GYNAECOLOGY – PAST QUESTIONS

(2007-2019)
(Compiled by Shahroze Ahmed, N-66,
Nishtar Medical University)

CONTENTS
SR # Unit Page #
1 Development & Anatomy of Female Sexual Organs & Pelvis 2
2 Hormonal Control of Menstrual Cycle & Hormonal Disorders 5
3 Disorders of Menstrual Bleeding 6
4 Implantation & Early Pregnancy 8
5 Contraception & Abortion 11
6 Subfertility 15
7 Genitourinary Problems 17
8 Urogynaecology & Pelvic Floor Problems 20
9 Benign Conditions of Ovary & Pelvis 23
10 Benign Conditions of Uterus, Cervix & Endometrium 25
11 Malignant Disease of the Ovary 28
12 Malignant Disease of the Uterus 28
13 Premalignant & Malignant Disease of the Lower Genital Tract 30
14 Gestational Trophoblastic Diseases 31
15 Gynaecologic Surgery & Therapeutics 32

1
▪ DEVELOPMENT & ANATOMY OF FEMALE SEXUAL ORGANS &
PELVIS
Development of Female Genitalia
1. Enumerate the structures which take part in the development of vagina.
[Annual 2014]

2. What structures are the precursors of female genital development?

[Supple 2011 held in 2012]

3. A newborn female baby is born with fused labia minora. Explain the embryological
development of external genitalia of the female. [Annual 2011]

4. What are the anatomical structures derived from Mullerian duct?

[Supple 2010 held in 2011]

Internal Reproductive Organs

1. Describe the relations of the uterus. [Annual 2012]

The Bladder, Urethra & Ureter

1.
a) Briefly give the ureteric course in pelvis.
b) Why there is risk of ureteric damage during hysterectomy?
c) How ureter can be damaged during hysterectomy? [Annual 2018]

2. A 60-year-old woman has been planned for radical hysterectomy for treatment of
stage 1 carcinoma cervix. Intraoperatively surgeon has to dissect ureter from pelvic
brim till bladder.
a) Write down the course of pelvic ureter.
b) Write down blood supply of pelvic ureter. [Supple 2017 held in 2018]

3.
a) Give the salient features of ureteric course in the pelvis.
b) Name the structures to which lower ureteric part is closely related hence
increasing the risk of ureteric injury during hysterectomy. [Annual 2015]

2
Pelvic Muscles, Ligaments & Fascia
1.
a) Define pelvic diaphragm.
b) Enumerate the muscles of pelvic diaphragm.
[Annual 2019]
2. Uterus and vagina are supported by pelvic diaphragm.
a) What is the pelvic diaphragm?
b) Describe its origin and insertion.
[Annual 2013]

Blood Supply
1.
a) Write down the course of uterine artery.
b) Name the branches of anterior division of internal iliac artery.
[Supple 2018 held in 2019]

2. A 30-year-old female P2+0 has been planned for myomectomy. During surgery, the
surgeon has to ligate uterine artery due to excessive bleeding.
a) Write down the course of uterine artery.
b) Name the branches of anterior division of internal iliac artery. [Annual 2016]

Lymphatics
1. A 40-year-old patient is diagnosed as a case of carcinoma cervix. Outline lymphatic
drainage of cervix. [Annual 2017]

2. A 35-year-old lady undergoes clinical staging for carcinoma of the cervix. An

examination under anesthesia reveals the growth eroding 25% of the area.
Gynecological surgeon is planning a radical hysterectomy with bilateral pelvic
lymphadenectomy. Name the lymph nodes which drain the cervix. [Annual 2010]

Mullerian Anomalies
1. A 16-year-old girl presented with her mother with complaints of failure to establish
menstruation. On examination, she has normal height and weight, normal
intellectual, normal breast development and fine axillary and pubic hair
development. On perineal examination, there is a short (2 cm) blind ended vagina.
a) What is your differential diagnosis based on history and examination?
b) What further investigations would you request to reach the diagnosis?
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c) On what aspects the management should be focused?
[Supple 2019 held in 2020]

2. A 16-year-old girl came with history of primary amenorrhea and cyclic lower
abdominal pain.
a) Name the two most likely causes of her problem.
b) Give the clinical and ultrasonographic findings which can be present in this case.
c) Which other system be investigated for any anomaly?
[Supple 2014 held in 2015]

3. Enlist the congenital abnormalities which can occur in vagina. [Annual 2014]

4. An 18-year-old unmarried girl comes with primary amenorrhea, secondary

characters are developed. She gives history of cyclic lower abdominal pain PA
examination reveals 16 weeks size mass. PV examination shows bulging bluish
membrane.
a) What is the diagnosis?
b) How will you confirm?
c) What is the treatment? [Annual 2013]

5. List four common Mullerian duct anomalies. [Supple 2010 held in 2011]

6. A 15-year-old girl presents with primary amenorrhea and cyclical lower abdominal
pain for six months. On examination, there is 16 weeks sized mass arising from pelvis
and bluish membrane bulging at introitus.
a) What is your diagnosis?
b) Outline her management. [Annual 2010]

7. A 16-year-old girl comes with complaints of cyclical abdominal pain 1 year and
failure to menstruate. Her secondary sexual characters are well developed. On
examination, a mass is felt in the sub-umbilical region.
a) What is the most likely diagnosis?
b) How will you investigate and treat her? [Annual 2008]

8. An 18-year-old tall unmarried girl presents with primary amenorrhea. Secondary sex
characters are developed. On examination, she has a blind vagina.
a) What is your diagnosis?

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b) How will you treat her? [Supple 2007 held in 2008]

9. A 16-year-old girl presents with primary amenorrhea and urinary retention. On

examination she has an abdominopelvic mass consistent with 20 weeks gestation.
a) What is the likely diagnosis?
b) Outline the management plan.
[Annual 2007]

▪ HORMONAL CONTROL OF THE MENSTRUAL CYCLE &

HORMONAL DISORDERS
Disorders of Sexual Development
1. A 14-year-old girl presented with primary amenorrhea. Findings of clinical evaluation
are suggestive of Turner syndrome.
a) What is the underlying pathology?
b) How will you manage her?
c) Enlist the associated medical conditions. [Supple 2016 held in 2017]

2. A newborn baby was brought by her mother with ambiguous external genitalia.
a) What are the causes of masculinization in a female?
b) Briefly give the principles of management in a case with adrenal hyperplasia
diagnosed at birth. [Annual 2009]

Amenorrhea & Oligomenorrhea

1. 33 years old P2+0 comes with secondary amenorrhea. How will you clinically
evaluate her? [Annual 2009]

2. An 18-year-old girl has primary amenorrhea.

a) What other features on examination will you look to find out if her puberty is
delayed or not?
b) What are the possible causes and investigations required? [Annual 2008]

