51. Danger signs and symptoms of pregnancy.
a) Severe headache.
b) Vaginal bleeding.
c) Abdominal disconfort.
d) Reduced foetal movements.
e) Loss of appetite.
52. The following are true or false, when the fundal height is smaller than the expected
for gestational age.
a) Congenital anomalies can be present.
b) Abnormal lie is a differential.
c) Menstrual error is the commonest cause.
d) Small for date.
e) Pregnancy associated with uterine fibroid.
53.A 18 year old presents with offensive PV discharge after sexual intercourse. What is
the most likely diagnosis?
a) Incomplete septic abortion
b) Puerperal sepsis
c) Vaginosis
d) Ectopic pregnancy
e) All the above.
54. For induction of labour Bishop scoring is very importan. It includes.
a) Cervical consistency.
b) Cervical position.
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c) Rupture of membranes.
d) Cervical dilation.
e) Cephalic presentation.
55. Induction of labour
a) Is indicated in hypertensive disease
b) A favourable cervix is long, hard and closed
c) Oxytocin is given as a bolus
d) Is contraindicated in cord prolapse
e) Misoprostol is licensed for this purpose in Uganda
56.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.
57. 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.
58. The following are factors related to dystocia.
a) Maternal Age
b) Gestational Diabetes.
c) POP.
d) Maternal exhaustion
e) Macrosomic foetus
59. 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.
60.About PPH
a) Pregnancy acquired coagulopathies are the commonest cause of primary PPH.
b) Prostaglandins have a role in the management.
c) TAH may be done in case of intractable PPH.
d) Placenta praevia and abruptio placenta are common causes.
e) Medical management has no role.
61. In primary postpartum haemorrhage, management includes.
a) Call for assistance.
b) Bimanual compression of uterus.
c) Use of magnesium sulphate.
d) Use of ergometrine 10 mg IV for atonic uterus.
e) Insert an indwelling urinary catheter.
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62.Which of the following is true about abortion.
a) PV bleeding is a late sign.
b) There is never associated fever.
c) An evacuation is carried out as a way of treatment in case of threatening
abortion.
d) A patient can develop a bleeding disorder.
e) All the above.
63.Regarding incomplete abortion.
a) Treatment is invariable by evacuation.
b) Male factor can be a causal factor.
c) Hospitalisation is always indicated.
d) All the above.
e) a) and c) above are true.
64. Habitual abortions
a) Best define as 3 or more consecutive spontaneous losses of nonviable foetus.
b) Investigations should be done before another pregnancy occur.
c) Spontaneous abortion due to infections.
d) Incompetent cervix is a common cause.
e) Is also call missed abortion.
65. Indications for elective caesarean section:
a) Successfully Repaired V.V.F.
b) Cord prolapse with a pulsatile cord.
c) Abruptio placentae with I.U.F.D.
d) Vasa praevia.
e) Two previous abdominal scar.
66. Immediate complications for caesarean section include:
a) Severe haemorrhage.
b) Injure to neighbours organs.
c) Infections.
d) Haemorrhage.
e) Intestinal obstruction
67. The management of severe Malaria at 12 WOA includes the following:
a) Use of Chloroquine and Fansidar.
b) Use of Coartem and Cotrimoxazole.
c) Intravenous Quinine and Anti pyretics.
d) Oxygen therapy in case of cerebral Hypoxia.
e) Renal dialysis.
68. The following are true in the management of multiple pregnancies
a) They should be admitted at 36 weeks to reduce the incidence of neonatal
complications
b) Active management of third stage always prevents post partum haemorrhage
c) Caesarean section is indicated if the second twin is a breech.
d) Triplet is indication of caesarean section
e) A and C above.
69. 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 seem
d) Monozygotic twin are the result of the division of 2 ova
e) Paternal side is not a risk factor.
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70. 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.
71. 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.
72.All the following are increase in multiple gestation.
a) Blood loss at delivery.
b) The evidence of congenital anomalies.
c) The evidence of cephalopelvic disproportion.
d) The incidence of placental abruption.
e) The incidence of malpresentation
73. The foetal 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.
74. The dangers of vacuum extraction include.
a) APH.
b) Ruptured uterus.
c) Intrauterine foetal death.
d) PPH.
e) Acute foetal distress.
75.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 breastfeeding
e) Mixed feeding may be practiced in PMTCT.
76.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.
77.About puerperium.
a) The following 4 weeks after delivery.
b) At the 3rd postpartum day the uterus 2 cm above the umbilicus.
c) The lochia disappear at the 7th postpartum day.
d) Milk retention can cause puerperal infection.
e) Psychosis is not a possible complication
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78. The following are true or false 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.
79.About puerperal infection.
a) Manual removal of the placenta is a predisposing factor.
b) Internal foetal monitoring has no role.
c) Prophylactic antibiotic can help to prevent it.
d) Poor socioeconomic condition and poor hygiene have an important role.
e) External cephalic version is a predisposing factor.
