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BMDC RQE study materials
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BMDC RQE practice questions

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Question 1Internal Medicine

A 58-year-old man has fasting plasma glucose of 6.9 mmol/L on two occasions. What is the most appropriate diagnostic label?

  1. Normal glucose tolerance
  2. Diabetes mellitus
  3. Impaired fasting glucose (prediabetes) Correct answer.
  4. Gestational diabetes

Explanation

Fasting plasma glucose between 5.6 and 6.9 mmol/L defines impaired fasting glucose, a prediabetic state. Diabetes requires a fasting value of 7.0 mmol/L or more, so this result falls short of the diabetes threshold.

Question 2Internal Medicine

Which finding most strongly suggests a diagnosis of nephrotic syndrome rather than nephritic syndrome?

  1. Urinary protein excretion above 3.5 g per day Correct answer.
  2. Cola-colored urine
  3. Presence of red blood cell casts
  4. Hypertension with oliguria

Explanation

Nephrotic syndrome is defined by heavy proteinuria, typically exceeding 3.5 g per day, together with hypoalbuminemia and edema. Nephritic syndrome instead features an active urinary sediment with red cell casts, hypertension, and oliguria.

Question 3Internal Medicine

A patient with chronic obstructive pulmonary disease has chronic retention of carbon dioxide. Which arterial blood gas pattern is most consistent with this state?

  1. High bicarbonate with high pH and normal PaCO2
  2. Normal bicarbonate with high pH and low PaCO2
  3. Low bicarbonate with low pH and low PaCO2
  4. Raised bicarbonate with near-normal pH and elevated PaCO2 Correct answer.

Explanation

Chronic hypercapnia is offset by renal bicarbonate retention, so pH stays close to normal despite elevated PaCO2. This fully compensated respiratory acidosis is the expected chronic pattern.

Question 4Internal Medicine

Which single laboratory test is best for confirming a diagnosis of primary hypothyroidism?

  1. Serum total T3
  2. Thyroid peroxidase antibody
  3. Serum thyroid-stimulating hormone Correct answer.
  4. Serum free T4

Explanation

A raised thyroid-stimulating hormone is the most sensitive initial indicator of primary hypothyroidism because the pituitary responds to falling thyroid hormone output. Free T4 is used to grade severity once TSH is abnormal.

Question 5Internal Medicine

A 30-year-old woman has sudden severe headache, fever, and neck stiffness. Which next step is most appropriate after blood cultures are drawn?

  1. Immediate empiric intravenous antibiotics Correct answer.
  2. Start antiviral therapy alone
  3. Oral analgesia and outpatient review
  4. Wait 48 hours for culture results

Explanation

Bacterial meningitis is a medical emergency in which early empiric intravenous antibiotics reduce mortality and neurologic sequelae. Therapy should not be delayed for imaging or culture results when the presentation is typical.

Question 6Internal Medicine

A 62-year-old man has resting tremor, bradykinesia, and rigidity. Which medication is the most effective symptomatic treatment for motor symptoms?

  1. Levodopa combined with carbidopa Correct answer.
  2. Haloperidol
  3. Propranolol
  4. Donepezil

Explanation

Levodopa is the most effective dopamine-replacement therapy for motor symptoms of Parkinson disease, and carbidopa reduces its peripheral breakdown. It gives the greatest improvement in bradykinesia and rigidity.

Question 7Internal Medicine

A patient with atrial fibrillation has a CHA2DS2-VASc score of 4. What is the most appropriate long-term strategy?

  1. Catheter ablation instead of anticoagulation
  2. Oral anticoagulation for stroke prevention Correct answer.
  3. Aspirin alone
  4. No antithrombotic therapy

Explanation

A CHA2DS2-VASc score of 2 or more in men indicates sufficient stroke risk to warrant oral anticoagulation. Aspirin is inferior to anticoagulation for stroke prevention in atrial fibrillation.

Question 8Internal Medicine

Which electrocardiographic finding is most characteristic of acute ST-elevation myocardial infarction?

  1. Sawtooth flutter waves
  2. Diffuse ST depression with PR depression
  3. ST-segment elevation in contiguous leads Correct answer.
  4. Narrow QRS with delta wave

Explanation

Acute transmural ischemia produces ST-segment elevation in leads facing the infarct territory, often with reciprocal depression elsewhere. This pattern drives immediate reperfusion decisions.

Question 9Internal Medicine

A 70-year-old woman has exertional dyspnea and a harsh systolic murmur at the right upper sternal border radiating to the carotids. What is the most likely diagnosis?