Polycystic Ovary Syndrome

1. A 22 years old multipara came with an ultrasound report showing polycystic ovaries.
a) What are the different clinical presentations related to this condition?
b) Briefly outline the management plan. [Supple 2016 held in 2017]

5
2. A 30-year-old nulliparous obese lady married for three years having oligomenorrhea
for 5 years. Her ultrasound report shows polycystic ovaries. What is likely cause of
her infertility? How will you treat her? [Annual 2012s]
3.
A 19 years old college student presents in the outpatient department with secondary
amenorrhea and hirsutism. Her BMI is 30.
a) What is most likely diagnosis?
b) What is the accepted criterion of diagnosis? [Annual 2010]

Premenstrual Syndrome
1. A 22 years old unmarried final year medical student complains of severe pre-
menstrual anxiety, lethargy, anorexia and bloating. Outline her management.
[Supple 2007 held in 2008]

▪ DISORDERS OF MENSTRUAL BLEEDING

Dysfunctional Uterine Bleeding
1. A 40-year-old P5+0 presents with abnormal uterine bleeding. After workup, she was
labeled as a case of dysfunctional uterine bleeding. What are treatment options?
[Annual 2012]

Heavy Menstrual Bleeding

1. A 48 years old para 2 presents with complains of cyclic heavy menstrual blood loss
for six months. Uterus is normal sized and fornixes are clear. There is no tenderness.
Ultrasound scan shows uterus of 7x4 cm. endometrial thickness is 28 mm.
a) What is the next step in the management of this patient?
b) What medical options does she have? [Supple 2019 held in 2020]

2. A 40-year-old P3, previous normal vaginal deliveries, presented in outpatient with

complains of heavy menstrual bleeding. On examination, she is pale, thyroid is not
enlarged, edema is negative. On bimanual examination, she has normal sizzed uterus
with both fornixes clear.
a) Define heavy menstrual bleeding.
b) Give the etiology of heavy menstrual bleeding.
c) What are the medical and surgical management options that can be offered to
this patient? [Annual 2019]

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3. 43 years old P4+0 came to emergency with excessive menstrual loss. Give the salient
points of her management. [Annual 2018]

4. A 30-year-old P4 comes to OPD with history of heavy vaginal bleeding for the last 6
months. Menstrual cycle is 8/28 days, regular with passage of clots. Pelvic
examination and ultrasound reveal a normal sized uterus with no pathology in
adnexa. Give medical management to the patient. [Annual 2017]

5. A 39-year-old P2+1 presented with regular heavy menstrual bleeding.

a) What investigations will you advise her?
b) What are different treatment options available for her?
c) If patient is diagnosed to have Bleeding of Endometrial Origin (BEO), what is the
most suitable method for her? [Annual 2016]

6. A 46-year-old P6+1 came with menorrhagia. Clinical examination revealed

insignificant findings.
a) How will you take endometrial biopsy with pipelle?
b) Will you consider Levonorgestrel Intrauterine System (LNG-IUS) for her? If yes,
then explain. [Annual 2015]

7. A 42-year-old lady presents with a history of irregular heavy bleeding. She is P6+0,
and the couple is using barrier method of contraception.
a) Which investigations will you perform?
b) Enumerate the medical and surgical treatment options.
[Annual 2014]

8. A 40-year-old P4+0 came with menorrhagia for last two years.

a) What relevant information should be looked for in ultrasound examination of the
lady?
b) Enlist the various medical treatments which can be offered to her.
[Supple 2014 held in 2015]

9. 38 years old P5+0 comes with complains of heavy regular periods.

a) What are the investigations?
b) What are the differential diagnoses?
c) How will you manage he patient medically?
[Annual 2008 + Supple 2008]

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10. A 36 years old lady comes to you with menorrhagia. Outline the current medical
management of menorrhagia. [Annual 2007]

Dysmenorrhea
1. A 32-year-old P4+1 presented with secondary dysmenorrhea for two years.
a) What are the causes of secondary dysmenorrhea?
b) What are the medical treatment options available for her?
[Supple 2017 held in 2018]

2. An 18 years old university student presents in your OPD with history of severe
dysmenorrhea for last two years. The pain is crampy in nature.
a) What is your most likely diagnosis and how will you confirm it?
b) Outline your management. [Annual 2014]

3. A 14-year-old girl with irregular heavy periods presents at your OPD. She went
through menarche at the age of 13 years. No significant features are found after
history and examination.
a) What is the most likely diagnosis?
b) How will you confirm your diagnosis? [Supple 2010 held in 2011]

▪ IMPLANTATION & EARLY PREGNANCY

Miscarriage
1. 25 years old G2P1 came at 7 weeks of pregnancy with complains of abdominal
discomfort and bleeding per vagina.
a) How will you evaluate her?
b) What is the role of ultrasound in this case? [Supple 2018 + Annual 2015]

2. A 22-year-old primigravida comes at eight weeks gestation in OPD with the diagnosis
of missed miscarriage. She is not bleeding per vagina. Outline management plan.
[Annual 2017]

3. A G3P1+1 cane at 8 weeks of gestation with an ultrasound report indicating missed

abortion.
a) How will you investigate this case?
b) Give the outline of management plan? [Supple 2014 held in 2015]

8
4. A 24-year-old recently married girl presents with 8 weeks amenorrhea and brownish
vaginal discharge. An ultrasound shows a gestation sac with fetal pole but no fetal
heart beat identified.
a) What type of miscarriage is she suffering from?
b) What are possible management options for her?
c) What are the complications of surgical management of this patient?
[Annual 2014]

5. A 19-year-old lady presents with 9 weeks amenorrhea along with pain and mild
bleeding. On examination, cervical os is closed. Ultrasound reveals 8 weeks fetus
with no cardiac activity. Her routine investigations are normal. Her blood group is B
positive.
a) What is the diagnosis?
b) What is the treatment? [Annual 2013]

6. A patient came in emergency with amenorrhea of 10 weeks, abdominal pain, and

severe vaginal bleeding.
a) What is the most likely diagnosis?
b) How will you manage her? Describe the procedure you will do. [Annual 2009]

7. A 20 years old patient, married for 2 years presents in the OPD with history of three
consecutive 2nd trimester abortions.
a) What is the most likely diagnosis?
b) How will you confirm the diagnosis?
c) What is the treatment in next pregnancy? [Supple 2008 held in 2009]

8. A 26-year-old lady comes with 10 weeks pregnancy and bleeding per vaginal. What is
the differential diagnosis? How will you manage missed abortion?
[Supple 2007 held in 2008]

Ectopic Pregnancy
1. A 20-year-old primigravida at five weeks presents with complaints of right lower
abdominal pain and vaginal bleeding. Vital signs are stable. On abdominal
examination, the abdomen is tender on right side. On ultrasound scan, the uterus is
empty and there is right adnexal mass. There is no free fluid in peritoneal cavity.
a) What criteria needs to be fulfilled before we decide on medical or surgical
management?

