100+ Free CMSA FCOG(SA) Part II Practice Questions

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2026 Statistics

Key Facts: CMSA FCOG(SA) Part II Exam

100 Qs

Practice MCQs

FCOG(SA) Part II Study Bank

50%

Pass Mark

CMSA Examination Regulations

R21 500

Examination Fee

CMSA Fee Schedule

4 Years

Registrar Training

HPCSA / CMSA Requirements

CMSA

Examining Body

College of O&G South Africa

The FCOG(SA) Part II examination certifies specialist expertise in Obstetrics & Gynaecology across South Africa. This 100-question practice bank covers high-risk obstetrics, maternal mortality audits, gynaecologic oncology, urogynaecology, and reproductive medicine.

Sample CMSA FCOG(SA) Part II Practice Questions

Try these sample questions to test your CMSA FCOG(SA) Part II exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 32-year-old G2P1 at 34 weeks gestation presents to the labor ward with a blood pressure of 165/110 mmHg, 3+ proteinuria, and severe frontal headache. According to South African ESMOE and National Department of Health guidelines, what is the initial loading dose of Magnesium Sulfate for eclampsia prophylaxis?

A.4 g IV slowly over 10-15 minutes plus 10 g IM (5 g in each buttock)

B.6 g IV bolus over 5 minutes followed by 2 g/hour IV infusion

C.2 g IV bolus over 20 minutes followed by 5 g IM in one buttock

D.10 g IV bolus over 30 minutes with no maintenance dose

Explanation: The standard South African ESMOE loading regimen for Magnesium Sulfate in severe preeclampsia/eclampsia is 4 g IV (as a 20% solution) slowly over 10-15 minutes, combined with 10 g IM (5 g of 50% solution deep IM into each buttock with 1 mL of 2% lignocaine). Maintenance therapy is 5 g IM into alternating buttocks every 4 hours, provided deep tendon reflexes are present, respiratory rate is > 16/min, and urine output is > 25 mL/hour.

2A 28-year-old primigravida at 38 weeks gestation develops severe postpartum hemorrhage following a precipitate vaginal delivery. After administration of Oxytocin 10 IU IM and Ergometrine 0.5 mg IM, her blood pressure is 150/100 mmHg and uterine atony persists. Which uterotonic agent is contraindicated in this patient?

A.Misoprostol 800 mcg sublingually or rectally

B.Ergometrine 0.5 mg IV repeated

C.Oxytocin 20 IU in 1000 mL Ringers Lactate IV infusion

D.Carboprost (15-methyl PGF2a) 250 mcg IM

Explanation: Ergometrine causes peripheral vasoconstriction and direct smooth muscle contraction, making it strictly contraindicated in women with hypertension, preeclampsia, or cardiac disease. Repeated doses or IV administration can trigger hypertensive crisis, stroke, or myocardial infarction. Misoprostol, oxytocin infusion, and carboprost (unless asthmatic) are safe alternative uterotonics.

3A 34-year-old G3P2 at 32 weeks gestation undergoes umbilical artery Doppler ultrasonography for suspected fetal growth restriction (FGR). The Doppler spectrum demonstrates absent end-diastolic flow (AEDF). What is the appropriate immediate clinical management?

A.Immediate emergency caesarean delivery within 1 hour

B.Administer antenatal corticosteroids, initiate intensive fetal surveillance (ductus venosus Doppler, biophysical profile), and plan delivery at 34 weeks or earlier if deteriorated

C.Discharge home with weekly umbilical artery Doppler monitoring

D.Initiate maternal hyperoxygenation and re-evaluate Doppler in 4 weeks

Explanation: Absent end-diastolic flow (AEDF) in the umbilical artery signifies significant placental insufficiency and microvascular obliteration. At 32 weeks gestation, management requires admission, administration of antenatal corticosteroids (Dexamethasone/Betamethasone) for lung maturation, daily cCTG/BPP, and longitudinal Doppler monitoring of the ductus venosus and middle cerebral artery. Delivery is typically indicated around 34 weeks, or earlier if ductus venosus A-wave becomes absent/reversed.

4A 26-year-old primigravida at 30 weeks gestation presents with painful vaginal bleeding, uterine hypertonus, and fetal bradycardia of 90 bpm. Her blood pressure is 150/95 mmHg. Bedside ultrasound shows a retroplacental hematoma. What is the most common maternal underlying risk factor for this condition?

A.Gestational diabetes mellitus

B.Hypothyroidism

C.Hypertensive disorders of pregnancy

D.Intrahepatic cholestasis of pregnancy

Explanation: Placental abruption (abruptio placentae) presents classic clinical features of painful vaginal bleeding, uterine hypertonus/tenderness, and fetal compromise. Chronic hypertension and preeclampsia are the single strongest risk factors for placental abruption, responsible for nearly 40-50% of severe cases due to maternal decidual vasculopathy.

5A 30-year-old G2P1 at 28 weeks twin gestation is diagnosed with Monochorionic Diamniotic (MCDA) twins. Ultrasound reveals Twin A with polyhydramnios (deepest vertical pocket DVP 11 cm) and a distended bladder, while Twin B has oligohydramnios (DVP 1.5 cm) and an non-visualized bladder. According to Quintero criteria, what stage of Twin-to-Twin Transfusion Syndrome (TTTS) is present?

