MCQs for OBGYN 6

 MCQs for OBGYN 6

201.Pelvic floor muscles include.

a) Levator ani.

b) Pyramidal muscle.

c) Superficial transverse perineal muscle.

d) Deep transverse perineal muscle

e) Internal obturator.

202.The nerve supply to the perineum:

a) Arises from S1, S2, S3 and S4.

b) Arises from one of the branches of the pudendal nerve

c) Arises from T6 and T12.

d) (a) and (b) above

e) None of above.

203.Cardiovascular changes during pregnancy include:

a) Increased in cardiac output.

b) Increased circulating volume up to 30-50% over the pre conception values.

c) Electrical axis of the right side of the heart is deviated.

d) Increased heart silhouette in x-rays.

e) Systolic murmur can be present up to 90 % of all pregnant woman

204.Risk factors for disseminated intravascular coagulation include:

a) Abruptio placenta.

b) Pre-eclampsia/eclampsia.

c) Amniotic fluid embolism.

d) Septic abortion

e) None of the above.

205.About foetal lie.

a) Relate foetal long axis to maternal long axis.

b) Relate foetal long axis to uterine long axis.

c) Can be established with ultrasound scan.

d) 1

st Leopold’s manoeuvre is used to identify it.

e) Transverse lie needs augmentation.

206.Which of the following are true about foetal aptitude?

a) Describes the relationship between the foetal and the pelvic inlet.

b) Describes the relationship between foetal parts.

c) Delivery is easy when aptitude is flexion

d) Delivery is easy when aptitude is extension.

e) Can change during labour.

207.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

208.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.

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d) Caesarean section is always the mode of delivery.

e) Glycosylated Hb determination is useful in ante partum care.

209.Ante partum haemorrhage (Placenta previa).

a) All women with APH should be delivered by caesarean section.

b) Induction of labour can be done in class I and II.

c) Speculum examination can be done when the bleeding stop and the mother is

stable.

d) Anticipate PPH.

e) Haemorrhage is typically painless.

210.Abruptio placenta.

a) Can lead to DIC.

b) Can cause Couvelaire uterus.

c) Is associated with uterine fibroids.

d) No risk factor for PPH.

e) All of above.

211.A 26 year old patient, primegravida was admitted at Mbarara Regional Referral

Hospital at 32 WOA due to APH. This was the first time she had bleed and on physical

examination the following finding were reported: MM: coloured and hydrated; RP:

88/ min; BP: 126/86 mmHg; Abd: FL 32 cm, cephalic, FHR: 146/min, V/V palpable.

Which of the following is the best option of management?

a) Digital vaginal examination to confirm diagnosis under general anaesthesia and

C/section if confirm.

b) Conservative management due to the good maternal conditions.

c) Digital examination, AROM and induction of labour.

d) Emergency c/section.

e) All of the above are right.

212.The following are predisposing factors for placenta praevia.

a) Repeated induced abortion.

b) Multi foetal gestation.

c) Praevia caesarean sections

d) Malposition.

e) Congenital anomalies of the uterus.

213.The following are true statements about abruptio placenta.

a) Maternal conditions are always related to amount of PV bleeding.

b) Is frequently related with low consumption of coagulating factors.

c) Smoking has no role.

d) AROM and induction is contraindicated.

e) Is highly related to PPH.

214.The following are risk factor for pre-eclampsia.

a) Primegravida.

b) History of genetic disorders.

c) Diabetes mellitus.

d) New husband.

e) Gestational trophoblastic diseases.

215.The following are common complications of eclampsia.

a) Abruptio placenta.

b) Foetal distress.

c) Meningitis.

d) Cardiovascular accident.

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e) Increased rate of c/section deliveries.

216.Physiopathology of pre-eclampsia.

a) Any event causing placental ischemia is a risk factor.

b) Immunological theory has the explanation in the familial predisposition.

c) Genetic information in the father has no role.

d) Impaired Trophoblastic differentiation/ invasion seem to have the main role.

e) VEGF/PlGF1 deficiency can be the starting even.

217.A 17 year old, pregnant woman was brought to maternity ward, because was found

to have generalized convulsion at the central market. O/E. (positive finding)

unconscious, pale +, BP 156/110 mmHg, hyperreflexia, urine dipstick for protein ++;

F/L 39 cm. V/E Cervix effaced, dilated 2cm, station – 1. How do you manage this

patient?

a) General measure, prophylactic antibiotic and immediate C/section.

b) General measures, antihypertensive, MgSO4, resuscitation of the patient, foetal

assessment and emergency c/section.

c) General measures, antihypertensive, anticonvulsant and augmentation.

d) General measures, BP control, fit control, mother stabilization and conservative

management.

e) None of the above is true.

218.How does MgSO4 act in controlling and preventing eclamptic fit?

a) Decreasing the release the acetylcholine at the neuromuscular plaque.

b) Acting as physiological calcium antagonist.

c) Blocking excitatory amino- acid receptors.

d) All of the above.

e) a) and b) above.

219.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) Plan to deliver the foetus depends on condition of the mother and the foetus.

220.Preterm labour predisposing factor.

a) Cervical incompetence.

b) Previous preterm delivery.

c) Divorced mother.

d) Polyhydramnios.

e) Social-economic disadvantages.

221.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.

222.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.

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d) Nitrazine test result can be affected by the presence of seminal fluid.

e) Occur before onset of labour and after 37 WOA

223.The following are complications of PPROM.

a) Necrotizing enterocolitis.

b) Intraventricular haemorrhages.

c) Earlier ductus arteriosus closure.

d) Hypobilirubinaemia.

e) Thermal instability.

224.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 hours.

e) Should be given only if delivery wont happened within the next 24 hours.