9
b) How should the patient be followed up after medical management?
[Supple 2019 held in 2020]

2. A 24 years old woman present in emergency department with light vaginal bleeding
after five weeks of amenorrhea. A recent pregnancy test was positive. She also
complains of sharp pain in right iliac fossa.
a) What is your differential diagnosis?
b) What are the key points in her history, examination and investigations?
[Annual 2019]

3. A 27-year-old pale looking P2+0 came with 6 weeks amenorrhea with abdominal
pain and slight vaginal bleeding. Her BP 85/60 mm Hg, pulse 125/min and her urine
pregnancy test done four days back was positive. No history of interference.
a) What is the most likely diagnosis?
b) Name the relevant investigations.
c) What is the role of surgery in this case? [Annual 2018]

4. A 19-year-old female P0A1 presented in emergency with amenorrhea for 6 weeks,

abdominal pain, fainting attacks and mild vaginal bleeding. On examination, pulse
120/min, BP 90/60 mm Hg and abdomen is tender.
a) What is the probable diagnosis?
b) Outing management plan of this patient. [Supple 2017 held in 2018]

5. A 21-year-old girl, who is married for 3 years, conceived after ovulation induction.
She presents at 7 weeks of gestation with ultrasound report showing 2 cm sac in
right adnexa with absent cardiac activity. Her beta HCG is 1600 IU and she is
asymptomatic.
a) What is the diagnosis?
b) Justify your management. [Annual 2016]

6. A 22-year-old woman married for one year, presents with amenorrhea for six weeks,
lower abdominal pain and vaginal bleeding for one day. Her urine for pregnancy test
is positive & on TVS, uterus is empty and there is right adnexal mass of 2.5x1.5 cm.
a) What is the most probable diagnosis?
b) What are the selection criteria for medical management?
[Supple 2011 held in 2012]

10
7. A 26-year-old primigravida has presented at six weeks of gestation with mild PV
spotting. A transvaginal ultrasound confirms a right sided tubal pregnancy. Outline
the criteria for expectant management. [Annual 2011]

8. A 26-year-old para 1+0 presents at a gestational age of six weeks with history of
lower abdominal pain and vaginal bleeding.
a) What is the most likely diagnosis?
b) How will you confirm your diagnosis? [Supple 2010 held in 2011]

9. A 26-year-old married lady para 1+0 presents in the emergency department with
amenorrhea at 6 weeks, unilateral lower abdominal pain and light vaginal bleeding
arising after the onset of pain.
a) What is most likely diagnosis?
b) What is your differential diagnosis? [Annual 2010]

10. A 26-year-old P2+0 presented with severe abdominal pain and attacks of faintness.
LMP was unsure. Her pulse was 110/min and BP was 90/60 mm Hg.
a) What is the most likely diagnosis?
b) How will you manage her? [Annual 2009]

11. A 20-year-old PG comes in emergency with secondary amenorrhea 6 weeks and

severe abdominal pain and a blood pressure of 80/60 mm Hg. Her pregnancy test is
positive and on USG no pregnancy seen in uterus. Abdomen is distended. USG 3 days
ago showed a 6 cm mass in right adnexa.
a) What is your diagnosis?
b) How will you manage her? [Supple 2008 held in 2009]

12. A primigravida at 8 weeks gestation presents with the history of mild vaginal
bleeding and fainting attacks. She is pale, with tender abdomen and pulse 120 bpm.
a) What is the likely diagnosis?
b) Give steps of management. [Annual 2007]

▪ CONTRACEPTION & ABORTION

Methods of Contraception
1. A 28-year-old lady P3+0 came to you for contraceptive advice. How would you
counsel her with regards to contraceptive methods available to her? [Annual 2014]

11
2. A patient 30 years of age P2 wants to consult for contraception. What methods you
will tell her? [Supple 2011 held in 2012]

3. A 25-year-old primigravida comes for her postnatal checkup for 6 weeks after her
delivery. She is breastfeeding and wants advice regarding contraception. List the
contraceptive options available for her. [Supple 2010 held in 2011]

4. Enlist six characteristics of an ideal contraceptive. [Annual 2010]

Combined Hormonal Contraception

1. A 34-year-old P4+0 came to you for contraception. After counselling she opted for
Combined Oral Contraception (COC).
a) How will you evaluate her before starting pills?
b) What are the benefits of pills apart from providing contraception?
[Supple 2016 held in 2017]

2. What are the non-contraceptive benefits of combined contraceptive pills?

[Annual 2014]

3. A 24-year-old P2+0 comes with previous two SVDs, last born child 6 months old. She
has come for contraceptive advice. You suggest her OCP (oral contraceptive pills).
a) How will you start and explain to her the usage?
b) What factors you will rule out in history before starting OCPs? [Annual 2008]

Progestogen-only Contraceptive Methods

1. A 26-year-old female with three normal deliveries attends contraception clinic for
advice. Her history, clinical examination and tests are unremarkable. After
discussion, she opts for hormone-releasing intrauterine system – Mirena.
a) Write down the hormone and its daily dose release from Mirena.
b) What are the contraindications of its use?
[Supple 2017 held in 2018]

2. A couple comes to you for contraception. You advise them LNG-IUS as a choice of
contraception.
a) What does it contain?

12
b) What are its advantages? [Annual 2017]
3. A 32-year-old P3+0 came to you for contraception advice. After evaluation, you have
decided to offer her ‘Progestogen Only Contraception’. Briefly describe the available
current methods of ‘Progestogen Only Contraception’. [Annual 2015]

Intrauterine Contraception
1. A 35-year-old P4+0 came to OPD with her husband. She is diabetic. She wants
effective contraception. Justify which method suits her and why?
[Supple 2018 held in 2019]

2. A P4+0 came after 6 months of insertion of IUCD with the complaint that she cannot
see or feel the thread of the IUCD.
a) What could be the possible causes?
b) How will you manage her? [Annual 2018]

3. An IUCD was inserted in a patient 6 months back, now she came in OPD because she
cannot feel thread of IUCD.
a) What is responsible cause for this?
b) When does perforation likely occur? [Annual 2012]

4. A 32-year-old P3+0 came to you for contraception. After discussion patient opted for
IUCD.
a) Give the mechanism of action of IUCD.
b) What are its complications? [Supple 2014 held in 2015]

5. A lady 37-year-old is anxious about use of intrauterine contraceptive device (IUCD).

What are the contraindications to the use of IUCD? [Supple 2007 held in 2008]

Female Sterilization & Vasectomy

1. A 35-year-old P4+0 came to OPD with her husband. She is diabetic. She wants
effective contraception. If they opt for sterilization/tubal ligation, what are its failure
rate, immediate and late complications? [Supple 2018 held in 2019]

2. A 38-year-old P4+3 came to OPD with her husband. Her last-born child has cerebral
palsy. She wants effective contraception.
a) Justify which method suits her best and why?

