ALL Ob-Gyn MCQS: Compiled and Edited by

ALL
OB-GYN
MCQs
Compiled and Edited By:
All OB-GYN MCQs Second rearranged Edition 2011
PartI:BasicsInOB-GYN:
1. History and Examination in OB-GYN: ........................................................................... 5
2. Anatomy of the female genital tract, bony pelvis and fetal skull: ............................... 6
3. Labor and Fetal Surveillance and Mechanism of Labor: .............................................. 9
4. Embryology of Female genital tract, Malformations, intersexuality and Puberty:.... 18
5. Physiology of Menstrual Cycle:................................................................................... 24
6. Physiological Changes During pregnancy: .................................................................. 29
7. Reproductive Biology:................................................................................................. 37
8. Antenatal Care: ........................................................................................................... 38
9. Fetal assessment: ....................................................................................................... 44
10. The Neonates:............................................................................................................. 46
PartII:Obstetric&PostpartumComplications:
11. Multiple Pregnancy:.................................................................................................... 47
12. Bleeding in early pregnancy: ..........................................................................................
Abortions: .............................................................................................................. 52
Ectopic pregnancies:.............................................................................................. 59
13. Antepartum Hemorrhage: .......................................................................................... 64
14. Rh isoimmunization and ABO incompatibility:........................................................... 71
15. Postpartum Hemorrhage and Coagulation disorder: ................................................. 74
16. Instrumental deliveries, C-section and Vaginal Birth After C-section (VBAC):........... 77
17. Premature Labor and PROM: ..................................................................................... 83
18. Prenatal Infections: .................................................................................................... 89
19. IUGR and IUFD: ........................................................................................................... 92
20. Post-term and IOL:...................................................................................................... 95
21. Abnormal Presentation and Breech: .......................................................................... 98
22. Puerperium and Puerperal Sepsis: ........................................................................... 103
PartIII:MedicalComplicationsinPregnancy:
23. Hypertensive Disorders in Pregnancies: ................................................................... 107
24. Diabetes in Pregnancy: ............................................................................................. 116
25. Anemia and Thyroid Diseases in Pregnancy:............................................................ 122
26. Cardiovascular Diseases: .......................................................................................... 123
27. Urinary Tract Diseases in pregnancies: .................................................................... 125
28. General Questions: ................................................................................................... 126
PartIV:Gynecology:
29. Contraception: .......................................................................................................... 129
30. Infections of the lower genital Tract: ....................................................................... 136
31. Pelvic Inflammatory Disease (PID):........................................................................... 139
32. Infertility and Hirsutism:........................................................................................... 142
33. Amenorrhea:............................................................................................................. 149
34. Incontinence & Genital Prolapse:............................................................................. 154
35. Menopause:.............................................................................................................. 158
36. Abnormal Uterine Bleeding: ..................................................................................... 161
37. Dysmemorrhea & PMS & Endometriosis: ................................................................ 165
3
PartV:Oncology:
38. General Oncology: .................................................................................................... 169
39. Uterine Fibroids (Leiomyomas): ............................................................................... 170
40. Benign and Malignant Ovarian cancer: .................................................................... 174
41. Uterine carcinoma: ................................................................................................... 178
42. Cervical cancer:......................................................................................................... 180
43. Gestational Trophpblastic Diseases (GTD): .............................................................. 182
424 Exams: ............................................................................................................................ 184
425 Exams:
Mid-Cycle: ......................................................................................................................... 203
Final:.................................................................................................................................. 206
426 Exams:
Mid-Cycle: ......................................................................................................................... 214
Mid-Cycle: ......................................................................................................................... 229
Final:.................................................................................................................................. 246
427 Exams:
Mid-Cycle: ......................................................................................................................... 256
Final:.................................................................................................................................. 268
428 Exams:
Mid-Cycle: ......................................................................................................................... 276
Final:.................................................................................................................................. 290
4
HistoryandExaminationinOB-GYN:
1. The Expected date of delivery of a human pregnancy can be calculated:
A. From a change in the patient's weight.
B. As 10 lunar months after the time of ovulation.
C. As40weeksafterlastmenstrualperiod.
D. As 280 days from the last full moon.
E. As 36 weeks after the last menstrual period.
2. The last menstrual period was June 30. the expected date of delivery (EDD) is
approximately:
A. March 23.
B. April 7.
C. March 28.
D. April 23.
E. March7.
5
Anatomyofthefemalegenitaltract,bony
pelvisandfetalskull:
1. Uterine Cervix:
A. Istheportionoftheuterusbelowtheisthmus B.
External OS cell lining is columnar epithelium C.
Laterally is attached to the round ligament
D. The cervical canal is covered with stratified squamous epithelium
E. Can be dilated with dilators without the need of anesthesia
2. The main support of the uterus is provided by

A. The round ligament
B. Thecardinalligament
C. The infandilo-pelvic ligament
D. The integrity of the pelvis
E. The broad ligament
3. The most important muscle in the pelvic floor is:

A. Bulbo cavernousus.
B. Ischio-cavernosus.
C. Levatorani.
D. Superficial transverse Perineal muscle.
E. Deep transverse Perineal muscle.
4. The pelvis includes which of the following bones:

A. Trochanter, hip socket, ischium, sacrum & pubis.
B. Ilium,ischium,pubis,sacrum&coccyx.
C. Ilium, ischium & pubis.
D. Sacrum, Ischium, ilium & pubis.
E. Trochanter, sacrum, coccyx, ilium & pubis.
5. The joint between the two pubic bones is called the:

A. Sacroiliac joint.
B. Pubissymphysis.
C. Sacrococcygeal joint.
D. Piriformis.
E. Intervertebral joint
6. The greatest diameter of the fetal head is:

A. Occipitofrontal.
B. Occipitomental.
C. Suboccipit bregmatic.
6
D. Bitemporal.
E. Biparietal.
7. Molding of the fetal head:

A. Usually cause brain damage.
B. Becomes progressively easier as gestational age increase.
C. Increase the difficulty of delivery.
D. DoesNOThavetimetooccurinbreechdelivery.
E. Does not happen when maternal pelvis is adequate.
8. The main blood supply of the vulva is:

A. Inferior hemorrhoidal artery.
B. Pudendalartery.
C. Ilioinguinal artery.
D. Femoral artery.
E. Inferior Hypogastric artery.
9. The following are typical in the female bony pelvis EXCEPT:

A. Has a transverse diameter of the inlet greater than the antero-posterior
diameter.
B. Has an obstetric conjugate of 11-12 cm.
C. Isfunnelshaped.
D. Has an obtuse greater sciatic notch.
E. Has a pubic angle greater than 90 degrees.
10. Regarding fetal head, Choose the CORRECT answer:

A. Can be delivered vaginally in persistent occipito-mental Presentation.
B. Will show Spalding's sign within 12 hours of Intrauterine death.
C. Can be delivered vaginally in persistent brow presentation.
D. Is likely to be a vertex presentation when the head is deflexed.
E. ConsideredtobeengagedwhentheBiparietaldiameterpassesthelevel ofthe
pelvicinlet.
11. The ovarian artery is a branch of:

A. Common iliac artery.
B. Internal iliac artery.
C. Aorta. D.
Hypogastric artery. E.
Sacral artery.
12. The normal lining of the fallopian tube is:

A. Squamous epithelium.
B. Transitional epithelium.
C. Cuboidal epithelium.
7
D. Columnarepitheliumwithcilia.
E. Fibrous connective tissue.
13. The cilia of the fallopian tube has the following function: A.
Remove the zona pellucida which surrounds the ovum. B.
Transporttheovumtowardstheuterus.
C. Enhance the rapid division of the zygote.
D. Transport the ovum towards the peritoneal cavity.
E. Has a bactericidal function to prevent peritoneal function
8
LaborandFetalSurveillanceandMechanismof
Labor:
1. Hyperextension of the fetal head is found in:
A. Vertex presentation
B. Facepresentation
C. Shoulder presentation
D. Breach presentation
E.Hydrocephalic baby
2. Stages of labor
A. The first stage commences at the time of membrane rupture
B. The cervix dilates at consistent rate of 3 cm per hour in the first stage
C. Thethirdstageendwiththedeliveryoftheplacentaandmembranes D.
Forceps or ventose may be useful in slow progress of the late 1st stage E.
Syntometrine is a combination of oxytocin and Ergometrine which is
used in the treatment of secondary postpartum haemorrhage (PPH)
3. All the following characteristics are applied to a pelvis favorable to vaginal

delivery EXCEPT:
A. Sacral promontory can not be felt.
B. Obstetricconjugateislessthan10cm.
C. Ischial spines are not prominent.
D. Subpubic arch accepts 2 fingers.
E. Intertuberous diameter accepts 4 knuckles on pelvic exam.
4. In the fetus:
A. The coronal suture lies between the two parietal bones.
B. The umbilical artery normally contains one artery and two veins.
C. Fetalliedescribesthelongaxisofthefetustothelongaxisofthemother.
D. Entanglement of the umbilical cord is common in diamniotic twins.
E. The anterior Fontanelle is usually closed by the time of labor.
5. Which of the following terms best describes the pelvic type of small posterior
saggital diameter, convergent sidewalls, prominent ischial spines, and narrow
pubic arch?
A. Android.
B. Gynecoid.
C. Anthropoid.
D. Platypelloid.
E. Mixed.
9
6. The second stage of labor involves:

A. Separation of the placenta.
B. Effacement of the cervix.
C. Expulsion of the placenta.
D. Dilation of the cervix.
E. Expulsionofthefetus.
7. Which is true?
A. Position – cephalic.
B. Station–levelofischialspines.
C. Presentation – flexion.
8. A pelvic inlet is felt to be contracted if :

A. The anterio-posterior diameter is only 12 cm.
B. Thetransversediameterisonly10cm .
C. Platypelloid pelvis.
D. The mother is short.
E. The patient had a previous C-section.
9. During clinical pelvimerty, which of the following is routinely measured:

A. Bi-ischeal diameter.
B. Transverse diameter of the inlet.
C. Shapeofthepubicarch.
D. Flare of the iliac crest.
E. Elasticity of the levator muscles.
10. At term, the ligaments of the pelvis change. This can result in:
A. Increasing rigidity of the pelvis.
B. Degeneration of pelvic ground substance.
C. Decreasing width of the symphysis.
D. Enlargementofthepelviccavity.
E. Posterior rotation of the levator muscles.
11. During clinical pelvimetry, which of the following is routinely measured:

A. True conjugate.
B. Transverse diameter of the inlet.
C. Shapeofthepubicarch.
D. Flare of the iliac crest.
E. Elasticity of the levator muscles.
10
12. During the delivery, the fetal head follow the pelvic axis. The axis is best
described as:
A. A straight line.
B. A curved line, 1ST directed anteriorly then caudal. C.
Acurvedline,1STdirectedposteriorlythencaudal. D. A
curved line, 1ST directed posteriorly then cephalic. E.
None of the above.
13. A head of level (one fifth) indicates:

A. Indicates that one fifth of the head is below the pelvic brim.
B. Indicatesthattheheadisengaged.
C. Indicated that forceps may not be used.
D. Indicates that head is at the level of the ischial spines.
E. Always occur in a term brow presentation.
14. In a vertex presentation, the position is determined by the relationship of what

fetal part to the Mother's pelvis:
A. Mentum.
B. Sacrum.
C. Acromian.
D. Occiput.
E. Sinciput.
15. Signs of Placental separation after delivery include:

A. Bleeding.
B. Changes of uterine shape from discoid to globular.
C. Lengthening of the umbilical cord.
D. Presentation of the placenta at the cervical os.
E. Alloftheabove.
16. The persistence of which of the following is usually incompatible with

spontaneous delivery at term:
A. Occiput left posterior
B. Mentumposterior.
C. Mentum anterior.
D. Occiput anterior.
E. Sacrum posterior.
17. An unstable lie is related to all of the following EXCEPT:

A. Prematurity.
B. Grand multiparty.
C. Placenta previa.
D. Fundalfibroid.
E. Cervical fibroid.
11
18. The relation of the fetal parts to one another determines:

A. Presentation of the fetus.
B. Lie of the fetus.
C. Attitude of the fetus.
D. Positionofthefetus. E.
None of the above.
19. The relationship of the long axis of the fetus to the long axis of the mother is
called:
A. Lie.
B. Presentation.
C. Position.
D. Attitude.
E. None of the above.
20. Engagement is strictly defined as:

A. When the presenting part goes through the pelvic inlet.
B. When the presenting part is level with the ischial spines.
C. WhenthegreatestBiparietaldiameterofthefetalheadpassesthepelvic inlet.
D. When the greatest Biparietal diameter of the fetal head is at the level of
ischial spines.
21. The fetal head may undergo changes in shape during normal delivery. The
most common etiology listed is:
A. Cephalohematoma.
B. Molding.
C. Subdural hematoma.
D. Hydrocephalus.
22. If the large fontanel is the presenting part, what is the presentation?
A. Vertex.
B. Sinciput.
C. Breech.
D. Face.
E. Brow.
23. Methods of determining fetal presentation & position include:

A. Cullen's sign.
B. Leopold'smaneuver.
C. Mauriceau-Smelli-Veit maneuver.
D. Carful history taking.
12
E. All of the above.
24. A transverse lie of the fetus is least likely in the presence of:
A. Placenta previa.
B. Pelvic contraction.
C. Preterm fetus.
D. Grand multiparity.
E. Normaltermfetus.
25. What is the station where the presenting part is at the level of the ischialspines
A. -2 .
B. -1 .
C. 0 .
D. +1 .
E. +2 .
26. A primpara is in labor and an episiotomy to be cut. Compared with a mid line
episiotomy, an advantage of medio-lateral episiotomy is:
A. Ease of repair
B. Fewer break downs
C. Lower blood loss
D. Less dyspareunia
E.Lessextensionoftheincision
27. A patient sustained a laceration of the premium during delivery, it involved the
muscles of Perineal body but not the anal sphincter. Such a laceration would
be classified as : A.
First degree
B. Seconddegree
C. Third degree
D. Forth degree
E. Fifth degree
28. An unstable lie is associated with all the following EXCEPT :

A. Prematurity
B. Grand multiparity
C. Placenta previa
D. Fundal fibroid
E. Cervicalfibroid
29. A primipara is in labor & and an episiotomy is about to be cut. Compared with
a midline episiotomy, an advantage of mediolateral episiotomy.
A. Ease of repair,
B. Fewer break downs.
13
C. Lower blood loss.

D. Less Dyspareunia.
E. Lessextensionoftheincision.
30. Which of the following statements about episiotomy if FALSE:

A. Median (midline) episiotomy is generally considered to be less painful the
mediolateral episiotomy.
B. Mediolateral or lateral episiotomy may be associated with more blood
loss than median one.
C. Indications for episiotomy include avoiding an imminent Perineal tear,
the use of forceps, breech delivery, & the delivery of premature infants.
D. Theearliertheepisiotomyisdoneduringdelivery,generallythemore
beneficialitwillbeunspeedingdelivery.
E. Episiotomy incisions are repaired anatomically in layers.
31. Regarding Episiotomy:

A. Commonly done in Left medio lateral side.
B. External anal sphincter is included in episiotomy.
C. Itisdoneaftertheheadcrownappear(crowning).
32. The first stage of labor :

D. EndswithfullyDilationofthecervix.
E. Expulsion of the fetus.
33. The heart rate of a normal fetus at term:

A. 80-100 bpm.
B. 100-120 bpm.
C. 120-160 bpm.
D. 160-180 bpm.
E. There is no baseline heart rate.
34. Repetitive late decelerations most commonly indicate:

A. Fetal academia.
B. Fetalhypoxia.
C. Fetal sleep state.
D. Fetal efforts of maternal sedation.
E. Rapid cervical dilation
35. Electronic fetal monitoring:

A. Has high specificity but low sensitivity.
B. Haslowspecificitybuthighsensitivity.
14
C. Has low specificity & sensitivity.

D. Has high specificity & sensitivity.
E. Has moderate sensitivity & specificity.
36. What is the uterine blood flow at term:

A. 50 ml/min.
B. 100 to 150 ml/min.
C. 300 to750 ml/min.
D. 500 to 750 ml/min.
E. 200 ml/min.
37. Regarding Fetal blood pH:

A. Can only be measured postnatally.
B. Is not a reliable way of assessing fetal distress.
C. Is dangerous to perform & should not be done.
D. Of 6.9 is considered to be normal.
E. Canbemeasuredduringlabor.
38. The following are major indicators of fetal asphyxia:

A. Old meconium at the time of induction of labor.
B. Loss of acceleration.
C. Deep type I deceleration in the 2ND stage of labor.
D. TypeII(late)decelerationswithtachycardia.
E. Excessive fetal movements
39. Which of the following is NOT a characteristic of normal labor:

A. Progressive cervical dilation.
B. Increasing intensity of contractions.
C. Uterine relaxation between contractions.
D. Moderatebleeding.
E. Moderate pain.
40. Bishop score includes all the followings EXCEPT:

A. Dilation of the cervix.
B. Position of the cervix.
C. Thepresentingpartofthefetus.
D. Length of the cervix.
E. Consistency of the cervix..
41. During which of the following conditions would the serum Prolactin level be
greatest:
A. sleep.
B. Ovulation.
C. Parturition.
15
D. Menopause.
E. Suckling.
42. Regarding Prostaglandins:

A. Maintain the corpus luteum of early pregnancy.
B. Have no role in the development of menorrhagia.
C. Areinvolvedintheonsetoflabor.
D. Have no rule in the development of dysmenorrhea.
E. Are small polypeptides.
43. Early deceleration is :

A. Associated with unengaged head of the fetus.
B. Associated usually with brain asphyxia.
C. A decrease in the fetal heart beat that peaks after the peak of uterine
contraction.
D. An indication of C-section.
E. Resultsfromincreasedvagaltonesecondarytoheadcompression.
44. The normal cord pH is :

A. 6.1.
B. 6.2.
C. 7.0.
D. 7.1.
E. 7.2.
45. The bishop score is used to predict :

A. The state of the fetus at the time of delivery.
B. Thesuccessrateoftheinductionofthelabor. C.
The fetal condition in the uterus.
D. The maternal well being in labor.
E. The maternal well being postpartum.
46. Which of the following fetal scalp pH results should prompt immediate
delivery:
A. 7.30.
B. 7.22.
C. 7.18.
D. 7.26.
E. 7.25
47. The volume of amniotic fluid is:

A. Is closely related to the fetal crown-rump length in the 3rd trimester of
A. Pregnancy
B. MaybepredictedbyUltrasound
16
C. Is reduced in sever rhesus disease

D. Increases following amniocentesis
E. Is increased in sever pre-eclampsia
48. Fetal nutrition is dependent on:

A. Maternal nutrient stores.
B. Maternal diet.
C. Placental exchange.
D. Maternal metabolism.
F. Alloftheabove.
49. Cephalopelvic disproportion in the absence of gross pelvic abnormality can be

diagnosed by:
A. Ultrasound.
B. A maternal stature of less than 158 cm.
C. Trialoflabor.
D. X-ray pelvimetry.
E. Pelvic examination.
50. Maternal mortality is lowest in mothers between what age groups:

A. 10 - 20.
B. 20 - 30.
C. 30 - 40.
D. 40 - 50.
E. 50 - 60.
51. Umbilical cord prolapse is associated with all the following, EXCEPT :
A. Post maturity.
B. Cephalo pelvic disproportion.
C. Multiparity.
D. Footing breech presentation.
E. Anencephaly.
52. In a Case of labor with meconium stained amniotic fluid, your next step is:
A. Amnio-infusion
B. Close observation
C. Fetalscalpbloodsample
D. Immediate C/S
17
EmbryologyofFemalegenitaltract,Malformations,
intersexualityandPuberty:
1. In patient with bicornuate uterus when getting pregnant can get all these
complication, EXCEPT:
A. Polyhydramnios
B. Abortion
C. Preterm labor
D. Abnormal fetal lie
E. Retained placenta
2. In Turner's syndrome:
A. A chromosomal structure of 45 XY is characteristic
B. Secondary amenorrhea is usual
C. Ovariesarestreak
D. The ovaries are multicystic
E. Phenotypically are male
3. Sexual differentiation
A. Developmentofmalegenitaliadependsonthepresenceoffunctioning
testesandresponsiveendorgans
B. Due to the absence of testes XX fetus exposed to androgens in uteri will
NOT be musculinized
C. The development of the female genital requires presence of the ovary
D. 45 XO fetus will have normal ovaries
E. The development of the testes does not require presence of the Y
chromosome
4. Turner syndrome: Which is true?

A. Genetically is 46 X O
B. Has testis in inguinal area
C. Usuallypresentswithprimaryamenorrhea.
D. Has low I.Q
E. Usually tall
5. Androgen insensitivity syndrome: Which is true?

A. Genotype is 46 XX
B. Phenotype they are female but with ill-developed breast
C. Usually have secondary amenorrhea
D. They have testes that should be kept to produce hormones
E. Theyhavenouterus
18
6. The karyotype of patient with Androgen insensitivity Syndrome is

A. 46XX
B. 46XY
C. 47XXY
D. 45XO
E. 45 XY
7. In Turner syndrome the following are usually present EXCEPT:

A. theovaryareusuallywelldeveloped.
B. The nipple are widely spaced
C. The girls are of short stature
D. Has web neck
E. The condition can be diagnosed by chromosomal
8. Regarding Androgen insensitivity syndrome all true EXCEPT:

A. Thechromosomalsexis46XX.
B. Scant or no pubic and axillary hair.
C. No uterus
D. Normal female external genetailia
E. Breast are usually well develop
9. Which is not true about Turner's syndrome:

A. Short stature
B. Buccalsmearischromatinpositive
C. The majority are 45XO
D. Very low urinary estrogen titer
E. High pituitary gonadotropin titer.
10. Androgen Insensitivity Syndrome:

A. The characteristic features include normal uterus and breast development,
and ambiguous genitalia.
B. The Karyotyping is 46XX.
C. They have normal female testosterone level.
D. Gonadectomymustbeperformedafterpubertybecauseoftheincreasedrisk of
malignancy.
E. Estrogen replacement therapy is not indicated because they have enough
estrogens to produce breast development.
11. While evaluating a 30-year-old woman for infertility, you diagnosed a

bicornuate uterus. You explain that additional testing is necessary because of
the woman's increased risk of congenital anomalies in which system?
A. Skeletal.
B. Hematopoietic.
C. Urinary.
19
D. Central nervous.
E. Tracheoesophageal.
12. Development stage:

A. Testosterone is secreted by Sertoli cells.
B. Anti-müllerian hormone is secreted by Leydig cells.
C. Anti-müllerianhormoneisresponsibleforinvolutionofnormalmüllerian
system.
13. Bicornuate uterus can cause all of the following EXCEPT:

A. Abortions
B. Abnormal fetal lie.
C. Infertility.
D. Retained placenta.
E. Congenitalanomaliesofthebaby.
14. In Turner’s syndrome patients, all of the following are true EXCEPT:
A. Thestreakovariesshouldberemovedsurgicallydueto25%tendencytobe
malignant.
B. Are usually less than 5 feet tall.
C. Have raised FSH levels.
D. Have female internal genitalia.
E. Have normal but infertile external genitalia.
15. The adenxea Uteri include all of the following EXCEPT:

A. Ovary.
B. Fallopian tubes.
C. Uterus.
D. Broad ligament.
E. Round ligament.
16. In the development of external genitalia: A.

Genital tubercles from the labia minora. B.
Genital smoothing from the labia majora. C.
Genitalfoldfromscrotuminmale.
D. Chlydrotestone is essential for muscularity of external genitalia.
E. Müllerian system develops to external genitalia.
17. Congenital uterine malformations causes all of the following EXCEPT:

A. Spontaneous abortions.
B. Premature labor.
C. Pregnancyinducedhypertension.
D. Abnormal fetal lie.
E. May Obstruct labor.
20
18. Ovarian Dysgenesis is associated with the elevation of which of the following
hormones.
A. PituitaryGonadotropins.
B. Estradiol.
C. Estriol.
D. Pregnandiol.
E. Progesterone.
19. Confirmation of the diagnosis of Turner syndrome is best done by:

A. Gyn PV examination.
B. Pregnantriol estimation.
C. Hysterosalpingography (HSG)
D. Chromosomalanalysis(Karyotyping).
E. Estimation of hypophyseal gonadotropins.
20. In cases of androgen insensitivity syndrome the following findings are true
EXCEPT:
A. Thechromosomalsexis46XX
B. Scant or no pubic or axillary hair.
C. No uterus.
D. Normal female external genitalia.
E. Breast are usually well developed.
21. In testicular feminization syndrome:

A. Thereareusuallynormaltestes.
B. Kalman's syndrome is a recognized cause.
C. Breast development is usually lacking.
D. There's usually very low testosterone level.
E. The karyotype is 46 XX.
22. In Turner's syndrome, the following are usually observed EXCEPT:

A. Theovariesareusuallywelldeveloped.
B. The nipples are widely spaced.
C. The girl is of short stature.
D. Has a webbed neck.
E. The condition can be diagnosed by chromosomal analysis.
23. Regarding the Development of internal genital organs:

A. The uterus, fallopian tubes, cervix & upper vagina develop from the
mesophrenic duct.
B. The testes secretes testosterone which cause regression of the müllerian
ducts in the male fetus.
C. The vagina is formed by the Urogenital sinus.
21
D. Müllerianagenesis(Mayer-Rokittanky-Kuster-Husersyndromes)is
characterizedbytheabsenceoftheuterus&uppervaginawithnormal
femaleexternalgenetailia&46XX.
E. Bicornuate uterus & uterus didelphus result from vertical fusion defects of
the müllerian ducts.
24. Regarding puberty, all of the following are true EXCEPT:

A. It is the transitional period of development during which an individual
matures from childhood to sexual & reproductive maturity.
B. Breast budding is the 1ST visible sign of puberty.
C. The maximum growth velocity occurs at 12 years.
D. Theageofmenarchehasdecreasedoverthelast3-4decadesdueto
improvednutrition,generalhealth&lifestylechanges.
E. Thelarche marks the attainment of reproductive maturity.
25. Turner's syndrome is associated with :

A. Absent uterus
B. Normal breast development
C. Primaryamenorrhea
D. Hirsutism
E. Normal height
26. Anomalies or the uterus can be associated with the following EXCEPT:
A. Urinary tract abnormalities.
B. Recurrent pregnancies loss.
C. Preterm labor.
D. Müllerian tract anomalies.
F. Polycysticovary.
27. First endocrine influence in 2ry sexual characters:

A. Secretion of delta-4 Androstenedione from the adrenal gland
B. Pineal body maturation
C. Pituitary maturation
D. Hypothalamicdownregulation.
28. Follicular growth (in non-ovulating follicle) is usually followed by:

A. Ovulation.
B. Cyst formation.
C. Atresia.
D. Arrest.
E. Regression.
22
29. The normal sequence of pubertal changes in the female is:

A. Thelarche,Maximalgrowthvelocity,menarche.
B. Maximal growth velocity, Thelarche, menarche.
C. Thelarche, menarche, maximal growth velocity.
D. Menarche, maximal growth velocity, Thelarche.
E. Menarche, body weight, Thelarche.
30. The barr body is:

A. ThecondensednonfunctioningXchromosome.
B. The darkest, widest band found on chromosomes.
C. On extra lobe on the female polymorpholnuclear leukocytes.
D. Found only in females.
E. The largest chromosome in the female genotype.
31. The most common cause of precocious puberty is :

A. Idiopathic.
B. Gonadoblastoma.
C. Albright syndrome.
D. Abnormal skull development.
E. Granulosa cell tumor.
32. The normal sequence of puberty is :

A. Thelarche,adrenarche,growth,menarche. B.
Menarche, adrenarche, thelarche ,growth. C.
Growth. thelarche, adrenarche, menarche D.
Adrenarche , thelarche, growth, menarche E.
Thelarche , menarche, adrenarche, growth.
23
PhysiologyofMenstrualCycle:
1. Which of the following is suggestive of ovulation:
A. Basal body temperature drop at least 0.5C in the second half of the cycle
B. Day 21 estrogen level is elevated
C. Progesterone level on day ten of the cycle is elevated
D. Regularcyclewithdysmenorrhea
E. Oligomenorrhoea
2. The luteal phase of the menstrual cycle is associated with:

A. High luteinizing hormone level
B. Highprogesteronelevels
C. High prolactin level
D. Low basal body temperature
E. Proliferative changes in the endometrium
3. The follicular phase of menstrual cycle is characterized by:

A. Endometrialglandproliferation.
B. Decreased Ovarian Estradiol production.
C. Progesterone dominance.
D. A fixed length of 8 days.
E. A reduction in aromatase activity.
4. A sample of cervical mucus is taken on day 12 of the menstrual cycle. The mucus is
thin, clear, & stretchy. It placed on a slide and allowed to air dry. When placed
under microscopic, what would you expect:
A. Calcium citrate.
B. Clear fields, devoid of bacteria Cell.
C. Thick mucus with background bacteria.
D. Afrenpatterncharacteristicofestrogen.
E. Clearly defined para-basal cells.
5. Estrogen hormone is produced from all of the following organs EXCEPT:

A. Corpus luteum.
B. Anteriorpituitary(anteriorlobeofhypophysis).
C. Placenta.
D. Testes,
E. Adrenal glands.
6. The midcycle LH surge:

A. Enhances thecal cell androgen production.
B. Luteinizes granulose cells.
C. Initiates resumption of meiosis.
24
D. Facilitates oocyte expulsion.

