452.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.
453.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) Hypoglycaemia is a possible complication.
454.The following are complications of PPROM.
a) Necrotizing enterocolitis.
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b) Intraventricular haemorrhages.
c) Earlier ductus arteriosus closure.
d) Hypobilirubinaemia.
e) Thermal instability.
455.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.
456.The following are absolutes contraindications for tocolysis.
a) PPROM.
b) Intrauterine foetal demise.
c) Nonreassuring foetal assessment.
d) Chorioamnionitis.
e) Presence of phosphatidylglycerol in amniotic fluid.
457.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
458.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
459.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
460.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.
461.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.
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462.The following plasmodium species cause a relapse of malaria
a) P. falciparum
b) P. ovale
c) P. malaria
d) P. vivax
e) P. lugninate
463.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.
464.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 Lumenfatrine
e) Parenteral chloroquine.
465.The following pathological lesions are caused by severe falciparum malaria
a) Abundance of malarial pigment in the reticuloendothelial system.
b) Oedematosis brain with broad, flattened red gyri.
c) Presence of haemoglobin in the renal tubules.
d) Kupffer cells are increased in size and number.
e) Pericardial and endocardial petechiae
466.Malaria in pregnancy causes anaemia by the following mechanisms.
a) Dyserythropoiesis
b) Phagocytosis.
c) Haemolysis of RBC.
d) Bone marrow suppression.
e) Erythropoiesis
467.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.
468.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
469.Regarding Ectopic pregnancy
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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
470.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.
471.Danger signs and symptoms of pregnancy.
a) Severe headache.
b) Vaginal bleeding.
c) Abdominal disconfort.
d) Reduced foetal movements.
e) Loss of appetite.
472.The following are true, 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.
473.An 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.
474.For induction of labour Bishop scoring is very important. It includes.
a) Cervical consistency.
b) Cervical position.
c) Rupture of membranes.
d) Cervical dilation.
e) Cephalic presentation.
475.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
476.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.
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477.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.
478.The following are factors related to dystocia.
a) Maternal Age
b) Gestational Diabetes
c) POP
d) Maternal exhaustion
e) Macrosomic foetus
479.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.
480.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.
481.In primary postpartum haemorrhage, management includes.
a) Call for assistance.
b) Bimanual compression of uterus.
c) Use of magnesium sulphate.
d) Use of ergometrin 10 mg IV for atonic uterus.
e) Insert an indwelling urinary catheter.
482.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.
483.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.
484.Habitual abortions
a) Best define as 3 or more consecutive spontaneous losses of nonviable foetus.
b) Investigations should be done before another pregnancy occur.
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c) Spontaneous abortion due to infections.
d) Incompetent cervix is a common cause.
e) Is also call missed abortion.
485.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.
486.Immediate complications for caesarean section include:
a) Severe haemorrhage.
b) Injure to neighbours organs.
c) Infections.
d) Haemorrhage.
e) Intestinal obstruction
487.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 Antipyretics.
d) Oxygen therapy in case of cerebral Hypoxia.
e) Renal dialysis.
488.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.
489.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.
490.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.
491.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.
492.Which of the following are increased in multiple gestation?
a) Blood loss at delivery.
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b) The evidence of congenital anomalies.
c) The evidence of cephalopelvic disproportion.
d) The incidence of placental abruption.
e) The incidence of malpresentation
493.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.
494.The dangers of vacuum extraction include.
a) APH.
b) Ruptured uterus.
c) Intrauterine foetal death.
d) PPH.
e) Acute foetal distress.
495.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.
496.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.
497.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
498.The following are trae 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.
499.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.
500.Objective of performing an episiotomy include.
a) To prolong 2nd stage of labour.
b) Preserve integrity of pelvic floor.
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c) Forestall uterine prolapse.
d) Save baby’s brain from injury
e) It is a routine in every primegravida.
501.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.
502.Factors affect wound healing.
a) Nutrition.
b) Infection.
c) Anaemia.
d) High concentrations of vitamin c.
e) None of above.
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