13
b) If they opt for vasectomy, what are its failure rate, immediate and late
complications? [Annual 2016]

3. A 38-year-old P4+0 comes with request for sterilization.

a) What are the various methods of sterilization?
b) What is the failure rate? [Annual 2013]

4. A P6+0 came to seek advice regarding family planning. She agreed for sterilization
after counselling.
a) What type of consent should be taken from the couple?
b) What are the various techniques available for female sterilization? [Annual 2009]

5. What are the various methods of sterilization in females? Comment on merits and
demerits of each. [Annual 2007]

Emergency Contraception
1. A 20-year-old woman presents in the OPD with history of burst condom during
intercourse. Her husband is university student and they cannot afford pregnancy,
a) What will you advise her?
b) What are the treatment options available for her? [Annual 2011]

2. Mrs. JB is a 28 years old lady, married for three years and a mother of 2. Her last
child was born 5 months back by emergency LSCS. She has come to OPD with history
of burst condom one day ago. She does not want to conceive with 2 young kids to
look after.
a) What advice will you give to the patient?
b) What contraception options are suitable for her? Name any two. [Annual 2019]

Abortion
1. A young lady undergoes an induced abortion at 12 weeks of gestation. What are the
complications of such an event? [Supple 2007 held in 2008]

14
▪ SUBFERTILITY
History & Examination
1. A 35 years old woman came in infertility clinic for history of subfertility for last 4
years. She has irregular cycle. What important part of history you must ask?
[Supple 2018 held in 2019]

2. A 24-year-old married woman attends the infertility clinic with her husband. She has
regular menstrual cycle of 5/28 days. List the relevant points in history taking for
female and male. [Supple 2010 held in 2011]

3. A couple has come with desire of fertility. They are married for last 2 years. What
important questions will you ask in history? [Annual 2008 + Supple 2008]

Investigations
1. A 28-year-old P0+0 married for past 5 years. Her menstrual cycle is regular and has a
normal pelvic scan. Semen analysis of the husband is normal. Suggest investigations
to evaluate her tubal patency. [Supple 2019 held in 2020]

2. A couple attended the infertility clinic for the first time having been trying to
conceive pregnancy for the last 12 months of unprotected intercourse. If the woman
had an irregular cycle, which tests would you advise and why? [Annual 2019]

3. A 35 years old woman came in infertility clinic for history of subfertility for last 4
years. She has irregular cycle. What investigations would you request? [Supple 2018
held in 2019]

4. A couple consults you three years after marriage for primary infertility at infertility
clinic. Wife has normal menstrual cycle but she has received antituberculosis therapy
before marriage for pulmonary tuberculosis.
a) What investigations you can advise to check tubal patency?
b) Write down normal parameters of semen analysis (WHO criteria)?
[Supple 2017 held in 2018]

5. A young couple comes to you with infertility of 2 years. 25-year-old wife has regular
menstrual cycle of 5/30 days. Coital frequency is 4/week. What investigations will
you advise to the couple? [Annual 2017]

15
6. A P1+0 came with history of secondary infertility for the last three years. Intimal
evaluation pointed towards tubal problem. How will you assess tubal patency?
[Annual 2015]

7. A couple presents in your infertility clinic after two years of marriage with complaints
of inability to conceive. History and examination of both husband and wife is
unremarkable.
a) What should be the first investigation advised to them?
b) What instructions will you give regarding this investigation? [Annual 2012]

8. A 32-year-old obese, nulliparous, married for five years has irregular menstrual cycle
for six years. Her husband’s serum analysis, her thyroid function tests and tubal
patency test are normal.
a) What is the most likely diagnosis?
b) What is the cause of infertility and give two important investigations?
[Supple 2011 held in 2012]

9. A couple has come with desire of fertility. They are married for last 2 years. What are
the investigations required? [Annual 2008 + Supple 2008]

10. A 27 years old lady presents with history of primary infertility for 3 years. Semen
analysis is normal and intercourse is unsatisfactory. How will you investigate her?
[Supple 2007 held in 2008]

11. A couple sexually active since marriage for the last five years presents to your clinic.
They have not been able to conceive a child as yet. You order semen analysis. What
are the parameters of normal semen analysis? [Annual 2007]

Management
1. A 28-year-old P0+0 married for past 5 years. Her menstrual cycle is regular and has a
normal pelvic scan. Semen analysis of the husband is normal. What is the treatment
if the tubes are found blocked? [Supple 2019 held in 2020]

2. A 35 years old woman came in infertility clinic for history of subfertility for last 4
years. She has irregular cycle. What treatment will she need? [Supple 2018 held in
2019]

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3. A 28-year-old nulliparous woman came with problem of primary infertility for the
last five years. After detailed evaluation, ovulation induction with clomiphene was
planned.
a) How does clomiphene enhance the chance of ovulation and pregnancy?
b) What alternatives are available for clomiphene resistant cases? [Annual 2018]

4. A 28-year-old lady presents with her 34-year-old husband. The couple has been
trying for a baby for four years. The couple has been thoroughly investigated and no
cause for their subfertility has been found.
a) What is the name given to this type of subfertility?
b) What are the treatment options for this couple? [Annual 2014]

5. An infertile couple failed to conceive despite repeated attempts of intrauterine

insemination, so IVF embryo transfer cycle has been planned. What are the various
steps of this cycle? [Annual 2009]

6. A couple sexually active since marriage for the last five years presents to your clinic.
They have not been able to conceive a child as yet. You order semen analysis. What
are the treatment options in case of poor semen analysis? [Annual 2007]

▪ GENITOURINARY PROBLEMS
Bacterial Vaginosis
1. A 23-year-old P2+0 came with complaints of vulvar itching, irritation and vaginal
discharge. Enlist three common causes. [Supple 2014 held in 2015]

2. 30 years old P4 last born child five years back, presented with offensive vaginal
discharge for six months. How will you treat this case? [Supple 2011 held in 2012]

Vulvovaginal Candidiasis
1. A 24-year-old P3+1 presented with thick curdy white discharge and itching. On
vaginal examination, there is soreness and excoriation
a) What is the most likely diagnosis?
b) How will you confirm the diagnosis?
c) How will you manage the patient? [Annual 2016]

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2. A young woman came to you with history of itching and white curdy discharge.
Vaginal candidiasis was diagnosed.
a) Enlist four predisposing factors.
b) How will you manage her? [Annual 2015]