E. Alltheabove.
7. An involuted corpus luteum becomes a hyalinized mass known as a:

A. Corpus delicti.
B. Corpus granulosa.
C. Graafian follicle.
D. Corpus atrectica.
E. Corpusalbicans.
8. Which of the following is the best method to predict the occurrence of ovulation:
A. Thermogenic shift in basal body temperature.
B. LHsurge.
C. Endometrial decidulaization.
D. Profuse, thin, acellular cervical mucous.
E. Mittelschmerz.
9. Luteal phase deficiency:

A. Hasinadequatelutealprogesteroneproduction.
B. Has inadequate follicular estrogen production.
C. Can be corrected by estrogen.
D. Associated with delayed menstruation.
E. Can lead to hypoprolactenemia.
10. On Examination of endometrial tissue obtained from a biopsy reveals simple

columnar epithelium with no sub nuclear vacuoles. The stroma is edematous, & a
tortuous gland contains secretions. These findings are consistent which stage of
menstrual cycle:
A. Mid-proliferative.
B. Late proliferative.
C. Early secretory.
D. Mid-secretory.
E. Non-ovulatory cycle.
11. Ovulation occurs:

A. Immediately after LH surge.
B. 6-8 hours after LH surge.
C. After Prolactin surge.
D. After follicles ripened in the ovary.
E. 36hoursafterLHsurge
12. Regarding Estrogen hormone:
25
A. Itisproducedincorpusluteum.
B. It is responsible for secretory changes in endometrium.
C. It is mainly secreted as E3 by the ovary.
D. Can not be detected in the blood of postmenopausal.
E. Stimulates sebaceous gland activity
13. Regarding Human Chorionic Gonadotropin, all of the following are true EXCEPT:
A. It is produced by the placenta.
B. Is reversible for the maintenance of corpus luteum.
C. It'sleveldoublesevery48hoursinectopicpregnancy.
D. Reaches a peak concentration in maternal serum by 10 weeks gestation.
E. Forms the main tumor marker for trophoblastic neoplastic diseases.
14. Endometrial changes during the menstrual cycle:

A. The basal layer of the endometrium is responsive to hormonal
stimulation.
B. The functional layer of the endometrium remains intact throughout the
menstrual cycle.
C. Theincreasedthicknessoftheendometriumduringtheproliferative
phaseisduetoestrogenaction.
D. Estrogen induces secretory changes in the endometrium & reduces
mitotic activity.
E. The zona compacta & spongiosum layer the basal layer of the
endometrium.
15. Inadequate luteal phase is associated with all of the following EXCEPT:
A. InsufficientsecretiononFSHintheantecedentfollicularphase.
B. Induction of ovulation with Clomiphene citrate.
C. Induction of ovulation with human menopausal gonadotropins.
D. Administration of progesterone in the luteal phase.
E. Hyperprolacternemia.
16. In the days after ovulation, all of the following occurs EXCEPT:
A. The basal temperature rises.
B. The endometrium undergoes secretory changes.
C. Theplasmaprogesteroneconcentrationfalls.
D. Cervical mucous becomes more viscous & scanty.
E. Corpus luteum form.
17. The following hormones are secreted from the anterior pituitary gland EXCEPT:
A. FSH.
B. HCG.
26
C. LH.
D. TSH.
E. Prolactin.
18. Ovulation may be indicated by all the following, EXCEPT :

A. Endometrial biopsy revealing secretary changes.
B. Upward shift in the basal temperature.
C. Changing of cervical mucous to thick and scanty.
D. Progesterone level > 6.5ng/ml.
E. Mid-cycleelevationinProlactin.
19. Which of the following is the primary source of estrogen ?

A. Theca interna cells.
B. Theca externa cells.
C. Granulosacells.
D. Interstitial cells.
E. Epithelial cells.
20. Gonadotropin-releasing hormone (GnRH) stimulates the release of:

A. Opiate peptides.
B. Adrenocorticotropic hormone (ACTH).
C. LH.
D. Growth hormone.
E. Thyroid-stimulating hormone.
22. Effect of estrogen on the Cervix mucous:

A. Increasetheglycoproteinlevel&thusallowthepenetrationofthe
sperms
B. Decrease the watery content
23. Raised FSH levels are found in all of the following conditions EXCEPT:
A. Postmenopausal women.
B. Turner's Syndrome.
C. WomenonCombinedOralContraceptivePills.
D. Gonadal dysgenesis.
E. Peri-menopausal women who had hysterectomy with bilateral
salpingooophorectomy.
24. Estrogen have all of the following actions, EXCEPT:

A. Produce proliferation of the endometrium.
B. Development of secondary sexual characteristics.
C. Fusion of the epiphysis.
27
D. Increase cervical mucous.

E. Preventionofthrombosis.
25. Which of the following pubertal events in is NOT mediated by gonadal

estrogen production?
A. Menstruation.
B. Pubichairgrowth.
C. Breast development.
D. Skeletal growth
E. Vaginal cornification
26. Which of the following statement regarding Prolactin is true?

A. Prolactin levels decreases shortly after sleep.
B. Prolactin levels increase levels increase after ingesting high glucose meals.
C. Prolactin levels decreases during surgery.
D. Prolactinlevelsincreaseduringstress.
E. Prolactin levels increases after menopause.
27. Besides infertility, the most common symptoms of a luteal phase defect:
A. Vaginal dryness.
B. Earlyabortion.
C. Tubal occlusion.
D. Breast tenderness.
E. Ovarian enlargement.
28
PhysiologicalChangesDuringpregnancy:
1. The following are presumptive skin signs of pregnancy except:
A. Chloasma
B. Maculo-papularrash
C. Linea Nigra
D. Stretch Marks
C. Spider Telangiectases
2. The resting pulse in pregnancy is:

A. Decreased by 20 bpm.
B. Decreased by 10 to 15bpm.
C. Unchanged.
D. Increasedby10to15bpm.
E. Increased by 20 bpm.
3. Normally, pregnancy in 2ND trimester is characterized by all of the following

EXCEPT:
A. Elevatedfastingplasmaglucose.
B. Decreased fasting plasma glucose.
C. Elevated postprandial plasma insulin.
D. Elevated postprandial plasma glucose.
E. Elevated plasma triglycerides.
4. All are CORRECT, EXCEPT, Pregnancy is associated with:

A. Increase cardiac output
B. Increase venous return
C. Increaseperipheralresistance
D. Increase pulse rate
E. Increase stroke volume
5. During normal pregnancy: Which is true?

A. Estradiol is the principal circulating estrogen
B. The blood pressure increases in first and second trimester
C. The tidal volume is reduced
D. InThesecondhalfofpregnancy,amnioticfluidismostlycontributedfetal urine
E. Maternal hydroureters should be taken always as a serious pelvic
condition
6. In normal pregnancy, all of the following are true EXCEPT:

F. Glucosuria increases.
G. Plasmaaldosteroneconcentrationfalls.
29
H. Creatinine clearance is increased.

I. Folate excretion is increased.
J. The presence of less than 300mg of proteins in 24hours urine collection
is considered normal
7. In normal pregnancy, levels of all of the following hormones increases

EXCEPT:
A. Total thyroxine (T4)
B. Parathyroidhormone(PTH)inthe2ND&3RDtrimesters.
C. Free cortisol.
D. Prolactin.
G.Estradiol
8. The increase in blood volume in normal pregnancy is made up of:

A. Plasma only.
B. Erythrocytes only.
C. More plasma than erythroblasts.
D. More Erythrocytes than plasma.
9. In the fetus, the most well oxygenated blood is allowed into the systemic
circulation by the:
A. Ductus arteriosus.
B. Foramen ovale.
C. Rt.Ventricle.
D. Ligamentum teres.
E. Ligamentum venosum
10. Changes in the urinary tract system in pregnancy include:

A. Increasetheglomerularfiltrationrate(GFR).
B. Decrease in renal plasma flow (RPF).
C. Marked increase in both GFR & RPF when the patient is supine.
D. Increase in the amount of dead space in the urinary tract.
E. Increase in BUN & creatinine.
11. Lowered Hemoglobin during normal pregnancy is a physiological finding. It's

mainly due to:
A. low iron stores in all women.
B. Blood lost to the placenta
C. Increasedplasmavolume.
D. Increased cardiac output resulting in greater red cell destruction.
E. Decreased reticulocytosis
30
12. The Maternal blood volume in normal pregnancy:

A. remains stable.
B. Decreases 10%.
C. Increases 10%
D. Increasesupto40%
E. Decreases up to 40%.
13. During pregnancy, maternal estrogen levels increases markedly. Most of this
estrogen is produced by the:
A. Ovaries.
B. Adrenals.
C. Testes.
D. Placenta.
E. Uterus.
14. During normal pregnancy, the renal glomerular filtrate rate (GFR) can
increase as much as:
A. 10%.
B. 25%.
C. 50%.
D. 75%.
E. 100%.
15. Fetal blood is returned to the umbilical arteries & the placenta through:
A. Hypogastricarteries.
B. Ductus venosus.
C. Portal vein.
D. Inferior vena cava.
E. Foramen ovale.
16. In normal physiological changes in pregnancy, all of the following are

increased EXCEPT:
A. Glomerular filtration rate.
B. Stroke volume.
C. Peripheralresistance.
D. Plasma volume.
E. White blood cells.
17. Regarding Renal changes in pregnancy, all of the following are true EXCEPT:
A. Bloodflowisincreasedby10%.
B. Glomerular filtration rate is increased by 50%.
C. Plasma urea will be reduced.
D. Glycosuria could be normal.
E. Mild hydronephrosis is normal.
31
18. Consequences of fluid retention, all of the following are CORRECT, EXCEPT:
A. Hemoglobin concentration decreases.
B. Hematocrit falls.
C. Serum albumin falls.
D. Stroke volume increases.
E. Renal blood flow increases
19. During Pregnancy, all of the following are CORRECT EXCEPT:

A. There will be hyperplasia & hypertrophy of the uterine muscle.
B. Estradiol will increase the columnar epithelial of the endocervix.
C. Estrogen will increase the glandular duct.
D. Progestin&HPLwilldecreasethenumberofglands.
E. Prolactin will be antagonized by the effect of estrogen
20. Regarding renal tract during pregnancy, the following are true EXCEPT:
A. The ureters are dilated.
B. The renal pelvis calyces are dilated.
C. The right side is affected more then the left side.
D. The primigravida shows more changes then multigravida.
E. Thebladdertoneincreases.
21. As pregnancy advances, which of the following hematological changes

occurs?
A. Plasmavolumeincreasesproportionallymorethanredcellvolume.
B. Red cell volume increases proportionally more than plasma volume.
C. Plasma volume increases & red cell volume remains constant.
D. Red cell volume decreases & plasma volume remains constant.
E. Neither plasma volume nor red blood cell volume changes.
22. Which of the following would normally be expected to increase during

pregnancy:
A. Plasma creatinine.
B. Thyroxin-bindingglobulin.
C. Hematocrit.
D. Core temperature.
E. Hair growth.
23. The supine position is important during late pregnancy because it may cause
all of the following EXCEPT:
A. Complete occlusion of the inferior vena cave.
B. Asignificantdecreaseinmaternalventilatorycapacity.
C. Hypotension & syncope.
D. A significant reduction in renal blood flow & glomerular filtration.
E. Augmentation of the cardiovascular effects due to high conduction
32
24. Which of the following is probably responsible for physiologic

hyperventilation during pregnancy?
A. Large fluctuations in plasma bicarbonate.
B. Increased estrogen production.
C. Increasedprogesteroneproduction.
D. Decreased functional residual volume.
E. Decreased plasma PO2
25. Normally the pregnant woman hyperventilates. This is compensated by:

A. Increased tidal volume.
B. Respiratory alkalosis.
C. Decreased Pco2 of the blood.
D. Decreasedplasmabicarbonate.
E. Decreased serum pH.
26. The resting pulse in pregnancy is :

A. Decreased by 30 beats /min.
B. Decreased by 10-15 beats/min.
C. Unchanged.
D. Increase by 30 beats/min.
E. Increasedby10-15beats/min.
27. After birth, all of the following vessels constrict EXCEPT:

A. Ductus arteriosus.
B. Umbilical arteries.
C. Ductus venosus.
D. Hepaticportalvein.
E. Umbilical vein.
28. Select the most correct statement about fetal & neonatal IgM:
A. It is almost entirely maternal in origin.
B. It is approximately 75% maternal & 25% fetal in origin.
C. It is 50% maternal, 50% fetal in origin.
D. It is 25% maternal, 75% fetal in origin.
E. Itisalmostentirelyfetalinorigin
29. Which one is true about the placenta:

A. 10% maternal contribution only
B. U.C covered with chorion
C. U.C contain wharlton jell
D. Placentallobesarethefunctionalunits.
33
30. Spinnbarkheit is a term which means :

A. Crystallization of the cervical mucous.
B. Thickening of the cervical mucous.
C. Mucous secretion of the cervix.
D. Threadingofthecervicalmucous.
E. Thinning of the cervical mucous.
31. Regarding Placental function:

A. hCG is a glycoprotein composed of alpha & β subunits. It's secreted by
cytotrophoblast.
B. Human placenta lactogen enhances insulin action & improves glucose
tolerance.
C. Placental Corticotropin releasing hormone increases ACTH & cortisol &
causes vasoconstriction of the feto-placental blood vessels.
D. Estrogenissecretedbythefeto-placentalunitresponsibleforthegrowth ofthe
myometrium&angiogenesis.
E. Progesterone causes vasodilatation of blood vessels & contraction of
uterine smooth muscle.
32. Regarding placental anatomy:

A. The decidua capsularis forms part of the placenta.
B. The fetal side of the placenta is divided into 30-40 cotyledons.
C. The intervillous space contains fetal blood.
D. Anatomically the placenta id fully formed by 30 weeks.
E. Fetalbloodvesselsdevelopinthemesenchymalcoreofthechorionicvilli.
33. Which of the following does NOT accurately describes the placenta in humans:
A. 15-20 cm in diameter.
B. 2-4 cm thick.
C. Weighs about 1/6 of what the term infant does.
D. Deliveredfrommaternal&fetaltissue.
E. Umbilical cord originates from the center of the placenta in all most of
the cases.
34. Maternal serum Prolactin levels in pregnancy are highest:

A. At the end of gestation just before delivery of the infant.
B. Just after the delivery of the infant.
C. As the placenta is released.
D. The3RDto4THdaypostpartum.
E. During breast feeding.
35. All of the following causes Oligohydromnios EXCEPT:

A. Renal agenesis
B. Poor placental perfusion
34
C. Post term pregnancy

D. Anencephaly
E. Urinary obstruction
36. Placental insufficiency is caused by all the following, EXCEPT:

A. Smoking in pregnancy.
B. Post maturity.
C. Dietaryinsufficiencyinpregnancy.
D. Hypertensive disorder in pregnancy.
37. All the following hormones are products of placental synthesis, EXCEPT :
A. HCG.
B. HPL.
C. Prolactin.
D. Progesterone.
E. Estriol.
38. We can detect the fetal heart beat by Sonography (Transvaginal) at:
A. 5 weeks
B. 6 weeks
C. 7 weeks
D. 8 weeks
E. 9 weeks
39. Pregnant lady with polyhydramnios, the cause could be:

A. Fetuswithoesophageal-atresia
B. Fetus with polycystic kidney disease
C. Fetal growth restriction
D. Hyperprolactinaemia during pregnancy
E. Patient is taking anti epileptic drugs
40. Polyhydramnios is associated with the following condition

A. Intrauterine growth restriction
B. Fetal kidney agenesis
C. Diabetes insipidus
D. Tracheo-oesophagealfistula
E. Hind water leakage
41. All the following are possible causes of Polyhydramnios, EXCEPT:

A. Diabetes
B. Multiple pregnancy
C. Fetus with hydrops fetalis
D. Fetus with duodenal atresia or neural tube defect
E. IUGR
35
42. Which of the following causes of polyhydramnios is more common:

A. Twin pregnancy.
B. Diabetes.
C. Hydrops fetalis.
D. Anencephaly.
E. Idiopathic.
43. Using your knowledge of normal maternal physiology, which of the following
would employ if a 38 weeks’ pregnant patient become faint while lying supine on
your examination table:
A. Blood transfusion.
B. Turningthepatientonherside.
C. Oxygen by face mask.
D. I.V. saline solution.
1. Skin changes during pregnancy should include:

A. Chloasma.
B. Striae.
C. Palmer erythema.
D. Vascular spiders.
E. Alloftheabove.
36
ReproductiveBiology:
1. The number of chromosomes in the human somatic cell is:
A. 24.
B. 44.
C. 46.
D. 48.
E. 23.
2. Regarding Oogenesis & ovulation:

A. Primary oocytes are formed after birth until puberty.
B.The1STmeioticdivisionisarrestedinthediplotenestageuntiljustbefore
ovulation.
C. Oogenesis is completed in 72 hours.
D. The ova survive for 3 days after ovulation.
E. Ovulation occurs 36 hours after FSH surge.
3. Regarding Fertilization & implantation:

A. Fertilization occurs in the inner third of the fallopian tube.
B.Thespermheadpenetratesthroughthecoronaradiata&zonapellucida while
thetailremainsoutside.
C. The 2ND meiotic division is completed before fertilization.
D. Implantation occurs at the morula stage.
E. The trophoblast invades the endometrium & differentiate into an outer
cytotrophoblast & an inner cyncytiotrophoblast.
4. The second meiotic division of the oocyte is normally completed:

A. at the stage of the primary follicle.
B. At the stage of the Graafian follicle.
C. In the peritoneal cavity.
D. In the uterus at the time of implantation.
E.Afterthespermpenetratesthesecondaryoocyte
5. Physiological changes in the reproductive system include :

A. There is no change in the vagina.
B. Theuterus1stenlargesbyhyperplasiathenbyhypertrophy.
C. There is no change in the cervix.
D. Estrogen has no role in the changes that occur during pregnancy.
E. Lower segment of the uterus will be formed in the 1st trimester.
37
AntenatalCare:
1. Sure sign of pregnancy is:
A. Amenorrhea
B. Hegar's sign
C. Nausea and vomiting
D. Auscultationoffetalheart
E. Abdominal distension
2. If your patient is 8 weeks pregnant which one of the following USS measurement is
most useful
A. Crown rump length
B. Biparietal diameter
C. Femur length
D. Placental site
E. Abdominal circumference
3. The following statement are all TRUE about vomiting in pregnancy, EXCEPT:
A. May be cured by admission to hospital
B. Iscommonestinthethirdtrimester
C. Associated with multiple pregnancy
D. Is associated with trophoblastic disease
E. Is associated with urinary tract infection
4. First trimester pregnancy may be terminated by

A. Prostaglandin inhibitor
B. Anti-progesterone
C. β sympathomimetic agonist
D. Synthetic estrogen
E. Medroxy-progesterone
5. The following ultrasonic measurements may be used to confirm or establish

gestational age:
A. Crownrumplength
B. Nuchal pad thickening
C. Amniotic fluid volume
D. Yolk sac volume
E. Biophysical profile
6. Antenatal booking investigations include all of the following, EXCEPT:

A. Complete blood count
B. Blood sugar
C. Hepatitis screening
38
D. Toxoplasmosis
E. Thyroidfunction
7. An Ultrasound in the 1st trimester of pregnancy is done for

A. Placental localization
B. Detecting of fetal weight
C. Assessment of amniotic fluid volume
D. Detection of fetal breathing
E. Datingofthepregnancy
8. A serum progesterone value less than 5ng/ml can exclude the diagnosis of viable
pregnancy with a certainty of:
A. 20%
B. 40%
C. 60%
D. 80%
E. 100%
9. In normal pregnancy, the value of β-hCG doubles every:

A. 2days.
B. 4 days.
C. 8 days.
D. 10 days.
E. 14 days.
10. The β-hCG curve in maternal serum in a normal pregnancy peaks at:
A. 6 weeks of pregnancy.
B. 8 weeks of pregnancy.
C. 10weeksofpregnancy.
D. 14 weeks of pregnancy.
E. 18 weeks of pregnancy.
11. The followings are considered normal symptoms of pregnancy EXCEPT:

A. Backache due to an increased lumbar lordosis.
B. Lower abdominal pain and groin pain due to stretch of round ligaments.
C. Visualdisturbance.
D. Calf pain due to muscle spasm.
E. Increased vaginal discharge.
12. A woman in early pregnancy is worried because of several small raised nodules on
areola of both breasts. There are no other findings. Your immediate management
should be:
A. Reassuranceafterthoroughexamination.
B. Needle aspiration of the nodules.
39
C. Surgical removal of the areola.

D. Mammography.
E. Radical mastectomy.
13. The source of progesterone that maintains the pregnancy during early 1ST
trimester:
A. Placenta.
B. Corpusluteum.
C. Corpus albicans.
D. Adrenal glands.
E. Endometrium.
14. During normal pregnancy, a weight gain anticipated. The average weight gain is
approximately:
A. 5-10 kg.
B. 10-15kg.
C. 15-20 kg.
D. 20-30 kg.
E. 30-40 kg
15. Counseling of a pregnant patient during early prenatal care should include
detection of & information on:
A. Smoking.
B. Alcohol abuse.
C. Drug abuse.
D. Avoiding infections.
E. Alloftheabove.
16. Ultrasound examination used for:

A. Fetal weight.
B. Presence of multiple gestation.
C. Whether abdominal masses are cystic or solid.
D. Placental position.
E. Alloftheabove.
17. Which of the following medications, when given before & during pregnancy may
help to protect neural tube defects?
A. Vitamin B6.
B. Iron.
C. Folicacid.
D. Zinc.
E. Magnesium
40
18. Which of the following is/are needed by women in increased amount during
pregnancy?
A. Iron.
B. Folic acid.
C. Protein.
D. Calcium.
E. Alloftheabove.
19. Often, an increase in vaginal discharge may be noted during pregnancy, It may be:
A. Bacterial.
B. Caused by Trichomonas.
C. Caused by Candidiasis.
D. Physiological.
E. Alloftheabove.
20. The following measures are usually performed during a routine antenatal visit for
a healthy uncomplicated pregnancy at 36 weeks gestations' EXCEPT:
A. Symphysis-fundal height.
B. Maternal blood pressure.
C. Maternal weight.
D. Mid-steamurinespecimen(MSU)forculture&sensitivity.
E. Listening to the fetal heart.
21. Which of the following is NOT a presumptive symptom/sign of pregnancy:

A. Cessation of menstruation.
B. Quickening.
C. Nausea & vomiting.
D. Breast changes.
E. Darkening of the skin on the palms of the hands.
22. Probable sign of pregnancy include:

A. Detection of fetal movement.
B. Enlargementoftheabdomen.
C. X-ray demonstrating a fetus.
D. Lower abdominal cramps.
E. Nausea in the morning
23. The softening of the cervical isthmus that occurs early in gestation is called:
A. Hegar'ssign.
B. Chadwick's sign.
C. Braxton Hick's contraction.
D. Von fernwald's sign.
E. Cullen's sign.
41
24. During early pregnancy, a pelvic examination may reveal that one adnexia is
slightly enlarged. This is most likely due to:
A. A parovarian cyst.
B. Fallopian tube hypertrophy.
C. Ovarian neoplasm.
D. Follicular cyst.
E. Corpuslutealcyst.
25. Booking investigations include all the following, EXCEPT :

A. Liverfunctiontest.
B. Glucose challenge test.
C. CBC.
D. US.
E. Toxoplasmosis.
26. Antenatal care can prevent all the following complications, EXCEPT :
A. Anemia due to iron deficiency or folic acid deficiency.
B. UTI of pyelonephritis.
C. Macrosomia.
D. Pretermlabor.
E. Rh immunization.
28. High alpha feto protein found in? EXCEPT

A. IUFD
C. Some Ovarian Cancer
D. Trisomy21
E. Neural tube defect
29. Nuchal translucency is used is a marker used for:

A. NTD.
B. Trisomies
30. Of the following laboratory studies, which test might be done routinely at booking:
A. Electrolytes.
B. Urinary estriol.
C. Serum glumatic-oxaloacetic transaminase.
D. Hemoglobin.
E. FTA-ABS.
31. The following drugs cross the placenta to the fetus, EXCEPT :
A. Heparin
B. Tetracycline
C. Warfarin
42
D. Diazepam
E. Aspirin
32. Which of these drugs don’t cross the placenta?

