The extended matching question (EMQ) component of the MRCOG Part 2 exam.
Each question will consist of a lead-in statement (which tells you clearly what to do), a question and a list of possible options to choose from.
Most option lists will provide 10 to 14 answer options. The option lists will nearly always be in alphabetical or numerical order for ease of reference; if not, they will be in the most appropriate order for quick reference.
The most important element of the format is that you must select the single answer that best fits. You may feel that there are several possible answers, but you must choose only the most likely one from the option list.
Marking
Incorrect answers are not penalised.
It is in your best interests to ensure that for each of the 50 questions, you have selected one option by the end of the examination.
Example questions
Where answers are provided to these examples, the questions have been removed of the bank of live questions that can be used in actual exams (although the same options lists may remain with different tested scenarios).
Some of the sample questions do not have answers. This is to encourage candidates to seek out information themselves and thus learn actively. These questions remain in the bank and may reappear in the exams. The same options lists may recur with different tested scenarios.
Question 1
Options:
Instructions: For the clinical situation described, choose the single most appropriate initial management option from the list.
A 28-year-old woman is referred to the gynaecology clinic with a history of mood swings and amenorrhoea for 11 months. She has a eight year history of oligomenorrhoea. She is fit and well, 170 cm tall, a non-smoker with a BMI of 24 kg/m2.
Results of initial investigations are as follows:
|
Serum FSH:
|
48.8 iu/l
|
(1 – 11iu/l) |
|
Serum LH:
|
56.1 iu/l | (2 – 13 iu/l) |
|
Serum Estradiol:
|
80 pmol/l | (110 – 1250 pmol/l) |
Repeat results six weeks later produced similar result.
Correct response: J (Premature ovarian insufficiency)
Question 2
Options:
Instructions: For each clinical scenario described below, choose the single most appropriate initial plan of management option from the list above.
A 30-year-old multiparous woman presented to the early pregnancy assessment unit (EPAU) with a history of amenorrhoea for six weeks and a positive urine pregnancy test yesterday. Two years ago, she had a left sided ectopic pregnancy. She is asymptomatic but is anxious about her past history which has instigated her visit to EPAU. Transvaginal ultrasound scan confirms an empty uterus, normal adnexae and small amount of free fluid.
Correct response: D (Measure serum beta hCG)
Question 3
Options:
Instructions: For the clinical scenario described below, choose the single most appropriate diagnosis from the above list of options.
A 28-year-old nulliparous woman at 26 weeks of gestation presents to the emergency department with acute onset lower abdominal pain and complaints of nausea and vomiting of 24 hours duration. On abdominal examination, there is generalised tenderness on the lower abdomen and uterus feels soft. Auscultation reveals normal fetal heart rate. Full blood count shows a haemoglobin level of 110 g/l, white cell count of 10 x109/l (4 – 119/l) and her C-reactive protein level is 30 mg/l ( Normal level <10 mg/l). Ultrasound examination of her abdomen and pelvis has shown mass in left side of pelvis and enlargement of the left adnexa and some free fluid in the pelvis.
Correct response: B (Adnexal torsion)
Question 4
Options:
Instructions: For the clinical situation described below, choose the single most appropriate initial management option from the above list.
A 35-year-old woman presents six months after vaginal birth of her third child with urinary incontinence following exercise and with coughing. She has no symptoms of urgency or nocturia. The symptoms are distressing to and she wants something to be done about them. She is breast feeding and her periods have returned last month. Her family is complete. Vaginal examination revealed a small-moderate cystocele which is evident on parting her labia majora and there is demonstrable stress incontinence.
Correct response: H (Pelvic floor physiotherapy)
Question 5
Options:
Instructions: For the clinical scenario described below, choose the single most appropriate management from the above list of options.
A 51-year-old postmenopausal woman with a BMI of 35 kg/m2 had endometrial hyperplasia without atypia diagnosed 14 months ago. She was treated with the levonorgestrel intrauterine system. Two consecutive endometrial biopsies at intervals of 6 months have been normal. She attends the gynaecology clinic for advice.
Correct response: J (LNG IUS to continue and endometrial biopsy every year)