401.The following are poor prognostic factors in trophoblastic disease for malignant
change.
a) Disease following normal delivery
b) beta-hCG more than 80,000 miu/mililitre
c) Disease following an abortion
d) A and C above
e) A and B above.
402.Risk factors for Perinatal death include:
a) Premature rupture of membranes.
b) Foetal hypoxia of unknown cause.
c) Chorioamnionitis.
d) Abruptio placenta.
e) Vasa praevia.
403.Maternal mortality.
a) Is the death of a woman while pregnant or within 42 days of termination of
pregnancy, including accidental and incidental causes.
b) Direct obstetrics death- resulting from obstetrics complications of pregnancy,
labour or the puerperium.
c) One of the most common indirect obstetric deaths in Mbarara Referral hospital is
puerperal sepsis.
d) Haemorrhage remains an important cause of direct matenal death.
e) All above are true.
404.APH.
a) Abortion is a common cause of APH.
b) In patient with placenta praevia type III AROM should be done followed by labour
induction.
c) In a patient with abruptio placenta faintness and collapse may occur without
external bleeding.
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d) FHR absence in a severe abruptio always means IUFD.
e) Severe abruptio with IUFD and DIC should be delivered immediately by
emergency C/section
405.Abruptio placenta
a) DIC is the commonest complication
b) Amniotic fluid embolism should not occur
c) Couvelaire uterus is always associated with DIC.
d) Trauma is the commonest cause in Uganda
e) Amniotomy is only done when induction is indicated
406.Placenta Previa management
a) Tocolytics are indicated in preterm management
b) Vaginal delivery should always be attempted if the mother is not severely affected
c) PPH should be anticipated
d) When mild bleeding at term, mother stable, labour should be awaited
e) All the above.
407.A 35 year old woman presents with history of periods of amenorrhea followed by
heavy bleeding and denies using drugs. She wants to get pregnant. The following are
likely causes
a) Over stimulation of the follicular system of the ovaries by the hypophysis
b) Under production of oestrogens and progesterone
c) Under production of FSH and LH
d) All the above
e) None of the above.
408.The following are true of oral contraceptive pills
a) They decrease the risk of ovarian cancer
b) They are contraindicated in parous women with endometriosis
c) They are contraindicated in young nulliparous girls
d) All of the above
e) None of the above
409.PID
a) Can affect women of reproductive age
b) TB is commonly associated
c) Doesn’t present with PV bleeding
d) Always associated with Futz – Hugh – Curtis syndrome
e) Bacteroides are commonly implicated.
410.About PID
a) Fever, lower abdominal pain and vaginal discharge considered major signs.
b) C reactive protein, have a good sensitivity for assessing out come.
c) Presence of fluid in the pouch of Douglas in an abdominal ultrasound is
pathognomonic.
d) Bilateral hydrosalpinx is usually associated to sub acute and chronic PID.
e) In a pelvic abscess criteria to discharge patient is ESR less than 100 mm.
411.Fitz-Hugh-Curtis syndrome.
a) There is left upper quadrant pain.
b) Salpingitis is not included.
c) N. gonorrhoea is not associated.
d) Viral hepatitis is a differential.
e) Occurs almost exclusive in women.
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412.Predisposing factors for vaginal candidiasis include.
a) Pregnancy.
b) Good immune status.
c) Glycosuria.
d) Broad spectrum antibiotic therapy.
e) Chronic anaemia.
413.Trichomoniasis is characterized:
a) Vaginal tenderness and pain.
b) Non-irritant discharge.
c) Patchy strawberry vaginitis.
d) Copious offensive frothy discharge.
e) Dysuria.
414.The natural defence of the genital tract.
a) Is maintained by acidity of the vagina.
b) Is interfered with lactobacilli.
c) Is enhanced by oestrogens and progesterone.
d) Is improved by menstruation.
e) The entire above is false
415.IUFD
a) Can occur secondary to infection
b) Coagulation profile is vital
c) A C/S delivery is always safe
d) PPH is a possible complication
e) Misoprostol can be used for induction of labour.
416.About post-abortal care (PAC)
a) Antibiotics cover to prevent infection
b) Immediate post abortion family planning to avoid another pregnancy
c) Connection to other reproductive health services
d) All of the above
e) None of the above.
417.About management of severe pre-eclampsia
a) Severe pre-eclampsia should be managed as outpatient after control of the blood
pressure
b) Magnesium sulphate should be used in all cases routinely
c) Methyldopa is the best option to treat the crisis
d) Aspirin 80 mg daily may help in preventing pre-eclampsia in patient at high risk
e) All the above
418.About MgSO4.
a) At 50 % concentration should be given IV to get fit prevention.
b) Act at the neuromuscular junction by blocking the acetylcholine release.
c) Prevent the Calcium entrance to the damaged cells.
d) Prevent convulsion by inhibiting epileptogens mediators.
e) At 12 meq/l serum level can induce cardio respiratory arrest.
