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Eng - Teste 2020-2021

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1. CM.

The following signs and symptoms should be reported immediately as a potential


danger signal in a pregnant woman:
a. vaginal bleeding
b. severe headache
c. swelling of the ankles and feet
d. blurring of vision
e. constipation
Correct answer: a, b, d
2. CM. Preterm labor is important because it commonly results in death of the infant due to:
a. abruptio placentae
b. birth trauma
c. jaundice
d. hyaline membranes disease
e. periventricular hemorrhages
Correct answer: d, e
3. CM. The following congenital anomalies are associated with increased quantities of
amniotic fluid:
a. duodenal atresia
b. anencephaly
c. renal agenesis
d. spina bifida
e. urethral hypospadias
Correct answer: a, b, d
4. CM. It is important to treat patients with asymptomatic bacteriuria in pregnancy because:
a. the patient is seriously ill
b. one third will develop septic shock during pregnancy
c. one third will develop cystitis during pregnancy
d. one third will develop acute pyelonephritis during pregnancy
e. it increases risk of preterm birth
Correct answer: d, e
5. CM. What antibiotics are contraindicated in pregnancy
a. tetraciclin
b. ampicilin
c. levomicetine
d. penicilline
e. cefasoline
Correct answer: a, c
6. CM. What can be used for pregnancy dating:
a. last menstrual period
b. ultrasound examination
c. the first movement of fetus
d. palpation of uterus in early pregnancy
e. palpation of uterus in the third trimester
Correct answer: a, b, c, d
7. CM. Choose the correct statements regarding chorioamnionitis:
a. it causes all cases of preterm labor
b. it usually follows preterm rupture of membranes
c. should be treated with combination of antibiotics
d. it only occurs in patients with vaginitis
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e. the most frequent sign is backache
Correct answer: b, c
8. CM. Which complications are common if diabetes is not well controlled?
a. fetal macrosomia
b. preeclampsia
c. oligohydramnios
d. polihydramnios
e. premature delivery
Correct answer: a, b, d
9. CM. Clinical criteria of chorioamnionitis include:
a. headache and backache
b. vaginal bleeding
c. fetal tachycardia
d. purulent vaginal discharge
e. fever more than 38C
Correct answer: c, d, e
10. CM. Which patients are at high risk of preterm labor?
a. patients who book early in pregnancy
b. patents with twin pregnancy
c. patients living in low socio-economic circumstances
d. patients with bacterial vaginosis
e. patients with a history of preterm labor in previous pregnancy
Correct answer: b, c, d, e

11. CM. Which of the following are at high risk of cord prolapse?
a. a patient with breech presentation
b. a patient with cephalic presentation
c. a patient with a post term pregnancy
d. a patient who ruptures her membranes when the fetal head is still palpable 4/5 of the pelvic
brim
e. a patient with severe polyhidramnios
Correct answer: a, d, e
12. CM. Management of patient with premature prelabor rupture of membranes include:
a. bimanual exploration of the cervix
b. prophylactic administration of antibiotics
c. administration of corticosteroids
d. transfer to a maternity with neonatological intensive care unit
e. estimation of gestational age as accurate as possible
Correct answer: b, c, d, e
13. CM. Normal maternal adjustments in pregnancy include:
a. rise in cardiac output
b. hemodilution
c. decrease of diastolic pressure
d. increase in plasma volume
e. decrease in red blood cell mass
Correct answer: a, b, c, d
14. CM. The causes of oligohydramnios are:
a. fetal growth retardation
b. renal agenesis
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c. preeclampsia
d. neural tube defects
e. prelabor rupture of membranes
Correct answer: a, b, c, e
15. CM. The causes of polyhydramnios are:
a. maternal diabetes
b. absence of esophagus
c. neural tube defects
d. preeclampsia
e. renal agenesis
Correct answer: a, b, c
16. CM. The fetus with postmaturity syndrome has the following:
a. loss of subcutaneous fat
b. short fingernails
c. dry, peeling skin
d. long fingernails
e. abundant vernix caseosa
Correct answer: a, c, d
17. CM. Indications for a cesarean section include:
a. previous cesarean section
b. placenta previa
c. fetal distress
d. cervical cerclage
e. cord prolapse
Correct answer: a, b, c, e
18. CM. What is indicated for prevention of respiratory distress syndrome in premature
neonates:
a. heparin
b. oxitocin
c. dexamethasone
d. magnesium sulphate
e. betamethasone
Correct answer: c, e
19. CM. Prerequisites for a forceps delivery include:
a. a completely dilated cervix
b. an empty bladder
c. the vertex in the occiput anterior position
d. ruptured membranes
e. the known position of the vertex
Correct answer: a, b, d, e
20. CM. Which of the circumstances increases the risk of a multiple pregnancy:
a. family history of multiple pregnancy
b. primiparity
c. induction of ovulation with clomiphen citrate
d. maternal age more than 30 years
e. in vitro fertilization
Correct answer: a, c, e
21. CM. Progesterone in pregnancy is produced in:
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a. posterior hypophysis
b. corpus luteum
c. adrenal gland
d. placenta
e. adenohypophysis
Correct answer: b, d
22. CM. Endometrium has the following layers:
a. functional
b. basal
c. intermediate
d. parabasal
e. suprabasal
Correct answer: a, b
23. CM. Name the anatomical parts of the fallopian tube:
a. interstitial
b. middle part
c. isthmic
d. ampullary
e. fimbrial
Correct answer: a, c, d, e
24. CM. The vascularization of the ovary is done through:
a. ovarian artery
b. uterine artery
c. a. iliaca communis
d. a. femoralis
e. a. pudenda
Correct answer: a, b
25. CM. Select correct statements regarding premature delivery:
a. pregnancy term 22-37 weeks
b. weight of the newborn 500 - 2500 g
c. pregnancy term 28-37 weeks
d. length of the newborn 25 - 45 cm
e. length of the newborn 25 - 49 cm
Correct answer: a, b, d
26. CM. In which situations labor induction is contraindicated:
a. previous cesarean section
b. transversal lay
c. preeclampsia
d. estimated fetal weight more than 4500 gr
e. postdate pregnancy
Correct answer: a, b, d
27. CM. Risk of what complications is increased in multiple pregnancy:
a. polyhydramnios
b. fetal growth restriction
c. macrosomia
d. postpartum hemorrhages
e. prematurity
Correct answer: a, b, d, e

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28. CM. Ultrasound criteria of the oligoamnios are:
a. determination of an maximum vertical sac less than 2 cm
b. determination of an vertical sac less than 5 cm
c. amniotic liquid index less than 5 cm
d. amniotic liquid index less than 7 cm
e. amniotic liquid index less than 10 cm
Correct answer: a, c
29. CM. What 2 hormones are characteristic only to pregnancy:
a. chorionic gonadotropin
b. testosterone
c. prolactin
d. estrogens
e. human chorionic somatomammotropin
Correct answer: a, e
30. CM. What are the components of Apgar score
a. frequency of respiration
b. fetal heart rate
c. fetal weight
d. muscular tonus
e. skin color
Correct answer: a, b, d, e
31. CM. Which dimensions of the pelvis can be appreciated through external pelviometry :
a. bispinarum distance
b. diagonal conjugate
c. bitrochanteric distance
d. bicristarum distance
e. external conjugate
Correct answer: a, c, d, e
32. CM. The newborn status is determined by:
a. Apgar score
b. Vitlingher scale
c. Silverman score
d. Glasgow scale
e. Boshop score
Correct answer: a, c
33. CM. Which of the following are risk factors for uterus rupture?
a. threatened preterm labor
b. transversal situs of the fetus
c. previous cesarean section
d. hydramnios
e. contracted pelvis
Correct answer: b, c, e
34. CM. What complications are caused by infections during pregnancy:
a. postpartum hemorrhages
b. fetal malformations
c. preterm deliveries
d. early neonatal sepsis
e. placenta previa
Correct answer: b, c, d
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35. CM. What statements are correct regarding management of prelabor preterm rupture of
membranes:
a. Corticosteroids are contraindicated because of increased risk of infection
b. prophylactic antibiotic of choice is Eritromicine
c. broad spectrum antibiotics are the best option
d. immediate induction of labor improve perinatal outcomes
e. expectant management decrease perinatal mortality and morbidity
Correct answer: b, e
36. CM. The aim of routine USG exam at 18-20 weeks of gestation is to determine:
a. gestational age of pregnancy
b. fetal lay and presentation
c. localization of placenta
d. biophysical profile
e. congenital anomalies of the fetus
Correct answer: a, c, e
37. CM. Indications for selective ultrasound exam after 21 weeks of gestation are:
a. diabetes
b. placenta previa
c. suspected fetal growth restriction
d. vaginal hemorrhage
e. maternal age >30 years
Correct answer: a, b, c, d
38. CM. Pelvic inlet is limited by:
a. the middle of foramen obturatoria
b. superior margin of the pubic symphysis
c. promontorium
d. anonymous line (arched)
e. the most prominent point on the pubic symphysis
Correct answer: c, d, e
39. CM. Pelvic outlet is limited by:
a. inferior margin of the symphysis pubis
b. ischiatic spines
c. ischiatic protuberance
d. coccyx apex
e. sacral-coccyx articulation
Correct answer: a, c, d
40. CS The pH of vagina in adults is:
a. 3,5-4,5
b. 4,5-5,5
c. 5,5-6,5
d. 6,5-7,5
e. >7,5
Correct answer: b

41. CS Protective bacterium in normal vagina is:


a. Peptostreptococcus
b. Lactobacillus
c. Gardenella vaginalis
d. E. coli

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e. Candida
Correct answer: b

42. CS The main source of physiological secretions found in the vagina is:
a. Bartholin`s glands
b. Gartner`s duct
c. Vaginal epithelium
d. Cervix
e. Uterus
Correct answer: d

43. CS Uterine-cervix ratio up to 10 years of age is:


a. 3:2
b. 3:1
c. 2:1
d. 1:2
e. 1:1
Correct answer: d

44. CS The epithelial lining of cervical canal is:


a. low columnar
b. high columnar
c. stratified squamous
d. ciliated columnar
e. columnar
Correct answer: b

45. CS Bartholin`s duct opens into:


a. labia majora and minora
b. a groove between labia minora and hymen
c. the lower vagina
d. the upper vagina
e. a groove between labia majora and hymen
Correct answer: b

46. CS Narrowest part of fallopian tube is:


a. interstitial portion
b. isthmus
c. infundibulum
d. ampulla
e. introrium
Correct answer: a

47. CS `Peg cells` are seen in:


a. vagina
b. vulva
c. ovary
d. tubes
e. uterus
Correct answer: d

48. CS The length of fallopian tube is:


a. 6-8 cm
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b. 10-12 cm
c. 15-18 cm
d. 18-20 cm
e. 6-8 cm
Correct answer: b.

49. CS Uterine artery is a branch of:


a. aorta
b. common iliac artery
c. internal iliac artery
d. external iliac artery
e. femural artery
Correct answer: c

50. CS Vaginal epithelium is derived from:


a. endoderm of urogenital sinus
b. mesoderm of urogenital sinus
c. endoderm of genital ridge
d. mesoderm of genital ridge
e. ectoderm of genital ridge
Correct answer: a

51. CM With regards to vagina the correct affirmations are:


a. makes an angle of 45◦ with the horizontal in erect posture
b. looks like letter `H` on cross section
c. vaginal axis lies parallel to the uterus and at right angles to the plane axis of inlet
d. is lined by stratified squamous epithelium
e. makes an angle of 90◦ with the horizontal in erect posture
Correct answer: a, b, d

52. CM The fallopian tube:


a. is lined entirely by ciliated columnar epithelium:
b. has a sub-mucous layer
c. undergoes shedding during menstrual cycle
d. is surrounded by peritoneum on all sides except along the line of attachment of mesolapinx
e. is 10-12 cm long
Correct answer: d, e

53. CS. According to WHO, anemia in pregnancy is diagnosed, when hemoglobin is less than:
a. 10.0gm%
b. 11.0gm%
c. 12.0gm%
d. 9.0gm%
e. 8.0 gm%
Correct answer: b

54. CS. Which of the following is most sensitive for the detection of iron in pregnancy:
a. serum iron
b. serum ferritin
c. serum transferrin
d. serum iron bending capacity
e. iron excretion rate
Correct answer: b
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55. CS. In pregnancy, which type of anemia is less common ?
a. vitamin B12 anemia
b. folic acid anemia
c. iron + folic acid anemia
d. iron deficiency anemia
e. hemolytic anemia
Correct answer: a

56. CS Most common cause of maternal anemia in pregnancy:


a. acute blood loss
b. iron deficiency
c. gastro-intestinal blood loss
d. hemolytic anemia
e. thalassemia
Correct answer: b

57. CS. Total amount of iron needed by the fetus during entire pregnancy is:
a. 500mg
b. 1000mg
c. 800mg
d. 300mg
e. 100mg
Correct answer: d

58. CM. The following statements are related to the therapy of iron deficiency anemia during
pregnancy:
a. oral iron can be given only if anemia is detected before 20 weeks of pregnancy
b. parenteral iron therapy markedly increases the reticulocytic count within 7-14 days
c. parenteral therapy is best choice during 30-36 weeks
d. blood transfusion may be useful in severe anemia beyond 36 weeks
e. it is not necessary any treatment
Correct answer: b, c, d, e

59. CM. Which methods are used for contraception in sickle cell anemia:
a. oral pills
b. iud
c. progestin only pills or implant
d. condoms
e. vaginal diaphagrama
Correct answer: d, e.

60. CM. Placenta previa is characterized by following:


a. painless bleeding
b. causeless bleeding
c. recurrent bleeding
d. presents after first trimester
e. often bleeding starts mildly
Correct answer: a, b, c, e

61. CS. A primigravida at 37 week of gestation admitted to labour room with central placenta
previa with heavy bleeding per vaginum. The fetal heart rate was normal at the next time of
examination. The best management option for her is:
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a. expectant management
b. cesarean section
c. induction and vaginal delivery
d. induction and forceps delivery
e. blood transfusion
Correct answer: b.

62. CM. In which situations expectant management of placenta previa before 34 weeks of
pregnancy is contraindicated?
a. evidence of fetal distress
b. fetal malformations
c. mother in a hemodynamically stable condition
d. women in labour
e. dead baby
Correct answer: a, b, d, e.

63. CM. In placenta previa expectant management is not done in case of:
a. active labour
b. anencephaly
c. dead baby
d. severe placenta previa
e. premature fetus
Correct answer: a, b, c, d

64. CM. Termination of pregnancy in placenta previa is indicated in:


a. active bleeding
b. active labour
c. gestational age < 34 weeks with live fetus
d. sévère fetal malformation
e. unstable lie
Correct answer: a, b, d

65. CS. All the following are indications for termination of pregnancy in antepartum
hemorrhage EXCEPT :
a. > 37 weeks
b. dic syndrom
c. transverse lie
d. continuous bleeding
e. fetal distress
Correct answer: c

66. CM. Savita is a 32 weeks pregnant woman diagnosed with severe antepartum hemorrhage.
Vitals are unstable with BP 80/60. Which of the following are next steps in management?
a. careful observation
b. blood transfusion
c. medical induction of labour
d. immediate cesarean section
e. expectant management
Correct answer: b, d

67. CS. A 32 weeks pregnant woman presents with mild uterine contractions and on
examination her vitals are stable and placenta previa is present. Best management is:
a. bed rest + dexamethasone
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b. bed rest + nifedipine and dexamethasone
c. bed rest + sedation
d. immediate cesarean section
e. careful observation
Correct answer: b

68. CS. A hypertensive pregnant woman at 34 weeks comes with history of abdominal pain,
vaginal bleeding and loss of fetal movements. On examination the uterus is hard (increased
tonus). Fetal heart sounds are absent. The most likely diagnosis is:
a. placenta previa
b. hydramnios
c. premature labour
d. abruptio placenta
e. active labour
Correct answer: d

69. CM. What conditions can cause DIC during pregnancy?


a. diabetes mellitus
b. amniotic fluid embolism
c. intrauterine death
d. abruptio placenta
e. coagulation disorders
Correct answer: b, c, d, e

70. CS. Which of the following is not used in DIC?


a. fresh frozen plasma
b. epsilon amino caproic acid
c. blood transfusion
d. intravenous fluids
e. cryoprecipitate
Correct answer: b

71. CS. An elderly multiparous woman was admitted with strong labour pains. The patient
suddenly goes in shock with cyanosis, respiratory disturbances and pulmonary edema. The
most likely clinical diagnosis is:
a. rupture of uterus
b. congestive heart failure
c. amniotic fluid embolism
d. concealed hemorrhage after trauma
e. stroke
Correct answer: c

72. CS After how many days of ovulation embryo implantation occurs?


a. 3-5 days
b. 7-9 days
c. 10-12 days
d. 13-15 days
e. >15 days
Correct answer: b

73. CS Fetal kidneys start producing urine by:

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a. 3 month
b. 4 month
c. 5 month
d. 6 month
e. 8 month
Correct answer: a

74. CS Fetal stage starts at:


a. 3 weeks
b. 6 weeks
c. 9 weeks
d. 12 weeks
e. >14 weeks
Correct answer: c

75. CM. Oxygenated blood from the placenta reaches the fetal heart in utero via:
a. umbilical arteries
b. umbilical vein
c. ductus venosus
d. ductus arteriosus
e. vena cava inferior
Correct answer: b, c, e

76. CS Ligamentum teres is formed after:


a. obliteration of the umbilical vein
b. obliteration of the ductus venous
c. obliteration of the ductus arteriosus
d. obliteration of the hypogastric artery
e. obliteration of the umbilical arteries
Correct answer: b.

