301.Techniques used to reduce the risk of wound infection include
a) Creation of dead space
b) Proper antisepsis
c) Proper antibiotic use
d) Use of many spaces
e) Avoiding hypothermia
302.Differential diagnosis of Ectopic pregnancy
a) Bleeding corpus luteum
b) Appendicitis
c) Endometriosis
d) Epigastric hernia
e) Abortions
303.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
304.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
305.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
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d) Previous operation involving the hand is a risk factor
e) Can occur at the ovary
306.Criteria for diagnosis of ovarian pregnancy include
a) Intact tube on the affected side
b) Foetal sac occupying the position of the ovary
c) Ovary must be connected to the uterus by the ovarian ligament
d) Demonstrate ovarian tissue in the sac wall
e) All the above
307.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 can’t be managed by any other measure
308.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 PTCT.
d) Consolation breast feeding is a component of sudden cessation of breastfeeding
e) Mixed feeding may be practiced in PMTCT.
309.The following factors affect MTCT.
a) Smoking and alcohol
b) Increased viral load.
c) Increased CD4 count
d) Urinary tract infection
e) Prolonged labour
310.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
311.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 mothers
e) The entire above are false.
312.HIV in pregnancy.
a) HIV causes Intrauterine foetal demise
b) Dual family planning is not meant for an HIV positive couple
c) Pneumocystis carinii Pneumonia is a common complication.
d) Increased risk for malaria attack.
e) Congenital malformation’s risk increased.
313.Uganda PMTCT 2006/2010
a) The goal is to reduce the MTCT rates in infants by 50%
b) Basic regimen is for HC11 and involves single dose nevirapine
c) AZT+3TC+EFV is the combination of choice in pregnancy
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d) 4dT+3TC+NVP is a combination of choice in anaemic pregnant mother with PCP
e) Integrated Young infant feeding counselling is not emphasised
314.Modified obstetric practices in PMTCT include the following
a) Vaginal cleansing with clean water
b) Administration of 2mg/kg of NVP tablets to a baby after 72hrs of delivery
c) An episiotomy may be performed when necessary
d) Delivery must be conducted in hospital
e) Elective C/S
315.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
316.PPH
a) Active management of 3rd stage of labour may prevent it
b) Ruptured uterus is not a cause
c) Sheehan’s syndrome is a consequence
d) Is an indirect cause of maternal mortality
e) Endometritis is a cause of primary PPH
317.Refocused ANC
a) There is reduced mother to health worker contact time
b) Is cheaper for the mother
c) Fewer attendances means heavier clinic days
d) There is less satisfaction to the mother since they are seen less often
e) All the above
318.Elective C/S
a) Is done to all TRR mothers
b) Is mandatory in a mother with previous C/S
c) Can help in MTCT prevention
d) Should be done on mothers request
e) Pregnancy dating is not important
319.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
320.A 17 year old presents with offensive PV discharge. What is the most likely
diagnosis?
a) Incomplete septic abortion
b) Puerperal sepsis
c) Vaginosis
d) Ectopic pregnancy
e) All the above
321.ANC
a) Male partner involvement is encouraged
b) IPT is given monthly in a PG
c) IPT is given monthly in HIV
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d) Routine investigations include urinalysis, HIV screening, Hb, and Full Blood Count
e) All the above
322.Complications of C/S
a) Obstetrics fistulae
b) Obstetric palsy
c) If bladder damaged, repair it after 3 months
d) Rupture of uterus may occur in subsequent pregnancies
e) All the above
323.The following are true regarding PMTCT:
a) ARV’s are contraindicated in the first trimester of pregnancy.
b) Assisted vaginal delivery reduces the risk of MTCT.
c) Patients on HAART should receive Nevirapine tablet when in active labour.
d) Close monitoring of the progress of labour using a partograph is recommended.
e) Exclusive breastfeeding of the infant for six months then weaning is encouraged.
324.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 placentae are common causes.
e) Medical management has no role.
325.Drugs of choice in management of severe pre-Eclampsia include the following:
a) Nifedipine.
b) Magnesium Sulphate.
c) Captopril.
d) Hydralazine.
e) Labetolol.
326.The major aims in management of eclampsia at 37WOA include the following:
a) Control blood pressure using furosemide and spironolactone.
b) Promote lung maturity using intravenous steroids i.e. dexamethasone.
c) Doing a bio-physical profile on ultrasound and a bishop score.
d) Prevent convulsions using Magnesium Sulphate.
e) Use of Labetalol instead of sublingual Nifedipine.
327.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.
