Obestetrics
Molar and
Ectopic Pregnancy
Molar Pregnancy
(Hydatidiform mole).
***) Regarding
hydatidiform mole, all the following are true except:
Commoner in women of blood group
A married to blood O men
Group AB women have the worst
prognosis
Are commoner in older gravida
Are complicated by ovarian cyst
Can be diagnosed by chest X-ray
Answer: E* Can be
diagnosed by chest X-ray
***) In hydatiform
mole pregnancy, all the following are true except:
Uterine size is larger than dates
Bilateral ovarian cysts (Lutein
cysts) is common
Aggravated morning sickness
Treatment is by suction, curettage
regardless of the size of the uterus
Pregnancy is allowed after 6
months
Answer: E* Pregnancy
is allowed after 6 months
***) The complications
of hydatiform mole include all the following except:
Hemorrhage
Sepsis
Perforation of the uterus
Inversion of the uterus
Choriocarcinoma
Answer: D* Inversion
of the uterus
***) Hydatiform mole
(vesicular mole) is usually treated by:
Hysterectomy
Prostaglandin induction
Syntocinon induction
Methotrexate
Suction-evacuation of the uterus
Answer: E*
Suction-evacuation of the uterus
Ectopic Pregnancy.
***) Regarding ectopic
pregnancy all of the following statements are true, except:
It is a pregnancy that implants
outside the uterus
The most common site of
implantation is the abdominal cavity
It may occur in the cervix
Previous infection is a major
cause
There is an increase incidence
among IUCD users
Answer: B* The most
common site of implantation is the abdominal cavity
***) In ectopic
pregnancy, all the following are true except:
Pain usually proceeds bleeding
Shoulder pain is an important
symptom
The isthmus of the tube is the
commonest site of implantation
Is often not diagnosed by os
The incidence is greater in women
with IUCD
Answer: C* The isthmus
of the tube is the commonest site of implantation
***) The commonest
site for tubal ectopic pregnancy is:
Fimbria
Ampulla
Isthmus
Intramural
Paratubal
Answer: B* Ampulla
???) All of the
following may be etiological factors of ectopic pregnancy, except:
Previous infection of the tubes
Delayed passage of the fertilized
ovum down the tube
Progesterone pills for
contraception
Intrauterine contraceptive device
IUCD users
Irregular periods
Answer: E* Irregular
periods
***) All of the
following may increase the incidence of ectopic pregnancy, except:
Previous pelvic infection
Use of birth control pills
Tubal surgery
Previous appendicitis
Tubal abnormalities
Answer: B* Use of
birth control pills
***) The ectopic
pregnancy may be due to:
Chronic salpingitis
Short fallopian tube
Long uterine cavity
Use of vaginal diaphragm
Contraceptive pills
Answer: A* Chronic
salpingitis
***) All of the
following are the clinical features of tubal pregnancy, except:
The patient may have evidence of
peritoneal irritation
Lower abdominal pain
Abdominal rigidity
Fainting
Severe vaginal bleeding
Answer: E* Severe
vaginal bleeding
***) The most
important symptom of ectopic pregnancy is one of the following:
Severe bleeding
Pain
Amenorrhea
Fainting
Pelvic heaviness
Answer: B* Pain
***) Vaginal bleeding
in ectopic pregnancy is due to:
Rupture of the fallopian tube
Rupture of the uterus
Vaginal laceration
Peritoneal hemorrhage
Hormone withdrawal
Answer: E* Hormone
withdrawal
***) The following
features suggest a diagnosis of ectopic pregnancy, except:
Amenorrhea of 6-10 weeks
Acute abdomen
Enlarged uterus
Decidual tissue at curettage
Vaginal bleeding
Answer: C* Enlarged
uterus
***) Regarding ectopic
pregnancy, all the following are true except:
Amenorrhea
Vaginal bleeding
Abdominal pain
Elevated hCG
Endometrium has always secretory
changes
Answer: D* Elevated
hCG
***) All true about
ectopic pregnancy, except:
Attacks of abdominal sharp
stabbing pain
Fainting attacks
Vaginal bleeding
Period of amenorrhea
Pregnancy test is always positive
Answer: A* Attacks of
abdominal sharp stabbing pain
***) Signs of ruptures
ectopic pregnancy include the following, except:
Rebound tenderness in the abdomen
Heavy vaginal bleeding
Cervical excitation on vaginal
examination
Localized tenderness in the pelvis
Tachycardia
Answer: B* Heavy
vaginal bleeding
***) Ectopic pregnancy
is confirmed by one of the following:
Ultrasound examination
Vaginal examination
Culdocentesis
hCG urine pregnancy test
Laparoscopy
Answer: E* Laparoscopy
***) Which of the following
can be a definite diagnosis of intrauterine pregnancy to rule out ectopic
pregnancy:
Decidual reaction at D&C
pathology specimen
Aria-stella phenomen at D&C
pathology specimen
Chorionic villi at D&C
pathology specimen
Positive pregnancy test
Positive β-hCG assay
Answer: C* Chorionic
villi at D&C pathology specimen
***) Differential
diagnoses of ectopic pregnancy are the following, except:
Acute salpingitis