77. CM. What is true about CIN :


a. premalignant lesion
b. hpv predisposes
c. pap smear can detect it
d. malignant lesion
e. occurs at squamo-columnar junction
Correct answer: a, b, c, e

78. CS. In a cervix low grade squamous intraepithelial lesion (LSIL) in Bethesda system
includes:
a. CIN I
b. CIN II
c. CIN III
d. squamous metaplasia
e. carcinoma in situ (CIS)
Correct answer: a

79. CS. Acetic acid staining of cervix shows following EXCEPT:


a. squmaous dysplasia
b. cervical carcinoma in situ
c. cervical polyp

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d. cervical dysplasia
e. condyloma acuminate
Correct answer: c

80. CM. Colposcopic features suggestive of malignancy are:


a. condyloma
b. vascular atypia
c. punctation
d. white epithelium
e. pale pink epithelium
Correct answer: b, c, d

81. CM. Cone biopsy is indicated in the following conditions:


a. indefinite diagnosis on colposcopy
b. CIN-III
c. cervical metaplasia
d. microinvasive carcinoma
e. cervical erosion (ectopy)
Correct answer: a, b, d

82. CS. Young lady comes with mild erosion of cervix and pap smear shows dysplasia. Next
step of management is:
a. antibiotics
b. colposcopy
c. cryosurgery
d. cone biopsy
e. laser vaporisation
Correct answer: b

83. CS. Treatment of choice of stage III CIN in 40-year-old female is:
a. hysterectomy
b. laser coagulation
c. cryocoagulation
d. cone excision
e. repeat pap smear after 6 months
Correct answer: a

84. CM. True statements about cervical cancer are:


a. 90% associated with HPV
b. nulliparity is a risk factor
c. multiparity is a risk factor
d. more frequent in immunocompromised patients
e. smoking is a predisposing factor
Correct answer: a, c, d, e

85. CM. Predisposing factors for cervical cancer are:


a. multiple sex partners
b. genital warts
c. hpv 16,18
d. virginity
e. late menarche
Correct answer: a, b, c

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86. CM. Risk factor for cervical cancer are:
a. HPV
b. smoking
c. late menarche
d. nulliparity
e. early start of sexual life
Correct answer: a, b, e

87. CM. Which of the following are not risk factors for cervical cancer?
a. low parity
b. multiple sexual partner
c. early start of sex (<16 years)
d. smoking
e. first sexual intercourse after 18 years
Correct answer: a, e

88. CM. High risk HPV for cervical cancer are:


a. HPV 16
b. HPV 18
c. HPV 21
d. HPV 31
e. HPV 36
Correct answer: a, b

89. CS. Carcinoma cervix extends to lateral pelvic wall. The stage would be:
a. stage I
b. stage II A
c. stage II B
d. stage III
e. stage IV
Correct answer: d

90. CM. What are the features of stage Ib2 cervical cancer?
a. microinvasive carcinoma with stromal invasion <3mm
b. microinvasive carcinoma with stromal invasion < 5mm
c. microinvasive carcinoma with stromal invasion > 5mm
d. size of lesion < 4cm
e. size of lesion > 4cm
Correct answer: c, e

91. CM. Which of the following statements about squamous cell carcinoma of cervix are
false:
a. common at squamo-columnar junction
b. CT scan is mandatory for staging
c. post coital bleeding is a common symptom
d. HPV 16 and 18 are associated with high risk of carcinogenesis
e. MRI is mandatory for staging
Correct answer: b, e

92. CM. Lymph nodes (LN) involved in cervical cancer:


a. inguinal LN
b. obturator LN
c. hypo-gastric LN
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d. external iliac LN
e. femoral LN
Correct answer: b, c, d

93. CS. A 55-years-old lady presenting to out patient department with post-coital bleeding for
3 months has a 1 x 1cm nodule on the anterior lip of cervix. The most appropriate
investigation to be done subsequently is:
a. pap smear
b. punch biopsy
c. endocervical curettage
d. colposcopy
e. cone biopsy
Correct answer: b

94. CS. Investigation of choice in post-coital bleeding in a 60-years-old woman is:


a. pap smear
b. colposcopy and biopsy
c. pelvic ultrasound
d. cone excision of cervix
e. laparoscopy
Correct answer: b

95. CM. Best methods of treatment of carcinoma in situ of cervix are:


a. simple hysterectomy
b. conisation
c. laser vaporization
d. cryosurgery
e. total hysterectomy
Correct answer: a, b

96. CS. In microinvasive cervical cancer, treatment of choice is:


a. conization
b. laser
c. simple hysterectomy
d. radical hysterectomy
e. total hysterectomy
Correct answer: c

97. CS. A lady undergoes radical hysterectomy for stage Ib cervical cancer. It was found that
cancer extends to lower part of the body of the uterus and upper part of cervix. Next step of
management will be:
a. chemotherapy
b. radiotherapy
c. chemoradiation
d. follow up
e. hormonal therapy
Correct answer: d

98. CM. Treatment of cervical cancer stage IB includes:


a. surgery
b. laser vaporization
c. radiotherapy
d. cryotherapy
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e. leep
Correct answer: a, c

99. CM. Treatment of stage IIa cervical cancer includes:


a. radical hysterectomy
b. radical hysterectomy with removal of pelvic lymph nodes
c. total abdominal hysterectomy with bilateral salpingo-oophorectomy
d. radiation therapy
e. hormonal replacement therapy
Correct answer: b, d

100. CM. Complications of cervical cone biopsy in a case of micro-carcinoma of cervix


include:
a. bleeding
b. cervical stenosis
c. infection
d. spread of malignancy
e. cervical dystocia
Correct answer: a, b, c , e

101. CS. A 55 year-old woman was found to have Ca cervix, FIGO stage 3, locally advanced.
What would be the management?
a. surgery plus chemotherapy
b. radiotherapy plus chemotherapy
c. chemotherapy
d. radiotherapy plus HPV vaccine
e. surgery plus hormonal replacement therapy
Correct answer: b

102. CM Karyotyping of fetus can be done through all of the following invasive methods:
a. amniocentesis
b. cordocentesis
c. chorionic villous sampling
d. fetal skin biopsy
e. amnioscopy
Correct answer: a, b, c

103. CM Prenatal diagnosis at 16 weeks of pregnancy can be performed using all of the
following:
a. amniotic fluid
b. maternal blood
c. chorionic villi
d. fetal blood
e. fetal skin biopsy
Correct answer: a, b, c

104. CS In which of the following conditions would maternal serum alpha- fetoprotein values
be the highest:
a. Down’s syndrome
b. omphalocele
c. gastroschisis
d. spina bifida occulta
e. twins
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Correct answer: c

105. CS Increased AFP level is seen in:


a. Down syndrome
b. molar pregnancy
c. over-estimated gestational age
d. congenital nephrotic syndrome
e. twins
Correct answer: c

106. CS Maximum level of alpha feto protein is seen in:


a. fetal serum
b. placenta
c. amniotic fluid
d. maternal serum
e. maternel urine
Correct answer: a

107. CM Monitoring of B-HCG is useful in management of:


a. hidatiform mole
b. choriocarcinoma
c. ectopic pregnancy
d. endodermal sinus tumor
e. preeclampsia
Correct answer: a, b, c

108. CS Amniotic fluid contains acetyl cholinesterase enzyme. What is the diagnose?
a. open spina bifida
b. gastroschisis
c. omphalocele
d. osteogenesis imperfect
e. down’s syndrome
Correct answer: a

109. CS Which of the following tests on maternal serum is most useful in distinguishing open
neural tube defects and ventral wall defects in a fetus?
a. carcinoembryogenic antigen
b. sphingomyelin
c. alpha-fetoprotein
d. pseudocholinesterase
e. beta-hcg
Correct answer: d

110. CS The best time to do chorionic villous sampling is:


a. between 6-8 weeks
b. between 7-9 weeks
c. between 9-11 weeks
d. between 11-13 weeks
e. between 13 -16 weeks
Correct answer: d

111. CS Chorionic villous sampling done before 10 weeks may result in:
a. fetal loss
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b. feto-maternal hemorrhage
c. oromandibular and limb defects
d. sufficient material not obtained
e. neural tube defect
Correct answer: c

112. CM Chorionic villous sampling is done to diagnose:


a. phenylketonuria
b. down’s syndrome
c. neural tube defect
d. thalassemia/sickle cell anemia
e. osteogenesis imperfect
Correct answer: a, b, d.

113. CM True about chorionic villi biopsy:


a. strongly associated with oro-mandibular defects
b. done at 10-13 weeks
c. Rh immunoglobulin prophylaxis is not necessary
d. done to diagnose genetic disorders
e. Rh immunoglobulin prophylaxis is necessary
Correct answer: a, b, d, c

114. CM True statements about amniocentesis are:


a. it carries risk of miscarriage
b. always done as a blind procedure
c. done between 14-20 weeks
d. chromosal abnormality can be detected
e. done between 8-12 weeks
Correct answer: a, c, d

115. CS Amniocentesis is done at:


a. 10-12 weeks
b. 14-20 weeks
c. 20-24 weeks
d. 24-28 weeks
e. >34 weeks
Correct answer: b

116. CS What is the earliest gestational age when detection of fetal heart activity can be
achieved be USG:
a. 6.0-6.5 weeks
b. 6.5-7 weeks
c. 7.1-7.5 weeks
d. 8 weeks
e. 9 weeks
Correct answer: a

117. CS What is the finding seen earliest in USG:


a. yolk sac
b. fetal heart activity
c. chorion
d. placenta
e. embryo
18
Correct answer: a

118. CS Pseudogestational sac is seen by ultrasonography in case of:


a. missed abortion
b. ectopic gestation
c. complete abortion
d. hematometra
e. h. mole
Correct answer: b

119. CS Earliest detectable congenital malformation by USG is:


a. anencephaly
b. spina bifida
c. meningocele
d. cystic hygroma
e. oesofageal atresia
Correct answer: a

120. CM 2nd trimester USG is done for:


a. sex determination
b. to guide amniocentesis
c. gestational age estimation
d. diagnosis of congenital defects
e. determination of fetal presentation
Correct answer: a, b, c, d

121. CM USG fetal growth parameters are:


a. biparietal diameter
b. head circumference
c. transcerebeller diameter
d. femur length
e. abdominal circumference
Correct answer: a, b, d, e

122. CS Doppler ultrasound in pregnancy detects:


a. cardiovascular malformation
b. neural tube defects
c. abdominal masses
d. IUGR
e. fetal sex
Correct answer: d

123. CS Late deceleration at CTG indicates:


a. head compression
b. cord compression
c. fetal hypoxia
d. breech presentation
e. placental insuficiency
Correct answer: c

124. CS Early deceleration at CTG denotes:


a. head compression
b. cord compression
19
c. placental insufficiency
d. fetal distress
e. breech presentation
Correct answer: a

125. CM Biophysical score includes:


a. fetal movements
b. respiratory movements
c. placental localization
d. uterine artery wave form
e. CTG
Correct answer: a, b, e

126. CS. A young woman with 6 weeks amenorrhoea presents with signs of acute abdomen.
Pregnancy test is positive, but USG shows empty uterus. Most likely diagnosis is:
a. ovarian cyst
b. ectopic pregnancy
c. complete abortion
d. septic abortion
e. pelvic abscess
Correct answer: b

127. CS. A woman presents with amenorrhoea of months duration; lower abdominal pain,
facial pallor, fainting and shock. Most likely diagnosis is:
a. ruptured ovarian cyst
b. ruptured ectopic pregnancy
c. threatened abortion
d. septic abortion
e. pelvic abscess
Correct answer: b

128. CS. Young lady presents with acute abdominal pain and history of 1½ months
amenorrhoea and positive pregnancy test. On USG examination there is collection of fluid in
the punch of Douglas and no gestational sac in uterus. Diagnosis is:
a. ectopic pregnancy
b. ruptured persisted follicle
c. threatened abortion
d. twisted ovarian cyst
e. pelvic abscess
Correct answer: a

129. CM. Causes of ectopic pregnancies includes:


a. IUD
b. tubal ciliary damage
c. blighted ovum
d. late fertilization
e. COC
Correct answer: b, d

130. CM. True statements about tubal pregnancy are:


a. prior tubal surgery is a risk factor
b. prior tubal pregnancy is a risk factor
c. prior PID/Chlamydia infection is the most frequent cause
20
d. IUD predisposes to tubal pregnancy
e. COC predisposes to tubal pregnancy
Correct answer: a, b, c, d

131. CS. Ectopic pregnancy is most commonly associated with:


a. endometriosis
b. congenital tubal anomalies
c. tuberculosis
d. tubal inflammatory diseases
e. retroverted uterus
Correct answer: d

132. CM. Most common manifestations of ruptured ectopic pregnancy includes:


a. vomiting
b. vaginal bleeding
c. abdominal pain
d. headache
e. fainting
Correct answer: a, b, c, e

133. CM. In which part of fallopian tube ectopic pregnancy will have longest survival:
a. isthmus
b. ampulla
c. cornua
d. interstitium
e. fimbria
Correct answer: d

134. CS. In ectopic pregnancy decidua is shed as:


a. decidua vera
b. decidua basalis
c. decidua capsularis
d. decidua rubra
e. decidua parietalis
Correct answer: a

135. CM. Modern diagnostic aids to diagnose ectopic pregnancy includes:


a. HCG
b. transvaginal USG
c. AFP
d. gravindex
e. culdocentesis
Correct answer: a, b

136. CM. Most important investigation for ectopic pregnancy:


a. trans-vaginal USG
b. serial βHCG levels
c. Doppler USG
d. progesterone
e. culdocentesis
Correct answer: a, b

137. CS. Most valuable diagnostic test in case of suspected ectopic pregnancy:
21
a. serial βHCG levels
b. transvaginal USG
c. progesterone measurement
d. culdocentesis
e. AFP measurement
Correct answer: b

138. CM. True statements regarding ectopic pregnancy are:


a. serum progesterone >25mg/ml exclude ectopic
b. βHCG levels should be >1000mIU/ml for earliest detection by TVS
c. βHCG levels should be <1000mIU/ml for earliest detection by TVS
d. methotrexate is used for treatment
e. βHCG double in 48hr
Correct answer: a, b, d

139. CM.True about ectopic pregnancy:


a. transvaginal USG is the imaging test of choice
b. associated with decidual reaction
c. doppler is of no significance
d. in ectopic pregnancy interstitial ring sign is seen
e. HCG level is sufficient for diagnosis
Correct answer: a, b, d

140. CM. In which of the following conditions, the medical treatment of Ectopic pregnancy is
contraindicated:
a. sac size is 3 cm
b. blood in pelvis is 70 ml
c. presence of fetal heart activity
d. previous ectopic pregnancy
e. hCG >1500mIU/ml
Correct answer: c, e

141. CS. A hemodynamically stable nulliparous patient with ectopic pregnancy has adnexal
mass 2.5x3cms and a Beta HCG titer of 1500 miu/ml. What modality of treatment is suitable
for her:
a. conservative management
b. medical management
c. laparoscopic surgery
d. laparotomy
e. repeat HCG after 48 hrs
Correct answer: b

142. CS. A female has a history of 6 weeks amenorrhea, USG shows empty sac, serum βhCG
6500IU/L. What would be next management:
a. medical management
b. repeat HCG after 48 hrs
c. repeat HCG after 1 week
d. surgical management
e. conservative management
Correct answer: a

22
143. CS. A 20year-old woman has been brought to casualty with severe abdominal pain, BP
70/40 mm Hg, pulse rate 120/min and a positive urine pregnancy test. She should be managed
by:
a. immediate laparotomy
b. laparoscopy
c. culdocentesis
d. resuscitation and Medical management
e. conservative management
Correct answer: a

144. CS. Which of the following methods of treatment is not done in ectopic pregnancy:
a. salpingectomy
b. salpingo-oophorectomy
c. salpingostomy
d. resection of involved segment
e. salpingotomy
Correct answer: b

145. CS.Management of unruptured tubal pregnancy includes:


a. methotrexate
b. prostaglandins
c. hysterectomy
d. laparoscopic salpingostomy
e. salpingectomy
Correct answer: a, d, e

146. CS. Which statement is not true about ectopic pregnancy:


a. previous ectopic is greatest risk
b. COC increase risk
c. increased risk with pelvic infections
d. increased risk with IVF
e. IUD use increases the risk
Correct answer: b

147. CS. A 22 old, sexually active female presents with 8 weeks amenorrhea and severe pain
in left lower abdomen. On USG, there was a thick endometrium with a mass in lateral adnexa.
The most probable diagnosis is:
a. ectopic pregnancy
b. torsion of dermoid cyst
c. tubo-ovarian mass
d. hydrosalpinx
e. ruptured ovarian cyst
Correct answer: a

148. CM. Diagnostic methods not useful in case of tubal pregnancy:


a. pelvic examination
b. USG
c. HCG
d. hysterosalpingography
e. hysterocontrastoscopy
Correct answer: d, e

23
149. CS. What is the treatment of choice of un-ruptured tubal pregnancy with serum b-HCG
titer of 2000 IU/ml:
a. single dose of methotrexate
b. variable doses of methotrexate
c. expectant management
d. laparoscopic salpingostomy
e. laparotomy
Correct answer: a

150. CS. Diagnostic criteria for primary abdominal pregnancy:


a. Spigelberg criteria
b. Rubin’s criteria
c. Studdiford criteria
d. Wrigly criteria
e. Friedrich criteria
Correct answer: c

151.CS A 35-year-old woman presents with infertility and palpable pelvic mass. Her CA-125
level is 90 mIU/ml . Diagnosis is:
a. ovarian ca
b. endometrioma
c. tuberculosis
d. borderline ovarian tumor
e. ectopic pregnancy
Correct answer: b

