PMDC National Licensing Examination Obstetrics and Gynaecology Syllabus

Obstetrics and Gynaecology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Obstetrics and Gynaecology in PMDC National Licensing Examination, not a summary of it.

1. 1

   Antenatal Care and Normal Pregnancy

   3 topics

   • Physiology of Pregnancy
   • Antenatal Assessment and Screening
   • Normal Labor and Delivery
2. 2

   High-Risk Pregnancy

   3 topics

   • Hypertensive Disorders of Pregnancy
   • Gestational Diabetes
   • Antepartum Hemorrhage
3. 3

   Obstetric Emergencies

   3 topics

   • Postpartum Hemorrhage
   • Obstructed Labor
   • Ectopic Pregnancy
4. 4

   Gynaecological Disorders

   4 topics

   • Abnormal Uterine Bleeding
   • Pelvic Inflammatory Disease
   • Fibroids and Ovarian Cysts
   • Menopause
5. 5

   Reproductive Health and Oncology

   3 topics

   • Contraception and Family Planning
   • Infertility
   • Cervical and Endometrial Cancer

Obstetrics and Gynaecology flashcards for PMDC National Licensing Examination

23 of 51 cards from the Obstetrics and Gynaecology deck — real questions with worked answers.

1. What is the gestational age (in weeks) used to define a full-term pregnancy?

   37 to 42 completed weeks. Pre-term is before 37 weeks; post-term is 42 weeks or beyond.

2. By how much does maternal plasma (blood) volume increase by term in normal pregnancy, and what is its main consequence?

   Plasma volume rises by about 40-50%. Because red cell mass rises less (about 20-30%), it produces a dilutional 'physiological anaemia of pregnancy'.

3. How do cardiac output, heart rate, and systemic vascular resistance change in normal pregnancy?

   Cardiac output rises ~30-50%, heart rate rises ~10-20 bpm, and systemic vascular resistance falls. Blood pressure dips in the second trimester then returns toward baseline at term.

4. What acid-base change occurs in the respiratory system during normal pregnancy?

   Progesterone-driven hyperventilation increases tidal volume and minute ventilation, causing a compensated respiratory alkalosis (low PaCO2, slightly raised pH with renal bicarbonate compensation).

5. Which hormone maintains the corpus luteum in early pregnancy, and which structure takes over progesterone production later?

   Human chorionic gonadotropin (hCG) maintains the corpus luteum; the placenta takes over progesterone production by around 7-9 weeks (luteoplacental shift).

6. What is Naegele's rule for estimating the expected date of delivery (EDD)?

   EDD = first day of last menstrual period (LMP) minus 3 months plus 7 days (and add 1 year). Assumes a regular 28-day cycle.

7. When is the most accurate ultrasound measurement for dating a pregnancy, and what is measured?

   First-trimester crown-rump length (CRL) between about 7 and 13 weeks is the most accurate method for dating.

8. What does the combined first-trimester screening test for Down syndrome measure?

   Nuchal translucency on ultrasound plus maternal serum free beta-hCG and PAPP-A, combined with maternal age, performed at about 11-14 weeks.

9. What pattern of quadruple/triple test markers suggests Down syndrome (trisomy 21)?

   Low AFP, low unconjugated estriol, high beta-hCG, and high inhibin A.

10. What does a raised maternal serum alpha-fetoprotein (AFP) suggest?

    Open neural tube defects (e.g., spina bifida, anencephaly), abdominal wall defects, multiple pregnancy, or underestimated gestational age.

11. At what gestational age is the oral glucose tolerance test (OGTT) routinely offered to screen for gestational diabetes?

    24-28 weeks of gestation (earlier if high risk).

12. What are the three stages of labor?

    First stage: onset of regular contractions to full cervical dilatation (10 cm). Second stage: full dilatation to delivery of the baby. Third stage: delivery of the baby to delivery of the placenta.

13. What distinguishes the latent from the active phase of the first stage of labor?

    Latent phase: cervix dilates slowly from 0 to about 4-6 cm with effacement. Active phase: faster, more regular dilatation from about 4-6 cm to 10 cm.

14. What are the cardinal movements (mechanism) of labor in order?

    Engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and expulsion.

15. What is the normal expected rate of cervical dilatation in the active phase of labor for a primigravida?

    Traditionally about 1 cm per hour (modern data accept somewhat slower); progress slower than expected on the partogram suggests need for assessment.

16. What is the most common fetal presentation and the ideal position for vaginal delivery?

    Cephalic (vertex) presentation is most common; the ideal is occiput-anterior (OA) position.

17. How is postpartum hemorrhage (PPH) defined?

    Blood loss of 500 mL or more after vaginal delivery, or 1000 mL or more after caesarean section. Primary PPH occurs within 24 hours, secondary PPH from 24 hours to 12 weeks postpartum.

18. What are the '4 Ts' causes of postpartum hemorrhage?

    Tone (uterine atony - most common), Trauma (lacerations/rupture), Tissue (retained placenta/products), and Thrombin (coagulation disorders).

19. What is the first-line uterotonic drug for management and prophylaxis of postpartum hemorrhage due to atony?

    Oxytocin. Active management of the third stage with prophylactic oxytocin is standard. Other agents: ergometrine, carboprost (prostaglandin F2-alpha), and misoprostol.

20. Which uterotonic is contraindicated in hypertensive women, and which is contraindicated in asthmatics?

    Ergometrine is contraindicated in hypertension/pre-eclampsia; carboprost (prostaglandin F2-alpha) is contraindicated in asthma.

21. How is gestational hypertension defined?

    New-onset blood pressure of 140/90 mmHg or higher after 20 weeks of gestation, without proteinuria or features of pre-eclampsia, in a previously normotensive woman.

22. What are the diagnostic criteria for pre-eclampsia?

    New-onset hypertension (BP 140/90 or higher) after 20 weeks PLUS proteinuria (300 mg/24h or protein:creatinine ratio 30 mg/mmol), OR hypertension with end-organ dysfunction (renal, hepatic, neurological, haematological) or fetal growth restriction.

23. What features define severe pre-eclampsia?

    BP 160/110 or higher, severe headache, visual disturbance, epigastric/RUQ pain, papilloedema, clonus, liver tenderness, platelets <100, abnormal LFTs, or HELLP syndrome.

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