Acute appendicitis
Acute red degeneration of fibroid
Rupture ovarian cyst
Vesicular mole
Answer: E* Vesicular
mole
***) Differential
diagnoses of ectopic pregnancy are the following, except:
Rupture of a corpus luteum cyst
Uterine abortion
Torsion of fallopian tube
Acute appendicitis
Spasmodic dysmenorrhea
Answer: E* Spasmodic
dysmenorrhea
***) Of the following,
which woman is at greater risk for ectopic pregnancy:
Healthy woman on birth control
pills
A woman with a past history of
three incidents of pelvic inflammatory disease
Woman with a history of
endometriosis
Woman with irregular menses
Woman with a past history of
several attacks of UTI
Answer: B* A woman
with a past history of three incidents of pelvic inflammatory disease
***) The most common
implantation site for ectopic pregnancy is the:
Abdominal cavity
The ovarian surface
The cervix
Ampulla of the fallopian tube
The interstitial portion of the
fallopian tube
Answer: D* Ampulla of
the fallopian tube
***) A 24 year old
patient married since 2 years. She is having 6 weeks amenorrhea and unilateral
anneal pain, acute abdomen, rapidly falling hematocrit, hypertensive and
positive pregnancy test. The most likely diagnosis is:
Endometriosis
Appendicitis
Urinary tract infection
Threatened abortion
Ectopic pregnancy
Answer: E* Ectopic
pregnancy
Placenta
The Placenta.
***) Where does
fertilization take place:
In the ovary
In the fimbrial end of the
fallopian tube
In the ampullary region of the fallopian
tube
In the uterus
In the isthmic region of tube
Answer: C* In the
ampullary region of the fallopian tube
***) Implantation of
the blastocyte occurs after:
1-2 days
3-5 days
6-8-days
9-10 days
12-14 days
Answer: C* 6-8-days
***) The method of
choice of placental localization is:
Ultrasonography
Angiography
Soft tissue placentography
Use of radioactive isotopes
Amniography
Answer: A*
Ultrasonography
***) All of the
following are placental hormones, except:
Follicular stimulating hormone
Human placental lactogen
Progesterone
Estrogen
Somatotropine (growth hormone)
Answer: A* Follicular
stimulating hormone
***) Human Placental
Lactogen (hPL) can be elevated in all of the following, except:
Diabetes
Twins
Hypertension
Erythroblastosis
Bronchogenic carcinoma
Answer: C*
Hypertension
Abnormalities of
the Placenta.
***) Placental
abnormality characterized by an accessory lobe is termed:
Placenta membranacea
Placenta circumvallate
Placenta succenturiata
Placenta fenestrata
Placenta increta
Answer: C* Placenta
succenturiata
***) One of the
following is true concerning placenta succenturiata:
The placenta is surrounded by a
fibrous ring
The placenta contains
fenestration in its center
The placenta is connected to an
accessory lobe by a small vessels and membrane
The chorionic plate is surrounded
by a membranous structure
The placenta is horse-shaped in
appearance
Answer: C* The
placenta is connected to an accessory lobe by a small vessels and membrane
***) One of the
following is true concerning a battledore placenta:
The umbilical cord is attached to
its central part
The umbilical cord is attached to
the central membranes
The umbilical cord is attached to
the margin of the placenta
The umbilical cord is attached to
an accessory lobe of the placenta
The umbilical cord is attached to
two lobes of placenta
Answer: C* The
umbilical cord is attached to the margin of the placenta
***) All of the following
are common causes of placental insufficiency, except:
Prolonged hypertension disease in
pregnancy
Obesity
Chronic renal disease
Severe anemia
Prolonged pregnancy
Answer: B* Obesity
***) Placental
insufficiency is caused by the following, except:
Smoking in pregnancy
Dieting in pregnancy
Hypertensive disorders in
pregnancy
Post maturity
Multiple pregnancy
Answer: B* Dieting in
pregnancy
***) All of the
following are causes of large placenta, except:
Multiple pregnancy
Chronic renal disease
Syphilis
Diabetes mellitus
Hydrops fetalis
Answer: B* Chronic
renal disease
Placenta Previa.
***) In placenta
previa all of the following statements are true, except:
Causes painless vaginal bleeding
Vaginal examination is
contraindicated
Is managed by caesarian section
if covering the cervical os
Presents with a woody hard uterus
Predisposes to postpartum
hemorrhage
Answer: D* Presents
with a woody hard uterus
***) All of the
following are commonly associated with placenta previa, except:
Sudden onset of fresh bleeding
Abnormal presentation
Unengaged head
Absence of fetal heart
Soft abdomen
Answer: D* Absence of
fetal heart
***) Vaginal
examination is contraindicated in one of the following situations during
pregnancy:
Carcinoma of the cervix
Gonorrhea
Prolapsed cord
Placenta previa
Active labor
Answer: D* Placenta
previa
Abruptio Placenta.
