6 months

94-Ist Trimester pregnancy,pap smear showed CIN II

Mangement:
a-terminate the pregnancy
b-colposcopy and biopsy
c-cone biopsy
d-repeat the smear

95-pregnant with cervical biopsy showed HSIL

Recommendation:
a-repeat the smear every trimester

96-Young nullipara, cervical biopsy showed micro invasive cancer cervix with
+ve margins CIN III
Best management:
a-Simple hysterectomy
b-wide cone biopsy?
c-LEEP
d-repeat biopsy

97-Galactorrhea ,hyperprolactinemia and 2ry amenorrhea

Diagnosis:
a-pituitary adenoma
b-breast disease

98-Cause of failure to have withdrawal bleeding after oestrogen due to which of

the following causes?:
a-ovarian
b-uterine
c-pituitary
d-hypothalamus

99-Regarding thyroid dysfunction in pregnancy.should avoid:

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a-propranolol in first trimester
b-Thyroxin in pregnancy
c-Radioactive iodine preconception
d-methimazole the whole pregnancy

100-which of the following is the best tool for follow up of an IUGR fetus:
a-Head circumference
b-Femur length
c-?AFI
d-Transcerebellar.
e-?

101-patient with failed induction ovulation with 50 and 100 mg clomid from day
5-9 of cycle
the next step is:
a-increase the dose to 150 mg

102-case scenario of premature ovarian failure

Diagnosis:
a-Fragile X

103-Causes of limb reduction:

a-amniocentesis at 9-12 weeks
b-amniocentesis at 15-20 weeks
c-Early CVS
d-late CVS

104-RTA patient with large pelvic hematoma and urinary incontinence.why?

a-injury to the lumbar plexus
b-?injury to the sacral plexus
c-injury to the superior hypogastric nerves
d-?

105- Tamoxifin used as treatment to breast cancer has greatest risk of:
a- endometrial hyperplasia

106-55 years old, known case of fibroids presented with heavy cycles.
Best management:
a-endometrial biopsy

107-Definition of variable deceleration according to the ACOG :

a-decrease 15 beat /minute ,Nadir 15
b-decrease 10,Nadir 15

108-what to do else for a young patient with a low malignant borderline ovarian
tumor found during oophorectomy?
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a-pelvic lymphadenectomy
b-omentectomy
c-?
d-?

109-38 years old,primigravida, 30 weeks, presented to ER ,complaining of

fatigue
BP:140/90, protein in urine -ve
what to do?
a-send her home
b-admit and close observation
c-steroids

110-Patient has SLE, with history of lupus nephritis when she was 8 weeks in
current pregnancy received steroids, now she is 37 weeks in labor ,not on
steroids.what will you do regarding the steroids?
a-start steroids
b-Donot give steroids

111- 17 years old with 1ry amenorrhea, Tanner II, what will you do next?:
a-FSH
b-U/S
c-Karyotyping

112-Nullipara,bulky uterus 14 weeks, pregnancy test -ve

known fibroid
Best management:
a-uterine artery embolization
b-Myomectomy

113-pregnant pt 36 weeks with BP 150/90 ,repeated measurement showed the

same readings.MgSO4 was started.
what will you do next?
a-IOL and delivery
b-steroids

114-Patient with cancer cervix received radiotherapy 2 years ago complaining

of offensive vaginal discharge ,itching and abdominal colicky pain.what is the
cause?
a- Enterovaginal fistula

115-patient had hysterectomy due to prolapse years ago, now she is complaint
from something coming from vagina.most probably:
a-Enterocele
b-Cystocele
c-Rectocele
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116-Patient is on ACEI wants to conceive:

a-stop ACEI and start Aldomet
b-stop ACEI when she get pregnant
c-continue ACEI

117-unexplained infertility ,what will you do?

a-sperm test
b-increase fecundability rate with induction of ovulation
c-They have increase pregnancy rate with assisted conception techniques

118-heavy smoker ,pregnant.

Risk to the fetus:
a-preeclampsia
b-congenital abnormalities
c-IUGR

119-Case scenario of a 25 years old patient with elevated FSH , diagnosed as a

premature ovarian failure.what lab. test is the most probably found?
a-elevated fasting blood sugar
b-High TSH
c-high cortisol

120-Effect of ephedrine on the fetus during treatment of post epidural

hypotension:
a-fetal bradycardia
b-Inotropic effect
c-Minimal change on placental circulation

121-Young girl with Tanner III, cafe au lait spots

Diagnosis:
a-McCune Albright syndrome

122-treatment of sarcoma botryoid :

a-chemotherapy
b-Radiotherapy
c-Vaginectomy with TAHBSO

123-Innervation of the bladder

124-1st desire to void at:

a-100 cc
b-200cc
c-500cc
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d-700cc

125-patient with preeclampsia.what will she have increase risk in the future?
a-cardiovascular disease
b-renal disease

126-pregnant patient with routine ANC ,BP 150/90. the best diagnostic for
preeclampsia
a-serial BP readings
b-protein in urine
c-transaminases
d-platelet count