A. Heparin
B. Warfarin
C. Tetracycline
D. Degoxin
E. None of the above
33. Hypoplasia & yellow discoloration of the primary teeth has occurred in infants
whose pregnant mothers were treated with drug:
A. Sulphonaudes.
B. Penicillin.
C. Streptomycin.
D. Dihydrostretomycin.
E. Tetracycline.
43
Fetalassessment:
1. In fetal circulation:
A. Oxygenated blood goes along the umbilical arteries
B. The fetal lung is bypassed by means of ductus venosus
C. The foramen ovale connects the two ventricles
D. Mostofthebloodenteringtherightatriumflowsintotheleftatrium
E. The blood in the umbilical arteries is more oxygenated that blood in
umbilical Vein
2. Components of biophysical profile include all of the following, EXCEPT:

A. Fetal movement
B. Placentalthickness
C. Fetal tone
D. Fetal breathing movement
E. Amniotic fluid volume assessment
3. Antenatal fetal monitoring can NOT be accomplished by:

A. Fetal kick chart.
B. Fetalscalpsampling.
C. Non-stress test.
D. Obstetric U/S & Biophysical profile.
E. Acoustic stimulation.
4. Which of the following procedures allow the earliest retrieval of DNA for prenatal
diagnosis in pregnancy:
A. Fetoscopy.
B. Amniocentesis.
C. ChorionicVilliSampling(CVS)
D. Percutaneous Umbilical Blood Sampling (PUBS)
E. Fetal biopsy.
5. Regarding the biophysical profile:

A. Is usually done in labor.
B. Never include an non-stress test.
C. Includesfetalmovement,fetaltone,fetalbreathing,fetalheartrate&
amnioticfluid.
D. Includes a Doppler study.
E. Includes tone, movement & breathing.
44
6. Fetal assessment include the following EXCEPT:

A. Fetal biophysical profile.
B. Fetal Doppler velocimetry.
C. Fetal biometry.
D. Fetal Cardiotocography.
E. Fetalbloodsugarsample
7. Patients with high risk pregnancy should have:

A. Follow-up in ANC every 6 weeks
B. Fetal kick chart.
C. Fetal maternal transfusion
D. Fetal amniotomy
E. Fetalbiophysicalprofile.
8. A biophysical profile includes all of the following assessment parameters EXCEPT:

A. Fetal movement.
B. Fetalweight.
C. Fetal tone.
D. Fetal breathing movements.
E. Amniotic fluid volume.
45
TheNeonates:
1. A low APGAR score at one minute:
A. Is highly correlated with late neurologic sequelae.
B. Indicates an academic newborn.
C. Has the same significance in premature & term infants.
D. Indicatestheneedforimmediateresuscitation.
E. Is a useful index of resuscitative efforts.
2. APGAR's score includes all the followings EXCEPT:

A. Skin color.
B. Muscle tone.
C. BloodpH.
D. Heart rate.
E. Respirations
3. Apgar's score consists of all the following, EXCEPT :

A. Newborn breathing.
B. Newborn tone.
C. Newborn heart rate.
D. Newborn color.
E. NewbornpH
4. Immediate therapy for infants with suspected meconium should routinely

include :
A. Corticosteroid
B. Antibiotics
C. Sodium bicarbonate
D. Clearingoftheairway
E. Giving O2 under positive pressure
46
MultiplePregnancy:
1. Multiple pregnancy increases
A. In white people more than black
B. Withadvancingmaternalage
C. With Bromocriptine use for infertility treatment
D. If first pregnancy
E. After ovarian diathermy for polycystic ovary syndrome
2. In twin deliveries: Which is true?

A. The first twin is at greater risk than the second
B. They usually go post date
C. Epidural analgesia is best avoided
D. Commonest presentation is cephalic and second breach
E. Thereisincreasedriskofpostpartumhemorrhage
3. The most common cause of uterine size-date disproportion:

A. Fetal macrosomia
B. Polyhydramnios
C. Inaccuratelastmenstrualperioddate
D. Multiple pregnancy
E. Molar pregnancy.
4. Which of the following is known to be the commonest presentation in twins?

A. Breech, cephalic
B. Cephalic, breech
C. Cephalic,cephalic
D. Breech, breech
E. Cephalic, transverse
5. The risk of postpartum uterine atony is associated with:

A. Hypotension.
B. Epidural anesthesia.
C. Median episiotomy.
D. Twinpregnancy.
E. Labor associated with an active rate of change of 2.3 cm per hour.
6. The major cause of the increased risk of morbidity & mortality among twin
gestation is:
A. Gestational diabetes.
B. Placenta previa.
C. Malpresentation.
D. Pretermdelivery.
47
E. Congenital anomalies.
7. Multiple gestations should be suspected in all of the following condition

EXCEPT:
A. Maternal weight gain is greater than expected.
B. The uterus is larger than expected.
C. Maternal AFP is elevated.
D. Pregnancy has occurred after induction with Gonadotropins.
E. Maternalperceptionoffetalmovementoccursearlierthanexpectedin
gestation.
8. The most common cause of perinatal death in mono-amniotic twin is:

A. Cordentrapment.
B. Cord prolapse.
C. Twin-twin transfusion syndrome.
D. Lethal congenital anomalies.
E. Placental abruption.
9. If twin A is in a transverse lie & twin B is vertex. The most appropriate route for
delivery is:
A. C-section.
B. Internal podalic version followed by breech extraction.
C. Both
D. Neither.
10. All of the following increased in multiple gestation EXCEPT:

A. Blood loss at delivery.
B. The incidence of congenital anomalies.
C. Theincidenceofcephalo-pelvicdisproportion.
D. The incidence of placental abruption.
E. The incidence of Malpresentation.
11. Regarding Hyperemesis gravidarum, which one of the following items is TRUE?
A. Isacomplicationofmultiplepregnancy
B. Not known to happen in molar pregnancy
C. Worsen in missed abortion
D. Liver function test is not required
E. Urine for culture and sensitivity is not important
12. Monozygotic twins, All of the following are correct EXCEPT :

A. Has a constant incidence of 1:250 births
B. Hasaconstantincidence1:600births C.
Is not related to induction of ovulation D.
Constitutes 1/3 of twins
48
E. Is not affected by heredity
13. The following are complications of multiple pregnancy EXCEPT :

A. Increase incidence of pre-eclamptic toxemia
B. Polyhydramnios
C. Increase incidence of preterm labor
D. Increaseincidenceofgestationaldiabetes
E. Increase incidence of placenta previa
14. Twins pregnancy :

A. Presentation of the second twin dictate the mode of delivery
B. Internal podalic version should not be performed for the second twin
C. Monozygotictwinsalwaysbearingsamesex
D. Commonly goes post mature
E. Should be delivered by caesarean section
15. The following are fetal complications in multiple pregnancy EXCEPT :

A. Increase incidence of perinatal mortality & morbidity
B. Increase incidence of prematurity
C. Increase incidence of mal-presentation
D. Increaseincidenceofcongenitalabnormalitiesparticularlysacralagenesis
E. Increase incidence of prolapsed cord during labor
16. The following are true for dizygotic twins EXCEPT:

A. Fertilization of more than one egg by more than one sperm
B. Most common type of twins represents 2/3 of cases
C. Bothtwinsareidentical&ofthesamesex.
D. There are two chorions & two amnions
E. Placenta may be separated or fused
17. The following factors affect the incidence of dizygotic multiple pregnancy
EXEPT :
A. Induction of ovulation
B. Increase maternal age
C. Heredity
D. Race
E. Nuliparity
18. The following statements about multiple pregnancy are true EXCEPT:
A. Its occurrence in West Africa.
B. Its incidence is increased by increased age and parity.
C. Twin to twin transfusion common in monochromic twins.
D. Canbediagnosedbyultrasoundonlyafter12weeks.
E. Associated with induction of ovulation.
49
19. The following are complication of multiple gestation EXCEPT :

A. Increase incidence of pre-eclampsia toxemia
B. Polyhydramnios
C. Increase incidence of premature labor
D. Increaseincidenceofgestationaldiabetes
E. Increase incidence of placenta previa
20. Twins can be diagnosed by :

A. Large uterus after delivery of the first twin
B. Uterus bigger than date during pregnancy
C. Ultrasonography
D. Auscultation
E. Alloftheabove
21. The following are common in twins pregnancy EXCEPT :

A. Increase incidence of premature labor
B. IncreaseincidenceofAPH
C. Increase incidence PPH
D. Increase incidence perinatal mortality
E. Increase incidence of GDM
22. Regarding twin pregnancies all of the following are correct EXCEPT:
A. It has a higher incidence of preterm labor
B. Mal-presentation of one of the main factors leading to increase incidence
of C/S
C. Abruptio placenta may occur with the sudden decompression of the
uterus immediately after delivery of the first twin
D. Dexamethasone is useful in case preterm labor
E. Identicalormonozygotictwinarisefromfertilizationoftwoovum
23. All are true about monozygotic pregnancy, EXCEPT :

A. The1stcommonlypresentsasbreech.
B. Pregnancy induced hypertension is common.
C. There is only one placenta.
D. Polyhydramnios is frequently present.
E. Anemia is common.
24. Excessive increased level of β-HCG is expected in :

A. Ectopic pregnancy.
B. Pregnancy of diabetic mothers.
C. Twinpregnancy.
D. Incomplete abortion.
E. Cervical carcinoma.
50
25. Regarding multiple pregnancy. All the following are true, EXCEPT :
A. Is frequently complicated by premature labor.
B. Is associated with an increased risk of post partum hemorrhage.
C. Occurs in approximately 1 in 80 pregnancies.
D. Oftencausesprolongedlabor.
E. Is often diagnosed early by US.
26. Multiple pregnancy increases:

27. Multiple Gestation is frequently associated with all of the following EXCEPT:
A. Hypertension.
B. Hydramnios.
C. Fertility drugs.
D. Post-maturity.
E. Pre-term labor.
51
Bleedinginearlypregnancy:
Abortions:
1. Regarding missed abortion, all of the following are CORRECT, EXCEPT:
A. Patient may present with loss of the symptoms of pregnancy
B. Per vaginal bleeding may be one of the presenting symptom
C. Immediateevacuationshouldbedoneoncethediagnosisismade
D. Disseminated intra-vascular coagulation may occur as a sequele of
missed abortion
E. Ultrasound should be done to confirm the diagnosis
2. 14 weeks pregnant woman had abortion and she was told that it is a complete
abortion. This is true regarding complete abortion:
A. Uterus is usually bigger than date
B. Cervical OS is opened with tissue inside the cervix
C. Need to have evacuation of the uterus
D. Aftercompleteabortionthereisminimalornopainandminimalorno
bleeding
E. Follow up with β-hCG for one year.
3. In patients with three consecutive spontaneous abortion in the second trimester

the most useful investigation is:
A. Chromosomal analysis
B. Hysterosalpingogram
C. Endometrial biopsy
D. Post coital test
E. Prolactin level
4. Regarding cervical incompetence, all of the following are true, EXCEPT:

A. Typicallycausespainfulabortions
B. Typically causes mid-trimester abortions
C. Is treated by Shirodkar suture (cervical cerculage) which is best
preformed early in the second trimester
D. May lead to premature rupture of the membrane
E. Can occur in patient with history of cone biopsy
5. Causes of first trimester abortion

A. Chromosomalabnormalities
B. Cervical incompetence
C. Bicornuate uterus
D. Gestational hypertension
E. Pre-eclampsia
52
6. Management of a patient with threatened abortion includes all of the following,

EXCEPT:
A. Ultrasound
B. Physical examination
C. CBC
D. Derailed menstrual history
E. Dilatationandcurettage.
7. A 25-year-old primigravida with 8 weeks threatened abortion, ultrasound would

most likely reveal:
A. Thickened endometrium with no gestational sac
B. Feral heart motion in the adnexia
C. Empty gestational sac
D. Collapsed gestational sac
E. Anintactgestationalsacwithfetal
8. Regarding incomplete abortion, all are true, EXCEPT:

A. There is a history of tissue passed per vagina
B. The cervix is open on vaginal examination
C. Ultrasound shows retained product of conception
D. Ultrasoundshowsintactgestationalsacnon-viablefetus
E. Management include evacuation
9. Most common cause of first trimester abortion

A. Chromosomalabnormalities
B. Syphilis
C. Rhesus isoimmunization
D. Cervical incompetence
E. Bifurcate uterus
10. Incompetent cervix

A. Is a cause for early pregnancy loss
B. Isbestdiagnosedbyhistory
C. Is a cause for fetal congenital abnormalities
D. Is not encounted with uterine anomities
E. Can be treated with tocolytics
11. Of the proposed etiologies for recurrent pregnancy wastage, the least likely is:
A. Maternaltrauma.
B. Maternal balanced translocation.
C. Paternal balanced translocation.
D. Luteal phase deficiency.
E. Autoimmune disease.
53
12. The most common etiology for spontaneous abortion of a recognized first
trimester gestation:
A. Chromosomal anomalyin 50-60%of gestations. B.
Chromosomal anomaly in 20-30% of gestations. C.
Maternal hypothyroidism.
D. Maternal Diabetes.
E. Progesterone deficiency.
13. In threatened abortion, which one of the following items is TRUE?

A. The cervix is open
B. Evacuation is the best treatment
C. All patients should be admitted
D. Inthemajorityofcasespregnancywillcontinuewithoutanycomplication
E. Does not necessitate giving Anti-D for Rh-negative mother
14. In case of threatened abortion :

A. Fetalheartispresent
B. Cervix is dilated
C. There is a history of passing tissue per vagina.
D. Patients needs immediate evacuation
E. No need to give anti-D for Rhesus negative mothers
15. Missed abortion may cause one of the following complication:

A. Bone marrow depression
B. Rupture uterus
C. High positive serum β-hCG
D. Skin allergies
E. Coagulopathy
16. Management of a patient with threatened abortion includes all the followings
EXCEPT:
A. Ultrasound.
B. Physical exam.
C. CBC.
D. Detailed menstrual history.
E. Immediatedilationandcurettage.
17. In threatened abortion at 15 weeks gestation in a nulliparous patient:

A. Pain is characteristic.
B. The internal os is often opened.
C. Fainting is characteristic.
D. Vaginalbleedingisusuallymild.
E. Absence of fetal movements suggest non viability.
54
18. Regarding threatened abortion:

A. Anti-D should be given to Rh- positive mother.
B. All patients should be admitted to the hospital.
C. Ultrasoundshouldbedonetoconfirmthediagnosis.
D. Vaginal examination will reveal severe pain.
E. The patient has vaginal bleeding and tissue passage per vagina.
19. Therapy in threatened abortion should include:

A. Progesterone IM
B. D & C
C. Prolonged bed rest
D. Restrictedactivity
E. Prostaglandin suppositories
20. During the first & second trimester of pregnancy, the most common pathologic
cause of vaginal bleeding :
A. Hydatiform mole
B. Abruptio placenta
C. Ectopic pregnancy
D. Abortion
E. Uterine rupture
21. Which of the following items may be associated with a mid trimester abortion:
A. Recurrent pelvic infection
B. Maternal smoking
C. Uterine anomalies
D. Sickle cell disease
E. Hyperemesis gravidarum
22. Bleeding in early pregnancy could be causes by all of the following, EXCEPT :
A. An ectopic pregnancy
B. Trophoblastic disease
C. Carcinomaoftheovary
D. Invasive carcinoma of the cervix
E. Threatened abortion
23. Which of the following is correct in the treatment of a case of threatened

abortion :
A. Bedrest
B. Oral stillbosterol
C. Curettage
D. Urgent admission to hospital
E. I.M Tranexamic acid
55
24. Abortion :
A. Hasanincidenceof15%ofallpregnancy
B. 18 weeks missed abortion is usually managed with suction curettage
C. In threatened abortion, the cervix is always open
D. 1st trimester abortion is usually causes by incompetent cervical os
E. Pregnancy usually continue to term in cases of inevitable abortion
25. Etiological factors in spontaneous abortion include :

A. Chromosomal abnormalities
B. Placental abnormalities
C. Maternal disease
D. Uterine abnormalities
E. Alloftheabove
26. A major hazard of a late missed abortion :

A. A positive human chorionic gonadotropin (hCG) titer
B. Systemic allergies
C. Bone marrow depression
D. Coagulopathy
E. Toxemia
27. A missed abortion is :

A. Death of the fetus at 36 weeks of gestation
B. In which the products of conception are expelled completely
C. In which the products of conception are partially expelled
D. Bleeding and cramps but the fetus still viable
E. Deathofthefetusbefore24weeksgestation
28. A 26- year- old married white whose LMP was 2 ½ months ago developed bleeding,
uterine cramps, and passed some tissue per vagina. Two hours later she began to
bleed heavily
I. The most likely diagnosis is :

A. Twin pregnancy
B. Threatened abortion
C. Inevitable abortion
D. Premature labor
E. Incompleteabortion
II. Of the option listed, the bleeding is most likely due to :

A. Retainedproductsofconception
B. Ruptured uterus
C. A systemic coagulopathy
D. Vaginal lacerations
56
A. Bleeding hemorrhoids
III. The indicated procedure is :

A. Hysterectomy
B. Vaginal packing
C. Compression of the hemorrhoids
D. IV fibrinogen
E. Uterinecurettage
29. Cervical cerculage:

A. Closureofincompetencecervix
B. Effective in prevention of all types of abortion
C. Should be removed at 32 weeks of pregnancy
D. Protect against exposure of the pregnant lady to infection
E. Should applied after 9 weeks of pregnancy
30. A 25 primigravida with 8 weeks threatened abortion. The US would most likely
reveal :
A. Thickened endometrium with no gestational sac.
B. Fetal heart motion in the adnexia.
C. Empty gestational sac.
D. Anintactgestationalsacwithfetalheartmotion.
E. Collapsed gestational sac.
D. Aftercompleteabortionthereisminimalornopainandminimalorno
bleeding
E. Follow up with β-hCG for one year.
32. Regarding Cervical incompetence, one is true:

A. Cone biopsy is not a predisposing factor
B. Cerculage is contraindicated
C. In not encountered with uterine anomalies
D. BestdiagnosedbyHx
E. Is a cause of early pregnancy abortion
57
D. Post coital test
E. Prolactin level
34. Therapy for threatened abortion should include:

A. Progesterone IM.
B. D & C.
C. Prolonged bed rest.
D. Restrictedactivity.
E. Prostaglandins suppository.
35. Approximately what percentage of spontaneous 1ST trimester abortions show

chromosomal abnormalities:
A. 1%.
B. 10%.
C. 25%.
D. 50%.
E. 75%.
36. Repeated 2ND trimester abortions, especially when associated with a lack of
painful uterine contractions, suggests most strongly:
A. Defective germ plasm.
B. Uterine myoma.
C. Maternal hyperthyroidism.
D. Folic acid deficiency.
E. Incompetentcervicalos.
37. Inevitable abortion is usually associated with all of the following EXCEPT:
A. Pain.
B. Dilated cervix.
C. Bleeding.
D. Fever.
E. The pregnancy is almost doomed.
38. Threatened abortion is characterized by:

A. The presence of empty sac by ultrasound.
B. Disappearance of pregnancy symptoms.
C. Passage of vaginal vesicles.
D. The cervix is affected.
E. Vaginalbleeding.
58
39. In spontaneous abortion:

A. Uncontrolledbloodsugarincreasestheriskofabortionindiabetic
patients.
B. If the patient has mild bleeding with opened internal os this is considered
to be threatened abortion.
C. Cervical incompetence is the most common cause of abortion in the 1ST
trimester.
D. History of bleeding & passing of tissue per vagina indicates the need for
curettage without the need for US.
E. D & C should be done immediately once missed abortion is diagnosed.
40. Early bleeding in pregnancy may be caused by the following, EXCEPT:

A. Incomplete abortion
B. Cervical cancer
C. Threatened abortion
D. Ectopic pregnancy
E. Vasapraevia
Ectopic pregnancies:
41. Regarding ectopic pregnancy, all of the following are true, EXCEPT:
A. Is associated with uterine enlargement
B. Is situated in the ovary in about 0.5% of all cases
C. Is more dangerous when it is situated in the isthmus of the fallopian tube
D. Canonlybediagnosedafterithasruptured
E. Is a complication of assisted conception
42. Acceptable management of ruptured ectopic pregnancy

A. Observation followed by Methotrexate
B. Diagnostic laparoscopy followed by observation
C. Repeat ultrasound next 24 hours to confirm the diagnosis
D. Exploratorylaparotomyandsalpingectomy
E. Dilatation and curettage
43. The following are factors affecting the choice of Methotrexate as a choice of
treatment for ectopic pregnancy, EXCEPT:
A. Size of the ectopic
B. Presence or absence of cardiac activity
C. Level of β-hCG
D. Parityofthepatient
E. Integrity of the tube
59
44. The most common cause of ectopic pregnancy is:

A. Historyofpelvicinflammatorydisease B.
Congenital anomalies of the tube
C. Endometriosis
D. Tubal surgery
E. Previous sterilization
45. Following evacuation of a molar pregnancy, β-hCG titers will fall to untraceable
levels in about 90% of patients within:
A. 2 weeks.
B. 4 weeks.
C. 8 weeks.
D. 10 weeks
E. 12weeks.
46. A 25 year-old G3 P1+1 presents to the emergency room complaining of lower

abdominal crampy pain 6 weeks form he last normal period. She had significant
vaginal bleeding but no passage of tissue & pregnancy test is Positive.
I) The patient's most likely diagnosis is:

A. Incomplete abortion.
B. Complete abortion.
C. Missed abortion.
D. Threatened abortion.
E. Ectopicpregnancy.
II) The most important step in this patient's evaluation should be:
A. Sonography.
B. Physical exam.
C. CBC.
D. Quantitative β-hCG.
E. Detailed menstrual history.
III) Transvaginal Ultrasonography would most likely reveal:

A. Fetal heart motion.
B. An intact gestational sac.
C. A discrete yolk sac motion.
D. A Thickened endometrium with gestational sac.
E. Fetalheartmotionintheadnexia.
47. The most common symptom of ectopic pregnancy is :

A. Profuse vaginal bleeding.
B. Abdominalpain.
C. Syncope.
60
D. Dyspareunia.
E. Decreased pregnancy associated symptoms.
48. Acceptable management of possible rupture ectopic pregnancy would include all
of the following EXCEPT:
A. Exploratory laparotomy.
B. Diagnostic laparoscopy.
C. Partial salpingectomy.
D. Total salpingectomy.
E. ObservationfollowedbyMethotrexate.
49. If the above described patient has had a previous term pregnancy prior to her
ectopic pregnancy, her chances of subsequent intrauterine pregnancy would be
about:
A. 80%
B. 60%
C. 40%
D. 20%
E. <10%
50. The commonest site of ectopic pregnancy is :

A. Peritoneal cavity
B. Mesosalpinx
C. Ovary
D. Ampullaofthefallopiantube
E. Isthmus portion of the fallopian tube
51. Etiological factor of ectopic pregnancy include all of the following EXCEPT:
A. Gonococcal Salpangitis
B. Tubal surgery
C. CombinedOCP
D. TB salpingitis
E. Previous ectopic
52. In ectopic pregnancy :

A. Rarely diagnosed before 12 weeks of gestation
B. Usuallypresentasobstetricemergencybefore12weeksgestation
C. IM progesterone is useful
D. 50% continued up to term
53. Patient with ectopic pregnancy:

A. Present with heavy per-vaginal bleeding
B. Methotrexate is the treatment of the choice in patient with ruptured one
C. Maycomplainofshoulderpain.
61
D. Present with cardio vascular collapse in all the cases

E. Never have fainting attacks.
54. In the management of ectopic pregnancy:

A. β-hCGtiterhasaroleintheDx&managementofectopicpregnancy.
B. D&C is the treatment of choice
C. Methotrexate should be used if the patient hemodynamically unstable
D. Shoulder pain is referred from bowel irritation
E. The presence of severe bleeding is an indication of conservative
management
55. Methotrexate Treatment in ectopic is contraindicated if:

A. β-hCG < 1500
B. No fetal heart.
C. Hemoperitonium
D. Gestational sac < 3 cm
B. Is associated with uterine enlargement
C. Is situated in the ovary in about 0.5% of all cases
D. Is more dangerous when it is situated in the isthmus of the fallopian tube
E. Canonlybediagnosedafterithasruptured
F. Is a complication of assisted conception.
57. The following are factors affecting the choice of Methotrexate as a choice of
C. Level of β-hCG
D. Parityofthepatient

A. Historyofpelvicinflammatorydisease B.
Congenital anomalies of the tube
C. Endometriosis
D. Tubal surgery
59. Lower abdominal pain and six weeks gestation:

A. Vaginal examination is contraindicated.
B. Right iliac fossa pain is diagnostic of appendicitis.
C. Placental abruption should be considered.
D. Could be gallstones.
62
E. USShasreliablediagnosticinformation.
60. The endometrial change of ectopic pregnancy:

A. Glandular cystic hyperplasia
B. Decidualtransformation
C. Secroteraty changes with chorial cell
D. Atypical hyperplasia
E. Proliferation endometrium
61. In ectopic pregnancy :

A. The ovarian ectopic pregnancy is the most common site
B. Morethan90%ofectopicpregnanciesoccursinthefallopiantube
C. The majority of tubal pregnancies occurs in the fimbria
D. The most common symptoms of ectopic pregnancy is vaginal bleeding
without abdominal pain
E. Pregnancy test is negative more than 90% of the cases
62. Which of the following is a contraindication to medical treatment in ectopic

pregnancy?
A. An intact tubal pregnancy.
B. The size is less than 3cm.
C. Thepresenceofhemoperitonium.
D. The absence of fetal cardiac activity.
E. A serum β-hCG of 1500.
63. The quantitative β subunit of HCG in a serum of patient with ectopic pregnancy
will :
A. Rise in a rate greater than expected.
B. Rise at rate consistent with the normal curve.
C. Riseataslowerthanexpected.
D. Plateau.
E. Progressively fall.
63
AntepartumHemorrhage:
1. Antepartum haemorrhage may be caused by the following, EXCEPT:
A. Placenta previa
B. Cervical cancer
C. Abruptio placenta
D. Ectopicpregnancy
E. Vasa praevia
2. Each of the following typical feature of placenta previa, EXCEPT:

A. Painless bleeding
B. First episode of bleeding is usually self limited
C. May be associated with post coital bleeding
D. Commonlyassociatedwithcoagulopathy
E. The uterus tends to be soft and non-tender
3. A 33 year old woman at 37 weeks gestation confirmed by early sonogram presents

with moderate to sever vaginal bleeding, and is note by sonogram to have
placenta previa, which of the following is the best management for her.
A. Induction of labor
B. Give tocolytic drugs
C. Caesareansection
D. Expectant management
E. Artificial rupture of the membrane
4. Regarding Abruptio placenta:

A. Postpartum hemorrhage occurs only when there in hypofibrinogenemia
B. Maternal anemia is a major cause for abruptio placenta
C. Fetus is not usually affected
D. Associatedwithantecedenthypertension
E. On Examination the abdomen is usually soft and lax
5. Regarding Placenta previa:

A. Is diagnosed when the placenta occupies the funds and start to bleed
B. Recognizedtobecomplicatedbypostpartumhemorrhage
C. The fetal heart rate is usually abnormal.
D. Less common in patients with repeat caesarian section
E. Diagnosis is confirmed when bleeding starts at 13 weeks of gestation
6. In placenta previa: Which is true?

