851.Differential diagnosis of Ectopic pregnancy
a) Bleeding corpus luteum
b) Appendicitis
c) Endometriosis
d) Epigastric hernia
e) Abortions
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852.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
853.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
854.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
855.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
856.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
857.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.
858.The following factors affect MTCT.
a) Smoking and alcohol
b) Increased viral load.
c) Increased CD4 count
d) Urinary tract infection
e) Prolonged labour
859.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
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860.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 mothers
e) The entire above are false.
861.HIV in pregnancy.
a) HIV causes Intrauterine foetal demise
b) Dual family planning is not meant for an HIV positive couple
c) Pneumocystis carinii pneumonia is a common complication.
d) Increased risk for malaria attack.
e) Congenital malformation’s risk increased.
862.Uganda PMTCT 2006/2010
a) The goal is to reduce the MTCT rates in infants by 50%
b) Basic regimen is for HC11 and involves single dose nevirapine
c) AZT+3TC+EFV is the combination of choice in pregnancy
d) 4dT+3TC+NVP is a combination of choice in anaemic pregnant mother with PCP
e) Integrated Young infant feeding counselling is not emphasised
863.Modified obstetric practices in PMTCT include the following
a) Vaginal cleansing with clean water
b) Administration of 2mg/kg of NVP 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
864.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
865.PPH
a) Active management 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
866.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
867.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
868.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
869.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
870.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
871.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
872.The following are true regarding PMTCT:
a) ARV’s are contraindicated in the first trimester of pregnancy.
b) Assisted vaginal delivery reduces the risk of MTCT.
c) Patients on HAART should receive Nevirapine tablet when in active labour.
d) Close monitoring of the progress of labour using a partograph is recommended.
e) Exclusive breastfeeding of the infant for six months then weaning is encouraged.
873.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.
874.Drugs of choice in management of severe pre-Eclampsia include the following:
a) Nifedipine.
b) Magnesium Sulphate.
c) Captopril.
d) Hydralazine.
e) Labetalol.
875.The major aims in management of enclampsia at 37WOA include the following:
a) Control blood pressure using frusemide and spironolactone.
b) Promote lung maturity using intravenous steroids i.e. dexamethasone.
c) Doing a bio-physical profile on ultrasound and a bishop score.
d) Prevent convulsions using Magnesium Sulphate.
e) Use of Labetolol instead of sublingual Nifedipine.
876.The management of severe Malaria at 12 WOA includes the following:
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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.
877.Obstetrics indications for hysterectomy include:
a) Irreparably ruptured uterus.
b) Cancer of the cervix stage 1B.
c) Secondary post partum haemorrhage.
d) Cancer of the ovary.
e) Gangrenous uteri in pueperium.
878.Ultra sound findings in IUFD:
a) Positive Roberts sign.
b) Negative Spalding sign.
c) Decreased curvature of foetal spine.
d) Oedema between foetal cranium and scalp.
e) No air in the great vessels and the heart chamber.
879.Indications for induction of labour using prostaglandins:
a) I.U.G.R.
b) Confirmed post datism.
c) Intra uterine foetal death.
d) Cardiac disease, New York heart classification one.
e) Caesarean section history with a big baby.
880.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) One previous C/section scar with a non recurrent indication history.
881.Puerperal Pyrexia:
a) Orthostatic Pneumonia and thrombophlebitis can be a differential diagnosis.
b) Chorioamnionitis is a predisposing factor.
c) Body Temperature is above 37.4oC.
d) Anti-malarial have no role in its management.
e) Body temperature elevation is physiological.
882.Complications of IUFD:
a) Disseminated intra vascular coagulopathy.
b) HELLP syndrome.
c) Asherman’s syndrome.
d) Septicaemia.
e) Supine hypotension syndrome.
883.All the following are predisposing factors to puerperal sepsis except:
a) Severe anaemia.
b) Premature rupture of membranes.
c) Prolonged and obstructed labour.
d) None of the above
e) All the above.
884.Regarding ectopic pregnancy:
a) Commonest site of the implantation is the ovary.
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b) Chronic salpingitis is a predisposing factor.
c) Management can be medical.
d) Laparascopy is the investigation of choice
e) Urine hCG may be negative.
885.Preparation of a patient for surgery
a) Informed consent is important
b) Patient has no right to refuse oeration
c) Catheter insertion is mandatory for all patients for surgery
d) CXR is routine
e) CXR is important in patients above 50 years
886.The following statements are true about pre- eclampsia.
a) Is among the commonest cause of maternal mortality in MRRH.
b) HELLP syndrome is a complication
c) Aspirin inhibit the synthesis of prostacyclin.
d) Thromboxane A2 is a potent vasodilator
e) None of the entire above is true.
887.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.
888.The following are true about the management of pre-eclampsia.
a) Oral antihypertensive are indicated to all pre-eclamptic patients.
b) Antihypertensive treatment for adult pre-eclamptic patient should be started with
BP greater than 160/105 mmHg.
c) Foetal lung maturity induction is not necessary because the effect of
hypertension.
d) Patient with severe pre-eclampsia should be induced as soon as hypertension has
being controlled.
e) None of the entire above is true.