3. A 23-year-old P2+0 came with complaints of vulvar itching, irritation and vaginal
discharge. Enlist three common causes. [Supple 2014 held in 2015]

4. A 32-year-old female presents in Outpatient Department with complains of curdy

white vaginal discharge and vulva soreness.
a) What is the causative agent?
b) Name factors which predispose to this type of vaginal infection.
c) How will you treat this patient? [Annual 2014]

5. A 30 years old lady comes to you in OPD with itchy vaginal discharge. On
examination, discharge is curdy white and vaginal soreness is seen.
a) What is diagnosis?
b) What are predisposing factors?
c) What is treatment? [Annual 2013]

6. 34 years old P4+0 comes with itchy vaginal discharge for 1 week. Her LMP was 10
days back. She is using OCPs for contraception.
a) What are the risk factors associated with this infection?
b) How will you treat this? [Annual 2008]

Trichomoniasis
1. A 23-year-old P2+0 came with complaints of vulvar itching, irritation and vaginal
discharge.
a) Enlist three common causes.
b) How will you diagnose and manage a case of trichomoniasis?
[Supple 2014 held in 2015]

Gonorrhea
1. A 24-year-old P1A+1 complains of increased vaginal discharge, lower abdominal pain
and dyspareunia. Speculum examination revealed endocervical mucopurulent
discharge and pelvic tenderness with cervical excitation.
a) What are diagnostic tests for gonorrhea?

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b) What is treatment of this infection? [Supple 2017 held in 2018]

Chlamydia
1. A 24 years old South African worker of NGO presented in gynae OPD with C/O
altered vaginal discharge and intermenstrual bleeding. Chlamydia trachomatis is
being suspected as the causative agent.
a) How would you treat her?
b) What are the complications she can develop? [Annual 2019]

Pelvic Inflammatory Disease

1. A 28 years old woman para 1 presents with lower abdominal pain, dyspareunia and
intermenstrual bleeding. On abdominal examination, there is lower abdominal
tenderness and on pelvic exam, there is cervical motion tenderness.
a) What is the provisional diagnosis?
b) What is your management? [Supple 2019 held in 2020]

2. A 30-year-old P1 patient comes with history of pain lower abdomen and vaginal
discharge. She gives history of fever off and on.
a) What clinical criteria are needed to make a diagnosis of Pelvic Inflammatory
Disease?
b) What are the long-term complications? [Annual 2017]

3. A 20 years old patient came with signs & symptoms of acute pelvic inflammatory
disease.
a) What investigations are required?
b) What treatment is given? [Annual 2012]

4. A 30-year-old P2+0 presents in OPD with history of bilateral lower abdominal pain
and fever accompanied by nausea and vomiting. Pelvic examination reveals adnexal
tenderness, cervical excitation and a sero-purulent discharge.
a) What is the most likely diagnosis?
b) Outline your management. [Annual 2011]

5. A 25-year-old woman presents to the accident and emergency department with a 24

hours history of severe abdominal pain accompanied by vaginal discharge, nausea &
fever.
a) What investigations will you carry out?

19
b) How would you treat her? [Supple 2010 held in 2011]

6. A 27-year-old lady with chronic pelvic pain comes to you. What are the treatment
options if she has got confirmed appearance of chronic pelvic inflammatory disease
(PID) on laparoscopy? [Supple 2007 held in 2008]

Genital Herpes
1. A 22 years old woman has been diagnosed to have genital herpes.
a) What are the clinical features of this infection?
b) How will you manage her? [Annual 2018]

2. A 24-year-old woman has been diagnosed to have genital herpes.

a) How will you manage her?
b) Enlist the complications associated with it. [Supple 2016 held in 2017]

3. A 28 years old lady presents in OPD with vaginal discharge and multiple fine ulcers
on the vulva. Examination revealed bilateral inguinal adenopathy.
a) How will you confirm the diagnosis?
b) Outline your management. [Annual 2010]

Genital Warts
1. 31 years old P3+0 presented in outdoor with multiple vulvar warts.
a) Name the causative organism and its subtypes causing majority of the genital
warts & mention their oncogenic potential.
b) Give the management of this condition. [Annual 2009]

▪ UROGYNAECOLOGY & PELVIC FLOOR PROBLEMS

Stress Incontinence
1. A 50 years old patient having 5 normal deliveries, presents with complains of leakage
of urine whenever she coughs or sneezes. She is anxious as this is disturbing her daily
life.
a) What is the most likely diagnosis?
b) What investigations would you advise her?
c) What are different treatment options? [Annual 2019]

20
2. A 65-year-old lady came with the problem of urinary incontinence.
a) How will you differentiate between stress and urge incontinence while taking
history?
b) Discuss briefly elements of conservative treatment of urinary incontinence.
[Annual 2018]

3. A 33-year-old P4 A+1, all vaginal births, presents in gynecology clinic with complaints
of urinary incontinence on coughing and sneezing. Urodynamic studies confirmed
stress urinary incontinence.
a) What are the risk factors for stress urinary incontinence?
b) What are different options for treatment in this patient?
[Supple 2017 held in 2018]

4. A 50-year-old P6+0 comes with history of dribbling of urine on coughing and

sneezing for the last 6 years. Pelvic examination revealed a normal sized uterus with
no pathology in adnexa. What treatment will you advise to the patient?
[Annual 2017]

5. A 60-year-old woman came with urinary incontinence. Evaluation established the

diagnosis of stress incontinence.
a) What are the aims of surgery in stress incontinence?
b) What is the role of Tension Free Vaginal Tape (TVT) in the management of stress
incontinence? [Annual 2015]

6. A 55 years old postmenopausal woman comes with inability to hold urine for long
time. She also gives history of dribbling with cough.
a) What is the diagnosis?
b) How will you investigate? [Annual 2013]

Detrusor Overactivity
1. A 35 years old multiparous lady presents with frequency of micturition, urgency and
incontinence. Her MSU is normal and cystometry demonstrates contractions on
filling.
a) What is the most likely diagnosis?
b) How will you treat her? [Annual 2010]

21
Prolapse
1. A 58 years old postmenopausal woman, P6A2, all home deliveries conducted by
traditional birth attendants, chronic asthmatic came with complaint of something
coming out of vagina for last 7 years. On examination, she has 2nd degree
uterovaginal prolapse.
a) Enumerate risk factors for her problem.
b) Write down treatment options for her. [Supple 2019 held in 2020]

2. An obese 55 years old P5+0, known asthmatic, came with complains of something
coming out of vagina. She has no urinary complaints.
a) What is the likely diagnosis?
b) Enumerate the risk factors for uterovaginal prolapse.
c) What are the management options for her? [Supple 2018 held in 2019]

3. A 28-year-old P2+0 came with first degree uterine prolapse with mild cystocele. How
will you manage her? [Supple 2016 held in 2017]

4. An obese 65-year-old lady P5+0 who is a known asthmatic is brought to you with a
complaint of something coming out of vagina. She denies any significant urinary and
bowel complaints. On examination, cervix is at the level of introitus.
a) What is the likely diagnosis?
b) Enumerate the risk factors for development of uterovaginal prolapse.
c) What are the management options available for her? [Annual 2016]

5. A 68-year-old P8+0 came with second degree uterovaginal prolapse.

a) Enlist the symptoms she can present with.
b) What management options are available for this problem?
[Supple 2014 held in 2015]

6. A 60-year-old lady presents with something coming out of vagina.

a) What is the etiology of uterovaginal prolapse?
b) How you assess three degrees of prolapse?
c) How would you manage her? [Annual 2014]

7. A 58-year-old woman P10+0, menopause for years, presented with second degree
uterovaginal prolapse.
a) What are the risk factors?

