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FMGE Obstetrics & Gynecology Syllabus

The Obstetrics & Gynecology syllabus for FMGE in full: 10 chapters, 35 topics and 126 sub-topics, every one listed below, plus 50 Obstetrics & Gynecology flashcards with answers.

10Chapters

35Topics

126Sub-topics

50Flashcards

Obstetrics & Gynecology syllabus: all 10 chapters

Expand any chapter to see its topics and sub-topics.

Anatomy and Physiology
2 topics
- Anatomy of the female reproductive system
  - External genitalia
  - Internal genitalia (uterus, fallopian tubes, ovaries)
  - Pelvic floor muscles
- Physiology of the menstrual cycle
  - Hormonal regulation (FSH, LH, estrogen, progesterone)
  - Follicular development
  - Ovulation
  - Endometrial changes
Normal Pregnancy
3 topics
- Antenatal care
  - Initial assessment
  - Risk assessment
  - Screening tests (ultrasound, biochemical markers)
  - Prenatal counseling
- Physiological changes in pregnancy
  - Cardiovascular changes
  - Respiratory changes
  - Gastrointestinal changes
  - Renal changes
  - Endocrine changes
- Fetal development and monitoring
  - Fetal growth and development
  - Fetal movements
  - Fetal heart rate monitoring (cardiotocography, Doppler ultrasound)
Obstetric Disorders
4 topics
- Hypertensive disorders of pregnancy
  - Gestational hypertension
  - Preeclampsia
  - Eclampsia
  - HELLP syndrome
- Gestational diabetes mellitus
  - Diagnosis
  - Monitoring
  - Management (dietary modification, insulin therapy)
- Preterm labor
  - Risk factors
  - Diagnosis
  - Prevention (progesterone supplementation)
  - Management (tocolysis, antenatal corticosteroids)
- Multiple pregnancy
  - Diagnosis
  - Complications (preterm birth, twin-to-twin transfusion syndrome)
  - Management
Labor and Delivery
4 topics
- Normal labor
  - Stages of labor (first stage, second stage, third stage)
  - Mechanisms of labor
  - Assessment of progress
- Intrapartum monitoring
  - Fetal heart rate monitoring (cardiotocography)
  - Assessment of fetal well-being
  - Partogram
- Management of labor
  - Induction of labor
  - Augmentation of labor
  - Pain relief methods (analgesia, anesthesia)
  - Instrumental delivery (forceps, vacuum extraction)
- Cesarean section
  - Indications
  - Preoperative preparation
  - Surgical techniques
  - Postoperative care
Postpartum Care
3 topics
- Physiological changes in the postpartum period
  - Uterine involution
  - Lochia
  - Breastfeeding
  - Maternal bonding
- Postpartum complications
  - Postpartum hemorrhage
  - Puerperal sepsis
  - Postpartum blues
  - Postpartum depression
- Contraception
  - Counseling on contraceptive methods (oral contraceptives, intrauterine devices, implants, sterilization)
  - Initiation of contraception in the postpartum period
Gynecological Disorders
4 topics
- Menstrual disorders
  - Dysmenorrhea
  - Menorrhagia
  - Oligomenorrhea
  - Amenorrhea
- Benign gynecological conditions
  - Fibroids (leiomyomas)
  - Ovarian cysts
  - Endometriosis
  - Pelvic inflammatory disease (PID)
- Gynecological cancers
  - Cervical cancer
  - Endometrial cancer
  - Ovarian cancer
  - Vulvar cancer
- Reproductive endocrinology
  - Polycystic ovary syndrome (PCOS)
  - Premature ovarian insufficiency (POI)
  - Hyperprolactinemia
Reproductive Endocrinology and Infertility
4 topics
- Evaluation of Infertility
  - History taking
  - Physical examination
  - Investigations (hormonal assays, imaging studies)
  - Male factor evaluation
- Assisted Reproductive Technologies (ART)
  - Intrauterine insemination (IUI)
  - In vitro fertilization (IVF)
  - Intracytoplasmic sperm injection (ICSI)
  - Gamete donation
- Endocrine Disorders Causing Infertility
  - Hypothalamic-pituitary dysfunction
  - Thyroid disorders
  - Hyperprolactinemia
- Ovulation Induction
  - Clomiphene citrate
  - Gonadotropins
  - Aromatase inhibitors for ovulation induction in women with anovulatory infertility
Urogynecology and Pelvic Floor Disorders
3 topics
- Urinary incontinence
  - Stress urinary incontinence
  - Urge urinary incontinence
  - Mixed urinary incontinence
  - Overflow incontinence
- Pelvic organ prolapse
  - Anterior compartment prolapse (cystocele)
  - Posterior compartment prolapse (rectocele)
  - Uterine prolapse
- Pelvic floor dysfunction
  - Pelvic floor muscle exercises (Kegel exercises)
  - Biofeedback therapy
  - Surgical management of pelvic organ prolapse
Sexual and Reproductive Health
4 topics
- Sexual health and contraception
  - Sexual history taking
  - Counseling on sexual health
  - Contraceptive counseling
- Sexually transmitted infections (STIs)
  - Chlamydia
  - Gonorrhea
  - Syphilis
  - Genital herpes
  - Human papillomavirus (HPV)
  - HIV/AIDS
- Menopause
  - Symptoms of menopause
  - Hormone replacement therapy (HRT)
  - Management of menopausal symptoms (hot flashes, vaginal dryness)
- Sexual dysfunction
  - Female sexual dysfunction (hypoactive sexual desire disorder, dyspareunia, vaginismus)
  - Male sexual dysfunction (erectile dysfunction, premature ejaculation)
Gynecological Oncology
4 topics
- Cervical cancer
  - Screening (Pap smear, HPV testing)
  - Diagnosis
  - Staging
  - Management
- Endometrial cancer
  - Clinical features
  - Diagnosis (endometrial biopsy)
  - Staging
  - Management
- Ovarian cancer
  - Clinical features
  - Diagnosis (CA-125, imaging studies)
  - Staging
  - Management
- Gestational trophoblastic disease
  - Hydatidiform mole
  - Invasive mole
  - Choriocarcinoma
  - Placental site trophoblastic tumor

