Obstetrics | Set 1

1. Which is the least frequent site of an ectopic pregnancy?

2. Perforation tends to occur earliest when an ectopic pregnancy is located in which portion of fallopian tube ?

3. Which of the following does not occur in post partum pituitary necrosis :

5. The Arius-Stella reaction may be seen with all except :

6. The passage of decidual cast in cases of ectopic pregnancy usually means :

7. What is the most common side effect with MTX therapy for ectopic pregnancy

8. Prenatal diagnosis at 16 weeks of pregnancy can be performed using all of the following, except:

9. A primigravida presents to casualty at 32 weeks gestation with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by;

A. Immediate cesarean section

B. Immediate induction of labor

C. Tocolytic therapy

D. Magnesium sulphate therapy

E. none

Correct : A. Immediate cesarean section

10. Placenta previa, all true except :

A. Shock out of proportion of bleeding

B. Malpresentation

C. Head not engaged

D. Painless bleeding

E. none

Correct : A. Shock out of proportion of bleeding

11. A 34wk GA lady presented with vaginal bleeding of an amount more of that of her normal cycle. O/E uterine contracts every 4 min, bulged membrane, the cervix is 3 cm dilated, fetus is in a high transverse lie and the placenta is on the posterior fundus. US showed translucency behind the placenta and the CTG (Cardiotocography) showed FHR of 170, the best line of management is:

12. Most important cause of immediate post partum hemorrhage:

13. Factors favoring long anterior rotation include all except

14. All following are indications for CS in OP except

15. Which vitamin deficiency is most commonly seen in a pregnant mother who is on phenytoin therapy for epilepsy?

16. Uterine inertia is due to EXCEPT?

A. Over distension of uterus

B. Presence of fibroid uterus

C. Fetal malpresentations

D. Abruptio placenta

E. repeated interautrine manipulation

Correct : D. Abruptio placenta

17. Exposure of female fetus to androgens may arrest differentiation of :

18. The risk for development of fetal macrosomia is increased in the following, EXCEPT:

19. Complications of the third stage of labor include all of the following except :

20. Shock is out of proportion to the amount of bleeding in :

22. Which method of terminating a molar gestation is never indicated

24. A 31-year-old, HIV-positive woman, gravida 3, para 2, at 32-weeks' gestation comes to the physician for a prenatal visit. Her prenatal course is significant for the fact that she has taken zidovudine throughout the pregnancy. Otherwise, her prenatal course has been unremarkable. She has no history of mental illness. She states that she has been weighing the benefits and risks of cesarean delivery in preventing transmission of the virus to her baby. After much deliberation, she has decided that she does not want a cesarean delivery and would like to attempt a vaginal delivery. Which of the following is the most appropriate next step in management?

A. Contact psychiatry to evaluate the patient

B. Contact the hospital lawyers to get a court order for cesarean delivery

C. Perform cesarean delivery at 38 weeks

D. Perform cesarean delivery once the patient is in labor

E. Respect the patient's decision and perform the vaginal delivery

Correct : E. Respect the patient's decision and perform the vaginal delivery

25. A 19-year-old primigravid woman at 42 weeks' gestation comes the labor and delivery ward for induction of labor. Her prenatal course was uncomplicated. Examination shows her cervix to be long, thick, closed, and posterior. The fetal heart rate is in the 140s and reactive. The fetus is vertex on ultrasound. Prostaglandin (PGE2) gel is placed intravaginally. One hour later, the patient begins having contractions lasting longer than 2 minutes. The fetal heart rate falls to the 70s. Which of the following is the most appropriate next step in management?

A. Administer general anesthesia

B. Administer terbutaline

C. Perform amnioinfusion

D. Start oxytocin

E. Perform cesarean delivery

Correct : B. Administer terbutaline

26. Which one of the following is a risk factor for developing DVT?

A. Family history of thromboembolic disease.

B. Factor V Leiden.

C. Antiphospholipid syndrome.

D. Sepsis.

E. All of the above.

Correct : E. All of the above.

