MCQs for OBGYN 3.1

MCQs for OBGYN 3

 1. Which of the following are not among of the comprehensive care for mother within the context of PMTCT?

a) Clinical staging of the woman living with HIV.

b) Prophylaxis for OIs infection with cotrimoxazole.

c) RFT if eligible for HAART.

d) Nutrition care and counselling.

e) Family planning services.

2. The following statements are true about PMTCT

a) The seroprevalence of HIV among pregnant women in Mbarara region is 6.8%

b) The seroprevalence of HIV among pregnant women in Uganda is 13%

c) PMTCT interventions reduce transmission of HIV to infants by 50%

d) Breast feeding alone contributes 35% of MTCT

e) Family planning is important.

3. About breech presentation.

a) Delivery can be performed by TBA.

b) Rotation to the sacrum anterior position may be facilitated.

c) Assessment of labour progression should be done at closer interval than for cephalic presentation.

d) Footling breech is better delivered by caesarean section.

e) All of the above.

4. Lumefantrine/artesunate is indicated during pregnancy for:

a) As 1st line in non complicated malaria in the 1st trimester.

b) As 1st line for complicated malaria in the 2nd trimester.

c) As 2nd line for non complicated malaria in the 2nd trimester.

d) After giving IV quinine for complicated malaria at any gestational age.

e) None of the entire above.

5. The following are contraindications for vaginal birth after a caesarean section.

a) Previous classical caesarean section.

b) Previous transverse low-segment incision.

c) Breech presentation.

d) Previous uterine rupture.

e) Mother decision.

6. The following are immediate complications for caesarean section.

a) Haemorrhages.

b) Secondary post partum haemorrhage.

c) Lesion of neighbour organs.

d) Infections.

e) Amniotic fluids embolization.

7. 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.

8. 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.

9. Partograph in labour.

a) Satisfactory progress means that the plot of cervical dilatation remain on or at the left of the ALERT line.

b) If the patient’s partograph crossed the alert line immediate augmentation is needed.

c) If the patient’s partograph crosses the action line emergency c/section should be done.

d) The longest normal time for latent phase in a multiparous woman is 20.1 hours.

e) The longest normal time for second stage for a nulliparous woman is 1.1 h.

10. A woman on COC missed a pill on her 5th day of the cycle. What should be done?

a) She should take another pill as soon as possible.

b) She should take another pill and use another contraceptive method for the rest of the cycle.

c) She should stop the pills and start another pack.

d) She missed the pill and had unprotected sex: she should consider emergency contraception.

e) None of the above.

11.About Norplant II.

a) Is a combined implant.

b) It is effective up to 5 years.

c) It is effective up to 7 years.

d) Can be used during the perimenopausal period.

e) None of the above.

12. About Fitz-Hugh-Curtis syndrome.

a) It is caused by Bacteroides Fragilis.

b) Involves salpingitis, ascites and perihepatitis.

c) Should be treated surgically.

d) Right upper quadrant pain can be the presenting form.

e) All of the above.

13.About menopause.

a) Perimenopause is the period which precedes menopause.

b) It is define as amenorrhoea, hypo-oestrogenemia and elevated luteinizing hormone.

c) It is characterized by amenorrhoea, hypo-oestrogenemia and low levels of FSH.

d) Multiparity shortens the age for menopause.

e) None of the above.

14. Pelvic organ prolapse.

a) Commonly associated to collagen disease.

b) Always treated surgically.

c) Sims position commonly used for examination.

d) Multiparity is a risk factors

e) All of the above.

15.Sonographic characteristic of malignancies.

a) Thin septae.

b) Thick capsule.

c) Enlarged lymph node.

d) Thick septae.

e) Absence of fluid in peritoneum.

16.About pre-eclampsia.

a) Thromboxane A2 is usually low.

b) Placental growth factor is elevated.

c) Placental growth factor is low.

d) Prostacyclin is elevated.

e) Vascular endothelium growth factor is elevated.

17. In pre-eclampsia.

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

b) IUGR is a complication

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.

