1. The following are true or false 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) AROM and induction is contraindicated.
e) Is highly related to PPH
2. About APH.
a) Kleihauer-Betke test can help to establish the differential.
b) Placenta praevia type IIb 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.
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3. 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
4. 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.
5. Abruptio Placenta. Management
a) Mild abruption needs emergency c/section independently of the gestational age.
b) Moderate abruption at 32 WOA: Tocolytic for 24 hours waiting for steroids
effects.
c) Abruption, mother in shock, at 34 wks: Resuscitation, amniotomy and
induction of labour with Misoprostol.
d) Severe abruption, IUFD, with DIC: correction of DIC, Amniotomy and
emergency c/section.
e) None of the entire above is true.
6. Abruptio placenta.
a) Fibrinogen degradation products and D-dimmer are always elevated.
b) Heparin is indicated during DIC management.
c) Is a common complication of severe pre-eclampsia
d) MgSO4 can be used in chronic abruption’s management.
e) Amniotomy is contraindicated.
7. About placenta previa
a) IVF has no role in the aetiology
b) Vaginal examination should always be done under general anaesthesia
c) Kleihauer–Betke test helps in differentiating from circumvallate placenta
d) Always prevent the engagement of the presenting part
e) None of the above.
8. 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
9. About pre-eclampsia.
a) Commonly affecting primiparous or multiparous with new husband.
b) The incidence is around 40 % of pregnancy.
c) Impaired trophoblast invasion seems to be the most important factor in the
pathogenesis.
d) Immunological factor are involved.
e) Vascular endothelial growth factors increased.
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10.About eclampsia’s management.
a) Control of the fits.
b) Control the blood pressure.
c) Plan to immediate delivery.
d) Magnesium sulphate is the best to prevent fit recurrences.
e) Caesarean section is always indicated.
11. The following are common complications of eclampsia.
a) Placenta praevia.
b) Abruptio placenta
c) Acute pulmonary oedema.
d) Disseminated intravascular coagulation.
e) Acute renal failure.
12. 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.
13.All the following antihypertensive medications are considered safe for short term
use in pregnancy.
a) Captopril.
b) Methyldopa.
c) Hydralazine.
d) Nifedipine.
e) Labetalol.
14. MgSO4.
a) Act by blocking the release of acetylcholine at the neuro-muscular plaque.
b) Is a natural calcium antagonist.
c) Is given 10g 50% IV as initial dose.
d) Has no advantage over fenitoine in fit’s prevention.
e) Produce oligo-anuria.
15. Hydralazine’s 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.
16.Which statements are true and false?
a) Magnesium Sulphate is the drug of election to reduced B.P
b) Labetalol is not useful in the treatment of Pre-eclampsia.
c) Antihypertensive therapy in pre- eclampsia should be use when diastolic B.P is
>105 to 110 mmHg.
d) Hydralazine is associated with significantly more maternal hypotension than other
antihypertensive drugs.
e) Aldomet is the drug of election in pre-existing hypertension.
17. The most common presenting symptom of eclamptic patient is.
a) Profuse vaginal bleeding.
b) Abdominal pain.
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c) Dyspareunia.
d) Convulsions.
e) Vomiting.
18.About hypertension during pregnancy.
a) Chronic hypertension is more common in nuliparous.
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
19. The following favours MTCT of HIV
a) High viral load
b) Type 1 HIV
c) High CD4 count
d) Sero conversion in pregnancy
e) HAART.
20. In PMTCT
a) The primary means by which an infant can become infected with HIV is through
sexual intercourse
b) The primary means by which an infant can become infected with HIV is through
use of unsterilised instruments
c) The primary means by which an infant can become infected with HIV is through
mother to child
d) Mixed feeding has no major effect on transmission if the infant has no oral sores.
e) All the above are true
21. National HIV prevention strategies include
a) Primary Prevention of HIV and other STIs through ABC model
b) Premarital HIV screening
c) Pre -conception HIV screening
d) PMTCT in HIV positive pregnant mothers
e) All the above
22.About H.I.V infection. Mark T or F
a) ART naïve means that the client is not on any ARV including History of taking NVP
for PMTCT.
b) HIV is transmitted to the infant during breast feeding because HIV is present in
breast milk and yet the babies gut cells are susceptible to HIV infection.
c) AZT 300mg twice daily starting at 36 WOG till delivery and for I week after delivery
+ AZT syrup 5mg/kg twice daily for 7 days given to the infant is the regimen of
choice.
d) During labour and delivery the foetus may become infected as a result of
maternal–foetus blood exchange during contractions or mucous membranes as a
result of trauma or foetal swallowing of HIV containing blood or maternal secretions
in the birth canal.
e) All the above.
23. 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.