27. Premature labour.

A. is associated with an increased risk of breech presentation.

B. is associated with uterine anomaly.

C. asymptomaticbacteruria is a proven risk factor.

D. is associated with genital tract infection.

E. All of the above

Correct : E. All of the above

28. A 22-year-old woman in labor progresses to 7 cm dilation, and then has no further progress. She therefore undergoes a primary cesarean section. Examination 2 days after the section shows a temperature of 39.1 C (102.4 F), blood pressure of 110/70 mm Hg, pulse of 90/min, and respirations of 14/min. Lungs are clear to auscultation bilaterally. Her abdomen is moderately tender. The incision is clean, dry, and intact, with no evidence of erythema. Pelvic examination demonstrates uterine tenderness. Which of the following is the most appropriate pharmacotherapy?

29. A 19-year-old nulliparous woman in her 35th week of pregnancy presents with nausea, blurred vision and a weight gain of 4.5 kg per week. Her blood pressure is 160/110 mmHg. Which of the following tests is the most suitable for the assessment of fetal status?

A. amniocentesis for the measurement of the lecithin/ sphingomyelin (L/S) ratio

B. amniocentesis for the measurement of the creatinine level of the amnotic fluid

C. sonographiccephalometry

D. a non-stress test (NST)

E. an oxytocin challenge test (OCT)

Correct : D. a non-stress test (NST)

30. All of the following can be used in hypertension in Pregnancy except

31. All are complications of illegal /Septic abortion except

32. A 31-year-old woman comes to the physician for follow-up after an abnormal Pap test and cervical biopsy. The patient's Pap test showed a high-grade squamous intraepithelial lesion (HGSIL). This was followed by colposcopy and biopsy of the cervix. The biopsy specimen also demonstrated HGSIL. The patient was counseled to undergo a loop electrosurgical excision procedure (LEEP). Which of the following represents the potential long-term complications from this procedure?

A. Abscess and chronic pelvic inflammatory disease

B. Cervical incompetence and cervical stenosis

C. Constipation and fecal incontinence

D. Hernia and intraperitoneal adhesions

E. Urinary incontinence and urinary retention

Correct : B. Cervical incompetence and cervical stenosis

33. Female patient with history of irregular vaginal bleeding tender right iliac fossa , CBC normal , B-HCG positive , most likely to be :

34. Cervical lesion (ectopy):

A. It is an ulcer of the cervix.

B. Should be treated in pregnant females.

C. Pap smear is advisable before management.

D. Commonly cause pain, dyspareunia & low back pain.

E. none

Correct : D. Commonly cause pain, dyspareunia & low back pain.

35. The foetal well-being can be assessed by all of the following, except ?

36. In which of the following condition vaginal delivery is contraindicated?

37. Which is contraindicated in trial of labour following Caesarian Section ?

38. A 20 year old full-term primigravida is brought to the casualty with labour pains for last 24 hours and a hand prolapse. On examination, she has pulse 96/min, BP 120/80 mm Hg, and mild pallor. The abdominal examination reveals the uterine height at 32 weeks, the foetus in transverse lie and absent foetal heart sounds. On vaginal examination, the left arm of the foetus is prolapsed and the foetal ribs are palpable. The pelvis is adequate. What would be the best management option ?