***) Concerning
abruptio placenta, all the following are true except:
It is a premature separation of
normally implanted placenta
The uterus is tender
In severe cases a central venous
pressure line should be inserted
The vaginal bleeding is painless
The management of choice is
termination of pregnancy
Answer: D* The vaginal
bleeding is painless
***) Abruptio placenta
can be secondary to all of the following, except:
Hypertensive disorders
Following delivery of first twin
In severe car accident
After rupture of membrane in
oligohydramnios
External cephalic version
Answer: D* After
rupture of membrane in oligohydramnios
***) In abruptio
placenta, all of the following may occur, except:
Shock
Vaginal bleeding
Uterine tenderness
Convulsions
Fetal distress
Answer: C* Uterine
tenderness
***) The most common
complication of abruptio placenta is:
Hepatic failure
Heart failure
Post partum hemorrhage
Adrenal failure
Cerebral edema
Answer: C* Post partum
hemorrhage
***) The following are
complications of placental abruption, except:
Renal cortical necrosis
Eclampsia
Afibrinogenemia
DIC (Disseminated Intravascular
Coagulopathy)
Intrauterine growth retardation
Answer: B* Eclampsia
***) The most
consistent factor predisposing to abruption placenta is:
Maternal hypertension
Trauma
Uterine decompression
Maternal parity
Maternal age
Answer: A* Maternal
hypertension
***) Treatment for
severe placental abruption at term with 3cm dilated cervix is:
Heparin
Blood transfusion
Steroid therapy for fetal lung
maturity
Tocolytic therapy
Urgent CS
Answer: E* Urgent CS
Placental Tumors.
***) Choriocarcinoma
is a primary tumor of:
Decidua
Undifferentiated gonadal cells
Myometrium
Trophoblast
Ovaries
Answer: D* Trophoblast
***) Choriocarcinoma
may result from all of the following, except:
Hydatidiform mole
Endometriosis
Term pregnancies
Ectopic pregnancies
Abortions
Answer: B* Endometriosis
***) The following are
clinical features of choriocarcinoma, except:
Irregular vaginal bleeding after
pregnancy
Metastases may present as lumps
in the vagina
Choriocarcinoma is self-limited
disease
May cause intraperitoneal
hemorrhage
May cause amenorrhea
Answer: C*
Choriocarcinoma is self-limited disease
***) Choriocarcinoma
is treated by:
Surgery
Chemotherapy
Antibiotics
Hormones
Radiotherapy
Answer: B*
Chemotherapy
Multiple
Gestation
Multiple Pregnancy.
***) The following about twins pregnancy are true, except:
Dizygotic
are more common than monozygotic
Dizygotic
incidence increases with maternal age
In
monozygotic twins a split at the 2 cells stage result in two placentas
All
twins are at risk of growth retardation
Polyhydramnios
is commoner in dizygotic than in monozygotic twins
Answer: C* In monozygotic twins a split at the 2 cells stage result
in two placentas
***) Multiple pregnancy predisposes to the following, except:
Placenta
previa
Diabetes
mellitus
Acute
pyelonephritis
Placental
insufficiency
Mal
presentation
Answer: C* Acute pyelonephritis
***) All of the following
are possible complications of multiple pregnancy, except:
Abnormal presentation
Dysfunctional labor
Umbilical cord prolapse
Cephalo-pelvic disproportion
Postpartum hemorrhage
Answer: B*
Dysfunctional labor
***) In multiple
pregnancy all of the following are possible risk, except:
PET (Pre-eclampsia toxemia)
Preterm labor
Oligohydramnios
Anemia
Ante partum hemorrhage
Answer: C*
Oligohydramnios
***) Twin pregnancy
shows an increase in the following complications, except:
Accidental hemorrhage
Pre-eclamptic toxemia (PET)
Polyhydramnios
Post-partum hemorrhage
Polycythemia
Answer: E*
Polycythemia
***) Compared with
single pregnancies, multiple pregnancies have a higher rate of the following
except:
Abortion
Abnormal presentation
Prolapsed cord
Lung maturity
Preterm delivery
Answer: D* Lung
maturity
***) Multiple
pregnancy is usually associated with increased incidence in all the following
except:
Ante partum hemorrhage
Anemia
Toxemia of pregnancy
Premature labor
Monilial genital infection
Answer: E* Monilial
genital infection
***) The incidence of
dizygotic twins is influenced by all of the following, except:
Race
Maternal age
Parity
Paternal age
Heredity
Answer: D* Paternal
age
***) In uniovular
twins, all the following are true except:
The first fetus commonly presents
by the breech
Anemia is common
There is only one placenta
Polyhydramnios is frequently
present
Pregnancy induced hypertension is
common
Answer: A* The first
fetus commonly presents by the breech
***) Regarding
monozygotic twins, all the following are true except:
They are always identical
They have only one placenta
They make up 1/3 of all twin
pregnancies
They are usually separated from
one another by amnion and chorion
They are more common if there is
family history
Answer: D* They are
usually separated from one another by amnion and chorion
Delivery in Multiple
Pregnancy.