152.CM Treatment of endometriosis include:


a. medroxyprogesterone acetate
b. iibolone
c. OCP
d. danazol
e. methotrexate
Correct answer: a, b, c, d

153.CM Treatment of endometriosis include:


a. estrogen
b. progesterone
c. OCP
d. danazol
e. GnRH
Correct answear: b, c, d, e

154.CM Drugs used in endometriosis are:


a. testosterone
b. danazol
c. GnRH
d. progesterone
e. estrogen
Correct answear: b, c, d

155.CS Best investigation to establish the diagnosis of endometriosis is:


a. laparoscopy
b. USG
24
c. X-ray
d. CT scan
e. seric hormone
Correct answear: a

156. CS True statement regarding adenomiosis is:


a. most common in nullipara
b. progestin are agents of choice for medical management
c. presents with menorrhagia, dysmenorrhea, and an enlarged uterus
d. more common in young women
e. hormone independent disease
Correct answear: c

157.CM Drugs for treatment of primary dysmenorrhea are:


a. bromocriptine
b. ibuprofen
c. mefenamic acid
d. norethisterone and ethinyl estradiol
e. estrogen
Correct answear: b, c, d

158. CS A 20-year-old woman gives a history of sharp pain in the lower abdomen for 2-3
days every month approximately 2 weeks before the menses. The most probable etiology for
her pain is:
a. endometriosis
b. dysmenorrhea
c. pelvic tuberculosis
d. mittelschmerz
e. PID
Correct answear: d

159.CS. Which is the treatment of choice for premenstrual syndrome?


a. SSRI
b. progesterone
c. estrogens
d. anxiolytics
e. tamoxifen
Correct answear: a

160.CS Which of the following is NOT recommended for management of cyclic mastalgia is:
a. evening primrose oil
b. danazol
c. tamoxifen
d. estrogen
e. oxytocine
Correct answear: d

161. CS Hysteroscopy means visualization of:


a. genital tract
a. fallopian tube
b. uterine cavity
c. cervix
d. abdominal cavity
25
Correct answer: c

162. CM For hysteroscopy, following insufflation media are used:


a. distilled water
a. air
b. glycine
c. CO2
d. O2
Correct answer: c, d

163. CM Hysteroscopy can diagnose:


a. Asherman’s syndrome
a. septate uterus
b. adenomyosis
c. TB endometritis
d. pregnancy
Correct answer: a, b, d

164.CM. Hysteroscopy is used in evaluation and treatment of:


a. uterine synechiae
a. abnormal vaginal bleeding
b. infertility
c. recurrent still birth and abortions
d. PID
Correct answer: a, b, c

165.CM Asherman’s syndrome can be diagnosed by:


a. hysterosalpingography
a. saline sonography
b. endometrial culture
c. hysteroscopy
d. bimanual examination
Correct answer: a, b, d.

166.CS Best gas used for creating pneumoperitonium at laparoscopy is:


a. N2
a. O2
b. CO2
c. N2O
d. O3
Correct answer: c

167. CS Laparoscopy is contraindicated in:


a. ectopic pregnancy
a. PID
b. endometriosis
c. peritonitis
d. genital endometriosis
Correct answer: d

168.CM Occurrence of ovulation is indicated by:


a. LH
a. FSH
26
b. estradiol
c. progesterone
d. cortisol
Correct answer: a, d

169. CS Which of the following methods for assessment of female infertility can best predict
timing of ovulation:
a. BBT
a. Fern Test
b. spin barkeit phenomenon
c. LH
d. vaginal secretion
Correct answer: d

170. CS Best indicator of ovarian reserve is:


a. FSH
a. estradiol
b. LH
c. FSH/LH ratio
d. progesterone
Correct answer: a

171. CS Luteal phase defect is best diagnosed by:


a. serum progesterone levels
a. endometrial biopsy
b. basal body temperature
c. ultrasonography
d. serum estradiol
Correct answer: c

172.CM The following are advantages of vaginal hysterectomy over abdominal hysterectomy:
a. better tolerated by elderly and obese patients
a. lower risk of post operative thrombo embolism
b. other visceral structures can be easily visualized
c. corrects prolapse of other organs
d. lower risk of p/o infections
Correct answer: a, b, d

173. CS Transcervical endometrial resection is used in :


a. endometriosis
b. DUB
c. carcinoma endometrium
d. Submucous fibroid
e. asherman syndrome
Correct answer: b

174. CM True statements regarding outpacient hysteroscopy aret:


a. abnormal uterine bleeding is an indication
b. normal saline as distension medium can be used
c. it is less accurate than saline infusion sonography
d. it is not reliable to exclude endometrial carcinoma
e. abnormal uterine bleeding is not an indication
Correct answer: a, b, d
27
175. CM To minimize ureteric damage, the following preoperative and operative precautions
may be taken:
a. cystoscopy
b. direct visualization during surgery
c. ureter should not be dissected off the peritoneum for a long distance
d. bladder should be pushed downwards and outwards while the clamps are placed near the
angles of vagina
e. ureter should be dissected off the peritoneum for a long distance
Correct answer: b, c, d

176.CM Indications of rectal examination in gynecology are:


a. in cases with mullerian agenesis
b. in virgin females
c. to differentiate rectocele from enterocele
d. for staging of ovarian malignancy
e. in cases of recto-vaginal fistula
Correct answer: a, b, c

177.CM The advantages of cryosurgery over electrocauterization are:


a. less discomfort to the patient
b. postoperative bleeding is much less
c. postoperative vaginal discharge is also much less
d. cervical stenosis is extremely rare
e. there is no advantage
Correct answer: a, b, d

178. CM Exploratory puncture of posterior fornix of vagina is performed in the differential


diagnosis of:
a. ectopic pregnancy
b. submucosal uterine myoma
c. adnexal inflammatory processes
d. spontaneous miscarriage
e. appendicitis
Correct answer: a, c

179. CM What are the curative indications for performing the endometrial curettage:
a. to stop uterine haemorrhages
b. to destroy intrauterine synaechiae
c. to remove the gestational sac and its fragments
d. to remove intrauterine devices
e. to diagnose tuberculous endometritis
Correct answer: a, b, c, d

180.CM What complications could possibly arise when performing the endometrial curettage:
A. uterine perforation
B. secondary amenorrhea
C. pseudo-ducts formation
D. uterine prolapse
E. dyspareunia
Correct answer: a, b, c

181. CM Endoscopic methods of investigation used in gynaecology are the following:


28
A. colposcopy
B. colonoscopy
C. culdoscopy
D. hysteroscopy
E. laparoscopy
Correct answer: a, c, d, e

182. CM Which solutions are used during the detailed colposcopy?:


a. 3% Lugol solution
b. KMnO4 solution
c. 3% Acetic acid solution
d. 6% H2O2 solution
e. 0.9% NaCl solution
Correct answer: a, c

183. CM The following pathological conditions can be diagnosed with the use of
hysteroscopy:
a. endometrial polyp
b. ectopic pregnancy
c. submucosal uterine myoma
d. endometrial hyperplasia
e. intramural myoma
Correct answer: a, c, d

184. CM What are the indications for diagnostic hysteroscopy:


a. uterine haemorrhages of unknown origin
b. infertility of unknown origin
c. determination of the uterine scar status
d. examination of the amniotic fluid
e. diagnosis of adenomyosis
Correct answer: a, b, c

185. CM What are the indications for emergency laparoscopy:


a. ectopic pregnancy
b. ovarian apoplexy
c. suspected uterine perforation
d. genital endometriosis
e. distortion of subserosal fibroid
Correct answer: a, b, c, e.

186. CM What are the indications for elective laparoscopy:


a. tubo-peritoneal infertility
b. genital endometriosis
c. polycystic ovary syndrome
d. ovarian apoplexy
e. ectopic pregnancy
Correct answer: a, b, c

187.CM Absolute contraindications for laparoscopy are the following:


a. terminal patient
b. sepsic shock
c. haemorrhagic shock
d. adhesions in the pelvic cavity
29
e. obesity
Correct answer: a, b, c

188.CS Imaging investigation method most frequently used in obstetrics and gynaecology is:
a. hysterosalpingography
b. radiopelvigraphy with double contrast
c. echography
d. X-ray examination
e. CT
Correct answer: c

189.CM What should be avoided for the purpose of conducting a cytological examination:
a. sexual intercourses 24-48 h prior to the examination
b. intravaginal treatment
c. menstruation period
d. manual examination prior to the procedure
e. specula examination
Correct answer: a, b, c, d

190.CM What are the indications for the fractional dilation and curettage:
a. endometrial or cervical canal cancer suspicion
b. cervical canal polyp
c. menopausal haemorrhages
d. pregnancy suspicion
e. adenomyosis
Correct answer: a, b, c

191. CS. Small for gestational age fetus is defined when:


a. birth weight is below the tenth percentile of the average of gestational age
b. birth weight is below the 20 percentile of the average of gestational age
c. birth weight is below the 30 percentile of the average of gestational age
d. weight of baby is less than 1000 gm
e. weight of the baby is less than 1500 gn
Correct answer: a.

192. CM. IUGR is seen in:


a. rubella
b. syphilis
c. CMV
d. chicken pox
e. HPV
Correct answer: a, b, c, d

193. CM. IUGR is characterized by all EXCEPT:


a. polycythemia
b. meconium aspiration syndrome
c. RDS
d. hypocalcemia
e. decreased abdominal circumference
Correct answer: c

194.CM. True statements about symmetrical IUGR with respect to asymmetrical IUGR:
a. worse prognosis
30
b. neurological defects
c. head larger than abdomen
d. less common
e. total number of cells is normal
Correct answer: a, d.

195.CM. IUGR can be detected by USG by:


a. ↓Fetal weigh
b. ↓BPD
c. ↑HC/AC
d. ↓Head circumference
e. ↑Amniotic fluid volume
Correct answer: a, b, c, d

196.CS. Best parameter for ultrasound evaluation of IUGR is:


a. placental membrane
b. length of femur
c. abdominal circumference
d. BPD
e. head circumference
Correct answer: c

197. CS. Birth weight of a baby can be increased by:


a. cessation of smoking
b. aspirin
c. Ca and vitamin D supplementation
d. bed rest
e. O2 therapy
Correct answer: a

198. CS. A large baby is born with which complication in pregnancy:


a. gestational diabetes
b. gestational hypertension
c. cardiac disease
d. anaemia
e. hepatosis of pregnancy
Correct answer: a

199. CS.Caudal regression syndrome is seen in babies of mother having:


a. PIH
b. cardiac disease
c. anaemia
d. gestational diabetes
e. hepatosis of pregnancy
Correct answer: d

200. CM. Hipoglycemia in new born is commonly seen in:


a. IUGR
b. mother with hypothyroidism
c. Rh incompatibility
d. macrosomia
e. hiperthyroidism
Correct answer: a, d.
31
201. CM. Intrauterine fetal distress is indicated by:
a. acceleration of 15/min
b. deceleration of 30/min
c. variable deceleration 5-25/min
d. fetal HR<80/min
e. fetal HR 160-180/min
Correct answer: b, c, d, e

202. CS. A pregnant lady with persistent late, variable decelerations with cervical dilatation of
6 cm shifted to operational theatre for surgery. Which of the following is not done in
management:
a. supine position
b. O2 inhalation
c. I.V. fluids
d. subcutaneous terbutaline
e. oxytocin stopped
Correct answer: a

203. CS. Which is not done in case of IUGR?


a. non stress test
b. oxytocin challenge test
c. ultrasound biometry
d. amniocentesis
e. doppler studies
Correct answer: b

204. CM. True statements regarding IUGR are:


a. abdominal circumference (AC) is the least sensitive parameter for detection of IUGR
b. in asymmetric IUGR head circumference/abdominal circumference(HC/AC) is reduced
c. serial biparietal diameter (BPD) is the only important measurement in IUGR
d. AC indirectly reflects fetal liver size and glycogen storage
e. amniotic liquid volume is reduced
Correct answer: d, e

205. CS. All are the risk factors associated with macrosomia, EXCEPT:
a. maternal obesity
b. prolonged pregnancy
c. previous large infant
d. short stature
e. diabetes
Correct answer: d

206. CM. Macrosomia is associated with:


a. gestational diabetes mellitus
b. maternal obesity
c. hipothyroidism
d. hyperbilirubinemia
e. preeclampsia
Correct answer: a, b

207. CS. A baseline bradicardia of fetal heart:


a. is a safe pattern
32
b. is a pattern which indicates an increased risk of fetal distress
c. indicates severe fetal distress
d. is usually caused by infection of the placenta and membranes
e. it is usually caused by temporary compression of umbilical cord
Correct answer: c
208. CS. Oligohydramnios can be defined as an amniotic fluid index of less than:
a. 10 cm
b. 7 cm
c. 6 cm
d. 5 cm
e. 2 cm
Correct answer: d
209. CS. A reactive non-stress is considered when:
a. a late acceleration is observed after each contraction
b. a late acceleration is observed only once
c. a late deceleration is observed after each contraction
d. at least two accelerations of fetal heart rate of 15 beats or more above the baseline or at
least 15 seconds are observed during 20 minutes
e. an acceleration of fetal heart rate of 15 beats or more above the baseline for at least 15
seconds is observed is observed during 20 minutes
Correct answer: d

210.CS. Normal fetal scalp pH is considered


a. 7.35-7.45
b. 7.25-7.35
c. 7.10-7.20
d. 7.00-7.10
e. 6.90-7.00
Correct answer: b

211. CM. What are the correct methods of intrauterine resuscitation?


a. suppressing uterine contractions and decreasing the uterine tone
b. administering oxygen to the fetus by means of an intrauterine catheter
c. infusing oxytocin in order to stimulate uterine contractions
d. rubbing the patient’s nipples so as to stimulate uterine contractions
e. turning the woman to lateral position and avoiding supine position
Correct answer: a, e
212. CM. How should the fetal heart rate be monitored in labor?
a. a cardiotocograph (CTG) should be used in high risk labors
b. in low risk pregnancies a fetal stethoscope is adequate
c. a doptone should be used in all high risk pregnancies
d. the fetal heart rate does not need to be monitored in all low risk pregnancies
e. if admission CTG is normal, fetal heart rate should not be monitored in labor
Correct answer: a, b.
213. CM Biophysical profile includes the following components:
a. fetal respiratory movements
b. motor activity and fetal muscular tone
c. level of chorionic gonadotropin in urine
d. amniotic fluid volume
e. non-stress CTG test
33
Correct answer: a, b, d, e
214. CS. Oligohydramnios can be defined as a maximum vertical pocket of amniotic fluid of
less than:
a. 10 cm
b. 7 cm
c. 6 cm
d. 5 cm
e. 2 cm
Correct answer: e

215. CM. Indications for induction of labour are:


a. placenta previa
b. prolonged pregnancy
c. heart disease at term
d. breech
e. intrauterine fetal death
Correct answer: b, e

216. CM. Contraindications for induction of labour are:


a. severe hydrocephalus
b. contracted pelvis
c. uterine scar
d. transverse lie
e. cephalic presentation
Correct answer: a, b, c, d

217. CS. In Bishop score all are included EXCEPT:


a. effacement of cervix
b. dilation of cervix
c. station of head
d. interspinal diameter
e. position of cervix
Correct answer: d

218. CM. Bishop's score includes:


a. dilation of cervix
b. effacement
c. cervical softening
d. condition of os
e. position of head
Correct answer: a ,b, c, e

219. CM. All of the following are used for induction of labour:
a. PG F2 α tablet
b. PG E1 tablet
c. PG E2 gel
d. misoprostol
e. mifepristone
Correct answer: b, c , d, e

220. CM. Indicate the drugs used for cervical ripening:


a. prostaglandin E2
34
b. ritodrine
c. progesterone
d. misoprostol
e. atropine
Correct answer: a, d

221. CM. Artificial rupture of membranes is contraindicated in:


a. placenta previa marginalis
b. HIV infected
c. genital active herpes infection
d. twins
e. vasa previa
Correct answer: b, c, e

222. CM. Which of the following methods for induction of labour should not be used in
patient with previous lower segment caesarean section:
a. prostaglandin gel
b. prostaglandin tablet
c. stripping of the membrane
d. oxytocin
e. misoprostol
Correct answer: a, b, e

223. CM. Which cardinal movement occur during labour:


a. flexion
b. extension
c. internal rotation
d. descent
e. asynclitisms
Correct answer: a, b, c, d

224. CM. Duration of latent phase of labour is affected by:


a. early use of conduction anaesthesia
b. unripe cervix
c. hypertonic uterine contraction
d. pre-eclampsia
e. excessive sedation
Correct answer: a, b, e

225. CS. A female at 37 weeks of gestation has mild labour pains for 10 hours and cervix is
persistently 1 cm dilated but not effaced. What will be the next appropriate management?
a. sedation and wait
b. augmentation with oxytocin
c. cesarean section
d. amniotomy
e. augmentation with prostaglandins
Correct answer: a

226. CM. Commonest causes of non – engagement at term, in primipara are:


a. CPD
b. hydramnios
c. brow presentation
d. breech
35
e. occipitoposterior position
Correct answer: a, e

227. CM. Which is not included in Active management of III stage of labour?
a. uterotonic within 1 minute of delivery
b. immediate clamping, cutting and ligation of cord
c. gentle massage of the uterus
d. controlled cord traction
e. spasmolytic within 1 minute of delivery
Correct answer: b, e

228. CS. During active labour average cervical dilation per hour in primipara is :
a. 1.2 cms
b. 1.5 cms
c. 1.7 cms
d. 2 cms
e. 0,5 cms
Correct answer: a

229. CS. Ritgen maneuver is done in:


a. shoulder dystocia
b. for delivery of head in breech presentation
c. for delivery of legs in breech
d. for delivery of head in normal labour
e. for delivery of hands in breech presentation
Correct answer: d

