783.The following are true about uterine fibroids.
a) Is associated with cervical carcinoma.
b) Can be associated with endometrial carcinoma
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c) Are frequently found in grand multiparous.
d) Can degenerate easily to a malignancy.
784.About anatomy of the genital tract.
a) Ovary is covered with peritoneum.
b) The ovarian arteries arise from the aorta just bellow the renal artery.
c) The vaginal artery is a branch of external iliac artery.
d) The uterine artery passes medially to reach the uterus at about the level of the
fundus.
785.A patient known to has an ovarian tumour suddenly reports abdominal pain,
vomiting and rapid pulse. The following are likely cause.
a) Rupture of the tumour.
b) Sudden infection of the tumour.
c) Massive haemorrhage in the tumour.
d) All of the above.
786.Endometrial carcinoma.
a) 95 % are not hormonal dependent.
b) The most common type is adenomiosarcoma.
c) Using COC doesn’t offer protection.
d) Is not related with infertility.
787.The following are cause secondary amenorrhea.
a) Polycystic ovarian syndrome.
b) Sheehan’s syndrome
c) Ackerman’s syndrome.
d) Hypo oestrogenic state.
788.The following are true about Physiological changes during pregnancy.
a) Uterus weight increased approximately 1 kg.
b) Plasma volume increased more than erythrocyte volume.
c) Cardiac silhouette elevated in chest X-ray.
d) Systolic murmur present as consequence of Valvular damage.
e) Increased water retention.
789.Regarding physiology during pregnancy.
a) Iron metabolism is increased in around 1g.
b) Ca demands are diminished.
c) Placental lactogen cause insulin resistant effect.
d) Memory abnormality can be reported.
e) Contact lenses intolerance due to oedema.
790.Anaemia during pregnancy.
a) Is physiologic anaemia in pregnancy when Hb level is lower than 11 mg/dl
b) Is physiologic anaemia when there plasma volume increase is higher than
erythrocyte volume and there is present a 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 level don’t need iron supplementation during
pregnancy.
791.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.
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d) Unclassified hypertension is hypertension in a patient with previous renal
damage.
e) Is a common cause of admission in our hospital?
792.About pre-eclampsia.
a) Commonly affecting primiparous or multiparous with new husband.
b) In vitro fertilization is not a risk factor.
c) Impaired trophoblast invasion and differentiation seems to be the most important
factor in the pathogenesis.
d) Immunological factor are involved.
e) Hydralazine is the choice to treat the crisis.
793.About eclampsia management.
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.
794.About APH.
a) Is any bleeding from genital tract before 28 WOA.
b) Is any vaginal bleeding during the second half of pregnancy.
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.
795.Mother to child transmission.
a) May occur as early as the time of the ovulation.
b) In uterus across the membranes.
c) In uterus across the placenta.
d) During labour/delivery in 60-70% of cases.
e) During labour/delivery in 10-15 % of cases.
796.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 breast feeding
in HIV positive mothers.
e) Mixed feeding may be practiced in PMTCT.
797.The following factors affect the MTCT.
a) Smoking and alcohol
b) Increased viral load.
c) Increased CD4 count
d) Urinary tract infection
e) Prolonged labour.
798.The following are modified obstetric practice except:
a) Administration of Nevirapine in labour.
b) Delayed rupture of membranes.
c) Exclusive breast feeding.
d) Avoidance of invasive procedure.
e) Using electric suction
799.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.
800.HIV in pregnancy.
a) Intrauterine foetal demise had been reported.
b) Global counting of CD4 can be reduced.
c) Pneumocystis carinii Pneumonia is a common complication.
d) Increased risk for malaria attack.
e) Congenital malformation’s risk increased.
801.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.
802.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.
803.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.
804.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.
805.Complications of obstructed labour.
a) Neonatal sepsis.
b) Death.
c) PPH
d) Rectovaginal fistula
e) All the above.
806.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.
807.Mode of delivery in obstructed labour.
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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.
808.Partograph in labour.
a) Started at 3 cm cervical dilatation
b) Base line foetal heart rate 110- 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.
809.Ruptured uterus; surgical options.
a) Laparoscope.
b) C/section.
c) Total abdominal hysterectomy.
d) Repair of uterus site alone.
e) Repair of rupture and tubal ligation.