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e) The entire above are false.
24. In relation with episiotomy.
a) Is routinely performed on all HIV Positive prime gravid mothers in 2nd stage
b) Should only be repaired in cases of active bleeding
c) Must be performed after vacuum extraction
d) Can cause PPH
e) It is one of the components of modified obstetric practices of PMTCT.
25. Obstructed labour.
a) Wilm’s tumour is a cause
b) Partograph cannot detect.
c) Occurs only in Multigravidas
d) Bandl’s ring may manifest.
e) Always delivery by caesarean section.
26. Complications of obstructed labour.
a) Neonatal sepsis.
b) Death.
c) PPH
d) Rectovaginal fistula
e) All the above.
27. Prevention of obstructed labour.
a) Use of partograph in labour.
b) Treatment of malaria
c) Use of TBS.
d) Good nutrition in childhood
e) Timely referrals.
28. 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.
29. Partograph in labour.
a) Started at 3 cm cervical dilatation
b) Base line foetal heart rate 105- 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.
30.Components of essential obstetric care include.
a) Parenteral antibiotics
b) Parenteral oxytocic drugs.
c) Use of anticonvulsants.
d) Manual removal of placenta.
e) Manual removal of retained products.
31.Comprehensive essential obstetric care includes:
a) Availability of surgical services.
b) Availability of anaesthesia services.
c) Blood transfusion services.
d) Obstetrics skills not needed
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e) Traditional birth attendant with surgical skills.
32.Regarding neonatal resuscitation.
a) Place infant on cool surface.
b) Dry the baby.
c) Leave on wet linen
d) Suction of nose is before the mouth.
e) Baby is placed with the neck slightly flexed.
33. 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.
34. The following are complications of PPROM.
a) Necrotizing enterocolitis.
b) Intraventricular haemorrhages.
c) Earlier ductus arteriosus closure.
d) Hypobilirubinaemia.
e) Thermal instability.
35. 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.
36. The following are absolute contraindications for tocolysis.
a) PPROM.
b) Intrauterine foetal demise.
c) Nonreassuring foetal assessment.
d) Chorioamnionitis.
e) Presence of phosphatidylglycerol in amniotic fluid.
37. Infection control practices include
a) Treat remote infection before elective operation
b) Wash incision site before performing antiseptic skin preparation
c) Prepare skin in a non concentric circle away from incision site
d) Keep pre operative stay as long as possible
e) Pre-operative hand and fore arm washing for one minute
38. In infection control, in order to prevent contamination of injection equipment
a) Discard medications that are cracked or leaking
b) If possible, don’t use single dose vials/ampoules
c) Discard any needle that has become contaminated
d) Each injection should be prepared in a clean area designated for it
e) All the above
39. Techniques used to reduce the risk of wound infection include
a) Creation of dead space
b) Proper antisepsis
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c) Proper antibiotic use
d) Use of many spaces
e) Avoiding hypothermia
40.About Malaria in pregnancy.
a) Can cause preterm deliveries.
b) Can lead to maternal death.
c) Anaemia is the commonest complication.
d) Can cause IUGR.
e) Renal failure can be a complication.
41. 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.
42. The following Plasmodium species cause a relapse of malaria
a) P. falciparum
b) P. ovale
c) P. malaria
d) P. vivax
e) P. lugninate
43.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 parasitisation.
44. 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.
45. 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 petechiae
46. Malaria in pregnancy causes anaemia by the following mechanisms.
a) Dyserythropoiesis
b) Phagocytosis.
c) Haemolysis of RBC.
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d) Bone marrow suppression.
e) Erythropioesis
47. Indications of methotrexate in management of Ectopic pregnancy include
a) hCG >10,000IU/L
b) Evidence of rupture
c) Heterotopic pregnancy
d) Ectopic pregnancy >4cm in greatest diameter
e) Hypotension.
48. In management of Ectopic pregnancy
a) Laparotomy should be performed only after securing blood
b) Auto transfusion can be done in a chronic leaking Ectopic
c) Secure 2 intravenous lines with large bore cannula
d) Oxygen and warmth are supportive measures
e) The primary goal is to preserve fertility
49.Regarding Ectopic pregnancy
a) Commonest site is the ampulla
b) Can be associated with sub fertility and PID
c) Location at the isthmus is the least dangerous
d) Previous operation involving the hand is a risk factor
e) Can occur at the ovary
50.Symptoms of pregnancy
a) Quickening is experienced at about 18 WOA in a PG
b) Uterus may be palpable abdominally by 12 WOA
c) Lightening is the reduction in fundal height which occurs at 38-40 WOA
d) Urine HCG is positive as early as 10 days after fertilization
e) Bimanual palpation has no role in diagnosis.
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