230. CM. What it is true about origin and propagation of contractions:


a. the right pacemaker predominates over left
b. intensity of propagation is greatest at cervix
c. the contraction spreads from pacemaker towards cervix
d. speed of contraction is 2 cm/sec
e. intensity is greatest in the lower segment of the uterus
Correct answer: a, c, d

231.CS. During the active phase of labour, the minimum effective dilation of the cervix in
primigravida should be at the rate of :
a. 0.5 cm/hour
b. 1 cm/hour
c. 1.5 cm/hour
d. 2 cm/hour
e. 2,5 cm/hour
Correct answer: a

232. CM. Factors which help in descent of the presenting part during labour are:
a. uterine contraction and retraction
b. straightening of the fetal axis
c. bearing down efforts
d. resistance from the pelvic floor
e. uterine atonia
Correct answer: a, b, c

36
233. CM. True statement concerning active phase of labour:
a. starts when the cervix is 3-5 cms dilated
b. cervix dilates at the rate of 0.35-0,4 cms/hour
c. epidural analgesia slows the progress
d. oxytocin should not be used
e. fetal malposition slows the active phase of labor
Correct answer: a, d

234. CS The latent phase of the first stage of labour is:


a. the period of time the cervix takes to dilate from 3 cm to full dilatation
b. the period of time from the onset of labour to full dilatation
c. the period of time from the onset of labour to 3 cm cervical dilatation
d. the period of time the cervix takes to dilate from 3 cm to 8 cm dilatation
e. the period of time after full dilatation
Correct answer: c

235. CS. What is the name given to the first oblique line on the partogram?
a. the action line
b. the alert line
c. the normal cervical dilation line
d. the danger line
e. the average line
Correct answer: b

236.CS. What is the name given to the second oblique line on the partogram?
a. the action line
b. the alert line
c. the normal cervical dilation line
d. the danger line
e. the transition line
Correct answer: a

237. CS. How often should the fetal heart rate be monitored during the first stage of labor in
low risk pregnancies?
a. every 3 hours during the latent phase
b. every 2 hours in the latent phase
c. hourly in the active phase
d. every 30 minutes in the active phase
e. every 15 minutes in the active phase
Correct answer: d

238. CS. Meconium staining of the liquor is commonest in:


a. patients with postterm labor
b. patients in term labor
c. patients in preterm labor
d. patients whose fetuses move a lot during pregnancy
e. patients with fetuses > 4000 gr
Correct answer: a

239. CS. Meconium staining of the liquor:


a. is uncommon
b. occurs in 10-20 % of patients
c. occurs in 30-40% of patients
37
d. occurs in half of patients
e. occurs in most patients
Correct answer: b

240. CS. What is the correct management when the liquor is meconium stained?
a. monitor the fetal heart rate carefully
b. deliver the fetus immediately by cesarean section
c. give the patient an oxitocin infusion to shorten the labor
d. give tocolitics
e. administer antibiotics
Correct answer: a

241.CS. The latent phase of the first stage of labor is:


a. the period of time the cervix takes to dilate from 3 cm to full dilatation
b. the period of time from the onset of labor to full cervical dilatation
c. the period of time from the onset of labor to 3 cm cervical dilatation
d. the period of time during which the cervix becomes effaced
e. the period of time during which the cervix becomes ripen.
Correct answer: c

242.CS. A patient presents in established labor with regular contractions. On vaginal


examination the cervix is 5 cm dilated. Where her cervical dilatation should be noted on the
partogram?
a. on the alert line opposite 5 cm cervical dilatation
b. on the action line opposite 5 cm cervical dilatation
c. at the beginning of the latent phase of labor opposite 5 cm cervical dilatation
d. at the end of latent phase of labor opposite 5 cm cervical dilatation
e. on the vertical line at the beginning of the active phase of labor opposite 5 cm cervical
dilatation
Correct answer: a

243. CS. When does a patient have adequate and effective uterine contractions?
a. if she has 2 or more contractions every 10 minutes with each contraction lasting 30
seconds or longer
b. if she has 3 or more contractions every 10 minutes with each contraction lasting 60
seconds or longer
c. if she progresses normally during labor
d. if she has pain with every contraction
e. if the uterus is relaxed between each contraction
Correct answer: c

244. CS. Cephalo-pelvic disproportion due to a small pelvic inlet should be diagnosed when:
a. there is no further dilatation of the cervix
b. there is 3/5 or more of the fetal head palpable above the pelvic brim and 2+ or more
moulding is present
c. there is 2/5 or less of the fetal head palpable above the pelvic brim and 1+ moulding is
present
d. the measurement of pelvic inlet are assessed as small during a pelvic examination
e. one hour passed after full dilatation
Correct answer: b
38
245. CS. When does the second stage of labor begin and end?
a. from the time the patient has an urge to bear down until the infant is completely delivered
b. from the time the cervix is fully dilated until the infant is completely delivered
c. from the beginning of the active phase until the cervix is fully dilated
d. from the beginning of the active phase until the infant is completely delivered.
e. from the time the cervix is fully dilated until delivery of the fetus and placenta
Correct answer: b

246.CS. What position in the second stage of labor should be discouraged


a. the dorsal position
b. the lateral position
c. the squatting position
d. the sitting position (in the special chair)
e. the kneeling position
Correct answer: a

247. CS. The active phase of the first stage of labor is:
a. the period of time the cervix takes to dilate from 3 cm to full dilatation
b. the period of time from the onset of labor to full cervical dilatation
c. the period of time from the onset of labor to 3 cm cervical dilatation
d. the period of time during which the cervix becomes effaced
e. the period of time during which the cervix becomes ripen
Correct answer: a

248. CS. The third stage of labour starts when:


a. the cervix is dilated to 3 cm
b. the cervix is fully dilated
c. the anterior shoulder of the infant is delivered
d. the infant is born
e. the placenta is delivered
Correct answer: d

249.CM. What positions in the second stage of labor should be encouraged:


a. the dorsal position
b. the lateral position
c. the squatting position
d. the sitting position (in the special chair)
e. the kneeling position
Correct answer: b, c, d, e

250. CM A pregnant woman diagnosed with idiopathic cholestasis of pregnancy. This


condition is associated with:
a. intense itching
b. 10-100 fold increase in cholic acid followed by chenodoxycholic acid
c. serum indirect bilirubin is increased
d. increase levels of alkaline phosphatase
e. dyslipidemia is present
Correct answer: a, b, d, e

251.CM. Best diagnostic tests for cholestasis of pregnancy is to determine the level of:
39
a. serum bilirubin
b. bile acid
c. serum alkaline phosphatase
d. serum transaminase
e. urine acetone
Correct answer: b, d

252. CM. True statements about idiopathic cholestasis of pregnancy are:


a. deep jaundice is present
b. pruritus is the first symptom
c. maximum incidence during iii trimester
d. increase liver transaminase
e. hepatic necrosis present
Correct answer: b, c, d

253. CM. Cholestasis of pregnancy is characterized by:


a. commonly occur in 1st trimester of pregnancy
b. increased maternal mortality
c. increased perinatal mortality
d. recurrence in subsequent pregnancy
e. generalized pruritus
Correct answer: c, d, e

254. CM. True statements regarding cholestasis in pregnancy are:


a. recurs in subsequent pregnancy
b. ursodeoxyholic acid relieves pruritus
c. mild jaundice occurs in majority of patients
d. pruritus may precedes laboratory findings
e. serum alkaline phosphatase is most sensitive indicator
Correct answer: a, b, c, d

255. CM. Treatment of Intrahepatic cholestasis of pregnancy consists of:


a. folic acid
b. ursodeoxycholic acid (UDCA)
c. dexametason
d. vitamin E
e. penicillin
Correct answer: b, c

256. CM. Which is true about fatty liver of pregnancy?


a. common in third trimester
b. micro-vesicular fatty changes
c. lysosomal injury is the cause
d. recurrence is very common
e. alcohol is the main cause
Correct answer: a, b

257. CS. Highest transmission of hepatitis B from mother to fetus occurs if the mother is
infected during:
st
a. 1 trimester
b. 2nd trimester
c. 3rd trimester
40
d. at the time of implantation
e. during delivery
Correct answer: e

258. CS. A pregnant woman is HbsAg positive and anti Hbe Ag positive. Risk of
transmission of Hepatitis B in child is:
a. 20%
b. 50%
c. 0
d. 90%
e. 70%
Correct answer: a

259. CS. A pregnant woman is diagnosed to be HBs Ag positive. Which of the following is
the best way to prevent infection to the child?
a. hepatitis vaccine to the child
b. full course of hepatitis B vaccine and immunoglobulin to the child
c. hepatitis B immunoglobulin to the mother
d. hepatitis B immunization to mother
e. breastfeeding is contraindicated
Correct answer: b

260. CM. Which of the following statements concerning viral hepatitis in pregnancy are true?
a. hepatitis B core antigen status is the most sensitive indicator of positive vertical
transmission of the disease
b. hepatitis B is the most common form of hepatitis after blood transfusion
c. the proper treatment of infants born to infected mothers includes the administration of
hepatitis B immunoglobulin as well as vaccine
d. patients who develop chronic active hepatitis are an increased risk of fetal malformations
e. hepatitis B is not a contraindication for breastfeeding
Correct answer: c, e

261. CM. What are recommendations for pregnancy termination in case of Hyperemesis
Gravidarum:
a. increased acetone in urine
b. decreased renal output
c. vomiting is more than 3 months
d. gradually increasing oliguria and proteinuria
e. neurological complications
Correct answer: b, d, e

262. CS. A 26-year-old woman in the 1st trimester of pregnancy has been admitted with
retching and repeated vomiting with large hematemesis. Her pulse rate is 126/minute and
systolic blood pressure is 80 mm Hg. The most likely diagnosis is:
a. mallory-weiss syndrome
b. bleeding from esophageal varices
c. peptic ulcer
d. hiatus hernia
e. appendicitis
Correct answer: a

41
263. CM. In a female with appendicitis in pregnancy treatment of choice is:
a. surgery at earliest
b. abortion with appendectomy
c. surgery after delivery
d. before 20 weeks is recommended laparoscopy
e. after 20 weeks is recommended laparotomy (incision should be made at Mc Burnay Point)
Correct answer: a, d, e.

264. CS. Which of the following is normally present in urine of a pregnant woman in 3rd
trimester?
a. glucose
b. fructose
c. galactose
d. lactose
e. maltose
Correct answer: a

265. CS. All of the following conditions are risk factors for urinary tract infections in
pregnancy EXCEPT:
a. diabetes
b. hypertension
c. sickle cell anemia
d. vesico-ureteral reflux
e. calculi
Correct answer: b

266. CM. Following antibiotics are safe to treat UTI in the 3-rd trimester of pregnancy:
a. erythromycin
b. ampicillin
c. co-trimoxazole
d. ciprofloxacin
e. cephalosporin
Correct answer: b, e

267. CM. True statements about asymptomatic bacteriuria in pregnancy:


a. incidence is up to 8 %
b. if untreated, progresses to pyelonephritis
c. early and prompt treatment prevents malformations in fetus
d. increase chance of premature infant
e. increase risk of small for gestational age fetus
Correct answer: a, b, d, e.

268. CS. With regards to acute pyelonephritis in pregnancy all of the following are true,
EXCEPT:
a. pregnancy decrease the risk
b. most common isolate is e. coli
c. higher incidence in the second half of pregnancy
d. responds to amino glycosides
e. more common in primigravida and young females
Correct answer: a

269. CS. A lady with 10-12 weeks of pregnancy develops acute retention of urine. The likely
cause is:
42
a. retroverted uterus
b. urinary tract infection
c. prolapse uterus
d. fibroid
e. cystitis
Correct answer: a

270. CS. A 25-year-old primigravida at 20 weeks of pregnancy has the first episode of an
asymptomatic bacteriuria. The risk of having pyelonephritis is:
a. no risk with first episode
b. less than 5%
c. 15%
d. 25%
e. more than 50%
Correct answer: d

271. CS. Antibiotic of choice for urinary tract infection (UTI) during pregnancy in the third
trimester is:
a. cephalosporins
b. quinolones
c. Co-trimoxazole
d. tetracyclines
e. penicillins
Correct answer: a

272. CM. Which statements are correct regarding asymptomatic bacteriuria during pregnancy:
a. bacterial count is over 10^5/ml
b. overall incidence is 5-10%
c. it should be treated with appropriate antimicrobial agent
d. risk of progression to pyelonephritis, if left untreated is rare
e. bacterial count is over 10^3/ml
Correct answer: a, b, c

273. CS. The best marker for neural tube defect is:
a. acetylglucosonidase
b. acetylcholinesterase
c. alpha-fetoprotein
d. chorionic gonadotrophin
e. lactatdehidrogenase.
Correct answer: b

274. CS. Which one of the following biochemical parameters is the most sensitive to detect
open spina bifida :
a. maternal serum alpha-fetoprotein
b. amniotic fluid alpha-fetoprotein
c. amniotic fluid acetylcholinesterase
d. amniotic fluid glucohexaminase
e. amniotic fluid chorionic gonadotrophin
Correct answer: c

275. CS. Hydrocephaly is best detected antenataly by:


a. X-ray abdomen
b. amniocentesis
43
c. clinical examination
d. ultrasonography
e. blood examination
Correct answer: d

276. CM. Which of the following is associated with hydrocephaly:


a. diabetes mellitus
b. pre-eclampsia
c. abruptio placentae
d. breech presentation
e. spina bifida
Correct answer: a, d, e

277. CS. Preconceptional intake of which of the following results in decreased incidence of
neural tube defect:
a. vitamin A
b. folic acid
c. vitamin E
d. vitamin C
e. vitamin B1
Correct answer: b

278. CS. Anencephaly is best diagnosed using:


a. maternal serum alpha-fetoprotein
b. amniotic fluid alpha-fetoprotein
c. USG
d. X-ray
e. amniotic fluid chorionic gonadotrophin
Correct answer: c

279. CS Most common type of twin pregnancy is:


a. vertex+transverse
b. both vertex
c. vertex+breech
d. both breech
e. breech+ transverse
Correct answer: b

280. CS Twin peak sign is seen in:


a. Monochorionic diamniotic
b. Dichorionic monoamniotic
c. Conjoined twins
d. Diamniotic dichorionic
e. None of above
Correct answer: d.
281.CS In multiple pregnancy, foetal reduction is done by:
a. KCl solution
b. mifepristone
c. PGF2-alpha
d. methotrexate
e. oxytocin

44
Correct answer: a

282.CM. Correct statements about establishing the chorionicity in twin pregnancy is:
a. same sex rule out dichorionicity
b. twin peak sign in dichorionicity
c. thick membrane is present in mono-chorionic twins
d. best detected after 16 weeks
e. best detected before 16 weeks
Correct answer: b, e

283.CS Which of the following statement about twinning is true?


a. The frequencies of monozygosity and disygosity are the same
b. Division after formation of the embryonic disk result in conjoined twins
c. The incidence of monozygotic twins varies with race
d. A dichorionic twin pregnancy always denotes dizygosity
e. Twinning causes no appreciable increase in maternal morbidity and mortality over
singleton pregnancies
Correct answer: b.

