MCQs for OBGYN 2

 MCQs for OBGYN 2

51. A G2 P1+0 HIV positive mother comes to your 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.

52. The perineal body is made of the following muscles.

a) Transverse perineal, Coccygeus, ischiocavernosus, levator ani, bulbocavernosus.

b) External anal sphincter, ischiocavernosus, bulbocavernosus, levator ani and transverse perini.

c) Bulbospongiosus, ischiocavernosus, transverse perineal, levator ani.

d) Bulbospongiosus, transverse perini, anal sphincter, levator ani.

e) None of the above.

53.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 obturator internus artery.

e) None of the above.

54.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.

55.Shoulder dystocia.

a) Is a common complication.

b) Associated with maternal obesity.

c) Turtle sign is not present.

d) Rubin manoeuvre can be done to hyper flex the arms.

e) McRobert manoeuvre can solve about 70 % of all cases.

56.Which is the order to do asepsis before delivering a mother?

a) Mons pubis. ( )

b) Perineal body ( )

c) Labia majora ( )

d) Internal side of the thigh ( )

e) Vaginal introitus. ( )

57. In PPH.

a) Blood transfusion is always required.

b) Blood transfusion may not be required.

c) Bleeding is from the uterus.

d) a) and c) above.

e) All of the above.

58. Managing PPH.

a) Intra vaginal Misoprostol is effective.

b) Oxytocin 10 IU after delivery of the baby is always preventive.

c) Record keeping is the least important.

d) All of the above.

e) None of the above.

59.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.

60. 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.

61. 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.

62.Lactational amenorrhea (LAM) method of contraception:

a) Is a permanent method.

b) Can be practiced when baby is 8 month.

c) Is about 80% effective

d) Is highly when mother is started her periods.

e) All of the above.

63.Emergency contraception:

a) Combined oral pills are more effective than the progesterone only pills.

b) Progesterone only pills (Ovrette) 2 doses 12 hours apart are enough.

c) Intra uterine device can be used within 7 days.

d) Is a routine method of contraception

e) All of the above are false.

64.Vacuum extraction:

a) Is a spontaneous vertex delivery.

b) Commonly done in our unit.

c) Can be done on face presentation.

d) Smallest cup is ideal.

e) Analgesics are not required.

65. PID.

a) Infection of the lower and upper genital tract.

b) Cervicitis is included in the syndrome.

c) Bacteroides are widely implicated.

d) Chlamydia trachomatis is very common.

e) Does not occur in pregnancy.

66.Organism responsible for salpingitis.

a) Mycoplasma.

b) Mycobacterium tuberculosis.

c) Escherichia coli.

d) Actinomycosis.

e) None of the above.

67. CA-125 glycoprotein (tumour marker).

a) Is a tumour specific antigen.

b) Is only detectable in carcinoma of the ovary.

c) Cannot be detectable in normal women.

d) Is used to monitor patient on chemotherapy.

e) You get raised levels in PID.

68.Second look surgery.

a) Only done by laparotomy.

b) Aim is confirm cure and to assess the effect of chemotherapy in tumour mass.

c) Done after 2 years of 10 therapies.

d) Done after 1 year of 10 therapies.

e) None of the above.

69.Endometriosis.

a) Functional endometrial tissue in the myometrium.

b) Present up to 25% among the infertile women.

c) Endometrial tissue’s transplantation can explain all cases.

d) Increases Phagocytosis of spermatozoids.

e) Affected patient is always symptomatic.

70.About endometriosis.

a) GnRH effective 100% in cure patient.

b) COC are also used and effective.

c) Surgery has important role.

d) Frequency is reduced with pregnancies.

e) Only present among reproductive age women.

71. Genital prolapse.

a) When a pelvic organ slips down and protrudes outside of the vagina.

b) Cystocele is when the anterior bladder wall slip down through the anterior vaginal wall.

c) In a rectocele the rectum is prolapsed into the posterior vaginal wall.

d) Always treated with surgery.

e) Cannot be prevented.

72. POP-Q classification of genital prolapse.

a) Aa point is 3cm above the hymen.

b) Ba is the lowest point of the anterior vaginal wall (range from TVL to TVL – 2cm).

c) In a grade I rectocele, Bp point is 1cm above the hymen.

d) In a grade III uterine prolapse: C point is 2 cm above the hymen.

e) In a grade III cystocoele prolapse: Aa point is 4 cm below the hymen.

73. Genital prolapse risk factors:

a) Multiparity.

b) Chronic respiratory processes.

c) Big intra abdominal masses have no clinical importance.

d) Collagen’s diseases are no important.

e) Cultural habits.

74.About cervical carcinoma.

a) Ugandan women have high risk.

b) Absent of screening programs increase the risk.

c) Viral infections have the main role.

d) The prognosis improves with earlier diagnoses.

e) Can be prevented.