FMGE Obstetrics & Gynecology flashcards — 50 questions with answers

What are the four parts of the fallopian tube from the uterus outward, and which is the usual site of fertilization?
Interstitial (intramural), isthmus, ampulla, and infundibulum (with fimbriae). The ampulla is the widest part and the usual site of fertilization (also the commonest site of ectopic pregnancy).
Name the three muscle layers of the myometrium and the four ligaments that support the uterus.
Layers: outer longitudinal, middle oblique (interlacing, the 'living ligature' that controls bleeding), inner circular. Supports: uterosacral, transverse cervical (cardinal/Mackenrodt), pubocervical, and round ligaments (broad ligament is a peritoneal fold, not a true support).
What is the arterial blood supply of the uterus and how does the ureter relate to the uterine artery?
The uterine artery (a branch of the anterior division of the internal iliac) supplies the uterus; the ureter passes BELOW the uterine artery about 1.5 cm lateral to the cervix ('water under the bridge'), a key landmark in hysterectomy.
Describe the hormonal and ovarian/endometrial events of the four phases of the menstrual cycle.
Follicular (proliferative): rising FSH→follicle growth, estrogen rises→endometrial proliferation. Ovulation: LH surge (~day 14) triggered by estrogen positive feedback. Luteal (secretory): corpus luteum secretes progesterone→secretory endometrium. Menstruation: corpus luteum regresses, progesterone/estrogen fall→shedding.
What triggers ovulation and how long does the corpus luteum survive without pregnancy?
The LH surge (driven by sustained high estrogen via positive feedback) triggers ovulation ~34–36 h after surge onset. The corpus luteum survives ~12–14 days then regresses unless rescued by hCG from a pregnancy.
Define Naegele's rule for estimating the expected date of delivery (EDD).
EDD = first day of last menstrual period + 1 year − 3 months + 7 days (i.e., add 9 months and 7 days). Assumes a regular 28-day cycle; pregnancy lasts ~280 days/40 weeks from LMP.
What is the recommended antenatal visit schedule and the key first-trimester screening tests in antenatal care?
Classic schedule: monthly to 28 wks, fortnightly 28–36 wks, weekly after 36 wks. Booking bloods: Hb, blood group & Rh, HIV, HBsAg, VDRL/syphilis, rubella, urine, blood sugar; first-trimester ultrasound for dating; combined screen (NT + PAPP-A + free β-hCG) at 11–13+6 wks.
What folic acid dose is recommended periconceptionally and for high-risk women to prevent neural tube defects?
400 µg (0.4 mg) daily for low-risk women, started before conception through the first trimester; 4–5 mg daily for high-risk women (previous NTD, diabetes, on antiepileptics).
List the major cardiovascular and hematological physiological changes in pregnancy.
Plasma volume rises ~40–50% and RBC mass ~20–30% → physiological (dilutional) anemia; cardiac output rises ~30–50% (increased HR and stroke volume); systemic vascular resistance and BP fall in mid-pregnancy; hypercoagulable state (increased fibrinogen and clotting factors).
What respiratory and renal changes occur in normal pregnancy?
