551.During antenatal management, the following are true
a) Refocused ANC involves reducing the number of visits and improving the quality
of contact time
b) All mothers must have four visits only
c) All mothers should have a birth plan as this improves decision on making
d) A and B
e) A and C
552.About antenatal care.
a) The more times the mother attends the clinic the better for her.
b) The more times the mother attends the clinic the less likely she is to get
problems.
c) All mothers who will get complications can be identified with good and close
monitoring.
d) a) and c) above.
e) None of the above.
553.Haematological findings in Iron deficiency anaemia.
a) Microcytic hyperchromic.
b) Macrocytic hypochromic.
c) Market anisocytosis.
d) The mean corpuscular value is low.
e) Mean corpuscular haemoglobin is increased.
554. The following are effects of progesterone in pregnancy.
a) Reduces vascular tone and BP increases.
b) Reduces vascular tone and peripheral temperatures increases.
c) Increases vascular tone and BP increases.
d) Increases vascular tone and BP decreases.
e) All of the above.
555. Incompetent cervix
a) We commonly treat by cervical cerclage at 20 weeks of gestation
b) Ultrasound scan before the procedure is not necessary
c) The stitch is only removed after 37 completed weeks
d) Cause may be congenital
e) All the above
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556.Which of the following doesn’t include WHO recommendation regarding breast
feeding in HIV mothers?
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.
557. During the management of malaria:
a) A negative blood slide means there is no malaria
b) Quinine can be used in early pregnancy
c) IV Quinine should be given in Normal saline since the mother is dehydrated
d) All the above
e) None of the above
558.About pathogenesis of malaria in pregnancy:
a) The Plasmodium falciparum parasites express VSAs that mediate adhesion of
parasite infected erythrocytes to the chondroitin sulphate A receptors
b) The Plasmodium falciparum parasites express VSAs that mediate adhesion of
parasite infected erythrocytes to the chondroitin sulphate C receptors
c) Adhesion occurs on the cytotrophoblast lining the intervillous intervillous space.
d) Adhesion occurs on the syncytiotrophoblast lining the intervillous intervillous
space
e) The var5csa gene encodes a parasite adhesion molecule that initiates the
pathology associated with pregnancy associated malaria (PAM).
559.Malaria in pregnancy
a) Plasmodium vivax causes cerebral malaria.
b) Plasmodium malariae causes relapses.
c) Chondroitin sulphate A receptors Protect PG’s agains severe malaria.
d) Prime gravida are more prone to hyperparasitaemia than grand multiparous.
e) None of the above
560.The following have been associated with bacteriuria in pregnancy:
a) Pre-term birth
b) Low birth weight
c) Perinatal mortality
d) Abortions
e) Diabetes Mellitus
561. About asymptomatic bacteriuria in pregnancy:
a) Refers to the presence of a positive urine culture in an asymptomatic person
b) Occurs in 2 to 7 percent of pregnancies
c) Defined as two consecutive voided urine specimens with isolation of the same
bacterial strain in quantitative counts of ≥10(5) cfu/mL
d) Presence of lactobacillus or propionibacterium does not indicate a contaminated
urine specimen
e) If left untreated, 50% of patients will progress to symptomatic bacteriuria
562. The following drugs can be used for treatment of asymptomatic bacteriuria:
a) Penicillins
b) Cephalosporins
c) Doxycycline
d) Sulphodoxine
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e) Dexamethasone
563. About renal physiological changes during pregnancy, the following are true except:
a) Glomerular Filtration Rate increases by 50%
b) Renal plasma flow increases by 50%
c) Oestrogens are responsible for the general ureteric relaxation
d) There is decreased predisposition to Urinary tract infections
e) There is increased creatinine clearance.
564. In the management of premature labour
a) Vacuum extraction should be done to expiate the delivery
b) Dexamethasone injection is mandatory to prevent respiratory distress syndrome
c) Prostaglandins should never be given
d) All the above
e) None of the above
565. All the following are increase in multiple gestation
a) Blood loss at delivery.
b) The evidence of congenital anomalies.
c) The evidence of cephalopelvic disproportion.
d) The incidence of placental abruption.
e) The incidence of malpresentation.
