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Monday, 2 June 2014

Ortho questions

1. A 67-year-old lady comes to clinic complaining of pain across her neck and shoulders and over her hips. She is stiff in the morning for two hours. Her examination, including joint examination, is unremarkable. Which test will be the most useful in establishing the correct diagnosis?
A. Erythrocyte sedimentation rate
B. Rheumatoid factor
C. Shoulder xray
D. Antinuclear antibody
E. Nerve conduction velocities


2. Which of the following is NOT a cause of periarthritis (tendinitis, bursitis)?
A. Injury
B. Repetitive use
C. Rheumatoid arthritis
D. Infection
E. Weather change

3. A 47-year-old man with no known illnesses presents with acute pain and swelling of the left first metatarsal-phalangeal joint. Serum uric acid is normal; arthrocentesis yields a very small amount of fluid, which by polarizing microscopy, is found to contain numerous needle-shaped, negatively birefringent crystals. Of the following therapies, the one that is NOT appropriate in this setting is:
A. Colchicine
B. Indomethacin
C. Allopurinol
D. Codeine
E. Ibuprofen

4. A 69-year-old man with a history of primary hyperparathyroidism presents with a swollen and tender knee. Radiographs of the knee demonstrate chondrocalcinosis of the meniscus, as well as a large joint effusion. Which of the following is most likely to be true in this case?
A. Examination of the synovial fluid under a polarizing microscope will reveal negatively birefringent, needle-shaped crystals
B. Examination of the synovial fluid under the polarizing microscope will reveal positively birefringent, rhomboid-shaped crystals
C. Treatment with allopurinol will improve this mans symptoms
D. An elevated serum uric acid level will establish the diagnosis of gout

5. A 55-year-old male presents with severe proximal muscle weakness and a rash on his neck and face that started after working in his yard last weekend. Which of the following is not true?
A. Polymyositis is a connective tissue disease
B. His condition may suggest an underlying malignancy is present
C. He most likely has SLE
D. CPK, LDH and aldolase should be measured
E. Biopsy of an effected muscle is probably required

6. Seronegative spondyloarthropathies include each of the following diseases except:
A. Ankylosing spondylitis
B. Polymyositis
C. Arthritis associated with inflammatory bowel disease
D. Reiters syndrome
E. Psoriatic arthritis

7. Each of the following statements about HLA-B27 positivity and seronegative spondyloarthropathies are true except:
A. The vast majority of patients with ankylosing spondylitis are HLA-B27 positive
B. Caucasian patients with spondylitis and inflammatory bowel disease have an increased prevalence of HLA-B27 positivity
C. HLA-B27 is expressed on erythrocytes
D. HLA-B27 positive patients have an increased prevalence of sacroiliitis
E. The tertiart structure if HLA-B27 seems to be important in the pathogenesis of the seronegative spondyloarthropathies

8. Which of the following statements is TRUE about the chronic anterior uveitis associated with Juvenile Rheumatoid Arthritis?
A. It is most commonly associated with pauciarticular disease
B. It is asymptomatic in the majority of cases
C. It can lead to blindness if not treated
D. It can only be detected by a slit lamp exam in its early stages
E. All of the above

9. Which of the following is NOT one of the major Jones criteria (revised) for the diagnosis of rheumatic fever?
A. Carditis
B. Arthralgia
C. Polyarthritis
D. Subcutaneous nodules
E. Chorea

10. Which of the following is NOT considered an extra-articular manifestation of rheumatoid arthritis?
A. Vasculitis
B. Wide-mouth diverticula
C. Pulmonary fibrosis
D. Olecranon nodules
E. Eye inflammation

11. A 30-year-old female has hand x-rays which demonstrate small marginal erosions of the MCP joints and the ulnar styloids. What is the most likely diagnosis?
A. Systemic Lupus Erythematosus
B. Osteoarthritis
C. Acute gouty arthritis
D. Rheumatoid arthritis
E. Ankylosing spondylitis

12. Which of the following characteristics is not commonly seen in osteoarthritis?
A. Erosions
B. Subchondral formation
C. Osteophyte formation
D. Joint space narrowing

13. Characteristic features of osteoarthritis include all of the following except:
A. Joint pain on motion
B. Morning stiffness
C. Crepitius
D. Bony swelling

