Multiple Choice Questions Section

Saudi Medical Journal introduces this new section on multiple choice questions as part of its commitment
to continuous education and learning. Board residents are encouraged to read this section to improve
their knowledge and direct their reading for written examinations.

All questions are supplied by and published with permission from the
Examination Department, Saudi Commission For Health Specialties
Riyadh, Kingdom of Saudi Arabia.

Choose the most appropriate single answer.

1. Premenstrual tension syndrome is characterized by:

(A) Severe symptoms in the first half of menstrual cycle

(B) Edema may be presented in 60% of patients
(C) An increase in the production of estrogens
(D) Menorrhagia is a common complaint
(E) Typically being seen in anovulatory cycles

2. An 18-year-old patient with normal secondary sexual characteristics presents with a history of primary
amenorrhea. An ultrasonography of the pelvis is as shown. What is the MOST likely diagnosis?

(A) Primary ovarian failure

(B) Testicular feminization
(C) Mllerian anomaly with rudimentary uterus
(D) Turners syndrome

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 Multiple choice questions

3. A 15-year-old patient presents with primary amenorrhea. On examination, secondary sexual

characteristics are absent. Investigation reports are as follows:
Test Patients value Normal values
Serum T3 4.8 pmol/L (3.1-6.8 pmo/L)
Serum T4 18 pmol/L (12-22 pmo/L)
Serum TSH 3.5 IU (0.5-4.7 miu/L)
Serum FSH 70 IU (3.5-12.5 miu/L)
Serum Prolactin 230 IU/mL (102-496 IU/mL)

Based on these reports, which of the following is the MOST likely diagnosis?

(A) Androgen insensitivity syndrome

(B) Gonadal dysgenesis
(C) Physiological delay
(D) Prolactinoma

4. A 15-year-old patient with dysmenorrheal experienced menarche at age 13 and currently has regular
menses. The patient is not sexually active. Physical examination including pelvic examination is normal.
The initial management of this patient should be:

(A) Laparoscopy
(B) Cervical dilatation
(C) Estrogen-progestin combination oral contraceptive
(D) Danazol
(E) Non-steroidal anti-inflammatory medication

5. A gravid 2 para 1 patient is screen positive in the second trimester for aneuploidy. The patient refuses
invasive testing and continues the pregnancy. At 26 weeks, an ultrasound reveals polyhydramnios. The
axial abdominal image of the fetus is as shown. Which of the following is the MOST likely diagnosis?

(A) Pelviureteral junction obstruction

(B) Polycystic kidneys
(C) Posterior urethral valves
(D) Duodenal atresia

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Answers on page 664

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 Multiple choice questions

ANSWERS:

1. Answer: B
Specialty Domain: Diagnosis
Section: Menstrual Abnormalities / Gynecology
Type: Recall
Reference: Katz VL, Lobo RA, Lentz G, Gershenson D. Reproductive Endocrinology
and Infertility. In: Comprehensive Gynecology. 5th ed. Philadelphia (PA):
Mosby; 2007. p. 907.

2. Answer: C
Specialty Domain: Diagnosis
Section: Menstrual Abnormalities / Gynecology
Type: Interpretation
Reference: Berek JS, editor. Berek & Novaks Gynecology. 14th ed. Philadelphia (PA):
Lippincott Williams & Wilkins ; 2006. p. 1007.

3. Answer: B
Specialty Domain: Diagnosis
Section: Menstrual Abnormalities / Gynecology
Type: Interpretation
Reference: Berek JS, editor. Berek & Novaks Gynecology. 14th ed. Philadelphia (PA):
Lippincott Williams & Wilkins ; 2006. p. 1044.

4. Answer: E
Specialty Domain: Management
Section: Menstrual Abnormalities / Gynecology
Type: Problem Solving
Reference: Katz VL, Lobo RA, Lentz G, Gershenson D. Reproductive Endocrinology
and Infertility. In: Comprehensive Gynecology. 5th ed. Philadelphia (PA):
Mosby; 2007. p. 903.

5. Answer: D
Specialty Domain: Diagnosis
Section: Normal Pregnancy / Gynecology
Type: Interpretation
Reference: Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams
Obstetrics. 23rd Edition. McGraw-Hill Professional; 2009. p. 359.

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