566. The following are true in the management of multiple pregnancies
a) They should be admitted at 36 weeks to reduce the incidence of neonatal
complications
b) Active management of third stage always prevents post partum haemorrhage
c) Caesarean section is indicated if the second twin is a breech
d) A and C above
e) None of the above
567. 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
568. About Diabetic in pregnancy.
a) Oral hypoglycaemic are recommended.
b) Nutritional counselling and exercise are not part of management.
c) Shoulder dystocia may occur during delivery.
d) Caesarean section is always the mode of delivery.
e) Patient with Pregestational Diabetic always need insulin treatment.
569. Assessment in IUGR.
a) Uterine fundal length, maternal weight gain, and foetal quickening.
b) Abdominal circumference is the best parameter during follow up.
c) Oligo hydramnios is usually associated.
d) Femur length/abdominal circumference is the best us parameter.
e) The frequency of symmetric IUGR is 75 %
570. The following are indication for removal cervical cerclage.
a) Rupture of the membranes.
b) Haemorrhages
c) Elevations of blood pressure.
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d) Uterine fibroid
e) Uterine contractions.
571. In the management of premature labour
a) Vacuum extraction should be done to expiate the delivery
b) Dexamethasone injection is mandatory to prevent respiratory distress syndrome
c) Prostaglandins should never be given
d) All the above
e) None of the above
572. In the management of mild pre eclampsia,
a) The patient can be seen weekly
b) The mother should be immediately admitted
c) The mother should be delivered by caesarean section when she reaches 40 weeks
of amenorrhea
d) All the above
e) None of the above.
573. The following statements are true about pre- eclampsia.
a) Is among the commonest cause of maternal mortality in MRRH.
b) SFlt-1 prevents the correct differentiation and invasion of the trophoblast.
c) Aspirin inhibit the synthesis of prostacyclin.
d) Thromboxane A2 is a potent vasodilator.
e) None of the entire above is true.
574. About management of severe pre Eclampsia
a) Severe pre Eclampsia should be managed as out patient after control of the blood
pressure
b) Magnesium sulphate should be used in all cases
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
575. 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.
576.MgSO4.
a) Act by preventing the release of acetylcholine at neuromuscular plaque.
b) Prevent the entry of calcium to the damaged endothelial cells.
c) Stimulate the N-methyl-D-aspartate receptors.
d) Toxicity appears with concentration of 8 to 10 meq/L.
e) Pulmonary oedema is a common complication.
577.A 25 year old patient at 32 weeks of amenorrhea was brought to maternity ward of
MRRH. These are the clinical findings on the physical examination. Pale xxx,
dehydrated, RP: 120/ min; BP 90/60 mmHg; delay in the capillary refilling time;
bleeding by mouth. Abd: Fundal height 36 cm, tenderness, and uterus hard, no
FHeart heard. Vaginally: scanty blood coming through the canal, reddish area around
the cervix was noticed. Which among the following is the most likely diagnosis?
a) Placental abruption.
b) Placenta praevia type IV.
c) Cervical carcinoma.
d) Severe placental abruption with IUFD and CID.
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e) Vasa praevia with IUFD.
578.About labour.
a) Is divided into two stages.
b) Latent phase is considered since the uterine contractions are started until the
moment the cervix reaches a dilatation of 5 cm.
c) Active phase is considered from 4 cm to 10 cm.
d) Second stage commencement is at 9 cm.
e) Maximum slope is part of the second stage.
579. Analgesia during labour.
a) Pudendal nerve block is not recommended.
b) Is not recommended in active labour.
c) Is commonly practiced.
d) Narcotics are commonly used in MUTH.
e) Companion support in labour has shown to help
580. 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.
581. The following are true about the partogram
a) Reduces the need for unnecessary vaginal examinations
b) Reduces the need for consultation
c) Should be used by midwives and students (nursing and medical)
d) Should be used by specialists’
e) All the above
582. Shoulder dystocia.
a) Is a common complication.
b) Associated with maternal obesity.
c) Associated with gestational diabetes.
d) Foetal clavicle fracture is a complication.
e) McRobert maneuver can solve about 70 % of all cases.
583. 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.
584. 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.