419.Physiopathology of pre-eclampsia.
a) Any event causing placental ischaemia is a risk factor.
b) Immunological theory has the explanation in the familiar predisposition.
c) Genetic information in the father has no role.
d) Impaired trophoblast differentiation/ invasion seem to have the main role.
e) VEGF/PlGF 1deffciency can be the starting even.
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420.Pre-eclampsia management.
a) 33 WOA, blood pressure 140/90 mmHg, urine protein xx, LFT and RFT normal:
admission, bed rest and oral antihypertensive treatment.
b) 33 WOA, 140/115 mmHg, urine protein xxx, blurred vision, vomiting; admission,
bed rest, oral antihypertensive treatment, MgSO4 50% IV.
c) 33 WOA, 160/115 mmHg urine protein xxx, blurred vision, vomiting and
hyperreflexia: admission, IV Hydralazine (5mg/30 min till BP is 120/80mmHg,
MgSO4 50% IM (14g) plan for immediate caesarean section.
d) 34 WOA, 140/100 mmHg, urine protein nil, asymptomatic, IV Hydralazine
5mg/30 min, after BP control, oral methyldopa.
e) 36 WOA, 140/110 mmHg urine protein xx, fronto-oocipital headache: Admission,
IV Hydralazine 5mg/30 min, IV MgSO4 20% and IM 50 %, Induction of labour
after BP control if bishop score > 7.
421.About eclampsia
a) Difenyl hidantoine is the drug of choice
b) Valium can be used as secure alternative in the absent of magnesium sulphate
c) Delivery is indicated only after complete stabilization of the patient
d) Vaginal delivery is contraindicated
e) All the above.
422.An HIV +ve mother delivers a healthy baby. PCR confirms that this baby is HIV –ve
at birth. What will you do to prevent MTCT
a) Breast feeding for only three months will protect the baby
b) Since the baby is negative, Nevirapine is not necessary
c) Replacement feeding with cow milk is the ideal
d) Wet Nursing is a recorgnised option
e) Condom use has no role in protecting this baby
423.A G2P1+0 HIV +ve mother comes to clinic. Which of the following will you
consider?
a) Initiation of HAART even without medical eligibility
b) CD4 count will not influence the decision to start ART
c) 3TC, D4T, EFV is the combination of Choice
d) 3TC, D4T, NVP is the combination of Choice
e) Triomune is never given.
424.Which of the following doesn’t include WHO recommendation regarding breast
feeding?
a) Exclusive breast feeding should be protected, promoted and supported for 6
month.
b) To minimize HIV transmission risk, breast feeding should be continued for as long
as possible.
c) HIV infected women should have access to information, follow-up.
d) Avoidance of breast feeding by HIV infected mother is not recommended.
e) Exclusive breast feeding for 6 month is recommended for both HIV negative and
HIV positive mothers.
425.The following are predisposing factors for placenta previa
a) Repeated induced abortion.
b) Multi foetal gestation.
c) IVF.
d) Malposition
e) Congenital anomalies of the uterus.
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426.Malaria in pregnancy.
a) Maternal immunoglobulin A antibodies cross the placenta to the foetal circulation.
b) Falciparum malaria parasites grow well in RBC containing haemoglobin F.
c) Plasmodium Vivax is more common in East Africa.
d) Coartem is the first line during the first trimester.
e) Quinine is the 1st line in the second trimester for uncomplicated malaria.
427.Anatomy of the female genital tract.
a) The uterine artery is a branch of the terminal part of the aorta.
b) The uterine artery is a branch of the internal iliac artery.
c) The uterine artery is the terminal branch of the internal femoral artery.
d) The uterine artery is a branch of the obsturator internus artery.
e) None of the above.
428.When monitoring a mother with the partograph.
a) If the graph reaches the action line you should do a C/section immediately.
b) If the graph leaves the alert line, you should put up oxytocin.
c) If the foetal heart slows down or increases you should put up fluids, give oxygen
and make the mother lie on her left.
d) If the graph reaches the action line, you should put up oxytocin immediately.
e) None of the above.
429.Shoulder dystocia.
a) Is a common complication.
b) Associated with maternal obesity.
c) Tortoise sign is not present.
d) Foetal clavicle fracture is a complication.
e) McRobert manoeuvre can solve about 70 % of all cases.
430.Ovarian tumour.
a) CA 125 is a tumour marker.
b) Dysgerminomas are common in reproductive age group.
c) Always present with ascites.
d) Serous adenocarcinoma is the commonest.
e) Bilateral tumours have a great probability of malignancy.
431.Operative features suggestive of malignancy in ovarian tomours.
a) Solid mass.
b) Large blood vessel in the surface.
c) Bilateral presence.
d) Ascites.
e) All of above.
432.Method of delivery of twins (mother in labour).
a) 1
st twin, cephalic presentation, C/section.
b) 1
st twin in transverse lie, external cephalic version can be attempted.
c) 1
st twin in breech presentation, C section is suggested.
d) The estimate weigh of the 2nd twin is more than 1000gramos in relation with 1st
twin. Normal vaginal deliver can be attempted.
e) If 2nd twin is breech, C/section should be done.