A. It is common primigravida
B. Maycauseabnormallie
C. Causes recurrent painful bleeding
64
D. All patients should be induced with prostaglandin pessaries

E. Digital examination is mandatory to exclude local causes
7. Antepartum hemorrhage: Which is true?

A. Is any bleeding from the genital tract during any stage of pregnancy
B. Requires assessment by vaginal examination
C. Maybecausedbycervicalcarcinoma
D. Is always painless
E. All patients should be delivered by Caesarian Section
8. A pregnant woman presents with a placenta praevia of a major defect and fetus is
malformed. Which of the following will be the best management?
A. Caesariansection
B. Oxytocin drip
C. Rupture of membranes
D. Induce with PG E2
E. Forceps delivery in the second stage to accelerate delivery.
9. Abruptio placenta:
A. Is defined as premature separation of low lying placenta.
B. There is no increase risk of recurrence.
C. The etiology of placental abruption is usually known.
D. The diagnosis of placental abruption is frequently confirmed by
ultrasound.
E. ThemostpredisposingconditionischronicmaternalHypertension.
10. Management of Placental Abruption includes all of the following EXCEPT:

A. Coagulation studies.
B. ExpectantmanagementincasesofIUFD.
C. Augmentation of labor.
D. Artificial rupture of Amniotic membrane.
E. Intensive I.V. fluid replacement.
11. The most common risk factors for placental abruption:

A. Diabetes.
B. Increasedmaternalage,Multiparity,hypertension&cigarettesmoking.
C. Intrauterine growth retardation.
D. Rh isoimmunization.
E. Multiple pregnancy.
12. The following is a contraindication for the use of amnio-hook:

A. Plcentaprevia
C. Breech presentation
65
D. IUGR
E. Face presentation
13. Regarding Abruptio placenta:

A. Is defined as premature separation of low lying placenta
B. There is no increase risk of recurrence
C. The etiology of placental abruption is usually known
D. The diagnosis of recent placental abruption is frequently confirmed by
ultrasound
E. Chronicmaternalhypertensionisaknowncause.
14. Management of placental abruption includes all of the following EXCEPT:

A. Coagulation studies
B. Tocolyticdrugsifthebabyispremature
C. Augmentation of labor
D. Artificial rupture of amniotic membrane
E. Intensive intravenous fluid replacement
15. The followings are causes of Antepartum hemorrhage EXCEPT:

A. Abruptio placenta.
B. Placenta brevia.
C. Cervical polyp.
D. Vasa previa.
E. Rhisoimmunization.
16. Extensive bleeding into the myometrium & beneath the uterine serosa in severe
cases of abruption placenta may result in :
A. Acouvelaireuterus.
B. Active uterus
C. Placental perfusion
D. Normal fetal heart rate
E. Reactive CTG tracing
17. Which of the following is NOT a complication of abruption placenta ?

A. Postpartum hemorrhage
B. Consumptive hemorrhage
C. Fetal demise
D. Acute renal failure
E. Subsequentectopic
18. One of the following contraindications for the use of amnio-hook :

A. Placentalprevia
C. Breech presentation
66
D. IUGR
E. Face presentation
19. Which of the following signs is most useful in predicting the absence of placental
abruption following trauma :
A. Absence of uterine contraction
B. Absence of vaginal bleeding
C. Presence of normal fetal heart tones
D. Absenceoftense,painfuluterus
E. Absence of nausea and vomiting
20. 24 -year- old patient ( G2 P1 + 0 ). At 34 weeks of gestation presented to

emergency with vaginal bleeding. Which one of the following is NOT TRUE ?
A. Admit the patient
B. Resuscitate the patient
C. Dodigitalexaminationimmediately
D. Cross-match blood
E. Do ultrasound
21. In the management of placenta previa centralis :

A. Once diagnosis is made, the treatment should urgent caesarean section
B. Patient may stay at home if she is living near the hospital
C. Vaginal examination should be done carefully to confirm diagnosis
D. Ifthepregnancyhasadvancedto37weeks,itisusuallybesttoperform
C/S
E. If the baby is premature liberal blood transfusion is the treatment of
choice for severe hemorrhage
22. The likely causes of ante -partum hemorrhage in 32 weeks pregnant women has
recurrent attack of vaginal bleeding with proven fundal placenta are :
A. Subserous uterine fibroid
B. Diabetes
C. Circumvallateplacenta
D. Anemia
E. Multiplepregnancy
23. The condition of placental abruption is associated with :

A. External cephalic version
B. Nulliparus women, among whom it is more common
C. Direct trauma which may be the main cause
D. Aclinicaldiagnosis
E. Always presents with vaginal bleeding
67
24. An 18 year old woman is noted to have a marginal placenta previa on an US at 24

weeks gestation. Which of the following is the most appropriate management?
A. Schedule cesarean delivery at 38 weeks.
B. Schedule an amniocentesis at 36 weeks & delivery by C-section if the
fetal lung is mature.
C. Reassessplacentalpositionat33-34weeks.
D. Recommend termination of pregnancy.
E. Reassess placental position digitally by vaginal examination 32-34 weeks.
25. The following may be signs of abruptio placenta, EXCEPT :

A. Vaginal bleeding.
B. Absenceofuterinecontractions.
C. Blood stained amniotic fluid.
D. Abnormal fetal heart rate.
E. Tense painful uterus.
26. In Placenta previa, all help in the diagnosis, EXCEPT:

A. Constantlowerabdominalpain
B. Mal presentation
C. Painless vaginal bleeding
D. US
E. History of repeated C-section.
27. 33 year female at 37 weeks gestation confirmed by early sonography presents with
moderate severe vaginal bleeding, she is noted to have placenta previa, which of
the following is the best management for her :
B. C-Section.
C. Expectant management
D. Artificial rupture of membrane
E. Give tocolytic drugs
28. Which of the following patients would be most likely to have a placenta previa:
A. 19-year-old G1, P0, Vertex presentation.
B. 24-year-old G2, P1, cephalic presentation, 2/5 palpable.
C. 34-year-old G5, P3+ 1(abortion), vertex presentation.
D. 36-year-old G7, Previous 5 LSCS, P6, transverse lie.
E. 28-year-old G3, P1+1(abortion), head at 0 station.
29. Routine pelvic examination is contraindicated in which of the following situations

during pregnancy:
A. Carcinoma of the cervix.
B. Gonorrhea.
C. Prolapsed cord.
68
D. Placentaprevia.
E. Active labor.
30. Which of the following is NOT a complication of abruptio placenta:

A. Postpartum hemorrhage.
B. Consumptive hemorrhage.
C. Fetal demise.
D. Acute renal failure.
E. Subsequentectopic.
31. Placenta previa is more likely to be found in a pregnancy associated with:

A. Multiple pregnancy.
B. Previous manual removal of placenta.
C. Pyometra.
D. IVF pregnancy.
E. PreviousC-section.
32. In placenta previa:

A. Common in primigravida.
B. Presents with vaginal bleeding with abdominal pain.
C. Hx.OfrepeatedC-sectionisariskfactor.
D. Characterized by bleeding at 10weeks gestation.
E. Associated with fetal anomalies.
33. Vasa previa diagnosis in early labor is best treated with:

A. Spontaneous delivery.
B. Tocolytic agents to prevent uterine contraction.
C. Forceps delivery as soon as the cervix is dilated.
D. C-section.
E. Ventouse delivery at 8 cm dilation.
34. The most common cause of vaginal bleeding complicating premature labor is:
A. Vaginal laceration.
B. An endocervical polyp.
C. Cervical dilation.
D. Placenta previa.
E. Placental abruption.
35. All are complication of abruptio placenta EXCEPT:

A. Macrosomia
B. IUFD
C. DIC
D. PPH
E. Uterine atony
69
36. Velamentous insertion of the cord is associated with an increased risk for:
A. Premature rupture of the membranes.
B. Fetalbleedingbeforelabor.
C. Torsion of the umbilical cord.
D. Fetal malformation.
E. Uterine malformations.
70
RhisoimmunizationandABOincompatibility:
1. Select the most correct statement about fetal and neonatal IgM:
A. It is almost entirely maternal in origin
B. It is approximately 75% maternal and 25% fetal in origin
C. It is 50% maternal, 50% fetal in origin
D. It is 25% maternal, 75% fetal in origin
E. Itisalmostentirelyfetalinorigin
2. Anti-D prophylaxis:
A. Should be given to all sensitized Rhesus negative women after delivery
B. ShouldbegiventoallRhesusnegativewomenafteramniocentesis.
C. Should be given to all Rhesus positive women who give birth to Rhesus
D. negative babies.
E. Should be given to all women who's babies are Rhesus negative
F. Is contra-indicated during pregnancy if the women is Rhesus negative
3. In Rhesus Iso-immunization, the following test may be helpful :

A. Rhesus antibody titer in liquor
B. Maternal serum bilirubin level
C. Liquorbilirubinlevel D.
Maternal hemoglobin E.
Baby gender
4. RH disease :
A. Occurs when the mother is Rh+
B. Occurs when the father is RHC.
C. OccurswhenthefetusisRh+ve
D. Can never occurs in the 1st pregnancy
E. Antibodies are formed against maternal RBCs
5. Rh isoimmunization Anti-D immunoglobulin should be given:

A. After every abortion occurring more than 8 weeks gestation
B. ToallRhnegativefemaleswhohaveanRhpositivebaby
C. Postpartum only to Rh negative female who are sensitized
D. Postpartum to Rh positive female with Rh negative husbands
E. After spontaneous rupture of membrane
6. RH incompatibility occurs with :

A. Rh –ve father & Rh+ve mother
B. Rh –ve mother & Rh –ve father
C. Rh –ve mother & Rh +ve father D.
Rh +ve mother & Rh +ve father
71
7. In ABO incompatibility :
A. The mother has to be blood group AB
B. The father has to be B1 group O
C. It doesn't protect against RH disease
D. Itisanantigenantibodyreaction
E. Erythroblastosis
8. Fetal RBCs can be distinguished from maternal RBCs by their :

A. Shape
B. Resistancetoacidelution
C. Lack of Rh factor
D. Lower amounts of hemoglobin
E. All of the above
9. Anti-D immunoglobulin should be given:

A. ToRh-negativemothersaftereveryabortionoccurringbeyond6-8
week'sgestation.
B. To all sensitized Rh-negative females who have Rh-positive.
C. Postpartum only to Rh-negative females who are sensitized regardless
of the fetal blood type.
D. Postpartum to Rh-positive females with Rh-negative husbands.
10. A Rh negative women has increase the chances of being immunized during
pregnancy when:
A. PerformingExternalcephalicversion.
B. Maternal anemia.
C. Premature labor.
D. Maternal Thyrotoxicosis.
E. Multiple pregnancy.
11. Fetal RBCs can be distinguished from maternal RBCs by their:

A. Shape.
B. Resistancetoacidelution.
C. Lack of Rh factor.
D. Lower amount of hemoglobin.
12. Fetal manifestations of erythroblastosis fetalis may include all of the

following EXCEPT:
A. Kimictrus
B. Hepatomegaly
72
C. Placentaledema
D. Splenic enlargement
E. Polycythemia
13. All of the following maternal antibodies may cause erythroblastosis fetalis
in the fetus EXCEPT:
A. Anti-nuclear antibodies
B. Anti-E
C. Anti-D
D. Anti-lewis
14. If blood must be given without adequate cross matching, the best to use is:
A. AB Rh-positive.
B. AB Rh-negative.
C. O Rh-positive.
D. O Rh-negative.
E. A Rh-positive.
15. A Rh negative woman with a history of stillborn at 38/52 due to hemolytic

diseases, her husbands-genotype CDE/cde. In her current pregnancy which
of the following statements is CORRECT:
A. 100% of her babies will be Rh positive.
B. Immunoglobulin should not be given regardless of baby's Rh status.
C. Immunoglobulin should be given regardless of baby's Rh status.
D. Thereis50%chancethatherbabywillbeRhnegative.
E. By history alone, she should not be allowed to go after 36/52.
73
PostpartumHemorrhageandCoagulationdisorder:
1. Regarding Postpartum haemorrhage:

A. MayoccurasaconsequenceofAntepartumhaemorrhage.
B. Ends with Hypercoagulable state
C. Hysterectomy is the first the first line of treatment
D. Always complicate intrauterine fetal death (IUFD)
E. Diagnosed only when the placenta is still undelivered
2. Regarding Secondary postpartum haemorrhage:

A. Is diagnosed when bleeding occurs 72 hours after delivery
B. Contra indicate breast feeding
C. The commonest cause is the cervical tears
D. Very common when the patient delivers a congenitally abnormal baby
E. Choriocarcinomacouldbeacause.
3. In Abruptio placenta: Which is true?

A. It is bleeding from abnormally situated placenta
B. Has minimum effect on the fetus
C. Causes painless bleeding
D. Canbeacauseofpostpartumhemorrhage
E. All should deliver by caesarean section
4. Atonic Post partum hemorrhage is best managed with :

A. Intra-venous progesterone
B. 0.5 mg oral ergometrine and uterine massage
C. 5 units oral syntocinon and uterine massage
D. Uterine massage
E. Uterinemassagewith40unitssyntocinonin500mlD5%NStobegiven
Intravenously
5. Postpartum hemorrhage can occur due to all the followings EXCEPT:

A. Fetal macrosomia.
B. Polyhydramnios.
C. Placenta brevia.
D. Abruptio placenta.
E. Postdatepregnancy.
6. Disseminated intravascular coagulation (DIC) :

A. Can be managed by leukocyte transfusion
B. Can cause decrease fibrinogen degeneration products
C. Can cause decrease PT , PTT
74
D. Is characterized by increase platelet count

E. CanbeencounteredincaseofIUFD
7. All of the following circumstances should alert an obstetrician to an increased

likelihood of postpartum hemorrhage EXCEPT:
A. Prolonged labor
B. Rapid labor
C. Postdatepregnancy
D. Oxytocin stimulation
E. Twin pregnancy
8. In DIC: Disseminating intravascular coagulation

A. The level of FDP (Fibrinogen degeneration products) is low
B. Platelet count is high
C. Bleedingtimeisprolonged
D. PT and PTT are normal
E. The Fibrinogen level is high
9. Clinical Presentation of DIC include the following EXCEPT:

A. Bleeding from IV sites
B. Hematuria
C. Failure active surgical hemostasis
D. Increasetemperature(fever)
E. Epistaxis
10. Clinical causes of DIC ( disseminating intravascular coagulation ) include the

following EXCEPT :
A. Ectopic pregnancy
B. Septic abortion
C. Mild pre-eclampsia
D. The use of tampons
E. IUFD
11. The treatment of DIC may include the following EXCEPT:

A. Heparin
B. Packed RBCs
C. Platelet transfusion
D. Leukocytetransfusion
E. Cryoprecipitate
12. Ergometrine to control post-partum hemorrhage :

A. Iscontraindicatedinpatientwithhighbloodpressure
B. It will not act on the smooth muscle of the blood vessels
C. Intravenous root is the only way to be given
75
D. It can be used for induction of labor

E. Is safe in cardiac patient
13. A 28 years old patient complains of the amenorrhea after D & C for postpartum
bleeding. The most likely diagnosis:
A. Gonadal dysgenesis
B. Sheehan's syndrome
C. Kallman's syndrome
D. Mayer-Rokitansky- Kuster-Hauser syndrome
E. Asherman'ssyndrome
14. Post-partum hemorrhage may have higher incidence in all the following
conditions EXCEPT:
A. Multiple pregnancies
B. Polyhydramnios
C. Macrosomic baby
D. Placenta previa
E. Pregnancy induced hypertension
15. All the following are causes of DIC in pregnancy, EXCEPT :

A. Fetal demise.
B. Abortion.
C. Placental abruption.
D. Placentaprevia.
E. Sepsis.
16. Regarding postpartum hemorrhage the following are true EXCEPT:

A. blood loss of 500 ml or more after vaginal delivery.
B. Blood loss of 1000 ml or more after C-section.
C. Atonichemorrhageislesscommonthantraumaticone.
D. Multiple pregnancy may predispose to postpartum hemorrhage.
E. Patient with previous history of postpartum hemorrhage are at high risk
for postpartum hemorrhage after next delivery.
17. The following statements are correct EXCPT:

A. Syntometrineiscomposedofsyntocinon&Ergometrine.
B. Ergometrine is contraindicated in cardiac patient.
C. Syntometrine is used prophylcatically in the management of 3RD stage of
labor.
D. Syntometrine is contraindicated in cardiac patients.
E. Syntometrine affects the smooth muscles of blood vessels.
76
Instrumentaldeliveries,C-sectionandVaginalBirth
AfterC-section(VBAC):
1. The following are always indications for Caesarean Section

A. Hydrocephalus
C. Preterm Labor
D. Activeprimarygenitalherpes
E. Sever pre-eclampsia
2. Obstructed labor: Which is true?

A. Diagnosis only when the cervix is fully dilated
B. Usually predicted before onset of labor
C. More common in developed countries
D. Mento-posteriorpositioncouldbeacause
E. X-ray pelvimetry is essential to predict cephalo-pelvic disproportion in
Primigravida
3. Prolapse of umbilical cord: Which is true?

A. Not an indication for caesarean section when baby viable at 36 weeks
B. Diagnosed when membranes are still intact
C. Ismorecommonwhenfetusacquiresanabnormallie
D. Incidence is 5%
E. Causes severe respiratory alkalosis
4. The best uterine scar a patient can have for Caesarian section is
A. Transverse upper segment
B. Longitudinal upper segment
C. Transverselowersegment
D. Longitudinal lower segment
E. A T-shaped incision
5. Which of the following is not a basic component of an obstetric forceps ?

A. Blade
B. Handle
C. Lack
D. Stem
E. Shank
6. Which instrument is not a basic of a laparoscopic set :

A. Trochar
B. Hegardilator
77
C. Veress needle
D. Light source
E. CO2 inflation set.
7. Which of the followings is a contraindication to a trial of labor after cesarean

delivery?
A. Priorclassicalincision.
B. Prior cesarean delivery for dystocia.
C. Prior IUFD.
D. Ultrasound estimation of fetal weight of 3500g.
E. Prior cesarean delivery for breech.
8. Indications for instrumental delivery include all the followings EXCEPT:

A. Prolonged second stage of labor.
B. Fetal distress.
C. Transverselie.
D. Breech presentation.
E. Maternal cardiac disease.
9. Obstructed labor:
A. Diagnosed only when the cervix is fully dilated.
B. Usually predicted before the onset of labor.
C. More common in developed countries.
D. Mento-posteriorpositioncouldbeacause.
E. X-ray pelvimetry is essential to predict cephalo-pelvic disproportion in a
primigravida.
10. Prerequisites for instrumental delivery include all the followings EXCEPT:
A. Cephalic presentation.
B. Engaged head.
C. Full dilation of the cervix.
D. Rupture of membranes.
E. Thepresenceofepiduralanalgesia.
11. Vacuum extraction (ventouse):

A. Causes more maternal birth canal injuries than the forceps.
B. Can be used when the cervix is 7 cm dilated.
C. Can be applied when the vertex is minus 2 station.
D. CancauseCephalohematomatothebaby.
E. Can be used in face presentation.
78
12. These conditions are always an indication for caesarean section. Which one of
these is an absolute indication for C/S :
A. Twin pregnancy
B. Breech presentation
C. Severe PET
D. Majordegreeplacentaprevia
E. IUGR
13. Advantage of lower segment caesarean section over the classic incision
includes:
A. Ease of repair
B. Decreases blood loss
C. Lower probability of subsequent uterine rupture
D. Decreases danger of intestinal obstruction
E. Alloftheabove
14. Indication for cesarean section include all of the following EXCEPT:
A. Previous caesarean section
B. Failed forceps delivery
C. Cervical cerculage.
D. Cord prolapsed
E. Primigravida.
15. Pre-requisite for a forceps delivery include all of the following EXCEPT :
A. A complete dilated cervix
B. An empty bladder
C. Thevertexintheoccipito-anteriorposition
D. Ruptured membrane
E. The known position of the vertex
16. Which of the following neonatal morbidities is not related to forceps delivery?
A. Fractured skull
B. Sepsis
C. Nerve palsies
D. Cephalohematoma
E. Convulsion
17. Kjelland's forceps :

A. May be used if the head is not engaged
B. Have no cephalic curve
C. Have knobs on the shank which point towards the sinciput
D. Haveaslidinglockintheordertocorrectasynclitism
E. Can be used with axis traction
79
18. An absolute indication foe an elective C-section is :

A. Previous CS.
B. Antepartum hemorrhage.
C. Twin pregnancy.
A. Placentapreviatotalis.
B. Fetal distress.
19. Immediate complications of C-section include all the following, EXCEPT :

A. Complications of anesthesia.
B. Bladder injury.
C. Thromboembolism.
D. Colon injury.
E. Hemorrhage.
20. Immediate complication of C/S include all except:

A. Bladder injury
B. Hemorrhage
C. Thromboembolism(alsoDMisnotimmediate)
D. Complication of anesthesia
21. All are contraindications to VBAC except:

A. LowersegmentC-section
B. Classical C-Section.
C. Rupture uterine
22. These conditions are always an indication for C-section. Which one of these is
an absolute indication for CS?
A. Twin pregnancy.
B. Breech presentation.
C. SeverePET.
D. Minor degree placenta previa.
E. IUGR.
23. One of the following is an absolute indication for C-section:

A. GradeIVplacentaprevia.
B. Abruptio placenta.
C. Cervical cerculage.
E. Twins pregnancy.
24. Pre-requisite for instrumental delivery include all of the following EXCEPT:
A. Cervix fully dilated.
B. Ruptured membranes.
C. Fetal head engaged.
80
D. Fetalheadat-2station.
E. Empty catheterized bladder.
25. A newborn is noted to have a darkened swelling of the scalp that does not
cross the midline. This is most likely a:
A. Caput succedaneum.
B. Subdural hemorrhage.
C. Cephalohematoma.
D. Subarachnoid hemorrhage.
E. Tentorial tear.
26. Which of the following anesthetic technique will produce the greatest uterine
relaxation?
A. Spinal block.
B. Caudal.
C. Nitrous oxide.
D. Halothane.
E. Paracervical.
27. What is the most common cause of anesthetic death in obstetrics :

A. Failed intubation.
B. Hemorrhage.
C. Stroke.
D. Reaction to medication.
E. Aspirationpneumonitis
28. Epidural nerve block in labor:

A. Involves the injection of an anesthetic agent into the subarachnoid space.
B. Causes transient hypertension.
C. Increasestherateofforcepsdelivery.
D. Increases the length of the 1St stage of labor.
E. Is contraindicated if the patient is on anti-coagulants.
relaxation?
A. Spinal block
B. Caudal
C. Nitrous oxide
D. Halothane
E. Paracervical
30. Most common cause of anesthesia death in pregnancy:

A. Aspirationpneumonia
B. Medication reaction
81
C. Stroke
D. Hemorrhage
31. Contraindication of caudal anesthesia include:

A. Pilonidal sinus.
B. Heart disease.
C. Anemia.
D. Prematurity.
32. The following are absolute indication for C-section EXCEPT:

A. Facepresentation.
B. Shoulder presentation.
C. Cervical cancer.
D. Fibroids in the lower uterine segment.
E. Previous classical C-section.
82
PrematureLaborandPROM:
1. All of these drugs can be used as tocolytic to stop labor, EXCEPT:
A. Salbutamol ventolin
B. Diazepam(valium)
C. Calcium channel blocker
D. Indomethacin non steroidal anti inflammatory drugs
E. Ritodrine (β agonist).
2. In cases with premature rupture of membranes, all the following are

acceptable in the conservative management except:
A. Frequentvaginalexaminationtoassesscervicaldilatation
B. serial complete blood count to diagnose rising of WBC
C. Close monitoring of maternal vital signs
D. Ultrasound to assess fetal weight and amount of liquor
E. Monitoring of the fetus by doing cardiotocogram
3. Regarding Surfactant:
A. Is secreted by type I pneumocytes
B. Are glycoprotein.
C. After38weekstheratiotosphingomyelinsis2:1.
D. Its secretion is suppressed by betamethzone.
E. Its deficiency leads to adult respiratory distress syndrome.
4. The following has a recognized relation with spontaneous preterm labor:

A. Fetus with anencephaly
B. Oligohydromnios
C. Maternal hypothyroidism
D. BacterialVaginosis
E. Transverse lie of the fetus
5. All the following are possible of premature labor, EXCEPT:

A. Multiple pregnancy
B. Polyhydramnios
C. Bicorrnuate utures
D. Anecephaly
E. Perinatel infection.
6. A positive nitrazine test is:

A. Strongevidenceofruptureofthemembranes.
B. Presumptive evidence of intact membranes.
C. An evidence of intact membranes.
D. Presumptive evidence of intact membranes.
83
7. The most serious complication of preterm premature rupture of membrane

(PPROM) at 28 weeks:
A. Fetal compression anomaly.
B. Pulmonary hypoplasia.
C. Intrauterineinfection.
D. Limb contraction.
E. Abruptio placenta.
8. The following are obstetrics causes for premature labor EXCEPT :

B. Multiparity
C. Premature preterm rupture of the membrane
E. Uterine congenital anomalies
9. In the diagnosis of premature rupture of the membrane, all of the following are
true EXCEPT:
A. History of fluid loss per vagina
B. Visualization of amniotic fluid in the vagina by sterile speculum
C. Positive Nitrazine test
D. Positive fern test
E. Positivemethylinebluetest
10. Rupture of membranes is suspected with all of the followings EXCEPT:

A. Positive Nitrazine test.
B. Positive Fern test.
C. Pooling of amniotic fluid on speculum examination.
D. Observing amniotic fluid drain through the cervix during speculum
examination.
F. ContractionsseenontheCTG.
11. All the followings are causes of preterm labor EXCEPT:

A. Multiparity.
B. Placenta previa.
C. Polyhydramnios.
12. The following are known causes of preterm labor EXCEPT:

A. Maternalhypoxia
B. Intrauterine fetal death
C. Polyhydramnios
E. Cervical incompetence
84
13. Early signs of premature labor include all of following EXCEPT:

A. Increasedvaginaldischarge
B. Increased uterine contraction
C. Low back pain
D. Cervical dilatation to 4 cm
E. Worsening pelvic pressure
14. Rupture of membranes is suspected with all the following, EXCEPT :

A. +ve nitrazine test.
B. +ve fern test.
D. ContractionseenontheCTG.
E. Observing amniotic fluid draining through the cervix during speculum
examination.
15. In cases of premature rupture of membrane, all the following is acceptable in

conservative management, EXCEPT:
A. Serial CBC to diagnose rising WBC.
B. Closed monitoring of maternal vital signs.
C. Frequentvaginalexaminationtoassescervicaldilation.
D. US to asses fetal weight and the amount of liquor.
E. Monitoring of fetus by doing cardiogram.
A. Frequentvaginalexaminationtoassesscervicaldilatation.
B. serial complete blood count to diagnose rising of WBC.
C. Close monitoring of maternal vital signs.
D. Ultrasound to assess fetal weight and amount of liquor.
E. Monitoring of the fetus by doing cardiotocogram.
17. A premature birth has been defined as:

A. Before37completedweeks'gestation.
B. Prior to the period of viability.
C. Weighing less than 1000 g.
D. Weighing more than 1000g but less than 2500g.
18. Preterm labor is defined as labor which starts:

A. Before 24 weeks of gestation.
B. Before37completedweeks.
C. Before the viability of the fetus.
D. When the fetus weighing < 1000 gm.
E. Prior to 40 weeks gestation.
85
19. Premature rupture of membrane is most strictly defined as rupture at any time
prior to:
A. A stage of fetal viability.
B. The 2ND stage of labor.
C. The 32ND week of gestation.
D. Theonsetoflabor.
E. The 38TH week of gestation.
20. Contraindications to tocolytic therapy includes the following EXCEPT:

A. Severe PET.
B. Severe antepartum hemorrhage.
C. IUGR.
D. Chorioamnionitis.
E. Pretermbreechpresentation.
21. Drugs used to inhibit preterm labor include:

A. Phenobarbitone.
B. Prostaglandins.
C. Cachannelinhibitors.
D. Anticholinergic drugs.
E. Dexamethasone.
22. Premature rupture of membrane is :

A. Rupture of membranes before the onset of labor. B.
Rupture of membranes before fetal lung maturity. C.
Rupture of membranes before term.
D. Rupture of membranes before 28 weeks gestation.
E. All the above.
B. Methotrexate
D. Indomethacin non steroidal anti inflammatory drugs Retodrine (_-
agonist)
24. The following are known contraindications to the usage of Tocolysis in

pregnancy EXCEPT:
A. Cardiacdisease.
B. Severe hypertension.
C. Clinical chorioamnionitis.
D. Intrauterine death.
E. Thyroid disease.
86
25. Dexamethasone is indicated in which of the following condition : A.