18. 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 50000 and 100000/mm3

d) Elevated liver enzymes.

e) b) and c) are false.

19.About APH.

a) Kleihauer-Betke test can help to establish the differential.

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 rule out.

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

e) History of PPH is a risk.

20. Antepartum haemorrhage.

a) Nitabush’s bands rupture 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

21.Which of the following are among the modified Obstetric care for PMTCT of HIV?

a) Reduction in using invasive obstetric procedure during labour/delivery.

b) Routinely delivery by elective caesarean section.

c) Vaginal cleansing with chlorhexidine when membranes are ruptured for more than 4 hours.

d) Use of instrumental delivery to accelerate 2nd stage.

e) All of the above.

22. The following are among the targeted categories for primary prevention of HIV.

a) Infants and children.

b) The adolescents and young people.

c) The adult of reproductive age.

d) Women living with HIV and their families.

e) All of the above.

23.Recommendations for safer breastfeeding in the context of HIV include:

a) Avoid infections during breastfeeding.

b) Seek immediate treatment for cracked nipples, infant mouth sores.

c) Mixed feeding.

d) a) and b) above are false.

e) All of the above.

24.About multiple pregnancy.

a) There is not significant increase in obstetric complications.

b) Risk of obstetric complications is slightly increased.

c) Perinatal morbidity/mortality is reduced.

d) At 2 year-old, infant mortality rate of twins is the same as that of singletons.

e) Is common in blacks.

25. The following are true about multifetal gestation.

a) Dizygotic twins are from the same spermatozoa.

b) Dizygotic twins are not from the same spermatozoa.

c) Monozygotic twins are not from the same spermatozoa.

d) Monozygotic twins are from the same spermatozoa.

e) b) and d) above.

26. The fetal heart rate during labour.

a) Decreases with a contraction.

b) Increases with a contraction.

c) Shows no changes with a contraction.

d) Starts to recover a contraction stops.

e) All the above.

27. The dangers of vacuum extraction include.

a) APH.

b) Ruptured uterus.

c) Intrauterine foetal death.

d) PPH.

e) Acute foetal distress.

28. Malaria in pregnancy.

a) Sequestration of infected red blood cell can occur in the placenta.

b) IUGR is a complication.

c) Pre-eclampsia can appear as a consequence.

d) Coartem is indicated for all non complicated malaria.

e) Increases risk for MTCT of HIV.

29. The following are immediate complications for caesarean section.

a) Haemorrhages.

b) Secondary post partum haemorrhage.

c) Lesion of neighbour organs.

d) Infections.

e) Amniotic fluids embolization.

30. The following are factors related to dystocia.

a) Maternal Age

b) Gestational Diabetes.

c) POP.

d) Maternal exhaustion

e) Macrosomic foetus

31. The following are risk factors for PPH.

a) Polyhydramnios.

b) Pre-eclampsia.

c) IUFD.

d) Amniotic fluid embolization.

e) Uterine fibroids

32.About menopause.

a) Anxiety, irritability, fatigue, depression, hot flashes and insomnia are typical complaints

b) Low dose ooestrogen replacement therapy are contraindicated in chronic liver impairment, oestrogens dependent tumour and active thromboembolism

c) Ooestrogen replacement can be given orally or transdermal administration

d) All of the above are true

e) Only (b) above are true

33.About pelvic inflammatory disease.

a) Is a polymicrobial infection.

b) Chlamydia causes Fitz-Hugh Curtis syndrome. 

c) N. Gonorrhoea is the commonest causative agent of pelvic abscesses.

d) B Fragilis is commonly involved.

e) CA-125 commonly elevated.

34. The following are lesions of the vulva. Choose which are caused by sexually transmitted infections agents

a) Condylomata acuminata

b) Sebaceous cyst

c) Endometriosis

d) Chancroid.

e) Only (a) and (d)

35. The following are steroidal contraceptives.

a) NUVA ring.

b) Mirena.

c) Mifepristone.

d) Cyclofem.

e) Progestasert.

36. The following are sign of malignancy in ovarian masses.

a) Solid masses are present.

b) Giant cyst.

c) Tumour present in both age extremes.

d) Positive tumours marker.

e) Bilateral ovarian mass.

