1151.Regarding physiology during pregnancy
a) Iron metabolism is increased by around 1g
b) Calcium demands are diminished
c) Placental lactogen causes insulin resistance
d) Loss of memory can be reported
e) Contact lens intolerance due to oedema can occur
1152.Anaemia during pregnancy
a) Physiologic anaemia in pregnancy, Hb less 11g/dl
b) Physiologic anaemia is when the plasma volume increases higher than
erythrocyte volume with a corresponding fall in Hb level
c) The commonest cause is iron deficiency
d) Malaria is not an important cause of anaemia in pregnancy in Africa
e) Pregnant women with normal Hb don’t need iron supplementation during
pregnancy
1153.About hypertension during pregnancy
a) Chronic hypertension is more common in nulliparous
b) Pre-eclampsia is hypertension plus oedema
c) Pre-eclampsia is hypertension plus proteinuria after 20 WOA
d) Unclassified hypertension is hypertension in a patient with previous renal damage
e) Is a common cause of admission in our hospital
1154.About pre-eclampsia
a) Commonly affects primiparous or multiparous with new husband
b) In vitro fertilization is not a risk factor
c) Impaired trophoblastic invasion and differentiation seems to be the most
important factor in the pathogenesis
d) Immunological factor are involved
e) Hydralazine is the choice to treat the crisis
1155.About management of eclampsia
a) Control of the fits
b) Control the blood pressure
c) Plan for immediate delivery
d) Magnesium sulphate is the best drug to prevent recurrence of fits
e) Caesarean section is always indicated
1156.About APH
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a) Is any bleeding from genital tract before 28 WOA
b) Is any vaginal bleeding during the second half of pregnancy
c) Placenta previa is more common than Abruptio placenta
d) Is a common cause of preterm delivery
e) Is the commonest cause of maternal death in Mbarara
1157.Mother to child transmission.
a) May occur as early as the time of the ovulation
b) Wet nursing is an acceptable option here
c) In uterus across the placenta
d) During labour/delivery in 60-70% of cases
e) During labour/delivery in 10-15% of cases
1158.Breastfeeding
a) On average Ugandan women breastfeed their infants for 19 months
b) MTCT of HIV occurs postnatally in breast feeding mother in 15-20% of cases.
c) Replacement feeding is essential in PMTCT
d) Consolation breast feeding is a component of sudden cessation of breast feeding
in HIV positive mothers
e) Mixed feeding may be practiced in PMTCT
1159.The following factors affect the MTCT
a) Smoking and alcohol
b) Increased viral load
c) Increased CD4 count
d) Urinary tract infection
e) Prolonged labour
1160.The following are modified obstetric practice except:
a) Administration of Nevirapine in labour
b) Delayed rupture of membranes
c) Exclusive breast feeding
d) Avoidance of invasive procedure
e) Using electric suction
1161.In PMTCT
a) TRRD means an HIV positive mother has died
b) TR means tested and results are reactive
c) Nevirapine tablet is given to the mother as soon as labour is established
d) Lower rates of stillbirths have been reported in HIV positive mother
e) The entire above are false
1162.HIV in pregnancy
a) Increased disk of intrauterine foetal demise
b) Absolute CD4 count can be reduced
c) Pneumocystis carinii Pneumonia is a common complication
d) Increased risk for malaria attack
e) Congenital malformation’s risk increased
1163.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
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1164.Among the commonest anaerobes causative organism for puerperal infection we
can find the following except?
a) Klebsiella
b) Peptococcus species
c) Peptostreptococcus
d) Bacteroides fragilis
e) Proteus mirabilis
1165.Which of the following are not among the risk factor for puerperal infection?
a) Poor antiseptic technique
b) Prolonged labour/ruptured membranes
c) External cephalic version
d) Forceps delivery
e) Bacterial vaginosis
1166.A patient delivered at Mbarara Regional Referral Hospital and developed a
moderate endometritis. Which of the following are true in the patient management?
a) Broad spectrum antibiotic combination and swab for culture and sensitivity on the
3
rd day of treatment
b) Swab from the lochia, cervical canal, endometrial cavity and wait for the results
to establish adequate antimicrobial treatment
c) As we know the commonest causative micro-organism and their sensitivity we,
advise to start with x-pen, gentamicin
d) Broad spectrum antibiotic should be started immediately and readjusted when the
result is available
e) None of the entire above is true
1167.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 +++,
dehydrated, Pulse: 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 F
Heart heard. Vaginally: scanty blood coming through the vagina, reddish area around
the External Cervical Os was noticed. Which among the following is the most likely
diagnosis?