14. Avascular Necrosis is:
A. A common complication of osteoarthritis
B. Seen more commonly in patients treated with high doses of corticosteroids (for example prednisone) than in patients not treated with corticosteroids
C. Associated with x-ray evidence of joint space narrowing at the time of presentation
D. Easily corrected by early surgical intervention

15. The likely cause of a higher incidence of osteomyelitis in children is:
A. Looped metaphysical vessels which may trap transient bacteria
B. pediatric frequent bactermia
C. An immature immune system
D. A and B only
E. B and C only

16. Osteoarthritis of a joint can be potentially treated by:
A. Fusion of the joint
B. Total joint replacement
C. Osteotomy
D. A and B only
E. A, B, and C

17. In myasthenia gravis:
A. Peripheral nerve transmission is defective
B. Is associated with antibodies and bind to actin
C. Muscle weakness is improved with muscle contraction
D. Clinical weakness can be reversed by anti-cholinesterase drugs

18. Polymyositis is an acquired myopathy:
A. Occurs primarily in males
B. Is caused by a virus
C. Usually involves foot and hand muscles
D. Often associated with malignancy

19. Each of the following are clinical characteristics of Reiter's Syndrome except:
A. Urethritis
B. Arthritis
C. Subcutaneious nodules
D. Conjunctivitis

20. Clinically, psoriatic arthritris presents as:
A. An assymetrical oligoarthriths
B. A symmetrical polyarthritis
C. Sacroiliitis
D. All of the above

21. Which of the following is not a characteristic X-ray findings in osteoarthritis?
A. Joint space narrowing
B. Erosions
C. Subchondral sclerosis (eburnation)
D. Osteophyte formation

22. Which of the following findings would be LEAST suggestive of rheumatoid arthritis?
A. Fever
B. Insidious onset of joint pain
C. Bone erosions on x-ray
D. Foot (MTP) pain
E. Symmetrical joint swelling

23. Which of the following is NOT a ARA 1987 classification criterion for rheumatoid arthritis?
A. Morning stiffness of one hour
B. Metacarpophalangeal joint swelling
C. Subcutaneous nodules
D. Cervical (neck) pain
E. Rheumatoid factor


24. All of the following can be seen with rheumatoid arthritis EXCEPT:
A. Anemia of chronic disease
B. Seizures
C. Thrombocytosis
D. Sjogren's syndrome
E. Pleuritis

25. Acute evaluation of fractures should include all but:
A. Evaluation of skin integrity
B. Assessment of neurologic function of the limb
C. Assessment of circulatory status of the limb
D. Emergent MRI to judge soft tissue injury
E. Examination for other injuries

26. All the following are recommended in the acute treatment of a fracture EXCEPT:
A. Rest
B. Elevation
C. Heat
D. Ice
E. Compression

27. Open fractures:
A. have a significant incidence of infection
B. usually are associated with minimal trauma
C. heal more rapidly than closed fractures
D. are always treated with internal fixation (plates and screws)

28. Children's fractures have the following characteristics:
A. usually require operative treatment
B. are more common than adult fractures, but usually less serious
C. usually heal quite slowly
D. are always associated with growth disturbances

29. Trendelenberg gait is positive in patients with weakness of:
A. adductor longus
B. adductor magnus
C. adductor brevis
D. gluteus medius and minimus
E. sartoris

30. Which of the following is true about stress fractures:
A. they occur from repetitive forces below the ultimate strength of the bone
B. they show up on x-ray before they show up on bone scan
C. they are more common in the upper than the lower extremity
D. the injured bone is diffusely tender on examination

31. The pathognomonic fracture of non-accidental trauma is:
A. Corner fracture
B. Greenstick fracture
C. Buckle fracture
D. Complete fracture
E. Open fracture.

32. A Salter/Harris fracture which crosses the physis exiting into the joint is defined as a Salter/Harris:
A. 1
B. 2
C. 3
D. 4
E. 5

33. The earliest sign of compartment syndrome is:
A. Paresthesia
B. Pain out of proportion to injury
C. Pulselessness
D. Paralysis
E. Pallor

34. One type of fracture in which surgical intervention is absolutely necessary is:
A. Corner fracture
B. Complete fracture
C. Salter/Harris fracture
D. Greenstick fracture
E. Open fracture

35. Which of the following is not associated with fibromyalgia?
A. Depression
B. Excessive stage 4 sleep
C. Dysmenorrhea
D. Irritable Bowel Disease

