607.HIV in pregnancy
a) Increased disk of intrauterine foetal demise.
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b) Absolute CD4 count can be reduced.
c) Pneumocystis carinii pneumonia is a common complication.
d) Increased risk for malaria attack.
e) Congenital malformation’s risk increased.
608.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 recorgnised option
e) Condom use has no role in protecting this baby
609.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
610.A G2P1+0 HIV positive 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
611.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) and b) are correct
e) b), and c) are correct
612.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
613.During ANC, the following are important and help out cone of pregnancy and labour
a) Routine weighing at every visit
b) Routine pelvic assessment at 36 WOA
c) Routine discussion of place of delivery and mode of transport
d) Routine Hb estimation at every visit
e) a), b) and c) above
614.The following are true about infection prevention
a) Hand washing, disinfection prophylactic antibiotics
b) Hand washing, prophylactic antibiotics, sterilization
c) Hand washing, use of protectives and equipment processing
d) Decontamination, cleaning of equipment and sterilization
e) All the above
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615.A gravida 1 Para 0+1 mother presents with vaginal bleeding at 40WOA. The
following is the best
a) No digital V/E, ultrasound and wait for spontaneous labour
b) No vaginal exam, ultrasound, examination under anaesthesia
c) The cause may be a heavy show
d) No digital exam, Hb estimation, Blood grouping and cross matching, prepare for
C/S
e) a) and c) above
616.A prime gravid mother is in labour, the partograph reaches the action line. The
appropriate action is
a) The mother has obstructed labour, deliver by C/S immediately
b) The mother has prolonged labour, rehydrate and augment with oxytocin 2.5IU in
5% dextrose
c) The mother has prolonged labour, rehydrate and deliver by Emergency C/S
immediately
d) Something is wrong. Reassess the partograph, labour and decide on the cause
e) The mother and the baby are distressed, turn her on the left side, give IV fluids
and oxygen and inform consultant
617.The best time to listen to the foetal heart in labour is
a) Before a contraction
b) During a contraction
c) After a contraction
d) b) and c) above
e) None of the above
618.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 btn 38-40 WOA
d) Urine HCG is positive as early as 10 days after fertilization
e) Bimanual palpation has no role in diagnosis
619.PPH
a) Active mgt 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
620.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
621.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
622.Induction of labour
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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
623.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
624.ANC
a) male partner involvement is encouraged
b) IPT is given monthly in a PG
c) IPT is given monthly in HIV
d) Routine investigations include urinalysis, HIV screening, Hb, and Full Blood Count
e) All the above
625.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
626.About pregnancy induced hypertension
a) Eclampsia may occur after delivery
b) Eclampsia may follow criminal abortion
c) Severe pre eclampsia may be complicated oliguria
d) Spinal anaesthesia is contraindicated
e) Pulmonary oedema is a known complication
627.A gravida 3 Para 2+0 presents to labour ward with PV bleeding at term, associated
with colicky abdominal pain. What is the most likely possibility
a) Labour pains with heavy show
b) Abruptio placenta
c) Ruptured uterus
d) Ectopic pregnancy
e) Cancer of the cervix
628.The following are common physiological changes during pregnancy.
a) Uterus at term weighing 1.1 kg.
b) Protein metabolism increased around 1000g.
c) Fat storage is greater during mid pregnancy.
d) Physiological anaemia in pregnancy.
e) Abnormalities in concentration, attention and memory
629.Objective of performing an episiotomy includes.
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 prime gravida.
630.Features of a medio-lateral episiotomy include.
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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.
631.Risk factors for perineal extension following episiotomy:
a) 2
nd stage arrest.
b) Vacuum extraction.
c) Small baby.
d) Persistent occiput posterior.
e) Nulliparity.
632.Regarding perineal tears:
a) 1
st degree: involves fourchet, perineal skin, vaginal mucosa, underlying fascia.
b) 2
nd degree: involves skin, mucosa membranes, fascias, muscle of perineal body,
but not the rectal sphincter.
c) 3
rd degree: external through skin, mucosa membrane, perineal body, and involve
anal sphincter.
d) 4
th extend through rectal mucosa to expose lumen of the rectum.
e) All of the above.
633.Regarding episiotomy repair.
a) Good lighting is not important.
b) Adequate analgesia prior to beginning of repair is not important.
c) Meticulous haemostasis is needed
d) Anatomical re-approximation is needed.
e) Use nylon 2/0 for vaginal mucosa.
634.Episiotomy.
a) All primegravida should get
b) Is contraindicated in HIV positive mothers
c) May lead to puerperal sepsis.
d) Should be done without anaesthesia.
e) Don’t require mother’s consent.
635.Multigravidas are at risk of:
a) Postpartum haemorrhage.
b) Anaemia in pregnancy.
c) Ruptured uterus.
d) Severe malaria in pregnancy.
e) Maternal depletion syndrome.
636.Multiple pregnancy
a) Triplets are better delivered by caesarean section.
b) Induction of labour is contraindicated.
c) There is high infant mortality and morbidity.
d) Cord prolapse may happen.
e) Risk factor for PPH.
637.Primegravidas are at risk of.
a) Severe malaria in pregnancy.
b) Pre-eclampsia/ eclampsia.
c) Precipitate labour
d) Maternal depletion syndrome.
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e) Obstetric fistula.