***) In twin delivery
all are correct statements, except:
The 2nd twin is at
greater risk than the 1st
Labor usually occurs before term
The commonest presentation is
verte and vertex
Post partum hemorrhage is rare
Labor is not prolonged
Answer: D* Post partum
hemorrhage is rare
***) In twin pregnancy
the second twin has higher perinatal mortality because of all of the following,
except:
High incidence of intrauterine
anoxia
High incidence of mal
presentation
High incidence of abruptio
placenta
More surgical intervention
The second twin is heavier
Answer: E* The second
twin is heavier
Growth
Discrepancies
Intrauterine Growth
Restriction IUGR.
***) All of the
following maternal factors are associated with IUGR, except:
Poor nutrition with anemia
Heavy smoking
Toxemia
Gestational diabetes
Alcohol consumption
Answer: D* Gestational
diabetes
Macrosomia.
***) With fetal
macrosomia all of the following complications are increased, except:
Fetal asphyxia
Brachial plexus injury
Post partum hemorrhage
Cord prolapse
Neonatal hypoglycemia
Answer: D* Cord
prolapse
Polyhydramnios.
***) All of the
following may cause polyhydramnios, except:
Diabetes mellitus
Multiple pregnancy
Anencephalic fetus
Fetal renal atresia
Fetal esophageal atresia
Answer: D* Fetal renal
atresia
***) Polyhydramnios
could be associated with all of the following, except:
Renal agenesis
Esophageal atresia
Anencephaly
Duodenal atresia
Illeal atresia
Answer: A* Renal
agenesis
Oligohydramnios.
***) All of the
following anomalies are associated with severe maternal oligohydramnios,
except:
Potter's syndrome
Dysplastic kidneys
Pulmonary hypoplasia
Musculoskeletal abnormalities
Gastrointestinal tract
obstructions
Answer: E* Gastrointestinal
tract obstructions
***) All of the
following are associated with oligohydramnios, except:
Renal agenesis
Esophageal atresia
Pulmonary hypoplasia
Urethral atresia
Amnion nodosum
Answer: B* Esophageal
atresia
Fetus and
Delivery
Pelvis.
***) The shortest
antero-posterior diameter of the pelvis is:
True
conjugate
Diagonal
conjugate
Obstetrical
conjugate
Antero-posterior diameter of
plane of midpelvis
Antero-posterior diameter of
inferior straight
Answer: C* Obstetrical
conjugate
***) In young women
the most common type of pelvis is:
Anthropoid pelvis
Android pelvis
Platypelloid pelvis
Gynecoid pelvis
Rachitic pelvis
Answer: D* Gynecoid
pelvis
***) The android
pelvis characteristically has the following, except:
A narrow sacroischiatic notch
A parallel pelvic side walls
A narrow sub-pubic angle
A prominent ischial spines
A narrow outlet A-P diameter
Answer: B* A parallel
pelvic side walls
Fetal Skull.
***) Regarding the
head vertex, all the following are true except:
It is bounded in front by the
anterior fontanel and the coronal sutures
It is the area between the 2
halves of the frontal and the 2 parietal bones
It is the area bounded behind by
the posterior fontanel and the lambdoidal suture
It is the area bounded laterally
by lines passing through the parietal eminences
It is felt in the majority of
cases during vaginal examination
Answer: B* It is the
area between the 2 halves of the frontal and the 2 parietal bones
***) The posterior
fontanel is defined:
The area lies between the
sagittal suture and the lambdoid suture
The area lies between the coronal
and sagittal sutures
The area lies between the coronal
and temporal sutures
The area lies between the
anterior and lambdoid sutures
The area lies between the
sagittal suture and biparietal bones
Answer: A* The area
lies between the sagittal suture and the lambdoid suture
***) The longest
anterio-posterior diameter of the fetal head is:
Occipito-frontal diameter
Suboccipito-pregmatic diameter
Occipito-mental diameter
Submento-pregmatic diameter
Mento-vertical diameter
Answer:
E*Mento-vertical diameter
***) In normal
developing fetus at 36 weeks pregnancy, the most like measurement of the BPD
(biparietal diameter) of the head is:
9.5 cm
9 cm
12 cm
8.5 cm
8 cm
Answer: A* 9.5 cm
***) Regarding
biparietal diameter, all the following are true except:
The biparietal diameter is the
distance between the parietal eminences
The measurement is 9.5 cm
In vertex presentation it is the
largest presenting diameter
It is measured by ultrasound
scanning for the maturity of fetus
It has no relation to the
engagement of the head in the pelvis
Answer: E* It has no
relation to the engagement of the head in the pelvis
***) Engagement of the
fetal head refers to the relationship between:
Biparietal diameter and ischial
spines
Biparietal diameter and pelvic
brim
Vertex and pelvic outlet
Vertex and ischial spine
Head and pelvic outlet
Answer: B* Biparietal
diameter and pelvic brim
***) In primigravida
at full-term in labor, the most common position of the head is:
ROT (right occiput transverse)
LOT (left occiput transverse)
LOA (left occiput anterior)
ROA (right occiput anterior)
DOP (direct occiput posterior)
Answer: C* LOA (left
occiput anterior)
***) Cephalohematoma
is most commonly found over the:
Frontal bone
Temporal bone
Parietal bone
Occipital bone
Ethmoid bone
Answer: C* Parietal
bone
Malpresentation and
Malposition.