810.Ruptured uterus (management).
a) Taken for operation immediately on arrival.
b) Resuscitation should be done.
c) Patients do not consent.
d) Antibiotics not necessary.
e) Live baby may be delivered.
811.Caesarean section.
a) Elective caesarean section can done for cord prolapse
b) Is the only mode of management for cord prolapse.
c) May be done under local anaesthesia.
d) Patient may take orally after 8 hours.
e) Deep venous thrombosis is likely to occur.
812.About Ectopic pregnancy.
a) PID is the commonest cause.
b) Congenital anomalies have no role.
c) Intrauterine device is a predisposing factor.
d) Always is outside of the uterus.
e) Can be diagnosed by ultrasound.
813.Ectopic pregnancy.
a) Conservative management is not possible.
b) Conservative surgery is an option of treatment.
c) After surgery the risk is increased.
d) Abdominal Ectopic sometimes is diagnosed in the moment of surgery.
e) Cervical Ectopic can be an indication of total abdominal hysterectomy.
814.About Ectopic pregnancy localization.
a) The commonest localization is the tube.
b) Ampullar localization is the commonest in the tube.
c) Abdominal Ectopic pregnancy is always primary.
d) Cervical Ectopic can be secondary.
e) Interstitial Ectopic is commonly seen.
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815.About normal labour.
a) Is started when cervix is 3 cm dilated.
b) Normally are considered in 3 stages.
c) The 3rd stage is started after placental delivery.
d) Second stage starting with the engagement of the presenting part and ending
with delivery.
e) Second stage usually lasting proxy 30 min.
816.Preterm labour predisposing factor.
a) Cervical incompetence.
b) Previous preterm delivery.
c) Divorced mother.
d) Changed partner during pregnancy or even before this.
e) Social-economic disadvantages.
817.About preterm labour, conservative management is contraindicated in:
a) Severe or multiple congenital anomalies are present.
b) Premature rupture of the membranes.
c) Chorioamnionitis.
d) Lung maturity is present.
e) APH is present.
818.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.
819.The following are complications of PPROM.
a) Necrotizing enterocolitis.
b) Intraventricular haemorrhages.
c) Earlier ductus arteriosus closure.
d) Hypobilirubinaemia.
e) Thermal instability.
820.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.
821.The following are absolutes contraindications for tocolysis.
a) PROM.
b) Intrauterine foetal demise.
c) Nonreassuring foetal assessment.
d) Chorioamnionitis.
e) Presence of phosphatidylglycerol in amniotic fluid.
822.About abortion.
a) Chromosome’s abnormalities causing more than 90 % of spontaneous abortions.
b) Is the second leading cause of maternal death in Mbarara.
c) History of previous abortion is not a risk factor.
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d) Septic abortion is the commonest cause of maternal death among teenager in
Mbarara.
e) Haemorrhage is a complication.
823.About abortion.
a) Is any pregnant loss before 28 weeks.
b) Is any pregnant loss weighing less than 400g.
c) Is any pregnant loss below 20 woa or weighing less than 500g.
d) a) and b) above.
e) None of the above.
824.The following are included between post abortal care.
a) Emergency treatment for incomplete abortion.
b) Emergency treatment to life threatening complications.
c) Post abortion family planning.
d) Nevirapine prophylaxis.
e) All of the above.
825.The following are always indications for elective caesarean section.
a) Severe pre-eclampsia.
b) Two or more previous caesarean section.
c) Cephalopelvic disproportion.
d) Conjoined twins.
e) Breech presentation.
826.The following are complication for caesarean section.
a) Deep venous thrombosis.
b) Disseminated intravascular coagulation.
c) Amniotic fluid embolism.
d) Puerperal infection.
e) Neighbouring organ lesion
827.About ruptured uterus.
a) Can be complete or incomplete.
b) Always implied 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.
828.About PPH.
a) Is an important cause of maternal death even in developed countries.
b) Usually due to a malpractice ( iatrogenic).
c) Retained placenta is a common cause.
d) Tears have no ethiological importance.
e) Inverted uterus can be cause by excessive cord traction.
829.PPH management.
a) Always call for assistance.
b) Establish two peripheral lines.
c) Checking uterus contraction is not important.
d) Active 3rd stage’s management can help in prevention.
e) Uterine artery embolization is not an option.