328.Obstetrics indications for hysterectomy include:
a) Unrepairably ruptured uterus.
b) Cancer of the cervix stage 1B.
c) Secondary post partum haemorrhage.
d) Cancer of the ovary.
e) Gangrenous uteri in pueperium.
329.Ultra sound findings in IUFD:
a) Positive Roberts sign.
b) Negative Spalding sign.
c) Decreased curvature of foetal spine.
d) Oedema between foetal cranium and scalp.
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e) No air in the great vessels and the heart chamber.
330.Indications for induction of labour using prostaglandins:
a) I.U.G.R.
b) Confirmed post datism.
c) Intra uterine foetal death.
d) Cardiac disease, New York heart classification one.
e) Caesarean section history with a big baby.
331.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) One previous C/section scar with a non recurrent indication history.
332.Puerperal Pyrexia:
a) Orthostatic Pneumonia and thrombophlebitis can be a differential diagnosis.
b) Chorioamnionitis is a predisposing factor.
c) Body Temperature is above 37.4oC.
d) Anti-malarial have no role in its management.
e) Body temperature elevation is physiological.
333.Complications of IUFD:
a) Disseminated intra vascular coagulopathy.
b) HELLP syndrome.
c) Asherman’s syndrome.
d) Septicaemia.
e) Supine hypotension syndrome.
334.All the following are predisposing factors to puerperal sepsis except:
a) Severe anaemia.
b) Premature rupture of membranes.
c) Prolonged and obstructed labour.
d) None of the above
e) All the above.
335.Regarding ectopic pregnancy:
a) Commonest site of the implantation is the ovary.
b) Chronic salpingitis is a predisposing factor.
c) Management can be medical.
d) Laparascopy is the investigation of choice
e) Urine hCG may be negative.
336.Preparation of a patient for surgery
a) Informed consent is important
b) Patient has no right to refuse operation
c) Catheter insertion is mandatory for all patients for surgery
d) CXR is routine
e) CXR is important in patients above 50 years
337.The following statements are true about pre-eclampsia.
a) Is among the commonest cause of maternal mortality in MRRH.
b) HELLP syndrome is a complication
c) Aspirin inhibit the synthesis of prostacyclin.
d) Thromboxane A2 is a potent vasodilator
e) None of the entire above is true.
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338.MgSO4.
a) Act by preventing the release of acetylcholine at neuromuscular plaque.
b) Prevent the entry of calcium to the damaged endothelial cells.
c) Stimulate the N-methyl-D-aspartate receptors.
d) Toxicity appears with concentration of 8 to 10 meq/L.
e) Pulmonary oedema is a common complication.
339.The following are true about the management of pre-eclampsia.
a) Oral antihypertensive are indicated to all pre-eclamptic patients.
b) Antihypertensive treatment for adult pre-eclamptic patient should be started with
BP greater than 160/105 mmHg.
c) Foetal lung maturity induction is not necessary because the effect of
hypertension.
d) Patient with severe pre-eclampsia should be induced as soon as hypertension has
being controlled.
e) None of the entire above is true.
340.About pre-eclampsia.
a) Thromboxane A2 is usually low.
b) Long time using condom can play a role.
c) Increased circulating forms like thyroxin kinase 1.
d) Prostacycline is elevated.
e) Vascular endothelium growth factor is elevated.
341.In pre-eclampsia.
a) Methyldopa 3g/daily can be given as treatment during hypertensive crisis.
b) Placenta previa is a complication.
c) The drug of choice to manage severe pre-eclampsia is hydralacine
d) MgSO4 should be given to all patients with pre-eclampsia.
e) All of the above.
342.About APH.
a) Kleihauer-Betke test can help to establish the differential.
b) Abortion is a common cause of APH.
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.
343.Ante partum 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.
344.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 xxx,
dehydrated, RP: 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
FHeart heard. Vaginally: scanty blood coming through the canal, reddish area around
the cervix was noticed.
Which among the following is the most likely diagnosis?
a) Placental abruption.
b) Placenta praevia type IV.
c) Cervical carcinoma.
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d) Severe placental abruption with IUFD and CID.
e) Vasa praevia with IUFD.
345.Abruptio placentae.
a) Can lead to DIC.
b) Can cause Couvelaire uterus.
c) Is associated with malaria.
d) No risk factor for PPH.
e) Smoking is risk factors.
346.PPH.
a) Best ensure 2IV access lines 24 gauge size.
b) Surgery is always the best option.
c) Team work is mandatory.
d) Vaginal lacerations are the commonest cause.
e) Ergometrin 10 mg IV is useful.
347.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.
348.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.
349.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
350.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
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