MCQs for OBGYN 5

 MCQs for OBGYN 5

151.The most frequent symptom of endometriosis

a) Infertility

b) Pain

c) Backache

d) Dyspareunia

e) All the above

152.A 35 year old woman presents with history of periods of amenorrhea followed by

heavy bleeding and denies using drugs. She wants to get pregnant. The following are

likely causes

a) Over stimulation of the follicular system of the ovaries by the hypophysis

b) Under production of oestrogens and progesterone

c) Under production of FSH and LH

d) All the above

e) None of the above

153.A 26 yr old married woman presents with infertility and amenorrhoea. She has a

normal satisfying sexual life. On work up she was found to be normal 46XX, no

ooestrogen or progesterone nor evidence of androgens. She has poorly developed

breasts. HSG is normal. The following are possible causes

a) Testicular feminization syndrome

b) Mullerian dysgenesis

c) Gonadal dysgenesis

d) B and C above

e) All the above

154.BSN students delivered mothers and assessed the babies. Which was a true and

complete assessment?

a) Pink body and limbs, active limb movements, male pulse rate 105/minute, weak

respirations active sneezing and cough on suction: A/S = 9

b) Active limb movements, pink body, pulse rate 105/minute blue fingers good

respiration, female and active sneezing on suction: A/S 9

c) Crying loudly, male , moving limbs actively, fights on suction, pulse rate

129/minute, blue chest: A/S =9

d) A and B above

e) B and C above

155.A 30 year old mother had a caesarean section for abruptio placenta at 36 weeks at 6

am in the morning. Professor Perez found her anaemic and the dressing oozing fresh

blood. The following are true

a) He ordered re-opening of the abdomen as there was intra-abdominal

haemorrhage

b) He did an abdominal examination to rule a ruptured uterus

c) He ordered some investigations and talked to the students about APH while

waiting for the results

d) He ordered a pressure dressing to be applied to the wound as this was bleeding

from the wound

e) None of the above.

156.The following are poor prognostic factors in trophoblastic disease for malignant

change

a) Disease following normal delivery

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b) beta-HCG more than 80,000 mIU/ml

c) Disease following an abortion

d) A and C above

e) A and B above

157.Treatment of endometriosis involves

a) Administration of gonadotrophins releasing hormone agonists to cause a pseudo

pregnancy

b) Administration of gonadotrophins releasing hormone antagonists to cause a

pseudo menopause state

c) Administration of large doses of oestrogens and androgens state to cause a

pseudo pregnancy

d) A and C above

e) B and C above

158.A 56year old lady presented with a small cervical lesion which bled to touch, she

reported that she had difficulty closing her left eye. She had nausea and loss of

appetite. She had a staring gaze and paresis on the right. No other pelvic lesions

were found.

a) This is Ca Cervix stage four

b) The condition can be diagnosed by ultrasound

c) The diagnosis can be suspected from the previous history and confirmed by

Laboratory investigations

d) She has burkitts lymphoma

e) None of the above

159.The following are true of oral contraceptive pills

a) They decrease the risk of ovarian cancer

b) They are contraindicated in parous women with endometriosis

c) They are contraindicated in young nulliparous girls

d) All of the above

e) None of the above

160.The following are causes of early neonatal deaths in Uganda

a) Hyaline membrane disease

b) Foetal asphyxia

c) Bronchopneumonia

d) All the above

e) None of the above

161.Dr Kaposi did staging of carcinoma of the uterus; the following is a correct staging

a) The uterus was sounded at 15 cm and there a bleeding lesion on the cervix;

stage= 3a

b) The uterus was 4cm long and the tumour was well differentiated

c) Prof. Kaposi got some suspicious currettings from the endocervix; stage=3

d) Prof. Kaposi got some suspicious currettings from the endocervix; stage=2

e) None of the above

162.Treatment of endometrial cancer involves

a) Tumour size reduction and chemotherapy

b) Tumour size reduction and radiotherapy

c) Hysterectomy and radiotherapy

d) Radical hysterectomy ( Wertheim’s)

e) All the above

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163.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) A and C above

e) None of the above

164.A gravida 6 Para 4+1 was admitted with severe pre eclampsia, the following is true

a) After control of the blood pressure she should have a caesarean section as the

quickest mode of delivery

b) Her blood vessels show abnormal reaction to vasopressin agents

c) A bleeding profile is part of the work up to prevent disseminated intravascular