  1. Mitral regurgitation
  2. Aortic regurgitation
  3. Aortic stenosis Correct answer.
  4. Tricuspid stenosis

Explanation

A crescendo-decrescendo systolic murmur at the right upper sternal border with carotid radiation is classic for aortic stenosis. Exertional dyspnea reflects the resulting pressure overload of the left ventricle.

Question 10Internal Medicine

A patient with decompensated heart failure has hypotension and poor perfusion. Which initial intravenous therapy is most appropriate?

  1. Intravenous fluid bolus
  2. Norepinephrine with inotropic support as needed Correct answer.
  3. Loop diuretic
  4. Beta-blocker bolus

Explanation

When heart failure is complicated by hypotension and hypoperfusion, vasopressor support with inotropes is needed to maintain organ perfusion. Diuretics are used when congestion predominates with adequate blood pressure.

Question 11Internal Medicine

Which organism is the most common cause of community-acquired pneumonia requiring hospitalization in adults?

  1. Mycoplasma pneumoniae
  2. Legionella pneumophila
  3. Pneumocystis jirovecii
  4. Streptococcus pneumoniae Correct answer.

Explanation

Streptococcus pneumoniae remains the leading cause of community-acquired pneumonia across all severity levels in adults. Empiric regimens are therefore designed to cover this organism.

Question 12Internal Medicine

A 45-year-old man has episodic wheeze and cough at night, with symptoms improving after inhaled salbutamol. Which diagnosis is most likely?

  1. Asthma Correct answer.
  2. Chronic obstructive pulmonary disease
  3. Bronchiectasis
  4. Pulmonary embolism

Explanation

Episodic wheeze with nocturnal symptoms and reversibility after a short-acting beta-agonist is characteristic of asthma. Variable airflow obstruction is the defining physiologic feature.

Question 13Internal Medicine

Which finding best distinguishes upper gastrointestinal bleeding from lower gastrointestinal bleeding?

  1. Hematochezia
  2. Abdominal cramping
  3. Melena
  4. Hematemesis Correct answer.

Explanation

Hematemesis, the vomiting of blood, localizes bleeding to the upper gastrointestinal tract proximal to the ligament of Treitz. Hematochezia and melena can arise from either site depending on transit time.

Question 14Internal Medicine

A patient with chronic hepatitis B has a rising alpha-fetoprotein level and a liver mass. Which surveillance test is recommended for hepatocellular carcinoma in at-risk patients?

  1. Serum alpha-fetoprotein alone annually
  2. Computed tomography every year
  3. Liver biopsy annually
  4. Ultrasound of the liver every six months Correct answer.

Explanation

Six-monthly liver ultrasound is the recommended surveillance method for hepatocellular carcinoma in patients with cirrhosis or chronic hepatitis B. Alpha-fetoprotein alone is insufficiently sensitive and specific.

Question 15Internal Medicine

Which feature most strongly suggests acute pancreatitis rather than a perforated peptic ulcer?

  1. Board-like abdominal rigidity
  2. Serum lipase elevated more than three times the upper limit Correct answer.
  3. Free air under the diaphragm
  4. Sudden severe epigastric pain

Explanation

A serum lipase level greater than three times the upper reference limit supports acute pancreatitis. Free air and board-like rigidity point instead toward a perforated viscus.

Question 16Internal Medicine

A 26-year-old woman has fatigue, weight loss, and a diffuse goiter with a suppressed TSH and elevated free T4. Which treatment is most appropriate for definitive control?

  1. Radioactive iodine with levothyroxine replacement
  2. Methimazole Correct answer.
  3. Levothyroxine
  4. Potassium iodide alone

Explanation

Graves disease is managed initially with antithyroid drugs such as methimazole to inhibit hormone synthesis. Definitive options like radioactive iodine are considered in relapse or patient preference after discussion.

Question 17Internal Medicine

Which clinical feature is most suggestive of diabetic ketoacidosis rather than hyperosmolar hyperglycemic state?

  1. Profound dehydration
  2. Kussmaul respirations with ketonemia Correct answer.
  3. Glucose above 30 mmol/L
  4. Altered mental status

Explanation

Diabetic ketoacidosis features substantial ketone production and metabolic acidosis, producing compensatory Kussmaul breathing. Hyperosmolar hyperglycemic state typically lacks significant ketosis despite very high glucose.

