553.The following are associated with breech presentation.
a) Polyhydramnios.
b) Oligohydramnios.
c) Multiple pregnancy.
-280-
d) Contracted pelvis.
e) Low socio-economic status.
554.About breech presentation.
a) Most are delivered by caesarean section.
b) First stage of labour is quicker than cephalic presentation.
c) Cord prolapse is not a risk.
d) Forceps cannot be used for delivery.
e) Can be managed by a TBAS.
555.Anaemia during pregnancy.
a) Physiologic anaemia in pregnancy, Hb less 11g/dl
b) Physiologic anaemia is when the plasma volume increases higher than
erythrocyte volume with a corresponding fall in Hb level
c) The commonest cause is iron deficiency
d) Malaria is not an important cause of anaemia in pregnancy in Africa
e) Pregnant women with normal Hb don’t need iron supplementation during
pregnancy.
556.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.
557.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.
558.The perineal body is made of the following muscles.
a) Transverse perineal, Coccygeus, ischiocavernosus, levator ani, bulbo cavernosus.
b) External anal sphincter, ischiocavernosus, bulbocavernosus, levator ani and
transverse perini.
c) Bulbo spongiosus, ischiocavernosus, transverse perineal, levator ani.
d) Bulbospongiosus, transverse perini, anal sphincter, levator ani.
e) None of the above.
559.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.
560.During the preconception period.
a) Height measurement is very important.
b) Administration of folic acid should be commenced
c) Rh negative mothers should be given anti D immunoglobulin.
d) Rh positive mothers should be given anti D immunoglobulin.
e) The first dose of IPT should be commenced.
561.Incompetent cervix
-281-
a) We commonly treat by cervical circlage at 20 weeks of gestation
b) Ultrasound scan before the procedure is not necessary
c) The stitch is only removed after 37 completed weeks
d) Cause may be congenital
e) All the above
562.Regarding psychosocial problems in Ante Natal care.
a) Chronic heavy alcohol ingestion has no effect on the baby.
b) Smoking is implicated in low birth weight babies
c) There is increases morbidity and mortality in babies born to teenage mothers.
d) Domestic Violence should be adressed.
e) Male involvement is never a challenge
563.Leopold’s manoeuvres include
a) Determination of Gestational Age
b) Cervical examination
c) Determination of presentation.
d) Auscultation
e) All the above.
564.Haematological findings in Iron deficiency anaemia.
a) Microcytic hyperchromic.
b) Macrocytic hypochromic.
c) Market anisocytosis.
d) The mean corpuscular value is low.
e) Mean corpuscular haemoglobin is increased
565.Conditions requiring folate supplementation in pregnancy include.
a) Antepartum Haemorrhage
b) Malaria
c) Haemolytic anaemia
d) Anaemia responding to iron therapy
e) Multiple pregnancy
566.During the management of malaria:
a) A negative blood slide means there is no malaria
b) Quinine can be used in early pregnancy
c) IV Quinine should be given in Normal saline since the mother is dehydrated
d) All the above
e) None of the above
567.Malaria in pregnancy.
a) Plasmodium vivax causes cerebral malaria.
b) Plasmodium malarie causes relapses.
c) Chondroitin sulphate A receptors Protect PG’s agains severe malaria.
d) Prime gravida are more prone to hyperparasitaemia than grand multiparous.
e) None of the above
568.The following are indication for removal cervical cerclage.
a) Rupture of the membranes.
b) Haemorrhages
c) Elevations of blood pressure.
d) Uterine fibroid
e) Uterine contractions.
569.Management of sickle cell crisis in pregnancy,
a) Exchange transfusion has no role
-282-
b) Opiate analgesics are not contraindicated.
c) Oxygen therapy is useful
d) Intra venous fluids should not be used in rehydration
e) Patient should be placed in intensive care unit.
570.The following are classified as a high risk pregnancy in Antenatal period
a) A grand multigravida at term without complaints during her fourth ANC visit.
b) A Gravida 2 Para 1+0 with a singleton pregnancy and a previous history of
multiple pregnancies.
c) A Gravida 3 para2+0 at term with 2 previous normal home deliveries.
d) A 16 year old prime Gravida at 32 weeks.
e) None of the above.