Coagulopathy

d) A and C above

e) None of the above

165.During antenatal management, the following are true

a) Refocused ANC involves reducing the number of visits and improving the quality

of contact time

b) All mothers must have four visits only

c) All mothers should have a birth plan as this improves decision on making

d) A and B

e) A and C

166.The perineum is supplied by the following

a) Pudendal nerve

b) Inferior haemorrhoid nerve

c) Ilio-inguinal nerve

d) Genital femoral nerve

e) All the above

167.The following are mesodermal in origin

a) Kidney, male genital ducts, prostate, rectum

b) Testis, upper vagina, ureter, seminal vesicle

c) Ovary, ureter, lower vagina, prostate gland

d) Brain, oesophagus, rectum, uterine tubes

e) None of the above

168.The following are important investigations in disseminated intravascular coagulation

a) Partial thromboplastin time

b) Prothrombin time

c) Thrombin time

d) A and C above

e) B and C above

169.Breech delivery

a) Lovset’s manoeuvre is for delivery of the head

b) Mauriceau-Smellie-Veit manoeuvre is for delivery of the head

c) Entrapped (stuck) head can be delivered by forceps

d) Breech extraction is always done

e) Tortoise sign can be present

170.Symphysiotomy

a) Risks include bladder injury

b) Can be done when cervix is not fully dilated

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c) Doesn’t need experience

d) Can be done in contracted pelvis

e) Head should be no more than 3/5 above the symphysis

171.PID

a) Can affect men and women of reproductive age

b) TB is commonly associated

c) Doesn’t present with PV bleeding

d) Always associated with Futz-Hugh-Curtis syndrome

e) Bacteroides are commonly implicated

172.Absolute indications for episiotomy

a) Small short primegravida

b) Foetal distress

c) Repaired VVF

d) Previous repaired 3rd or 4th degree perineal tear

e) Complicated vaginal delivery

173.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

174.Incompetent cervix

a) We commonly treat by cervical cerclage 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

175.Physiological management of 3rd stage of labour

a) Oxytocin 10IU IM is given on the anterior thigh

b) Controlled cord traction is done

c) No intervention is done

d) Practiced by mid wives and TBA’s in the village

e) Associated with PPH

176.Refocused ANC

a) Is for all pregnant women

b) Is only practiced in hospitals

c) TT can be given in the 1st trimester

d) Repeat dose of TT is after 6 months after the 1st dose

e) Same as goal oriented ANC

177.Preparation of a patient for surgery

a) Informed consent is important

b) Patient has no right to refuse operation

c) Catheter insertion is mandatory for all patients for surgery

d) CXR is routine

e) CXR is important in patients above 50 years

178.Clinical parameter of gestational age.

a) Quickening is appreciated about 16 wks in multigravidas and 18 in primegravidas

b) Foetal biparietal diameter accurate before 16 WOA

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c) Foetal heart tones may be heard at 20 wks by Pinard stethoscope

d) Ossified foetal bone appears at 12 to 14 wks

e) Bimanual palpation is not necessary

179.During embryonic development the trophoblast is

a) Endodermal in origin

b) Mesodermal in origin

c) Ectodermal in origin

d) All of the above

e) None of the above

180.The following are true about the refocused antenatal care.

a) There is reduced mother health worker time contact.

b) It is cheaper on the mothers.

c) The fewer attendances are will give heavier clinics as more mothers come on

particular day.