A.Stage I

B.Stage II

C.Stage III

D.Stage IV

Explanation: Quintero Stage I TTTS is defined by severe oligohydramnios (DVP < 2 cm) in the donor twin and severe polyhydramnios (DVP > 8 cm) in the recipient twin, but with the donor bladder still visible and normal Doppler studies. Stage II occurs when the donor twin's bladder is no longer visualized. Stage III requires critically abnormal Dopplers (AEDF/REDF in umbilical artery, reversed A-wave in ductus venosus). Stage IV is hydrops fetalis in one or both twins.

6A 31-year-old G4P3 at 36 weeks gestation with two previous low transverse caesarean deliveries presents in active labor. Cardiotocography reveals recurrent deep variable decelerations followed by sudden severe fetal bradycardia of 70 bpm. The patient experiences sudden loss of uterine contractions, loss of fetal station on vaginal examination, and acute severe abdominal pain. What definitive surgical intervention is indicated?

A.Vacuum-assisted vaginal delivery in the labor room

B.Forceps delivery with fundal pressure

C.Emergency laparotomy for delivery and repair of uterine rupture or hysterectomy

D.Hysteroscopy and manual removal of placenta

Explanation: The clinical picture of sudden loss of uterine contractions, loss of station, severe persistent fetal bradycardia, and acute abdominal pain in a patient with scar rupture indicates complete uterine rupture. Immediate emergency laparotomy is mandatory to rescue the fetus, control maternal hemorrhage, and perform uterine repair or subtotal/total hysterectomy.

7A 25-year-old primigravida at 29 weeks gestation presents with spontaneous rupture of membranes. Speculum examination confirms pooled amniotic fluid in the vaginal vault with nitrazine positive testing. There are no signs of chorioamnionitis. According to South African STGs, which oral antibiotic regimen is recommended for PPROM latency therapy?

A.Erythromycin 250 mg 6-hourly orally for 10 days

B.Amoxicillin-clavulanic acid 1 g 12-hourly orally for 7 days

C.Doxycycline 100 mg 12-hourly orally for 7 days

D.Ciprofloxacin 500 mg 12-hourly orally for 5 days

Explanation: Oral Erythromycin (250 mg 6-hourly or 500 mg 8-hourly for 10 days) is the established latency antibiotic of choice in PPROM. It prolongs latency, reduces neonatal infectious morbidity, RDS, and necrotizing enterocolitis. Amoxicillin-clavulanic acid (co-amoxiclav) is strictly contraindicated in PPROM because it is strongly associated with an increased incidence of necrotizing enterocolitis (NEC) in neonates.

8A 35-year-old G2P1 at 36 weeks gestation with Rheumatic Heart Disease and moderate mitral stenosis (valve area 1.2 cm²) experiences worsening dyspnea and orthopnea. On examination, pulse is 115 bpm (irregular, atrial fibrillation), blood pressure 110/70 mmHg, and lung bases have bilateral crepitations. What is the immediate pharmacological agent of choice to control heart rate and improve diastolic filling time?

A.Sublingual Nifedipine

B.Intravenous Furosemide followed by rate control with IV Metoprolol / Digoxin

C.Intravenous Hydralazine bolus

D.Oral Terbutaline

Explanation: In mitral stenosis during pregnancy, tachycardia shortens diastolic filling time, causing rapid elevation of left atrial pressure and pulmonary edema. Immediate therapy involves IV loop diuretics (Furosemide) to reduce preload, combined with rate-controlling agents such as beta-blockers (Metoprolol) or Digoxin to slow sinus/afib rate and prolong diastole. Direct cardioversion may be needed if hemodynamically unstable.

9A 29-year-old G1P0 at 12 weeks gestation presents for her first antenatal visit. She is known to have Type 1 Diabetes Mellitus. What is the target HbA1c level recommended prior to and during early pregnancy to minimize the risk of major congenital malformations (such as sacral agenesis and ventricular septal defects)?

A.< 6.5% (48 mmol/mol)

B.< 8.5% (69 mmol/mol)

C.< 10.0% (86 mmol/mol)

D.< 5.0% (31 mmol/mol)

Explanation: Optimizing glycemic control with a target HbA1c < 6.5% (48 mmol/mol) prior to conception and during early embryogenesis reduces the risk of congenital malformations (including caudal regression syndrome / sacral agenesis, cardiac defects, and neural tube defects) to background population rates (~2%). Higher HbA1c levels (> 8-10%) increase malformation rates exponentially.

10A 30-year-old G3P2 at 39 weeks gestation is in second stage of labor for 2 hours with epidural analgesia. The fetal head is at station +3, direct occipito-anterior position, and caput is minimal. Contractions are strong. What is the most appropriate instrumental delivery method when criteria for operative vaginal delivery are fulfilled?

