Gynaecology: NCK Exam Questions & Revision
Gynaecology covers disorders of the female reproductive system and family planning. NCK questions commonly test contraceptive methods such as the IUCD and implants, menstrual disorders, ectopic pregnancy, fibroids, ovarian cysts and cervical cancer screening.
High-yield topics
The areas that come up most often in gynaecology questions.
Sample exam questions
Which is a long-acting reversible contraceptive (LARC) method?
- A. Combined oral pills
- B. Male condom
- C. The intrauterine device (IUCD)
- D. Emergency contraceptive pills
Why: IUCDs and implants are long-acting reversible contraception, effective for several years and reversible on removal.
A woman with amenorrhoea presents with sudden lower abdominal pain and signs of shock. The likely diagnosis is:
- A. Normal menstruation
- B. A ruptured ectopic pregnancy
- C. A urinary tract infection
- D. Ovulation pain
Why: A ruptured ectopic pregnancy classically presents with amenorrhoea, acute abdominal pain and signs of internal bleeding (shock). It is a surgical emergency.
What surgical interventions are indicated for a patient diagnosed with both rectocele and cystocele?
- A. Anterior colporrhapy.
- B. Posterior colporrhapy.
- C. Abdominal hysterectomy.
- D. Anterioposterior colporrhaphy.
Why: An anterioposterior colporrhaphy is the surgical intervention indicated for a patient with both rectocele and cystocele. This procedure addresses both the anterior wall of the vagina, where the bladder (cystocele) protrudes, and the posterior wall, where the rectum (rectocele) protrudes. Anterior colporrhaphy alone would only address the cystocele, while posterior colporrhaphy would only address the rectocele. An abdominal hysterectomy is not directly related to the repair of these conditions.
When a Papanicolaou smear result is abnormal, what is the subsequent step in assessing the patient for cervical cancer?
- A. A repeat pap smear.
- B. An endocervical curettage.
- C. A colposcopy.
- D. A conization.
Why: When a Papanicolaou (Pap) smear result is abnormal, the next step is typically a colposcopy. This procedure allows for a closer examination of the cervix using a special magnifying instrument. It helps to identify any areas of abnormality that may require biopsy. A repeat Pap smear may not provide additional information, an endocervical curettage is more invasive and usually follows colposcopy if needed, and a conization is a more invasive procedure reserved for when significant abnormalities are confirmed.
Which medications are recognized for diminishing the effectiveness of hormonal contraceptives?
- A. Artemether Lumefantrine, Rifampicin.
- B. Pyrazinamide, Phenytoin.
- C. Phenytoin, Rifampicin.
- D. Ethambutol, co-trimoxazole.
Why: Phenytoin and Rifampicin are known enzyme inducers that can increase the metabolism of hormonal contraceptives, thereby reducing their effectiveness. Artemether Lumefantrine and Pyrazinamide do not have a significant effect on hormonal contraceptive efficacy. Ethambutol and co-trimoxazole also do not interfere with hormonal contraceptives.
Signs of hypothyroidism affecting the reproductive system include:
- A. Increased libido, oligospermia.
- B. Impotence, rnetrorrhagia.
- C. Anovulation, high incidence of spontaneous abortion.
- D. Irregular menstrual cycles, increased libido.
Why: Hypothyroidism can lead to reproductive issues such as anovulation, which is the absence of ovulation, and a higher incidence of spontaneous abortion due to hormonal imbalances. Options a and d mention increased libido, which is not typically associated with hypothyroidism. Option b includes metrorrhagia, which is irregular bleeding, but does not address the common reproductive issues like anovulation and spontaneous abortion associated with hypothyroidism.
Want hundreds more gynaecology questions with instant marking and spaced repetition? Start free for 30 days.
Revision tips
- Practise with real past-paper questions, not just notes — recognition is not the same as recall.
- Always read the rationale, even when you answer correctly, so you learn why the other options are wrong.
- Revise little and often using spaced repetition rather than cramming the night before.
- Track your weak topics and spend most of your time there, not on what you already know.