22
b) How will you treat it? [Annual 2012]

8. What are the management options for uterovaginal prolapse? [Supple 2011 held in
2012]

9. A 50-year-old perimenopausal lady presented in the OPD with history of urge

incontinence, stress incontinence & frequency. Abdominal examination is
unremarkable and pelvic examination reveals a 1st degree uterovaginal prolapse with
a moderate cystocele. How will you investigate her? [Annual 2011]

10. A 60-year-old woman presents with a six months history of feeling of something
coming out of vagina. There are no associated bladder symptoms. The most likely
diagnosis is uterovaginal problems.
a) Describe the different forms of female genital prolapse.
b) Which treatment option is appropriate for her? [Supple 2010 held in 2011]

11. A 65 years old P+0 comes with c/o something coming out of vagina for 3 years.
Initially it was reducible but now it has become irreducible.
a) What is the diagnosis?
b) What are the associated complications?
c) How will you manage her? [Annual + Supple 2008]
▪ BENIGN CONDITIONS OF THE OVARY & PELVIS
Ovarian Cysts
1. A 29-year-old P3+0 came with an ultrasound report showing presence of a dermoid
cyst.
a) What can be the various clinical presentations of dermoid cyst?
b) How will you manage her? [Annual 2018]

2. A 30-year-old P3+0 came with pain in lower abdomen. Ultrasound shows dermoid
cyst.
a) What is dermoid cyst?
b) What clinical features can be attributed to dermoid cyst?
[Supple 2016 held in 2017]

3. A 28-year-old P2+0 came with lower abdominal pain. Right sided ovarian cyst about
10-12 cm was diagnosed on ultrasonography.

23
a) What are the causes of pain associated with an ovarian cyst?
b) Which ovarian cyst is most common in this age group? What are the features of
this particular cyst? [Supple 2014 held in 2015]

4. A 26-year-old P2+0 comes with M/C of 4/30-40 days with average flow. Her
ultrasound shows a unilocular clear right ovarian cyst 7x8 cm. left ovary is normal.
a) What is diagnosis?
b) What complications can occur?
c) What is the management? [Annual 2013]

5. A 25-year-old girl P1 came with mass in lower abdomen. On ultrasound report, there
is right ovarian cyst 10x12 cm.
a) What investigations should be done?
b) What will be the treatment? [Annual 2012]

6. A 28-year-old P2+0 comes with C/O pain left iliac fossa on and off. Her menstrual
cycle is normal and LMP was 7 days back. On pelvic examination, you find 6 cm mass
in left adnexa. Her USG shows 6.5 cm cyst with multiple acrogenic shadows. The X-
ray shows a tooth in the cyst.
a) What is the most likely diagnosis and why?
b) How will you manage her? [Annual 2008]

Endometriosis
1. A 30-year-old married for 3 years presents with complains of painful menstrual cycle
and inability to conceive. On pelvic examination, there is 5x4 cm right sided
chocolate cyst.
a) What is the likely diagnosis?
b) What management options are available for her? [Supple 2018 held in 2019]

2. A 37-year-old P4+0 presented with increasingly severe secondary dysmenorrhea,

menorrhagia and dyspareunia.
a) What is the most likely cause?
b) Enumerate two relevant investigations.
c) What management options you can discuss with her?
[Supple 2016 held in 2017]

24
3. A 30-year-old female married for five years presented with complaints of painful
menstrual cycle and inability to conceive. On pelvic scan, there is 5x5 cm right sided
chocolate cyst.
a) What is the likely diagnosis?
b) What management options are available for her? [Annual 2016]

4. A 28-year-old nulliparous came with primary infertility for the last 4 years. She gives
history of severe dysmenorrhea and dyspareunia.
a) What is the most likely underlying cause?
b) How this condition can cause infertility? Give the possible mechanisms?
[Supple 2014 held in 2015]

5. A 20-year-old nulliparous patient comes with inability to conceive for 4 years. Her
menstrual cycle is 6/30 regular with heavy flow. She gives history of deep
dyspareunia and dysmenorrhea. Vaginal examination reveals tenderness, ultrasound
shows bilateral ovarian cyst with multi-loculations of 7x6 cm and 6x5 cm. CA 125 is
30 U/ml.
a) What is the most likely diagnosis?
b) Justify treatment options. [Annual 2013]

6. A 26-year-old married lady presents in OPD with history of primary subfertility of 2

years, secondary amenorrhea and deep dyspareunia. On examination, a tender mass
of 5 cm is felt in the left adnexa.
a) What is your provisional diagnosis?
b) List two investigations which will help you to confirm your diagnosis.
[Annual 2010]

▪ BENIGN CONDITIONS OF UTERUS, CERVIX & ENDOMETRIUM

Fibroids
1. A 30 years old para 2 previous SVDs and LBC 8 years old presented with urinary
frequency and urgency for six months. Her menstrual cycle is regular but there is
heavy menstrual blood loss. She gives previous history of having fibroid uterus but
no record available. On abdominal examination, there is a 12-week size mass, firm in
consistency, and smooth surface and mobile. On pelvic examination, the uterus is
12-14 weeks size, anteverted and mobile

25
a) What are the conservative options for management of fibroid considering there
are pressure symptoms?
b) Which surgical procedure should be suggested in case conservative management
fails? [Supple 2019 held in 2020]

2. A 34 years old nulliparous woman presents in clinic with complaints of menorrhagia,

dysmenorrhea, urinary frequency and right loin pain. On examination, she has pale
sclerae and a pelvic mass which is same size as a 25-week pregnancy. Her last
menstrual period was a week ago and extremely heavy.
a) What are the possible diagnoses?
b) What investigations would you perform and why? [Annual 2019]

3. 32 years old P2+1 came with 20 weeks mass abdomen. Ultrasound diagnosis is
fibroid uterus.
a) What signs and symptoms can be attributed to fibroid uterus?
b) What are the management options for her?
[Supple 2018 held in 2019]

