MRCPI Part 2 Written – Percentage Mock – Paper 1

1. 35 years old G2P1 has come for booking visit. She had a previous instrumental delivery and had sustained a third-degree perineal tear, following which it was repaired and she is asymptomatic. But she is anxious to know whether she will sustain the injury again. What is her risk of sustaining a third or fourth degree perineal tear in this pregnancy?

2. The incidence of periumbilical adhesion with previous laparoscopy is

3. 35-year-old P1L1, is planned for a resection of a sub-mucous fibroid. Hysteroscopy reveals,

What is the ideal distension medium for the resection of the fibroid using a resectoscope?

4. 27. 38 year old multiparous woman is undergoing diagnostic laparoscopy for chronic pelvic pain. What is the chance that the bowel injury might be missed at the time of laparoscopy?

5. 31 year old P1L1 was delivered 6 weeks before at 28 weeks of gestation due to severe pre-eclampsia and HELLP syndrome. During her postnatal review, her BP is found to be normal and she was on anti-hypertensives for 2 weeks following delivery. She is very anxious that she may develop pre-eclampsia again in the subsequent pregnancy. What is the risk of recurrence of pre-eclampsia in her subsequent pregnancy?

6. The risk of sustaining a further third or fourth degree tear in a subsequent delivery following a delivery that has ended up in a fourth degree tear is

7. A 35-year-old female, who is a para 3, had firstly a vaginal delivery and two Caesarean sections – first was done in view of foetal distress and the second was elective caesarean. She has presented with chronic pelvic pain three months after her last lower uterine segment Caesarean section (LSCS). What is the incidence of nerve entrapment after LSCS?

8. What is the recurrence rate of shoulder dystocia?

9. You are ST3 on call asked to attend an obstetric emergency call for the problem shown in figure. You and midwife successfully managed the problem and you then advise them to prepare for PPH.

What is approximate chance of PPH?

10. You are going to take an ANC lecture in your hospital where your special focus will be on pregnancy with diabetes. A 32-year-old woman tells you she is diagnosed with gestational diabetes during this pregnancy, and her capillary blood glucose level is 4 mmol/L. What is her risk of developing type2 diabetes within 5 years of this birth?

11. A lady has hemophilia A, husband normal. She gave birth to female baby, what are the chances of her offsprings being carrier?

12. Mrs. Sadiya, 26 years old, presented with hyperemesis gravidarum. She has been admitted to hospital for Intravenous hydration with antiemetics. Her Liver function tests show as slightly increased bilirubin, with elevated liver enzymes. She has no jaundice. What is the Incidence of raised LFTs in women with Hyperemesis Gravidarum ?

13. Uterine artery Doppler can predict hypertensive disorders in the first and second trimester. What is the false positivity rate?

14. What is the risk of passing TS to the children in women with Turner;s syndrome,whose karyotype is 45XO?

15. Non smokers have a carboxyhemoglobin level of 1%.In heavy smokers this level may rise upto

16. All are true regarding abdominal ectopic pregnancy except

17. Mrs. Lovely, 40 years old, is in her first pregnancy. Now she is 12 weeks pregnant. She was recently diagnosed as HIV positive; she is not on any medications as her Downs syndrome risk is high 1 in 100. She is advised to get invasive prenatal tests. What is the risk of transmission of HIV to baby?

18. Third stage active management of labour reduces postpartum Haemorrhage by

19. Atrial & ventricular ectopic beats are more frequently seen in pregnant women.How many pregnant women exhibit this on continuous ECG recordings?

20. Prevalence of ectopic pregnancy in women undergoing ART treatment is

21. The percentage of Pre-term births associated with PPROM is

22. The recurrence rate of breech after one breech presentation is

23. 36 years old G3P2 with three previous CS has now presented with bleeding P/V, and on ultrasound was found to have placenta previa. The ultrasound image is given below

24. You receive a call from GP as a pregnant woman came to him at 26 weeks with reports showing CMV specific IgM positive; CMV specific IgG negative. He knows that CMV causes congenital abnormalities, hence he wants to know the risk of vertical transmission of the fetus?

25. You see a nulliparous woman in infertility clinic . She returned with a ultrasound showing intramural fibroid in uterus measuring 6 X 4.5 cm . What is the incidence of subfertility in women with fibroid

26. Rachel, 38 weeks pregnancy has been induced because of Diabetes mellitus . Because of pathological CTG, forceps was applied , Delivered baby’s head but shoulders not delivered with routine axial traction. With flexion and abduction of the rachel hips, positioning thighs on her abdomen. Shoulders got released . What is the success rate of this manoeuvre

27. Risk of spontaneous re-version after successful ECV at 36 wks in a Primigravida

28. Mrs. Sabina ,26 year old is into her 10th week of pregnancy.this is her 4th pregnancy .
Last 2 deliveries were complicated by abruption .she had to undergo Emrgency cesarean section for same reason.
Now she is asking about chances of recurrence in this pregnancy as well

29. The FY1 who is incharge of the labour ward called you to review a patient who gave birth a few days earlier seems confused and delusional. They worried that she may have postpartum psychosis.
Upon reviewing the patients notes and you came aware that patient does not risk factors for postpartum psychosis. What percentage of patients who develop postpartum psychosis will have no history to class them at high risk?

