1401.A patient delivered at Mbarara Regional Referral Hospital develops a moderate
endometritis. Which of the following are true in the patient management?
a) Broad spectrum antibiotic combination and swab for culture and sensitivity in the
3
rd day of treatment.
b) Swabs 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 it sensitivity we advice
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.
1402.The following are true about Physiological changes during pregnancy.
a) Maternal weight increases approximately by 0.3kg/week
b) Plasma volume increases more than erythrocyte volume
c) Cardiac silhouette elevated in chest X-ray
d) Systolic murmur present as consequence of Valvular damage
e) Increased water retention
1403.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
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e) Contact lens intolerance due to oedema can occur
1404.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
1405.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
1406.About pre-eclampsia
a) Commonly affects primiparous or multiparous with new husband
b) In vitro fertilization is not a risk factor
c) Impaired trophoblast 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
1407.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
1408.About APH.
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
1409.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
1410.Breastfeeding
a) On average Ugandan women breastfeed their infants for 19 months
b) MTCT of HIV occurs post natally in breast feeding mother in 15-20 % of cases.
c) Replacement feeding is essential in PTCT
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
1411.The following factors affect the MTCT
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a) Smoking and alcohol
b) Increased viral load
c) Increased CD4 count
d) Urinary tract infection
e) Prolonged labour
1412.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
1413.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
1414.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
1415.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
1416.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
1417.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, gentamycin
d) Broad spectrum antibiotic should be started immediately and readjusted when the
result is available
e) None of the entire above is true
1418.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, RP: 120/ min; BP 90/60 mmHg; delay in the capillary refilling time;
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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 praevia type IV
c) Cervical carcinoma
d) Severe placental abruption with IUFD and CID
e) Vasa previa with IUFD
1419.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
1420.Physiopathology of pre-eclampsia
a) Prostacyclin level higher than thromboxane A 2
b) Placental growth factor level is elevated
c) Endothelin production elevated
d) Trophoblastic invasion of the spiral arteries is complete
e) None of the above
1421.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
1422.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 90 mmHg
1423.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
1424.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
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1425.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
1426.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
1427.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
1428.Prevention of obstructed labour
a) Use of partograph in labour
b) Treatment of malaria
c) Use of TBAs
d) Good nutrition in childhood
e) Timely referrals
1429.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
1430.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
1431.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
1432.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
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1433.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
1434.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
1435.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
1436.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
d) Nitrazine test result can be affected by the presence of seminal fluid
e) Hypoglycemia is a possible complication
1437.The following are complications of PPROM
a) Necrotizing enterocolitis
b) Intraventricular haemorrhages
c) Earlier ductus arteriosus closure
d) Hypobilirubinaemia
e) Thermal instability
1438.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.
1439.In intrauterine 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
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1440.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
1441.The following are absolutes contraindications for tocolysis
a) P-PROM
b) Intrauterine foetal demise
c) Non reassuring foetal
d) Chorioamnionitis
e) Presence of phosfaditilglycerol in amniotic fluid
1442.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
1443.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
e) None of the above
1444.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
1445.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
1446.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
1447.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
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d) Tears have no etiological importance
e) Inverted uterus can be caused by excessive cord traction
1448.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
1449.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
1450.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
1451.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
e) Primegravidas are protected against hyperparasitaemia
1452.The following are 3rd generation progesterones
a) Etonogestrel
b) Gestodene.
c) Mestranol.
d) Norgestrinate.
e) Megestrol.
1453.The following are non-contraceptive benefits of COC’s
a) Protection against ectopic pregnancies
b) Reduced risk of ovarian cancer
c) Relief from menstrual disorders.
d) Improvement in bone mineral density.
e) Reduced risk of Rheumatoid arthritis.
1454.Combined oral contraceptives
a) Suppress ovulation by diminishing the frequency of GnRH pulses and halting the
luteininsing hormone surge.
b) Make the cervical mucus thick, scanty and less viscous.
c) When administered correctly and constantly they confer a greater than 99%
method effectiveness in preventing pregnancy.
d) Alter tubal transport in favour of fertilization.
e) Are indicated for the teartment of anovulatory DUB.
1455.The NUVA ring
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a) is an intrauterine ring.
b) Contains the progesterone, ketodesogestrel.
c) Is inserted after every 4 weeks.
d) Contains ethinyl estradiol.
e) Main side effect is breakthrough bleeding.
1456.The following are intrauterine contraceptive devices
a) Copper T300A
b) Mirena.
c) Progestasert.
d) NUVA ring.
e) Organon.
1457.Concerning implantable contraceptives
a) Norplant is a two-rod haexonorgestrel system
b) Implanon is a single-rod implant that contains etonorgestrel acetate as the active
hormone.
c) Norplant II is a laevonorgestrel containing contraceptive that is effective for up to
5 years.
d) Acute liver disease is an absolute contraindication to Norplant use.
1458.The following plasmodium species cause a relapse of malaria
a) P. falciparum
b) P. ovale
c) P. malaria
d) P. vivax
e) P. lugninate
1459.Severe malaria in pregnancy
a) Placental site specific antibodies prevent P. falciparum sequestration in the
placenta in primegravidae.
b) Immunosuppresion, effected through high levels of cortisol in pregnancy, explains
the increase in susceptibility to falciparum malaria in pregnancy.
c) Most immune pregnant women remain asymptomatic even in the presence of
heavy parasitaemia.
d) Red cell sequestration starts in the place uta, in the sixth month of pregnancy.
e) The relation between malaria and impaired foetal growth is mediated through
anaemia and placental parasitation.