Respiratory: tidal volume and minute ventilation rise (progesterone-driven) causing a compensated respiratory alkalosis; functional residual capacity falls. Renal: GFR and renal plasma flow rise ~50% → lower serum creatinine/urea; mild glycosuria and increased frequency.
By what gestational ages is fetal cardiac activity first seen on ultrasound and quickening typically felt?
Cardiac activity on transvaginal ultrasound by ~6 weeks (visible when crown-rump length ≥7 mm). Quickening (maternal perception of movements) ~18–20 weeks in primigravida, ~16–18 weeks in multigravida.
Describe the four components of the biophysical profile (BPP) plus the fifth, and the normal score.
Ultrasound assesses: fetal breathing movements, gross body movements, fetal tone, and amniotic fluid volume; plus the non-stress test (NST). Each scores 0 or 2; total 8–10 is reassuring, 6 equivocal, ≤4 abnormal.
Define preeclampsia and list the criteria for severe features.
Preeclampsia = new-onset hypertension (≥140/90 on two occasions) after 20 weeks with proteinuria (≥300 mg/24h or protein/creatinine ≥0.3) OR end-organ dysfunction. Severe features: BP ≥160/110, platelets <100,000, creatinine >1.1, raised transaminases, pulmonary edema, headache/visual symptoms.
What is the first-line anticonvulsant for eclampsia and the antidote for its toxicity?
Magnesium sulfate is first-line for seizure prophylaxis and treatment of eclampsia. Calcium gluconate is the antidote for magnesium toxicity (signs: loss of deep tendon reflexes, respiratory depression, oliguria).
What defines HELLP syndrome?
Hemolysis (low haptoglobin, raised LDH, schistocytes), Elevated Liver enzymes, and Low Platelets — a severe variant/complication of preeclampsia; definitive treatment is delivery.
How is gestational diabetes mellitus (GDM) screened and diagnosed using the 75 g OGTT?
Universal/risk-based screening at 24–28 weeks. 75 g 2-hour OGTT (IADPSG/WHO) diagnostic if any value met: fasting ≥92 mg/dL, 1-hour ≥180 mg/dL, or 2-hour ≥153 mg/dL. (DIPSI uses 75 g non-fasting 2-h ≥140 mg/dL in India.)
What are the main maternal and fetal complications of poorly controlled GDM?
Fetal: macrosomia, shoulder dystocia, neonatal hypoglycemia, hyperbilirubinemia, polyhydramnios, congenital anomalies (if pregestational). Maternal: preeclampsia, increased cesarean rate, and future risk of type 2 diabetes.
Define preterm labor and name the antenatal interventions for fetal lung maturity and neuroprotection.
Preterm labor = regular contractions with cervical change before 37 completed weeks. Antenatal corticosteroids (betamethasone/dexamethasone) between 24–34 weeks for fetal lung maturity; magnesium sulfate <32 weeks for fetal neuroprotection; tocolytics to delay delivery 48 h.
How are twin pregnancies classified by chorionicity and which type carries the highest risk?
Dichorionic-diamniotic (DCDA), monochorionic-diamniotic (MCDA), and monochorionic-monoamniotic (MCMA). Monochorionic twins risk twin-to-twin transfusion syndrome; MCMA carries the highest risk (cord entanglement). Chorionicity is best determined by first-trimester ultrasound (lambda/twin-peak sign = DCDA, T-sign = MCDA).
List the cardinal movements of labor in order.
Engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and expulsion.