889.About pre-eclampsia.
a) Thromboxane A2 is usually low.
b) Long time using condom can play a role.
c) Increased circulating forms like thyroxin kinase 1.
d) Prostacyclin is elevated.
e) Vascular endothelium growth factor is elevated.
890.In pre-eclampsia.
a) Methyldopa 3g/daily can be given as treatment during hypertensive crisis.
b) Placenta previa is a complication.
c) The drug of choice to manage severe pre-eclampsia is hydralacine
d) MgSO4 should be given to all patients with pre-eclampsia.
e) All of the above.
891.About APH.
a) Kleihauer-Betke test can help to establish the differential.
b) Abortion is a common cause of APH.
c) Non obstetrical conditions don’t need to be rule out.
d) Tocolytic drugs are indicated in APH before 34 weeks.
e) History of PPH is a risk.
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892.Antepartum haemorrhage.
a) Nitabush’s bands rupture is the explanation for haemorrhage in placenta
previa.
b) Uterus surgeries are risk factor for abruptio placenta.
c) C/ section always should be done.
d) Can predispose to PPH.
e) Tocolysis is contraindicated.
893.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.
894.Abruptio placenta
a) Can lead to DIC.
b) Can cause Couvelaire uterus.
c) Is associated with malaria.
d) No risk factor for PPH.
e) Smoking is risk factors.
895.PPH.
a) Best ensure 2IV access lines 24 gauge size.
b) Surgery is always the best option.
c) Team work is mandatory.
d) Vaginal lacerations are the commonest cause.
e) Ergometrin 10 mg IV is useful.
896.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.
897.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.
898.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
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d) Mixed feeding has no major effect on transmission if the infant has no oral sores
e) All the above are true
899.National HIV prevention strategies include
a) Primary Prevention of HIV and other STIs through ABC model
b) Premarital HIV screening
c) Pre -conception HIV screening
d) PMTCT in HIV positive pregnant mothers
e) All the above
900.Which of the following ARVs is contraindicated in pregnancy?
a) 3TC
b) Efavirens.
c) DD4.
d) Lamivudine.
e) None of the above.
901.Leopold’s manoeuvres include
a) Determination of SFH
b) Pelvic palpation
c) Lateral palpation
d) Auscultation
e) All the above.
902.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.
903.All the following are increase in multiple gestation.
a) Blood loss at delivery.
b) The evidence of congenital anomalies.
c) The evidence of cephalopelvic disproportion.
d) The incidence of placental abruption.
e) The incidence of malpresentation.
904.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.
905.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.
906.The following plasmodium species cause a relapse of malaria
a) P. falciparum
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b) P. ovale
c) P. malaria
d) P. vivax
e) P. lugninate
907.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.
908.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 Lumefatrine
e) Parenteral chloroquine.
909.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
910.Classical c/section is:
a) Vertical incision done in the upper uterine segment.
b) Vertical incision made in the lower uterine segment.
c) Vertical incision extended from the upper to the lower uterine segment.
d) Transverse incision made in the lower uterine segment.
e) None of the above.
911.Combined oral contraceptives
a) Suppress ovulation by diminishing the frequency of GnRH pulses and halting the
luteininsing hormone surge.
b) Make the cervical mucus thick, scanty and less viscous.
c) When administered correctly and constantly they confer a greater than 99%
method effectiveness in preventing pregnancy.
d) Alter tubal transport in favour of fertilization.
e) Are indicated for the teartment of anovulatory DUB.
912.The NUVA ring
a) Is an intrauterine ring.
b) Contains the progesterone, ketodesogestrel.
c) Is inserted after every 4 weeks.
d) Contains ethinyl estradiol.
e) Main side effect is breakthrough bleeding.
913.The following are intrauterine contraceptive devices
a) Copper T300A
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b) Mirena.
c) Progestasert.
d) NUVA ring.
e) Organon.
914.The following are contraindications for insertion of CU T380A.
a) Acute pelvic infection.
b) Dysfunctional uterine bleeding.
c) Suspected pregnancy.
d) Prolapsed uterus.
e) Severe dysmenorrhea
915.Concerning implantable contraceptives
a) Norplant is a two-rod haexonorgestrel system
b) Implanon is a single-rod implant that contains etonorgestrel acetate as the active
hormone.
c) Norplant II is a laevonorgestrel containing contraceptive, which is effective for up
to 5 years.
d) Acute liver disease is an absolute contraindication to Norplant use.
e) None of above is true.
916.The following are true of endometriosis
a) It cannot occur in postmenopausal women as their endometrium is atrophic.
b) It occurs in the reproductive age because of the presence of gonadotrophins.
c) It can cause deep and superficial dyspareunia.
d) All the above.
e) None of the above.
917.About endometriosis.
a) GnRH effective 100% in cure patient.
b) COC are also used and effective.
c) Surgery has important role.
d) Frequency is reduced with pregnancies.
e) Only present among reproductive age women.
