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Saudi Board Part One Examination – Obstetrics & Gynaecology: free practice test

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Practice test questions with answers and explanations

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01A 52-year-old woman undergoes staging surgery for a suspected epithelial ovarian malignancy. Based on the normal lymphatic pathway of the ovary, which nodal group must be assessed because it receives direct drainage along the ovarian vessels?

Practice question Unit: Anatomy

  1. ASuperficial inguinal nodes below the inguinal ligament

    Superficial inguinal nodes drain the vulva and lower vagina, not the ovary.

  2. BPresacral nodes in front of the lower sacrum

    Presacral nodes receive drainage mainly from the cervix and rectum via the uterosacral ligaments.

  3. CDeep inguinal nodes medial to the femoral vein

    Deep inguinal nodes receive lymph from the superficial inguinal nodes and the clitoris, not directly from the ovary.

  4. DPara-aortic nodes at the level of the renal vessels ✓ Correct answer

    Ovarian lymphatics follow the ovarian vessels in the infundibulopelvic ligament to the para-aortic nodes, so isolated high nodal spread is possible.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 1: Anatomy, p. 2; Berek and Hacker's Gynecologic Oncology, chapter: Epithelial Ovarian Cancer

02A resident assisting at an abdominal hysterectomy is asked to identify the dense condensation of connective tissue at the base of the broad ligament that attaches the cervix and upper vagina to the lateral pelvic wall and carries the uterine vessels. Which structure is this?

Practice question Unit: Anatomy

  1. ARound ligament of the uterus

    The round ligament runs from the uterine cornu to the inguinal canal and gives little support.

  2. BCardinal ligament ✓ Correct answer

    The cardinal ligament is the main lateral support of the cervix and vaginal apex and transmits the uterine vessels.

  3. CInfundibulopelvic ligament

    The infundibulopelvic ligament carries the ovarian vessels from the pelvic brim to the ovary.

  4. DUtero-ovarian ligament

    The utero-ovarian ligament joins the ovary to the uterine cornu, far above the cervix.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 1: Anatomy, p. 2; Williams Gynecology, chapter: Anatomy

03After one sperm fuses with the oocyte, what mechanism normally prevents entry of further sperm?

Practice question Unit: Embryology/Genetics

  1. ALoss of the corona radiata cells by tubal enzymes

    Dispersal of corona cells helps sperm reach the zona rather than blocking them.

  2. BAcrosome reaction occurring in the oocyte cytoplasm

    The acrosome reaction is a sperm event that enables penetration; it does not block polyspermy.

  3. CCompletion of the first meiotic division at ovulation

    Meiosis I completes before ovulation; meiosis II completes at fertilisation, neither blocks polyspermy.

  4. DCortical granule release altering the zona pellucida ✓ Correct answer

    Cortical granule exocytosis modifies zona proteins (the zona reaction) so other sperm cannot bind or penetrate.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 2: Embryology/Genetics, p. 2; Williams Obstetrics, chapter: Implantation and Placental Development

04A healthy woman at 30 weeks has haemoglobin 108 g/L with normal ferritin and MCV. Which physiological change explains this?

Practice question Unit: Physiology

  1. ARed cell mass falls in the second trimester

    Red cell mass increases rather than falls.

  2. BPlasma volume rises more than red cell mass ✓ Correct answer

    Plasma volume expands by about 40–50% while red cell mass rises by about 20–30%, causing dilutional anaemia.

  3. CFetal uptake of maternal iron exceeds intake

    Normal ferritin and MCV argue against iron depletion.

  4. DErythropoietin production is suppressed

    Erythropoietin rises in pregnancy.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 3: Physiology, p. 2; Williams Obstetrics, chapter: Maternal Physiology

05Which enzyme converts pregnenolone to progesterone and DHEA to androstenedione?

Practice question Unit: Biochemistry

  1. A17β-hydroxysteroid dehydrogenase

    17β-HSD interconverts androstenedione and testosterone, and oestrone and oestradiol.

  2. B3β-hydroxysteroid dehydrogenase ✓ Correct answer

    3β-HSD converts Δ5 steroids to Δ4 steroids, a step needed for every active steroid class.

  3. C21-hydroxylase

    21-hydroxylase acts on progesterone and 17-hydroxyprogesterone.

