503.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.
504.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
505.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.
506.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.
507.In intra uterine 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
508.Complications of I.U.F.D:
a) Disseminated intra vascular coagulopathy.
b) HELLP syndrome.
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c) Asherman’s syndrome.
d) Septicaemia.
e) Supine hypotension syndrome.
509.About APH.
a) Is any bleeding from genital tract before 28 WOA.
b) Vasa praevia can be a cause.
c) Placenta previa is more common than Abruptio placenta.
d) Is a common cause of preterm delivery.
e) Is the commonest cause of maternal death in Mbarara.
510.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.
511.About management of eclampsia
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.
512.Which statements are true and false?
a) Magnesium Sulfate 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 Preexisting hypertension.
513.The most common presenting symptom of eclamptic patient is.
a) Profuse vaginal bleeding.
b) Abdominal pain.
c) Dyspareunia.
d) Convulsions.
e) Vomiting.
514.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.
515.Risk factors for postpartum endometritis include all the following except.
a) Prolonged labour.
b) Prolonged rupture of membranes.
c) Multiple vaginal exams.
d) Prolonged monitoring with intrauterine catheter.
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e) Breast feeding
516.All the following factors affect wound healing except.
a) Nutrition.
b) Infection.
c) Anaemia.
d) High concentrations of vitamin c.
e) None of above.
517.The following are true 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.
518.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.
519.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
520.National HIV prevention strategies include
a) Primary Prevention of HIV and other STIs through ABC model
b) Premarital HIV screening
c) Preconception HIV screening
d) PMTCT in HIV positive pregnant mothers
e) All the above
521.About H.I.V infection
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.
522.In PMTCT.
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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.
e) The entire above are false.
523.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.
524.Obstructed labour.
a) Wilm’s tumour is a cause
b) Partograph cannot detect.
c) Occurs only in Multigravidas
d) Bandle’s ring may manifest.
e) Always delivery by caesarean section.
525.Complications of obstructed labour.
a) Neonatal sepsis.
b) Death.
c) PPH
d) Rectovaginal fistula
e) All the above.
526.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.
527.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.
528.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.
529.Causes of Uterine rupture include.
a) Obstructed labour.
b) Previous caesarean section.
c) Manual removal of placenta.
d) Injudicious use of oxytocic drugs.
e) Premature labour.
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530.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.
531.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.
532.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.
533.In management of Ectopic pregnancy
a) Laparotomy should be performed only after securing blood
b) Autotransfusion 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
534.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
535.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.
536.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.
537.Danger signs and symptoms of pregnancy except.
a) Severe headache.
b) Vaginal bleeding.
c) Abdominal discomfort.
d) Reduced foetal movements.
e) Loss of appetite.
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538.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.
539.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.
540.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
541.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.
542.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.
543.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.
544.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 threatened abortion.
d) A patient can develop a bleeding disorder.
e) All the above.
545.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.
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e) a) and c) above are true.
546.Habitual abortions
a) Best defined 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.
547.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.
548.Immediate complications for caesarean section include:
a) Severe haemorrhage.
b) Injure to neighbours organs.
c) Infections.
d) Haemorrhage.
e) Intestinal obstruction
549.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.
550.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.
551.Classic signs and symptoms of complete uterine rupture include:
a) Sudden onset of tearing abdominal pain.
b) Cessation of uterine contractions.
c) Absence of foetal heart.
d) Recession of the presenting part
e) All of the above.
552.About ruptured uterus
a) Can be complete or incomplete
b) Always implies there is foetal death
c) Is a common morbidity and mortality cause in Mbarara district
d) Can be prevented by improving primary care of health
e) Is always an indication for obstetrical hysterectomy.
553.The following are associated with breech presentation.
a) Polyhydramnios.
b) Oligohydramnios.
c) Multiple pregnancy.
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d) Contracted pelvis.
e) Low socio-economic status.
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