638.Pregnancy and its physiology
a) Stretching of the muscle cell in the uterus is due to placental lactogen
b) In the uterus, there is an increase in fibrous tissue mainly in the internal layer
c) The uterus capacity is increased from 10mls to 2L
d) At 14 weeks the uterus maintains the pear shape
e) All the above
639.About preterm labour/delivery
a) Despite co existing factors, adolescence remains a high risk factor for preterm
labour
b) Single women are at higher risk
c) Placenta previa is the commonest foetal factor inducing premature delivery
d) Cyclo oxygenase 2 has no role in the pathogenesis
e) None of the above
640.Pre term labour management
a) Betamimetic drugs are indicated in patients with hyperthyroidism
b) Cyclooxygenase is inhibited by indomethacin
c) Hydration and bed rest is highly effective in uterine activity inhibition
d) The only benefit provided by steroids in premature babies is acceleration of
foetal lung maturity
e) Pre delivery administration of steroids can be replaced by post natal
administration of surfactant
641.The following are among potentially effective interventions to reduce the incidence
of preterm deliveries
a) Smoking cessation
b) Adequate diagnosis and management of asymptomatic bacteraemia
c) Treatment of bacteria Vaginosis
d) None of the above
642.About placenta previa
a) IVF has no role in the aetiology
b) Vaginal examination should always be done under general anaesthesia
c) Kleihauer-Betke test helps in differentiating from circumvallate placenta
d) Always prevent the engagement of the presenting part
e) None of the above
643.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
644.Abruptio placenta
a) DIC is the commonest complication
b) Amniotic fluid embolism should not occur
c) Couvelaire uterus is always an indication for hysterectomy
d) Trauma is the commonest cause in Uganda
e) Amniotomy is only done when induction is indicated
645.About pre eclampsia
a) Proteinuria is considered when a random sample show 30mg/ml
b) Urine dipstick is indicated twice per week during conservative management
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c) Severe pre eclampsia is a contraindication for labour induction
d) Doppler velocimetry can be done for foetal wellbeing assessment
e) None of the above
646.Which of the following is the best choice for severe pre eclampsia
a) Short acting nifedipine
b) Lobetolol injection
c) Apresolin injection
d) Nitroglycerin injection
e) Sodium nitropruside
647.Which of the following are false?
a) POP can be corrected with obstetric forceps.
b) Vacuum extraction has no role in ROP position.
c) POP is frequently related to labour dystocias.
d) Episiotomy should be offered to all mothers with ROA position.
e) LOP position can be corrected spontaneously.
648.Immediate complications for caesarean section include:
a) Severe haemorrhage.
b) Injure to neighbours organs.
c) Infections.
d) Haemorrhage.
e) Intestinal obstruction
649.Recommendations for elective caesarean section include
a) Primegravida with breech presentation at 30 wks in labour.
b) Successful repaired VVF.
c) Severe pre- eclampsia Bishop’s score below 6.
d) One previous caesarean section history.
e) Multi foetal pregnancy (triplet).
650.Caesarean section.
a) Most common mode of delivery in our service.
b) Is always indicated in previous caesarean section uterine scar.
c) Mother can start oral feeding after 6-8 hours.
d) Patients don’t need to be prepared.
e) Is done in all cases of foetal distress.
651.The following are associated with breech presentation.
a) Polyhydramnios.
b) Oligohydramnios.
c) Multiple pregnancy
d) Contracted pelvis.
e) Low socio-economic status.
652.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.
653.Obstructed labour.
a) Occurs only in prime gravida.
b) Cystic hygroma is a cause.
c) Wilm’s tumour is not a cause.
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d) Cannot occur when using partograph.
e) All of the above are false.
654.Postpartum haemorrhage.
a) Prostaglandins are helpful in its managements.
b) May occur in subsequent pregnancies.
c) Oxytocic drugs have no role in management.
d) Very common in primegravidas.
e) Is anticipated in mothers with APH.
655.PPH.
a) Misoprostol (Cytotec) can be used to treat it.
b) Hysterectomy is one of the treatment modality in uncontrolled haemorrhage.
c) Can occur before labour.
d) Foetal demise is a risk factor.
e) Uterine atony is a common cause.
656.The following are common complications of eclampsia.
a) Abruptio placenta.
b) Foetal distress.
c) Meningitis.
d) Cardiovascular accident.
e) Increased rate of c/section deliveries.
657.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
658.The following are common physiological changes during pregnancy.
a) Uterus at term has increased the weigh 500 times.
b) Proteins metabolism increased around 1000g.
c) Fat storage is greater during 3rd trimester.
d) Hb level below 110 g/l in up to 6 % of all pregnant women.
e) Abnormalities in concentration, attention and memory.
659.Cardiovascular changes during pregnancy include:
a) Increased circulating volume up to 30 % over the pre conceptional values.
b) Increased circulating volume up to 45-50% over the pre conceptional values.
c) Electrical axis of the heart right deviated.
d) Increased heart silhouette in x-rays.
e) Diastolic murmur can be present up to 90 % of all pregnant woman
660.Changes in coagulating system during pregnancy include:
a) Reduction in platelets count.
b) Decreased in fibrin-fibrinogen circulating complexes.
c) Increased platelets aggregation.
d) Increased circulating levels of all coagulating factors excepting XI and XIII.
e) None of the above
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