36. Which of the following is true about polymyalgia rheumatica?
A. Patients typically have problems swallowing
B. 30% of patients have rheumatoid arthritis
C. It occurs predominantly in people over 50 years of age
D. Most symptoms resolve within 48 hours with ibuprofen

37. Which of the following is NOT true about the uveitis associated with Juvenile rheumatoid Arthritis?
A. it is usually asymptomatic
B. it is most commonly associated with pauciarticular JRA
C. it is best detected by routine slit lamp exams by a ophthalmologist
D. early major damage occurs in the retina
E. early major damage occurs in the cornea, pupil and lens

38. A 36-year old man develops heart failure and cirrhosis, accompanied by a progressive "bronzing" of his skin over several years. He comes to your office because his right knee has been swollen for a few days.After obtaining a complete history and physical exam, you aspirate the knee, obtaining some opaque fluid. The white blood cells count from the fluid is 17,500 cells/mlWhich additional finding would you expect to observe in analyzing the fluid sample under a polarizing microscope?
A. Needle-shaped crystals, with the yellow crystal parallel to the compensator axis.
B. Rhomboid crystals, with the blue crystal parallel to the compensator axis.
C. Chondrocalcinosis.
D. Rhomboid crystals, with the blue crystal perpendicular to the compensator axis.


39. Which therapy is LEAST appropriate for treating acute gouty arthritis
A. Indomethacin
B. Tylenol with codeine
C. Colchicine
D. Allopurinol
E. Prednisone

40. Seronegative spondyloarthropathies include each of the following diseases except:
A. Ankylosing spondylitis
B. Polymyositis
C. Arthritis associated with inflammatory bowel disease
D. Reiter's syndrome
E. Psoriatic arthritis

41. Each of the following statements about HLA-B27 positivity and seronegative spondyloarthropathies are true except:
A. The vast majority of patients with ankylosing spondylitis are HLA-B27 positive
B. Caucasian patients with spondylitis and inflammatory bowel disease have an increased prevalence of HLA-B27 positivity
C. HLA-B27 is expressed on erythrocytes
D. HLA-B27 positive patients have an increased prevalence of sacroiliitis
E. The tertiary structure HLA-B27 seems to be important in the pathogenesis of the seronegative spondyloarthropathies

42. All of the following are true about ankylosing spondylitis except:
A. Males are more often symptomatic than females
B. Back pain usually presents after the age of 50
C. Back pain is often relieved by activity
D. The hips are the most commonly involved diarthrodial joints

43. Which of the following is not an expected finding of ankylosing spondylitis?
A. Positive HLA-B27
B. Positive rheumatoid factor
C. Elevated erythrocyte sedimentation rate
D. Radiographic changes of sacroiliitis

44. A patient has been diagnosed as having rheumatoid arthritis. Which laboratory finding would you NOT expect to find:
A. Elevated erythrocyte sedimentation rate
B. HLA-DR4 antigen positive
C. Elevated serum albumin
D. Elevated platelet count
E. Positive rheumatoid factor

45. Which of the following is true regarding fibromyalgia?
A. Depression is a common association
B. Average age of onset is 20-30 years of age
C. Is caused by serotonin receptor dysfunction
D. Incidence is greater in young men

46. Which of the following is true about polymyalgia rheumatica?
A. Patients typically have problem digesting food
B. 30% of patients have temporal arteritis
C. Diagnosis hinges on rapid response with ibuprofen
D. Weight gain is common

47. Fractures heal most effectively when subjected to forces of:
A. Distraction
B. Torsion
C. Compression
D. Hoop stress
E. Nicotine

48. Rationale for OPERATIVE treatment of a fracture include all of the following EXCEPT:
A. Restore axial and rotational alignment of extremity
B. Re-establish congruity of joint surface
C. Increase speed of bone healing
D. Permit earlier mobilization of extremities and joints
E. Permit earlier mobilization of multiply injured patient


49. The correct order for the stages of fracture healing is:
A. Inflammation, soft callus, microvascular ingrowth, hard callus, remodeling
B. Inflammation, microvascular ingrowth, soft callus, hard callus, remodeling
C. Microvascular ingrowth, inflammation, soft callus, hard callus, remodeling
D. Inflammation, soft callus, hard callus, microvascular ingrowth, remodeling
E. Inflammation, microvascular ingrowth, hard callus, soft callus, remodeling