***) The transverse
lie in multipara at term in labor best treated by:
External version
Internal version and extraction
Pitocin induction
Cesarean section
Internal version, than oxytocin
induction
Answer: D* Cesarean
section
***) One of the
following is absolute indication for cesarean section:
Brow presentation
Anterior face presentation
Occipito-posterior position
Right occipital presentation
Transverse arrest of the head
Answer: A* Brow presentation
***) In case of face
presentation during labor, all of the following are felt on vaginal
examination, except:
Chin
Mouth
Nose
Anterior fontanel
Orbital ridge
Answer: D* Anterior
fontanel
***) The most common
cause of breech presentation is:
Polyhydramnios
Placenta previa
Prematurity
Hydrocephalus
Multiple pregnancy (twin
gestation)
Answer: C* Prematurity
***) Breech
presentation is associated with the following, except:
Prematurity
Polyhydramnios
Oligohydramnios
Hydrocephaly
Postmaturity
Answer: E*
Postmaturity
***) Breech
presentation diagnosed antenatally at 37 weeks gestation, is best managed by:
Cesarean section
External cephalic version
X-ray maturity
Ultrasonography and observation
Oxytocin infusion of lower
femoral epiphysis are seen by X-ray
Answer: B* External
cephalic version
***) Non-engagement of
the fetal head in the second stage of labor is due to all of the following,
except:
Mal position
Hydrocephaly
Contracted pelvis
Compound presentation
Anencephaly
Answer: E* Anencephaly
***) A high head at
term could be due to the following except:
Wrong dates
Cephalopelvic disproportion
Placental abruption
An occipito-posterior position
Placenta previa
Answer: C* Placental
abruption
***) In face
presentation with head not engaged in mento-posterior position the ideal
treatment is:
Forceps delivery as
mento-posterior
Forceps rotation to
mento-anterior then forceps delivery
Vacuum delivery
Cesarean section
Internal podalic version and breech
extraction
Answer: D* Cesarean
section
Labor and
Delivery
Labor and Cervical
changes.
***) False labor pains
as compared to true labor pains are characterized by all of the following,
except:
Contractions occur at irregular intervals
There is demonstrable progressive
dilatation of the cervix
They are not intensified by
walking
Located chiefly in lower abdomen
Short duration
Answer: B* There is
demonstrable progressive dilatation of the cervix
***) Progress of labor
is assessed by one of the following criteria:
Frequency of uterine contractions
Intensity of uterine contractions
Softening of the cervix
Effacement of the cervix
Dilatation of cervix
Answer: E* Dilatation
of cervix
Labor Stages.
***) All of the
following are signs of placental separation in third stage of labor, except:
Appearance of contraction ring
Uterus becomes globular, firm and
ballotable
Sudden gush of blood
Rise of uterine fundus
Elongation of the cord
Answer: A* Appearance
of contraction ring
***) The third stage
of labor follows one of the following:
Rupture of the membranes
Full dilatation of the cervix
Delivery of the fetal head
Delivery of the fetus
Delivery of the placenta
Answer: E* Delivery of
the placenta
Obstetric
Anesthesia.
***) All the following
types of analgesia are used during first stage of labor, except:
Pethidine
Epidural analgesia
Cervical block
Pudendal block analgesia
Inhalation analgesia
Answer: D* Pudendal
block analgesia
***) All of the
following are indications of epidural anesthesia, except:
Ante-partum hemorrhage
Heart disease
Pulmonary disorders
Premature delivery
Hypertension
Answer: B* Heart
disease
Fetal Monitoring in
Labor.
***) The normal fetal
heart rate in labor is:
80-100 beats per minute
100-120 beats per minute
120-160 beats per minute
160-180 beats per minute
180-200 beats per minute
Answer: C*120-160
beats per minute
***) The most
dangerous sign of imminent fetal death during fetal heart monitoring is:
Early deceleration
Variable deceleration
Loss of beat to beat variability
Late deceleration
Fetal tachycardia
Answer: D* Late
deceleration
***) All of the
following may cause fetal hypoxia, except:
Maternal hypotension
Subserous fibroid
Uterine hyperactivity
Occlusion of umbilical cord
Placental insufficiency
Answer: B* Subserous
fibroid
Induction of Labor.
***) The following may
be used safely to accelerate labor, except:
Intravenous oxytocin
Ergometrine
Prostaglandin
Rupture of membranes
Stimulation of the nipples
Answer: B* Ergometrine
Complications
& Risks of Delivery
Preterm Labor PTL.