433.Labour management in multifoetal gestation.
a) Induction of labour is contraindicated.
b) IV fluids should be given as soon as labour starts.
c) Vacuum extraction can be done on breech 2nd twin.
d) Forceps can be done on delivery after coming head.
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e) Both babies have a high morbidity and mortality.
434.The following are common complication of multifoetal pregnancy.
a) Pregnancy induced hypertension.
b) Preterm labour
c) Foetal growth restriction.
d) Shoulder dystocia.
e) Puerperal sepsis.
435.The following is correct for twin pregnancy.
a) Diamniotic, dichorionic placentation occurs with division prior to morula stage.
b) Diamniotic monochorionic placentation occurs with division in the first 3 days of
fertilization.
c) Diamniotic monochorionic placentation occurs with division between day 8-12
after fertilization.
d) Monochorionic, mono amniotic placentation occurs with division after 8-12 days
post fertilization.
e) All of the above
436.About caesarean section.
a) Increase risk of MTTC transmission of HIV.
b) Increase risk of puerperal infection.
c) Classical incision has less risk of uterine ruptures in subsequent pregnancies.
d) In emergencies, patients don’t need to be consented.
e) Is the commonest cause of maternal death.
437.Post caesarean care.
a) Ambulation should no be started before 24 hours.
b) Oral feeding neither is nor indicated before 12 hours.
c) Foley catheter in prolonged/obstetric labour should be keep inserted for 21 days.
d) Elective operations antibiotic prophylaxis should be extended for at least 72
hours.
e) Deep venous thrombosis prevented by ambulation.
438.Regarding episiotomy.
a) It’s done to shorten second stage only.
b) Done in every primegravida.
c) Reduces the risk of MTCT of HIV.
d) Medio-lateral incisions are more prone to extension than median episiotomy.
e) The entire above.
439.Depo-Provera:
a) Contains both progesterone and oestrogens.
b) Can cause break through bleeding.
c) Is effective for 10 weeks.
d) Contains 3rd generation progesterone.
e) Return to fertility is immediate after termination its use.
440.The following are possible complications of intrauterine device.
a) Syncope attacks.
b) Abnormal menstrual bleedings.
c) Spotting.
d) Spontaneous expulsion.
e) Dyspareunia.
441.Vasectomy.
a) Leads to sterility after 10 ejaculations.
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b) May cause impotence.
c) Involves ligation of Vasa efferentia.
d) Can lead to primary testicular failure.
e) Is reversible.
442.The following factors can lead to male infertility.
a) Excessive smoking.
b) Morbid obesity.
c) Orchidopexy.
d) Vasectomy.
e) All above
443.Cervical carcinoma Clinical staging.
a) Clinical lesion visible, 3,5 cm on diameter, anterior lip, uterus free, normal
ultrasound and proctoscopy, cytoscopy showing bladder infiltration is stage
.............
b) Lesion no visible clinically but histology informing; Endocervical adeno carcinoma,
LFT normal, US scan negative, uterus fix to the pelvis, RFT abnormal is stage
...........
c) No clinical lesion visible, histology informed you, cervical carcinoma with stromal
invasion 3mm on deep and 5 mm on transverse diameter: stage.........
d) Cervical carcinoma invading lower third of the vagina is stage .........
e) The carcinoma has extends beyond the cervix but has not extended on the pelvic
wall, the carcinoma involves the vagina but not as far as the lower third:
stage..............
444.The following are true about uterine fibroids.
a) Treated always by surgery.
b) Red degeneration more common in post menopause.
c) Hyaline degeneration is a possible complication.
d) Medical treatment has no benefits.
e) Cannot be treated by endoscopic surgery.
445.Criteria for medical treatment for uterine fibroid include.
a) Giant fibroid previously surgery.
b) Small fibroids.
c) Contraindications for surgery.
d) To earn time and compensate the patient for surgery.
e) To preserve fertility.
446.About genital prolapse.
a) Commonly affecting young women.
b) Always treated by Manchester’s operation.
c) Kegel’s exercise can prevent it.
d) Pelvic floor usually affected.
e) Can’t appear after TAH.
447.Tumour marker in gynaecology.
a) Alpha-feto-protein (AFP) for Endodermal sinus tumour.
b) CA-125 for fibroids.
c) CA-125 for ovarian tumour.
d) hCG for choriocarcinoma.
e) All the above are true.
448.Vaginal hysterectomy possible complications.
a) Obstetric fistula.
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b) Ureteric injuries.
c) Pudendal artery damage.
d) Vaginal vault prolapse.
e) Rectum lesion.
449.Malaria in pregnancy.
a) Plasmodium ovale causes hyperparasitaemia.
b) Can present as acute pulmonary congestion.
c) Plasmodium falciparum causes relapses in pregnancy.
d) Plasmodium ovale causes renal failure in pregnancy.
e) The pigment haemozoin is directly responsible for the fever episodes
450.In PMTCT:
a) TRRD means HIV positive mother who has been received Nevirapine.
b) Episiotomy is contraindicated.
c) Dose of Nevirapine is 200 mg for the mother and 0.6 ml for the baby.
d) Rupture of membranes can only be done when indicated.
e) Caesarean Section increases the risk of MTCT.
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