Question 18Internal Medicine

A patient has a serum sodium of 118 mmol/L with confusion after rapid water intake. What is the most important principle in correction?

  1. Restrict fluid intake without monitoring
  2. Limit correction to about 8-10 mmol/L in the first 24 hours Correct answer.
  3. Correct sodium fully within six hours
  4. Use hypertonic saline in all cases regardless of symptoms

Explanation

Overly rapid correction of hyponatremia risks osmotic demyelination, so sodium should rise by no more than about 8-10 mmol/L per day. Symptomatic severe hyponatremia may need hypertonic saline with close monitoring.

Question 19Internal Medicine

Which finding is most consistent with iron deficiency anemia on laboratory testing?

  1. Low ferritin with low mean corpuscular volume Correct answer.
  2. High ferritin with high mean corpuscular volume
  3. Normal ferritin with target cells
  4. High transferrin saturation

Explanation

Iron deficiency reduces stored iron, so ferritin falls, and impaired hemoglobin synthesis produces microcytosis. These two findings together are the typical laboratory signature.

Question 20Internal Medicine

A 68-year-old smoker has a hemoglobin of 90 g/L and a raised erythropoietin-independent erythrocytosis. Which condition should be suspected with isolated elevated hemoglobin and low erythropoietin?

  1. Thalassemia trait
  2. Polycythemia vera Correct answer.
  3. Iron deficiency anemia
  4. Anemia of chronic disease

Explanation

Polycythemia vera is a myeloproliferative neoplasm causing erythropoietin-independent red cell production, often with low erythropoietin and elevated hemoglobin. JAK2 mutation testing confirms the diagnosis.

Question 21Internal Medicine

Which autoantibody is most specific for systemic lupus erythematosus?

  1. Rheumatoid factor
  2. Antinuclear antibody
  3. Anti-histone antibody
  4. Anti-double-stranded DNA Correct answer.

Explanation

Anti-double-stranded DNA is highly specific for systemic lupus erythematosus and correlates with disease activity and nephritis. Antinuclear antibody is sensitive but not specific.

Question 22Internal Medicine

A patient with acute gout has severe pain in the first metatarsophalangeal joint. Which treatment is most appropriate during the acute attack?

  1. Colchicine or a nonsteroidal anti-inflammatory drug Correct answer.
  2. Allopurinol started alone at high dose
  3. Probenecid at high dose
  4. Aspirin at high dose

Explanation

Acute gout is treated with anti-inflammatory agents such as colchicine, nonsteroidal anti-inflammatory drugs, or corticosteroids. Urate-lowering therapy is not started alone during an acute flare because shifts in urate can prolong or worsen it.

Question 23Internal Medicine

Which clinical feature most strongly suggests a diagnosis of rheumatoid arthritis rather than osteoarthritis?

  1. Asymmetric involvement of the first metatarsophalangeal joint
  2. Symmetrical small-joint swelling with prolonged morning stiffness Correct answer.
  3. Pain worse with activity in the knees
  4. Heberden nodes with brief morning stiffness

Explanation

Rheumatoid arthritis typically causes symmetrical synovitis of small joints with morning stiffness lasting over an hour. Osteoarthritis produces activity-related pain with brief stiffness and bony nodes.

Question 24Internal Medicine

A patient with advanced chronic kidney disease has a hemoglobin of 85 g/L and low erythropoietin. What is the most appropriate treatment?

  1. Erythropoiesis-stimulating agent with iron assessment Correct answer.
  2. High-dose vitamin B12 injections
  3. Oral iron alone without assessing stores
  4. Immediate blood transfusion regardless of symptoms

Explanation

Anemia of chronic kidney disease results mainly from inadequate erythropoietin production, so erythropoiesis-stimulating agents are used after ensuring adequate iron stores. Iron status must be evaluated because functional iron deficiency limits response.

Question 25Surgery

A 45-year-old man has a painful, swollen scrotum of sudden onset with crepitus on examination. Which condition is most likely?

  1. Hydrocele
  2. Epididymal cyst
  3. Varicocele
  4. Fournier gangrene Correct answer.

Explanation

Crepitus in the scrotum indicates gas in the soft tissues, which is the hallmark of a necrotizing fasciitis of the perineum known as Fournier gangrene. This is a surgical emergency requiring urgent debridement and broad-spectrum antibiotics, since delay increases mortality substantially.

Question 26Surgery

Which finding best distinguishes testicular torsion from epididymo-orchitis on physical examination?