225.Oligohydramnios is associated with

a) Congenital anomalies of the urinary system.

b) Placental insufficiency.

c) IUFD.

d) Intrauterine growth restriction.

e) Oesophageal atresia.

226.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) All of above.

e) (b) and (c).

227.About PPH.

a) Active management of 3rd stage of labour may prevent it

b) Ruptured uterus is possible cause

c) Sheehan’s syndrome is a consequence

d) Is an indirect cause of maternal mortality

e) DIC is a complication

228.About PPH.

a) Misoprostol (Cytotec) can be used to treat.

b) Hysterectomy is one of the modes of delivery in uncontrolled haemorrhage.

c) Can occur before labour.

d) Foetal demise is a risk factor.

e) Uterine atony is a common cause.

229.Epidemiology of multifoetal gestation.

a) Incidence of monozygotic twins is uniform worldwide.

b) Incidence of Dizygotic twins is uniform worldwide.

c) Incidence is thought to be higher among whites.

d) Paternal family history is not a risk factor.

e) Overweight and tall women are at a greater risk for twin birth.

230.Multi foetal pregnancy.

a) Triplets are better delivered by caesarean section.

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b) Induction of the labour is contraindicated.

c) Risk for locked twins is always present.

d) Cord prolapse may happen.

e) Risk factor for PPH.

231.Labour management in multifoetal gestation.

a) Induction of labour is contraindicated.

b) IV fluids should be given as soon as labour starts.

c) Vacuum extraction can be done on breech 2nd twin.

d) Forceps can be done on delivery after coming head.

e) Both babies have a high morbidity and mortality.

232.Components of essential emergency obstetric care include:

a) Parenteral Oxytocic drugs.

b) Parenteral antibiotics.

c) Manual removal of retained products.

d) Manual removal of the placenta.

e) Use of oral anticonvulsant.

233.The following are common renal disorder during pregnancy.

a) Nephrotic syndrome.

b) Mild right hydronephrosis.

c) Pyelonephritis.

d) Calculi.

e) Glomerulonephritis.

234.Risk factors for perinatal death include:

a) Premature rupture of membranes.

b) Foetal hypoxia of unknown cause.

c) Chorioamnionitis.

d) Abruptio placenta.

e) Vasa praevia.

235.Maternal death in Uganda.

a) 60 to 80 % are preventable.

b) Infections are among the first three causes.

c) Only doctor’s actions are needed to reduce maternal mortality rate.

d) HIV/AIDS infection is the commonest cause.

e) Malaria and post abortal infections killing more mother than HIV, haemorrhages

and eclampsia together.

236.A gravid 6 presents with cardiac disease at antenatal clinic.

a) Mitral stenosis is the most frequent heart disease during pregnancy.

b) Cardiac failure usually presents during early puerperium.

c) Diastolic murmur suggest organic heart disease rather than systolic.

d) Systolic murmur grade II suggests cardiovascular diseases.

e) Cardiomegaly is not part of the diagnosis.

237.During the follow up of a patient who had molar pregnancy

a) Amenorrhoea is a common feature

b) Contraceptive is important

c) Respiratory symptoms are important

d) Prophylactic cytotoxic therapy is mandatory

e) Persistent headaches and blurring of vision are poor prognostic sign.

238.Primegravidas are at risk of.

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a) Severe malaria in pregnancy.

b) Pre-eclampsia/ eclampsia.

c) Precipitate labour

d) Choriocarcinoma

e) Postpartum haemorrhage.

239.Immediate complications for caesarean section include:

a) Severe haemorrhage.

b) Injure to neighbours organs.

c) Anaesthetics complications.

d) Haemorrhage.

e) Intestinal obstruction

240.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.

241.Caesarean section.

a) Most common mode of delivery in our service.

b) Is always indicated in previous caesarean section uterine scar.

c) Patients don’t need to be prepared.

d) Is done in all cases of foetal distress.

e) Mother can start oral feeding after 6-8 hours.

242.About frank breech.

a) It has the greatest risk for cord prolapse.

b) The hips are extended.

c) The knees are extended.

d) The knees are flexes.

e) The hips are flexes

243.Incomplete breech.

a) The hips are flexes

b) The hips are extended.

c) The knees are flexes.

d) The Knees are extended.

e) It’s the commonest type at term.

244.Classic sign and symptoms of complete uterine rupture include:

a) Sudden onset of tearing abdominal pain.

b) Cessation of uterine contractions.

c) Absent of foetal heart.

d) Recession of the presenting part

e) All of the above.

245.Rupture uterus surgical options.

a) Total abdominal hysterectomy.

b) Subtotal hysterectomy.

c) Repair of rupture alone.

d) Repair rupture and tubal ligation.

e) Laparoscope.

246.Obstructed labour mode of delivery.

a) Should be always c/section.

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b) Vacuum extraction may be done.

c) Forceps delivery is contraindicated.

d) Symphysiotomy can be done.

e) Destructive operation can be done.

247.In obstructed labour

a) The mother is usually un co-operative

b) The commonest cause is CPD

c) Rupture uterus is sequelae.

d) Caesarean section is not always applicable

e) All the above.

248.Which of the following is not part of routine comprehensive care for a mother within

the context of PMTCT?

a) WHO Clinical staging of the mother living with HIV

b) Prophylaxis for OIs with co-trimoxazole

c) Liver function tests

d) Nutritional care and counselling

e) All the above

249.The following are among targeted categories for primary prevention of HIV.

a) Infants and children

b) The adolescents and young people

c) Fishing communities and uniformed forces

d) Women living with HIV and their families

e) All of the above.

250.Recommendations for safer breastfeeding in the context of HIV include:

a) Avoid infections during breastfeeding

b) Seek immediate treatment for cracked nipples, infant mouth sores

c) Mixed feeding

d) a) and c) above are false

e) All the above are true