Prematurelabortopreventneonatalrespiratorydistresssyndrome B.
Ectopic pregnancy to enhance fetal lung maturity
C. Spontaneous rupture of membrane at 39 week
D. At 38 weeks severe abruption placenta
E. Threatened abortion
26. Complication of pregnancy that predispose to preterm labor includes all the
following EXCEPT :
A. polyhydramnios
B. Urinary tract infection
C. 25yearsoldprimigravida.
D. Premature rupture of membranes
E. Multiple pregnancy
27. Which of the following complications is associated with ruptured appendix &
peritonitis ?
A. Fetal growth restriction
B. Oligohydromnios
C. Chorioamnionitis
D. Pretermbirth
E. Placental abruption
28. Inhibition of prostaglandin synthesis are not generally used for tocolysis
because they:
A. Are effective
B. Produce marked hypertension
C. Maycauseprematureclosureofthefetalductusarteriosus
D. Are too expensive
E. Are associated with lactic acidosis
A. Frequentvaginalexaminationtoassesscervicaldilatation.
30. Retodrine is a b adrenergic receptor stimulator that is used to arrest preterm

labor. Which of the following is a major maternal risk of its use?
A. Hypertension.
B. Decreased plasma glucose.
C. Decreased serum potassium.
87
D. Cardiacarrhythmias.
E. Asthma
32. Prostaglandin synthesis is inhibited by:

A. progesterone.
B. Indomethacin.
C. ACTH.
D. Prolactin-inhibiting factor.
E. Thyroid hormone.
33. Side effects of β sympathomimetics include all of the following, EXCEPT:

A. Tachycardia
B. Pulmonary oedema
C. Headache
D. Prematureclosureofductusarteriosus
E. Palpitation
88
PrenatalInfections:
1. In prenatal infection
A. Rubella can be prevented by administration of rubella vaccine during
pregnancy
B. Toxoplasma is a virus
C. HIVvirusinfectthebabymorereadilywhendeliveredvaginallythan
caesareansection
D. Cytomegalovirus causes macrosomic babies
E. In HIV patient breast-feeding is encouraged
2. Transplacental infection occur with all, EXCEPT:

A. Cytomegalovirus.
B. Toxoplasma
C. Rubella
D. Syphilis
E. Gonorrhea
3. In HIV infection which of the following is CORRECT ?

A. It is DNA virus
B. Virus can be isolated from saliva
C. Breastfeedingincreasetransmissiontothebaby
D. Caesarean section increase transmission of infection to the baby
E. Negative HIV antibodies guarantees absence of infection
4. The following may be indicative of chorioamnionitis EXCEPT:

A. Maternal pyrexia
B. Maternal tachycardia.
C. Tender uterus
D. Fetalbradycardia
E. Increased white-cell count in the mother
5. In Toxoplasmosis infection, all are true EXCEPT:

A. Hepatosplenomegaly
B. Jaundice
C. Retenitis
6. A pregnant woman with Active vulval herpes infection, How would you
manage her?
A. Give acyclovir & then deliver
B. Deliver & give the baby prophylactic acyclovir
C. C/S.
89
7. Rubella’s eye manifestation on the newborn is mainly:

A. Cataract.
B. Microcephaly
C. Retinopathy
8. Which of the following is NOT considered a high risk pregnancy :

A. Gestational diabetes
B. Cardiac disease in pregnancy
C. Candida infection in pregnancy
D. Bleeding in pregnancy
E. Patient with history of previous IUFD
9. Genital tract Candida occurs more frequent in all these patients EXCEPT :
A. Diabetic
B. On long term antibiotic therapy
C. Thyrotoxicosis
D. On oral contraceptive pills
E. Pregnant
10. Regarding Rubella immunization :

A. Rubella negative patients should be vaccinated during pregnancy
B. Rubella vaccine is a Toxoid
C. The majority of pregnant patients are rubella non immune
D. Breast feeding should be inhibited if vaccine is given postnatally
E. Pregnancyshouldbeavoidedfor3monthsaftervaccination
11. Regarding Rubella vaccination, choose the correct answer :

A. It'saliveattenuatedvirus.
B. Should be given in pregnancy in non-immune mother.
C. Should be given to all pregnant mothers in the 1st antenatal visit.
D. Pregnancy should be avoided for one year after the vaccination.
E. It's a toxoid.
12. The following are characteristic findings in neonatal rubella infection, EXCEPT :
A. Deafness.
B. Spinabifida.
C. Congenital heart disease.
D. Cataracts.
13. Mother with hepatitis B positive:

A. wegivethebabybothimmunoglobulinsandliveattinuatedvaccinewhen born
90
14. The following maternal infections may cross the placenta:

A. Herpes genitals.
B. Parvovirus B19.
C. Toxoplasmosis.
D. Chicken pox.
E. Cytomegalovirus.
15. Which of the following is the predominant bacteria in vagina during pregnancy:
A. Peptostreptococci.
B. Listeria monocytogenes.
C. Lactobacilli.
D. Streptococcus agalatia.
E. Staphylococcus.
16. The following can be associated with toxoplasmosis infection during pregnancy
EXCEPT:
A. Rhinitis
B. Brain calcification
C. Hepatic Splenomegaly
D. Hydrocephalus
E. Spinabifida
91
IUGRandIUFD:
1. All these tests can be useful in management of intrauterine fetal growth

restriction (IUGR) EXCEPT:
A. Fetal kick chart
B. Cardiotocography CTG non stress test
C. Chorionicvilloussampling
D. Biophysical profile
E. Umbilical cord Doppler waveforms
2. The following are possible complications of IUGR EXCEPT :

A. Intrauterine death
B. Severe hypoxia and fetal distress in labor
C. Meconium aspiration
D. Hypoglycemia
E. Postmaturity
3. The definition of intrauterine growth restriction (IUGR):

A. Infantwithbirthweightbelow10thpercentileforagivegestationage B.
Infant with birth weight below 25th percentile for a given gestation age C.
Infant with birth weight of 2.8 kg
D. Infant with birth weight below 50th percentile for a given gestation age
E. Infant born at 30 weeks of gestation with a weight of 2.3 kg
4. Maternal causes for intrauterine growth restriction may one of these EXCEPT:
A. Hypertensive diseases with pregnancy
B. Chronic renal diseases with pregnancy
C. Smoking and alcoholism
D. Cyanotic heart disease
E. Rheumaticmitralstenosis
5. Risk factors for shoulder dystocia include all the followings EXCEPT:
A. Maternal obesity.
B. Macrosomia.
C. Maternal diabetes.
D. Prolonged second stage of labor.
E. IUGR.
6. Causes of IUGR include all the followings EXCEPT:

A. Constitutionalsmallmother.
B. Fetal urinary tract anomalies.
C. Premature rupture of membranes.
92
D. Placental insufficiency.
7. The most accurate method for diagnosis of IUFD :

A. No fetal movement by the mother
B. Decrease in symptoms & signs of pregnancy
C. Recurrent bleeding per vagina
D. Absence of fetal heart sound by Doppler
E. AbsenceoffetalheartbyrealtimeUUSmovement
8. The following are causes for a uterus that is large for gestation during
pregnancy, EXCEPT :
B. IUGR
C. Fibroid
D. Polyhydramnios
E. Incorrect dating of pregnancy

A. Constitutionalsmallmother.
10. The most serious maternal complication of IUFD:

A. Acute amnionitis.
B. Acute psychosis.
C. Pelvic thrombophlebitis.
D. Hypofibrinogenemia.
E. Infertility.
11. IUGR may occur in all of the following EXCEPT:

A. Pre-eclampsia.
B. Congenital anomaly.
C. Gestationaldiabetesmellitus.
D. Sickle cell anemia.
E. Maternal smoking.
12. In cases of IUFD:

A. A cause can be indentified in most cases.
B. Immediate delivery is indicated.
C. More common with good antenatal care.
D. Fetal chromosome should not be done.
E. Carefulexaminationofthenewbornisimportant.
93
13. If IUGR is encountered:

A. Immediate delivery is indicated.
B. C-section is the only way in those cases.
C. Steroids should not be administrated in causes post maturity.
D. Congenitalanomaliesshouldberuledout.
E. Perinatal mortality/morbidity is unaffected.
14. The commonest cause of IUFD is :

A. True knots in the cord.
B. Gestational diabetes mellitus.
C. Unexplained.
D. Infections.
E. Complete placental abruption.
15. The most common chromosomal abnormality in the abortuses is:

A. Blanced translocation.
B. Unblanced translocstion.
C. Triploidy.
D. Trisomy.
E. Turner (45 XO).
94
Post-termandIOL:
28. Which is a contraindication of induction of labor
A. Historyofuppersegmentcaesariansection
B. Sever P E T at 36 weeks
C. Gestational diabetes on insulin at 39 weeks
D. Post term pregnancy
E. Chorioamnionitis
29. Which of the following is an indication for induction of labor:

A. Placenta previa.
B. Post-termgestation.
C. Cord presentation.
D. Prior classical C-section.
E. Active genital herpes.
30. The following are indications for induction of labor EXCEPT :

A. Sever pre-eclampsia
B. Diabetes mellitus-controlled with high dose of insulin
C. Prolonged rupture of membrane without uterine contraction
D. IUFD ( intrauterine fetal death)
E. Historyofprevious3C/S.
31. The most common reason for postdate pregnancy is:

A. Inaccurategestationalage.
B. Fetal anencephaly.
C. Oligohydramnios.
D. IUGR.
E. Advanced maternal age.
32. Which of the followings is an indication for induction of labor?

A. Placenta brevia.
B. Posttermgestation.
D. Prior classical cesarean section.
33. In postterm pregnancy all the followings are true EXCEPT:

A. Associated with meconium stained liquor.
B. The fetus has long nails.
C. May results in oligohydraminos.
D. Not associated with respiratory distress syndrome.
E. Itisagestationalagebeyond43weeks.
95
34. Which of the followings is a contraindication for Oxytocin infusion to

induce labor?
A. Irregular first stage labor.
B. Transverselie.
35. Indications for induction of labor include all the following EXCEPT :
A. Prolonged pregnancy
B. Severe pre-eclampsia
C. IUGR
D. Previous3LSCS(lowersegmentc/s)
E. Prolonged rupture of membranes without labor
36. Risks and complications of induction of labor include all the following, EXCEPT :
A. Failed induction.
B. Atonic postpartum hemorrhage.
C. Uterine hyperstimulation leading to fetal hypoxia.
D. Prostaglandinmaycausehypothermiaduetoitsdirecteffectonthermo
regularitycentersinthebrain.
E. Ruptured uterus in grand multipara of patients with previous C-section.

A. History of upper segment caesarian section
E. Chorioamnionitis
38. Risk and complications of induction of labor include all of the following
EXCEPT:
A. Failed induction
B. Atonic PPH
C. Uterine hyperstimulation leading to fetal hypoxia
D. Prostaglandinmaycausehypothermiaduetoitsdirecteffectonthermo
regulatorycentersinthebrain
F. Rupture uterus in grandmultipara of patients with previous CS
12. Which of the following has NOT been shown to stimulate (induce) labor:
A. Amniotomy.
B. Prostaglandins.
C. Enemas.
D. Breast stimulation.
E. Overeating.
96
13. Regarding induction of labor all statements are false, EXCEPT: A.

Chance of success is not dependent on the cervical bishop score. B.
Is indicated in patient with mitral stenosis.
C. Vaginalprostaglandinpessariesreducetheinductionofdeliveryinterval.
D. In indicated at 40 weeks gestation.
E. All diabetic women should be induced at 38 weeks of gestation.
14. Actions of Oxytocin include:

A. Anti-diuretic activity.
B. Production of transient hypertension.
C. Increase in uterine muscle contractility.
D. Activation of myoepithelial cells of the breast.
E. Alloftheabove
15. What is the 1/2 life of Oxytocin:

A. < 1 min.
B. 3min.
C. 10 - 15 min.
D. 20 - 30 min.
16. Amnio-hook (artificial ROM) may cause all except:

A. Amniotic fluid embolus
B. IUGR
D. Fetal distress
E. Cord prolapse
17. Complications of artificial rupture of membranes include all the following,

EXCEPT :
B. Amniotic fluid embolism.
C. Fetal distress.
D. Meconiumaspiration.
E. Cord prolapse.
18. A contraindication to the use of Oxytocin for stimulating labor at term is:
A. Dead fetus.
B. Hypertonicuterinedysfunction.
C. Hypotonic uterine dysfunction.
D. Twin gestation.
E. Prior history of LSCS.
97
AbnormalPresentationandBreech:
1. Compound presentation is most consistently associated with :
A. Prematurity.
B. Advanced maternal age.
C. Uncoordinated uterine contractions.
D. Diabetic pregnant woman.
E. Large pelvic vessels.
2. Complete breech means:

A. Flexion at hip joint and extension in knee joint
B. Flexionathipjointandflexionatkneejoint
C. Extension at the hip joint
D. Flexion at knee joint and extension at the hip joint
E. Flexion of one leg at hip joint and extension of the other leg at the hip
joint
3. Regarding shoulder presentation, the following are true EXCEPT:

A. Cord prolapse is common
B. 3rd degree Perineal tear is common
C. Deep transverse arrest can occur*
D. Morecommoninprimigravida
E. Always end by shoulder dystocia.
4. Breech presentation: Which is true?

A. Constitutes 10% of all term deliveries
B. Common in post term labor
C. Vacuum extraction can be used when cervix is fully dilated
D. Forcepscanbeusedforaftercominghead
E. External cephalic version is best performed between 32-34 weeks
gestation.
5. Which of the following is contraindication for delivery using vacuum

extraction?
A. Facepresentation
B. Second twins in vertex presentation
C. post term pregnancy
D. Occipito transverse position
E. Chorioamnionitis
6. Umbilical cord prolapse is most likely to occur with:

A. Frank breech.
B. Complete breech.
98
C. Singlefootlingbreech.
D. Double footling breech.
7. The most frequent severe complication of vaginal breech delivery:

A. Cord prolapse.
B. Spinal cord injury.
C. Headentrapment.
D. Cord avulsion.
E. Placental Separation
8. The major cause of serious neonatal morbidity & mortality for infants with
breech presentation is:
A. Birthtrauma.
B. IUGR.
C. Cord prolapse.
D. Associated congenital anomalies.
E. Cerebral palsy.
9. The most common complication of External Cephalic Versions:

A. Placental separation.
B. Fetomaternal hemorrhage.
C. Persistentfetalbradycardia.
D. Inability to convert the fetus to the vertex presentation.
E. Reversion of the fetus to breech presentation.
10. An absolute contraindication for vaginal breech delivery is:

A. Footlingbreechpresentation.
B. Hyperextension of the head.
C. Prolonged latent phase of labor.
D. A large fetus with estimated fetal weight > 3000 gm.
E. Previous pregnancy loss.
11. A 24-year-old G1 P0, Rh-negative , 36 weeks a breech presentation and is

considering external cephalic version. She should be told :
A. She should be offered general anesthesia
B. The procedure can be done with oligohydraminos
C. Prophylaxis with anti-globulin D can wait until after delivery
D. Engagement of the presenting part is not considered a contraindication
to version
E. TocolysiswithintravenousRetodrinehasbeenshowntoimprovethe
resultsofexternalversion
99
12. The following are possible causes of breech presentation EXCEPT :

A. Prematurity
B. Sub-serousfundalfibroid
C. Multiple pregnancy
D. Placenta previa
E. Bicornuate uterus
13. Which of the following is contraindicated for delivery using Vacuum

extraction?
A. Facepresentation
B. 38 weeks gestation
C. Chorioamnionitis
D. Post-term pregnancy
E. Occipito transverse position
14. In breech presentation:

A. Frank breech is the commonest type.
B. Brachial plexus injury is a recognized complication.
C. Prolapse of the umbilical cord can occur.
D. Fetal mortality is increased.
E. Alloftheabove.
15. The incidence of breech presentation at term is :

A. 20%
B. 10%
C. 3.5%
D. 15%
E. 0.5%
16. With regard to breech presentation :

A. In vaginal delivery the fetus is prone to Cephalohematoma
B. Hyperextension of the fetal head is a favorable
C. Externalcephalicversion(ECV),reducesthebreechpresentationatterm
1%
D. Mid trimester amniocentesis is likely to result in breech presentation at
term
E. The perinatal morbidity is ten time higher than in cephalic presentation
17. External cephalic version is contraindicated in all of these conditions EXCEPT

A. Scarred uterus
C. Placenta previa
D. Severe maternal hypertension
E. Gestationaldiabetes
100
18. Regarding Breech presentation, the following are true EXCEPT:

A. Accounts for up to 3 % term pregnancies
B. May be diagnosed on clinical examination of the abdomen
C. Maybeassociatedwithfetalabnormality
D. Is a contraindication for vaginal delivery
E. Makes intrapartum hypoxia more likely than is true of cephalic
presentation
19. An infant presents as a breech presentation and delivered without assistance

as far as the umbilicus. The reminder of the body is manually assisted by the
obstetrician. This is called :
A. Version and extraction
B. Spontaneous breech delivery
C. Assistedbreechdelivery
D. Total breech extraction
E. Pipers of the after-coming head
20. At 39 week gestation, a fetus was felt to be breech presentation as judged by

information gained through Leopold's maneuvers. The breech was well down
in the pelvis, and the uterus was irritable. Pelvimetry was within normal limits
and the estimated fetal weight was 3.4 kg. which of the following should be
done ?
A. Cesareansection
B. External cephalic version
C. Internal podalic version
D. Oxytocin induction
21. All are causes of breech EXCEPT:

A. Prematurity.
B. Congenital anomalies.
C. Hydrocephalus.
D. Pelvic tumor.
E. Increasedmaternalage.
22. All of the following associated with increase incidence of breech presentation,
EXCEPT:
A. Placenta previa
B. Müllerian anomaly
C. Uterine leiomyoma
D. Nulliparity
E. Prematurity
101
23. The following are contraindication to external cephalic version, EXCEPT:

A. Contracted pelvis
B. Placenta previa
D. Presenceofcervicalsutureinsite
E. Scared uterus
24. Face presentation :

A. All cases must be delivered by C-section.
B. All cases can be delivered vaginally.
C. The presenting diameter is occipitofrontal.
D. The fetal head is hyperflexed.
E. MentoposteriorpositionmustbedeliveredbyC-section.
102
PuerperiumandPuerperalSepsis:
1. Regarding Puerperium:
F. Refer to the first 6 months after delivery
G. The lochia usually persist for 7 weeks
H. Theuterinefundusshouldnotbepalpableabdominallyby14daysafterdelivery
E. The incidence of post partum depression is 50%
F. Fever due to engorged breast occurs on the second day after delivery
2. The most common complication of breast feeding is:

A. Amenorrhea.
B. Pregnancy.
C. Excessive weight loss.
D. Puerperalmastitis.
E. Breast abscess.
3. Oxytocin in the Puerperium is associated with :

A. Involutionoftheuterus
B. Initiation of lactation
C. Resumption of menses
D. Sub-involution of the uterus
E. Post partum mastitis
4. Of the following, the greatest predisposing cause of puerperal infection is:

A. Retainedplacentaltissue.
B. Iron deficiency
C. Coitus during late pregnancy
D. Poor nutrition
E. Maternal exhaustion
5. Which of the following is the most likely causes of a fever in a women on the second
day postpartum:
A. Pneumonia
B. Endometritis.
C. Mastitis
D. Cholycystitis
E. Thrombophlebitis
6. Postpartum, the deciduas becomes necrotic and is normally cast off within five to six
days as :
A. Decidual cast
B. Placental remnants
C. Lochia
D. Carunculae myrtiforms
103
7. A syndrome of amnenorrhea-glactorrhea developing postpartum is :

A. Ahumada del Castillo
B. Ciari-formmel
C. Budd-chiari
D. Sheehan's
E. Simmonds
8. What is the recurrence risk of postpartum depression ?

A. 5%.
B. 20%.
C. 70%.
D. 95%.
9. Immediately after delivery:

A. The uterine fundus is between the umbilicus & the symphysis pubis.
B. The uterus weighs about 500 gm.
C. The lochia is yellowish in color.
D. There is decreased venous return to the heart.
E. There is increased diuresis.
10. Infectious maternal (puerperal) morbidity is defined as:

A. Death of mother.
B. High rectal temperature in the first ten days in one occasion.
C. Postpartum hemorrhage.
D. On oral temperature of 38_ C or more on 2 separate occasions during the first
24 days postpartum.
E. On oral temperature of 38_ C or more on 2 separate occasions during the first
10 days postpartum.
11. The most common bacteria isolated from cases of puerperal infection is:
A. E.coli.
B. Anaerobic streptococcus.
C. Anaerobic staphylococcus.
D. Aerobic streptococcus.
E. Clostridium perfringens.
12. Immediately after the completion of a normal labor, the uterus should be :
A. Firm&contractedattheleveloftheumbilicus.
B. At the level of the symphysis pubis.
C. Immobile.
D. Atonic.
E. Boggy
104
13. In the mother, suckling leads to which of the following response:

A. Decrease of Oxytocin.
B. Increase of Prolactin-inhibiting hormone.
C. Increase of hypothalamic dopamine.
D. IncreaseofhypophysealProlactin.
E. Increase of LH-releasing hormone.
14. After parturition, endometrium regenerates from the decidual:

A. Basalzone.
B. Compact zone.
C. Functional zone.
D. Parietal layer.
E. Spongy zone.
15. A routine postnatal check include all of the following EXCEPT:

A. Breast examination.
B. Pap smear.
C. Serumbloodsugar2hr.p.p.
D. Bimanual vaginal examination.
E. Contraceptive counseling.
16. Risk factors of post partum Endometritis include all of the following, EXCEPT:
A. Prolonged labor
B. Prolonged rupture of membranes
C. Multiple vaginal exams
D. Prolonged monitoring with an intrauterine pressure catheter
E. Gestationaldiabetes.
17. Symptoms and signs of puerperal endometritis include all the following,
EXCEPT :
A. Malodorous vaginal discharge.
B. Lower abdominal pain.
C. Fever.
D. Involutionoftheuterus.
E. Uterine tenderness on palpation.
18. All the following methods inhibit lactation EXCEPT :

A. Restrictionoffluidanddiuretics
B. Tight breast binder and analgesics
C. estrogen hormone in large dose
D. Thyroxin hormone
E. Dopamine agonist
105
19. Breast feeding :

A. Should be discontinued if breast infection is suspected
B. Should be started until 3 days postpartum
C. Should be replaced by bottle feeds if the patient had a caesarean section
D. Hasaroleininnvoulatingofthefetus
E. Should not be supplemented with iron
20. In the mother suckling leads to which of the following responses?

A. Decrease Oxygen
B. Increase of prolactin-inhibiting factor
C. Increase of hypothalamic dopamine
D. IncreaseofhypothalamicProlactin.
E. Increase of luteinizing hormone-releasing factor
21. Breast feeding accelerates the involution of the uterus through:

A. The increased level of prolactin.
B. Thereleaseofoxytocin.
C. The increased level of estrogen.
D. The decreased level of progesterone.
E. The decreased level of HPL.
106
HypertensiveDisordersinPregnancies:
1. Therapeutic termination of early pregnancy is indicated in:
A. Uterine fibroid
B. Maternalpulmonaryhypertension
C. Placenta previa
D. Maternal blood sugar >12 mmol/L
E. Triplet pregnancy
2. In Pre-eclampsia, right upper quadrant part abdominal pain is due.

A. Tensionofthelivercapsule
B. Cholecystitis
C. Pancreatitis
D. Gastric ulcer
E. Oesophagitis
3. In eclampsia: Which is true?