37.A 30 year old patient presented to an infertility clinic c/o recurrent pregnancy loss. Which of the following factors would you investigate?

a) Rubella infection.

b) Fallopian tubes patency.

c) Cervical competence.

d) Antiphospholipid antibodies.

e) Uterine congenital anomalies.

38. The overall incidence of infertility is 10-15 %. The following answers are true or false.

a) The tubal factors can be evaluated by HSG and intrauterine insufflations of indigocarmin at the time of laparoscopy.

b) The endometrial cavity should be evaluated during the proliferative phase of the cycle.

c) Endometrial biopsies are most informative when performed during the proliferative phase of the cycle

d) (a) and (b) above are true

e) All of the above are false

39. A 14 years old girl was seen on gynaecological clinic. Report heavy PV bleeding lasting 12 days. LNMP – 15 days ago

a) Dysfunctional uterine bleeding can be the diagnosis

b) Anovulation due to abnormalities in neuro endocrine function is the most common cause

c) High doses of progestin intravenously or orally are administered

d) All of the above are true.

e) None of the above are true

40. In primary dysmenorrhoea.

a) Trend to disappear after deliveries.

b) Endometriosis should be considered.

c) COC can be given.

d) GnRH is the choice for treatment.

e) None of the above.

41. In secondary dysmenorrhoea.

a) PID is a cause.

b) More common among teenagers.

c) CT scan is a very useful investigation in establishing the cause.

d) Cyclooxygenase inhibitors have no role in the treatment.

e) Breast tenderness is not associated.

42.About CIN.

a) Cannot be screened by visual inspection under Acetic Acid.

b) Patients who have not screening with cytology are at higher for advanced

carcinoma of the cervix.

c) CIN I should always be treated by cervical conisation.

d) CIN III hysterectomy is the treatment for all patients

e) Most of the lesions are located in the SCJ

43.Cervical carcinoma.

a) Squamous cell carcinoma most often present with and exophytic lesion.

b) Adjuvant CRT has no shown benefits for the patients who undergo operations.

c) Adenosquamous carcinoma often present with exophytic lesions.

d) A lesion extended to the lower third of the vagina is stage IIb.

e) Palliative care has no role in early stages.

44. Gestational Trophoblastic Neoplasia.

a) In stage I the disease confined to the uterus.

b) Can fallow normal pregnancy.

c) Can follow an abortion.

d) Has a tumour marker.

e) All the above.

45.Choriocarcinoma.

a) Most commonly develops after molar pregnancy.

b) The most common site of metastasis is liver.

c) Persistent P.V bleeding is the commonest symptom of consultation.

d) There is uterine sub involution.

e) Most lesions begin in uterus.

46. 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.

47. Depo Provera. (DMPA).

a) Contains both progesterone and oestrogens.

b) Can cause breakthrough bleeding.

c) Is effective for 10 weeks.

d) Contains 3rd generation progesterone.

e) Return to fertility is immediate after terminating its use.

48. A woman on her 40th birth day presents at the gynaecology clinic complaining of irregular PV bleeding. The following are possible options:

a) Perimenopause should be considered among the causes.

b) Endometrial ablation by thermal balloon should be done immediately.

c) Transvaginal ultrasound can be of help.

d) Emergency D & C should be performed.

e) HRT should be started immediately.

49. A 32 year old woman, nulliparous with a history of menorrhagia was seen by Dr. Wasswa Ssalongo and diagnosis of fibromyoma was made Mark true or false

a) Fibromyomata are composed of smooth muscle and fibrous tissue

b) It developed is related to the action of progesterone

c) Interstitial fibromyomata, uterine contractions dilated the Cervix and expel the tumour through it

d) Red degeneration can occur.

e) Only (a) and (c) above are true

50.VVF repair.

a) Surgical repair is the only mode of treatment.

b) Ureteric catheters are inserted after closure.

c) Not advisable to repair during pregnancy.

d) An IVP is mandatory in all VVF.

e) Be repair at least 2 months after delivery.