***) All of the
following may cause premature delivery, except:
Abruptio placenta
Chronic hypertensive vascular
disease
Placenta previa
Oligohydramnios
Smoking
Answer: D*
Oligohydramnios
***) All of the
following have been associated with an increased risk of preterm delivery
except:
Placenta previa
Oligohydramnios
Hyperemesis gravidarum
First-trimester bleeding
Multiple gestation
Answer: B* Oligohydramnios
Premature Rupture
of Membranes PROM.
***) The following
tests can be used for the diagnosis of premature rupture of membranes, except:
Nitrazine test
Ferning test
Schiller's test
Nile blue sulfate
Evans blue test
Answer: C* Schiller's
test
???) Premature
ruptures of membranes risks include the following except:
Premature labor
Cord prolapse
Fetal pneumonia
Placental abruption
Maternal septicemia
Answer: D* Placental
abruption
Prolonged Pregnancy
(Postmaturity).
***) A patient
presented in labor claiming to be at 43 week gestation. Which of the following
neonatal findings would support the diagnosis of a post-mature infant:
Anemia
Increase in subcutaneous fat
Long fingernails
Vernix
Fusion of fetal eye lids
Answer: C* Long fingernails
Umbilical Cord
Prolapse.
***) Prolapsed
umbilical cord may occur in all of the following, except:
Polyhydramnios
Transverse
lie
Placenta
previa centralis
Breech presentation
Prematurity
Answer: C* Placenta
previa centralis
***) Pulsating cord
prolapse at 4 cm cervical dilatation is best managed by:
Augmentation of labor by oxytocin
drip
Vacuum extraction
By giving prostaglandin vaginal
tablets
By putting the patient in knee
chest position and wait for vaginal delivery
Cesarean section
Answer: E* Cesarean
section
Uterine Rupture.
***) The commonest
predisposing factor of rupture of uterus is:
Previous CS
Use of syntocinon (Oxytocin) non
properly
Forceps delivery
Internal cephalic version
Vacuum extraction
Answer: A* Previous CS
***) Uterine rupture
may be associated with all of the following except:
Amniocentesis
Previous cesarean section
Myomectomy
Administration of oxytocin or
prostaglandins
Difficult forceps delivery or
intrauterine manipulation
Answer: A* Amniocentesis
***) The most constant
early symptom in uterine rupture during labor is:
Hematuria
Hypotension
Pain
Vaginal bleeding
Cessation of contractions
Answer: C* Pain
***) The first sign of
rupture uterus is:
Abdominal pain
Tender scan
Unexplained tachycardia
Fetal distress
Vaginal bleeding
Answer: A* Abdominal
pain
Operative
Obstetrics
Operative Vaginal
Delivery.
***) Vacuum extraction
is contraindicated in one of the following condition:
Occipito-posterior position
Gestational age 32 weeks
Occipito-transverse position
In patients with heart disease
In patients with previous
caesarian section
Answer: B* Gestational
age 32 weeks
Episiotomy and
Lacerations.
***) Regarding
episiotomy all of the following statements are true except:
Shorten the second stage
Reduce trauma to the fetal head
Reduce damage of the pelvic floor
It is usually followed by vaginal
stenosis
Reduce the incidence of third
degree tears
Answer: D* It is
usually followed by vaginal stenosis
Caesarean Section
CS.
***) All of the
following are indications for cesarean section, except:
Transverse lie
Mento-posterior position
Fetal distress in the first stage
Twin pregnancy
Prolapsed pulsating cord
Answer: D* Twin
pregnancy
***) A multigravida
with mitral stenosis in labor with obvious cephalopelvic disproportion, best
delivered with:
Cesarean section
Forceps delivery in the second
stage
Vacuum delivery if cervix not
fully dilated
Enhance labor by syntocinon
(oxytocin)
Await spontaneous vaginal
delivery
Answer: A* Cesarean
section
***) All of the
following are possible indications for classical cesarean section, except:
Carcinoma of the cervix
Impacted shoulder presentation
Severe adhesions in the lower
uterine segment
Large cervical fibroid
Posterior placenta previa grade
II
Answer: B* Impacted
shoulder presentation
***) Indications for a
Caesarian section include all of the following, except:
Cord prolapse
Previous Caesarian section
Fetal distress
Transverse
lie
Migraine
Answer:
E* Migraine
***) All the following
are indications for caesarean section except one:
Prolapsed cord
Transverse lie at term
Placenta previa at term
Intrauterine fetal death at term
Previous for CS
Answer: D*
Intrauterine fetal death at term
***) All of the
following are indications to primary cesarean section except:
Prolapsed cord
Cord presentation
Mal presentation
Face presentation
(mento-anterior)
Fetal distress
Answer: D* Face presentation
(mento-anterior)
***) All of the
following might be an indication to do classical cesarean section except one:
Transverse lie at term with the
back down
Severe pelvic-abdominal adhesions
Previous cesarean section with
severe pelvic-abdominal adhesions
Per mortem
Cephalopelvic disproportion
Answer: E*
Cephalopelvic disproportion
Puerperal
Complications
Postpartum Changes.