A. Caesarean section must be carried out in all cases
B. Hypotensive drugs should not be used
C. Urinary output is increased
D. Antidiuretic drugs are essential in all cases
E. Ergometrineshouldbeavoidedinthethirdstageoflabor
4. Immediate appropriate response to an initial eclamptic seizure include all of

the following, EXCEPT:
A. Ultrasoundforfetalgrowth
B. Maintain adequate oxygenation
C. Administer magnesium sulphate
D. Prevent maternal injury
E. Monitor the fetal heart rate
5. The most important reason to give antihypertensive drug for hypertension in

pregnancy is to decrease the:
A. Incidence of IUGR
B. Incidence of oligohydraminos
C. Incidence of fetal death
D. Incidence of placental abruption
E. Riskofmaternalcomplicationssuchasstroke
6. Risk factors for pre- eclampsia include all of the following, EXCEPT:
A. Elderly primigravida
B. African ethnicity
C. Positive family history of hypertension
107
D. Positive history of pre- eclampsia in previous pregnancies

E. Positivehistoryofmacrosomicbaby
7. Pre-eclampsia is associated with an increase risk of all of the following, EXCEPT:

A. Delivery of a small for gestational age infant
B. Placental abruptio
C. Pulmonary edema
D. Prolongeddurationoflabor
E. Cerebral vascular accident (CVA)
8. Pregnancy induced hypertension :

A. Means high blood pressure at 10 weeks gestation.
B. Needs no treatment.
C. Pregnancy will be managed as normal.
D. Fetus will be at risk of fetal anomaly.
E. FetuswillbeatriskofIUGR.
9. The following are known complications of pre-eclampsia EXCEPT :

B. Uterinerupture.
C. Prematurity.
E. IUFD.
10. Severely pre-eclamptic patients have a decrease in :

A. Response to pressor amines.
B. Plasmavolume.
C. Total body sodium.
D. Uric acid.
11. What is the most common cause of acute renal failure in pregnancy ?
A. Drug abuse.
B. SLE.
C. Pre-eclampsiaandeclampsia.
D. Sickle cell disease.
E. Placenta previa.
12. Regarding essential hypertension in pregnancy, all the following is true, EXCEPT
A. Commonly associated with +ve family Hx of hypertension.
B. Usuallydiagnosedinthe3rdtrimester.*
C. More common in women over the age of 35.
D. It's usually not associated with significant proteinuria.
E. Will develop pre-eclampsia more commonly than normotensive women .
108
13. A pre-eclamptic patient has just delivered and has a soft uterus with moderate
bleeding. Examination reveals no laceration. Of the options below, the BEST
choice is :
A. 0.2 mg IV ergometrine.
B. 0.5 mg oral ergometrine.
C. 5 units of oral oxytocin.
D. 0.5 mg IM ergometrine.
E. 20unitsOxytocinina500mlofD5WgivenIV.
14. Pregnancy induced proteinuric hypertension is associated with all the following,
EXCEPT :
A. An increase in serum uric acid level.
B. Plasma volume decreases.
C. An increase in the incidence of IUGR.
D. Anincreaseincreatinineclearance.
E. Hb concentration increases.
15. Regarding pre-eclampsia, proteinuria is defined as :

A. 100 mg/24 hour urine.
B. 200 mg/24 hour urine.
C. 300mg/24hoururine.
D. > 500 mg/24 hour urine.
E. < 300 mg/34 hour urine.
16. Which adverse pregnancy outcome isn't increased in pregnancies complicated

by chronic hypertension :
A. Fetal growth restriction.
B. Preterm birth.
C. Spontaneous preterm rupture of membranes.
D. Perinatal death.
E. Posttermbirth
17. A syndrome seen in pre-eclampsia called HELLP syndrome is characterized by

all of the following EXCEPT:
A. Elevation of Liver enzymes.
B. Hemolysis.
C. Low platelet count.
D. ProlongationoftheProthrombintime.
18. The most common presenting prodromal sign or symptom in patient with
eclampsia is:
A. Right upper quadrant pain.
B. Edema.
C. Headache.
109
D. Visual disturbance.
E. Severe hypertension.
19. Appropriate response to an initial eclamptic seizure include all of the following
EXCEPT:
A. AttempttoabolishtheseizurebyadministratingI.M.diazepam.
B. Maintain adequate Oxygenation.
C. Administer Mg sulphate by either the I.M. or I.V. route.
D. Prevent maternal injury.
E. Monitor the fetal heart rate.
20. The most consistent finding in Eclampsia patients is:

A. Hyperreflexia.
B. 4+ proteinuria.
C. Generalized edema.
D. Diastolic blood pressure greater than 110 mmHg.
E. Convulsions.
21. Eclampsia occurring prior to 20 weeks of gestation is most commonly seen in

women with:
A. A history of chronic hypertension.
B. Multiple gestation.
C. Gestationaltrophoblasticdiseases.
D. A history of seizure disorder.
E. A history of choric renal diseases.
22. Of the following, the most common complication of eclampsia is:

A. Mg intoxication.
B. Recurrent seizures following administration of Mg sulphate.
C. Intracranialhemorrhage.
D. Maternal death.
E. Pulmonary edema
23. If a woman with pre-eclampsia is not treated prophylcatically to prevent

eclampsia, her risk of seizing is approximately:
A. 1/10.
B. 1/25.
C. 1/75.
D. 1/200.
E. 1/500.
110
24. Likely contributory mechanism of the anticonvulsant action of Mg sulphate

includes all the following EXCEPT:
A. Neuronal Ca-channel blockade.
B. Peripheral neuromuscular blockade.
C. Reversal of cerebral arterial vasoconstriction.
D. Inhibitionofplateletaggregation.
E. Release of endothelial prostacyclin.
25. All of the following antihypertensive drugs are considered safe for short-term
use in pregnancy EXCEPT:
A. Captopril.
B. Methyldopa.
C. Hydralazine.
D. Nifedipine.
E. Labetalol.
26. The reason to treat severe chronic hypertension in pregnancy is to decrease

the:
A. Incidence of IUGR.
B. Incidence of Placental abruption.
C. Incidence of Preeclampsia.
D. RiskofMaternalComplicationssuchasStroke.
27. The reason of using antihypertensive treatment in pregnancy is to:

A. Reduce the placental blood flow.
B. Reduce the risk of CVA in the fetus.
C. ReducetheriskofCVAinthemother.
D. Prevent hypertensive renal disease.
E. Prevent myocardial infarction.
28. Which of the following laboratory tests would be most suggestive of

preeclampsia?
A. Elevated bilirubin.
B. Decreased hematocrit.
C. Elevated lactate dehydrogenase (LDH).
D. Elevateduricacid.
E. Elevated creatinine.
29. HELLP Syndrome includes all the followings EXCEPT:

A. Hemolysis.
B. Increased AST.
C. Increasedplatelets.
D. Increased ALT.
111
30. The drug of choice to prevent convulsions in eclampsia is:

A. MagnesiumSulfate.
B. Hydralazine.
C. Labetalol.
31. PET (Pre-Eclamptic Toxemia):

A. MgSO4isthedrugofchoiceforeclampticconvulsions.
B. Exaggerated knee jerk indicates MgSO4 toxicity.
32. The proteinuria in eclampsia contains?

A. Only albumin
B. Only globulin
C. More albumin than globulin D.
More globulin than albumin E.
Neither albumin nor globulin
33. Which adverse pregnancy outcome is not increased in pregnancies complicated

by chronic hypertension :
A. Fetal growth restriction
B. Pre-term birth
C. Spontaneous preterm rupture of membrane
D. Perinatal death
E. Post-termbirth
34. Pregnancy induced proteinuria hypertension is associated with all following,

EXCEPT :
A. Increases in serum uric acid level
B. Plasma volume decreases
C. Increases in the incidence of IUGR
D. Increaseincreatinineclearance
E. Hemoglobin concentration increase
35. A pre-eclamptic patient has just delivered & has a soft uterus with moderate
bleeding. Examination reveals no laceration. Of the options below, the BEST
choice :
A. 0.2 mg IV ergometrine
B. 0.5 mg oral ergometrine
C. 5 units oral oxytocin
D. 0.5 mg IM ergometrine
E. 20unitsoxytocinina500mlofD5WgivenIV
36. Of the following, the most common cause of maternal death from eclampsia is:
A. Infection.
B. Uremia.
112
C. Congestive heart failure.

D. Fever.
E. Cerebralhemorrhage.
37. The criteria for severe pre-eclampsia include all the following, EXCEPT:
A. Diastolic blood pressure of 110 mmhg or more.
B. Proteinuria more than 5g/24 hours.
C. Presence of epigastric pain .
D. Decreasedhematocrit.
E. Oliguria.
38. The immediate appropriate response to an eclamptic seizure includes all the
following, EXCEPT :
A. Monitor the fetal heart rate.
B. USdoneforfetalgrowth.
C. Administer Mg sulphate.
D. Maintain adequate oxygenation.
E. Prevent maternal injury.
39. All the following factors increase the risk of the development of pre-eclampsia,
EXCEPT :
A. Closedspacedpregnancies.
B. Pre-existing diabetes.
C. Multiple gestation.
D. Pre-eclampsia with a previous pregnancy.
E. Pre-existing renal disease.
40. Risk factors to preeclampsia include all the following EXCEPT:

A. Premature delivery.
B. Placenta abruption.
C. Renal failure.
D. DIC.
E. Polycythemia.
41. Pregnancy induced hypertension is more common in all the following EXCEPT:
A. Primigravida.
B. Multiple pregnancy.
C. Patients with pre-existing hypertension.
D. WomenwithUTI.
E. Women with diabetes mellitus.

preeclampsia?
113
B. Decreased Hematocrit.
D. Elevateduricacid.
43. 30 weeks pregnant primigravida presented with raised blood pressure of

150\95 mmHg and proteinuria +3, which one of the following is done :
A. Immediate caesarian section.
B. 24hoururinecollectionforprotein,CBC.LFT,uricacidandcoagulation
profile.
C. Send her home and to be seen after 4 weeks.
D. Advice to not get pregnant again.
E. Macrosomia is a recognized complication of this problem.
34. Early clinical evidence of magnesium sulfate toxicity would show:

A. Flushing
B. Diplopia
C. Decreased oxygen saturation
D. Loss of deep tendon reflexes E.
Headache
35. The following are true regarding patients with essential hypertension in labor,
EXCEPT :
A. Shouldn'thaveepiduralanalgesia.
B. Can be safely given IV syntocinon.
C. Shouldn't be given ergometrin as a routine in the 3rd stage.
D. Should have continuous fetal heart rate monitoring.
E. IV labetalol is a safe drug when required.
36. Proteinuria in pregnancy may be caused by :

A. UTI.
B. Pre-eclamptic toxemia.
C. Nephrotic syndrome.
D. Contaminated with vaginal discharge.
E. Alltheabove.
37. Markedly obese pregnant patients often experience all the following
complications, EXCEPT :
A. Hypertension.
B. Diabetes mellitus.
C. Thromboembolism.
D. Fetalgrowthrestriction.
E. Difficult intubation during anesthesia.
114
38. What is the mechanism of action of alpha methyl dopa?

A. Increase peripheral vascular resistance.
B. Increase sodium and water retention.
C. Actscentrallytodecreasesympatheticactivity.
D. Relaxes arterial smooth muscle.
E. Decrease the cardiac output.
115
DiabetesinPregnancy:
1. Gestational diabetes is associated with an increase risk of all the following,
EXCEPT:
A. Cesarean section
B. Shoulder dystocia
C. Fetal macrosomia
D. Intrauterine fetal death
E. Intrauterinegrowthrestriction
2. Control of gestational diabetes is accomplished with the following, EXCEPT:

A. Insulin
B. Diet
C. Oralhypoglycemicagents
D. Exercise
E. Insulin and diet
3. Infants of mother with gestational diabetes have an increased risk of the

following, EXCEPT:
A. Hypoglycemia
B. Hypoinsulinemia
C. Hypocalcemia
D. Hyper bilirubine
E. Polycythemia
4. The best screening test for gestational diabetes

A. Fasting blood sugar
B. Random blood sugar
C. Glucosechallengetest
D. Glucose tolerance test
E. Blood sugar series
5. Glucose tolerance test :

A. Is used as a screening test for diabetes.
B. Isconsideredtobeadiagnostictestfordiabetes.
C. Is performed in a non-fasting state.
D. Should be avoided during pregnancy as it needs a loading dose of glucose.
E. 50 mg of glucose should be given to the patient.
6. Indications of glucose tolerance test GTT in pregnancy include all the following
EXCEPT :
A. Previous Hx of gestational diabetes mellitus.
B. Hx of macrosomic baby.
116
C. Glycosuriainoneoccasion.
D. Hx of unexplained fetal death.
E. Hx of babies with congenital sacral agenesis.
7. Regarding Good control of diabetes in pregnancy :

A. Maintains blood sugar level between 8 and 12 mmol/L.
B. Isachievedbytwicedailyinjectionofinsulin.
C. Increases the incidence of polyhydramnios.
D. Has no effect on the incidence of congenital abnormalities.
E. Is aimed of increasing fetal hyperinsulinisim.
8. In the Saudi population, the most common problem during pregnancy is :

A. Diabetes.
B. Toxemia.
C. Heart disease.
D. UTI.
E. Iron deficiency anemia.
9. Maternal complications associated with polyhydramnios include :

A. High blood pressure.
B. Urinary tract anomalies.
C. Diabetes.
D. Postmature pregnancy.
10. Which of the following items in a pregnant patient's History suggests the
possibility of her having diabetes :
A. IUGR.
B. Past Hx of twins.
C. 1st trimester bleeding.
D. Diabetic husband.
E. Unexplainedstillbirths.
11. During pregnancy, blood tests for diabetes are more abnormal than in
nonpregnant state. This is due to :
A. Decreased insulin.
B. Increased absorption from the GI tract.
C. Increasedplacentallactogen.
D. Estrogen decreases and progesterone increases.
E. Hemoconcentration.
12. The test that is used to diagnose diabetes is :

A. Glucose challenge test.
B. FBS & random blood sugar.
117
C. Glucosetolerancetest.
D. Hb A1C.
E. CBC.
13. Which of the following is a known complication of diabetes in pregnancy :

A. Itincreasestheincidenceofcongenitalabnormalities.
B. Development of pregnancy induced hypertension.
C. Development of oligohydraminos.
D. Development of retinopathy.
E. Jaundice.
14. Gestational diabetes should be suspected in all the following conditions,

EXCEPT:
A. A strong family Hx of diabetes.
B. Previous Hx of big baby.
C. Polydepsiaandpolyuria.
D. Hx of unexplained fetal loss.
E. Polyhydramnious.
15. Infants of diabetic mothers are at risk of one of the following :

A. Low Hb.
B. Hypercalcemia.
C. Hyperglycemia.
D. Microsomia.
E. Respiratorydistresssyndrome.
16. Insulin requirements of pregnant diabetic women are greatest during :

A. The 1st half of pregnancy.
B. The2ndhalfofpregnancy. C.
During lactation.
D. The immediate postpartum period.
17. Gestational Diabetes Mellitus (GDM) is associated with:

A. Increasedriskofspontaneousabortions.
B. Increased risk of fetal cardiac malformations.
C. Increased risk of fetal CNS malformations.
D. IUGR.
E. Decreased head circumference: abdominal circumference ratio.
18. Infants of mothers with GDM have an increased risk of all of the following
EXCEPT:
A. Hypoglycemia.
B. Hyperglycemia.
118
C. Hypocalcaemia.
D. Hyperbilirubinemia.
E. Polycythemia.
19. GDM is associated with an increased risk of all the following EXCEPT:
A. C-section.
B. Shoulder dystocia.
C. Fetal Macrosomia.
D. IUFD.
E. IUGR.
20. Infants of mothers with GDM are at an increased risk of becoming:

A. Obese adults.
B. Type II diabetes.
C. Neither
D. Both.
21. Compared to Type II diabetes, type I diabetes is associated with all of the
following EXCEPT:
A. Greater incidence of pre-eclampsia.
B. Greater incidence of preterm delivery.
C. Greater risk of maternal hypoglycemia.
D. Greater risk maternal diabetic ketoacidosis.
E. ReducedriskofIUGR.
22. GDM substantially increase the mother's risk for the ultimate development of:
A. Type I DM.
B. Type II DM.
C. Neither.
D. Both.
23. Which of the followings is a known complication of diabetes in pregnancy?

A. Fetal microsomia (small baby).
B. Oligohydraminos.
C. Iron deficiency anemia.
D. Fungalinfection.
E. Placenta previa.
24. Regarding gestational diabetes mellitus (GDM):

A. It is the most common cause of IUGR.
B. The best screening test is random blood sugar.
C. Thediagnostictestisglucosetolerancetest(GTT).
D. All patients should be treated by insulin, as diet alone is not enough.
E. All patients should be delivered before term to avoid complications.
119
25. Diabetes in pregnancy can cause all the following congenital anomalies
EXCEPT:
A. Sacral agenesis.
B. Central nervous system abnormalities.
C. Lower limb hypoplasia.
D. Congenital heart disease.
E. Yellowteethdiscoloration.
26. Infants of diabetic mothers are at risk of one of the following :

A. Low hemoglobin
B. Hypocalcaemia
C. Hyperglycemia
D. Microsomia
E. Respiratory distress syndrome
27. The serum insulin level in the newborn infant of a diabetic mother in
comparison to the infant of a euglycemic mother is generally :
A. Higher
B. The same as euglycemic
C. Lower
D. Extremely labile
28. With overt diabetes, what is the most common fetal malformation?
A. Congenitalheartdisease.
B. Caudal regression.
C. Renal agenesis.
D. Neural tube defect.
29. All the following are considered to be complications of gestational diabetes,

EXCEPT :
A. Polyhydramnios.
B. IUGR.
C. Fetal macrosomia.
D. Sudden unexpected intrauterine fetal death.
E. Neonatal hypoglycemia.
30. Regarding gestational diabetes, choose the correct answer :

A. Cleft lip is the most common congenital anomaly seen with gestational
diabetes.
B. Fetal lung maturity is accelerated in diabetic patient compared to non
diabetic mothers.
120
C. Macrosomiaisoneofthecomplicationsofuncontrolledgestational
diabetes.
D. Gestational diabetes usually starts before 12 weeks gestation.
E. Gestational diabetes has a very low incidence in Saudi Arabia.
31. The most common congenital anomaly associated with diabetes is:
A. Congenitalheartdisease.
B. Neural tube defect.
C. Sacral agenesis.
D. Renal agenesis
E. Caudal regression
32. Regarding gestational diabetes mellitus :

A. The incidence of this disease is very low in KSA.
B. Potential diabetic patients should have only glucose challenge test as a
diagnostic test.
C. Intrauterine growth retardation is more common in patients with
gestational diabetes than those patients with long standing diabetes
mellitus.
D. Oralhypoglycemicagentsarenotsafeduringpregnancy.
E. Oral hypoglycemic agents can be used in pregnancy for better control of
blood sugar.
33. Polyhydramnios is commonly found with

A. IUGR
B. Placenta previa
D. Fetal renal agenesis
E. Diabetesmellitus
34. Risk factors for the development of gestational diabetes include all the
following, EXCEPT :
A. Obesity.
B. Family Hx of diabetes.
C. Previous Hx of IUFD.
D. PreviousHxofIUGR.
E. Previous Hx of diabetes.
121
AnemiaandThyroidDiseasesinPregnancy:
1. In a pregnant female which of the following depicts the level of iron:
A.Transferrinlevel
B. Serum ferritin level
C. Haemoglobin level
D. Iron binding capacity
E. Serum Iron
2. The most common type of anemia in pregnancy is due to :

A.Irondeficiency.
B. Sickle cell disease.
C. Folate deficiency.
D. Hemolytic disease.
E. Vitamin B12.
3. Folic acid deficiency results in :

A. Microcytic anemia.
B.Megaloblasticanemia.
C. Aplastic anemia.
D. G6PD deficiency.
E. WBC stippling.
4. Sickle cell:
A. Diseases presents in a heterotype (SA).
B.Increasestheriskofurinarytractinfections.
5. A 29 year old primigravida woman at 16 weeks of gestation reports irritability,

palpitation and difficulty in gaining weight. Physical examination is normal
except for a pulse of 104 beats/min and lid lag. Laboratory studies reveal Hb of
10.1g/dl, serum free thyroxin of 10 ng/dl and thyrotropin of 0.1 mU1ow. What
is the most likely diagnosis?
A. Thyroid storm.
B. Hypothyroidism.
C. Depression.
D.Hyperthyroidism.
6. According to WHO, Hb in a pregnant woman shouldn't be less than:

A. <8
B.<10
C. <9
D. <11
E. <13
122
CardiovascularDiseases:
1. Disseminated intravascular coagulation has a recognized association with:

A. IUFD
C. Iron deficiency
D. Diabetic mother
E. Prolonged bed rest
2. Risk Factors for DVT include all, EXCEPT:

A. Smoking
B. Operative delivery
C. Lupus anticoagulation
D. Maternal weight over 80 kg
E. Hyperthyroidism
3. In pregnant patients with rheumatic heart disease, all of the following is true,
EXCEPT:
A. Should be always given iron to avoid anemia.
B. Commonlydevelopatrialfibrillation.
C. Should be given prophylactic antibiotic in labor.
D. Usually remain asymptomatic.
E. Ergometrine should not be given routinely in cases with mitral stenosis.
4. Which of the following isn't considered a high risk pregnancy ?

A. Gestational diabetes.
B. Cardiac disease in pregnancy.
C. Candidainfectioninpregnancy.
D. Bleeding in pregnancy.
E. Patient with a Hx of previous IUFD.
5. Regarding cardiac disease in pregnancy, according to the New York Heart

Association classification, a patient with cardiac disease & slight limitation of
physical activity would be:
A. Class O.
B. Class I.
C. ClassII.
D. Class III.
E. Class IV.
123
6. Which of the following accounts for most heart disease in pregnancy ?

A. Cardiomyopathy
B. Previous myocardial infarction
C. Hypertension
D. Thyroid disease
E. Congenitalheartdisease(CHD)
7. What is the most serious disadvantage of switching from Warfarin to heparin

during pregnancy in women with mechanical heart prosthesis ?
A. The risk of embryopathy is increased.
B. The risk of thrombo-embolism is increased.
C. Theneedforself-injection.
D. Hemorrhage is more likely.
8. If delivery occurs unexpectedly while the patient is on Heparin and excessive

bleeding occurs, what is the appropriate initial intervention?
A. Administrationofprotamineacetate.
B. Administration of vitamin K .
C. Administaration of tranexemic acid.
D. Ligation of the hypogastric arteries.
E. Infusion of fresh frozen plasma.
9. Which of the following symptoms in pregnancy is most suggestive of heart

disease ?
A. Tachypnea.
B. Syncopewithexertion.
C. Tachycardia.
D. Peripheral edema.
E. Fatigue.
10. Regarding anticoagulants in pregnancy, which of the following laboratory

parameters should be maintained at a level of 1.5 to 2.5 times baseline value?
A. Bleeding time.
B. Partialthromboplastintime.
C. Prothrombin time.
D. Thrombin time.
124
UrinaryTractDiseasesinpregnancies:
1. All are true, about acute pyelonephritis in pregnancy, EXCEPT:
A.Occurin60%ofpregnantwomen. (it complicates only 1-2% of
pregnancies)
B. Can be preceded with asymptomatic Bacteriuria
C. In severe form there should be administered and I.V. antibiotics should be
started
D. when recurrent should be investigated
E. May lead to premature labor
2. UTI in pregnancy :
A. Occurs in about 10% of pregnancies.
B. Can be easily diagnosed when there is more than 1000 bacteria per ml on
culture.
C. Is commoner in multigravida when compared with primigravida.
D.Mayleadtopretermlabor.
E. If it's reoccurring, it necessitated investigations after delivery.
3. The predisposing factor to ( case of burning micturation, loin pain) is:

A.Hydrouretersbecauseofprogesteroneeffect
B. Compression of ureters in the 3rd trimester by enlarging uterus
125
GeneralQuestions:
8. All are the risks associated with macrosomia, EXCEPT:

A. Maternal obesity
B. Prolonged Pregnancy
C. Previous large infant
D. ShortStature
E. Gestational Diabetes Mellitus
9. Which of the following is not associated with large infants?

A. Diabetic mothers
B. Multiparity
C. Large parents
D. Maternalsmoking
E. Maternal obesity
10. Fetal tachycardia could result from

A. Maternal febrile illness
B. Maternal hypothyroidism
C. Labetalol ingestion
D. Post maturity
E. Pethidine injection
11. Perinatal mortality refers to:

A. Number of stillbirths per 1,000 total births.
B. Numberofstillbirths&neonataldeathsper1,000totalbirths. C.
Number of stillbirths & neonatal deaths per 1,000 live births. D.
Number of neonatal deaths per 1,000 total births.
E. Number of stillbirths & neonatal deaths per 100,000 total births.
12. Markedly obese pregnant patients often experience all of the following
complications EXCEPT :
A. Hypertension
B. Diabetes Mellitus
C. Thromboembolism
D. Fetalgrowthrestriction
E. Difficult intubation during anesthesia
13. All of the following are possible causes of acute abdomen in pregnancy EXCEPT :
A. Large ovarian cyst
B. Largefetus
C. Large appendix
126
D. Large peptic ulcer

E. Cholycystitis
14. A patient in the third trimester of pregnancy is seen in the emergency room and
while being examined has a convulsion. The doctor should immediately:
A. Obtain neurologic consultation
B. Obtain psychiatric consultation
C. Give IV valium
D. Protectthepatientfromselfharm
E. Obtain a chest film
15. A 22 year old G2 P1 experienced spontaneous rupture of membranes at 16 weeks

gestation. 24 hrs later, she has a temp. of 39 degrees and a white blood cell count
of 15.000/mm3. Her cervix is dilated 2cm and there are no contractions. Which
course of management is associated with the least morbidity ?
A. Perform a hysterectomy.
B. Induce labor with oxytocin.
C. Perform suction and evacuation.
16. Fetoprotein can be elevated in all the following, EXCEPT :

A. Anencephaly.
B. Duodenal atresia.
C. Closed meningiocele.
D. Fetaldeath.
E. Twin pregnancy.
17. The mechanism of Action of alpha methyldopa:

A. Increased peripheral vascular resistance.
B. Increased sodium & water diuresis.
C. Actcentrallytodecreasesympathetic.
D. Relaxes arterial smooth muscles.
E. Decrease the cardiac out put.
18. Maternal aspiration of gastric contents during labor is most often due to:
A. Gastric hypotonicity.
B. Pelvic pain.
C. Pneumothorax.
D. Anesthesia.
E. Narcotics.
19. Oligohydromnios is characteristically associated with:

A. Rh isoimmunization.
B. Renalagenesis.
C. Diabetes mellitus.
127
D. Hypothyroidism.
E. Placenta previa.
128
Contraception:
1. Which of the following contraceptive methods should NOT be used by a
patient with coronary heart disease?
A. Combinedoralcontraceptivepills
B. Male condom
C. Female condom
D. Diaphragm
E. Spermicidal agent
2. Permanent sterilization include all of the following, EXCEPT:

A. Vasectomy
B. Tubal ligation
C. Mirena IUCD
D. Hysterectomy
E. Bilateral salpingectomy
3. The combined contraceptive pills: Which is true?