1460.The following mechanisms explain the anaemia caused by malaria in pregnancy
a) Haemolysis of parasitized red blood cells.
b) Haemolysis of non-parasitized red blood cells.
c) Sequestration of parasitized red blood cells.
d) Dyserythropoiesis.
e) Erythrophagocytosis.
1461.The following pathological lesions are caused by severe falciparum malaria
a) Abundance of malarial pigment in the reticuloendothelial system.
b) Oedematosis brain with broad, flatte red gyri.
c) Presence of haemoglobin in the renal tubules.
d) Kupffer cells are increased in size and number.
e) Pericardial and endocardial pete...
1462.The following syndromes are associated with chronic malaria
a) Nephritic syndrome.
b) Nephrotic syndrome.
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c) Tropical splenomegaly sundrome.
d) Burkitt’s lymphoma syndrome.
e) Pickiwilliam syndrome
1463.The following treatment regimens are currently recommended by MOH as for
treatment of simple malaria in pregnancy
a) Oral quinine
b) Oral Chloroquine and Fansidar
c) Coartem
d) Artemether and Lumefatrine
e) Parenteral chloroquine
1464.Bartholin’s abscess
a) Is the end result of acute Bartholinitis
b) Common organisms found are Staphylococcus and Chlamydia.
c) The Bartholin’s gland duct gets blocked by fibrosis and the exudates pent up
inside to produce abscess.
d) Usually presnts as a unilateral tender swelling beneath the posterior half of the
labium minus
e) Incision and curettage (I&C) is the treatment of choice.
1465.Bartholin’s cyst
a) May develop in the duct or gland.
b) The content is usually hairy cheesy fluid.
c) Is usually located on the anterior half of the labia majora.
d) Incision of drainage is the treatment of choice.
e) Marsupialization is the treatment of choice.
1466.The following are common causes of cyclic chronic pelvic pain
a) Dysmenorrhoea.
b) Ovarian remnant syndrome.
c) Mittelschmerz.
d) Retroverted uterus
e) Pelvic congestion syndrome
1467.The following are contraindications for insertion of Cu T380A.
a) Acute pelvic infection.
b) Dysfunctional uterine bleeding.
c) Suspected pregnancy.
d) Prolapsed uterus.
e) Severe dysmenorrhoea.
1468.The following are indications for removal of an IUCD
a) Flaring up of salpingitis.
b) Perforation of uterus.
c) One year premeopause.
d) Pregnancy occurring with the device in situ.
e) Persistence intermenstrual bleeding.
1469.The following steroidal contraceptives contain progesterone
a) NET-EN
b) Cyclofen.
c) Mesygyna
d) Mirena.
e) Organon.
1470.The following chemicals can be used for emergency contraception
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a) Premarin.
b) Laevonorgestrel
c) Mitepristone.
d) Mirena.
e) Cu T380A
1471.The following are ovarian causes of female infertility
a) Stein-Leventhal syndrome.
b) LUF syndrome.
c) Resistant ovarian syndrome.
d) Asherman’s syndrome.
e) Sheehan’s syndrome.
1472.The following are true about Physiological changes during pregnancy.
a) Uterus weight increased approximately 1 kg.
b) Plasma volume increased more than erythrocyte volume.
c) Cardiac silhouette elevated in chest X-ray.
d) Systolic murmur present as consequence of Valvular damage.
e) Abnormalities in concentration, attention and memory
1473.Cardiovascular changes during pregnancy include:
a) Increased circulating volume up to 30 % over the preconception values.
b) Increased circulating volume up to 45-50% over the preconception values.
c) Electrical axis of the heart right deviated.
d) Increased heart silhouette in x-rays.
e) Diastolic murmur can be present up to 90 % of all pregnant woman
1474.Leopold’s manoeuvres include
a) Determination of SFH
b) Pelvic palpation
c) Lateral palpation
d) Auscultation
e) All the above
1475.Which of the following are true about foetal aptitude?
a) Describes the relationship between the foetal and the pelvic inlet.
b) Describes the relationship between foetal parts.
c) Delivered is easy when aptitude is flexion
d) Delivery is easy when aptitude is extension.
e) Can change during labour.
1476.The following are true about position.
a) Relates the denominator to the lower uterine segment.
b) Relates the denominator to the maternal pelvic brim.
c) POP is always an indication for c/section.
d) LOA is a normal position.
e) ROP is an abnormal position.
1477.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
1478.Haematological findings in Iron deficiency anaemia.
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a) Microcytic hyperchromic.
b) Macrocytic hypochromic.
c) Market anisocytosis.
d) The mean corpuscular value is low.
e) Mean corpuscular haemoglobin is increased.
1479.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.
1480.Which of the following are false and true
a) POP can be corrected with obstetric forceps.
b) Vacuum extraction has no role in ROP position.
c) POP is frequently related to labour dystocias.
d) Episiotomy should be offered to all mothers with ROA position.
e) LOP position can be corrected spontaneously
1481.ANC
a) Male partner involvement is encouraged
b) IPT is given monthly in a PG
c) IPT is given monthly in HIV
d) Routine investigations include urinalysis, HIV screening, Hb, and FBC
e) All the above
1482.About APH
a) Is any bleeding from genital tract before 28 WOA
b) Vasa praevia can be a cause.
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
1483.About APH. Complete.
Placenta previa. Abruptio placenta.
a) Pain
b) Signs of toxaemia
c) Uterine tone
d) Foetal heart rate
e) Bleeding.
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