4. A 32-year-old nulliparous female presented with complaints of heavy menstrual

bleeding. She noticed a mass in abdomen. On examination, a firm, mobile and
irregular mass of 20 weeks gestation size was noted in her lower abdomen.
a) What is the most likely diagnosis?
b) What are the symptoms of this condition?
c) What is the surgical treatment for this patient? [Supple 2017 held in 2018]

5. A 35-year-old P3+0 comes with heavy menstrual bleeding for the last 1 year.
Abdominal examination revealed a 14 cm firm mass. Her hemoglobin is 11g %.
Ultrasound shows a single submucous fibroid uterus measuring 10x10 cm. Outline
management plan of this patient. [Annual 2017]

6. A 40-year-old female presented to OPD with complains of irregular vaginal bleeding.

On pelvic scan, there is 2x2 cm thickened area near fundus in endometrial cavity.
a) What is the most likely diagnosis?
b) What are the management options available for her?
c) Enumerate three complications that she may encounter due to treatment?
[Annual 2016]

26
7. A 30-year-old P3+0 came with 24 weeks size mass abdomen. USG confirmed
diagnosis of fibroid.
a) What signs and symptoms are attributed to fibroid?
b) What management options you can offer her? [Annual 2015]
8.
A patient 30 years of age presented with menorrhagia for two years. On
examination, a 10x8 cm fibroid was identified in her uterus. Discuss different
treatment options. [Supple 2011 held in 2012]

9. A 38-year-old multiparous lady presents with history of increasingly heavy, regular,

painful periods. She says that she would like to retain her fertility. On examination,
the abdomen is distended with a pelvic mass equal to about eighteen-week size
pregnancy. Vaginal examination confirms this and an ultrasound examination shows
multiple fibroids which are mostly intra-myometrial and one subserous.
a) How would you manage her?
b) What are the two most important things which you would like to inform her prior
to treatment? [Annual 2011]

10. A 45-year-old Para 3+0 presents to gynecology OPD with heavy periods and an
abdominopelvic mass of 16 weeks size. An ultrasound scan shows that the uterus
contains fibroids.
a) What are fibroids?
b) How would you manage her? [Supple 2010 held in 2011]

11. A G3P2+0 came at 16 weeks of pregnancy with moderate lower abdominal pain for
the last one week. Ultrasound revealed a fibroid about 5x6 cm in the fundal region.
a) What is the cause of her pain and how she should be managed?
b) How delivery should be planned? [Annual 2009]

12. A 45-year-old P5G1+0 comes with complains of heavy irregular vaginal bleeding for 1
year. On examination, she is pale. Her pelvic examination shows uterus 12-14 weeks.
a) What is your diagnosis?
b) What is your management? [Supple 2008 held in 2009]

13. A 45-year-old lady P1+0 has presented with complains of mass lower abdomen,
menorrhagia and dragging sensation.
a) What is most likely diagnosis?

27
b) How will you investigate her?
[Supple 2007 held in 2008]

▪ MLAIGNANT DISEASE OF THE OVARY

Epithelial Tumors
1. A 60 years old patient comes with a mass abdomen. CT scan reveals irregular 15x10
cm left ovarian tumor with ascites. CA 125 is 150 IU. She is diagnosed as a case of
ovarian cancer. Outline further plan of the patient. [Annual 2017]

2. A 55-year-old woman has been diagnosed with stage II ovarian cancer. Discuss the
role of surgery in this case. [Annual 2015]

3. A 56-year-old female presents with left adnexal mass which after histopathology
confirmed malignant epithelial ovarian tumor.
a) Name the common epithelial tumors.
b) What is the marker for epithelial tumors?
c) What post-operative treatment options you can offer to this patient?
[Annual 2014]

4. A 32-year-old P3+0 woman comes with weight loss and abdominal distension for 6
months. She complains of indigestion and urinary frequency. Her abdominal
examination shows firm to hard mass reaching upto umbilicus.
a) What is your diagnosis?
b) What are the investigations and management? [Supple 2008 held in 2009]

▪ MALIGNANT DISEASE OF THE UETRUS

Endometrial Carcinoma
1. A 60 years old woman presents with first episode of postmenopausal bleeding.
a) What is most appropriate first line of investigation and why?
b) A transvaginal ultrasound scan showed an endometrial thickness of 3.8 mm.
What is the most appropriate management plan? [Annual 2019]

2. A 60 years old para 1+0 presents in OPD with mass in abdomen and history of weight
loss. On examination, a fixed pelvic mass of 29 weeks size is seen.
a) What is the most likely diagnosis?
28
b) Which specific investigations you would advise to confirm diagnosis?
c) What treatment options are available for her? [Supple 2018 held in 2019]

3. 58 years old P1+0 came with postmenopausal bleeding.

a) What relevant investigations should be done to make a diagnosis?
b) What is the role of surgery in the management of endometrial carcinoma?
[Annual 2018]

4. A 64-year-old multiparous lady, known hypertensive and diabetic presented in OPD

with complains of postmenopausal bleeding for 1 month. On examination, vulva,
vagina and cervix normal. Uterus is enlarged to 10 weeks size.
a) What is the most likely diagnosis?
b) What specific investigations will you advise to confirm the diagnosis?
c) What is the treatment of CA endometrium? [Supple 2017 held in 2018]

5. A 60-year-old lady P0+0 presented in OPD with mass abdomen and weight loss. On
examination, a fixed pelvic mass of 16 weeks size is seen.
a) What is the most likely diagnosis?
b) What specific investigations will you advise to confirm the diagnosis?
c) What treatment options are available for her? [Annual 2016]
6.
A 58-year-old obese and known diabetic woman came with postmenopausal
bleeding and pain lower abdomen. Pelvic examination revealed uterus about 10-12
weeks size, mobile and slightly tender.
a) What is the most likely diagnosis?
b) Name the relevant investigations.
c) Give the staging of this disease. [Supple 2014 held in 2015]

7. A 67-year-old woman presents with a single episode of postmenopausal bleeding.

a) What investigations will you perform?
b) What is the mainstay treatment of endometrial carcinoma? [Annual 2014]

8. A 60 years old nulliparous woman presented with postmenopausal bleeding. What

are risk factors for endometrial carcinoma? [Annual 2012]

9. A 65 years old woman comes with the complains of postmenopausal bleeding for 6
months. She is nulliparous and obese. Pap smear is normal.