284.CS Monochorionic monoamniotic twin occurs if division occurs:


a. before 24 hours
b. 1-4 days
c. 4-8 days
d. >8 days
e. >10 days
Correct answer: d

285.CS. Conjoined twins occurs if division occurs:


a. before 24 hours
b. 1-4 days
c. 4-8 days
d. >8 days
e. >14 days
Correct answer: e

286. CS. A double headed monster is known as a:


a. diplopagus
b. dicephalus
c. craniophagus
d. heteropagus
e. toracophagus
Correct answer: b

287.CM. Twin pregnancy predisposes to:


a. hydramnios
b. pregnancy induces hypertension
c. malpresentation
d. prematurity
e. post-maturity
Correct answer: a, b, c, d

288.CM Indications of urgent delivery of the second baby in twins are:


a. abruption placentae
45
b. cord proplapse of the second baby
c. inadvertent use of iv oxytocine with the delivery of the anterior shoulder of the first baby
d. breech presentation of the second baby
e. pregnancy induced hypertension
Correct answer: a, b, c

289.CS Absolute proof of monozygosity is determined by:


a. DNA finger printing
b. intervening membrane layers
c. sex of the babies
d. reciprocal skin grafting
e. ultrasound
Correct answer: a

290.CS Embryo reduction of multiple pregnancy is done at:


a. 6-8 weeks
b. 9-12 weeks
c. 13-15 weeks
d. 16-18 weeks
e. 19-22 weeks
Correct answer: b

291. CS A pregnant woman with fibroid uterus develops acute pain in abdomen with low-
grade fever and mild leukocytosis at 28 weeks. The most likely diagnosis is:
a. preterm labor
b. torsion of fibroid
c. red degeneration of fibroid
d. infection in fibroid
e. hyaline degeneration
Correct answer: c

292. CM. True statements about red degeneration of myoma uteri are:
a. it occurs commonly during pregnancy
b. immediate surgical intervention is needed
c. caused by interference with blood supply
d. treated with analgesics
e. calcification is a frequent feature
Correct answer: a, c, d

293. CS Red degeneration in uterine fiboid is most common in:


a. second trimester
b. third trimester
c. puerperium
d. first trimester
e. intrapartum
Correct answer: a

294. CM Methods of treatment of myoma uteri are:


a. myomectomy
b. radiofrequency ablation
c. embolization of uterine artery
d. laser myomectomy
e. hysterectomy
46
Correct answer: a, c, d, e

295. CS A 29-year-old nulliparous women complains of severe menorrhagia and lower


abdominal pain during last 3 months. On examination there was a 14 weeks size uterus with
fundal fibroid. The treatment of choice is:
a. myomectomy
b. GnRH analogs
c. hysterectomy
d. wait and watch
e. embolization of uterine artery
Correct answer: a

296. CM. Uterine fibromyoma is associated with:


a. endometriosis
b. pelvic inflammatory disease
c. dysmenorrhea
d. amenorrhea
e. heavy menstrual bleeding
Correct answer: a, c, e

297. CM. Submucosal fibroid is detected by:


a. hysteroscopy
b. hystersalpingography
c. USG
d. laparascopy
e. manual examination
Correct answer: a, b, c

298. CM. Drugs which reduce the size of myoma are:


a. GnRH agonists
b. danazol
c. progesterone
d. mifepristone
e. estrogens
Correct answer: a, b, d

299. CM Preferred management options in a 26-year-old woman with 7x8cm size fibroid are:
a. follow-up
b. OCP
c. myomectomy
d. hysterectomy
e. danazol
Correct answer: a, c

300. CM True statements regarding fibroid uteri are:


a. estrogen dependent tumor
b. capsulated
c. can lead to red degeneration in pregnancy for which urgent surgery is required
d. danazol used in treatment
e. estrogen independent tumor
Correct answer: a, d

301. CS Malignant prevalence in uterine fibroids is:


47
a. 0.5%
b. 1%
c. 5%
d. 10%
e. 15%
Correct answer: a

302. CS Least common complication of uterine fibroids is:


a. menstrual disorder
b. malignancy
c. urinary retention
d. degeneration
e. torsion of fibroid
Correct answer: b

303. CS. Which condition is not associated with myoma uteri?


a. amenorrhea
b. pelvic mass
c. infertility
d. menstrual irregularity
e. dysmenorrhea
Correct answer: a

304. CS. What is the earliest most common presenting feature of anterior cervical fibroid:
a. urinary frequency
b. bleeding
c. acute abdomen
d. constipation
e. menstrual disorder
Correct answer: a

305. CM. The indications for myomectomy in the case of uterine fibroids are:
a. associated infertility
b. recurrent pregnancy loss
c. heavy menstrual bleeding
d. red degeneration
e. constipation
Correct answer: a, b, c

306. CS. External cephalic version is contraindicated in:


a. primigravida
b. flexed breech
c. anemia
d. PIH
e. twin pregnancy
Correct answer: d

307. CS.The complication associated with internal podalic version for transverse lie is:
a. uterine rupture
b. uterine atony
c. cervical laceration
d. vaginal laceration
e. rupture of membranes
48
Correct answer: a

308. CS. Ventuouse in 2nd stage of labour is contraindicated in:


a. persistent occipito-posterior position
b. heart disease
c. uterine inertia
d. preterm labour
e. myopia forte
Correct answer: d

309. CM. Contraindications for vacuum extraction are:


a. prematurity
b. brow presentation
c. fetal distress
d. floating head
e. undilated cervix
Correct answer: a, b, d, e

310. CS. Which statement is true regarding ventouse:


a. minor scalp abrasions and subgaleal hematomas in new born are more frequent than forceps
b. can be applied when foetal head is above the level of ischial spine
c. maternal trauma is more frequent than forceps
d. can not be used when fetal head is not fully rotated
e. can be applied when the membranes are intact
Correct answer: a

311. CM. True statements about vacuum extraction of the fetus are:
a. can be used in non dilated cervix
b. can not be used in incompletely dilated cervix
c. used in face presentation
d. applied 3 cm posterior to anterior fontanel
e. applied 3 cm anterior to posterior fontanel
Correct answer: b,e

312. CM. True statements about instrumental vaginal delivery are:


a. full cervical dilatation is the only pre-requisite
b. forceps is used in all cases of breech delivery
c. forceps may be used if ventouse fails
d. ventouse can not be used in rotatinal occipito-transverse-posterior delivery
e. can be applied when foetal head is above the level of ischial spine
Correct answer: c, d

313. CM. Outlet forceps means:


a. head at station "0"
b. full cervical dilatation
c. rupture of membrane
d. rotation >45
e. head with sutura sagitalis in antero-posterior diameter of outlet
Correct answer: b, c, e

314. CM. Which criteria for outlet forceps application are false :
a. fetus should be in vertex presentation
b. sagital suture should be less than 15 degrees from anterio posterior diameter
49
c. there should be no caput succedaneum
d. head should be at zero station
e. can not be used when fetal head is not fully rotated
Correct answer: b, c, d, e

315. CS. Complication not seen in outlet forceps is:


a. third degree perineal tear
b. vulvar hematoma
c. extension of episiotomy
d. cervical tear
e. labial laceration
Correct answer: d

316. CS. In heart disease prophylactic forceps is applied at the head station of:
a. -1
b. +1
c. 0
d. +2
e. – 2
Correct answer: d

317. CS. Forceps should not be used in:


a. twin delivery
b. hydrocephalus
c. post maturity
d. after coming head of breech
e. prematurity
Correct answer: b

318. CM. Indications for forceps delivery are:


a. mento-posterior face presentation
b. deep transverse arrest
c. eclampsia in 2-nd stage of labour
d. maternal heart disease
e. fetal distress
Correct answer: b, c, d, e

319. CS. Forceps delivery is done in all situations, EXCEPT:


a. mento-posterior face presentation
b. deep transverse arrest
c. after coming head in breach
d. maternal heart disease
e. fetal distress
Correct answer: a

320. CM. Which of the following statements are true for episiotomy?
a. should be performed routinely in primipara
b. can be either mild-line or mediolateral
c. involvement of anal sphincter is classified 3rd-4th degree perineal tear
d. mid-line episiotomies bleed less and are easier to repair
e. mid-line episiotomy heals more quickly
Correct answer: b, c, d, e

50
321. CS. All of the following statements are true for episiotomy, EXCEPT:
a. should be performed routinely in primipara
b. can be either mild-line or mediolateral
c. involvement of anal sphincter is more frequent with mid line
d. mid-line episiotomies bleed less and are easier to repair
e. mid-line episiotomy heals more quickly
Correct answer: a

322. CS. Perineal tear should be repaired:


a. 24 hrs later
b. 48 hrs later
c. 72 hrs later
d. immediately
e. the next day after birth
Correct answer: d

323. CM. Which of the following are always indications of cesarean section?
a. placenta abruption
b. untreated stage of i ca cervix
c. active primary genital herpes
d. central placenta previa
e. cehhalopelvic disproportion
Correct answer: b, c, d, e

324. CS. An absolute indication for LSCS in case of heart disease is:
a. coarctation of aorta
b. eisenmenger syndrome
c. Ebsteins anomaly
d. pulmonary stenosis
e. aortal stenosis
Correct answer: a

325. CS. Which of the following is not a contraindication of vaginal delivery after previous
Caesarean?
a. previous classical C/S
b. 2 previous C/S
c. breech presentation in previous pregnancy
d. puerperial infection in previous pregnancy
e. previous history of uterine rupture
Correct answer: c

326. CM. Which of the following are contraindications of vaginal delivery after previous
Caesarean?
a. previous classical C/S
b. no history of vaginal delivery in the past
c. breech presentation in previous pregnancy
d. > 2 previous C/S
e. previous history of uterine rupture
Correct answer: a, d, e

327. CM. Vaginal birth after caesarean section is contraindicated in:


a. oprevious classical section
b. suspected CPD
51
c. no vaginal birth previously
d. previous uterine rupture
e. post-term pregnancy
Correct answer: a, b, d

328. CS. Best level of anaesthesia for LSCS is:


a. T8
b. T10
c. T6
d. T4
e. T2
Correct answer: d

329. CS. All the following statements are true regarding forceps and vacuum delivery,
EXCEPT :
a. vacuum requires more clinical skills than forceps
b. vacuum is preferred more in HIV patients than forceps
c. forceps is more associated with fetal facial injury
d. vacuum has more chance of formation of cephalo-hematoma
e. forceps requires more clinical skills than vacuum
Correct answer: a

330. CM. Which statements are true regarding forceps and vacuum delivery:
a. vacuum requires more clinical skills than forceps
b. vacuum produce more perineal lacerations
c. forceps is more associated with fetal facial injury
d. vacuum has more chance of formation of cephalo-hematoma
e. forceps requires more clinical skills than vacuum
Correct answer: c, d, e

331. CM. Induction of labor by amniotomy can lead to the following complications:
a. cord prolapse
b. abruptio placenta
c. rupture of uterus
d. infection
e. fetal distress
Correct answer: a, d

332. CS. Zavenelli's manoeuver is done in:


a. shoulder dystocia
b. deep transverse arrest
c. retained placenta
d. face presentation
e. uterine inertia
Correct answer: a

333. CS. In menstrual cycle increased level of LH (the LH surge) are due to:
a. increased progesterone
b. increased estrogen
c. increased FSH
d. increased androgens
e. decreased progesterone
Correct answer: b
52
334. CS. The menstrual cycle is initiated by:
a. FSH
b. estrogen
c. LH
d. Progesterone
e. ACTH
Correct answer: a

335. CM. The corpus luteum secretes:


a. estrogens
b. progesterone
c. inhibin
d. hCG
e. androgens
Correct answer: a, b, c

336. CS. Corpus luteum functions maximally without an implantation for………. days:
a. 9
b. 12
c. 6
d. 15
e. 14
Correct answer: a

337. CS. Maximum function of corpus luteum occurs:


a. at ovulation
b. immediately after ovulation
c. 3 days after ovulation
d. 8-9 days after ovulation
e. 14 days after ovulation
Correct answer: d

338. CS. True statement about timing of LH surge:


a. occur 12 hours before ovulation
b. occur 24 hours before ovulation
c. occur 12 hour after ovulation
d. occur 24 hour after ovulation
e. occur at time of ovulation
Correct answer: b

339. CM. Naturally occurring estrogen are:


a. estrone
b. estradiol
c. estriol
d. diethylstilbesterol
e. pregnanediol
Correct answer: a, b, c

340. CS. The production of cervical mucus is stimulated by:


a. progesterone
b. estradiol
c. estriol
53
d. pregnenolone
e. relaxin
Correct answer: b

341. CS. Ferning of cervical mucus depends on:


a. FSH
b. LH
c. estrogen
d. progesterone
e. androgen
Correct answer: c

342. CS. End product of progesterone metabolism found in urine is:


a. pregnanelone
b. 17-OH pregnanelone
c. pregnanediol
d. pregnanetriol
e. pregnil
Correct answer: c

343. CS. Clomiphene citrate is:


a. antiandrogen
b. synthetic estrogen
c. antiestrogen
d. GnRH analogue
e. synthetic progestin
Correct answer: c

344. CM. Clomiphene citrate is indicated in:


a. Stein – Leventhal Syndrome
b. ovarian cyst
c. Asherman’s syndrome
d. carcinoma of endometrium
e. anovulatory cycle
Correct answer: a, e

345. CM. True statements about clomiphene citrate are:


a. can cause hyperstimulation syndrome
b. is used for ovulation induction
c. multiple pregnancies are seen in 3-8% cases
d. used to trear Asherman’s Syndrome
e. is an antiandrogen
Correct answer: a, b, c

346. CM. Side effects of clomiphene citrate include:


a. multiple pregnancy
b. increase risk of ovarian cancer
c. constipation
d. teratogenic effect on off-springs
e. multiple polycystic ovary
Correct answer: a, b, e

347. CM. GnRH analogue may be administered the following conditions:


54
a. prostate Ca
b. endometrial Ca
c. uterine myoma
d. precocious puberty
e. cervical cancer
Correct answer: a, c, d

348. CM. GnRH analogues are useful in:


a. endometriosis
b. hyperprolactinemia
c. precocious puberty
d. myoma uteri
e. uterine cancer
Correct answer: a, c, d

349. CM. Danazol is used in the treatment of:


a. breast cyst
b. non-cyclical mastalgia
c. endometriosis
d. dysfunctional uterine bleeding
e. uterine myoma
Correct answer: c, d, e

350. CM. Which of the following statements are true about mifepristone:
a. also called RU-486
b. used for termination of pregnancy
c. acts on androgen receptors
d. given only intravenously
e. used for myoma uteri
Correct answer: a, b, e

351. CM. Which of the following are the features of inhibin:


a. non-steroidal water soluble protein
b. secreted by Graffian follicle
c. stimulates FSH secretion
d. increased secretion of inhibin occurs in polycystic ovarian disease
e. Inhibin A begins to rise in late luteal phase
Correct answer: a, b, d

352. CS. The probable source of relaxin is:


a. ovary
b. adrenal cortex
c. liver
d. bartholin’s gland
e. anterior pituitary
Correct answer: a

353. CM. Which of the following statements are NOT true for inhibin:
a. it is a non-steroidal water soluble protein
b. secreted by Graffian follicle
c. stimulates FSH secretion
d. increased secretion of inhibin occurs in polycystic ovarian disease
e. Inhibin A begins to rise in late luteal phase
55
Correct answer: c, e

354. CM. Pregnancy is confirmed by:


a. morning sickness
b. amenorrhea
c. fetal heart activity
d. fetal movement by examiner
e. fetal sac in USG
Correct answer: c, d, e

355. CM. Signs positive in early pregnancy are:


a. Hegar’s sign
b. Palmer’s sign
c. Foodell’s sign
d. Piskacek’s sign
e. Braxton’s sign
Correct answer: a, d

356.CS. Best parameter for estimation of fetal age by ultrasound in the 3rd trimester is:
a. femur length
b. BPD
c. abdominal circumference
d. intraocular distance
e. nasal bone
Correct answer: a

357.CS. Transvaginal USG can detect fetal cardiac activity as early as:
a. 6 weeks
b. 7 weeks
c. 8 weeks
d. 10 weeks
e. 11 weeks
Correct answer: a

358.CS. In transvaginal ultrasound, earliest detection of gestation sac is possible by:


a. 21 days after ovulation
b. 21 days after implantation
c. 28 days post ovulation
d. 14 days after ovulation
e. 28 days after implantation
Correct answer: d

359. CS. An expectant mother feels quickening at:


a. 12-18 weeks
b. 16-20 weeks
c. 21-24 weeks
d. 25-28 weeks
e. 29-32 weeks
Correct answer: b

360.CS. Folic acid supplementation reduces the risk of:


a. neural tube defect
b. toxemia of pregnancy
56
c. placenta previa
d. Down’s syndrome
e. anencephaly
Correct answer: a

361. CS. Use of folic acid to prevent congenital malformation should be best initiated:
a. during 1st trimester of pregnancy
b. during 2nd trimester of pregnancy
c. during 3rd trimester of pregnancy
d. before conception
e. all pregnancy
Correct answer: d

362. CS. Increased demand of following occurs in pregnancy except:


a. folic acid
b. iron
c. Vit B 12
d. zinc
e. Vit E
Correct answer: c

363.CS. Appropriate treatment of women having edema in pregnancy includes:


a. salt restriction
b. fluid restriction
c. diuretics
d. bed rest
e. legs bandage
Correct answer: d

364.CS. Teenage pregnancy is associated with all mentioned below, EXCEPT:


a. caesarean section is more common
b. eclampsia more common
c. post dated pregnancy
d. increased maternal mortality rate
e. twins more frequently
Correct answer: c

365.CM. Term delivery implies that the gestational age of the fetus calculated from the time
of onset of menstrual period is:
a. 40 weeks
b. 42 weeks
c. 280 days
d. 260 days
e. 296 days
Correct answer: a, c

366. CS. Use of one of the following vaccination is absolutely contraindicated in pregnancy:
a. hepatitis B
b. cholera
c. rabies
d. yellow fever
e. Flu
Correct answer: d
57
367. CM. Is true about lochia:
a. vaginal discharge for the first fortnight during puerperium
b. its reaction is alkaline tending to become acid towards the end
c. it is caused by dysfunctional uterine bleeding
d. it must be treated
e. the average amount of discharge for the first 5-6 days is estimated to be 250 ml
Correct answer: a, b, e

368.CS. Put in correct order characteristics of lochia during puerperium :


a. rubra , serosa, alba
b. serosa, rubra, alba
c. alba, serosa, rubra
d. alba, mucosa, serosa
e. serosa, alba, rubra
Correct answer: a

369. CS. Likely size of uterus at 8 weeks post partum is:


a. 100 gm
b. 300 gm
c. 500 gm
d. 700 gm
e. 900 gm
Correct answer: a

370. CM. Decreased lactation is seen in:


a. maternal anxiety
b. antibiotic therapy
c. cracked nipples
d. breast abscess
e. bromocriptine therapy
Correct answer: a, c, d, e

371. CM. Contraindication to breast feeding are:


a. tuberculosis during pregnancy
b. bromocriptine theraby for mother
c. heavy breast engorgement
d. Ca breast
e. mother on domperidone
Correct answer: b, d

372. CM. Contraindication for breast feeding are:


a. hepatitis-B infection of mother
b. lithium treatment of mother
c. acute bacterial mastitis
d. hepatitis C infection of mother
e. abscess of the breast
Correct answer: b, e

373. CM. About colostrum true statements are:


a. secreted after 10 days of childbirth
b. rich in immunoglobulin
c. contain more protein
58
d. contain less fat
e. daily secretion is about 10ml/day
Correct answer: b, c, d

374. In comparision to breast milk, colostrum has higher content of:


a. carbohydrate
b. fat
c. sodium
d. potassium
e. proteins
Correct answer: c, e

375. CM. Contraceptive methods in lactation mothers are:


a. barrier method
b. progesterone only pill
c. oral contraceptive pills
d. lactational amenorrhea
e. IUD
Correct answer: a, b, d, e

376. CS. Which contraceptive method is to be avoided in lactation mothers:


a. barrier method
b. progesterone only pill
c. oral contraceptive pills
d. lactational amenorrhea
e. IUD
Correct answer: c