50. Which of the following is the most common, serious extra-articular (not involving joints) manifestation of PAUCIARTICULAR Juvenile Rheumatoid Arthritis?
A. Pericarditis
B. asymptomatic anterior uveitis (inflammation in the anterior chamber of the eyes)
C. lymphadenopathy
D. leukemia
E. high spiking fevers


51. Which of the following joints are most commonly involved in osteoarthritis?
A. Distal interphalangeal joints of the hand
B. Metacarpophalangeal joints of the hand
C. Wrists
D. Ankles


52. Which of the following is/are characteristics of osteoarthritis:
A. Morning stiffness
B. Pain at rest
C. Pain on walking
D. All of the above


53. Risk factors for osteonecrosis (avascular necrosis) include all of the following except:
A. Oral corticosteroids
B. Hypertension
C. Sickle cell disease
D. Systemic lupus erythematosus


54. Which of the following is not felt to be a risk factor for getting systemic lupus erythematosus?
A. African-American Female
B. Child-bearing age
C. Patient treated for arrhythmia
D. Identical twin of affected pair
E. Complement 4 deficiency


55. Sclerodactyly is associated with which of the following?
A. Raynaud's phenomenon
B. Gout
C. Male gender
D. diarrhea
E. shortened survival


56. The heliotrope rash is seen in which of the following diseases?
A. Rheumatoid arthritis
B. SLE
C. Dermatomyositis
D. Raynaud's phenomenon
E. Diffuse Systemic sclerosis

1.       a
2.       e
3.       c
4.       b
5.       c
6.       b
7.       c
8.       e
9.       b
10.   b
11.   d
12.   a
13.   b
14.   b
15.   d
16.   e
17.   d
18.   d
19.   c
20.   d
21.   b
22.   a
23.   d
24.   b
25.   d
26.   c
27.   a
28.   b
29.   d
30.   a
31.   a
32.   c
33.   b
34.   e
35.   b
36.   c
37.   d
38.   b
39.   d
40.   b
41.   c
42.   b
43.   c
44.   c
45.   a
46.   b
47.   c
48.   c
49.   b
50.   b
51.   a
52.   c
53.   b
54.   c
55.   a
56.   c

Posted by at 1 comment:

Tuesday, 27 May 2014

Gynae BCQs

 MCQ.1
                A couple presented in OPD with H/0 infertility since last 2
                years. Husbands semen analysis was advised. What is WHO criterion - for minimum sperm count in normal semen?
                a) 10 million.
                b) 20 million.
                c) 30 million.
                d) 40 million.
                e) 70 million.
                Key: b
               
                MCQ.2
                A 23 years old primigravida presents with abdominal pain, syncope and vaginal spotting. Assessment reveals that she has an ectopic pregnancy. The most common site of pregnancy is:
                a) Ampulla.
                b) Isthmus.
                c) Fimbrial end.
                d) Abdomin.
                e) Cervix.
                Key: a
               
                MCQ.3
                Mean age for menopause is:
                a) 40 years.
                b) 45 years.
                c) 51 years.
                d) 48 years.
                e) 39 years.
                Key: c
               
                MCQ.4
                Second degree uterovaginal prolapse is characterized by: a) Complete protrusion of uterus outside introitus.
                b) Descent of genital tract within vagina.
                c) Descent of genital tract upto introitus.
                d) Descent of genital tract outside the introitus.
                e) Descent of cervix below the ischeal spines.
                Key: d
               
                MCQ.5
                A 63 years old lady presents with abdominal mass and weight loss, was diagnosed as having an ovarian tumour.
                The most common ovarian tumour in this woman would be:
                a) Epithelial tumour.
                b) Germ cell tumour.
                c) Stromal tumour.
                d) Sex cord tumour.
                e) Trophoblastic tumour.
                Key: a
               
                Page 1 of 7
                MBBS Final Professional Examination 2007
                Gynaecology
                 Model Papers (MCQs)
                 
               
               
                MCQ.6
                A young girl, 23 years old is presented with complaint of abdominal pain, menorrhagia and 18 weeks size mass arising from hypogastrium. The most likely diagnosis is: a) Endometriosis.
                b) Pelvic inflammatory disease.
                c) Ovarian cyst.
                d) Fibroid uterus.
                e) Mesenteric cyst.
                Key: d
               