571. A Gravida 3 Para 1 +1 had her LNMP on 25/ 12/2009. The following statements are
correct
a) Her weeks of amenorrhea on 19/05/2010 will be 23wks.
b) She would be a Para 2 + 1 if she lost her pregnancy today
c) Her EDD will be 1/09/2010.
d) Her EDD will be 1/10/2010.
e) She would be a Para 1 + 2 if she lost her pregnancy today
572. The following tests are routinely performed during ANC
a) HIV serology
b) Sickling test
c) Hemogllobin level estimation
d) Urinalysis
e) Maternal serum Alpha foetal protein
573.In the refocused ANC
a) Four visits are recommended
b) The objective of the second visit is to screen for abnormalities
c) The objective for the third visit is to screen for abnormalities
d) HIV is most recommended between 28-32 weeks as this is the best period to
initiate Combivir for PMTCT
e) The first visit should ideally last 40minutes.
574.Habitual abortion
a) Is defined as 3 or more consecutive losses of pregnancies before 28 weeks
b) Cervical stitch is always successful
c) Can be investigated before pregnancy
d) A and C
e) None of the above
575.About post-abortal care (PAC)
a) Antibiotics cover to prevent infection
b) Immediate post abortion family planning to avoid another pregnancy
c) Connection to other reproductive health services
d) All of the above
e) None of the above
576.About Diabetic in pregnancy.
a) Oral hypoglycaemic are recommended.
b) Nutritional counselling and exercise are not part of management.
c) Shoulder dystocia may occur during delivery.
d) Caesarean section is always the mode of delivery.
e) Patient with Pregestational Diabetic always need insulin treatment.
-283-
577.Neonatal complications of poorly controlled diabetes in pregnancy include,
a) Polycythaemia
b) Hypocalcaemia
c) Hypomagnesaemia
d) Hypoglycaemia
e) Respiratory distress syndrome
578.Pre term labour may be present in all the following conditions except,
a) Multiple pregnancies
b) Antepartum Haemorrhage
c) Cervical incompetence.
d) Obstetric ultrasonography
e) Uterine abnormalities
579.The following are associated with preterm birth
a) Infection with Plasmodium falciparum
b) Infection with Gardinella Vaginalis
c) Infection with Cryptococcus neoformans
d) Long term medication with steroids
e) All of the above
580.Preterm labour and PPROM
a) Rupture of membranes is not associated with ascending infection.
b) Pre term labour accounts for about 10% of perinatal mortality
c) Most of pre term labour is due to unknown reasons.
d) Best mode of delivery incase of chorioamnionitis is by caesarean section.
e) Pulmonary hypoplasia and skeletal deformities may be seen due to
oligohydromnious.
581.Diagnosis of PROM,
a) Vaginal examination shoud not be done.
b) Abdominal palpation is important.
c) Amniotic fluid will have vernix caeserosa and a characteristic smell.
d) Nitrizine test has no role.
e) A sterile speculum exam is performed to observe the cervix for amniotic fluid
leakage.
582.Tocolysis,
a) Should never be done in obstructed labour.
b) It can be done to allow time for administration of steroid therapy.
c) Intravenous ritodrine will have no effect on carbohydrate metabolism in a diabetic
mother.
d) Is contra indicated in mothers with chorioamnionitis
e) Can be done in presence of APH since vasodilation caused may not potentiate
bleeding.
583.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
584.About management of severe pre Eclampsia
a) Severe pre Eclampsia should be managed as out patient after control of the blood
pressure
-284-
b) Magnesium sulphate should be used in all cases
c) Methyldopa is the best option to treat the crisis
d) Aspirin 80 mg daily may help preventing pre Eclampsia in patient at high risk
e) All the above
585.About eclampsia
a) Phenobarbital is the drug of choice
b) Valium can be used as secure alternative in the absent of magnesium sulphate
c) Delivery is indicated only after complete stabilization of the patient
d) Vaginal delivery is contraindicated
e) All the above.
586. HELLP Syndrome,
a) Affects 4 to 12% of those with pre eclampsia& eclampsia
b) Incidence of recurrence in subs equent pregnancies is 20%
c) Stabilisation of coagulation is key in the management.
d) Main liver enzyme particularly elevated is Alkaline phosphatase
e) Acute renal failure and Disseminated intra vascular coagulation are not related
complications.
587.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.