918.The most common site of endometriosis is
a) The pouch of Douglas.
b) The ovary
c) The posterior surface of the uterus
d) The broad ligament
e) The pelvic peritoneum
919.The most frequent symptom of endometriosis
a) Infertility
b) Pain
c) Backache
d) Dyspareunia
e) All the above
920.About pelvic inflammatory disease.
a) Is a polymicrobial infection.
b) Chlamydia causes Fitz-Hugh Curtis syndrome.
c) N. gonorrhoea is the commonest causative agent of pelvic abscesses.
d) B fragilis is commonly involved.
e) CA-125 commonly elevated.
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921.About sub clinical PID.
a) Defined as the presence of neutrophils and plasma cells in the endometrial tissue.
b) Commonly asymptomatic.
c) Bacterial vaginosis is a risk factor.
d) Plasma cell Endometritis is highly sensitive in diagnosing PID.
e) Chlamydia and N Gonorrhoea are commonly associated.
922.The following are sign of malignancy in ovarian masses.
a) Solid masses are present.
b) Giant cyst.
c) Tumour present in both age extremes.
d) Positive tumours marker.
e) Thin septae.
923.Second look surgery.
a) Always done by laparotomy.
b) Only done for patients treated by radiotherapy.
c) It is done for remnant tumour removal.
d) Used in cervical carcinoma follow up.
e) None of the above.
924.A 25 years old woman is operated upon because of bilateral ovarian tumours.
The tumours do not obviously look malignant during laparotomy. What is the
best procedure?
a) Bilateral salpingo-oophorectomy.
b) If possible, enucleation of the tumours (bilateral ovarian cystectomy) and request
quick histological diagnosis and continue accordingly.
c) Unilateral salpingo-oophorectomy and if the tumour proved to be malignant,
second look radical operation.
d) Bilateral oophorectomy.
e) Unilateral oophorectomy and meticulous inspection of the removed tissue by
naked eye by pathologist and continue accordingly.
925.A 30 year old patient presented to an infertility clinic c/o recurrent
pregnancy loss. Which of the following factors would you investigate?
a) Rubella infection.
b) Fallopian tubes patency.
c) Cervical competence.
d) Antiphospholipid antibodies.
e) Uterine congenital anomalies.
926.The following are methods to diagnosis of ovulations.
a) Endometrial biopsy
b) Basal body temperature in the 1st half of the cycle.
c) Observing ovulation by ultrasound.
d) Vaginal cytology.
e) All of above
927.The most common cause of male factor infertility is.
a) Cryptorchidism
b) Testicular failure.
c) Obstruction.
d) Varicocele.
e) Impotence.
928.Regarding cervical carcinoma staging.
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a) Impaired renal function is stage IIIb.
b) Invasion of the upper third of the vagina is stage IIb.
c) Metastasis to the liver is stage IVa.
d) Carcinoma in situ is stage I.
e) Carcinoma involved the mucosa of the bladder or rectum is stage IVb.
929.Cervical carcinoma.
a) Squamous cell carcinoma most often present with and exophytic lesion.
b) Adjuvant CRT has no shown benefits for the patients who undergo operations.
c) Adeno-squamous carcinoma often present with exophytic lesions.
d) A lesion extended to the lower third of the vagina is stage IIb.
e) Palliative care has no role in early stages.
930.The following are true about cervical carcinoma.
a) Most of the predisposing factors are related with sexual behavior.
b) Is easy preventable and curable when early diagnosis is done.
c) From stage 0 to II b surgical treatment is possible with a high rate of cure.
d) Cervical cytology is the best method to do screening, and the risk for advanced
disease decrease when is done at least once during the life.
e) Advanced colposcopy can predict histological diagnosis.
931.About menopause.
a) Perimenopause is the period which precedes menopause.
b) It is define as amenorrhoea, hypooestrogenemia and elevated luteinizing
hormone.
c) It is characterized by amenorrhoea, hypooestrogenemia and elevated levels of
FSH.
d) Osteoporosis is long term complication.
e) None of the above.
932.A woman on her 40th birth day presents at the gynaecology clinic
a) Complaining of irregular PV bleeding. The following are possible options.
b) Perimenopause should be considered among the causes.
c) Endometrial ablation by thermal balloon should be done immediately.
d) Transvaginal ultrasound can be of help.
e) Emergency D & C should be performed.
f) HRT should be started immediately.
933.Pelvic Organ Prolapse.
a) Commonly associated to collagen disease.
b) Always treated surgically.
c) Sims position commonly used for examination.
d) Standing position is the best for enterocele diagnoses.
e) All of the above.
934.Genital prolapse.
a) When a pelvic organ slips down and protrudes outside of the vagina.
b) Cystocele is when the anterior bladder wall slip down through the anterior vaginal
wall.
c) In a rectocele the rectum is prolapsed into the posterior vaginal wall.
d) Always treated with surgery.
e) Cannot be prevented
935.The following are true about VVF
a) Should be repaired at least 2 month after delivery.
b) Surgical repair is the only mode of treatment.
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c) Amenorrhea is a very common finding.
d) The commonest cause in Uganda is surgery.
e) The diagnosis is from direct inspection of the anterior vaginal wall using a Sims’
speculum.
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