                MCQ.7
                A 25 years old school teacher Para 1 wants to use oral contraceptive pills for contraception. She is asking about the mode of action of oral contraceptive pills. The mechanism of action of oral contraceptive pills is: a) Inhibiting ovulation by suppression of serum FSH.
                b) Inducing endometrial atrophy.
                c) Increasing cervical mucous hostility.
                d) Inducing endometritis.
                e) Inhibiting prolactin.
                Key: a
               
                MCQ.8
                Women complaining of milky whitish discharge with fishy odour. No history of itching. Most likely diagnosis is: a) Bacterial vaginosis.
                b) Trichomoniasis.
                c) Candidiasis.
                d) Malignancy.
                e) Urinary tract infection.
                Key: a
               
                 MCQ.9
                A young medical student has come to you with complaints of oligomenorrrhea, hirsuitism and weight gain, ultrasound reveals bulky ovaries with sub-capsular cysts. Most likely diagnosis is:
                a) Ovarian cancer.
                b) Cushing’s syndrome.
                c) Polycystic ovarian disease.
                d) Diabetes mellitus.
                e) Pelvic inflammatory disease.
                Key: c
               
                MCQ.10
                A 43 year old, lecturer has come to you with complaints of heavy but regular menstrual bleeding with flooding and clots. There is no anatomical reason for heavy flow.
                The most effective remedy for reducing her menstrual flow is:
                a) Tranexemic acid.
                b) Dilatation and Curettage.
                c) Depomedroxy progesterone acetate.
                d) Misoprostol.
                e) Ergometrine maleate.
               
                Key: a
                 
                MCQ.11 A 39 years old women Para 6 has presented with complaint of post coital bleeding for the past three months. Your first investigation should be: a) Dilatation & Curettage.
                b) Cone biopsy of cervix.
                c) Pap smear.
                d) Colposcopy.
                e) Laparoscopy.
                Key: c
               
                MCQ.12
                A 28 years old woman has 14 weeks size irregular uterus.
                She does not complain of abdominal pain or menorrhagia.
                Her pap smear is normal. The best next step in her management would be:
                a) Continued observation.
                b) Endometrial biopsy.
                c) Hysterectomy.
                d) Pelvic ultrasonography.
                e) Laparoscopy.
                Key: d
               
                MCQ.13
                The most effective treatment of pruritis vulvae associated with atrophic vulvitis is:
                a) Antihistamines.
                b) Hydrocortisone.
                c) Alcohol injections.
                d) Tranquilizers.
                e) Topical estrogen therapy.
                Key: e
               
                MCQ.14
                The most common cause of rectovaginal fistula is: a) Obstetrical.
                b) Irradiation of the pelvis.
                c) Carcinoma.
                d) Crohn’s disease.
                e) Endometriosis.
                Key: a
               
                MCQ.15
                A 40 years old multiparous woman complains of involuntary loss of urine associated with coughing, laughing, lifting or standing. The history is most suggestive of:
                a) Fistula.
                b) Stress incontinence.
                c) Urge incontinence.
                d) Urethral diverticulum.
                e) Urinary tract infection.
                Key: b
                 
                 
               
               
                MCQ.16
                A 28 years old G3 P2 has presented with complaints of brownish vaginal discharge, passage of vesicles and excessive vomiting. Ultrasound scan shows snowstorm appearance in uterus with no fetus. The most likely diagnosis is:
                a) Septic induced abortion.
                b) Twin pregnancy.
                c) Gestational trophoblastic disease.
                d) Ectopic pregnancy.
                e) Fibroid uterus.
                Key: c
               
                MCQ.17
                The maximum number of oogonia are formed at what age of female life:
                a) One month intrauterine.
                b) Five month intrauterine.
                c) At birth.
                d) At puberty.
                e) At 21 years of age.
                Key: b
               
                MCQ.18
                Menarche usually occurs at age of:
                a) 8 and 10 years.
                b) 11 and 13 years.
                c) 14 and 16 years.
                d) 17 and 18 years.
                e) 18 and above.
                Key: b
               
                MCQ.19
                The most common cause of vesicovaginal fistula (VVF) in under developed countries would be:
                a) Obstetrical injuries.
                b) Pelvic irradiation.
                c) Carcinoma .
                d) Haemorrhoidectomy.
                e) Operative injury.
                Key: a
               
                MCQ.20
                A 28 year old patient complains of amenorrhea after having dilatation and curettage. The most likely diagnosis is:
                a) Kallman’s Syndrome.
                b) Turner’s Syndrome.
                c) Asherman’s Syndrome.
                d) Pelvic inflammatory disease.
                e) Anorexia nervosa.
               