588.Bishops score of the cervix involves all the following except,
a) Station of the presenting part in relation to the Ischial spines
b) Length of the cervix in metres
c) Position of cervix that is posterior, anterior or central.
d) Cervical dilatation
e) consistency of the cervix
589. The following are foetal indications for induction of labour.
a) Pre eclampsia
b) Severe systemic lupus erythematosus
c) Hydrops foetalis
d) Intra uterine growth restriction
e) Placenta praevia
590.The following are true about the risk factors for prolonged pregnancy except:
a) Foetal anencephaly
b) Foetal adrenal hypoplasia
c) X-linked placental sulfatase deficiency
d) Previous prolonged pregnancy
e) Macrosomia
591.About prolonged pregnancy, the following complications may occur
a) Birth asphyxia
b) Meconium aspiration syndrome
c) Prolonged labour
d) Polyhydraminos due to prolonged period of placental production of amniotic fluid
beyond 42 weeks
e) Foetal distress is not a complication before onset of labour.
-285-
592. Post Term pregnancy
a) Any pregnancy in the 42nd week
b) It is a High Risk Pregnancy
c) Pregnancy of 42 completed weeks or more
d) Delivery should be expedited in cases of severe oligohydraminos
e) Should always be managed expectantly until spontaneous onset of labour
593. About induction of labour and prolonged pregnancy.
a) Routine induction of labour after 41weeks reduces the incidence of foetal distress
and caesarean section.
b) Prostaglandins are not useful in ripening of the cervix.
c) Uterine hyperstimulation and failed induction are potential risks.
d) Can be done in a mother with grade four placenta praevia
e) Always results in caesarean section
594.The following are clinical features of a post mature new born
a) Low set rigid ears
b) Unusual low level of alertness
c) Wrinkled peeling skin especially on the palmer surface
d) Open eyes, with a facial appearance of a “worried old man”
e) All the above
595. Antepartum Haemorrhage (APH)
a) Previous APH does not predispose to APH in future pregnancies.
b) Recurrent pain free bleeding with an abnormal lie means Vasa Praevia.
c) Incidence of placenta praevia is 15% of all pregnancies.
d) Immediate management involves delivery of the baby.
e) Can never co exist with severe pre-eclampsia
596. Placenta Previa management
a) Tocolytics are indicated in preterm management
b) Vaginal delivery should always be attempted if the mother is not severely affected
c) PPH should be anticipated
d) When mild bleeding at term, mother stable, labour should be awaited
e) All the above.
597.Normal labour.
a) Episiotomy is used only if needed
b) The second stage of labour may be managed passively
c) The shape of the maternal pelvis will not affect the progress of labour
d) Lengthening of the umbilical cord is a sign of failed placental separation.
e) A gush of blood vaginally in the third a sign of ruptured uterus.
598. 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
599. The most common cause of uterine rupture includes
a) Previous traumatizing operations or manipulations such as myomectomy
b) Excessive or inappropriate uterine stimulation with oxytocin
c) Separation of a previous caesarean hysterotomy scar
d) Only A and C
-286-
e) All the above
600. The following signs and symptoms are most commonly associated with uterine
rupture
a) Massive vaginal bleeding
b) Woody hard abdomen due to peritoneal irritation from free blood in the peritoneal
cavity
c) Shock
d) Intra uterine foetal death
e) All the above
601. The following are true about the management for a ruptured uterus
a) Aggressive intravenous fluid resuscitation
b) Emergency exploratory Laparotomy
c) Emergency Abdominal Ultrasound to estimate amount of blood in the peritoneal
cavity and assess foetal viability
d) Whole blood is most recommended when blood transfusion in indicated
e) Packed cells is most recommended when blood transfusion in indicated
602. The following incision poses the greatest risk of uterine rupture
a) Lower segment uterine transverse incision
b) Lower segment uterine vertical incision
c) Classical uterine incision
d) Cherney incision
e) Only C and D
603. Mother to child transmission HIV.
a) May occur as early as the time of ovulation
b) May occur in utero across the placenta
c) Occurs in 10-20% during post natal period
d) During labour/delivery in 60-70% of cases occur
e) During labour/delivery in 10-15 % of cases occur
604.About Breastfeeding
a) On average Ugandan women breastfeed their infants for 19 months
b) MTCT of HIV occurs post natally in breast feeding mother in 10-20 % of cases.
c) Replacement feeding is essential in PMTCT
d) HIV positive mothers are not encouraged to breast feed for 6 months
e) Mixed feeding may be practiced in PMTCT
605.The following are modified obstetric practice except:
a) Administration of single dose Nevirapine in labour.
b) Delayed rupture of membranes.
c) Exclusive breast feeding.
d) Avoidance of invasive procedures.
e) Using electric suction.
606.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 mother.
e) The entire above are false.
Nhận xét
Đăng nhận xét