A. External cephalic version

B. Decapitation and delivering the baby vaginally

C. Internal podalic version

D. Lower Segment Caesarean section

E. none

Correct : B. Decapitation and delivering the baby vaginally

39. Which one of the following is diagnosed by Spiegelberg criteria ?

40. The presence of a retraction ring at the junction of upper and lower uterine segment in labour indicates ?

41. The indications of an elective caesarean section include all of the following, except ?

A. Placenta Praevia

B. Cephalopelvic disproportion

C. Previous lower segment caesarean section

D. Carcinoma Cervix

E. none

Correct : C. Previous lower segment caesarean section

42. Hyperemesis gravidarium in 1st trimester is seen with increased frequency in allof the following except:

44. Which of the follwing is responsible for inability to rotate anteriorly in the occipitoposterior position :

A. Moderate size fetus

B. Gynecoid pelvis

C. Weak uterine contractions

D. Good levatorani muscle contractions

E. none

Correct : C. Weak uterine contractions

45. Ectopic pregnancy is differentiated from abortion by the fact that in ectopic pregnancy :

A. Pain appears after vaginal bleeding

B. There is slight amount of bleeding

C. No enlargement of uterus

D. Histological examination of products of expulsion shows villi

E. none

Correct : D. Histological examination of products of expulsion shows villi

46. Following a vaginal delivery, a woman develops a fever, lower abdominal pain and uterine tenderness. She is alert, and her blood pressure and urine output are good. Large gram positive rods suggestive of clostridia are seen in a smear of cervix. management should include all except :

A. Immediate radiographic examination for gas in uterus

B. High dose antibiotic therapy

C. Hysterectomy

D. close observation for renal failure or hemolysis

E. none

Correct : C. Hysterectomy

47. Engaging diameter, in fully extended head :

48. A woman experiencing a molar pregnancy has an increased risk of which of the following in subsequent gestations?

49. A woman with a complete mole is most likely to present with which of the symptoms?

50. Fetal hyperinsulinemia leads to:

A. Fetal macrosomia causes difficult vaginal delivery

B. Inhibition of pulmonary surfactant causing Intrauterine asphyxia

C. Decrease serum K causing respiratory distress syndrome

D. Neonatal hypoglycemia with myocardial injury

E. none

Correct : A. Fetal macrosomia causes difficult vaginal delivery

51. The following are eitiological factors of atonic postpartum hge except :

52. If the foetus is lying accros the uterus, with the head in the flank

53. Refers to the part of the foetus that occupies the lower segment of the uterus or pelvic

55. Engagement is said to occur when.......

A. The fetal head is within the maternal pelvis

B. The biparietal diameter of the fetal head is through the plane of the inlet.

C. The presenting part is just above the level of ischial spines.

D. The vertex is in transverse position

E. none

Correct : B. The biparietal diameter of the fetal head is through the plane of the inlet.

57. Which is the most common cause of abnormal lie?

58. Which of the following statements regarding vaginal breech birth is FALSE?

A. Increased risk if footling

B. In about 30% there is slow cervical dilatation in the first stage

C. CTG is advised

D. Pushing is not encouraged until the buttocks are visible

E. Epidural analgesia is mandatory

Correct : E. Epidural analgesia is mandatory

60. Refers to the part of the foetus that occupies the lower segment of the uterus or pelvis

61. Engagement is said to occur when.......

A. The fetal head is within the maternal pelvis

B. The biparietal diameter of the fetal head is through the plane of the inlet.

C. The presenting part is just above the level of ischial spines.

D. The vertex is in transverse position.

E. none

Correct : B. The biparietal diameter of the fetal head is through the plane of the inlet.

63. The most common type of breech

64. At which part of the pelvis are the transverse and anterior-posterior diameter most similar?

66. Flexion of the fetal head occurs when it meets resistance from :

67. A woman delivers a 9 lb baby with midline episiotomy & develops a 3rd degree tear. Inspection shows that the following structures are intact.

68. Leopold maneuvers refers to :

69. Following changes occur in urinary system during normal pregnancy:

A. Increase in renal blood flow

B. Increase in glomerular filtration rate

C. Increase in capacity of kidney pelvis

D. All of the above

E. none

Correct : D. All of the above

70. Mechanism of labor in abortion stick ( use of stick to induce abortion)is due to

A. Necrosis of uterine endometrium and stimulation of uterine contraction

B. Oxytocin present in the stick

C. Prostaglandins present in the stick

D. All of the above

E. none

Correct : A. Necrosis of uterine endometrium and stimulation of uterine contraction

Quiznetik

Obstetrics | Set 1

1. Which is the least frequent site of an ectopic pregnancy?

2. Perforation tends to occur earliest when an ectopic pregnancy is located in which portion of fallopian tube ?

3. Which of the following does not occur in post partum pituitary necrosis :

4. The most dangerous symptom during pregnancy is:

5. The Arius-Stella reaction may be seen with all except :

6. The passage of decidual cast in cases of ectopic pregnancy usually means :

7. What is the most common side effect with MTX therapy for ectopic pregnancy

8. Prenatal diagnosis at 16 weeks of pregnancy can be performed using all of the following, except:

9. A primigravida presents to casualty at 32 weeks gestation with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by;

