SMLE (Saudi Medical Licensing Exam) · Obstetrics and Gynecology

Clinical Cases

42 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 42 questions

  1. A 28-year-old woman at 8 weeks of amenorrhoea has lower abdominal pain, vaginal bleeding and a positive pregnancy test. She is haemodynamically unstable. What is the most likely diagnosis?
  2. A 25-year-old woman at 10 weeks has vaginal bleeding with a closed cervix and a viable fetus on ultrasound. What is the diagnosis?
  3. A 32-year-old woman at 34 weeks has a blood pressure of 160/110 mmHg, headache and proteinuria. What is the diagnosis?
  4. A woman with severe pre-eclampsia has a seizure. What is the drug of choice to prevent further seizures?
  5. A 28-year-old woman at 36 weeks has painless vaginal bleeding. What is the most important next step?
  6. A 30-year-old woman at 33 weeks has sudden severe abdominal pain, a rigid uterus and dark vaginal bleeding. What is the diagnosis?
  7. A woman has a heavy postpartum bleed with a soft, boggy uterus. What is the first step?
  8. A primigravida is in labour. The cervix has not dilated for 4 hours despite adequate contractions. What is the diagnosis?
  9. Which maternal infection in the first trimester most often causes congenital cataracts, deafness and heart defects?
  10. A 26-year-old woman has a two-day history of fever, lower abdominal pain, cervical motion tenderness and purulent discharge. What is the diagnosis?
  11. A 35-year-old woman has dysmenorrhoea, dyspareunia and infertility. Ultrasound shows a chocolate cyst of the ovary. What is the diagnosis?
  12. A 24-year-old overweight woman has irregular periods, hirsutism and acne. Ultrasound shows multiple small ovarian follicles. What is the diagnosis?
  13. A 45-year-old woman has menorrhagia and a bulky, irregular uterus. What is the most likely cause?
  14. A 58-year-old woman has postmenopausal bleeding. What is the first investigation?
  15. A 30-year-old woman has an abnormal cervical smear showing high-grade dysplasia. What is the next step?
  16. Which virus is most strongly linked to cervical cancer?
  17. A woman has primary infertility with regular periods. Her partner has a normal semen analysis. What is the best test of tubal patency?
  18. A pregnant woman at 28 weeks is rhesus negative with a rhesus-positive partner and no antibodies. What is the usual management?
  19. Which is the screening test for gestational diabetes?
  20. Which drug is safe to treat hypertension in pregnancy?
  21. A pregnant woman is started on an anti-epileptic. Which supplement should be given before conception and in the first trimester?
  22. A woman presents with a missed period and a positive pregnancy test but an empty uterus and a beta hCG of 2500 IU/L. What is the most likely diagnosis?
  23. A 22-year-old woman has vaginal bleeding at 12 weeks, a uterus larger than dates and a snowstorm appearance on ultrasound. What is the diagnosis?
  24. Which is the commonest cause of primary amenorrhoea with normal breast development and absent uterus?
  25. Which is the first-line treatment for a trichomonas vaginalis infection?
  26. A woman at 41 weeks is offered induction of labour. Which agent is usually used for cervical ripening?
  27. During labour the CTG shows repeated late decelerations. What does this suggest?
  28. Which is the definition of preterm birth?
  29. Which hormone is responsible for milk ejection (let-down)?
  30. Which is the contraceptive of choice for a woman who is breastfeeding at 4 weeks postpartum?
  31. Which is the most common cause of maternal death worldwide?
  32. A woman has had two second-trimester miscarriages. Which is the most likely cause?
  33. A woman at 38 weeks has a transverse lie. What is the correct management?
  34. Which finding indicates the second stage of labour?
  35. A 50-year-old woman has hot flushes and vaginal dryness. What is the most effective treatment if she has no contraindication?
  36. What is the recommended screening for breast cancer by mammography in the general population in many guidelines?
  37. A breastfeeding woman has a painful, red, hot area of the breast and fever. What is the diagnosis?
  38. A woman with severe nausea and vomiting at 9 weeks has ketonuria and 6 percent weight loss. What is the diagnosis?
  39. A pregnant woman has a positive group B streptococcus swab at 36 weeks. What is the recommended management?
  40. A woman has painless cervical dilation at 20 weeks and a bulging amniotic sac. What is the treatment?
  41. Which finding is typical of polyhydramnios?
  42. A 28-year-old woman has a missed period and a positive test. The last menstrual period was 8 weeks ago. By Naegele rule, estimate the due date.

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