Show the other 30 Obstetrics & Gynecology flashcards

What are the three stages of labor and their definitions?
First stage: onset of true labor to full cervical dilatation (10 cm) — latent (0–6 cm) and active phases. Second stage: full dilatation to delivery of the baby. Third stage: delivery of the baby to delivery of the placenta.
In intrapartum cardiotocography, what defines a normal/reassuring fetal heart rate trace?
Baseline 110–160 bpm, moderate variability (6–25 bpm), presence of accelerations, and absence of decelerations (or only early decelerations). This is a Category I trace.
Differentiate early, variable, and late decelerations on CTG by mechanism.
Early decelerations: mirror contractions, caused by head compression (benign). Variable decelerations: abrupt, variable timing/shape, caused by cord compression. Late decelerations: nadir after the contraction peak, caused by uteroplacental insufficiency (ominous, indicate fetal hypoxia).
What are the four components of active management of the third stage of labor (AMTSL)?
Administration of a uterotonic (oxytocin 10 IU IM, within 1 min of delivery), controlled cord traction (Brandt-Andrews), and uterine massage after placental delivery; delayed cord clamping is also recommended. AMTSL reduces postpartum hemorrhage.
List the absolute indications for cesarean section.
Central placenta previa, transverse lie/persistent non-cephalic malpresentation, cephalopelvic disproportion, two or more previous cesareans/classical scar, cord prolapse with non-imminent delivery, active genital herpes, and certain fetal conditions — situations where vaginal delivery is unsafe or impossible.
Compare a lower-segment (LSCS) versus classical cesarean incision.
LSCS: transverse incision in the lower uterine segment — less bleeding, stronger scar, lower rupture risk, allows future VBAC; standard choice. Classical: vertical incision in the upper segment — more bleeding and higher rupture risk; reserved for very preterm/transverse lie, anterior placenta previa, or dense adhesions.
Describe the key physiological changes of the postpartum period (puerperium).
Puerperium lasts ~6 weeks. Uterus involutes (returns to pelvis by 2 weeks, normal size by 6 weeks); lochia progresses rubra→serosa→alba; lactation established (prolactin + oxytocin let-down); diuresis clears excess fluid; menstruation returns ~6–8 weeks if not breastfeeding.
Define primary postpartum hemorrhage and recall the 'four Ts' of its causes.
Primary PPH = blood loss ≥500 mL (vaginal) or ≥1000 mL (cesarean) within 24 h of delivery. Causes — Tone (uterine atony, commonest ~70%), Trauma (lacerations/rupture), Tissue (retained placenta), Thrombin (coagulopathy).
What is the stepwise uterotonic management of atonic PPH?
Uterine massage + oxytocin (first-line), then ergometrine (avoid in hypertension), carboprost/PGF2α (avoid in asthma), and misoprostol. If medical measures fail: balloon tamponade, B-Lynch suture, uterine artery/internal iliac ligation, and finally hysterectomy.
Compare the typical-use failure rates and mechanisms of combined oral contraceptive pills versus copper IUD versus etonogestrel implant.
COCP: inhibits ovulation (estrogen+progestin); typical failure ~7%. Copper IUD: spermicidal/inflammatory, prevents fertilization; failure <1%, lasts 10 yrs. Etonogestrel implant: inhibits ovulation + thickens cervical mucus; failure <0.1% (most effective reversible method), lasts 3 yrs.
What are the WHO Medical Eligibility Category 4 (absolute) contraindications to combined hormonal contraceptives?
Examples: <6 weeks postpartum and breastfeeding, smoking ≥15/day at age ≥35, history of VTE/DVT/PE, known thrombogenic mutations, history of stroke or ischemic heart disease, migraine with aura, current breast cancer, severe hypertension, and active liver disease.
Define the PALM-COEIN classification of abnormal uterine bleeding.
Structural causes (PALM): Polyp, Adenomyosis, Leiomyoma, Malignancy/hyperplasia. Non-structural (COEIN): Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, Not otherwise classified.
