Original EMREE questions on obstetrics & gynaecology, with explanations.
Short answer: 10 original multiple-choice practice questions on obstetrics & gynaecology for EMREE, the Emirates Medical Residency Entrance Examination, each with the correct answer and a full explanation. The blueprint gives this subject 15 percent of the exam. They are original and are not real exam items.
About these questions
Every question here is original. Meddex wrote it for exam preparation. None is a real, recalled or leaked exam item, and none comes from DHA, Prometric, UAE University or the NIHS.
Meddex is independent and is not affiliated with DHA, Prometric, UAE University or the NIHS.
Clinical review of the question bank is not complete yet. Treat the explanations as study aids and check official guidance before you rely on a fact.
This is a sample, not the whole bank, and doing well on it does not predict an exam result.
What ob & gyn covers
Antenatal care, labour, obstetric emergencies, contraception, menstrual and gynaecological disorders.
Separate antenatal, labour and gynaecology questions, and note the gestation in each stem, because it changes the answer.
Where it fits in the exam
The organiser's EMREE blueprint (November 2025 edition) gives Obstetrics & Gynaecology 15 percent of the exam, which is about 18 of 120 questions. It says the distribution may differ by up to 5 percent in each category. These weights are official, and the question counts are our arithmetic.
The organiser does not state how many answer options its questions have or whether each has one best answer. Meddex practice items use four options with one best answer, as a practice format.
How to use these questions
Decide your answer before you press Show answer. Then read the reason for every option, including the ones you rejected. Note the idea you missed and come back to it in a few days.
Practice questions
Question 1
Obstetrics & GynaecologyEasy
A 24-year-old woman attends 4 days after unprotected intercourse in the middle of her cycle. She does not want a pregnancy and has no medical problems. Which method is the most effective emergency contraception?
The copper IUD is the most effective emergency contraceptive and can be inserted up to 5 days after unprotected intercourse, or up to 5 days after the earliest expected ovulation. It also provides ongoing contraception. Ulipristal is effective up to 120 hours and is more effective than levonorgestrel, but the IUD remains the most effective.
Why A is wrong. Ulipristal is the best oral option but is less effective than the IUD.
Why B is wrong. Levonorgestrel is least effective and is licensed to 72 hours.
Why D is wrong. The Yuzpe method is less effective with more side effects.
Topic: Emergency contraception. Reference: FSRH Clinical Guideline: Emergency Contraception; WHO Medical Eligibility Criteria for Contraceptive Use
Question 2
Obstetrics & GynaecologyMedium
A 30-year-old woman and her partner have been unable to conceive after 18 months of regular unprotected intercourse. She has regular 28-day cycles and the semen analysis is normal. Which first-line investigation best confirms ovulation?
AOption A: Diagnostic laparoscopy and dye test
BOption B: Serum oestradiol on day 2 of the cycle
COption C: Mid-luteal serum progesterone (day 21 of a 28-day cycle)
DOption D: Random serum prolactin level alone
Show answer for question 2
Correct answer: C. Mid-luteal serum progesterone (day 21 of a 28-day cycle)
A serum progesterone measured in the mid-luteal phase (about 7 days before expected menses, day 21 of a 28-day cycle) confirms ovulation. Tubal patency should also be assessed, usually with hysterosalpingography or hysterosalpingo-contrast sonography, whereas laparoscopy is reserved for suspected pelvic disease. Prolactin is checked if cycles are irregular.
Why A is wrong. Laparoscopy is invasive and not a first-line test.
Why B is wrong. Oestradiol on day 2 does not confirm ovulation.
Why D is wrong. Prolactin is indicated with irregular cycles or galactorrhoea.
Topic: Infertility: assessment of ovulation. Reference: NICE CG156 Fertility problems; ESHRE guidance on unexplained infertility
Question 3
Obstetrics & GynaecologyMedium
A 26-year-old woman has 4 menstrual cycles per year, hirsutism (Ferriman-Gallwey score 14), acne and a BMI of 31 kg/m2. TSH, prolactin and 17-hydroxyprogesterone are normal. According to the Rotterdam criteria, which statement is correct?
AOption A: Oligo-ovulation plus clinical hyperandrogenism suffices after excluding other causes
BOption B: Diagnosis requires elevated fasting insulin or documented insulin resistance on testing
COption C: A polycystic ovarian morphology on ultrasound is mandatory for diagnosis, whatever the other features
DOption D: Diagnosis requires an LH to FSH ratio above 2 measured in the early follicular phase
Show answer for question 3
Correct answer: A. Oligo-ovulation plus clinical hyperandrogenism suffices after excluding other causes
The Rotterdam criteria require two of three features: oligo- or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology, once mimics such as thyroid disease, hyperprolactinaemia and non-classic congenital adrenal hyperplasia are excluded. Ultrasound is therefore not mandatory. LH to FSH ratio and insulin are not diagnostic criteria.
Why B is wrong. Insulin resistance is common but not diagnostic.
Why C is wrong. Ultrasound is one of three criteria, not a requirement.