***) The period of
time from the end of delivery until the reproductive organs have returned to
normal is called:
Menopause
Puerperium
Perineum
Ante-partum
Intra-partum
Answer: B* Puerperium
***) Postpartum
hemorrhage is diagnosed when blood loss exceeds:
100 cc
200 cc
300 cc
400 cc
500 cc
Answer: E* 500 cc
***) In postpartum
hemorrhage the most common cause is:
Atonic uterus
Cervical tear
Uterine rupture
Retained placental tissue
Inversion of the uterus
Answer: A* Atonic
uterus
***) Regarding post
partum hemorrhage all of the following are predisposing factors, except:
Multiple pregnancies
Polyhydramnios
Giving syntometrine with the
delivery of anterior shoulder
Prolonged labor
Precipitated labor
Answer: C* Giving
syntometrine with the delivery of anterior shoulder
***) Concerning
postpartum hemorrhage, all the following are true except:
More common in twin pregnancy
than single pregnancy
Less common in primigravida than
multigravida
The commonest cause is laceration
of the cervix
It may be caused by bleeding from
non-placental site
The prevention is by active
management of the third stage of labor
Answer: C* The
commonest cause is laceration of the cervix
***) Postpartum
hemorrhage is caused by the following, except:
Prolonged labor
Retained parts of the placenta
Cervical tear
Full bladder
Toxemia of pregnancy
Answer: D* Full
bladder
***) One of the
following is the most common cause of primary post-partum hemorrhage:
Vaginal or cervical lacerations
Uterine inversion
Coagulopathy
Uterine rupture
Uterine atony
Answer: E* Uterine
atony
***) The most common
cause of secondary post-partum hemorrhage:
Uterine atony
Injury to birth canal
Low platelet count
Breast feeding
Retained parts of placenta
superimposed by uterine infection
Answer: E* Retained
parts of placenta superimposed by uterine infection
***) The most common
symptom of acute inversion of the uterus is:
Postpartum hemorrhage
Uterine prolapse
Retained placenta
Retention of urine
Abdominal pain
Answer: A* Postpartum
hemorrhage
***) After delivery of
the baby and the placenta you discovered a firm raunded mass in the pelvis
below the level of the umbilicus. The mass is most likely is:
Uterine fibroids
Ovarian cyst
Distended bowel
Pelvic kidney
Contracted uterus
Answer: E* Contracted
uterus
***) Uterine atony
might be caused by the following except:
Prolonged labor
Multiple pregnancy
Polyhydramnios
Uterine fibroids
Preterm labor
Answer: E* Preterm
labor
***) Inversion of the
uterus is almost always subsequent upon:
Multiple pregnancy
Polyhydramnios
Traction on the umbilical cord
before separation
Abruption placenta
Difficult forceps delivery
Answer: C* Traction on
the umbilical cord before separation
Postpartum Fever.
***) The commonest
cause of maternal pyrexia in puerperium is:
Deep vein thrombosis
Endometritis
Engorged breasts
Subacute bacterial endocarditis
Urinary tract infection
Answer: B*
Endometritis
***) The most common
cause of post partum mastitis is one of the following:
Beta
streptococci
E.Coli
Staphylococcus
aureus
Streptococcus
fecalis
Chlamydia
trachomatis
Answer:
C* Staphylococcus aureus
***) All of the
following are possible predisposing factors for puerperal sepsis, except:
Prolonged rupture of membranes
Carrier of group A beta
streptococci
Multiple vaginal examinations
Elective cesarean section
Non-proper surgical scrub
Answer: D* Elective
cesarean section
***) Factors
contributing to puerperal infection are the following, except:
Prolonged labor
Precipitate labor
Instrumental delivery
Excessive vaginal examination
Home delivery
Answer: B* Precipitate
labor
***) The most common
bacteria causing puerperal infection is:
Escherichia coli
Anaerobic streptococcus
Anaerobic staphylococcus
Aerobic streptococcus
Clostridium perfringes
Answer: B* Anaerobic streptococcus
***) Puerperal
infection may be spread by several routes. The most common route that result in
septic thrombophlebitis:
Venous
Lymphatic
Arterial
Direct extension
By inhalation of toxic materials
Answer: A* Venous
***) A patient with
post-partum deep venous thrombosis complains of chest pain and dyspnea. The
helpful investigation to diagnose pulmonary embolism is:
Lung spiral CT
Electrocardiogram (ECG)
Arterial blood gases
Chest auscultation
Chest X-Ray
Answer: A* Lung spiral
CT
***) One of the
following can cause subinvolution of the uterus after normal delivery:
Urinary tract infection
Gastroenteritis
Endometriosis
Monilial infection
Endometritis
Answer: E*
Endometritis
***) Which of the
following is the most common site of puerperal infection:
The upper urinary tract (kidneys)
The lower genital tract (infected
lacerations and episiotomies)
The lower urinary tract (bladder)
The upper genital tract
(endometrium)
The cardiovascular system
(bacteremia and septic thrombophlebitis)
Answer: D* The upper
genital tract (endometrium)
Drugs and
Pregnancy
Drugs and
Pregnancy.