75. Management in cervical carcinoma and pre-invasive lesions.

a) Stage 0 better treated by Wertheim operation.

b) CIN I a period of 2 years without action is advisable in high risk patients.

c) Radiotherapy can be used in stage IVb with high cure rate.

d) Stage III patients don’t need for palliative care.

e) LLETZ can be used in all pre-invasive lesions.

76. Dysmenorrhoea.

a) There is pathology in spasmodic Dysmenorrhoea.

b) Secondary dysmenorrhoea is mostly confined to adolescent.

c) Primary dysmenorrhoea pain normally goes following pregnancy and delivery.

d) Oral contraceptives puts play role.

e) Investigations aren’t required.

77. The following are known causes of female infertility:

a) Sigmond-Sheehan’s syndrome.

b) Stock-Adams-Morgatny syndrome.

c) Endometriosis.

d) Klinefelter’s syndrome

e) Meig’s syndrome.

78. In a patient with recurrent abortion, which of the following are possible causes?

a) Sigmond-Sheehan’s syndrome.

b) Cervical incompetence.

c) Antiphospholipid antibody syndrome.

d) TORCH infections.

e) Congenital anomalies of the genital tract.

79. You are on call at KIUTH and are assessing a 16 year old patient with peritonitis and septic shock due to a post abortal sepsis. Which of the following would you consider in the management?

a) Broad spectrum antibiotic combination.

b) Patient resuscitation with 5 % dextrose.

c) Fluid challenge.

d) Blood and plasma transfusion.

e) Laparotomy as soon as patient’s condition allowed it.

80. Preventing fistula in obstetric care.

a) Development of primary health system is not important.

b) Improvement of transport facilities.

c) Adequate health policies.

d) Adequate vaccination’s programs.

e) Women’s rights empowering.

81.Criminal abortion prevention.

a) Improving accessibility to family planning method.

b) Maternal education level has no role.

c) Legalization of elective abortion.

d) Adequate sexual education programs.

e) Health policies are no related.

82. Maternal death in Uganda.

a) 60 to 80 % are preventable.

b) Infections are among the first three causes.

c) Only doctor’s actions are needed to reduce maternal mortality rate.

d) HIV/AIDS infection is the commonest cause.

e) Malaria and post abortal infections killing more mother than HIV, haemorrhages and eclampsia together.

83.About pre-eclampsia.

a) Thromboxane A2 is usually low.

b) Genetic theory explained familiar predisposition.

c) Oedema is part of the diagnosis.

d) Prostacyclin is elevated.

e) Vascular endothelium growth factor is elevated.

84. In pre-eclampsia.

a) Methyldopa 3g/daily can be given as treatment during hypertensive crisis.

b) Severe headache is a sign of aggravating factors

c) The drug of choice to manage severe pre-eclampsia is Hydralazine.

d) MgSO4 should be given to all patients with pre-eclampsia.

e) All of the above.

85. Preterm delivery in pre eclampsia is indicated in:

a) Diastolic BP  110 mmHg despite the adequate use of the appropriate antihypertensive agents.

b) Laboratory evidence of end-organ involvement despite good BP control.

c) Platelets count between 50,000 and 100,000/mm3

d) Elevated liver enzymes.

e) b) and c) are false.

86.About APH.

a) Vasa previa is one of the differential diagnoses.

b) Placenta praevia type III is better delivery vaginally due to the lower risk for bleeding.

c) Non-obstetrical conditions don’t need to be ruled out.

d) Tocolytic drugs are indicated in APH before 34 weeks.

e) History of PPH is a risk.

87. Antepartum haemorrhage.

a) Intravellous pressure is the explanation for haemorrhage in placenta previa.

b) Uterus surgeries are risk factor for abruptio placenta.

c) C/section always should be done.

d) Can predispose to PPH.

e) Tocolysis is contraindicated

88. Abruptio placenta

a) Trauma, short umbilical cords, folic acid deficiency and maternal hypertension are associated as possible aetiologies.

b) Amniotomy is generally considered to be advantageous.

c) Is a common complication of severe pre-eclampsia

d) MgSO4 can be used in all patients with pre eclampsia.

e) The potential complications are hemorrhagic shock, D.I.C and foetal hypoxia

89.About diagnosis of vaginal bleeding in early pregnancy. Join the column A with the correct diagnosis in column B

Column A Column B

Symptoms and signs Probable diagnosis

a) LAP, uterus softer than normal,

closed cervix

Molar pregnancy

b) LAP, closed cervix, tender adnexal

mass, Cervical motion tenderness

Threatened abortion

c) Heavy bleeding, uterus softer and

larger than dates, Ovarian cyst

Ectopic pregnancy

d) Heavy bleeding, dilated Cervix,

Uterus smaller than dates

Complete Abortion

e) History of expulsion of products of

conception, Closed Cervix, light

bleeding

Incomplete Abortion