Define primary versus secondary amenorrhea.
Primary amenorrhea: no menses by age 15 with normal secondary sexual characteristics, or by 13 with none. Secondary amenorrhea: absence of menses for ≥3 cycles or ≥6 months in a previously menstruating woman (commonest cause: pregnancy).
Differentiate fibroids (leiomyoma), adenomyosis, and endometriosis.
Fibroid: benign smooth-muscle tumor of myometrium (estrogen-dependent), causes menorrhagia/bulk symptoms. Adenomyosis: endometrial glands within the myometrium → enlarged tender 'globular' uterus, dysmenorrhea. Endometriosis: endometrial tissue outside the uterus (ovary/peritoneum) → dysmenorrhea, dyspareunia, infertility; chocolate cysts on ovary.
How do the common gynecological cancers classically present and what is the principal risk reduction strategy for each?
Cervical: postcoital bleeding (HPV-linked; prevent with HPV vaccine + Pap screening). Endometrial: postmenopausal bleeding (unopposed estrogen). Ovarian: vague abdominal symptoms, late presentation (CA-125). Vulvar: pruritus/lump. Choriocarcinoma: bleeding with very high β-hCG.
Outline the hypothalamic-pituitary-ovarian axis and the 'two-cell, two-gonadotropin' theory of estrogen synthesis.
Hypothalamus releases GnRH (pulsatile) → pituitary releases FSH and LH → ovary produces estrogen/progesterone with negative/positive feedback. Two-cell theory: LH stimulates theca cells to make androgens from cholesterol; FSH stimulates granulosa cells (aromatase) to convert androgens to estrogen.
What is the recommended order of basic infertility evaluation in a couple?
Semen analysis (male factor), assessment of ovulation (mid-luteal day-21 progesterone, cycle history), and tubal patency (hysterosalpingography or laparoscopy with dye/chromopertubation). Also assess ovarian reserve (AMH, antral follicle count) and rule out anatomical/uterine factors.
Define the WHO lower reference limits for a normal semen analysis (key parameters).
Volume ≥1.5 mL, sperm concentration ≥15 million/mL, total count ≥39 million/ejaculate, total motility ≥40% (progressive ≥32%), and normal morphology ≥4% (strict criteria).
Differentiate IVF from ICSI and name the most serious complication of ovarian stimulation in ART.
IVF (in-vitro fertilization): eggs and sperm combined in a dish, fertilization occurs spontaneously. ICSI: a single sperm is injected directly into the oocyte (used for severe male-factor infertility). Most serious complication: ovarian hyperstimulation syndrome (OHSS) — capillary leak, ascites, hemoconcentration, thromboembolism risk.
State the Rotterdam criteria for diagnosing polycystic ovary syndrome (PCOS).
Two of three required (after excluding mimics): (1) oligo/anovulation, (2) clinical or biochemical hyperandrogenism (hirsutism, raised free testosterone), (3) polycystic ovaries on ultrasound (≥12 follicles 2–9 mm and/or ovarian volume >10 mL).
What is the first-line agent for ovulation induction in PCOS and its mechanism, plus the second-line oral option?
Letrozole (an aromatase inhibitor that lowers estrogen, increasing FSH) is now first-line. Clomiphene citrate (a selective estrogen receptor modulator blocking hypothalamic estrogen feedback → increased FSH/LH) is the classic alternative. Metformin helps insulin resistance; gonadotropins are used if oral agents fail.
Classify urinary incontinence into stress, urge, and overflow types with their causes.
Stress incontinence: leakage with cough/exertion due to urethral sphincter/pelvic floor weakness (raised intra-abdominal pressure). Urge incontinence: detrusor overactivity → sudden urgency. Overflow incontinence: chronic retention/bladder outlet obstruction. Diagnosis aided by urodynamics.
What is the first-line treatment for stress incontinence versus urge (overactive bladder) incontinence?
Stress: pelvic floor muscle (Kegel) exercises first-line; surgery (mid-urethral sling/colposuspension) if refractory. Urge/OAB: bladder training and lifestyle, then antimuscarinics (oxybutynin, solifenacin) or beta-3 agonist (mirabegron).