585. Active management of third stage of labour (AMSTIL) involves:
a) Using a balloon tamponade to enhance uterine involution
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b) Delivery of the cord by controlled cord traction with counter traction over the
supra pubic area
c) Monitoring of the Blood pressure, pulse rate, GCS, and Per vaginal bleeding every
20 minutes for one hour
d) Pelvic floor exercises (kegel's exercise)
e) Administration of 10IU of oxytocin IM on the anterior thigh within 2 minutes of
delivery of the baby
586. Classical c/section is:
a) Vertical incision done in the upper uterine segment.
b) Vertical incision made in the lower uterine segment.
c) Vertical incision extended from the upper to the lower uterine segment.
d) Transverse incision made in the lower uterine segment.
e) None of the above.
587. The following are contraindications for vaginal birth after a caesarean section.
a) Previous classical caesarean section.
b) Previous transverse low-segment incision.
c) Surgeon opinion.
d) Previous uterine rupture.
e) Mother decision.
588. Physiological management of 3rd stage of labour
a) Oxytocin 10IU IM is given on the anterior thigh
b) Controlled cord traction is done
c) No intervention is done
d) Practiced by mid wives and TBA’s in the village
e) Associated with PPH
589.These methods can be used in treatment of postpartum haemorrhage except:
a) Caesarean section
b) Total abdominal hysterectomy
c) Internal Iliac ligation
d) Cytotec
e) Syntometrienne
590. A 26 year old patient, primegravida was admitted at Mbarara Regional Referral
Hospital at 35 WOA due to APH. This was the first time she had bleed and on physical
examination the following finding were reported: MM : coloured and hydrated; RP:
88/ min; BP: 126/86 mmHg; Abd: FL 36 cm, cephalic, FHR: 146/min, V/V palpable.
Which of the following is the best option of management?
a) Digital vaginal examination to confirm diagnosis under general anesthesia and
C/section if confirm.
b) Conservative management due to the good maternal conditions.
c) Digital examination, AROM and induction of labour.
d) Emergency c/section.
e) All of the above are right.
591. The following are true statements about abruptio placenta.
a) Maternal conditions are always related to amount of PV bleeding.
b) Is frequently related with low consumption of coagulating factors.
c) Smoking has no role.
d) ARM and induction is contraindicated.
e) Is highly related to PPH.
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592. A patient at 32 WOA was diagnosed of having a severe abruptio placenta with
intrauterine foetal death and DIC, which of the following is the best option to deliver
the patient?
a) General measures, resuscitating the patient and emergency c/section.
b) General measures, whole blood transfusion, fresh frozen plasma, IV fluids
emergency C/section.
c) General measures, whole blood transfusion, fresh frozen plasma, IV fluids, after
correction the DIC ARM and attempt to vaginal delivery by inducing or
augmenting labour.
d) None of the above.
e) All of the above can be used with similar results.
593. In PPH.
a) Blood transfusion is always required.
b) Blood transfusion may not be required.
c) Bleeding is always from the uterus.
d) a) and c) above.
e) All of the above.
594.The following are important investigations in disseminated intravascular coagulation
a) Partial thromboplastin time
b) Prothrombin time
c) Thrombin time
d) A and C above
e) B and C above
595. Maternal changes in puerperium.
a) Return to normality is 2 weeks after delivery.
b) Return to normal 20 weeks after delivery.
c) Return to normal 42 weeks after delivery.
d) Return to normal 32 days after delivery.
e) None of the above
596. The following are true about puerperal infection.
a) It is the infection of the genital tract of a woman while pregnant or after delivery.
b) The commonest site of infection is episiotomy wound.
c) Caesarean section has the greatest risk for infection.
d) Endometritis is the commonest infection.
e) None of the above.
597.The following are causes of early neonatal deaths in Uganda
a) Hyaline membrane disease
b) Foetal asphyxia
c) Bronchopneumonia
d) All the above
e) None of the above
598.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.
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599.Malaria in pregnancy:
a) Plasmodium Vivax causes cerebral malaria.
b) Plasmodium malariae causes relapses.
c) Chondroitin sulphate A receptors protect primegravida against severe malaria
attacks.
d) Primegravidas are more prone to hyperparasitaemia than grandmultipara.
e) All pregnant women require only 2 doses of intermittent presumptive treatment.
600.The following species of malaria parasites cause relapse of malaria in pregnancy.
a) P. falciparum.
b) P. vivax.
c) P. ovale.
d) P. inguinale.
e) P. malariae.
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