d) There is less satisfaction to the mothers as they are seen less

e) None of the above

181.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

182.About management of severe pre Eclampsia

a) Severe pre Eclampsia should be managed as outpatient after control of the blood

pressure

b) Magnesium sulphate should be used in all cases routinely

c) Methyldopa is the best option to treat the crisis

d) Aspirin 80 mg daily may help in preventing pre-eclampsia in patient at high risk

e) All the above

183.About Eclampsia, pathophysiological explanation may be

a) The presence of amniotic embolization of the brain arteries

b) Vasoconstriction of the brain arteries with subsequent ischemia, infarctions,

oedema and perivascular haemorrhages

c) Because the hypovolaemia in pre-eclamptic patient causing cerebral hypoxia

d) The hypercoagulability of the blood causes stroke and partial infarctions

e) None of the above

184.About eclampsia

a) Difenyl hidantoine is the drug of choice

b) Difenyl hidantoine 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

185.The following are true about molar pregnancy.

a) Elevated serum hCG levels more than 40,000IU

b) Pelvic ultrasound assessment is needed.

c) TSH, T3 and T4 assessment.

d) Can be followed by a choriocarcinoma

e) All the above

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186.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 recognised option

e) Condom use has no role in protecting this baby

187.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

188.A G2P1+0 HIV +ve 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

189.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) a) and b) are correct

e) b), and c) are correct

190.The following are predisposing factors for placenta previa

a) Repeated induced abortion.

b) Multi foetal gestation.

c) IVF.

d) Malposition

e) Congenital anomalies of the uterus.

191.Malaria in pregnancy.

a) Maternal immunoglobulin A antibodies cross the placenta to the foetal circulation.

b) Falciparum malaria parasites grow well in RBC containing haemoglobin F.

c) Plasmodium Vivax is more common in East Africa.

d) Coartem is the first line during the first trimester.

e) Quinine is the 1st line in the second trimester for uncomplicated malaria.

192.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.

193.Anatomy of the female genital tract.

a) The uterine artery is a branch of the terminal part of the aorta.

b) The uterine artery is a branch of the internal iliac artery.

c) The uterine artery is the terminal branch of the internal femoral artery.

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d) The uterine artery is a branch of the obturator internus artery.

e) None of the above.

194.When monitoring a mother with the partograph.

a) If the graph reaches the action line you should do a C/section immediately.

b) If the graph leaves the alert line, you should put up Oxytocin.

c) If the foetal heart slows down or increases you should put up fluids, give oxygen

and make the mother lie on her left.

d) If the graph reaches the action line, you should put up Oxytocin immediately.

e) None of the above.

195.Shoulder dystocia.

a) Is a common complication.

b) Associated with maternal obesity.

c) Tortoise sign is not present.

d) Rubin manoeuvre can be done to hyper flex the arms.

e) McRobert manoeuvre can solve about 70 % of all cases.

196.About ovarian tumours.

a) Dysgerminomas are common in the reproductive age group.

b) Serous cyst adenomas contain tissues all the 3rd germ layers.

c) Dermoid cysts are common in the under 10 year’s group.

d) Bilateral tumours have a great risk of malignancy.

e) Always present with ascites.

197.Germ cell tumour includes.

a) Dysgerminomas.

b) Endodermal sinus tumour.

c) Embryonal carcinoma.

d) Choriocarcinoma.

e) Teratomas.

198.Operative features suggestive of malignancy.

a) Areas of haemorrhage in the tumour.

b) Large blood vessel in the surface.

c) Bilateral presence.

d) Ascites.

e) Presence of adhesions.

199.On the menstrual cycle.

a) Ovulation occurs 14 days to the first day of menstruation.

b) There are low levels of oestrogens and high levels of progesterone in the second

half.

c) All cycles are always ovulatory.

d) All of the above.

e) None of above.

200.Pathophysiology of the placenta.

a) Human chorionic gonadotropin (hCG), human placental lactogen (hPL) and

human chorionic thyrotropin (hCT) are produced by the placental endocrine unit.

b) Velamentous insertion of the umbilical cord is an abnormality in which the cord

has a membranous insertion.

c) Three umbilical vessels are normally found: two veins and one artery

d) All of the above.

e) Only (b) and (c).