29
a) How will you investigate here?
b) What is the probable diagnosis?
c) How will you treat her? [Annual 2008]

10. A 57 years old postmenopausal lady presents with abdominal mass.

a) What is the differential diagnosis?
b) How will you investigate this patient? [Annual 2007]

▪ PREMALIGNANT & MALIGNANT DISEASE OF THE LOWER

GENITAL TRACT
Premalignant Disease of Cervix
1. A 30-year-old P3+0 presents in OPD with history of repeated episodes of post-coital
bleeding for last three months. A pap smear taken by her family doctor shows severe
dyskaryosis. Rest of history and examination are unremarkable.
a) What is the most likely diagnosis?
b) How will you confirm the diagnosis? [Annual 2011]

2. A 35 years old multiparous lady presents with intermenstrual bleeding. A cervical

smear shows severe dyskaryosis suggestive of CIN3. Outline your definitive
management. [Annual 2010]

Malignant Disease of Cervix

1. A 39 years old woman para 2 presents with complains of post-coital bleeding for two
months. On examination, there is a 2 cm sized lesion on the cervix, no extension
beyond cervix and no involvement of vagina. If we suspect the cervical malignancy,
a) What is the stage?
b) What will be the management according to this stage?
[Supple 2019 held in 2020]

2. A 65-year-old woman came with irregular vaginal bleeding for the last six months,
pain in lower abdomen and backache.
a) Name four important conditions to be considered in differential diagnoses.
b) How will you manage a case of stage 1b cervical cancer?
[Supple 2016 held in 2017]

30
3. A 64 years old woman presented with weight loss, anorexia and offensive vaginal
discharge. Examination revealed a tumor involving the cervix and extending into the
upper two-thirds of vagina. The pelvis appears fixed. A biopsy shows squamous cell
carcinoma.
a) What is the stage of disease?
b) What is the treatment option? [Supple 2011 held in 2012]

4. A sixty-year-old P7+0 came with postmenopausal bleeding. Evaluation revealed

presence of stage IIB cervical cancer.
a) What do you understand by stage IIB cervical cancer?
b) How she should be managed? [Annual 2009]

Malignant Disease of Vulva

1. A 70 years old postmenopausal lady comes with vulval cancer. O/E ulcerative growth
of 3x3 cm seen on left labia majora. Groin lymph nodes are not palpable. Biopsy
shows vulvar carcinoma.
a) What is the commonest vulvar cancer histologically?
b) What is the stage of this patient?
c) What is treatment?
[Annual 2013]

▪ GESTATIONAL TROPHOBLASTIC DISEASES

1. A G2P1+A0 came at 14 weeks gestation with vaginal bleeding. Abdominal

examination reveals uterus about 18 weeks size and fetal parts not felt.
a) What is most likely diagnosis?
b) Enlist the complications associated with this condition.
c) What management options you can discuss with her?
[Supple 2016 held in 2017]

2. A 35-year-old woman in her 6th pregnancy reports vaginal bleeding at 10th week of
gestation. On examination, uterus is enlarged to 14 weeks and ultrasound shows
snow-storm appearance with absence of fetus.
a) What is likely diagnosis?
b) What is the management and follow-up? [Annual 2012]

31
▪ GYNAECOLOGIC SURGERY & THERAPEUTICS
Hysterectomy
1. A 50-year-old woman is diagnosed with complex hyperplasia with atypia of
endometrium. Total abdominal hysterectomy (TAH) and bilateral salpingo-
oopherectomy (BSO) is advised.
a) What are the three steps of TAH + BSO?
b) At what different sites ureters are likely to be injured while doing this procedure?
[Supple 2019 held in 2020]

2. A 50-year-old P5 comes with heavy menstrual bleeding requesting hysterectomy for

bleeding of endometrial origin. Write three advantages and three disadvantages of
vaginal hysterectomy. [Annual 2017]

3. A 45-year-old P6+0 came to you with menorrhagia not responding to medical

treatment. You have decided to do vaginal hysterectomy.
a) Enlist three indications of vaginal hysterectomy.
b) Name the pedicles cut & ligated during vaginal hysterectomy in an order of
sequence.
c) What are the complications? [Annual 2015]

4.
a) What are different modes of hysterectomy?
b) What are specific complications of hysterectomy?
c) What are contraindications and benefits of vaginal hysterectomy? [Annual 2014]

5. Mrs. K is admitted through gynecology OPD for total abdominal hysterectomy for
DUB. She is 45 years of age and wants to know about the possible complications of
her surgery. What are the immediate complications of abdominal hysterectomy?
[Supple 2010 held in 2011]

6. You are attending a patient in outdoor who had vaginal hysterectomy with anterior
colporrhaphy two months ago.
a) How will you evaluate and examine her?
b) What problems or complications she may present with? [Annual 2009]

32
Hysteroscopy
1. A 35-year-old patient came with misplaced thread of IUCD. You plan hysteroscopy.
a) What are the other indications of hysteroscopy?
b) What complications can occur? [Supple 2018 held in 2019]

2. A P4+0 came with history of heavy menstrual loss. You have decided to do
hysteroscopy.
a) Describe the procedure.
b) What are the complications? [Annual 2018]

3. A 40-year-old woman complains of irregular bleeding for last 6 months. After

examination and investigations, diagnostic hysteroscopy has been planned.
a) What are the indications of hysteroscopy?
b) What are the complications of hysteroscopy? [Supple 2017 held in 2018]

4. A 40 years old patient comes with menorrhagia. You plan hysteroscopy.

a) What are the indications of hysteroscopy?
b) What complications can occur? [Annual 2013]

5. List six indications for diagnostic hysteroscopy. [Annual 2011]

Laparoscopy
1. Consent is being obtained from a 24-year-old lady for diagnostic laparoscopy.
a) The patient wishes to know what complications can occur during the procedure?
b) Which gas is used to expand the abdomen and how is it introduced?
[Annual 2019]

2.
a) What is laparoscopy?
b) Enlist the indications of diagnostic laparoscopy.
c) What complications can occur during this procedure? [Supple 2016 held in 2017]

3. Give the indications of diagnostic laparoscopy. [Supple 2014 held in 2015]

4. A 25 years old lady with primary subfertility of two years duration is due to undergo
a diagnostic laparoscopy and wants to know about possible complications associated

33
with this procedure. List the complications of diagnostic laparoscopy which you
would tell her. [Annual 2010]

5. On routine diagnostic laparoscopy, a 24-year-old with infertility presents with

persisting post-operative pain and abdominal distention.
a) What is the likely diagnosis?
b) What are other potential complications of laparoscopy? [Annual 2007]

Hysterosalpingography
1. Your registrar has ordered you to do hysterosalpingography of an infertile patient
whose tubal patency has to be checked. How will you perform this procedure?
[Annual 2012]

Dilation & Curettage

1. Enlist the complications of dilation and curettage. [Supple 2011 held in 2012]

2. A 45 years old lady presents with irregular vaginal bleeding. She has been advised
diagnostic dilation and curettage (D&C) by her doctor. How will you perform the
procedure? [Annual 2008]

34