A. Pre-dispose to pelvis inflammatory disease
B. Predispose to ovarian cyst
C. Predispose to benign breast cyst
D. ContraindicatedinapatientwithhistoryofDVT
E. Failure rate is 2 per hundred woman years
4. The following is an absolute contraindications to the combined oral

contraceptive pills:
A. Varicose veins
B. Previous history of viral hepatitis
C. Prostheticheartvalve
D. Diabetes mellitus
E. Age above 35 years
5. The following conditions are aggravated by oral contraceptive pills

A. Hirsutism
B. Endometriosis
C. Dysmenorrhea
D. Pre-menstrual syndrome
E. Genitalfungalinfection
6. Regarding Intra uterine contraceptive device (IUCD)

A. Reduces pelvic inflammatory disease
B. Inhibits ovulation
C. Increases incidence of endometrial cancer
129
D. Ifpregnancyoccursthereisincreasedriskofectopicpregnancy.
E. Failure rate is 0.1%
7. Combined Oral Contraceptive Pills contain:

A. A synthetic estrogen alone
B. A progestin alone
C. Bothestrogenandprogestin
D. Bromocriptine
E. Androgen
8. Mechanisms of Oral Contraceptive Pills include all of the following EXCEPT:

A. Ovulation suppression
B. Enhancedovarianandrogenproduction
C. Altered cervical mucus
D. Altered endometrium
E. Altered tubal motility
9. Postulated mechanism of the IUCD include all of the following action EXCEPT:
A. Altered tubal motility
B. Altered endometrium
C. Alteredcervicalmucus
D. Cupper has spermicidal effect
E. inhibition of implantation
10. Regarding injectable progesterone contraception, all of the following is true,

EXCEPT:
A. Medroxyparogesterone acetate is the most commonly used
B. May cause irregular uterine bleeding
C. May cause amenorrhea.
D. Shouldnotbegiventolactatingmother.
E. Does not carry a risk of venous thrombosis.
11. With regards to contraception failure, the pearl index refers to:
A. Numbers of Pregnancies in years.
B. Number of pregnancies in 1 woman-year.
C. Numberofpregnanciesin100woman-year.
D. Number of pregnancies in 100 woman-years over pregnancy losses.
E. Number of Pregnancy losses in 100 woman-years.
12. Contraindication of OCP, EXCEPT:

A. IHD
B. Previous DVT
C. Previous CVA
D. Family Hx of Breast Carcinoma.
130
E. 35Y,smokes>15cigaretteperday.
13. Combined oral contraceptive pills are associated with :

A. Dysmenorrhea
B. Menorrhagia
C. Polymenorrhoea
D. Ovarian cyst
E. Intermenstrualbleeding.
14. OCP have the following beneficial effects EXCPET :

A. Decrease endometrial cancer
B. Decrease benign breast disease
C. Decrease iron deficiency anemia
D. Decreased ovarian cancer
E. Decreasetheincidenceofrenalfailure
15. Side effect of OCP include all the following EXCEPT:

A. Break through bleeding
B. Dysmenorrhea.
C. Nausea
D. Mastalgia
E. Chloasma
16. The use of OCP reduces the risk of all the following EXCEPT:
B. Hepaticadenoma.
C. Salpangitis
D. Ovarian cancer
E. Endometrial cancer
17. Which of the following statements regarding the use of IUCD is TRUE :
A. Most IUD were withdrawn from the market due to the financial burden
B. The Contraceptive effectiveness of IUD is similar to that of barrier
methods
C. The risk of Salpangitis in IUD wearer is positively correlated with duration
of use
D. Contraceptiveeffectivenessofcopper-containingIUDishigherthanthat of
theinertdevice
E. Women using progesterone containing IUD have heavier than the women
using the inert device.
18. All are true regarding OCP EXCEPT :

A. Increase viscosity of cervical mucosa
B. Can cause venous thrombosis
131
C. Can cause mild hypertension

D. Act by preventing the ovulation
E. Usuallycauseamenorrhea
19. IUCD are relatively contraindicated in the following patient EXCEPT:

A. With past history of chronic Salpangitis.
B. With Submucous fibroid
C. With history of ectopic pregnancy
D. With septate uterus
E. WithhistoryofCsection
20. Complication of IUCD include all the following EXCEPT:

A. Premenstrual –spotting
B. Dysmenorrheal
C. Menorrhagia
D. Pelvic infection
E. Failureratearetwicethatexpectedinthepatientstakingprogestinonly pill.
21. Lowest pregnancy rate in 100 women using the method for 1 year :
A. IUCD
B. OCP
C. Condom
D. Diaphragm
E. Spermicidal cream
22. The use of progesterone only pills :

A. Ovulationisnotregularlyinhibited
B. Protection against is as good as combined pill
C. There is a risk of DVT
D. Breakthrough bleeding is rare
E. The dose of progesterone is much larger than in combined pill
23. A contraceptive method that prevent transmission of STD is:

A. Condom.
B. OCP.
C. IUCD.
D. Spermicide.
24. The goal for developing a successful contraception include all of the following
EXCEPT:
A. Regulate fertility.
B. Stabilize population growth.
C. Reducing maternal morbidity.
132
D. Diminishingtheincidence.
E. Decreasing the prevalence of STD.
25. What is the effect of oral contraceptives on the incidence of DVT & embolism?
A. Decreases the incidence.
B. Doesn't affect the incidence.
C. Increases thrombosis but not pulmonary embolism.
D. Increasestheincidence.
E. Increases pulmonary embolism but not deep vein thrombosis.
26. The mechanism of action of OCPs include all the following, EXCEPT:
A. Enhancesovarianandrogenproduction.
B. Alter the cervical mucous.
C. Alter the endometrium.
D. Ovulation suppression.
E. Alter the tubal motility.
27. Postulated mechanism of action of IUD includes all the following, EXCEPT :
A. Alterthecervicalmucous.
B. Alter the endometrium.
C. Inhibits fertilization.
D. Alter the tubal motility.
E. Inhibition of implantation.
28. Which of the following contraceptive methods should not be used by a patient
with coronary heart disease?
A. COCP.
B. Male condoms.
C. Female condoms.
D. Diaphragm.
E. Spermicidal agent.
29. Estrogens commonly used in oral contraceptive pills include.

A. Ethinylestradiol.
B. Ethinyl estriol.
C. Northisterone.
D. Ethisterone.
E. Estradiol valorates.
30. The use of Progesterone-only contraceptive pills is governed by the following

considerations, choose the CORRECT answer:
A. Ovulationisnotregularlyinhibited.
B. Protection against pregnancy is as good as combined pills.
133
C. There is a substantial risk in older women with venous thrombus &

embolism in their user.
D. Breakthrough bleeding is rare.
E. The dose of progesterone is much larger than in combined.
31. The goals for developing a successful contraceptive include all of the following
EXCEPT:
A. Regulating fertility.
B. Stabilizing population.
C. Reducing maternal morbidity.
D. Diminishingtheincidence.
E. Decreasing the prevalence of sexually transmitted diseases.
32. Regarding IUCD, all of the following are INCORRECT, EXCEPT:

A. Inhibition of ovulation is the main mechanism of action.
B. Has a failure of 6%.
C. Statisticallyincreasestheincidenceofectopicpregnancy.
D. Is commonly associated with excessive menstrual loss.
E. Not suitable for patients with previous delivery.
33. The following are known contraindications to the use of combined oral
contraceptive pills (COCP), EXCEPT:
A. Deep venous thrombosis or pulmonary embolism.
B. Active liver disease.
C. Benign intracranial hypertension.
D. RepeatedLSCS.
E. Cholestasis in pregnancy.
34. The combined oral contraceptive pill, besides being used as a method of
contraception, can be used to treat the following, EXCEPT:
A. Endometriosis.
B. Ovulation pain.
C. Menorrhagia.
D. Dysmenorrhea.
E. Mucinousovariancyst.
35. Progesterone only pills work as contraceptives by:

A. Suppressingovulation.
B. Altering the cervical mucosa.
C. Producing endometrial hyperplasia.
D. Reducing libido.
E. Acting as a spermicide.
134
36. Combined oral contraceptive pills containing estrogen & progesterone produce
the following effects, EXCEPT:
A. Act by preventing ovulation.
B. Can cause hypertension.
C. Can cause venous thrombosis.
D. Usuallycauseamenorrhea.
E. Increase the viscosity of cervical mucous.
37. Regarding Progesterone only pills preparation:

A. Affect the cervical mucous.
B. Reliablyinhibitovulation.
C. Are contraindicated in mild hypertension.
D. Are reliable as the combined preparation.
E. Are not suitable for lactating mothers.
38. Which of the following is an absolute contraindication to the use of COCP?
A. Varicose veins.
B. DM.
C. Seizure disorders.
D. Recenthistoryofdeepvenousthrombosis.
E. Mild essential hypertension.
39. IUCD may prevent pregnancy by all of the following mechanism EXCEPT:
A. Creating chronic endometritis.
B. Inducing endometrial atrophy.
C. Inhibitingovulation.
D. Altering tubal motility.
E. Destroying sperm.
135
InfectionsofthelowergenitalTract:
1. Vulvovaginal Candidiasis:
A. Cause muco-purulent cervicitis.
B. Frequently associated with systemic symptoms.
C. MaybediagnosedmicroscopicallybymixingdischargewithKOH.
D. Is treated with doxycycline.
E. Is one of the sexually transmitted diseases.
2. Bacterial Vaginosis:
A. Is rare vaginal infection.
B. Is always symptomatic.
C. Is usually associated with profound inflammatory reaction.
D. Causesfishydischargewhichresultsfrombacterialamineproduction.
E. Is treated with Clotrimazole.
3. Trichomoniasis:
A. Associated with cytological findings in PAP smear.
B. Associated with pregnancy & Diabetes mellitus.
C. Issexuallytransmittedparasitewhichcausespruriticdischarge.
D. May cause overt warts.
E. Is diagnosed on a wet smear which reveals clue cells.
4. Chlamydia Trachomatis infection:

A. Are commonly manifested as vaginal discharge.
B. PAP smear usually suggest inflammatory changes.
C. Infection in the male partner present as urethritis.
D. May ascend into the upper genital tract resulting in tubal occlusion.
E. Alloftheabove.
5. All the followings can be transmitted sexually EXCEPT:

A. HIV.
B. Chlamydia.
C. Gonorrhea.
D. VaginalCandidiasis.
6. Regarding gonococcal infection of the female genital tract, the following are
common site of infection:
A. bartholine gland
B. Skene gland
C. Urethra&cervix
D. Rectal crypt
E. All of the above
136
7. Vaginal Trochomitis is :
A. sexuallytransmitteddisease
B. Yeast infection
C. Cause Salpangitis
D. Is more common in diabetic
8. Candida occur in all of the following EXCEPT:

A. Diabetic
B. Long term anti biotic
C. Thyrotoxicosis
D. OCP
E. Pregnant

A. HIV.
B. Clamydia.
C. Gonorrhea.
10. Genital tract Candida occurs more frequent in all these patients, EXCEPT:
A. Diabetic.
B. On long term antibiotic therapy.
C. Thyrotoxicosis.
D. On oral contraceptive pills.
E. Pregnant.
11. Regarding Vaginal Trichomoniasis, choose the CORRECT answer:

A. Is a yeast infection.
B. Isgenerallysexuallytransmitted.
C. Frequently cause Salpangitis.
D. Is more common in diabetic patients.
E. Treated by antifungal drugs.
12. The treatment choice for gardenerella vaginosis is :

A. Ampicillin.
B. Metronidazole.
C. Clindamycin.
D. Gentamycin.
E. Vancomycin.
13. Which of the following is NOT detected by a cervical smear?

A. Herpes Simplex Virus
B. Human Papilloma Virus
C. Actinomycosis
137
D. Trichomonas
14. Metronidazole is indicated for which of the following conditions:

A. Bacterial vaginosis
B. Trichomonas
C. Prophylaxis before vagina surgery
D. Alloftheabove
15. Vaginal Trichomoniasis, choose the correct answer :

A. Is a yeast infection
B. Isgenerallysexuallytransmitted
C. Frequently cause salpingitis
D. Is more common in diabetic patients
E. Threatened by antifungal drugs
16. All the following infection can be transmitted through sexual intercourse,
EXCEPT:
A. Genital herpes
B. Human Immunodeficiency Virus (HIV)
C. Chlamydia
D. Gonorrhea
E.VaginalCandidiasis
138
PelvicInflammatoryDisease(PID):
1. Treatment of pelvic inflammatory disease (PID) include the following, EXCEPT:

A. Oral doxycycline
B. Removal of IUCD
C. Clindamycin
D. Tetracycline
E. Dilatationandcurettage(D&C)
2. The differential diagnosis of vulvar swelling includes all the followings EXCEPT:
A. Bartholin's cyst.
B. Hematoma.
C. Condyloma.
D. Nabothiancyst.
E. Papilloma.
3. The terminology of pelvic inflammatory diseases indicates:

A. Infection of the vagina.
B. Infection of Bartholin's glands
C. Infection of Skene's glands.
D. Infection of the urinary bladder.
E. Endometritisandsalpingo-oophoritis.
4. Late sequele of Salpangitis:

A. Endometriosis
B. Endometrial hyperplasia
C. Fallopian tube cancer
D. Hydrosalpinx
E. Cervitis
5. Recto-vaginal fistula result from all of the following EXCEPT:

A. obstetrical delivery
B. Irradiation to the pelvis
C. Carcinoma
D. Hemmorraidectomy
E. Obesity
6. The etiology of PID include all of the following except:

A. TB.
B. Hepatitisvirus.
C. Chlamydia.
D. Group B streptococci.
139
E. Gonorrhea
A. Bartholin's cyst
B. Hematoma.
C. Condyloma.
D. Nabothiancyst.
E. Papilloma.
8. A 38 year old woman is seen for the evaluation of a swelling in her right vulva.
She has also noted pain in this area when walking and during coitus. On
examination a mildly tender flactuant mass was noticed just outside the
introits in the right vulva. What the most likely diagnosis?
A. Bartholin'sabscess.
B. Lymphogranuloma venerum.
C. Chancroid.
D. Vulva carcinoma.
E. Herpes infection.
9. Treatment of pelvic inflammatory disease include the following, EXCEPT:

A. Oral doxycycline
B. Removal of IUCD
C. Clindamycin
D. Tetracycline
E. Dilatationandcurettage(D&C)
10. On bimanual examination, bilateral adnexal masses were palpated. A vaginal

US was done for her and it showed bilateral tubo-ovarian abscesses. What is
the most appropriate next step in her management:
A. Admit the patient for emergency laparoscopic drainage of the abscess.
B. AdmitthepatientandgiveherIVantibiotic.
C. Treat with multiple oral antibiotics as an outpatient.
D. Call interventional radiotherapy to perform "CT guided Percutaneous
aspiration".
E. Admit the patient for exploratory laparotomy, TAH and BSO.
11. Bartholin's abscess:

A. Is often asymptomatic.
B. Is usually bilateral.
C. Is most commonly due to gonococcus infections.
D. Isbesttreatedsurgically.
E. Is usually presented as painful swelling to one side to clitoris.
140
12. The mechanism of infertility in pelvic inflammatory disease (PID) include the
following EXCEPT:
A. Polycysticovary.
B. Peritubal adhesions.
C. Hydrosalpinx.
D. Pyosalpinx.
E. Frozen pelvis.
13. Disorders of pelvic support are commonly associated with all of the following
EXCEPT:
A. Multiparity. (children)
B. Aging.
C. Alcoholconsumption.
D. Pelvic trauma.
E. Heavy lifting.
141
InfertilityandHirsutism:
1. All the following are true, about ovarian hyperstimulation, EXCEPT:
A. It can follow any of ovulation induction drugs
B. In severe type admission to the intensive care unit may be required
C. Theovarieswillbeverysmallinsizehaveunilateralcyst.
D. It can diagnosed clinically and by ultrasound
E. Patients with PCO are at increased risk
2. All of the following are true about PCO EXCEPT:

A. TodiagnosePCOhormonalanalysiscanbedoneatanytimeofthecycle
B. It is associated with reversed FSH:LH ratio
C. It is associated with increase resistance to insulin
D. Can be associated with increased prolactin level
E. The ovaries have characteristic appearance by the ultrasound
3. Evaluation of infertile couples:

A. History of regular cycles is suggestive of anovulation
B. Historyofseveredysmenorrheaanddyspareuniaissuggestiveof
endometriosis
C. Endometriosis is diagnosed by hysteroscopy
D. Hysterosalpingogram is the only means of assisting ectopic pregnancy
E. Thyroid disease does not affect fertility
4. Treatment of infertility
A. Clomiphene citrate helpful in patients with anovulatory premature
ovarian failure
B. Ovarian drilling is helpful in the treatment of infertility endometriosis
C. IVF is not helpful in the treatment of infertility due to male factor
D. Hyperstimulationsyndromecanoccursinpatienttreatedby
gonadotropins
E. Spontaneous pregnancy can occur in patients with Müllerian agenesis
5. All of the following possible causes of infertility, EXCEPT:

A. Previous laparotomy for any reason
B. Smoking
C. High body mass index
D. PCO
E. Uterinesubserousfibroids
6. The following value of semen analysis indicates abnormal semen quality:

A. Volumelessthan2ml
B. Count of 40 million / ml
142
C. Motility 60%
D. Abnormal form 30%
E. Liquefaction complete in 30 minutes
7. Regarding human fertility: Which is true?

A. Fertilizationusuallyoccurs5-7daysbeforeimplantationandbeforethe
extrusionofthesecondpolarbody
B. Subfertility only treated with IVF
C. An adverse male factor is detectable in 60% of couples with low fertility
D. Mumps in adulthood has no effect on male fertility
E. Oligospermia means that sperm shape is abnormal
8. The commonest cause for infertility

A. Tubal obstruction
B. Malefactor
C. Chronic anovulation
D. Hyper androgens
E. Hypothyroidism.
9. All the following are possible causes of anovulation, EXCEPT:

A. High body mass index
B. Anorexia nervosa
C. Polycystic ovarian syndrome
D. Premature ovarian failure
E. Sicklecelltrait
10. Polycystic ovarian diseases, all of the following can be seen, EXCEPT:
A. Acne
B. Streakovaries
C. Insulin resistance
D. Hirsutism
E. Galactorrhea
11. The initial evaluation in an infertile couple should include:

A. Ovarian biopsy.
B. Semenanalysis.
C. D & C.
D. Laparoscopy.
E. Sperm penetration assay.
12. Induction of ovulation agents:

A. Clomiphene citrate is an anti-androgen.
B. Clomiphene citrate is given by injection.
C. Gonadotropins is given orally.
143
D. Ultrasound scan is not needed with induction.

E. Causesmultiplefollicles.
13. In polycystic ovary syndrome patients, all the followings are true EXCEPT:
A. Theyareusuallyunderweightwithlowbodymassindex.
B. They have hirsutism.
C. They have Oligomenorrhoea.
D. They have high Prolactin level.
E. They have Subfertility.

A. Basal body temperature drop at least 0.5 C in the second half of the cycle
B. Day 21 Estrogen level is elevated
C. Progesterone level on day ten of the cycle is elevated.
D. Regularcyclewithdysmenorrhea.
E. Oligomenorrhoea
15. Which of the following is a basic investigation for the male infertility :
A. Semenanalysis.
B. Sperm penetration assay of cervical mucous.
C. Sperm penetration assay of hamster ova.
D. Splits ejaculate analysis.
E. Sperm antibodies test.
16. Characteristic of normal semen analysis all true EXCEPT:

A. Volume > 2ml
B. pH of 7.2-7.8
C. Sperm count > 2o million /ml.
D. Sperm motility >50%
E. Normalspermmorphologyis<20%
17. In Secondary infertility:

A. Isfrequentlyduetotubalproblems
B. The problem is often a chromosomal defect in women.
C. Is frequently due to male factor
D. Commonly associated with endometriosis.
E. May be due to hypoprolactenemia
18. 32 year old woman with PCO has infertility of 1 year’s duration. Her menses
occur at irregular intervals, and basal body temperature is monophasic. An
endometrial biopsy shows endometrial hyperplasia with mild atypia. The most
appropriate therapy:
A. Danazol
B. Megrostol acetate
144
C. Oral contraceptive
D. Clomiphenecitrate
E. Human Gonadotropins.
19. In an infertile couple all are correct EXCEPT:

A. Fibroidcancauseinfertility.
B. Ovulation can be induced by Clomiphene.
C. Gonadotropins can cause hyperstimulation.
D. Polycystic ovary is a common problem.
E. Hyperprolactenemia can cause infertility.
20. Regarding Hyperprolactenemia all are true EXCEPT:

A. Can be drug induced
B. Stress can play role
C. Can cause infertility
D. Incaseofpituitaryadenomasurgicalremovalisthebestchoice
E. Dopamine agonist is the treatment of the choice
21. Galactorrhea (non-gestational lactation) may result from all of the following
EXCEPT:
A. pituitary adenoma
B. Hypothyroidism
C. Renal failure
D. Intrapartumhemorrhage
E. Bronchogenic carcinoma
22. The test used to diagnose ovulation on day 21 in a 28 days menstrual cycle is:
A. Estrogen.
B. FSH.
C. Progestrone.
D. LH.
E. Prolactin.
23. Ovulation induction complications include:

A. Ovarianhyperstimulation.
24. What is the association of ovulation induction for fertility and multiple births?
A. Decreases the incidence multiple pregnancy.
B. Increasestheincidencemultiplepregnancy.
C. Increases the incidence of only dizygotic twins.
D. Doesn't affect the incidence of twins.
145
25. All of the following are true about PCO except:

A. TodiagnosePCOhormonalanalysiscanbedoneatanytimeofthecycle
26. According to WHO, Sperm count shouldn't be less than :

A. 50 million /ml
B. 60 million/ml.
C. 90 million/ml.
D. 20 million/ml.
E. 10 million/ml.
27. PCO, all true EXCEPT:

A. Hirsutism.
B. Imperforatedhymen
C. Infertility.
D. Acne.
E. Amenorrhea
28. A woman with bilateral proximal tubal blockage which was diagnosed by
Hysterosalpingiogram and her husband have normal spermogram. There best
chance to have a pregnancy is by:
A. Doing a laproscopic opening of the tube and then expectant management.
B. Giving the woman clomide for 6 months and expectant management.
C. Doing controlled ovarian hyperstimulation and IUI.
D. DoingIVFofthecouple.
29. Hyperprolactenemia:
A. Associated with positive progesterone challenge test.
B. Ovulation can be induced with dopamine antagonist.
C. If macro-adenoma is the cause, the management is surgical.
D. May be a cause of Homonymous hemianopia.
E. Galactorrheaispresentin30%ofcases.
30. The most likely cause of infertility in a 30 year old women, P2+4 who had
salpingitis after her last abortion, 3 years ago is:
A. Submucous fibroid.
B. Asherman's syndrome (Uterine synechiae).
C. Blockedtubes.
D. Tuberculous endometritis.
E. Endocervicitis.
146
31. The following agents are used in ovulation induction in patients undergoing
assisted conception, EXCEPT:
A. Clomiphene Citrate.
B. Human menopausal gonadotropin.
C. GRH analogues.
D. hCG.
E. Aspirin.
32. Regarding ovulation can be diagnosed by the following measures, EXCEPT:

A. Measuringday14serumprogesterone.
B. Observing a rise in basal body temperature in the 2ND half of the
menstrual cycle.
C. Study of the cervical mucous.
D. Endometrial histology.
E. Ultrasound.
33. Hysterosalpingiogram (HSG) is contraindicated in the following EXCEPT:

A. Suspicious pregnancy.
B. PID.
C. Congenitalmalformationsoftheuterus. D.
Presence of abnormal uterine bleeding. E.
Uterine malignancy.
34. Hirsutism can be found in all of the following conditions, EXCEPT:

A. Polycystic ovary syndrome
B. On Danazol therapy
C. Adrenal hyperplasia
D. Patientonoralcontraceptivepills
E. Androgen secreting ovarian tumor
36. A 28 year old lady comes to your clinic complaining of progressive hirsutism
(growing a beard) noticed in the past 3 months. Her initial evaluation includes
all the following, EXCEPT :
A. Check her testosterone level.
B. EnhancedCTofthebrain.
C. Do US of the ovaries.
D. Do US of the uterus.
E. Check her 17 hydroxy progesterone level.
37. Regarding Hyperprolactenemia, all of the following are CORRECT EXCEPT:

A. Can be drug induced.
B. Incasesonpituitaryadenomasurgicalremovalisthebestoption.
C. Stress can play a role.
D. Can cause infertility.
147
E. Dopamine agonist is the treatment of choice.
38. All of the following are true regarding TB infection EXCEPT:

A. Is transmitted by hematogenous spread
B. It causes infertility ,abnormal uterine bleeding ,pelvic pain
C. Itcausesseveretenderness&cervicalexcitationonpelvicexamination
D. 2/3 have evidence of old pulmonary TB.
E. Diagnosis depends on endometrial biopsy for culture & histopathological
examination.
39. Regarding Infertility:

A. A patient who is P 0 +3 is defined as primary infertility.
B. Painful menstruation suggests unovulatory menstrual cycles.
C. Measuring progesterone level in the follicular phase is the diagnostic
feature for ovulation.
D. Includingthehusbandintheinvestigationisessential.
E. Estrogen is used in induction of ovulation.
148
Amenorrhea:
1. Recognized feature of Sheehan syndrome :
A. Menorrhagia
B. Galactorrhea
D. Hypothyroidism
E. Dwarfism
2. The earliest sign of Sheehan syndrome is :

A. Secondary amenorrhea
B. Failureoflactation
C. Loss of axillary + pubic hair
D. P.V bleeding
E. Increase appetite
3. In Sheehan syndrome, changes that take place include the following EXCEPT :
A. Complete lactation failure
B. Feeling of lethargy
C. Genital atrophy
D. Amenorrhea
E. IncreasedBasalMetabolicRate(B.M.R)
4. A 26 years old lady presented with secondary amenorrhea and FSH and LH are
found to be high, your diagnosis will be?
A. Sheehan syndrome
B. Asherman syndrome
C. Prematureovarianfailure.
D. Imperforated hymen
E. Pituitary adenoma
5. Patients with the following condition present with primary amenorrhea:

A. Bicornuate uterus
B. Polycystic ovary syndrome
C. Imperforatehymen
D. Sheehan’s Syndrome
E. Anorexia nervosa
6. The presentation of Asherman's Syndrome typically involves:

A. Hypomenorrheaandamenorrhea.
B. Galactorrhea.
C. Menorrhagia.
D. Metrorrhagia.
149
E. Dysmenorrhea.
7. Secondary amenorrhea is a recognized feature of:

A. Imperforated hymen.
B. Testicular feminization syndrome.
C. Pregnancy.
E. Müllerian agenesis.
8. Pituitary insufficiency & amenorrhea is best treated with :

A. Low potent estrogen
B. FSHwithGnRH.
C. Cyclic progesterone
D. Clomide
E. Regular intercourse
9. Ovarian dysgenesis is associated with elevation of which hormones:

A. pituitaryGonadotropins
10. The following are true about Asherman syndrome EXCEPT:

A. Usuallycausesprimaryamenorrhea
B. Causes Secondary amenorrhea
C. May result from excessive dilation & curettage
D. Usually diagnosed by Hysterosalpingogram
E. Usually associated with intrauterine adhesion
11. Feature characteristically associated with imperforated hymen in a 16 yearold

girl include :
A. Acuteretentionoftheurine
B. Absence of secondary sexual characteristics.
C. Hirsutism.
D. Short stature.
E. Present with secondary amenorrhea.
12. Regarding Primary amenorrhea ,all the following are correct EXCEPT:
A. Failureofbreastdevelopmentbyageof10requireinvestigation B.
kalman syndrome is recognized cause
C. it may be due to systemic disease
D. turner is known cause
E. the majority are constitutional
13. In Sheehan syndrome ,changes that take place include all of the following
EXCEPT:
A. Genital atrophy
150
B. Feeling of lethargy
C. Complete lactation failure
D. Amenorrhea
E. Increasedbasalmetabolicrate
14. A 48-year-woman who had two normal pregnancies 13 and 15 years ago
presents with the complaint of amenorrhea for 7 months. She expresses the
desire to become pregnant again. After exclusion of pregnancy, which of the
following tests is next indicated in the evaluation of this patient's amenorrhea?
A. Hysterosalpingogram.
B. Endometrial biopsy.
C. Thyroid function test.
D. Testosterone and DHAS levels.
E. LHandFSHlevels.
15. In Polycystic Ovary Syndrome patients, all the followings are true EXCEPT:
A. Theyareusuallyunderweightwithlowbodymassindex.
C. They have oligomenorrhea.
D. They have high prolactin level.
E. They have subfertility.
16. To diagnose a woman with PCOS you need to have :