***) The following
drugs are not given in pregnancy, except:
Tetracycline
Thiazides
Chloramphenicol
Heparin
Warfarin
Answer: D* Heparin
***) These drugs cross
the placenta to the fetus, except:
Heparin
Warfarin
Tetracycline
Diazepam
Aspirin
Answer: A* Heparin
***) All of the
following drugs are teratogenic, except:
Tetracycline
Paracetamol
Thiazides
Stilbestrol
Warfarin
Answer: B* Paracetamol
***) All of the
following drugs are contraindicated in pregnancy, except:
Tetracycline
Iodides
Diphenylhydantoin (Epanutin)
Warfarin
Pyridoxine
Answer: E* Pyridoxine
***) One of the
following drugs can be safe if used during pregnancy:
Warfarin
Septrin
Tetracycline
Erythromycin
Chloramphenicol
Answer: D*
Erythromycin
***) Which of the
following drugs given during pregnancy can give "Grey Baby Syndrome":
Ampicillin
Chloramphenicol
Gentamycin
Tetracycline
Streptomycin
Answer: B* Chloramphenicol
***) Regarding drugs
in pregnancy, all the following are true except:
Digitalis does not cross the
placenta
Warfarin crosses the placenta
Heparin does not cross the
placenta
Hydralazine causes relaxing
vascular smooth muscle
Methotrexate crosses the placenta
Answer: A* Digitalis
does not cross the placenta
***) Brown
discoloration of the teeth can occur in infants exposed in uterus to:
Penicillin
Tetracycline
Chloramphenicol
Gentamycin
Streptomycin
Answer: B*
Tetracycline
Breastfeeding and
Drugs.
***) Milk ejection
reflex is affected by one of the following hormones:
Estrogens
Progesterone
Human placental lactogen
Oxytocin
Chorionic gonadotropin
Answer: D* Oxytocin
***) All of the following
drugs are contraindicated during breast feeding except one:
Cytotoxic drugs
Chloramphenicol
Iodine
Heparin
Thiouracil
Answer: D* Heparin
***) All of the
following drugs are contraindicated during breast feeding except one:
Bromocriptine
Cephalosporins
Ergotamine
Cimetidine
Tetracycline
Answer: B*
Cephalosporins
Oxytocin.
***) All of the
following are true regarding oxytocin, except:
Prolonged treatment can cause
water intoxication
Can cause milk ejection
Single rapid IV injection can
cause transient hypotension, tachycardia and ECG changes
It is not effective when given
orally
It can cause contraction of the
lower uterine segments
Answer: E* It can
cause contraction of the lower uterine segments
***) Regarding
oxytocin, one of the following is true:
Induces vigorous sustained
uterine contractions
Comes from the anterior pituitary
gland
Possesses no antidiuretic
activity
Has long half life
Acts on myoepithelial cells of
the mammary glands
Answer: E* Acts on
myoepithelial cells of the mammary glands
***) All of the
following are complications of Syntocinon (oxytocin) toxicity, except:
Headache
Nausea and vomiting
Polyuria
Coma
Weight gain
Answer: C* Polyuria
Immunizations.
***) The first
immunoglobulin produced in any immune response is:
IgA
IgM
IgD
IgE
IgG
Answer: B* IgM
***) The only
immunoglobulin can cross placenta:
IgM
IgA
IgG
IgE
IgD
Answer: C* IgG
***) All of the
following vaccines are contraindicated during pregnancy, except:
German measles
Tetanus
Mumps
Poliomyelitis
Hepatitis
Answer: B* Tetanus
***) All of the
following vaccines can be given to the pregnant patient after the second
trimester, except:
Tetanus toxoid vaccine
Smallpox vaccine
Cholera vaccine
Vaccination against hepatitis B
virus
Typhoid vaccine
Answer: B* Smallpox vaccine
***) Mumps in
pregnancy is associated with:
Increase fetal wastage
Lymph reduction defect
Maternal pneumonia
No major complications
Congenital deafness
Answer: D* No major complications
???) Regarding
immunization during pregnancy, which of the following vaccines would be the
safest to receive:
Mumps
Poliomyelitis
Rabies
Rubella
HIV
Answer: C*
Poliomyelitis
Drugs.
***) All of the
following drugs have effect on the uterine muscle, except:
Salbutamol
Cervidil
Isoxsuprine
Clomiphene citrate
Methergine
Answer: D* Clomiphene
citrate
***) Regarding the
actions of hydralazine, all the following are true except:
Increased renal blood flow
Increased cardiac output
Reflex tachycardia
Smooth muscle relaxation
Decreased placental perfusion
Answer: E* Decreased
placental perfusion
*******************************************
425) All of the following are
complications of post-maturity, except:
Meconium aspiration syndrome
Hypoglycemia
Hypocalcemia
Loss of subcutaneous fat
Hyaline membrane disease
Answer: C* Hypocalcemia (It may
lead to Hypercalcemia)
***) Which of the following is
characteristic feature of acute gonococcal urethritis:
Dysuria
Genital ulceration
High fever
Generalized lymphadenopathy
Sweating
Answer: 1* Dysuria
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