MCQs for OBGYN 4

MCQs for OBGYN 4

 101.Management in cervical carcinoma and pre invasive lesions.

a) Stage 0 better treated by Wertheim operation.

b) CIN I a period of 2 years without action is advisable in high risk patients.

c) Radiotherapy can be used in stage IVb with high cure’s rate.

d) Stage III patients don’t need for palliative care.

e) LLETZ can be used in all pre-invasive lesions.

102.Dysmenorrhoea.

a) There is pathology in spasmodic Dysmenorrhoea.

b) Secondary dysmenorrhoea is mostly confined to adolescent.

c) Primary dysmenorrhoea pain normally goes following pregnancy and delivery.

d) Oral contraceptives puts play role.

e) Investigations aren’t required.

103.The following are known causes of female infertility:

a) Sheehan’s syndrome.

b) Stock-Adams-Morgatny syndrome.

c) Endometriosis.

d) Klineffelter’s syndrome

e) Meig’s syndrome.

104.In a patient with recurrent abortion, which of the following are possible causes?

a) Sigmond-Sheehan’s syndrome.

b) Cervical incompetence.

c) Antiphospholipid antibody syndrome.

d) TORCH infections.

e) Congenital anomalies of the genital tract.

105.You are on call at MUTH and are assessing a 16 year old patient with peritonitis and

septic shock due to a post abortal sepsis. Which of the following would you consider

in the management?

a) Broad spectrum antibiotic combination.

b) Patient resuscitation with 5 % dextrose.

c) Fluid challenge.

d) Blood and plasma transfusion.

e) Laparotomy as soon as patient’s condition allowed it.

106.Preventing fistula in obstetric care.

a) Development of primary health system is not important.

b) Improvement of transport facilities.

c) Adequate health policies.

d) Adequate vaccination’s programs.

e) Women’s rights empowering.

107.Criminal abortion prevention.

a) Improving accessibility to family planning method.

b) Maternal education level has no role.

c) Legalization of elective abortion.

d) Adequate sexual education programs.

e) Health policies are no related.

108.Maternal death in Uganda.

a) 60 to 80 % are preventable.

b) Infections are among the first three causes.

c) Only doctor’s actions are needed to reduce maternal mortality rate.

d) HIV/AIDS infection is the commonest cause.

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e) Malaria and post abortal infections killing more mother than HIV, haemorrhages

and eclampsia together.

109.Multiple pregnancy

a) Dizygotic twins are a product of two ova and one 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 two ova

e) Paternal side is not a risk factor

110.Which of the following is not part of routine comprehensive care for a mother within

the context of PMTCT?

a) WHO Clinical staging of the mother living with HIV

b) Prophylaxis for OIs with co-trimoxazole

c) Liver function tests

d) Nutritional care and counselling

e) All the above

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

a) Infants and children

b) The adolescents and young people

c) Fishing communities and uniformed forces

d) Women living with HIV and their families

e) All of the above.

112.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 c) above are false

e) All the above are true

113.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

114.About HIV/ AIDS in pregnancy

a) Sperm washing is a very effective way to prevent both the mother and her baby

b) There is no difference between low and high viral load mothers about MTCT risk

c) AZT cannot be used as monotherapy from 28 WOG

d) A combination of AZT during pregnancy with a single dose of Nevirapine during

labour increased the risk to the mother due to side effects

e) In patient with combination therapy if the treatment is discontinued, the drugs

should not be discontinued at the same time

115.About PMTCT

a) Mothers taking HAART during pregnancy have similar outcome like those on

Combination regimens in preventing MTCT

b) Caesarean section is recommended in both low and high viral loads

c) Infant formula is offered to protect the baby because it has been enriched with

maternal immunoglobulin.

d) Malarial infection can increase the risk of MTCT

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e) Dapsone is used for prophylaxis of OIs

116.An HIV positive mother delivers a healthy baby. PCR confirms that this baby is HIV

negative at birth. What will you do to prevent MTCT

a) Breast feeding for only three months will protect the baby

b) Since the baby is negative, Nevirapine is not necessary

c) Replacement feeding with cow milk is the ideal

d) Wet Nursing is a recognised option

e) Condom use has no role in protecting this baby.

117.The following statements are true about PMTCT

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

b) The sero prevalence 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

118.PMTCT

a) PEP: AZT/3TC or TDF/3TC for 1 month

b) PEP: Apply antiseptic, Know your status, LFTs, follow up

c) AZT: Hb<8g/dl, Neutropenia, monotherapy, suspension

d) Initiation of HAART: CD4>200, Triomune, Pre ART register, Comprehensive HIV

card

e) OIs: Dapsone, Fluconazole, Cotrimoxazole

119.The following have been associated with bacteriuria in pregnancy:

a) Pre-term birth

b) Low birth weight

c) Perinatal mortality

d) Abortions

e) Diabetes Mellitus

120.About asymptomatic bacteriuria in pregnancy:

a) Refers to the presence of a positive urine culture in an asymptomatic person

b) Occurs in 2 to 7 percent of pregnancies

c) Defined as two consecutive voided urine specimens with isolation of the same

bacterial strain in quantitative counts of ≥10(5) cfu/mL

d) Presence of lactobacillus or propionibacterium does not indicate a contaminated

urine specimen

e) If left untreated, 50% of patients will progress to symptomatic bacteriuria

121.The following drugs can be used for treatment of asymptomatic bacteriuria:

a) Penicillins

b) Cephalosporins

c) Doxycycline

d) Sulphodoxine

e) Dexamethasone

122.About renal physiological changes during pregnancy, the following are true except:

a) Glomerular Filtration Rate increases by 50%

b) Renal plasma flow increases by 50%

c) Oestrogens are responsible for the general ureteric relaxation

d) There is decreased predisposition to Urinary tract infections

e) There is increased creatinine clearance

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123.About ectopic pregnancy:

a) The gestational sac can be seen at an HCG level of 1500 IU/L using a

transabdominal U/S scan

b) The gestational sac can be seen at an HCG level of 6500 IU/L using a transvaginal

U/S scan

c) A cervical ectopic pregnancy can be treated using a cone biopsy

d) Can be treated using methotrexate

e) Can undergo resorption

124.Indications for medical treatment of ectopic pregnancy include the following except:

a) Presence of cardiac activity

b) Beta HCG titres less than 5000mIU/ml

c) Unruptured ectopic

d) An ectopic greater than 3.5 cm

e) An ectopic less than 3.5 cm

125.Concerning medical treatment in ectopic pregnancy, the following statements are

false:

a) Methotrexate should be given on days 2, 4, 6, 8, 10.

b) Methotrexate should be given on days 1, 3, 5

c) Serum creatinine should not be done

d) Qualitative beta HCG is important in treatment

e) Ninety percent (90%) of an intravenous (IV) dose of methotrexate is excreted

unchanged within 24 hours of administration

126.These drugs are given to bypass the metabolic block induced by methotrexate, and

thus rescue normal cells from toxicity:

a) Folinic acid

b) N5-formyl-tetrahydrofolate, citrovorum factor

c) Bisphosphates

d) Reduced folate

e) Cyclophosphamide

127.Each year, malaria is responsible for the following:

a) 50 million women living in malaria-endemic areas become pregnant

b) 10,000 women die as a result of malaria infection during pregnancy

c) 800,000 infants die as a result of malaria infection during pregnancy

d) 2 million malaria infections in pregnant women in Sub Saharan Africa

e) 1,000 women die as a result of malaria infection during pregnancy

128.About pathogenesis of malaria in pregnancy:

a) The plasmodium falciparum parasites express VSAs that mediate adhesion of

parasite infected erythrocytes to the chondroitin sulphate A receptors

b) The plasmodium falciparum parasites express VSAs that mediate adhesion of

parasite infected erythrocytes to the chondroitin sulphate C receptors

c) Adhesion occurs on the cytotrophoblast lining the intervillous space

d) Adhesion occurs on the syncytiotrophoblast lining the intervillous space

e) The var5csa gene encodes a parasite adhesion molecule that initiates the

pathology associated with pregnancy associated malaria (PAM).

129.Active management of third stage of labour (AMSTIL) involves:

a) Using a balloon tamponade to enhance uterine involution

b) Delivery of the cord by controlled cord traction with counter traction over the

supra pubic area

c) Monitoring of the Blood pressure, pulse rate, GCS, and Per vaginal bleeding every

20 minutes for one hour

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d) Pelvic floor exercises (Kegel’s exercise)

e) Administration of 10IU of Oxytocin IM on the anterior thigh within 2 minutes of

delivery of the baby

130.These methods can be used in treatment of postpartum haemorrhage except:

a) Caesarean section

b) Total abdominal hysterectomy

c) Internal Iliac ligation

d) Cytotec

e) Syntometrienne

131.The following statements are true about pre- eclampsia.

a) Is among the commonest cause of maternal mortality in MRRH.

b) SFlt-1 prevents the correct differentiation and invasion of the trophoblast.

c) Aspirin inhibit the synthesis of prostacyclin.

d) Thromboxane A2 is a potent vasodilator.

e) None of the entire above is true.

132.Hydralazine use in pre-eclampsia.

a) Is vasodilator with central alpha blocker action.

b) Should be given 10 mg/ 30 min up to 30 mg as the maximum dose.

c) Ampoules containing 20 mg should be diluted in 20 ml of 5 % dextrose and given

over 10 min.

d) a) and c) above.

e) None of the above.

133.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.

134.The following are true about the management of pre-eclampsia.

a) Oral antihypertensive are indicated to all mild pre-eclamptic patients.

b) Antihypertensive treatment for adult pre-eclamptic patient should be started with

BP greater than 160/110 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.

135.APH.

a) Abortion is a common cause of APH.

b) In patient with placenta praevia type II ARON should be done followed by labour

induction.

c) In a patient with chronic abruptio placenta aspirin should be given 6 hourly to

protect placental blood flow.

d) FHR absence in a severe abruptio always means IUFD.

e) Severe abruptio with IUFD and DIC should be delivered immediately by

emergency C/section.