377. CS. Maria, a 30 year old woman develop a deep vein thrombosis in her left calf on
fourth post operative day following cesarean section done for fetal distress. The patient is
started on heparin and is scheduled to begin a 6 weeks course of warfarin therapy.
The patient is a devoted mother who wants to breast feed her baby. What is the advice which
is given to the patient:
a. patient may continue breast feeding at her own risk
b. patient should breast feed her baby if her INR is at <2.5
c. patient can breast feed her baby after 6 weeks course of warfarin is over
d. warfarin is not a contraindication during lactation
e. warfarin is absolutely contraindicated during lactation
Correct answer: d

378. CS. The uterus becomes pelvic organ after delivery in:
a. 2 days
b. 7 days
c. 14 days
d. 21 days
e. 30 days
Correct answer: c

379. CS. Without breast feeding the first menstrual flow usually begins – weeks after
delivery:
a. 2-4 weeks
b. 4-6 weeks
c. 6-8 weeks
59
d. 8-10 weeks
e. More than 10 weeks
Correct answer: c

380. CS. Most common immunoglubulin secreted by mother in milk and colostrum is:
a. IgA
b. IgG
c. IgE
d. IgD
e. IgM
Correct answer: a

381. CS. Most common cause of first trimester abortion is:


a. chromosomal abnormalities
b. syphilis
c. rubella
d. rhesus isoimmunization
e. cervical incompetence
Correct answer: a

382. CS. Recurrent abortion in the first trimester is most often due to:
a. chromosomal abnormalities
b. uterine anomaly
c. hormonal disturbance
d. infection
e. Rh incompatibility
Correct answer: a

383.CM. What drugs are used for first trimester medical abortion
a. mifepristone
b. atosiban
c. methotrexate
d. misoprostol
e. ethacridine lactate
Correct answer: a, c, d

384.CS. Mifepristone is not used in:


a. threatened abortion
b. fibroid
c. second trimester abortion
d. molar pregnancy
e. induction of labor
Correct answer: a

385.CM. Methods of choice for first trimester termination of pregnancy are:


a. dilatation and curettage
b. manual vacuum aspiration
c. mefepristone+misoprostole
d. methotrexate+gemeprost
e. electrical vacuum aspiration
Correct answer: b, c, e

386.CM. Causes of recurrent abortions are:


60
a. TORCH infection
b. uterine pathology
c. thrombofilia
d. herpes infection
e. HIV infection
Correct answer: b, c

387.CS. Most common cause of postpartum hemorrhage is:


a. trauma
b. uterine inversion
c. retained products
d. uterine atony
e. bleeding disorders
Correct answer: d

388.CM. Complications of pregnancy increasing risk of postpartum hemorrhage are:


a. macrosomia
b. twin pregnancy
c. hydramnios
d. gestational hypertension
e. preterm birth
Correct answer: a, b, c

389.CM. Atonic uterus is more common in:


a. twin pregnancy
b. primigravida
c. multigravida
d. breech delivery
e. hydramnios
Correct answer: a, c, e

390.CM. Drugs used in the treatment of postpartum hemorrhages:


a. misoprostol
b. tranexamic acid
c. mifepristone
d. carboprost
e. ergometrine
Correct answer: a, b, d, e

391.CM. Postpartum hemorrhage could be a reasonable possibility in the following situations:


a. oligoamnios
b. triplets
c. long labor
d. breach presentation
e. thrombocytopenia
Correct answer: b, c, e

392.CS. What drug is not used for treatment of postpartum hemorrhages:


a. oxitocin
b. syntometrine
c. misoprostol
d. oestrogen
61
e. tranexamic acid
Correct answer: d

393.CS. What is the drug most commonly used in prevention of postpartum hemorrhage:
a. oxitocin
b. syntometrine
c. misoprostol
d. ergometrin
e. tranexamic acid
Correct answer: a

394.CM. Massive postpartum hemorrhage may warrant following interventions:


a. hysterectomy
b. thermal endometrial ablation
c. internal iliac artery ligation
d. balloon tamponade
e. uterine artery embolisation
Correct answer: a, c, d, e

395.CS. B-Lynch suture is applied on:


a. cervix
b. vagina
c. fallopian tube
d. uterus
e. ovaries
Correct answer: b

396.CM. True statements regarding postpartum hemorrhages are:


a. B-Lynch suture is applied
b. shirodcar suture is applied
c. atosiban used
d. more common in multipara
e. polyhydramnios is a risk factor
Correct answer: a, d, e

397.CM. True statements regarding postpartum hemorrhages are:


a. misoprostol is used
b. colloids are the first option for volume replacement
c. most common cause is trauma
d. multiple vaginal exams increase the risk
e. multiparity is a risk factor
Correct answer: a, e

398.Which drug is not used for treatment of postpartum hemorrhage


a. oxytocin
b. ergometrine
c. carboprost
d. ritodrin
e. syntometrine
Correct answer: d
399.CS. What clinical findings indicate that the bleeding is from a tear?
a. the bleeding consists of a continuous stream of bright red blood
62
b. the uterus is atonic an abdominal palpation
c. the lost blood do not form clots
d. dark red clots of blood are passed when the uterus is rubbed up.
e. fragments of placenta are missing
Correct answer: a

400.CS. What is the probable diagnosis in a patient that suddenly becomes shocked without
any signs of vaginal bleeding during the third stage of labor and on abdominal examination
the uterus cannot be palpated?
a. an atonic uterus
b. a ruptured uterus
c. an inverted uterus
d. a cervical tear
e. placenta acretta
Correct answer: c

401.CS. What is the first step in the management of a postpartum hemorrhage when the
placenta has already been delivered?
a. the uterus must be immediately rubbed up
b. a rapid intravenous infusion of 40 units of oxytocin should be started
c. the patient’s bladder must be emptied
d. the cause of bleeding must be looked for
e. the hematocrit, hemoglobin and blood group should be determined
Correct answer: a

402.CM. True statements about placenta accreta are:


a. seen more frequently in cesarean scar
b. chorionic villi invade serosa
c. chorionic villi invade endometrium
d. it is an etiological factor for amniotic fluid embolism
e. in most cases hysterectomy is the treatment of choice
Correct answer: a, c, e

403.CM. Which are NOT the causes of placenta accreta?


a. previous cesarean section
b. previous currettage
c. previous myomectomy
d. previous placenta previa
e. previous abruptio placenta
Correct answer: d, e

404.CM. Placenta accreta is NOT associated with:


a. placenta previa
b. multiple pregnancy
c. multiparity
d. uterine scar
e. uterine malformations
Correct answer: b, e

405.CS. All of the following drugs are used for prevention and treatment of postpartum
hemorrhages, EXCEPT:
a. misoprostol
b. oxytocin
63
c. mifepristone
d. ergometrine
e. carboprost
Correct answer: c

406.CM. Coagulopathy is the cause of postpartum hemorrhage in the following conditions:


a. prolonged retention of dead fetus
b. preeclampsia
c. amniotic fluid embolism
d. abruptio placenta
e. retention of placenta
Correct answer: a, b, c, d.

407.CM. The causes of postpartum hemorrhages are:


a. uterine hypotonia
b. soft canal ruptures
c. clotting disorders
d. uterine hypertony
e. uterine inversion
Correct answer: a, b, c, e

408.CM. Immediate serious complications of postpartum hemorrhages are:


a. collapse
b. shock
c. death
d. Sheehan syndrome
e. Simmons syndrome
Correct answer: a, b, c

409.CM. Late serious complications of postpartum bleeding are:


a. Sheehan syndrome
b. collapse
c. thromboembolic disease
d. decortication
e. chronical respiratory infection
Correct answer: a, c

410.CM. The prophylaxis of bleeding during third stage of labor consists of:
a. oxytocin administration
b. controlled cord traction
c. the examination of placenta and membranes
d. ice pack over the uterus
e. routine bladder catheterization
Correct answer: a, b, c.

411.CM. Treatment of uterine atonia includes:


a. massage of the uterus
b. massage of the uterus is contraindicated
c. bladder catheterization
d. administration of oxytocin
e. administration of misoprostol
Correct answer: a, c, d, e

64
412.CM. Which drugs are used for prevention of postpartum hemorrhage
a. oxytocin
b. ergometrine
c. calcium gluconate
d. ritodrin
e. syntometrine
Correct answer: a, b, e

413.CM. Which oxytocic drugs may be given if there is a contraindication to the use of
syntometrine?
a. ergometrine
b. a combination of oxytocin and ergometrine
c. oxytocin
d. prostaglandin E2
e. misoprostol
Correct answer: c, d, e

414.CM. What are infrequent causes of postpartum hemorrhage:


a. cervical and vaginal tears
b. uterine inversion
c. DIC syndrome
d. coagulopathy
e. uterine atonia
Correct answer: b, c, d

415.CM. The treatment of a patient with a secondary postpartum hemorrhage will include:
a. ampicillin and metronidasole
b. oxytocin
c. red blood cells transfusion in severe anemia
d. removal of retained products of conception under general anesthesia
e. tocolisis
Correct answer: a, b, c, d
416.CM. Which of the following are risk factors for uterus rupture?
1. threatened preterm labor
2. transversal situs of the fetus
3. previous cesarean section
4. hydramnios
5. contracted pelvis
Correct answer: b, c, e
417.CM. Surgical methods used for treatment of massive postpartum hemorrhages include:
a. uterine and ovarian arteries ligation
b. McDonald suture
c. B-Lynch suture
d. hysterectomy
e. internal iliac artery ligation
Correct answer: a, c, d, e

418.CS. The following statements are related to postpartum hemorrhages, EXCEPT:


a. it is always a preventable condition
b. atonicity of the uterus is the commonest cause
c. prophylactic oxytocine should be used routinely in the third stage of labor

65
d. represent the leading cause of maternal mortality in developing countries
e. uterine inversion is a rare cause
Correct answer: a

419.CM. Major risk factors for preeclampsia are:


a. chronic hypertension
b. primiparity
c. antiphosfolipid syndrom
d. previous eclampsia
e. smoking
Correct answer: a, c, d

420.CM. Risk factors for preeclampsia includes:


a. primiparity
b. multiparity
c. obesity
d. placenta previa
e. multiple pregnancy
Correct answer: a, c, e

421.CS. What is NOT considered criteria of severe preeclampsia:


a. severe headache
b. persistent oliguria
c. level of fibrinogen over 5 g/liter
d. thrombocytopenia < 100000 mm
e. elevated liver enzymes
Correct answer: c
422.CM. In preeclampsia impending signs of imminent eclampsia are:
a. blurred vision
b. waight gain more that 2 kg per week
c. severe proteinuria >5 gr/24 hours
d. severe headache
e. brick deep tendon reflexes
Correct answer: a, d, e

423.CS. All of the following indicate superimposed preeclampsia, EXCEPT:


a. new onset proteinuria
b. increase in systolic BP by 30 mm Hg and/or diastolic BP by 15 mm Hg
c. trombocitopenia
d. elevated liver enzimes
e. oliguria
Correct answer: B

424.CM. The following pathophysiologic changes are characteristic for preeclampsia:


a. vasoconstriction
b. hypovolemia
c. decreased peripheral vascular resistance
d. increased vascular permeability
e. activation of coagulation system
Correct answer: a, b, d, e
425. CM. Laboratory changes characteristic to severe preeclampsia include:

66
a. increased level of creatinine
b. elevated liver enzymes
c. decreased hematocrit
d. thrombocytopenia
e. hyperproteinemia
Correct answer: a, b, d
426.CM. What complications of pregnancy are characteristic to preeclampsia:
a. fetal growth restriction
b. preterm delivery
c. antepartum fetal death
d. embriopathies
e. polihydramnios
Correct answer: a, b, c
427.CM. What are two main causes of death in women with preeclampsia / eclampsia:
a. renal necrosis
b. liver insufficiency
c. intra-cerebral hemorrhages
d. pulmonary edema
e. liver rupture
Correct answer: c, d
428.CM. Risk of which complications is increased by preeclampsia:
a. abruptio placenta
b. fetal macrosomia
c. DIC syndrome
d. postpartum thromboembolism
e. fetal growth restriction
Correct answer: a, c, d, e
429.CM. What are the possible consequences of preeclampsia/eclampsia
a. antenatal death of the fetus
b. coagulopathic hemorrhage
c. prematurity
d. retinal detachment
e. placenta previa
Correct answer: a, b, c, d
430.CM. Which are the indications for pregnancy termination in case of severe preeclampsia:
a. persistent oliguria
b. thrombocytopenia
c. pulmonary edema
d. hydramnios
e. severe fetal growth restriction
Correct answer: a, b, c, e

431.CM. What are considered criteria of severe preeclampsia:


a. proteinuria more than 1 g/day
b. persistent oliguria
c. level of fibrinogen over 5 g/liter
d. thrombocytopenia under 100000 mm
e. generalized edema
Correct answer: b, d

67
432.CM. Following drugs are used to treat pregnancy associated hypertension:
a. labetalol
b. captopril
c. methyldopa
d. nifedipine
e. hydralazine
Correct answer: a, c, d, e

433.CM. Which of the following antihypertensives are not safe in pregnancy:


a. labetalol
b. ACE inhibitors
c. methyldopa
d. nifedipine
e. enalapril
Correct answer: b, e

434.CS. Which of the following antihypertensives is not given in pregnancy:


a. labetalol
b. enalapril
c. methyldopa
d. nifedipine
e. hydralazine
Correct answer: b

435.CM. Which of the following may be an early warning sigh of preeclampsia?


a. weight gain during the last months of pregnancy
b. generalized edema especially of the face
c. leg cramps
d. edema of the feet at the end of the day
e. pain on passing urine
Correct answer: a, b

436.CM. What are important sighs of magnesium sulphate over-dosage?


a. respiratory depression
b. hyperventilation
c. a urine output of less than 30 ml per hour
d. depressed tendon reflexes
e. tachycardia
Correct answer: a, d

437.CS. All of the following can be administered in acute hypertension during labor,
EXCEPT:
a. labetalol
b. hydralasine
c. nitropruside
d. nifedipine
e. diazoxide
Correct answer: e

438.CS. Which is the drug of choice for management of eclampsia


a. diazepam
b. phenitoin
68
c. fenobarbital
d. MgSO4
e. lytic cocktail regime
Correct answer: d

439.CS. Which is the drug of choice for severe hypertension caused by preeclampsia:
a. labetalol
b. metoprolol
c. methyldopa
d. nifedipine
e. hydralazine
Correct answer: a

440.CM. Which of the following women has high risk of preeclampsia?


a. a patient with a history of preeclampsia starting early in the third trimester of a previous
pregnancy
b. a patient with chronic hypertension
c. grande multiparas
d. twin pregnancy
e. a patient with a history of postpartum hemorrhage
Correct answer: a, b, d

441.CS. A 28 year old woman with preeclampsia develop convulsions. The first measure to
be done after convulsions:
a. give MgSO4
b. sedation
c. immnediate delivery
d. care of airway
e. give Nifedipine
Correct answer: d

442.CM. Which of the following are contraindications to giving syntometrine during the third
stage of labor?
a. an atonic uterus
b. hypotension after delivery
c. gestational hypertension
d. preeclampsia
e. fetal macrosomia
Correct answer: c, d

443.CM. What are rare causes of death in women with pre-eclampsia?


a. hepatic rupture
b. pulmonary edema
c. renal insufficiency
d. hepatic failure
e. intracerebral hemorrhage
Correct answer: a, c, d

444.CM. Which are NOT features of HELLP syndrome:


a. thrombocitopenia
b. eosinophilia
c. creatinin doubling baseline
d. raised liver enzyme
69
e. hemolitic anemia
Correct answer: b, c

445.CS. All are true about preeclampsia, EXCEPT:


a. cerebral hemorrhage
b. pulmonary edema
c. acute renal failure
d. deep venous thrombosis
e. liver rupture
Correct answer: d

446.CS. The leading cause of death in severe preeclampsia /eclampsia is:


a. cerebral hemorrhage
b. pulmonary edema
c. acute renal failure
d. deep venous thrombosis
e. liver rupture
Correct answer: a

447.CS. Earliest sign of MgSO4 toxicity is:


a. hypotension
b. anuria
c. coma
d. respiratory depression
e. depression of deep tendon reflexes
Correct answer: e

448.CS. What is antidote used in cases of MgSO4 toxicity?


a. protamin sulphate
b. calcium gluconate
c. cofeine
d. atropine
e. naloxone
Correct answer: b

449. CS. A previously normotensive women, at 32 weeks of pregnancy, has a blood pressure
150/100 mm Hg, proteinuria 0,03 gr/24 hours, edema of legs. What is the diagnosis?
a. chronic hypertension
b. gestational hypetension.
c. mild preeclampsia.
d. severe preeclampsia.
e. transient hypertension .
Correct answer: b

450.CS. A previously normotensive women, at 32 weeks of pregnancy, has a blood pressure


150/100 mm Hg, proteinuria 0,5 gr/24 hours, pedal edema. What is the diagnosis?
a. chronic hypertension
b. gestational hypetension.
c. mild preeclampsia.
d. severe preeclampsia.
e. transient hypertension
Correct answer: c

70
451.CS. A patient with preexisting hypertension who develops a diastolic blood pressure of
105 mm Hg and 2+proteinuria (1 gr/day) at 36 weeks of pregnancy should be graded as
having:
a. pre-eclampsia
b. severe pre-eclampsia
c. imminent eclampsia
d. eclampsia
e. superimposed preeclampsia
Correct answer: e
452. CM. What is the management of a patient with pre-eclampsia at 36 weeks gestation?
a. oral antihypertensive drugs
b. diuretics
c. hospitalization
d. a loading dose of magnesium sulfate
e. delivery
Correct answer: a, c, e