Describe the POP-Q staging concept for pelvic organ prolapse and name the prolapse types by compartment.
POP-Q measures descent relative to the hymen (Stage 0 no prolapse to Stage IV complete eversion). Types: cystocele (anterior/bladder), rectocele (posterior/rectum), enterocele (small bowel), uterine prolapse, and vaginal vault prolapse (post-hysterectomy). Conservative: pessary/pelvic floor exercises; surgical repair if symptomatic.
Match the common sexually transmitted infections to their causative organisms.
Gonorrhea — Neisseria gonorrhoeae; Chlamydia — Chlamydia trachomatis; Syphilis — Treponema pallidum (painless chancre); Chancroid — Haemophilus ducreyi (painful ulcer); Genital herpes — HSV-2; Trichomoniasis — Trichomonas vaginalis (strawberry cervix); Genital warts/cervical cancer — HPV.
Differentiate the three common causes of vaginitis by discharge and diagnostic finding.
Bacterial vaginosis: thin grey fishy discharge, clue cells, positive whiff test, pH >4.5 (Gardnerella). Candidiasis: thick white 'cottage cheese' discharge, pseudohyphae, normal pH, itching. Trichomoniasis: frothy yellow-green discharge, motile trophozoites, strawberry cervix, pH >4.5.
Define menopause and list the typical hormonal changes and vasomotor/genitourinary symptoms.
Menopause = permanent cessation of menses, diagnosed retrospectively after 12 months of amenorrhea (average age ~51). Hormones: high FSH and LH, low estradiol. Symptoms: hot flushes/night sweats (vasomotor), vaginal atrophy/dryness, dyspareunia, mood changes, and long-term osteoporosis and cardiovascular risk.
What organism causes nearly all cervical cancers, and which HPV types and histologic type predominate?
Human papillomavirus (HPV), especially high-risk types 16 and 18 (cause ~70% of cases). The commonest histologic type is squamous cell carcinoma (arising at the transformation zone); prevention is HPV vaccination plus Pap/HPV screening.
Identify the key risk factors and classic presentation of endometrial carcinoma.
Risk factors are states of unopposed estrogen: obesity, nulliparity, late menopause, early menarche, PCOS, tamoxifen, and Lynch syndrome. Classic presentation: postmenopausal bleeding. Commonest type: endometrioid adenocarcinoma; diagnosis by endometrial biopsy.
What tumor marker and inheritance pattern are linked to epithelial ovarian cancer, and what defines gestational trophoblastic disease including a key follow-up rule?
Epithelial ovarian cancer: marker CA-125; familial cases linked to BRCA1/BRCA2 mutations; presents late ('silent killer'). Gestational trophoblastic disease: abnormal trophoblast proliferation (hydatidiform mole — 'snowstorm' on USG with markedly elevated β-hCG; choriocarcinoma). After molar evacuation, monitor serial β-hCG to detect persistent/malignant disease and avoid pregnancy during follow-up.

Same Obstetrics & Gynecology syllabus in other exams

The Obstetrics & Gynecology outline above is identical in these 3 exams:

FMGE Obstetrics & Gynecology FAQ

What is in the FMGE Obstetrics & Gynecology syllabus?

FMGE Obstetrics & Gynecology is split into 10 chapters: Anatomy and Physiology, Normal Pregnancy, Obstetric Disorders, Labor and Delivery, Postpartum Care, Gynecological Disorders, Reproductive Endocrinology and Infertility, Urogynecology and Pelvic Floor Disorders, Sexual and Reproductive Health and Gynecological Oncology. Together they contain 35 topics and 126 sub-topics.

How many chapters are in FMGE Obstetrics & Gynecology?

10 chapters, containing 35 topics and 126 sub-topics. The largest chapter is Obstetric Disorders, with 4 topics.

Are there flashcards for FMGE Obstetrics & Gynecology?

Yes — a 50-card Obstetrics & Gynecology deck, printed in full in the flashcards section of this page and available in the Examius app with spaced repetition. The free plan covers one exam of your choice, including its flashcards; Examius Pro, a one-time purchase, unlocks every other exam and deck.