a) Placental abruption
b) Placenta previa type IV
c) Cervical carcinoma
d) Severe placental abruption with IUFD and CID
e) Vasa previa with IUFD
1168.In relation with the above presented patient: Which of the following is true about
her management?
a) Establishing two peripheral lines, blood for FBC, clotting profile, blood transfusion
and emergency c/section
b) Immediate induction of labour using a Foley catheter
c) General measures for all APH, AROM, correction of the DIC and emergency
C/section
d) General measures for all APH, AROM, correction of the DIC and induction of
labour
e) General measures for all APH, AROM, correction of the shock and DIC and
induction of labour
1169.Physiopathology of pre-eclampsia
a) Prostacyclin level higher than thromboxane A2
b) Placental growth factor level is elevated
c) Endothelin production elevated
d) Trophoblastic invasion of the spiral arteries is complete
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e) None of the above
1170.MgSO4
a) Act by blocking the release of acetylcholine at the neuro-muscular junction
b) Is a natural calcium antagonist
c) Is given 10 g 50% Iv as initial dose
d) Has no advantage over phenytoin in prevention of fits
e) Produce oligo-anuria
1171.Hydralazine use in pre-eclampsia.
a) Is a central vasodilator
b) Is given as IV bolus initially: 10mg slowly followed by 5mg every 30 min
c) Can be use as infusion
d) Is given 5mg IV hourly
e) The last dose should be given when diastolic BP is 90mmHg
1172.A comprehensive post-abortal care includes
a) Post-abortal counselling
b) Treatment of the complications
c) Family planning services
d) RCT
e) All of the above
1173.Multiple pregnancy
a) Dizygotic twins are the product of 2 ova and 1 sperm
b) There is greater than expected maternal weight loss
c) Maternal anaemia may be seen
d) Monozygotic twins are the result of the division of 2 ova
e) Paternal side is not a risk factor
1174.Multiple pregnancy
a) All get PPH
b) Most of them delivery boys
c) Associated with high neonatal morbidity and mortality
d) Twin to twin transfusion can occur
e) High risk of pregnancy induced hypertension
1175.Dizygotic twinning
a) Is influenced by hereditary and parity
b) Maternal age has no influence
c) Use of clomifen reduces the incidence
d) Results from fertilization of one ovum
e) Always result in twins of same sex
1176.Obstructed labour
a) Cystic hygroma is a cause
b) Partograph cannot detect
c) Occurs only in multigravidas
d) Bandl’s ring may manifest
e) Always delivery by Caesarean section
1177.Prevention of obstructed labour
a) Use of partograph in labour
b) Treatment of malaria
c) Use of TBAs
d) Good nutrition in childhood
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e) Timely referrals
1178.Mode of delivery in obstructed labour.
a) Symphysiotomy is method of choice
b) Forceps may be used
c) Should be always by c/section
d) Vaginal delivery is contraindicated
e) Destructive operations always done
1179.Partograph in labour
a) Started at 3 cm cervical dilatation
b) Base line foetal heart rate 110- 160 beats/ min
c) Always deliver by Caesarean section when patient reaches action line
d) Alert line means do Caesarean section
e) Ruptured membranes cannot be done
1180.Ruptured uterus (management).
a) Taken for operation immediately on arrival.
b) Resuscitation should be done
c) Patients do not consent
d) Antibiotics not necessary
e) Live baby may be delivered
1181.Caesarean section.
a) Elective caesarean section can be done for cord prolapse
b) Is the only mode of management for cord prolapse
c) May be done under local anaesthesia
d) Patient may take orally after 8 hours
e) Deep venous thrombosis is likely to occur
1182.About normal labour
a) Is started when cervix is 3 cm dilated
b) Normally considered in 3 stages
c) The 3rd stage is started after placental delivery
d) Second stage starts with the engagement of the presenting part and ending with
delivery
e) Second stage usually lasting proximately 30 min
1183.Preterm labour predisposing factor
a) Cervical incompetence
b) Previous preterm delivery
c) Divorced mother
d) Changed partner during pregnancy or even before this
e) Social-economic disadvantages
1184.Preterm labour, conservative management is contraindicated in
a) Severe or multiple congenital anomalies
b) Premature rupture of the membranes
c) Chorioamnionitis
d) Lung maturity is present
e) APH is present
1185.Preterm premature rupture of the membranes
a) Infections are an important cause
b) Is more common among smokers
c) Cervical incompetence can be a cause
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d) Nitrazine test result can be affected by the presence of seminal fluid
e) Hypoglycaemia is a possible complication
1186.The following are complications of PPROM
a) Necrotizing enterocolitis
b) Intraventricular haemorrhages
c) Earlier ductus arteriosus closure
d) Hypobilirubinaemia
e) Thermal instability
1187.Intrauterine foetal death.
