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FCPS Part 1 Obstetrics and Gynae MCQs
Obstetrics and gynaecology questions in Part 1 test the basic science behind pregnancy, the menstrual cycle, placental physiology, fetal development and prenatal testing.
Below are 5 free single-best-answer questions drawn from the most frequently examined obstetrics and gynae concepts, each with the answer and a rationale for every option. The full bank has 59 obstetrics and gynae concepts, each asked several different ways.
Free obstetrics and gynae questions
Question 1
Agalactia and amenorrhoea after a delivery complicated by massive haemorrhage point to:
- A. Conn syndrome
- B. Kallmann syndrome
- C. Nelson syndrome
- D. Sheehan syndrome
- E. Addison disease
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Answer: D. Sheehan syndrome
Pregnancy enlarges the lactotroph mass without increasing its blood supply, so severe hypotension from haemorrhage causes infarction. Failure of lactation is usually the first sign, followed by other axes.
Why not the others: Addison disease: primary adrenal failure with pigmentation. Conn syndrome: aldosterone excess, hypertension. Nelson syndrome: pituitary tumour after adrenalectomy. Kallmann syndrome: anosmia with hypogonadism.
High-yield: Major postpartum haemorrhage + agalactia = Sheehan syndrome.
Question 2
Sudden collapse, hypoxia and DIC during labour:
- A. Acute myocardial infarction
- B. Amniotic fluid embolism
- C. Eclampsia
- D. Pulmonary embolism
- E. Placental abruption
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Answer: B. Amniotic fluid embolism
Fetal material entering the maternal circulation triggers an anaphylactoid reaction: pulmonary vasospasm, right-heart failure, hypoxia, then consumptive coagulopathy.
Why not the others: PE: no early DIC and usually postpartum days. Oxytocin: transient hypotension, no hypoxia or DIC. High spinal: bradycardia and weakness, no coagulopathy. Abruption: before delivery.
High-yield: Collapse + hypoxia + DIC around delivery = amniotic fluid embolism.
Question 3
Best non-invasive initial imaging for fetal structural anomalies is:
- A. Amniocentesis
- B. Mammography
- C. Chorionic villus sampling
- D. MRI
- E. Ultrasound
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Answer: E. Ultrasound
Ultrasound visualises the fetus directly and is safe, non-invasive and first-line for structural anomalies, including open neural tube defects. Maternal serum AFP and amniotic acetylcholinesterase support the diagnosis.
Why not the others: Mammography: poor in dense young breasts. MRI and CT: not first-line. Amniocentesis: invasive, used for karyotype. Chorionic villus sampling: invasive, karyotype.
High-yield: See the defect: ultrasound; screen the blood: maternal serum AFP.
Question 4
Twelve weeks pregnant with loin pain, rigors and high fever; most likely diagnosis?
- A. Chronic pyelonephritis
- B. Nephrotic syndrome
- C. Acute cystitis
- D. Acute pyelonephritis
- E. Appendicitis
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Answer: D. Acute pyelonephritis
Ascending infection, usually E. coli, reaches the renal parenchyma, helped in pregnancy by progesterone-induced ureteric dilatation. White cell casts form only in tubules, so they localise infection to the kidney.
Why not the others: Acute cystitis: no fever or loin pain. Chronic pyelonephritis: scarring over years. Appendicitis: not urinary. Nephrotic syndrome: heavy proteinuria and oedema.
High-yield: Fever + rigors + loin pain (or white cell casts) = pyelonephritis, not cystitis.
Question 5
Earliest invasive test giving definitive prenatal diagnosis, using placental tissue at 10-12 weeks:
- A. Nuchal translucency scan
- B. Amniocentesis
- C. Chorionic villus sampling
- D. Cordocentesis
- E. Maternal serum AFP
Show answer
Answer: C. Chorionic villus sampling
Chorionic villus sampling takes placental villi at 10-12 weeks, giving plentiful fetal DNA for first-trimester diagnosis. Amniocentesis is not done until 16-20 weeks.
Why not the others: Amniocentesis: 16-20 weeks, too late for a first-trimester diagnosis. Cordocentesis: fetal blood, later in pregnancy. Maternal serum AFP: a screening test. Nuchal translucency scan: screening. Maternal serum beta-hCG: screening.
High-yield: CVS 10-12 weeks; amniocentesis 16-20 weeks.
Keep going with obstetrics and gynae
Anaesgen brings every concept back on a spaced-repetition schedule timed to your exam date, as a different question each time, with full mock papers for Paper 1 and 2.
Get full access Try the 5 sample questionsHigh-yield obstetrics and gynae one-liners
The most-tested obstetrics and gynae concepts, as a clue and the answer it points to:
- Postpartum haemorrhage, no lactation, amenorrhoea, hypopituitarism → Sheehan syndrome.
- Labour/delivery + collapse + hypoxia + DIC → amniotic fluid embolism.
- Fetal anomalies, neural tube defect, young breast lump → ultrasound.
- Pregnancy, loin pain, rigors, white cell casts → acute pyelonephritis.
- Placental villi, 10-12 weeks, thalassaemia → CVS.
- Cyclical pain, normal breasts, primary amenorrhoea, bulging blue introitus → imperforate hymen.
- Hypertension after 20 weeks + proteinuria or organ damage → pre-eclampsia.
- Primary PPH, soft boggy uterus, long labour → uterine atony.
- Commonest ectopic site, widest tubal segment, fertilisation site → ampulla.
- Baseline below 110, late decelerations, absent variability → fetal hypoxia.
- Pregnancy, Hb 12 → 10.5, normal indices → physiological haemodilution.
- Cervix to sacrum, apical support, procidentia → uterosacral ligament.
- Mediolateral episiotomy at crowning, away from sphincter → 60° from midline.
- Heavy periods, dysmenorrhoea, uniform tender enlarged uterus → adenomyosis.
- Rh-negative mother, Rh-positive baby or sensitising event → anti-D immunoglobulin.
- Pregnant woman collapses → call for help, then ABC with manual uterine displacement.
- Diabetes with vascular disease, hypertension, oestrogen risk → avoid combined pill.
- Term pregnancy, raised diaphragm, rapid desaturation → FRC down about 20%.
- Magnesium sulfate, toxicity, earliest sign → loss of deep tendon reflexes.
- Amenorrhoea, shock, empty uterus, free fluid, shoulder-tip pain → ruptured ectopic.
Other FCPS Part 1 subjects
AnatomyPharmacologyPathologyBiochemistry & GeneticsCardiovascularNeurophysiologyMicrobiologyHaematologyGeneral PhysiologyImmunologyEndocrineRespiratoryEmbryologyRenal & Acid-BaseHistologyGI & LiverPhysicsBiostatistics
New to the exam? Read the FCPS Part 1 exam guide: dates, format and a 12-week study plan.