                Key: c
               
               
                 
                 
                MCQ.21 A large cystic ovarian tumour is detected in a woman on routine antenatal check up. The most common complication she can encounter is:
                a) Torsion.
                b) Rupture.
                c) Haemorrhage.
                d) Degeneration.
                e) Infection.
                Key: a
               
                MCQ.22
                Which of the following is used to take cervical smear: a) Colposcope.
                b) Vaginoscope.
                c) Ayre’s spatula.
                d) Laparoscope.
                e) Forceps.
                Key: c
               
                MCQ.23
                Normal duration of menstrual cycle is:
                a) 1-3 days.
                b) 1-4 days.
                c) 2-7 days.
                d) 7-10 days.
                e) 1-2 days.
                Key: c
               
                 MCQ.24 a 20 year old medical student presents with five years history of weight gain, irregular periods and worsening fascial hair. What is the most likely diagnosis?
                a) Polycystic ovarian disease.
                b) Hypothyroidism.
                c) Obesity.
                d) Cushing’s Syndrome.
                e) Nephrotic Syndrome.
               
                Key: a
                MCQ.25 28 years old woman with previous history of having baby with Down’s Syndrome is now 12 weeks pregnant. Which of the following would you suggest to her: a) Amniocentesis.
                b) Obstetric ultrasound.
                c) Chorionic villus sampling.
                d) Fetal blood sampling.
                e) Wait till eighteen weeks for detailed ultrasound and amniocentesis.
                Key: c
                 
                 
               
               
                MCQ.26
                A newly married girl comes to gynae OPD with history of dysuria, burning, micturition and sore perineum. What is your likely diagnosis:
                a) Trichomonas vaginalis.
                b) Candida infection.
                c) Trauma due to coitus.
                d) Honey moon cystitis.
                e) Genital herpes.
                Key: d
               
                MCQ.27
                Gonadotropin releasing hormone (GnRH) stimulates the release of:
                a) ACTH.
                b) Growth hormone.
                c) Leutinising Hormone (LH).
                d) Thyroid stimulating hormone (TSH).
                e) Opiate peptides.
                Key: c
               
                MCQ.28
                Serum prolactin levels are highest in which of the following conditions:
                a) Menopause.
                b) Ovulation.
                c) Parturition.
                d) Sleep.
                e) Running.
                Key: c
               
                MCQ.29
                Main uterine support is:
                a) Uterosacral ligaments.
                b) Round ligaments.
                c) Transverse cervical ligaments.
                d) Ovarian ligaments.
                e) Broad ligaments.
                Key: c
               
                MCQ.30
                The most likely cause of abnormal uterine bleeding in 13
                years old girl is:
                a) Uterine cancer.
                b) Ectopic pregnancy.
                c) Anovulation.
                d) Systemic bleeding diatheses.
                e) Trauma.
                Key: c
               
                 
                 
                 
                 MCQ.31 Which of the following pubertal event would occur even in the absence of ovarian estrogen production: a) Thelarche.
                b) Menarche.
                c) Pubarche.
                d) Skeletal growth.
                e) Vaginal cornification.
                Key: c
               
                MCQ.32
                58 years old woman has presented with complaints of postmenopausal bleeding for the past two weeks. The most essential investigation would be:
                a) Colposcopy.
                b) Pap smear.
                c) Cone biopsy.
                d) D & C (dilatation & Curettage).
                e) Hysteroscopy.
                Key: d
               
                MCQ.33
                The most common symptom of endometrial hyperplasia is:
                a) Vaginal discharge.
                b) Vaginal bleeding.
                c) Amenorrhea.
                d) Pelvic pain.
                e) Abdominal distention.
                Key: b
               
                MCQ.34
                56 years old woman has come to you with the complaints of hot flushes irritability, joint pains with lack of sleep.
                Most appropriate treatment would be:
                a) Hysterectomy.
                b) Vitamins.
                c) Combined oestrogen, progesterone preparations.
                d) Phytooestrogens.
                e) Selective estrogen receptor modulators (SERMS).
                Key: c
               
                MCQ.35
                Which of the following is used as an emergency contraceptive:
                a) Combined oral contraceptive pills.
                b) Progesterone only.
                c) Depoprovera.
                d) Levonorgestril (EM-Kit).
                e) Ergometrine.

                Key: d 
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