Why D is wrong. The LH to FSH ratio is not part of the criteria.
Topic: PCOS: diagnosis. Reference: International Evidence-based Guideline for the Assessment and Management of PCOS; Rotterdam ESHRE/ASRM consensus
Question 4
Obstetrics & GynaecologyMedium
A 58-year-old woman with a BMI of 38 kg/m2 and type 2 diabetes presents with one episode of postmenopausal bleeding. Transvaginal ultrasound shows an endometrial thickness of 11 mm. Which is the most appropriate next step?
AOption A: Endometrial sampling by outpatient biopsy or hysteroscopy
BOption B: Repeat ultrasound in 6 months
COption C: Measure serum CA-125 only
DOption D: Start hormone replacement therapy
Show answer for question 4
Correct answer: A. Endometrial sampling by outpatient biopsy or hysteroscopy
Postmenopausal bleeding is endometrial cancer until proven otherwise. A thickness above 4 mm (and clearly 11 mm here) requires tissue diagnosis by outpatient endometrial sampling or hysteroscopy with biopsy. Obesity and diabetes increase risk through unopposed oestrogen exposure.
Why B is wrong. Delay risks missing curable early-stage cancer.
Why C is wrong. CA-125 is neither sensitive nor specific for endometrial cancer.
Why D is wrong. HRT would not address the bleeding and may worsen the risk if cancer is present.
Topic: Postmenopausal bleeding. Reference: NICE/RCOG guidance on suspected cancer: postmenopausal bleeding; ACOG Committee Opinion: Evaluation of Postmenopausal Bleeding
Question 5
Obstetrics & GynaecologyMedium
A 28-year-old nulliparous woman has CIN 3 on a colposcopically directed biopsy. The transformation zone is fully visible and there is no suspicion of invasion. She wishes to have children in the future. What is the most appropriate management?
AOption A: Radical trachelectomy with pelvic lymphadenectomy
BOption B: Large loop excision of the transformation zone (LLETZ)
COption C: Repeat cytology and HPV testing in 12 months
DOption D: Total abdominal hysterectomy with conservation of ovaries
Show answer for question 5
Correct answer: B. Large loop excision of the transformation zone (LLETZ)
High-grade CIN (CIN 2 and 3) should be treated by excision, most commonly large loop excision of the transformation zone (LLETZ), which also provides a histological specimen to exclude invasion. Treatment is conservative and fertility-sparing, though women should be counselled about a small increase in preterm birth. Hysterectomy and trachelectomy are for invasive disease.
Why A is wrong. Radical trachelectomy is for early invasive cancer.
Why C is wrong. Surveillance alone is inappropriate for CIN 3.
Why D is wrong. Hysterectomy is excessive for pre-invasive disease in a young woman.
A 24-year-old woman asks about cervical cancer prevention. Which statement correctly identifies the main cause of cervical cancer?
AOption A: Long-term intrauterine device use causing chronic cervical inflammation
BOption B: Persistent infection with high-risk HPV, mainly types 16 and 18
COption C: Herpes simplex virus type 2 infection with repeated genital recurrences
DOption D: Chlamydia trachomatis infection that has become chronic and untreated
Show answer for question 6
Correct answer: B. Persistent infection with high-risk HPV, mainly types 16 and 18
Virtually all cervical cancers are caused by persistent infection with high-risk human papillomavirus, with types 16 and 18 responsible for around 70 percent. Prevention relies on HPV vaccination and screening with HPV testing or cytology. Smoking and immunosuppression increase the risk of persistence.
Why A is wrong. IUDs are not a cause and may even be associated with lower risk.
Why C is wrong. HSV-2 is not an established cause of cervical cancer.
Why D is wrong. Chlamydia is a cofactor at most, not the cause.
Topic: Cervical cancer: aetiology. Reference: WHO Global Strategy to Accelerate the Elimination of Cervical Cancer; ACOG Practice Bulletin: Cervical Cancer Screening
Question 7
Obstetrics & GynaecologyMedium
A 51-year-old woman with an intact uterus has had no periods for 8 months and has severe vasomotor symptoms disturbing sleep. She is a non-smoker with normal BP, BMI 25 kg/m2 and no history of breast cancer or venous thromboembolism. Which treatment is most appropriate?
AOption A: A selective serotonin reuptake inhibitor as first-line
BOption B: Oestrogen alone orally
COption C: Systemic oestrogen combined with a progestogen
DOption D: Vaginal oestrogen pessary only
Show answer for question 7
Correct answer: C. Systemic oestrogen combined with a progestogen
Systemic hormone therapy is the most effective treatment for vasomotor symptoms in healthy women under 60 or within 10 years of menopause. A progestogen must be added in a woman with a uterus to prevent endometrial hyperplasia and cancer. Local vaginal oestrogen treats only genitourinary symptoms, and SSRIs are alternatives for women who cannot take HRT.
Why A is wrong. SSRIs are less effective and are reserved for those who cannot use HRT.
Why B is wrong. Unopposed oestrogen with an intact uterus increases endometrial cancer risk.