127-Diagnosis of chorioamnionitis :
a-malodorous vaginal discharge
b-Bacteria in liquor
c-Temperature 37.3

128-In patient with heart disease willing to conceive .you informed her that the
risk is highest immediately postpartum due to:
a-increase cardiac output

129-Neonate of diabetic mother most likely to develop what other than

hypoglycaemia and hypokalemia:
a-breast feeding difficulty
b-diabetes later in life
c-seizures

130-Diabetic patient on insulin,most common complication during pregnancy:

a-Macrosomia

131-which uterine abnormality carries the most morbidity or damage?

a-complete septum
b-Bicornuate
c-Didelphis

132-3 successive abortions,one parent with translocation,risk of recurrence of

abortions:
a-%?

133-common tumor to produce hormones

a- Granulosa cell tumor
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134-patient with symptoms of virilization
Her last delivery 9 years ago.
what to do next?
a-U/S

135-IUGR in labor, with meconium

136-patient with drippling of urine when standing ,dysparunia and UTI:

A- uretheral diverticulum

137-postpartum thyroiditis
a-high risk for recurrence in future pregnancies

138-pregnant ,pap smear AGUS:

a-colposcopy with biopsy

139-Histopathology report showed crowded back to back endometrial glands

with increased number of glands with nuclear changes
a-complex endometrial hyperplasia with atypia

Simple hyperplasia Without Cytologic Atypia (Two of the four criteria must be
present)
Increased number of glands relative to stroma
Dilated glands with irregular outlines
Crowded, clustered glands
Tall, columnar epithelium with nuclear pseudostratification
Complex Hyperplasia Without Cytologic Atypia( Both criteria must be present)
Increased number of glands relative to stroma
Back-to-back glands (crowded glands with little or no intervening stroma)
Hyperplasia With Cytologic Atypia(Three of the first four criteria must be
present)
Variation of size and shape of nuclei
Nuclear enlargement
Loss of polarity
Coarse chromatin clumping
Prominent nucleoli
Hyperchromatism

140-2ry amenorrhea ,BMI is very low with lanugo hair, FSH is normal
a-Anorexia nervosa
b-exercise induced amenorrhea

141-unexplained 1ry infertility 2 years

what is next?
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a-postcoital test
b-they will get benefit from advanced ART
c-Assisted reproductive techniques

142-Eclampsia may cause:

a-cortical necrosis
b-tublar necrosis

143-patient with 2 family members with ovarian cancer , her chance to have the
disease is:
a-5-7%

144-patient with ANC ,her 1st visit at 8 weeks it was diamniotic dichorionic
twins. pt returned back at 14 weeks ,you found fatal heart positive for one sac
and the other sac is complete mole.what is your management?
a-Termination
b-continuation of pregnancy
c-Expectant management

145-Galactorrhea related to OCP happens in:

a-during off days of OCP(due to estrogen withdrawal & absence of the inhibitory effect on
prolactin action onbreast)
b-2nd week
c-3rd week

146-patient with Eisenmenger s syndrome, cause of postpartum deterioration

is:
a-Hypotension
b-decrease cardiac output

147-least association with IUGR:

a-Trisomy21
b-Turner
c-Triploidy

148-chocolate cyst ruptured during laparoscopy .Management:

a-removal of cyst wall

149-False positive rate of laparoscopy for ectopic pregnancy:

a-0-2%
b-3-5%

150-most common outcome of chlamydia:

a-infection
b-perihapatitis
c-Preterm labor
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151-prognosis of endometrial cancer depends on:

a-estrogen receptor
b-progesterone receptor

152-Risk factor for ovarian cancer with positive family history but negative
BRCA1 and BRCA 2:
a-15%

153-contraindicated in pregnant patent with cardiac disease :

a- Ergometrine

154-commonest age of hydatiform mole is:

a-41-50

155-best indicator factor for IVF success:

a-Age
b-FSH

156-parameter to measure discrepancy in twins:

a-AC measurement

157-PET with renal involvement ,pathophysiology:

a-Endothelial swelling

158-patient with microprlactinoma was on bromocriptine before pregnancy

,stopped during pregnancy developed bitemporal hemianopia.what will be your
management?
a-restart Bromocreptine
b-transsphenoidal surgery

159-Symmetrical IUGR associated with

a-Rubella
b-CRF
c-PET
d-DM

160-preterm labor ,os closed ,intact membranes

a-discharge the pt
b-CTG

161-Diagnosis od adenomyosis:
a-myometrial thickness 2.5cm
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162- Endometriosis its abnormal uterine bleeding, treatment:

a-OCP

163-cervical fibroid in pregnancy:

a-expectant management

164-epidural anaesthesia
a-slightly increase risk for C/S or unchanged

165-primary CMV,transmission to the fetus:

a-25-30%

166-effect of smoking during pregnancy on the foetus later on in life:

a-learning disabilities,speech difficulties

167-commonest cause of hypotension with epidural :

a-slow injection
b-trendlenberg postion
c-cesarean section

good luck!