Facharzt FMH Gynäkologie und Geburtshilfe Practice Questions - Facharzt FMH für Gynäkologie und Geburtshilfe Spécialiste FMH en gynécologie et obstétrique Exam - Facharzt FMH Gynäkologie und Geburtshilfe Practice Questions - Facharzt FMH für Gynäkologie und Geburtshilfe Spécialiste FMH en gynécologie et obstétrique Exam

Question 1

A 29-year-old primigravida at 34+2 weeks of gestation presents to the labor ward with a severe throbbing frontal headache, visual scotoma, and epigastric discomfort. Her blood pressure is 168/112 mmHg on two measurements taken 15 minutes apart. Urinalysis shows 3+ proteinuria (protein-to-creatinine ratio 0.8 mg/mg). Laboratory analysis reveals platelet count 145,000/µL, serum creatinine 75 µmol/L, AST 38 U/L, and LDH 210 U/L. Fetal cardiotocography (CTG) is reassuring with a normal baseline of 135 bpm. In accordance with SGGG and international guidelines, what is the most urgent and appropriate initial pharmacotherapy regimen?

Intravenous magnesium sulfate loading dose (4–6 g over 20 minutes) plus intravenous labetalol (or oral rapid-acting nifedipine) for acute blood pressure lowering Immediate intravenous hydralazine bolus alone without magnesium sulfate, withholding seizure prophylaxis unless hyperreflexia is documented Oral diazepam 10 mg for seizure prophylaxis combined with oral furosemide 40 mg for diuresis Immediate urgent cesarean delivery under general anesthesia prior to initiating maternal blood pressure stabilization

Correct Answer:

Intravenous magnesium sulfate loading dose (4–6 g over 20 minutes) plus intravenous labetalol (or oral rapid-acting nifedipine) for acute blood pressure lowering

Question 2

A 32-year-old woman at 30+4 weeks of gestation in her first pregnancy is being monitored for early-onset fetal growth restriction (FGR). Fetal biometry shows an estimated fetal weight at the 2nd percentile. Umbilical artery (UA) Doppler ultrasound reveals absent end-diastolic flow (AEDF). Middle cerebral artery (MCA) Doppler demonstrates brain-sparing with a pulsatility index (PI) below the 5th percentile. Ductus venosus (DV) Doppler shows forward flow during atrial systole (positive a-wave). Computerized cardiotocography (cCTG) shows a short-term variability (STV) of 4.2 ms with no decelerations. According to ISUOG and TRUFFLE consensus guidelines, what is the most appropriate management plan?

Immediate emergency cesarean section within 2 hours without awaiting corticosteroid maturation Administer antenatal corticosteroids (betamethasone 12 mg IM, two doses 24 hours apart), hospitalize for daily cCTG and DV Doppler monitoring, aiming for delivery if DV a-wave becomes absent/reversed or cCTG STV drops <3.5 ms Outpatient weekly ultrasound surveillance with no indication for maternal corticosteroids since ductus venosus flow remains normal Immediate labor induction with vaginal misoprostol after administration of maternal intravenous hydration

Correct Answer:

Administer antenatal corticosteroids (betamethasone 12 mg IM, two doses 24 hours apart), hospitalize for daily cCTG and DV Doppler monitoring, aiming for delivery if DV a-wave becomes absent/reversed or cCTG STV drops <3.5 ms

Question 3

A 28-year-old woman with a monochorionic diamniotic (MCDA) twin pregnancy presents at 19+4 weeks for routine ultrasound. The inter-twin membrane is confirmed. Twin A exhibits a deepest vertical pocket (DVP) of amniotic fluid of 1.5 cm with a non-visualized collapsed bladder. Twin B exhibits a DVP of 9.2 cm with a significantly distended bladder. Umbilical artery Doppler in Twin A demonstrates persistent absent end-diastolic flow, while Twin B has normal Doppler waveforms. According to the Quintero staging system and SGGG/ISUOG guidelines, what stage is this condition and what is the primary gold standard intervention?

Quintero Stage I; managed expectantly with serial weekly ultrasound surveillance Quintero Stage II; treated primarily with serial aggressive amnioreduction of the recipient twin's sac Quintero Stage III; treated with fetoscopic laser photocoagulation of communicating placental anastomoses (Solomon technique) Quintero Stage IV; managed with selective feticide of Twin A via cord occlusion

Correct Answer:

Quintero Stage III; treated with fetoscopic laser photocoagulation of communicating placental anastomoses (Solomon technique)

Question 4

A 31-year-old P2G2 woman delivers a 4,100 g infant vaginally following a 10-hour labor augmented with oxytocin. Ten minutes after delivery of the placenta, brisk vaginal bleeding is noted, totaling approximately 800 mL within 5 minutes. On abdominal palpation, the uterine fundus is soft, boggy, and located 3 cm above the umbilicus. Continuous uterine massage is initiated. What is the most appropriate next pharmacotherapy step according to SGGG postpartum hemorrhage (PPH) guidelines?

Administer oral methylergometrine 0.2 mg and await response before giving parenteral agents Administer intramuscular carboprost tromethamine (15-methyl PGF2alpha) 250 µg as the sole first-line agent Administer intravenous recombinant factor VIIa immediately as first-line hemostatic therapy Administer intravenous oxytocin (bolus of 5–10 IU slowly or infusion of 20–40 IU in 500 mL saline) plus intravenous tranexamic acid 1 g within 3 hours of birth

Correct Answer:

Administer intravenous oxytocin (bolus of 5–10 IU slowly or infusion of 20–40 IU in 500 mL saline) plus intravenous tranexamic acid 1 g within 3 hours of birth

Question 5

A 26-year-old primigravida at 31+1 weeks of gestation presents with sudden painless pooling of clear fluid from the vagina. Sterile speculum examination confirms clear amniotic fluid pooling in the posterior fornix with positive IGFBP-1 / PAMG-1 rapid test. Maternal temperature is 36.8°C, maternal pulse 76 bpm, and fetal heart rate is 140 bpm with no uterine contractions. Laboratory markers (CRP and leukocyte count) are normal. What is the standard evidence-based management strategy for this patient with preterm premature rupture of membranes (PPROM)?

Immediate labor induction with vaginal dinoprostone to prevent intrauterine infection Hospital admission, administration of antenatal corticosteroids (betamethasone), latency antibiotic therapy (oral erythromycin or IV ampicillin followed by oral amoxicillin), and expectant management with maternal/fetal surveillance until 34–37 weeks Immediate placement of an emergency rescue cervical cerclage to prevent further amniotic leakage Continuous tocolytic therapy with intravenous atosiban for 14 consecutive days until reaching 34 weeks of gestation

Correct Answer:

Hospital admission, administration of antenatal corticosteroids (betamethasone), latency antibiotic therapy (oral erythromycin or IV ampicillin followed by oral amoxicillin), and expectant management with maternal/fetal surveillance until 34–37 weeks

Question 1

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Prepare with the Facharzt FMH Gynäkologie und Geburtshilfe Practice Questions - Facharzt FMH für Gynäkologie und Geburtshilfe Spécialiste FMH en gynécologie et obstétrique Exam practice quiz. This question bank includes 100 questions covering year-old, woman, weeks, presents, and fetal. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Facharzt FMH Gynäkologie und Geburtshilfe Practice Questions - Facharzt FMH für Gynäkologie und Geburtshilfe Spécialiste FMH en gynécologie et obstétrique Exam

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Facharzt FMH Gynäkologie und Geburtshilfe Practice Questions - Facharzt FMH für Gynäkologie und Geburtshilfe Spécialiste FMH en gynécologie et obstétrique Exam

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