80.Objective of performing an episiotomy include.
a) To prolong 2nd stage of labour.
b) Preserve integrity of pelvic floor.
c) Forestall uterine prolapse.
d) Save baby’s brain from injury
e) It is a routine in every primegravida.
81. Features of a medio-lateral episiotomy include.
a) Extensions are common.
b) Dyspareunia may be occasional.
c) Postoperative pain common.
d) More difficult to repair.
e) Blood loss is less compared to midline episiotomy.
82. Factors affect wound healing.
a) Nutrition.
b) Infection.
c) Anaemia.
d) High concentrations of vitamin c.
e) None of above.
83.Risk factors for disseminated intravascular coagulation include:
a) Abruptio placenta.
b) Pre-eclampsia/eclampsia.
c) Amniotic fluid embolism.
d) Use of hypertonic saline to induce labour.
e) None of the above.
84.Supportive care during labour and child birth includes
a) Personal support from a person of her choice throughout labour and birth
b) Good communication and support by health workers
c) Procedures and findings need not to be explained to the mother
d) Discourage ambulation
e) Distress caused by pain cannot be managed by any other measure
85.Caesarean section.
a) Most common mode of delivery in our service.
b) Is always indicated in previous caesarean section uterine scar.
c) Patients don’t need to be prepared.
d) Is done in all cases of foetal distress.
e) Mother can start oral feeding after 6-8 hours.
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86. IUFD
a) Can occur secondary to infection
b) Coagulation profile is vital
c) A C/S delivery is always safe
d) PPH is a possible complication
e) Misoprostol can be used for induction of labour.
87. 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
88.Complications of IUFD:
a) Disseminated intra vascular coagulopathy.
b) HELLP syndrome.
c) Asherman’s syndrome.
d) Septicaemia.
e) Supine hypotension syndrome.
89.Cardiovascular changes during pregnancy include:
a) Increased circulating volume up to 60% over the preconception values.
b) Increased circulating volume up to 45-50% over the preconception values.
c) Electrical axis of the heart is deviated to the left.
d) Increased heart silhouette on x-rays.
e) Systolic murmur can be present up to 90% of all pregnant woman
90.Changes in coagulating system during pregnancy include:
a) Reduction in platelets count.
b) Increased in fibrin-fibrinogen circulating complexes.
c) Increased platelets aggregation.
d) Increased circulating levels of all coagulating factors including XI and XIII.
e) None of the above
91. Malaria in pregnancy.
a) Plasmodium vivax causes cerebral malaria.
b) Plasmodium malariae causes relapses.
c) Chondroitin sulphate A receptors protects primegravidas against severe malaria.
d) Primegravidas are most prone to hyperparasitaemia than grand multiparous.
e) All pregnant women require 3 doses of intermittent presumptive treatment.
92. Malaria in pregnancy causes anaemia by the following mechanisms.
a) Dyserythropoiesis
b) Phagocytosis.
c) Haemolysis of RBC.
d) Bone marrow suppression.
e) Erythropoiesis.
93.Objective of performing an episiotomy include.
a) To prolong 2nd stage of labour.
b) Preserve integrity of pelvic floor.
c) Forestall uterine prolapse.
d) Save baby’s brain from injury
e) It is a routine in every primegravida.
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94. Features of a medio-lateral episiotomy include.
a) Extensions are common.
b) Dyspareunia may be occasional.
c) Postoperative pain common.
d) More difficult to repair.
e) Blood loss is less compared to midline episiotomy.
95.Regarding perineal tears:
a) 1
st degree: involves fourchet, perineal skin, vaginal mucosa, underlying fascia.
b) 2
nd degree: involves skin, mucosa membranes, fascias, muscle of perineal body,
but not the rectal sphincter.
c) 3
rd degree: external through skin, mucosa membrane, perineal body, and involve
anal sphincter.
d) 4
th extend through rectal mucosa to expose lumen of the rectum.
e) All of the above.
96.Regarding episiotomy repair.
a) Good lighting is not important.
b) Adequate analgesia prior to beginning of repair is not important.
c) Meticulous hemostasis is needed
d) Anatomical re-approximation is needed.
e) Use nylon 2/0 for vaginal mucosa.
97.Risk factors for Perinatal death include:
a) Premature rupture of membranes.
b) Foetal hypoxia of unknown cause.
c) Chorioamnionitis.
d) Abruptio placenta.
e) Vasa previa.
98.Risk factors for disseminated intravascular coagulation include:
a) Abruptio placenta.
b) Pre-eclampsia/eclampsia.
c) Amniotic fluid embolism.
d) Use of hypertonic saline to induce labour.
e) None of the above.
99. Multigravidas are at increased risk of:
a) Postpartum haemorrhage.
b) Anaemia in pregnancy.
c) Ruptured uterus.
d) Severe malaria in pregnancy.
e) Maternal depletion syndrome.
100.Multiple pregnancy.
a) Triplets are better delivered by caesarean section.
b) Induction of the labour is contraindicated.
c) There is high infant mortality and morbidity.
d) Cord prolapse may happen.
e) Risk factor for PPH.
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