A.Vacuum extraction (ventouse) application

B.Breech extraction

C.High forceps traction above engagement

D.Internal podalic version

Explanation: Vacuum extraction (ventouse) or low/outlet forceps delivery is the standard choice for low station (+3) occipito-anterior position when second stage is prolonged. Vacuum extraction has a high success rate and low maternal perineal trauma profile when fetal head is well engaged at +3 station.

About the CMSA FCOG(SA) Part II Exam

The Fellowship of the College of Obstetricians and Gynaecologists of South Africa Part II — FCOG(SA) Part II is the final specialist qualification in Obstetrics and Gynaecology in South Africa. It assesses advanced clinical competencies, operative decision-making, high-risk maternal-fetal care, gynaecologic oncology, urogynaecology, and national maternal mortality audit guidelines (Saving Mothers).

Assessment

Written examination (Paper 1 & Paper 2), OSCE clinical examination, and structured oral examination covering Obstetrics, Maternal-Fetal Medicine, Gynaecological Oncology, Urogynaecology, Reproductive Medicine, and Saving Mothers SA Guidelines.

Time Limit

Written: 2 x 3 hours; OSCE & Oral sessions

Passing Score

Overall 50% with written subminimum

Exam Fee

R24 650 (College of Obstetricians and Gynaecologists of South Africa (Colleges of Medicine of South Africa))

CMSA FCOG(SA) Part II Exam Content Outline

25%

Maternal-Fetal Medicine & High-Risk Obstetrics

Hypertensive disorders of pregnancy, severe preeclampsia, eclampsia management, obstetric hemorrhage (PPH, NASG, uterine compression sutures), medical disorders (cardiac, diabetes, renal), fetal growth restriction, Doppler ultrasonography, multiple gestation, preterm labor, and fetal monitoring.

20%

Gynaecological Oncology

Cervical cancer screening, HPV pathology, FIGO 2018 staging, management of CIN and invasive cervical carcinomas, endometrial cancer (FIGO 2023), epithelial ovarian malignancies, Risk of Malignancy Index (RMI), vulvar carcinoma, and gestational trophoblastic disease (GTD/GTN).

15%

Urogynaecology & Pelvic Floor Dysfunction

Pelvic organ prolapse (POP-Q classification system), stress and urge urinary incontinence, urodynamic testing, mid-urethral sling surgery, vesicovaginal fistula (VVF) etiology and surgical repair, and 3rd/4th degree obstetric anal sphincter injuries (OASI).

15%

Reproductive Endocrinology & Infertility

Polycystic ovary syndrome (PCOS), primary and secondary amenorrhea (MRKH, AIS, POI), endometriosis staging and surgical excision, adenomyosis, infertility evaluation, ovulation induction (Letrozole), assisted reproductive technologies (IVF/ICSI), and menopausal hormone therapy.

15%

Operative Gynaecology & Endoscopy

Uterine fibroid FIGO classification and management (myomectomy, uterine artery embolization), laparoscopic surgical entry (Palmer's point, Hasson technique), hysteroscopic resection, intraoperative surgical complications (ureteric and bowel injuries), and ectopic pregnancy management.

10%

Maternal Mortality Audits & Saving Mothers SA Guidelines

National Committee for Confidential Enquiry into Maternal Deaths (NCCEMD) triennial reports, Saving Mothers South Africa guidelines, ESMOE emergency protocols, maternal resuscitation, severe obstetric sepsis, and South African National Department of Health STGs.

How to Pass the CMSA FCOG(SA) Part II Exam

What You Need to Know

Passing score: Overall 50% with written subminimum
Assessment: Written examination (Paper 1 & Paper 2), OSCE clinical examination, and structured oral examination covering Obstetrics, Maternal-Fetal Medicine, Gynaecological Oncology, Urogynaecology, Reproductive Medicine, and Saving Mothers SA Guidelines.
Time limit: Written: 2 x 3 hours; OSCE & Oral sessions
Exam fee: R24 650

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

CMSA FCOG(SA) Part II Study Tips from Top Performers

1Master ESMOE emergency protocols for severe preeclampsia/eclampsia, massive postpartum hemorrhage, and maternal cardiopulmonary resuscitation.

2Review FIGO 2018 cervical cancer staging and FIGO 2023 endometrial cancer staging guidelines, including molecular classifications.

3Analyze the latest Saving Mothers South Africa report recommendations regarding preventable maternal deaths, sepsis management, and delay categories.

Frequently Asked Questions

What is the structure of the FCOG(SA) Part II examination?

The FCOG(SA) Part II examination comprises written papers (Paper 1 and Paper 2 containing Single Best Answer questions and Extended Matching Questions), followed by an Objective Structured Clinical Examination (OSCE) and structured oral examinations.

What is the passing score requirement for FCOG(SA) Part II?

Candidates must achieve an overall pass mark of at least 50% across the examination, with a subminimum requirement achieved in the written component to progress to the clinical/oral examination.

Which national South African clinical guidelines are essential for FCOG(SA) Part II preparation?

Candidates must be intimately familiar with the Saving Mothers South Africa Triennial Reports, ESMOE (Essential Steps in Managing Obstetric Emergencies) protocols, and the NDoH Hospital Level STGs & EML for Obstetrics and Gynaecology.

100+ Free CMSA FCOG(SA) Part II Practice Questions

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