453.CS. How common is preeclampsia?


a. most pregnant women develop preeclampsia
b. about 25% of all women develop preeclampsia
c. about 15% of all women develop preeclampsia
d. about 3-5% of all women develop preeclampsia
e. very rare
Correct answer: d
454.CS. A previously normotensive woman, at 32 weeks of pregnancy, has a blood pressure
170/110 mm Hg, proteinuria 5,0 gr/24 hours, severe headache, nausea and vomiting. What is
the diagnosis?
a. chronic hypertension
b. gestational hypetension.
c. mild preeclampsia.
d. severe preeclampsia.
e. transient hypertension .
Correct answer: d
455.CM. A previously normotensive women, at 32 weeks of pregnancy, has a blood pressure
170/110 mm Hg, proteinuria 5,0 gr/24 hours, severe headache, nausea and vomiting. What is
the management ?
a. antihypertensive treatment
b. evaluation of fetal well-being
c. diuretics
d. dexametazone.
e. MgSO4
Correct answer: a, b, d, e
456. CM. Which drugs are contraindicated in preeclampsia?
a. hydralazin
b. metil-ergometrin.
c. misoprostol
d. captopril
e. nifedipine
Correct answer: b, d

71
457.CM. Complications of preeclampsia are the following:
a. retinal detachment
b. intracranial hemorrhage
c. fetal growth restriction
d. hydramnion
e. renal insufficiency
Correct answer: a, b, c, e

458.CS. All of the following are possible consequneces of preeclampsia, EXCEPT:


a. antepartum fetal death
b. coagulopathic bleeding
c. prematurity
d. blindness
e. fetal malformations
Correct answer: e

459.CS. Congenital infection in fetus with minimal teratogenic risk is:


a. varicella
b. rubella
c. HIV
d. cytomegalovirus
e. toxoplasmosis
Correct answer: c

460.CS. Most frequent cause of intrauterine infection is:


a. rubella
b. hepatitis
c. toxoplasma
d. CMV
e. herpes virus
Correct answer: d

461.CS. Congenital anomalies are most severe in :


a. cytomegalovirus
b. rubella
c. mumps
d. toxoplasma
e. herpes virus
Correct answer: b

462.CM. Not implicated in congenital transmission :


a. hepatitis A
b. toxoplasma
c. syphilis
d. streptococcus group B
e. cytomegalovirus
Correct answer: a, d

463.CS. Which of the following perinatal infections has the highest risk of fetal infection in
the first trimester:
a. hepatitis B
b. syphilis
72
c. toxoplasmosis
d. rubella
e. varicella
Correct answer: d

464.CS. A lady G2 P1 with 10 weeks pregnancy has one child with ocular toxoplasmosis. The
risk of present child to be infected is:
a. 25%
b. 50%
c. 75%
d. 100%
e. Nil
Correct answer: e

465.CS. Syphilis in pregnancy should be treated with:


a. ceftriaxone
b. penicillin
c. tetracicyline
d. ampicillin
e. gentamicine
Correct answer: b

466.CS. Choose the most appropriate treatment for Herpes simplex virus infection:
a. penicillin
b. metronidasole
c. doxyciciline
d. ceftriaxone
e. aciclovir
Correct answer: e

467.CS. The following infections are transmitted to fetus trans-placentally, EXCEPT:


a. toxoplasmosis
b. syphilis
c. streptococcus B
d. rubella
e. cytomegalovirus
Correct answer: c
468.CS. A pregnant woman is routinely screened for which of the following disease entities?
a. parvovirus
b. toxoplasmosis
c. cytomegalovirus (CMV)
d. syphilis
e. herpes simplex virus
Correct answer: d

469.CS. Which of the following is a common reservoir of toxoplasmosis?


a. school-age children
b. bird droppings
c. cats
d. contaminated seafood
e. blood
Correct answer: c
73
470.CS. Which of the following is a common reservoir of HIV?
a. school-age children
b. bird droppings
c. cats
d. contaminated seafood
e. blood
Correct answer: e

471.CM. It is important to treat patients with asymptomatic bacteriuria in pregnancy because:


a. the patient is seriously ill
b. one third will develop septic shock during pregnancy
c. it is associated with small for gestational age fetuses
d. more than one third will develop acute pyelonephritis during pregnancy
e. it increases risk of preterm birth
Correct answer: c, d, e

472.CM. What complications are caused by infections during pregnancy:


a. postpartum hemorrhages
b. fetal malformations
c. preterm deliveries
d. early neonatal sepsis
e. placenta previa
Correct answer: b, c, d
473.CM. Which infections are transmitted to newborn during delivery:
a. toxoplasmosis
b. herpes virus
c. rubella
d. hepatitis B
e. streptococcus B
Correct answer: b, d, e
474.CM. Prevention of mother to child transmission of HIV includes:
a. antiretroviral therapy
b. elective cesarean section
c. episiotomy
d. exclusion of breastfeeding
e. induction of labor at 38 weeks
Correct answer: a, b, d
475.CM. Screening of following infections is recommended routinely during pregnancy:
a. HIV
b. cytomegalovirus
c. syphilis
d. herpes virus
e. toxoplasmosis
Correct answer: a, c
476.CM. Which infections are transmitted to fetus mostly trans-placentaly:
a. Toxoplasmosis
b. Rubella
c. Herpes virus
d. Hepatitis B
74
e. Syphilis
Correct answer: a, b, e

477.CM. Which infections cause serious fetal malformations:


a. toxoplasmosis
b. HIV
c. streptococcus B
d. rubella
e. herpes virus
Correct answer: a, d
478.CM. What complications are caused by Chlamydia trachomatis infection during
pregnancy:
a. Fetal malformations
b. Preterm birth
c. Abruption placentae
d. Conjunctivitis in newborn
e. Early neonatal sepsis
Correct answer: b, d
479.CM. What drugs are recommended for treatment of Chlamydia trachomatis infection
during pregnancy:
a. tetracycline
b. eritromicine
c. clarithromycin
d. ceftriaxone
e. ciprofloxacin
Correct answer: b, c

480.CS. During pregnancy baby can be affected in utero in all, EXCEPT:


a. Syphilis
b. Toxoplasma
c. Poliomyelitis
d. Rubella
e. Cytomegalovirus
Correct answer: c

481.CS. Transmission of herpes is maximum in:


a. Ist trimester
b. IInd trimester
c. IIIrd trimester
d. during parturition
e. postpartum
Correct answer: d

482.CS. Transmission of HIV is maximum in:


a. Ist trimester
b. IInd trimester
c. IIIrd trimester
d. during parturition
e. postpartum
Correct answer: d

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483.CS. Transmission of toxoplasmosis is maximum in:
a. Ist trimester
b. IInd trimester
c. IIIrd trimester
d. during parturition
e. postpartum
Correct answer: c

484.CS. Transmission of cytomegalovirus is maximum in:


a. Ist trimester
b. IInd trimester
c. IIIrd trimester
d. during parturition
e. postpartum
Correct answer: a

485.CS. Cesarean section is preferred in:


a. hepatitis B
b. cytomegalovirus
c. herpes
d. varicella zoster virus
e. streptococcus B
Correct answer: c

486.CS. Which infection is not transmitted to newborn at delivery:


a. toxoplasmosis
b. gonococcus
c. HSV type II
d. hepatitis B
e. chlamydia
Correct answer: a

487.CM. Strategies used to decrease mother to child transmission of HIV include:


a. elective cesarean section
b. antiretroviral therapy (ART) during pregnancy
c. omitting ergometrine
d. avoiding breastfeeding
e. intrapartum ART
Correct answer: a, b, d, e

488.CS. Dysmenorrhea would be most likely to occur in which of the following women:
a. a young teenager
b. a woman on birth control pills
c. a 48-year-old woman with irregular cycles
d. a marathon runner with one menstruation per year
e. a 35-year-old women with regular cycles
Correct answer: a

489. CS. All of the following statements about the two-cell hypothesis of estrogen
production are true EXCEPT:
a. theca cells produce androstendione
b. luteinizing hormone (LH) stimulates theca cells
c. aromatization of androgens takes place in the granulosa cells
76
d. FSH activates the enzyme aromatase
e. Estradiol is transported to the theca cells
Correct answer: e

490. CM. All of the following characterize the follicular phase of the menstrual cycle:
a. variable length
b. growth and development of the ovarian follicles
c. basal body temperature over 37 0C
d. vascular growth of the endomentrium
e. secretion of the estrogen from the ovary
Correct answer: a, b, d, e

491. CS. Which of the following conditions is considered a relative emergency in a teenager
with amenorrhea:
a. uterine agenesis
b. turner’s syndrome
c. imporforate hymen
d. androgen infectivity syndrome
e. Klinefelters syndrome
Correct answer: c

492.CS. Elevated gonadotropin levels are expected with which of the following conditions
associated with amenorrhea:
a. Rokitansky-Kuster-Hauser syndrome
b. Kallman’s syndrome
c. gonadal dysgenesis
d. anorexia nervosa
e. pituitary adenoma
Correct answer: c
493.CS. Hypothalamic amenorrhea is seen in:
a. Asherman syndrome
b. Stein-Leventhal syndrome
c. Kallman Syndrome
d. Sheehan’s syndrome
e. Turner syndrome
Correct answer: c

494.CS. A 19 yesr old patient complains of primary amenorrhea. She had well developed
breasts and pubic hear, but on exam there was absence of uterus and vagina. Likely diagnosis
is:
a. XXY
b. XO
c. Mullerian agenesis
d. Gohadal dysgenesis
e. Klinefelter syundrom
Correct answer: c

495.CS. The commonest cause of primary amenorrhea is:


a. genital tuberculosis
b. ovarian dysgenesis
c. mullerian duct anomalies
d. hypothyroidism
77
e. imperforate hymen
Correct answer: b

496.CM. Which is not primary amenorrhea:


a. Sheehan syndrome
b. Kallmann’s syndrome
c. Mayer-Rokitansky-Koster-Hauser Syndrome
d. Turner syndrome
e. Asherman syndrome
Correct answer: a, e

497. CS. A woman has 2 kids. She presents with galactorrhea and amenorrhea for 1 year.
The most probable diagnosis is:
a. pregnancy
b. pituitary tumor
c. Sheehan’s syndrome
d. Metastasis to pituitary from other carcinoma
e. Kallmann’s syndrome
Correct answer: b

498.CM. In a woman presenting with amenorrhea, headache, blurred vision and galactorrhea
appropriate investigations include:
a. FSH
b. LH
c. X-ray or MRI
d. prolactin level
e. HCG
Correct answer: c, d

499.CM. Most appropriate treatment options for a 42 years old woman with dysfunctional
uterine bleeding are
a. progesterone
b. prostaglandins
c. hysterectomy
d. danazol
e. endometrial ablation
Correct answer: a, e

500.CS. Primary amenorrhea with absent uterus, normal breasts and scanty pubic hear is seen
in:
a. Mayer-Rokitansky-Koster-Hauser Syndrome
b. Turner syndrome
c. Noonan Syndrome
d. Testicular feminizing syndrome
e. Kallmann’s syndrome
Correct answer: d

501.CM. What conditions are associated with primary amenorrhea


a. Testicular feminizing syndrome
b. Stein-Leventhal syndrome
c. Turner syndrome
d. Mayer-Rokitansky-Koster-Hauser Syndrome
e. Sheehan syndrome
78
Correct answer: a, c, d

502.CM. Evidence based treatments for heavy menstrual bleeding are


a. oral contraceptive pills
b. progesterone for three months cyclically
c. tranexamic acid
d. NSAIDs
e. ethamsylate
Correct answer: a, b, c, d

503.CM. Which of the following are not indicated in heavy menstrual bleeding:
a. NSAIDs
b. progestins
c. clomiphene
d. misoprostol
e. tranexamic acid
Correct answer: c, d

504.CM. Treatment of dysfunctional uterine bleedings in young female is:


a. oral contraceptives
b. progesterone
c. D&C
d. MVA
e. misoprostol
Correct answer: a, b

505.CM. Puberty heavy menstrual bleeding are treated with:


a. progesterone
b. progesterone and estrogen
c. GnRH analogues
d. danazol
e. MVA
Correct answer: a, b, c

506.CS. Most common cause of puberty menorrhagia is:


a. endometriosis
b. malignancy
c. anovulation
d. bleeding disorder
e. sub-mucous leiomyoma
Correct answer: c

507.CM. Initial evaluation of adolescent with abnormal uterine bleeding:


a. haemogram
b. USG
c. examination under anesthesia
d. platelet count
e. D&C
Correct answer: a, b, d

508.CS. Polymenorrhea means:


a. menses <21 days
b. menses >35 days
79
c. painful menses
d. DUB
e. menstrual bleeding >7 days
Correct answer: a

509.CS. In case of secondary amenorrhea who fails to get withdrawal bleeding after taking
estrogen and progesterone, the fault lies at the level of:
a. pituitary
b. hypothalamus
c. ovary
d. endometrium
e. adrenal gland
Correct answer: d

510.CM. 16 years old with primary amenorrhea with negative progesterone challenge test, but
positive combined progesterone and estrogen test. Diagnosis may be:
a. mullerian agenesis
b. PCOS
c. Asherman syndrome
d. prolactinoma
e. ovarian digenesis
Correct answer: d, e

511.CS. Positive progesterone challenge test in a patient of secondary amenorrhea, seen in:
a. Asherman syndrome
b. endometrial TB
c. hypopituitarism
d. premature ovarian failure
e. PCOS
Correct answer: e

512.CM. A patient with amenorrhea had bleeding after giving a trial of progesterone. This
implies:
a. sufficient estrogen
b. sufficient progesterone
c. normal ovarian function
d. intact endometrium
e. intact pituitary axis
Correct answer: a, d, e

513.CM. Causes of secondary amenorrhea are:


a. Turner syndrome
b. endometriosis
c. Asherman’s Syndrome
d. thyroiditis
e. PCOS
Correct answer: c, d, e

514.CS. In a 45 years old lady with heavy menstrual bleeding for 6 months duration and
normal endometrium on biopsy, best line of management is:
a. progesterone for 6 months
b. oral combined contraceptive pills for 6 months
c. D&C
80
d. NSAIDs
e. hysterectomy
Correct answer: c

515.CS. A 45 years old woman present with a history of heavy menstrual bleeding for last six
months. The first line of management is:
a. hysterectomy
b. progesterone for 3 cycles
c. NSAIDs
d. D&C
e. oral contraceptives for 3 months
Correct answer: d

516.CS. A 30 years old woman para 2, with hypertension have heavy menstrual bleeding.
Which is best treatment for her?
a. combined pills
b. oral progesterone
c. Mirena
d. hysterectomy
e. endometrial ablation
Correct answer: c

517.CM. A 35 years old lady is not having her menses for last 6 months. She has high serum
FSH and LH and low estradiol. The likely causes are:
a. panhypopituitarism
b. PCOS
c. exogenous estrogen administration
d. premature menopause
e. resistant ovarian syndrome
Correct answer: d, e

518.CS. In which of the following cases is it necessary to remove the gonads at the time the
diagnosis is made:
a. androgen insensivity syndrome (46,XY)
b. Turner’s syndrome (45,X0)
c. Pure gonadal dysgenesis (46,XY)
d. Kallman’s syndrome (46,XX)
e. None of the above
Correct answer: c

519.CM. The following are characteristic for androgen insensitivity syndrome (testicular
feminization)
a. normal breast development
b. absence of pubic hear
c. amenorrhea
d. presents of uterus and tubes
e. male gonads
Correct answer: a, b, c, e

520.CS. Karyotype X0, absence of secondary sexual characteristics, primary amenorrhea,


short stature, somatic abnormalities. Diagnosis?
a. Kallman’s syndrome
b. Morris’s syndrome
81
c. Klinefelter’s syndrome
d. Turner’s syndrome
e. Cushing’s syndrome
Correct answer: d

521.CS. Karyotype XY, normal breast development, absence of pubic hear, amenorrhea, male
gonads, vaginal pouch. Diagnosis?
a. Kallman’s syndrome
b. Morris’s syndrome
c. Klinefelter’s syndrome
d. Turner’s syndrome
e. Cushing’s syndrome
Correct answer:

522.CS> What is the karyotype in Turner’s syndrome


a. X0
b. XX
c. XY
d. XXY
e. XYY
Correct answer: a

523.CS. What is the karyotype in androgen insensitivity syndrome (testicular feminization):


a. X0
b. XX
c. XY
d. XXY
e. XYY
Correct answer: c

524.CM. All of the following are characteristics of Turner‘s syndrome:


a. karyotype X0
b. primary amenorrhea
c. somatic abnormalities
d. increased levels of estrogens
e. increased levels of gonadotropins
Correct answer: a, b, c, e

525.CS. Select the most appropriate therapy for congenital adrenal hyperplasia
a. estrogens and progestins
b. hydrocortisone
c. progestins
d. prostaglandin inhibitors
e. gonadotropin analogs
Correct answer: b

526. CS. Treatment of Turner syndrome includes:


a. estrogen replacement therapy
b. gonadectomy
c. surgical removal of the clitoris
d. surgical modeling of artificial vagina
e. administration of Dexamethasone
Correct answer: a
82
527. CS. Treatment of Rokitansky-Kuster-Hauser syndrome includes:
a. estrogen replacement therapy
b. gonadectomy
c. surgical removal of the clitoris
d. surgical modeling of artificial vagina
e. administration of Dexamethasone
Correct answer: d

528. CS. Treatment of testicular feminization syndrome includes:


a. estrogen replacement therapy
b. gonadectomy
c. surgical removal of the clitoris
d. surgical modeling of artificial vagina
e. administration of Dexametazone
Correct answer: b