Why D is wrong. Local oestrogen does not treat systemic vasomotor symptoms.
Topic: Menopause: hormone therapy. Reference: NICE NG23 Menopause: diagnosis and management; International Menopause Society guidance on menopausal hormone therapy
Question 8
Obstetrics & GynaecologyMedium
A 27-year-old woman with polycystic ovary syndrome (BMI 31 kg/m2) has had oligo-amenorrhoea and 14 months of infertility. Her partner has a normal semen analysis and a hysterosalpingogram shows patent tubes. She has started lifestyle measures. According to current international PCOS guidance, which is the preferred first-line drug for ovulation induction?
AOption A: Gonadotrophin injections with ultrasound monitoring
BOption B: Letrozole
COption C: Metformin as the sole agent
DOption D: Clomifene citrate at 50 mg for 5 days
Show answer for question 8
Correct answer: B. Letrozole
Current international PCOS guidance recommends letrozole as the preferred first-line oral agent for ovulation induction in anovulatory women with PCOS and no other infertility factors, because it gives higher ovulation, pregnancy and live birth rates than clomifene. Clomifene and metformin are alternatives, and gonadotrophins are second-line options needing close monitoring because of multiple pregnancy risk.
Why A is wrong. Gonadotrophins carry a higher risk of multiple pregnancy and ovarian hyperstimulation and are used when oral agents fail.
Why C is wrong. Metformin alone has weaker evidence for live birth than letrozole or clomifene.
Why D is wrong. Clomifene remains an alternative but is no longer the preferred first choice.
Topic: Infertility: ovulation induction in polycystic ovary syndrome. Reference: International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2023 (Teede et al.); NICE CG156 Fertility problems: assessment and treatment
Question 9
Obstetrics & GynaecologyMedium
A 38-year-old woman has heavy menstrual bleeding with haemoglobin 9.0 g/dL. Ultrasound shows a single 8 cm intramural fibroid distorting the endometrial cavity. She strongly wishes to conceive in the future. Which is the most appropriate definitive treatment?
AOption A: Myomectomy, with pre-operative anaemia correction
BOption B: Levonorgestrel intrauterine system
COption C: Hysterectomy with ovarian conservation
DOption D: Long-term GnRH agonist therapy
Show answer for question 9
Correct answer: A. Myomectomy, with pre-operative anaemia correction
Myomectomy removes symptomatic fibroids while preserving the uterus and fertility. A levonorgestrel IUS is not suitable when the cavity is distorted, hysterectomy ends fertility, and GnRH agonists give only temporary shrinkage before surgery and cannot be used long term because of bone loss. Anaemia should be corrected pre-operatively.
Why B is wrong. A distorted cavity makes IUS retention and efficacy poor.
Why C is wrong. Hysterectomy is contraindicated by the desire for fertility.
Why D is wrong. GnRH agonists are temporary and cause hypo-oestrogenic effects.
Topic: Fibroids: management. Reference: NICE NG88 Heavy menstrual bleeding; RCOG/FIGO guidance on uterine fibroids
Question 10
Obstetrics & GynaecologyEasy
A 38-year-old woman with two vaginal births leaks urine when she coughs or runs. She has no urgency, her urine dipstick is negative and pelvic examination is normal. She asks for surgery. Which is the most appropriate initial management?
AOption A: An antimuscarinic drug taken once daily to calm the bladder
BOption B: Supervised pelvic floor muscle training for at least 3 months
COption C: A midurethral sling at the next available operating list
DOption D: Duloxetine started as the first-line drug therapy for her symptoms
Show answer for question 10
Correct answer: B. Supervised pelvic floor muscle training for at least 3 months
Supervised pelvic floor muscle training for at least 3 months is first-line for stress and mixed urinary incontinence. Surgery is considered when conservative treatment has failed, and antimuscarinic drugs treat urgency rather than stress leakage. Duloxetine is not routinely offered as initial therapy because of its adverse effects.
Why A is wrong. Antimuscarinics treat overactive bladder, not leakage on effort.
Why C is wrong. Surgery is reserved for women whose conservative management has failed.
Why D is wrong. Duloxetine is not offered routinely as first-line therapy and causes frequent adverse effects such as nausea.
Topic: Urogynaecology: first-line treatment of stress urinary incontinence. Reference: NICE NG123 Urinary incontinence and pelvic organ prolapse in women: management
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Frequently asked questions
The blueprint gives Obstetrics & Gynaecology 15 percent of the exam, about 18 of 120 questions, and says it may differ by up to 5 percent. It is the organiser's own figure from the November 2025 blueprint.
No. They are original practice questions written by Meddex for exam preparation. The organiser publishes a blueprint, not sample questions, and a confidentiality agreement covers the real exam, so we do not use or claim real or recalled items.
The Meddex app has the full bank, which you can practise by topic with a free account. These pages are a short sample, and the questions on them do not change.
No. Each question has a Show answer button. The answer, the explanation and the reason each wrong option is wrong are part of the page text, so they are there when you press it.