  1. Relief of pain on elevating the testis
  2. Presence of a transilluminating swelling
  3. Transverse lie of the testis with absent cremasteric reflex Correct answer.
  4. Gradual onset of pain over several days

Explanation

In torsion the testis often lies transversely and rides high, and the cremasteric reflex is typically absent on the affected side. Prehn sign, in which elevation relieves pain, is classically associated with epididymitis rather than torsion, so it is a weaker discriminator.

Question 27Surgery

A patient has a deep laceration over the palmar surface of the wrist with loss of sensation over the thenar eminence and inability to oppose the thumb. Which nerve is most likely injured?

  1. Median nerve Correct answer.
  2. Musculocutaneous nerve
  3. Ulnar nerve
  4. Radial nerve

Explanation

The median nerve supplies sensation to the thenar eminence and innervates the thenar muscles including opponens pollicis. Injury therefore produces sensory loss over the thenar skin and weakness of thumb opposition.

Question 28Surgery

A 30-year-old woman has a 2 cm firm, mobile, well-defined breast lump that is painless. What is the most appropriate next step in management?

  1. Radical mastectomy
  2. Triple assessment with clinical examination, imaging and tissue sampling Correct answer.
  3. Observation for six months before any investigation
  4. Reassurance alone without further investigation

Explanation

Any discrete breast lump requires triple assessment: clinical examination, imaging (ultrasound in a young woman, mammography as appropriate) and tissue diagnosis by core biopsy or fine needle aspiration. This approach reliably distinguishes benign fibroadenoma from malignancy.

Question 29Surgery

Which feature most strongly suggests a malignant rather than benign breast lump?

  1. Bilateral cyclical tenderness
  2. Fluctuant tender mass with fever
  3. Hard, irregular, fixed mass with skin tethering Correct answer.
  4. Smooth, mobile, rubbery mass

Explanation

Malignant breast lumps are typically hard, irregular and fixed to surrounding tissue, sometimes with skin dimpling or nipple retraction from infiltration of suspensory ligaments. Benign lesions tend to be smooth, mobile and well demarcated.

Question 30Surgery

A 55-year-old man presents with painless gross haematuria. Which investigation is the most important initial step in evaluating for urothelial malignancy?

  1. Cystoscopy with upper tract imaging Correct answer.
  2. Urine culture only
  3. Serum prostate specific antigen
  4. Renal ultrasound alone

Explanation

Painless visible haematuria in an older adult is a red flag for urothelial cancer, and cystoscopy combined with upper tract imaging is the standard initial evaluation. Urine culture and ultrasound alone cannot exclude a bladder or renal pelvic tumour.

Question 31Surgery

Which of the following is the most reliable early sign of hypovolaemic shock in an adult trauma patient?

  1. Widened pulse pressure
  2. Bradycardia with hypertension
  3. Increased urine output
  4. Tachycardia with narrowed pulse pressure Correct answer.

Explanation

Early compensated hypovolaemia produces tachycardia and a narrowed pulse pressure as peripheral vasoconstriction raises diastolic pressure. Hypotension is a late finding, so relying on it alone may delay recognition of significant blood loss.

Question 32Surgery

A patient sustains a stab wound to the anterior chest and becomes hypotensive with distended neck veins and muffled heart sounds. What is the most likely diagnosis?

  1. Massive haemothorax
  2. Aortic dissection
  3. Tension pneumothorax
  4. Cardiac tamponade Correct answer.

Explanation

Beck triad of hypotension, distended neck veins and muffled heart sounds points to cardiac tamponade, often from penetrating chest trauma. Urgent pericardial decompression is life-saving.

Question 33Surgery

Which statement about acute appendicitis in pregnancy is most accurate?

  1. Leucocytosis is diagnostic because pregnancy does not alter white cell counts
  2. The appendix is displaced upward by the enlarging uterus, so pain may be felt higher than the right iliac fossa Correct answer.
  3. The appendix lies lower in the pelvis as pregnancy advances
  4. Appendicitis is extremely rare in pregnancy and can be excluded on that basis

Explanation

As the uterus enlarges, the appendix is displaced cranially and laterally, so pain and tenderness may localise to the right upper quadrant or flank. Diagnostic delay is common and increases the risk of perforation, so imaging such as ultrasound or MRI is used early.

Question 34Surgery

A 62-year-old man has painless obstructive jaundice with a palpable non-tender gallbladder. What is the most likely diagnosis?