  4. DAromatase

    Aromatase converts androgens to oestrogens.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 4: Biochemistry, p. 2; Speroff's Clinical Gynecologic Endocrinology and Infertility, chapter: Hormone Biosynthesis, Metabolism, and Mechanism of Action

06A 22-year-old woman with acne starts a combined pill with ethinylestradiol. After 4 months her acne has improved. Which hepatic effect of the oestrogen contributes most?

Practice question Unit: Pharmacology

  1. ALower albumin, which raises free testosterone

    Albumin changes are minor, and a rise in free testosterone would worsen acne.

  2. BLower cortisol-binding globulin, which lowers cortisol

    Oestrogen raises, not lowers, cortisol-binding globulin, and this does not explain acne.

  3. CHigher SHBG, which lowers free testosterone ✓ Correct answer

    Ethinylestradiol raises sex hormone-binding globulin, binding testosterone and reducing androgen effects on the skin.

  4. DHigher hepatic 5α-reductase activity

    More 5α-reductase would increase dihydrotestosterone and worsen acne.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 5: Pharmacology, p. 2; Williams Obstetrics, chapter: Contraception

07A 22-year-old has a 6 cm ovarian cyst. Ultrasound shows a hyperechoic nodule with acoustic shadowing and fat-fluid level. What is the likely diagnosis?

Practice question Unit: Pathology/Histology

  1. AMature cystic teratoma ✓ Correct answer

    A Rokitansky nodule with shadowing and fat signals a dermoid cyst.

  2. BEndometrioma

    Endometriomas have uniform ground-glass echoes.

  3. CHaemorrhagic corpus luteum

    Haemorrhagic cysts show a lace-like pattern and resolve.

  4. DMucinous cystadenoma

    Mucinous tumours are large and multilocular.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 6: Pathology/Histology, p. 2; Williams Gynecology, chapter: Pelvic Mass

08A woman has a thin grey vaginal discharge with a fishy odour. Vaginal pH is 5.0 and microscopy shows clue cells. What is the diagnosis?

Practice question Unit: Microbiology/Immunology

  1. ATrichomoniasis

    Trichomonas shows motile flagellated organisms and frothy discharge.

  2. BAtrophic vaginitis

    Atrophic vaginitis occurs with low oestrogen and lacks clue cells.

  3. CBacterial vaginosis ✓ Correct answer

    Amsel criteria: thin discharge, pH over 4.5, fishy amine odour and clue cells.

  4. DVulvovaginal candidiasis

    Candida gives thick white discharge with normal pH.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 7: Microbiology/Immunology, p. 2; Williams Gynecology, chapter: Gynecologic Infection

09On about which day after fertilisation does the blastocyst begin to implant?

Practice question Unit: Endocrinology & Reproduction

  1. ADay 1 to 2

    On days 1-2 the zygote is cleaving in the tube.

  2. BDay 3 to 4

    On days 3-4 the morula is entering the uterine cavity.

  3. CDay 14 to 15

    By day 14 implantation is complete and gastrulation is starting.

  4. DDay 6 to 7 ✓ Correct answer

    The blastocyst hatches and begins attaching to the endometrium on days 6-7.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 8: Endocrinology & Reproduction, p. 2; Speroff's Clinical Gynecologic Endocrinology and Infertility, chapter: Sperm and Egg Transport, Fertilization, and Implantation

10Which fetal shunt directs well-oxygenated inferior vena cava blood from the right atrium to the left atrium?

Practice question Unit: Normal Pregnancy (Fetal/Placental/Parturition)

  1. AForamen ovale ✓ Correct answer

    The crista dividens steers IVC blood through the foramen ovale to the left heart and brain.

  2. BDuctus arteriosus

    The ductus arteriosus connects pulmonary artery to aorta, bypassing the lungs.

  3. CUmbilical ring

    The umbilical ring is an abdominal wall opening, not a cardiac shunt.

  4. DDuctus venosus

    The ductus venosus carries umbilical venous blood past the liver to the IVC.

Reference: SCFHS Saudi Board Part One Exam Blueprint – Obstetrics & Gynecology (24-27, v.1), Section 9: Normal Pregnancy (Fetal/Placental/Parturition), p. 2; Williams Obstetrics, chapter: Embryogenesis and Fetal Development

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