10. Placenta previa, all true except :

12. Most important cause of immediate post partum hemorrhage:

13. Factors favoring long anterior rotation include all except

14. All following are indications for CS in OP except

15. Which vitamin deficiency is most commonly seen in a pregnant mother who is on phenytoin therapy for epilepsy?

16. Uterine inertia is due to EXCEPT?

17. Exposure of female fetus to androgens may arrest differentiation of :

18. The risk for development of fetal macrosomia is increased in the following, EXCEPT:

19. Complications of the third stage of labor include all of the following except :

20. Shock is out of proportion to the amount of bleeding in :

21. The gold standard in diagnosing ectopic pregnancy

22. Which method of terminating a molar gestation is never indicated

23. Invasive molar tissue is most commonly found in

26. Which one of the following is a risk factor for developing DVT?

27. Premature labour.

29. A 19-year-old nulliparous woman in her 35th week of pregnancy presents with nausea, blurred vision and a weight gain of 4.5 kg per week. Her blood pressure is 160/110 mmHg. Which of the following tests is the most suitable for the assessment of fetal status?

30. All of the following can be used in hypertension in Pregnancy except

31. All are complications of illegal /Septic abortion except

33. Female patient with history of irregular vaginal bleeding tender right iliac fossa , CBC normal , B-HCG positive , most likely to be :

34. Cervical lesion (ectopy):

35. The foetal well-being can be assessed by all of the following, except ?

36. In which of the following condition vaginal delivery is contraindicated?

37. Which is contraindicated in trial of labour following Caesarian Section ?

39. Which one of the following is diagnosed by Spiegelberg criteria ?

40. The presence of a retraction ring at the junction of upper and lower uterine segment in labour indicates ?

41. The indications of an elective caesarean section include all of the following, except ?

42. Hyperemesis gravidarium in 1st trimester is seen with increased frequency in allof the following except:

43. Most common indication for C/S :

44. Which of the follwing is responsible for inability to rotate anteriorly in the occipitoposterior position :

45. Ectopic pregnancy is differentiated from abortion by the fact that in ectopic pregnancy :

46. Following a vaginal delivery, a woman develops a fever, lower abdominal pain and uterine tenderness. She is alert, and her blood pressure and urine output are good. Large gram positive rods suggestive of clostridia are seen in a smear of cervix. management should include all except :

47. Engaging diameter, in fully extended head :

48. A woman experiencing a molar pregnancy has an increased risk of which of the following in subsequent gestations?

49. A woman with a complete mole is most likely to present with which of the symptoms?

50. Fetal hyperinsulinemia leads to:

51. The following are eitiological factors of atonic postpartum hge except :

52. If the foetus is lying accros the uterus, with the head in the flank

53. Refers to the part of the foetus that occupies the lower segment of the uterus or pelvic

54. Means the head is at the level of the ischial spines

55. Engagement is said to occur when.......

56. The following hormone is not produced by the placenta...

57. Which is the most common cause of abnormal lie?

58. Which of the following statements regarding vaginal breech birth is FALSE?

59. Refers to a maneuver which attempts to turn a breech baby to a cephalic presentation

60. Refers to the part of the foetus that occupies the lower segment of the uterus or pelvis

61. Engagement is said to occur when.......

62. After what age gestation would abnormal lie warrant hospital admission

63. The most common type of breech

64. At which part of the pelvis are the transverse and anterior-posterior diameter most similar?

65. Breech presentations occurs in ___ of term pregnancies

66. Flexion of the fetal head occurs when it meets resistance from :

67. A woman delivers a 9 lb baby with midline episiotomy & develops a 3rd degree tear. Inspection shows that the following structures are intact.

68. Leopold maneuvers refers to :

69. Following changes occur in urinary system during normal pregnancy:

70. Mechanism of labor in abortion stick ( use of stick to induce abortion)is due to