529. CM. Which of the following are Mullerian tract abnormalities?


a. bicornuate uterus
b. testicular feminization syndrome
c. uterus didelfus
d. Rokitansky-Kuster-Hauser syndrom
e. aplazia of the inferior third of vagina
Correct answer: a, c, d

530. CS. Which of the following pathologies are caused by enzyme deficiency (52-ά-
reductasis):
a. Turner syndroms
b. testicular feminisation syndrome
c. uterus didelfus
d. Rokitansky-Kuster-Hauser syndrom
e. Klinefelter syndrome
Correct answer: b

531. CM. Which of the following pathologies are caused by chromosomial abnormalities?
a. Turner syndrome
b. testicular feminization syndrome
c. uterus didelfus
d. Rokitansky-Kuster-Hauser syndrome
e. Klinefelter syndrome
Correct answer: a, e

532. CS. The most important indication for surgical repair of a bicornuate uterus is:
a. infertility
b. dysmenorrhoea
c. menorrhagia
d. habitual abortion
e. dysuria
Correct answer: d

533. CS. Ideal age for repair of vaginal agenesisis:


a. 6 months
83
b. 3 years
c. 7 years
d. at puberty
e. before marriage
Correct answer: e

534. CS. IOvary develop from:


a. mullerian duct
b. genital ridge
c. genital tubercle
d. mesonephric duct
e. sinovaginal bulbs
Correct answer: b

535. CM. Diagnosis of septate uterus is done by:


a. USG
b. uterine sound
c. hysteroscopy
d. hystero-sapingography
e. laparoscopy
Correct answer: a, b, c, d

536. CM. All of the following are features of mullerian agenesis::


a. 46 XX karyotype
b. normal breast development
c. absent vagina
d. ovarian agenesis
e. normal pubic hear
Correct answer: a, b, c, e

537.CM. True about Rokitansky Kuster Hauser syndrome:


a. absent uterus
b. absent ovary
c. absent vagina
d. XX phenotype
e. XY phenotype
Correct answer: a, c, d

538.CM. Rokitansky Kuster Hauser syndrome is characterized by:


a. ovarian agenesis
b. absent fallopian tube
c. vaginal atresia
d. bicornuate uterus
e. absent uterus
Correct answer: b, c, e

539.CS. Complete failure of mullerian duct fusion will result in:


a. uterus didelphys
b. arcuate uterus
c. subseptate uter
d. bicornuate uterus
e. absent uterus
Correct answer: a
84
540.CS. The first sign of puberty in girls is:
a. breast budding
b. growth spurt (peak height velocity)
c. menarche
d. pubic hair growth
e. axillary hair growth
Correct answer: a

541.CS. Which of the following pubertal events in girls is not estrogen dependent:
a. menstruation
b. vaginal cornification
c. height spurt
d. hair growth
e. production of cervical mucus
Correct answer: d

542.CS. A 9 year old girl presents with menarche. History reveals thelarche at the age of 7
and adrenarche at the age of 8 years. The most common cause of this condition in girls is:
a. idiopathic
b. gonadal tumor
c. Mc Cure Albright syndrome
d. hipothyroidism
e. PCOS
Correct answer: a

543.CS. Medication used in treatment of idiopathic central precocious puberty is:


a. exogenous gonadotrophins
b. ethinyl estradiol
c. Gn RH analogues
d. progesterone
e. dexamethasone
Correct answer: c

544.CM. During sexual differentiation in males:


a. leydig cells produce Mullerian Inhibiting Substance
b. primitive Gonads differentiate into testis due to the presence of SRY gene
c. androgen binding protein is responsible for the development of male external Genitalia
d. Wolffian duct regresses
e. dihydrotestosterone transforms indifferent external genitalia into penis and scrotum
Correct answer: b, e

545. CS. Most common cause of ambigious genitalia in a female child is:
a. placenta steroid sulfatase deficiency
b. fetal aromatase deficiency
c. wnt4 mutation
d. congenital adrenal hyperplasia
e. androgen producing tumor
Correct answer: d

546. CS. Most common cause of female pseudohermaphroditism is:


a. virilizing ovarian tumor
b. ovarian dysgenesis
85
c. exogenous androgen
d. congenital adrenal hyperplasia
e. adrenal tumor
Correct answer: d

547.CM. Female pseudohermaphrodizm true is:


a. 46XX chromosomal pattern
b. absent ovary
c. absent uterus
d. presence of testis
e. clitoromegaly
Correct answer: a, e

548.CS. The treatment for a case of virilizing adrenal hyperplasia is:


a. estrogens
b. antiandrogens
c. ACTH
d. cortisone
e. progesterone
Correct answer: d

549.CM. Common features of Turner’s syndrome:


a. secondary amenorrhea
b. edema of hands and feet
c. XO genotype
d. mental retardation common
e. streak ovaries
Correct answer: b, c, e

550.CM. All are features of Turner’s syndrome EXCEPT:


a. karyotype is 46 XO
b. normal breast
c. underdeveloped uterus
d. normal secondary sexual characteristics
e. primary amenorrhoea
Correct answer: b, d

551.CS. A girl presents with primary amenorrhea, shot stature, widely spaced nipple.
Karyotype of the girl would be:
a. 45XO
b. 46XXY
c. 46XY
d. 46XX
e. 46XYY
Correct answer: a

552.CS. 17-year-old girl with amenorrhea, absent breasts, hypoplastic uterus. Most likely
condition is:
a. Turner’s syndrome

86
b. Sheehan Syndrome
c. Androgen intensitivity syndrome
d. Klinefelter’s syndrome
e. Mullerian agenesis
Correct answer: a

553.CS. 15-year-old female presents with primary amenorrhea. Her breasts are Tanner 4 but
she has no axillary or pubic hair. The most likely diagnosis is:
a. Turner’s syndrome
b. Mullerian agenesis
c. Testicular feminization syndrome
d. Premature ovarian failure
e. Ovarian disgenesis
Correct answer: c

554.CM. Which of the following statement are true regarding androgen insensitivity
syndrome:
a. absent vagina
b. Karyotype is XX
c. Karyotype is XY
d. public hair is normally present
e. breast is development is normal
Correct answer: a, c, e

555.CS. A girl presents with: primary amenorrhea, grade V thelarche, grade II pubarche, no
axillary hair, likely diagnosis is:
a. testicular feminization syndrome
b. Mullerian agenesis
c. Turners syndrome
d. gonadal dysgenesis
e. Marfan syndrom
Correct answer: a

556.CS. In Testicular Feminization syndrome Gonadectomy is indicated:


a. as soon as it is diagnosed
b. at puberty
c. only when malignancy develops in it
d. when hirsutism is evident
e. after initiation of HRT
Correct answer: b

557.CS. Pure gonadal dysgenesis will be diagnosed in the presence of:


a. bilateral streak gonads
b. bilateral dysgenetic gonads
c. one side steak and other disgenetic gonads
d. one side streak and other normal looking gonad
e. XO Kariotipe
Correct answer: a

558.CM. True about Klinefelter syndrome:


a. XXY
b. XO
87
c. male hypogonadism
d. female hypogonadism
e. high FSH
Correct answer: a, c, e

559.CS. A pacient of 47 XXY karyotype present with feature of hypogonadism. Likely


diagnosis :
a. Turners syndrome
b. Klinefelters syndrome
c. Edwards syndrome
d. Down syndrome
e. Marfan syndrom
Correct answer: b

560. CS. A girl has primary amenorrhea with normal ovaries, absent internal genitalia, but
normal external genitalia. Most probable diagnosis:
a. Mayer-Rokitansky-Kuster-Hauser syndrome
b. Turner’s syndrome
c. Noonan’s syndrome
d. Androgen insensitivity syndrome
e. Kallman syndrome
Correct answer: a

561.CS. A 19-year-old patient came with primary amenorrhea. She had well developed
breasts and pubic hair. However there was absence of vagina and uterus. Likely diagnosis is:
a. Turners syndrome
b. Mullerian agenesis
c. Kinefelter’s syndrome-XXY
d. Gonadal agenesis
e. Moris syndrome
Correct answer: b

562.CS. In which of the following conditions do the ovaries functions normally:


a. Turner’s syndrome
b. Rokitansky-Kuster-Hauser syndrome
c. Androgen insensitivity syndrome
d. Swyer’s syndrome
e. PCOS
Correct answer: b

563.CM. Major risk factors for preeclampsia are:


a. chronic hypertension
b. primiparity
c. antiphosfolipid syndrom
d. previous eclampsia
e. smoking
Correct answer: a, c, d

564.CM. Risk factors for preeclampsia includes:


a. primiparity
b. multiparity
c. obesity
d. placenta previa
88
e. multiple pregnancy
Correct answer: a, c, e

565.CS. What is NOT considered criteria of severe preeclampsia:


a. severe headache
b. persistent oliguria
c. level of fibrinogen over 5 g/liter
d. thrombocytopenia < 100000 mm
e. elevated liver enzymes
Correct answer: c
566.CM. In preeclampsia impending signs of imminent eclampsia are:
a. blurred vision
b. waight gain more that 2 kg per week
c. severe proteinuria >5 gr/24 hours
d. severe headache
e. brick deep tendon reflexes
Correct answer: a, d, e

567.CS. All of the following indicate superimposed preeclampsia, EXCEPT:


a. new onset proteinuria
b. increase in systolic BP by 30 mm Hg and/or diastolic BP by 15 mm Hg
c. trombocitopenia
d. elevated liver enzimes
e. oliguria
Correct answer: b

568.CM. The following pathophysiologic changes are characteristic for preeclampsia:


a. vasoconstriction
b. hypovolemia
c. decreased peripheral vascular resistance
d. increased vascular permeability
e. activation of coagulation system
Correct answer: a, b, d, e
569. CM. Laboratory changes characteristic to severe preeclampsia include:
a. increased level of creatinine
b. elevated liver enzymes
c. decreased hematocrit
d. thrombocytopenia
e. hyperproteinemia
Correct answer: a, b, d,
570.CM. What complications of pregnancy are characteristic to preeclampsia:
a. fetal growth restriction
b. preterm delivery
c. antepartum fetal death
d. embriopathies
e. polihydramnios
Correct answer: a, b, c
571.CM. What are two main causes of death in women with preeclampsia / eclampsia:
a. renal necrosis
b. liver insufficiency
89
c. intra-cerebral hemorrhages
d. pulmonary edema
e. liver rupture
Correct answer: c, d
572.CM. Risk of which complications is increased by preeclampsia:
a. abruptio placenta
b. fetal macrosomia
c. DIC syndrome
d. postpartum thromboembolism
e. fetal growth restriction
Correct answer: a, c, d, e
573.CM. What are the possible consequences of preeclampsia/eclampsia
a. antenatal death of the fetus
b. coagulopathic hemorrhage
c. prematurity
d. retinal detachment
e. placenta previa
Correct answer: a, b, c, d
574.CM. Which are the indications for pregnancy termination in case of severe preeclampsia:
a. persistent oliguria
b. thrombocytopenia
c. pulmonary edema
d. hydramnios
e. severe fetal growth restriction
Correct answer: a, b, c, e

575.CM. What are considered criteria of severe preeclampsia:


a. proteinuria more than 1 g/day
b. persistent oliguria
c. level of fibrinogen over 5 g/liter
d. thrombocytopenia under 100000 mm
e. generalized edema
Correct answer: b, d

576.CM. Following drugs are used to treat pregnancy associated hypertension:


a. labetalol
b. captopril
c. methyldopa
d. nifedipine
e. hydralazine
Correct answer: a, c, d, e

577.CM. Which of the following antihypertensives are not safe in pregnancy:


a. labetalol
b. ace inhibitors
c. methyldopa
d. nifedipine
e. enalapril
Correct answer: b, e

578.CS. Which of the following antihypertensives is not given in pregnancy:


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a. labetalol
b. enalapril
c. methyldopa
d. nifedipine
e. hydralazine
Correct answer: b

579.CM. Which of the following may be an early warning sigh of preeclampsia?


a. weight gain during the last months of pregnancy
b. generalized edema especially of the face
c. leg cramps
d. edema of the feet at the end of the day
e. pain on passing urine
Correct answer: a, b
580.CM. What are important sighs of magnesium sulphate over-dosage?
a. respiratory depression
b. hyperventilation
c. a urine output of less than 30 ml per hour
d. depressed tendon reflexes
e. tachycardia
Correct answer: a, d
581.CS. All of the following can be administered in acute hypertension during labor,
EXCEPT:
a. labetalol
b. hydralasine
c. nitropruside
d. nifedipine
e. diazoxide
Correct answer: e

582.CS. Which is the drug of choice for management of eclampsia


a. diazepam
b. phenitoin
c. fenobarbital
d. MgSO4
e. E-lytic cocktail regime
Correct answer: d

583.CS. Which is the drug of choice for severe hypertension caused by preeclampsia:
a. labetalol
b. metoprolol
c. methyldopa
d. nifedipine
e. hydralazine
Correct answer: a

584.CM. Which of the following women has high risk of preeclampsia?


a. a patient with a history of preeclampsia starting early in the third trimester of a previous
pregnancy
b. a patient with chronic hypertension
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c. grande multiparas
d. twin pregnancy
e. a patient with a history of postpartum hemorrhage
Correct answer: a, b, d
585.CS. A 28 year old woman with preeclampsia develop convulsions. The first measure to
be done after convulsions:
a. give MgSO4
b. sedation
c. immediate delivery
d. care of airway
e. give Nifedipine
Correct answer: d

586.CM. Which of the following are contraindications to giving syntometrine during the third
stage of labor:
a. an atonic uterus
b. hypotension after delivery
c. gestational hypertension
d. preeclampsia
e. fetal macrosomia
Correct answer: c, d

587.CM. What are rare causes of death in women with pre-eclampsia?


a. hepatic rupture
b. pulmonary edema
c. renal insufficiency
d. hepatic failure
e. intracerebral hemorrhage
Correct answer: a, c, d

588.CM. Which are NOT features of HELLP syndrome:


a. thrombocitopenia
b. eosinophilia
c. creatinin doubling baseline
d. raised liver enzyme
e. hemolitic anemia
Correct answer: b, c

589.CS. All are true about preeclampsia, EXCEPT:


a. cerebral hemorrhage
b. pulmonary edema
c. acute renal failure
d. deep venous thrombosis
e. liver rupture
Correct answer: d

590.CS. The leading cause of death in severe preeclampsia /eclampsia is:


a. cerebral hemorrhage
b. pulmonary edema
c. acute renal failure
d. deep venous thrombosis

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e. liver rupture
Correct answer: a

591.CS. Earliest sign of MgSO4 toxicity is:


a. hypotension
b. anuria
c. coma
d. respiratory depression
e. depression of deep tendon reflexes
Correct answer: e

592.CS. What is antidote used in cases of MgSO4 toxicity:


a. protamin sulphate
b. calcium gluconate
c. cofeine
d. atropine
e. naloxone
Correct answer: b

593.CS. A previously normotensive women, at 32 weeks of pregnancy, has a blood pressure


150/100 mm Hg, proteinuria 0,03 gr/24 hours, edema of legs. What is the diagnosis:
a. chronic hypertension
b. gestational hypetension
c. mild preeclampsia
d. severe preeclampsia
e. transient hypertension
Correct answer: b
594.CS. A previously normotensive women, at 32 weeks of pregnancy, has a blood pressure
150/100 mm Hg, proteinuria 0,5 gr/24 hours, pedal edema. What is the diagnosis:
a. chronic hypertension
b. gestational hypetension
c. mild preeclampsia
d. severe preeclampsia
e. transient hypertension
Correct answer: c

595.CS. A patient with preexisting hypertension who develops a diastolic blood pressure of
105 mm Hg and 2+proteinuria (1 gr/day) at 36 weeks of pregnancy should be graded as
having:
a. pre-eclampsia
b. severe pre-eclampsia
c. imminent eclampsia
d. eclampsia
e. superimposed preeclampsia
Correct answer: e
596.CM. What is the management of a patient with pre-eclampsia at 36 weeks gestation?
a. oral antihypertensive drugs
b. diuretics
c. hospitalization
d. a loading dose of magnesium sulfate
e. delivery
Correct answer: a, c, e
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597.CS. How common is preeclampsia?
a. most pregnant women develop preeclampsia
b. about 25% of all women develop preeclampsia
c. about 15% of all women develop preeclampsia
d. about 3-5% of all women develop preeclampsia
e. very rare
Correct answer: d
598.CS. A previously normotensive woman, at 32 weeks of pregnancy, has a blood pressure
170/110 mm Hg, proteinuria 5,0 gr/24 hours, severe headache, nausea and vomiting. What is
the diagnosis?
a. chronic hypertension
b. gestational hypetension
c. mild preeclampsia
d. severe preeclampsia
e. transient hypertension
Correct answer: d

599.CM. A previously normotensive women, at 32 weeks of pregnancy, has a blood pressure


170/110 mm Hg, proteinuria 5,0 gr/24 hours, severe headache, nausea and vomiting. What is
the management ?
a. antihypertensive treatment
b. evaluation of fetal well-being
c. diuretics
d. dexametazone.
e. MgSO4
Correct answer: a, b, d, e
600. CM. Which drugs are contraindicated in preeclampsia?
a. hydralazin
b. metil-ergometrin.
c. misoprostol
d. captopril
e. nifedipine
Correct answer: b, d

601.CM. Complications of preeclampsia are the following:


a. retinal detachment
b. intracranial hemorrhage
c. fetal growth restriction
d. hydramnion
e. renal insufficiency
Correct answer: a, b, c, e

602.CS. All of the following are possible consequneces of preeclampsia, EXCEPT:


a. antepartum fetal death
b. coagulopathic bleeding
c. prematurity
d. blindness
e. fetal malformations
Correct answer: e

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