136.Cervical carcinoma.

a) HPV and HIV association is an important risk factor in Uganda.

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b) The presence of unilateral hydronephrosis is not a IIIb stage.

c) Stage Ib 1 can be treated with radical trachelectomy in patient with fertility’s

desire.

d) CRT combination after surgery does not improve the survival rate at 5 years for

stage IIb

e) All of the above.

137.About CIN.

a) All CIN should be treated surgically.

b) CIN III or CIS is always an indication for TAH.

c) Visual Inspection Under acetic acid (VIA) is not useful in CIN screening.

d) A positive Schiller’s test should be considered as diagnostic for CIN.

e) Squamous Columnar Junction is not important when taking a Pap smear.

138.Choriocarcinoma.

a) Can arise from any type of trophoblastic tissue.

b) It commonly appears after a partial mole.

c) Placental Site Tumour is easily diagnosed because the presence of chorionic villi.

d) Typical presentation is the presence of theca-lutein cyst.

e) hCG level higher than 105 IU/L is considered as poor prognosis.

139.The following are true about Choriocarcinoma management.

a) Stage I should always be treated with TAH only.

b) Stage I can be treated with single CT agent.

c) Combination CT is indicated in stage II as initial choice independently of the risk

score.

d) Stage III high risk should receive initially second line Combination CT.

e) When metastases are present the response to CT treatment is poor.

140. Are the following statement true about Choriocarcinoma and its follow up?

a) Stage I can be allowed to conceive within the 1st year after treatment.

b) COC are contraindicated.

c) Stage III: hCG levels should be checked weekly until are normal during 3

consecutive months.

d) Stage IV if TAH is done second look surgery should be done within 6 month.

e) In stage IV hCG determination should be stopped after 1 year with normal level.

141.Modified obstetric practices in PMTCT include the following

a) Vaginal cleansing with clean water

b) Administration of 2mg/kg of Nevirapine 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

142.An HIV +ve mother delivers a healthy baby. PCR confirms that this baby is HIV

-ve at birth. What will you do to prevent MTCT

a) Breast feeding for only three months will protect the baby

b) Since the baby is negative, Nevirapine is not necessary

c) Replacement feeding with cow milk is the ideal

d) Wet Nursing is a recognised option

e) Condom use has no role in protecting this baby

143.The following statements are true about PMTCT

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

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

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

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d) Breast feeding alone contributes 35% of MTCT

e) Family planning is important

144.A G2P1+0 HIV +ve mother comes to clinic. Which of the following will you consider

a) Initiation of HAART even without medical eligibility

b) CD4 count will not influence the decision to start ART

c) 3TC, D4T, EFV is the combination of Choice

d) 3TC, D4T, NVP is the combination of Choice

e) Triomune is never given

145.About waste management

a) Hospital, Blood banks and domiciliary make the largest source of Health care

waste

b) Yellow bin is for placenta and anatomical wastes

c) Sharps constitute more than 1% of health care waste

d) a) and b) are correct

e) b), and c) are correct

146.About pre eclampsia.

a) In the differential with other proteinuric disorders soluble forms- like tyrosine

kinase, placental growth factor appears to be useful.

b) In pre eclampsia is common the presence of specific systemic findings of disease

activity (e.g. low complements levels, red and white cells and/or cellular cast in

urinalysis.

c) Recurrence: Pre eclampsia is over three times more common in multiparous

women with a previous history of the disease than a nulliparous.

d) Pre eclampsia in prime gravid woman can predict remote cardiovascular events.

e) Pre eclamptic women are at high risk to develop some specific kind of cancer.

147.About pre eclampsia.

a) HELLP syndrome with renal failure affects long term renal function.

b) LDH can be used to do the diagnosis of microangiopathic haemolysis.

c) All patients with diastolic blood pressure 100 mm hg should be admitted

prescribed bed rest.

d) A high level haemotocrit may be indicative o contraction of intravascular volume

and improvement in patient outcome

e) Early foetal growth restriction may be the first manifestation of pre eclampsia.

148.During conservative management to severe pre-eclampsia in a patient with 32 WOA,

(Methyldopa, Mg SO, and ASA) a CTG is done and lose of the variability was found.

This is indicative of.

a) Acute foetal distress.

b) Chronic placental insuffiency and chronic foetal distress.

c) Possible infection coexisting.

d) Side effects of Methyldopa.

e) None of the above.

149.The following are true of endometriosis

a) It cannot occur in postmenopausal women as their endometrium is atrophic.

b) It occurs in the reproductive age because of the presence of gonadotrophins.

c) It can cause deep and superficial dyspareunia.

d) All the above.

e) None of the above

150.The most common site of endometriosis is

a) The pouch of Douglas.

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b) The ovary

c) The posterior surface of the uterus

d) The broad ligament

e) The pelvic peritoneum