  1. Gallstone impaction in the cystic duct
  2. Carcinoma of the head of the pancreas Correct answer.
  3. Acute cholecystitis
  4. Acute pancreatitis

Explanation

Courvoisier law states that a palpable, non-tender gallbladder with painless jaundice is unlikely to be due to stones, because chronic stone disease fibroses the gallbladder. A periampullary or pancreatic head malignancy is the classic cause.

Question 35Surgery

Which investigation is the most sensitive for detecting common bile duct stones in a patient with suspected choledocholithiasis?

  1. Serum alkaline phosphatase
  2. Magnetic resonance cholangiopancreatography Correct answer.
  3. Transabdominal ultrasound of the gallbladder
  4. Plain abdominal radiograph

Explanation

MRCP is a non-invasive technique that images the biliary tree with high sensitivity for ductal stones, avoiding the risks of endoscopic retrograde cholangiopancreatography. Ultrasound visualises the gallbladder well but is less reliable for the distal common bile duct.

Question 36Surgery

A patient develops cramping abdominal pain, vomiting and absolute constipation with a tympanic abdomen and multiple air-fluid levels on radiography. What is the most likely diagnosis?

  1. Perforated peptic ulcer
  2. Acute mesenteric ischaemia
  3. Small bowel obstruction Correct answer.
  4. Acute pancreatitis

Explanation

Colicky pain, vomiting, distension and absolute constipation with multiple air-fluid levels are the classic features of mechanical small bowel obstruction. Initial management includes resuscitation, nasogastric decompression and correction of electrolytes.

Question 37Surgery

Which type of hernia carries the highest risk of strangulation?

  1. Umbilical hernia in an adult
  2. Incisional hernia
  3. Indirect inguinal hernia
  4. Femoral hernia Correct answer.

Explanation

Femoral herniae pass through the narrow femoral canal and have a rigid neck, giving them the highest rate of strangulation among groin herniae. For this reason they are generally repaired promptly after diagnosis.

Question 38Surgery

A 70-year-old smoker has sudden severe abdominal pain with a pulsatile expansile epigastric mass. What is the most appropriate immediate management?

  1. Diagnostic laparoscopy
  2. Oral analgesia and discharge
  3. Urgent CT angiography and vascular surgical referral Correct answer.
  4. Elective outpatient ultrasound

Explanation

A pulsatile expansile abdominal mass with severe pain suggests a leaking or ruptured abdominal aortic aneurysm, a life-threatening emergency. Urgent CT angiography confirms the diagnosis and guides immediate vascular repair.

Question 39Surgery

Which finding is characteristic of a limb with acute critical ischaemia?

  1. Visible dilated tortuous superficial veins
  2. Warm limb with bounding pulses
  3. Pain, pallor, pulselessness, paraesthesia and paralysis Correct answer.
  4. Oedema with erythema and fever

Explanation

Acute limb ischaemia classically produces the six Ps: pain, pallor, pulselessness, paraesthesia, paralysis and perishing cold. Paraesthesia and paralysis indicate threatened viability and demand immediate revascularisation.

Question 40Surgery

A patient has a deep partial-thickness burn involving 20% of total body surface area. What is the most appropriate initial fluid strategy?

  1. Colloid transfusion at twice the calculated volume
  2. Intravenous crystalloid calculated from body weight and burn surface area Correct answer.
  3. Oral rehydration only
  4. No fluids until urine output falls

Explanation

Significant burns cause plasma loss and require intravenous crystalloid resuscitation, commonly calculated with the Parkland formula using body weight and percentage burn. Fluid is titrated to urine output rather than given as a fixed bolus.

Question 41Surgery

Which feature best differentiates a superficial partial-thickness burn from a full-thickness burn?

  1. Circumferential eschar requiring escharotomy
  2. Presence of blanching with preserved sensation Correct answer.
  3. Absence of any pain
  4. Leathery white eschar with no sensation

Explanation

Superficial partial-thickness burns remain pink, blanch on pressure and are painful because nerve endings are intact. Full-thickness burns are insensate, leathery and do not blanch, which is why they require excision and grafting.

Question 42Surgery

A patient develops fever, tachycardia and wound erythema on the second day after surgery. What is the most appropriate initial management?

  1. Commence anticoagulation
  2. Immediate re-exploration in theatre
  3. Reassurance without intervention
  4. Wound inspection with culture and empirical antibiotics Correct answer.

Explanation

Early postoperative fever with wound changes suggests surgical site infection, so the wound should be inspected, sampled for culture and treated with appropriate antibiotics. Collections may require drainage if an abscess is found.