830.PPH.
a) APH is a predisposing factor.
b) Uterine over distension can predispose.
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c) Postdate is a risk factor.
d) Prolonged labour is a common cause.
e) Parity has importance.
831.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.
832.The following are physiological changes during puerperium.
a) Maternal heart rate reduced in proxy 10 to 15 beat/ min.
b) Endometrium is in a physiological state within the 15 days after delivery.
c) Increased water retention.
d) Oedema reabsorption.
e) Foul smelling vaginal discharge.
833.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.
834.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.
835.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.
836.The following factors affect wound healing.
a) Steroid therapy
b) Proper apposition of layers.
c) Immune status.
d) Infection.
e) Cancer.
837.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.
838.Among the commonest anaerobes causative organism for puerperal infection we can
find the following except?
a) Klebsiella.
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b) Peptoccocus species.
c) Peptoestreptococcus
d) Bacteroides fragilis.
e) Proteus mirabilis.
839.Which of the following are not among the risk factor for puerperal infection?
a) Poor antiseptic technique.
b) Prolonged labour/ruptured membranes.
c) External cephalic version.
d) Forceps delivery.
e) Bacterial vaginosis
840.A patient delivered at Mbarara Regional Referral Hospital develops a moderate
endometritis. Which of the following are true in the patient management?
a) Broad spectrum antibiotic combination and swab for culture and sensitivity in the
3
rd day of treatment.
b) Swabs from the lochia, cervical canal, endometrial cavity and wait for the results
to establish adequate antimicrobial treatment.
c) As we know the commonest causative micro-organism and it sensitivity we advice
to start with x-pen, gentamycine.
d) Broad spectrum antibiotic should be started immediately and readjusted when the
result is available.
e) None of the entire above is true.
841.A 25 year old patient at 32 weeks of amenorrhea was brought to maternity ward of
MRRH. These are the clinical findings on the physical examination. Pale xxx,
dehydrated, RP: 120/ min; BP 90/60 mmHg; delay in the capillary refilling time;
bleeding by mouth. Abd: Fundal height 36 cm, tenderness, and uterus hard, no
FHeart heard. Vaginally: scanty blood coming through the canal, reddish area around
the ECO was noticed. Which among the following is the most likely diagnosis?
a) Placental abruption.
b) Placenta praevia type IV.
c) Cervical carcinoma.
d) Severe placental abruption with IUFD and CID.
e) Vasa praevia with IUFD.
842.In relation with the above presented patient: Which of the following is true about
her management?
a) Establishing two peripheral lines, blood for FBC, clotting profile, blood transfusion
and emergency c/section.
b) Immediate induction of labour using a Foley catheter.
c) General measures for all APH, AROM, correction of the DIC and emergency
C/section.
d) General measures for all APH, AROM, correction of the DIC and induction of
labour.
e) General measures for all APH, AROM, correction of the shock and DIC and
induction of labour.
843.Physiopathology of pre-eclampsia.
a) Prostacycline level higher than thromboxane A2 .
b) Placental growth factor level is elevated.
c) Endothelin production elevated.
d) Trophoblastic invasion of the spiral arteries is complete.
e) None of the above
844.MgSO4.
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a) Act by blocking the release of acetylcholine at the neuro-muscular plaque.
b) Is a natural calcium antagonist.
c) Is given 10 g 50% Iv as initial dose.
d) Has no advantage over fenitoine in fit’s prevention.
e) Produce oligo-anuria
845.Hydralazine’s use in pre-eclampsia.
a) Is a central vasodilator.
b) Is given as IV bolus initially: 10mg slowly followed by 5mg every 30 min.
c) Can be use as infusion.
d) Is given 5mg IV hourly.
e) The last dose should be given when diastolic BP is 9o mmHg.
846.A comprehensive post abortal care includes.
a) Post abortal counselling.
b) Treatment of the complications.
c) Family planning services.
d) RCT.
e) All of the above.
847.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
848.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
849.Concerning wound classification
a) Clean wound is made under ideal operating conditions with a break in sterile
technique
b) Clean contaminated wound; there is a minor break in sterile technique
c) Contaminated wound; operations with major break in sterile technique and
incisions encounter acute non purulent inflammation
d) Dirty wound: there are no evident infectious foreign bodies or devitalised tissues
e) All the above
850.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
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