a) Robert’s sign is characterized by: the presence of a gas ring around the skull
bones and the presence of gas burble in the cardiac cavities.
b) The Spalding sign is described as the presence of: overlapping of the parietal
bones and sharp angulations of the spine.
c) The antiphoslipidid antibody syndrome is an important cause of IFD.
d) Coagulopathy is the most afraid complication during expecting management.
e) Maternal death can be caused secondary to a toxaemic invasion of the maternal
general circulation.
1188.In intra uterine foetal demise
a) The mother should be considered at high risk for PPH
b) Clotting profile should be done on admission and at least 6 hourly during
induction of labour, and after delivery
c) If derangement of the coagulation factors, fresh frozen plasma should be given
d) Labour should not be allowed in patient with previous caesarean section
e) Autopsy examination should not be done to confirm the cause of the death
1189.The following are recommendations about the use of corticosteroids in preterm
labour
a) Should be used not only to help lung maturity if no reducing mortality and
intraventricular haemorrhages
b) Should not be used below 28 weeks
c) Betamethasone is given 24 mg in 24 hourly
d) The benefits appear after 12 hour
e) Should be given only if delivery won happened within the next 24 hours
1190.The following are absolutes contraindications for tocolysis
a) PPROM
b) Intrauterine foetal demise
c) Non reassuring foetal
d) Chorioamnionitis
e) Presence of phosfaditilglycerol in amniotic fluid
1191.About abortion
a) Chromosome’s abnormalities causing more than 90 % of spontaneous abortions
b) Is the second leading cause of maternal death in Mbarara
c) History of previous abortion is not a risk factor
d) Septic abortion is the commonest cause of maternal death among teenagers in
Mbarara
e) Haemorrhage is a complication
1192.About abortion
a) Is any pregnant loss before 28 weeks
b) Is any pregnant loss weighing less than 400g
c) Is any pregnant loss below 20 WOA or weighing less than 500g
d) a) and b) above
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e) None of the above
1193.The following are included between post abortal care
a) Emergency treatment for incomplete abortion.
b) Emergency treatment to life threatening complications
c) Post abortion family planning
d) Nevirapine prophylaxis
e) All of the above
1194.The following are always indications for elective Caesarean section.
a) Severe pre-eclampsia
b) Two or more previous Caesarean section
c) Cephalopelvic disproportion
d) Conjoined twins
e) Breech presentation
1195.About ruptured uterus
a) Can be complete or incomplete
b) Always implies there is foetal death
c) Is a common morbidity and mortality cause in Mbarara district
d) Can be prevented by improving primary care of health
e) Is always an indication for obstetrical hysterectomy
1196.About PPH.
a) Is an important cause of maternal death even in developed countries
b) Usually due to a malpractice i.e. iatrogenic
c) Retained placenta is a common cause
d) Tears have no aetiological importance
e) Inverted uterus can be caused by excessive cord traction
1197.PPH management
a) Always call for assistance
b) Establish two peripheral lines
c) Checking uterus contraction is not important
d) Active 3rd stage’s management can help in prevention
e) Uterine artery embolization is not an option
1198.PPH.
a) APH is a predisposing factor
b) Uterine over distension can predispose
c) Postdate is a risk factor
d) Prolonged labour is a common cause
e) Parity has importance
1199.The following are physiological changes during puerperium
a) Maternal heart rate reduced by 10 to 15 beat/ min
b) Endometrium is in a physiological state within the 15 days after delivery
c) Increased water retention
d) On the 3rd postpartum day, the uterus is 2 cm above the umbilicus
e) Lochia disappears by the 7th postpartum day
1200.Malaria in pregnancy
a) Coma, severe anaemia and convulsion, can be indicative of severe malaria
b) Can be prevented by; using mosquito net, education, and Fansidar administration
4 times during pregnancy
c) Should be always treated with IV quinine
d) Early diagnosis and treatment don’t help in preventing complications
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e) Primegravidas are protected against hyperparasitaemia
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