Question 43Surgery

Which is the most important measure to reduce surgical site infection in elective colorectal surgery?

  1. Routine drain insertion
  2. Prolonged postoperative antibiotics for a week
  3. Preoperative intravenous antibiotic prophylaxis with correct timing Correct answer.
  4. Shaving the skin the night before surgery

Explanation

Timely preoperative intravenous prophylaxis achieving adequate tissue levels at incision is the single most effective preventive measure. Additional measures include normothermia, glycaemic control and avoiding unnecessary shaving.

Question 44Surgery

A patient has a 3 cm solitary thyroid nodule that is firm and fixed, with ipsilateral cervical lymphadenopathy. What is the most appropriate next step?

  1. Radioactive iodine ablation
  2. Observation with repeat ultrasound in one year
  3. Fine needle aspiration cytology of the nodule Correct answer.
  4. Total thyroidectomy without cytology

Explanation

A suspicious thyroid nodule with lymphadenopathy requires fine needle aspiration cytology under ultrasound guidance to establish whether malignancy is present. Surgery is planned according to cytological and imaging findings.

Question 45Surgery

Which complication is most specific to total thyroidectomy and should be anticipated in the immediate postoperative period?

  1. Hypocalcaemia from parathyroid injury Correct answer.
  2. Hypoglycaemia from pancreatic injury
  3. Hyperkalaemia from muscle injury
  4. Hypercalcaemia from parathyroid stimulation

Explanation

Transient or permanent hypocalcaemia from inadvertent parathyroid devascularisation or removal is a characteristic complication of total thyroidectomy. Patients are monitored for perioral tingling and carpopedal spasm and treated with calcium and vitamin D.

Question 46Surgery

A patient has a recurrent laryngeal nerve palsy after thyroidectomy. Which voice abnormality is most expected?

  1. Normal voice with dysphagia only
  2. Complete loss of voice with stridor
  3. Hoarseness with a weak, breathy voice Correct answer.
  4. High-pitched nasal speech

Explanation

Unilateral recurrent laryngeal nerve palsy causes vocal cord paresis with hoarseness and a weak breathy voice, while the airway remains patent. Bilateral injury is more dangerous because both cords may be paralysed, causing stridor and airway obstruction.

Question 47Surgery

A 25-year-old man has a small, painless, reducible swelling above and medial to the pubic tubercle that appears on coughing. What is the diagnosis?

  1. Femoral hernia
  2. Indirect inguinal hernia Correct answer.
  3. Hydrocele of the cord
  4. Direct inguinal hernia

Explanation

An indirect inguinal hernia passes through the deep ring and lies above and medial to the pubic tubercle, often descending into the scrotum in young men. Femoral herniae lie below and lateral to the pubic tubercle.

Question 48Surgery

Which finding on digital rectal examination most strongly suggests carcinoma of the prostate?

  1. Smooth, symmetrically enlarged gland
  2. Soft, boggy gland with a prominent median sulcus
  3. Hard, irregular nodule with loss of the median sulcus Correct answer.
  4. Tender, warm, fluctuant gland

Explanation

Prostate cancer typically produces a hard, irregular gland with obliteration of the median sulcus and sometimes fixation to surrounding tissue. Benign prostatic enlargement tends to be smooth, symmetrical and rubbery.

Question 49Obstetrics and Gynaecology

A woman at 12 weeks of gestation has a blood pressure of 150/100 mmHg on two occasions before pregnancy was confirmed. Which diagnosis best fits?

  1. Preeclampsia
  2. Chronic hypertension Correct answer.
  3. White-coat hypertension
  4. Gestational hypertension

Explanation

Hypertension documented before 20 weeks of gestation, or present before conception, is classified as chronic hypertension. Gestational hypertension arises after 20 weeks and preeclampsia requires proteinuria or organ dysfunction in addition to raised pressure.

Question 50Obstetrics and Gynaecology

Which finding is most characteristic of an ectopic pregnancy on transvaginal ultrasound?

  1. Bilateral enlarged multicystic ovaries
  2. A thickened endometrium with a double decidual sign
  3. A gestational sac with yolk sac inside the uterine cavity
  4. An empty uterine cavity with free fluid in the pouch of Douglas Correct answer.

Explanation

An ectopic pregnancy typically shows no intrauterine gestational sac together with an adnexal mass, and free pelvic fluid may indicate tubal rupture or leakage. The combination of an empty uterus and free fluid in a woman with a positive pregnancy test raises strong suspicion.