30. A 29-year-old Egyptian G1P0 woman who is 14 weeks pregnant has screened positive to HIV infection. During counselling, you felt it was important to explain the declining rate of mother-to-child transmission (MTCT) because of interventions. What is the current rate of MTCT of HIV infection?

31. A 29-year-old Egyptian G1P0 woman who is 14 weeks pregnant has screened positive to HIV infection. During counselling, you felt it was important to explain the rate of mother-to-child transmission (MTCT) without any interventions. What is the current rate of MTCT of HIV infection?

32. Mrs. X , 28-year-old woman, who is 37 weeks pregnant, is seen in antenatal clinic. This is her second pregnancy. She is HIV positive + HBsAg and HBeAg positive. She has been fully compliant with her HAART (highly active antiretroviral therapy) throughout her pregnancy. Her latest serum viral load is <50 copies/mL. Her pregnancy has been uncomplicated. She is not concerned about vertical transmission of HIV but keen to know what is the risk of vertical transmission of hepatitis B to neonate if the baby does not receive and vaccine or immunoglobin?

33. Mrs.. Tina at 9 weeks gestation has been diagnosed with missed miscarriage she is here for Manual vaccum aspiration as outpatient procedure . While consenting she asks you what’s the possibility of her requiring additional treatment ?

34. Mrs.Babitha , A 45-year-old women gravid 1 para 0 is referred to antenatal clinic for booking. She misses her dating scan. She is now 16 weeks’ pregnant and her booking bloods reveal normal haematological and biochemical tests. However, she is offered quadruple test .what os the detection rate and false positive rate of this test ?

35. Julie , 26 year old has been treated for Cesarean scar pregnancy in her pregnancy has been treated by current age with uterine artery embolisation .
At the time of discharge she is asking about possibility of Cesarean scar pregnancy recurring again .

36. A primigravida at 35 weeks gestation develops primary genital herpes . She is being referred by the midwife to discuss the mode of delivery The consultant advises elective caesarean section to reduce the risk of neonatal transmission of herpes simplex virus (HSV) at birth. She wants to know the risk of transmission of neonatal HSV at birth?

37. A woman has come to infertility clinic who is planned for IVF treatment. But she is scared of injections and also got to know that some friend of her sister got the injections and because of the injections she got some pain abdomen and breathing difficulty, something called OHSS and was hospitalised . She wants to know the chance of her developing severe OHSS requiring hospitalisation?

38. During a woman’s fertile period, the pregnancy risk following a single episode of unprotected sexual intercourse (UPSI) has been estimated to be up to:

39. A 20-year-old girl presents with recurrent abdominal pain and primary amenorrhea. On examination, both breast development and pubic hair distribution are noted to be Tanner Stage V. An abdominal mass is detected on palpation. Speculum examination showing a pinkish colour at the end of the speculum, you suspect that she is having transverse vaginal septum of lower third of vagina, what would be her chances of successful spontaneous conception in the future?

40. A 45 year old women has a positive family history of breast cancer and ovarian cancer in her mother and her sisters. She has been recently diagnosed with BRCA-1 positive. What would you counsel her regarding risk reduction surgery

41. You have been asked by your consultant to write a patient information lea et on caesarean section. You decide to include information on serious and frequently occurring risks.
What is the incidence of ureteric injury at the time of caesarean section?

42. What is the most appropriate advice for the woman regarding recommencing her subcutaneous insulin?

43. Mrs. X is 30 years old at 36 weeks pregnancy in her third pregnancy. Her first pregnancy was low risk normal delivery with midwife, second pregnancy was emergency cesarean section for fetal distress. Now opted for VBAC, what is the success rate VBAC for her ?

44. Ms.X, 17 years old girl underwent surgical evacuation of molar pregnancy at 8 weeks . Karyotyoe is 46XX.Her Risk of needing chemotherapy is

45. Miss Sarah is a P0+3 who had 3 early pregnancy loss as part of her routine recurrent miscarriage investigation she was diagnosed to have Antiphospholipid syndrome. What percentage of women with recurrent miscarriage have antiphospholipid antibodies?

46. Mrs. X, 28 years old woman who is 36 weeks pregnant in her second pregnancy comes to the labour ward because of upper abdominal pain and slight vaginal bleeding. Her first pregnancy ended in Caesarean section because of placental abruption. She has a normal blood pressure (BP) and a reactive non-stress test. What are her chances of having another placental abruption?

47. A 30-year-old woman attends at 12 weeks for a nuchal translucency measurement as part screening for aneuploidy. What approximate detection rate for trisomy 21 using nuchal translucency alone will you quote to this woman?

48. You are asked to see a 21-year-old para 1 in the early pregnancy assessment unit. She is 9 weeks into her second pregnancy and presents with cramping abdominal pain and vaginal bleeding. Pelvic ultrasound scan shows a picture of incomplete miscarriage. She opts for surgical management of the miscarriage, and you ask for her consentfor surgical evacuation.
What is the risk of uterine perforation at the time of surgical evacuation?

49. A prospective study was conducted to assess the relationship between extreme exercising and premature delivery. Results showed a Relative risk of 4. What is the risk attributable to extreme exercising?

50. A new cancer bio marker is tested against a gold standard for its diagnostic accuracy. Following are the details.

What happens to NPV if cut off value is changed from B to A?