A. More than 10 cysts on each ovary measuring 2 mm.
B. Hypomenorrhea or amenorrhea.
C. Hyperandrogenism either biochemical or clinical.
D. Only2oftheabove.
E. All the above.
17. Secondary amenorrhea may be due to the following, EXCEPT:

A. Endometriosis.
B. Thyrotoxicosis.
C. Pregnancy.
D. Anorexia.
E. Ovarian failure.
18. The ovary in polycystic ovarian syndrome characteristically shows :

A. Fibrosis.
B. Thecacellshyperplasia.
C. Granulosa cells hyperplasia.
D. Increased fatty infilteration.
E. Capsular thining.
151
19. Which of the following features is associated with an imperforated hymen :

A. Hirsutism.
B. Closed spina bifida.
C. Absence of secondary sex characteristics.
D. Short stature.
E. Cycliclowerabdominalpainwithprimaryamenorrhea.
20. Polycystic Ovarian syndrome (PCOS):

A. Estradiol levels are high.
B. There is increased sensitivity to insulin.
C. If Ovulation can be induced, the chance of conception is high.
D. Androstenedionelevelsarehigh.
E. Sex-hormones binding globulin are increased.
21. Polycystic Ovarian syndrome:

A. Estradiol levels are high.
B. There is increased sensitivity to insulin.
C. Has no change in FSH:LH ratio.
D. Andostendionelevelsarehigh.
E. Sex hormone binding globulin are increased.
22. The following is related to premature ovarian failure:

A. Therearedecreasedlevelsofestrogen.
B. Is associated with autoimmune disease.
C. There are decrease levels of FSH.
D. It is seen in association with autoimmune disease.
E. Karyotype is indicated in women who develop the problem before 25
years of age.
23. The following are know criteria for diagnosing Polycystic ovarian syndrome
(PCOS), EXCEPT:
A. Decreasedbodyweight.
B. Hormonal evidence of androgen excess.
C. Chronic anovulation.
D. Recurrent miscarriages.
E. Inappropriate gonadotropin secretions.
24. A Feature of Polycystic ovarian syndrome:

A. ElevatedlevelofserumFSH.
B. Endometrial hyperplasia.
C. Breast atrophy.
D. Loss of androgen level.
E. Regular ovulation.
152
25. Secondary amenorrhea can be due to the following EXCEPT:

A. Asherman syndrome.
B. Sheehan's syndrome.
C. Galactorrhea.
D. PCO disease.
E. Sicklecellanemia.
26. A 19-year-old women comes to your office with a compliant of never having
had menses. Physical examination shows that she is 1.37 m tall, & weighs 42 kg.
she lacks breast & pubic hair development. There is webbing of her neck &
cubitus valgus. Which of the following is likely to be true?
A. Testicular feminization.
B. Klinefelter syndrome.
C. Turner'ssyndrome.
D. Congenital adrenal hyperplasia.
E. Normal but delayed development.
27. Hypothalamic cause of secondary amenorrhea include all of the following

EXCEPT:
A. Significant weight loss.
B. Strenuous exercise.
C. Tricyclic antidepressant
D. Sheehan's syndrome.
E. C&D.
28. The most common mass associated with amenorrhea in a reproductive age
women is:
A. Follicular cyst.
B. Corpus luteal cyst.
C. Benign cystic teratoma.
D. Leiomyoma.
E. Pregnancy.
29. A 16 year old girl with imperforated hymen present with :

A. Secondary Amenorrhea
B. Hematocolpous
30. Secondary amenorrhea may be related to :

A. Emotional factor
B. Systemic disease
C. Nutrition
D. Specific endocrine disorder
E. Alloftheabove
153
Incontinence&GenitalProlapse:
1. Urge incontinence
A. Is due to pelvic anatomic defect.
B. Patient loses small amount of urine.
C. Can be diagnosed with stress test.
D. Canbetreatedmedically.
E. Can be treated surgically with sling
2. Which of the following factors predispose to genital prolapse:

A. Repeated LSCS
B. Multiparty
C. Pelvic inflammatory disease
D. Endometriosis
E. Repeated Candidiasis
3. The treatment of cystocele in a 32 years old may include the following, EXCEPT:
A. Pelvic floor exercise.
B. Weight loss.
C. Vaginal hysterectomy.
D. Anterior colporrhaphy.
E. Vaginal Pessary.
4. Urinary stress incontinence is:

A. The loss is of large amount of urine when intra-abdominal pressure
increases.
B. Thelossisofsmallamountofurinewhenintra-abdominalpressure
increases.
C. Inability to control the bladder of all urine
D. Inability to pass urine
E. Constant loss of small amounts of urine
5. In Urogenital prolapse, the following statement are correct EXCEPT:

A. Urethrocele is prolapse of the urethra in the vagina.
B. Obesity is the risk factor.
C. Inguinalherniaismanifestation
D. Rectoceles are associated with chronic constipation
E. Cystoceles are associated with prolonged 2nd stage of labor
6. An Enterocele:
A. Contain part of the peritoneum.
B. Islinedbyperitoneum
C. Herniates into the bladder
154
D. Can be treated medically

E. Can be clinically demonstrated by abdominal exam.
7. Regarding Rectocele
A. Can be treated medically
B. Surgery is indicated in all patients
C. Constipation is not a predisposing factor
D. Shouldonlybecorrectedifitisinterferingwithdefecationandlifestyle
E. Is common in younger patients
8. True incontinence can result from the following EXCEPT:

A. Pelvic irradiation
B. Trauma
C. Prolonged obstructed labor
D. C-section
E. Epiduralanalgesia
9. 49 years old women comes in complaining that several years it feels as though
"her organ are progressively falling out her vagina" along with this, she
complains of losing urine with straining, occasional urgency, and sometimes a
feeling of incomplete emptying of her bladder with voiding. On further
examination you will find :
A. Rectocele
B. Cystocele
C. Enterocele
D. Complete uterine prolapse
E. UTI
10. 38 years old multigravida women complains of the painless loss of urine,
beginning immediately after coughing, laughing, lifting, or straining. Immediate
cessation of the activity stops the urine loss .this history is must suggestive of :
A. Fistula
B. Stressincontinence
C. Urge incontinence
D. Urethral incontinence.
E. UTI
11. The work up of patients with incontinence include all of the following EXCEPT:
A. Culture & sensitivity
B. Stress test
C. pelvisU/S
D. Cystometric study
E. Residual urine volume
155
12. Detrusor instability should be managed by:

A. Drugtherapy.
B. Electrical therapy.
C. Operative therapy
D. Psychiatric therapy.
E. No therapy.
13. Regarding Cystocele, the following are true EXCEPT :

A. Is more common in multiparus women.
B. The best way of treatment is vaginal hysterectomy.
C. Is usually associated with stress incontinence.
D. None of the above.
14. Clinical symptoms of uterine prolapse include the following EXCEPT:

A. Cervical ulcer.
B. Dyspareunia.
C. Amenorrhea.
D. Urinary retention.
E. Low back ache.
15. Stress incontinence: the following statement are correct EXCEPT:

A. Is more common in older women.
B. Can be treated with estrogen.
C. More common in women after menopause.
D. Becomes worse after menopause.
E. Isalwaysisolated.
16. Stress incontinence:

A. Ismorecommoninmultiparus. B.
Means passing urine frequently. C.
Can be treated by antibiotic.
D. Bladder drilling is an effective treatment.
E. Almost always is associated with utero-vaginal prolapse.
17. True incontinence can result from the following EXCEPT:

A. Pelvic irradiation
B. Trauma
C. Prolonged obstructed labor
D. C-section
E. Recurrentcystitis.
156
18. When the cervix protrudes well beyond the introitus, in a case of uterine
prolapse, the prolapse is called which of the following:
A. 1ST degree.
B. 2ND degree.
C. 3RDdegree.
D. Procedentia.
157
Menopause:
1. An increased risk of Osteoporosis is associated with:

A. Bromocriptine use.
B. Excessglucocorticosteroidusage.
C. Androgen excess in the female.
D. Early menarche.
E. Excessive protein intake.
2. The use of estrogen alone in menopausal women increase the risk of :

A. Endometrialcancer
B. Ovarian cancer
C. Bone cancer
D. Bowel cancer
E. All of the above
3. Recently the main risk of hormone replacement therapy after menopause is:
A. fracture the neck of femur
B. Cancer of the colon
C. Hirsutism
D. Cancerofbreast
E. Genital atrophy
4. In the menopause :
A. Osteoporosis is common in black women
B. Theyhaveincreasetendencyoffracture
C. Post menopausal bleeding is always due to endometrial carcinoma
D. HRT is always indicated
E. OCP can be used as hormone replacement
5. Postmenopausal women:
A. Malignancy is the commonest cause of postmenopausal bleeding.
B. FSH and LH are characteristically low.
C. Fibroid uterus tends to grow bigger.
D. Hormonalreplacementtherapyincreasestheriskofbreastcancer.
E. Endometrium is characteristically thick on USS.
6. Which of the following is an indication for estrogen treatment?

A. Fibroid.
B. Threatened abortion.
C. Endometriosis.
D. Postmenopausalatrophicvaginitis.
158
E. Induction of ovulation for anovulatory cycle.
7. The following is a symptom of Climacteric(menopause):

A. obesity.
B. Premenstrual tension.
C. Hotflushes.
D. Menorrhagia.
E. Ectopic pregnancy
8. Regarding hot flushes in the menopausal period. All the following are true,
EXCEPT :
A. They are reduced by exercise.
B. They are less in obese women.
C. They are more in smoking women.
D. The best treatment is HRT.
E. Itusuallydisappearsin1month.
9. Which of the following statement is INCORRECT:

A. Climacteric is the phase during which a woman passes form the
reproductive stage to non-reproductive stage.
B. Pre-menopauseisthetimeduringclimactericduringwhichtheperiods
becomesirregular.
C. Menopause is the final menstruation which occurs during the climacteric.
D. Premature menopause is cessation of menstruation before the age of 40.
E. Oral contraceptive pills delay the onset of menopause.
10. True statement concerning the development of postmenopausal osteoporosis

include:
A. In typical patients, the yearly rate of bone loss remains constant.
B. Estrogen replacement therapy is not effective in treatment.
C. X-ray density of the wrist determines estrogen dosage.
D. Inmostpatients,fracturesoftrabecularboneoccurearlierthanfractures of
corticalbone(e.g.Femur)
E. Very common in black population.
11. The severity of menopausal vasomotor symptoms correlates best with:

A. Mental status at the time if climacteric.
B. Rateofestrogenwithdrawal.
C. Serum estrogen concentration.
D. Serum FSH concentration.
E. Serum LH Concentration.
159
12. Which of the following is NOT a physical finding associated with the
climacteric:
A. Atrophic vaginitis.
B. Clitoromegaly.
C. Vaginal stenosis.
D. Small labia minora.
E. Amenorrhea.
13. Recognized feature of postmenopausal women is:

A. Low FSH & LH.
B. Increased bone mineral density.
C. HighFSH.
D. High level of estrogen.
E. Increase the incidence of uterine fibroid.
160
AbnormalUterineBleeding:
(DUB, Menoorrhagia and PMB)
1. After menopause: Which is true?

A. There is increase in vaginal acidity
B. Gonadotropins secretion falls.
C. Recurrentvaginalbleedingshouldbeinvestigatedbyendometrialbiopsy.
D. Malignancy is the leading cause of post menopausal bleeding.
E. Bone mineral density increases.
2. All the following are possible causes of menorrhagia, EXCEPT

A. Uterine fibroid
B. Adenomyosis
D. Endometrial hyperplasia
E. Combineoralcontraceptivepills
3. After menopause
A. There is increase vaginal acidity.
B. Gonadotropins level falls.
C. There is increase in bone density.
D. The size of an existing fibroid increases.
E. Anypostmenopausalbleedingshouldbeinvestigatedbyendometrial
sampling.
4. Menorrhagia is:
A. Intermittent irregular vaginal bleeding
B. Commonly presents as postmenopausal bleeding
C. Heavymenstrualcyclemorethan80ml
D. Infrequent spaced cycles every 45 days
E. The main presentation in case of Asherman Syndrome
5. An Obese 63-years old women present with a 3 month history of continuous

scanty bleeding. Adequate history and physical examination what is your
recommendation ?
A. Cervical cone biopsy
B. D&C
C. Cycling with progestin
D. Laparoscopy
E. Official visit every 6month for the evaluation.
161
6. Amount of blood loss during the normal menses :

A. 10 to 25 ml.
B. 25to75ml. C.
80 to 120 ml. D.
125 to 175 ml.
7. Post menopausal bleeding :

A. May be considered as a normal variation
B. Ultrasound can exclude uterine malignancy
C. Hysteroscopy is contraindicated
D. Cervicalcancerneedexclusion.
E. Atrophic vaginitis should not be considered for its very rare finding.
8. Menorrhagia :
A. progesteronemedicatedIUCDcantreatthiscondition
B. D&C are not required for diagnosis & management of the patient above
40 years or more
C. Asherman syndrome is the main cause

A. Uterine fibroid
B. Adenomyosis
E. Combineoralcontraceptivepills
10. Which statement regarding menstrual abnormality is correct ?

A. Menorrhagia is defined as a "frequent period".
B. Bleeding due to uterine polyps is called dysfunctional uterine bleeding.
C. Oligomenrrhiameansperiodswithmorethan35daysapart.
D. Menorrhagia means a "heavy period".
E. Polymmenorrhea means periods that occur every 28 days.
11. Regarding Menorrhagia:

A. ProgesteronemediatedIUCDcantreatthiscondition.
B. D & C is not required for diagnosis & management in a 40 years or more.
C. In adolescent, it is important to rule out malignancy.
D. Asherman syndrome is a main cause.
E. It is defined as bleeding occurring every 2 weeks.
12. Initial management for patient with post menopausal bleeding is:
A. pap smear.
B. Ultrasound.
C. CT scan.
162
D. D & C.
E. History&physicalexamination.
13. The most common cause of menstrual abnormality in reproductive-aged

women is:
B. Uterine leiomyomas.
C. Adenomyosis.
D. Anovulation.
E. Coagulopathy.
14. The most common serious complication of radical hysterectomy is:

A. Intra-operative death.
B. Illness from transfusion.
C. Genitourinary fistula.
D. Premature menopause.
E. Bowel injury.
15. Which of the following conditions is LEAST likely to be associated with

endometrial hyperplasia:
A. Hyperprolactenemia.
B. Exogenous estrogen.
C. Granulosa-theca cell tumor.
D. Congenital adrenal hyperplasia.
E. Polycystic ovarian syndrome.
16. The most common symptom of endometrial hyperplasia:

A. Vaginal discharge & itching.
B. Vaginalbleeding.
C. Amenorrhea.
D. Pelvic pain.
E. Abdominal distension.
17. Menorrhagia occurring at the age of puberty may be due to:

A. Folic acid deficiency anemia.
B. Congenital adrenal hyperplasia.
C. VonWillbrand’sdisease.(Congenitalcoagulopathy)
D. Androgen insensitivity disease.
E. Nelson’s syndrome.
18. The initial attempt to control uterine bleeding due to blood dyscrasia
(Prothrombin deficiency) after ruling out anatomic lesions should be:
A. Hysterectomy.
B. D& C & hysterectomy.
163
C. Cyclic estrogens.
D. Oralcontraceptives.
E. Pregnancy.
164
Dysmemorrhea&PMS&Endometriosis:
1. Regarding Adenomyosis:
A. Is the presence of endometrial glands and stroma out side the uterus
B. Can be diagnosed by D&C
C. Can be detected by hysteroscopy
D. Cancauseseveredysmenorrhea E.
Can cause infertility
2. The treatment of endometriosis include all the following EXCEPT:

A. Birth control pills (BCP).
B. Oral progesterone.
C. Estrogen.
D. Depoprovera.
E. GnRH analogue.
3. These are possible sites for endometriosis deposits EXCEPT:

A. Brain.
B. Peritoneum.
C. Uterosacral ligaments.
D. Ovaries.
E. Scars.
4. The diagnosis of endometriosis is confirmed by histologically identifying

extragenital implants containing :
A. EndometrialglandsandStroma.
B. Hypertrophic smooth muscle
C. Hemorrhage & iron pigment deposit
D. Fibroid
E. Stromal decidulaization
5. Regarding Adenomyosis, the following are true EXCEPT:

A. Causes dysmenorrhea
B. Usually associated with menorrhagia
C. Theuterinesizenotaffectedbythedisease
D. Hysterectomy is the treatment of choice to cure this condition.
E. Only confirmed after histopathology
6. Secondary dysmenorrhea can be caused by all of the following EXCEPT:

A. Endometrial polyp
B. Endometriosis
C. PID
D. Uterine leiomyoma
165
E. OCP
7. Regarding Endometriosis :
A. is the presence of endometrial tissue in the myometrium
B. The liver is the most common site
C. Implantation,lymphatic–vascularmetastasis&coelmicmetaplasiaare the
theoriesaboutthepathogenesis
D. OCP are contraindicated as they worsen the symptom
E. Is best treatment by avoiding the pregnancy
8. Pelvic endometriosis :
A. Is a cause of 1ry dysmenorrheal
B. Associated with excessive vaginal discharge
C. Associated with prolonged use of IUCD
D. Combined OCP are predisposing factor
E. Canbediagnosedbylaparoscopy
9. The following are theories of endometriosis EXCEPT:

A. Retrograde menstruation
B. Endometrialhyperplasia
C. Immunological factor
D. Coilemic metaplasia
E. Lymphatic spread
10. A woman with symptomatic endometriosis is likely to complain of all of the

following EXCEPT:
A. Dyspareunia.
B. Moodswings.
C. Painful defecation.
D. Severe dysmenorrhea.
E. Infertility.
11. Primary dysmenorrhea is most likely caused by:

A. Uterinehypercontractility.
B. Increased parity.
C. High levels of estrogen.
D. Coitus during menses.
E. Obesity.
12. The following are theories for endometriosis, EXCEPT:

A. Coelimic metaplasia.
B. Endometrialhyperplasia.
C. Retrograde menstruation.
D. Immunological factor.
166
E. Lymphatic spread of endometrial fragments
13. Regarding Endometriosis, all of the following are CORRECT, EXCECPT:

A. Is frequently associated with infertility.
B. Causes deep dyspareunia.
C. Is often asymptomatic.
D. Causespostcoitalbleeding.
E. Causes Dysmenorrhea.
14. Endometriosis is :
A. The presence of endometrial glands outside the uterus.
B. The presence of endometrial stroma outside the uterus.
C. Thepresenceofendometrialglands&Stromaoutsidetheuterus.
D. A disease of menopause.
E. Hyperplasia of normally located endometrium.
15. Dyspareunia in endometriosis can be caused by the following EXCEPT:

A. Endometriomas.
B. Flexed retroversion of the uterus.
C. Uterosacral implants.
D. Danazol therapy.
E. Theuseofthebirthcontrolpill.
16. The operation of Endometriosis should be:

A. Tailoredtothepatient'sage,symptoms,&extentofdisease.
B. Total abdominal hysterectomy (TAH) & bilateral Salpingo-oophorectomy
(BSO).
C. Removal of implants only.
D. Presacral neuroectomy.
E. Unilateral Salpingo-oophorectomy.
17. Each of the following can be a treatment modality for endometriosis EXCEPT :
A. Depoprovera medroxy progesterone
B. GnRH analogues
C. Estrogenskinpatches D.
Oral contraceptive pills E.
Danazol
18. The leading theories in the pathogenesis of endometriosis include :

A. Retrograde menstruation with transport of endometrial cells
B. Metaplasia of coleomic epithelium
C. Hematogenous of lymphatic spread
D. Direct transplantation of endometrial cells
E. Alloftheabove
167
19. A 40 year-old woman complains of menorrhagia and dysmenorrhea that

progressed gradually, the most likely diagnosis is:
A. Endometrial cancer.
B. Adenomyosis.
C. Cervical cancer.
D. Ovarian cyst.
E. Endometrial polyps.
20. The diagnosis of endometriosis is often strongly suspected from patient's initial
history expressing the following EXCEPT:
A. Infertility
B. Dysmenorrhea.
C. Vaginaldryness.
D. Dyspareunia.
E. Chronic Pelvic pain.
21. Premenstrual tension should be initially treated with:

A. COCP.
B. Hysterectomy.
C. Aldosterone.
D. Diuretics.
E. D & C.
168
GeneralOncology:
1. Which of the following tumors is LEAST likely to be hormonally active:

A. Sertoli-lyeding cell tumor.
B. Granulosa cell tumor.
C. Hair cell tumor.
D. Fibroma.
E. Thecoma.
2. The most common malignancy in the female reproductive organs:

A. Carcinoma of the cervix.
B. Carcinoma of the ovary.
C. Carcinomaofthebreast.
D. Carcinoma of the uterine corpus.
E. Leiomyosarcoma of the uterus
3. 16 year old single girl presented with a mass in the pelvis was detected
clinically all the following investigation can be done , EXCEPT :
A. CT
B. Laparoscopy
C. PAPsmear
D. USS
E. MRI
4. Laparoscopy is used in the diagnosis of the following EXCEPT:

B. Endometriosis.
C. Ovarian cyst.
D. Tubal patency.
E. Submucousfibroid.
169
UterineFibroids(Leiomyomas):
1. The Commonest uterine fibroid to cause excessive bleeding is :
A. Submucousfibroid.
B. Subserous fibroid.
C. Intramural fibroid.
D. Cervical fibroid.
E. Broad ligament fibroid.
2. Acceptable treatment for uterine fibroids includes all of the following EXCEPT:
A. No treatment.
B. Myomectomyduringpregnancyifreddegenerationoccurs.
C. Myomectomy.
D. Hysterectomy.
E. GnRH agonist.
3. Uterine fibroid: Which is true?

A. Is commoner in white people than black.
B. All should be treated immediately.
C. Sarcomatous change occurs in 1%.
D. Cancauseobstructedlabor.
E. In pregnancy should indicate caesarian section.
4. The following is TRUE regarding degenerative changes in uterine fibroids :

A. Sarcoma occurs in 2%.
B. Cystic degeneration is common with the use of oral contraceptive pills.
C. Hyaline degeneration causes acute pain.
D. Torsion is common in intramural fibroid
E. Reddegenerationshouldbemanagedconservatively.
5. The following are TRUE about Leiomyomas EXCEPT:

A. Usually multiple.
B. Usuallymalignant.
C. Usually discrete.
D. Usually spherical or irregular lobulated.
E. Usually easy enucleated from the surrounding myometrium.
6. Fibromyoma of the uterus:

A. Is pre malignant tumor
B. Symptoms are related to the site
C. Estrogendependenttumor
D. Can be associated with endometriosis & endometrial hyperplasia.
E. Can cause postpartum hemorrhage.
170
7. Uterine fibroid:
A. Commonly associated with endometriosis
B. Are tumors of Striated muscle.
C. Commonly present with post menopausal bleeding
D. Associated with multiparty
E. progesteronedependenttumor
8. Regarding red degeneration in fibroids, all are true EXCEPT:

A. Common during pregnancy.
B. Causes acute abdominal pain.
C. Surgeryisthe1STlinetreatment.
D. Caused by ischemic necrosis.
E. Can occur in postmenopausal women on HRT.
9. Regarding Submucous uterine fibroids all of the following are correct EXCEPT:
A. May become polypoidal.
B. Can become infected.
C. Frequentlycauseinfertility.
D. Often present with menorrhagia.
E. Can be removed hysteroscopically.
10. Regarding uterine leiomyomata may undergo the following changes EXCEPT:
A. Hyaline degeneration.
B. Squamousmetaplasia.
C. Atrophy.
D. Calcification.
E. Sarcomatous change.
11. Uterine leiomyomata generally require no treatment. When treatment is

indicated, it is most frequently because of :
A. Interference with reproductive function.
B. Rapid enlargement with the hazards of Sarcomatous degeneration.
C. Pain.
D. Excessiveuterinebleeding.
E. Impingement on an other organ.
12. A patient with uterine leiomyoma accompanied by excessive uterine bleeding

should be initially evaluated and /or treated by :
A. myomectomy
B. Hysterectomy
C. Irradiation
D. High dose of estrogen
E. Hysteroscopywithendometrialbiopsy
171
13. These are possible symptoms caused by fibroids EXCEPT:

A. Pelvic pain.
B. Subfertility.
C. Pressure symptoms.
D. Deepveinthrombosis.
E. Irregular vaginal bleeding.
14. True statement regarding leiomyomas is:

A. The severity of the bleeding is proportional to the size and he number of
myomas
B. Intermenstrual pain is present in more than 50% of women with myomas
that have not undergone degeneration
C. Intermenstrual bleeding is the most common menstrual disorders
D. Themajorityofthewomenwithmultiplemyomasarefertile
E. It is highly malignant
15. A 20 year old lady pregnant in 1st trimester came complaining of lower
abdominal pain, in examination a mass continued with the uterus was found
what is the diagnosis:
A. Reddegenerationoffibroid
B. Ectopic pregnancy
C. Uterine rupture
D. Rupture placenta
E. Placenta previa
16. Types of uterine fibroid degeneration include all EXCEPT :

A. Red degeneration
B. Yellowdegeneration
C. Calcification
D. Hyaline degeneration
E. Fatty degeneration
17. Acceptable treatment for uterine fibroids include all of the following EXCEPT:
A. No treatment.
B. Myomectomy during pregnancy if red degeneration occurs.
C. Myomectomy.
D. Hysterectomy.
E. GnRH agonists.
18. Regarding uterine fibroid in pregnancy, all are true EXCEPT:

A. Are often asymptomatic.
B. May present with abdominal pain.
C. May cause obstructed labor.
172
D. Shouldberemovedsurgicallyifitbecomessymptomatic.
E. May cause postpartum hemorrhage.
173
BenignandMalignantOvariancancer:
1. Which of the following is an early symptom of ovarian cancer?
A. Pelvic pain.
B. Bloating.
C. Dysuria.
D. Constipation.
E. It'susuallyasymptomatic.
2. Ovarian neoplasm most commonly arise from:

A. Ovarianepithelium.
B. Ovarian stroma.
C. Ovarian germ cells.
D. Ovarian sex cords.
E. Metastatic disease.
3. Which of the following tumors is NOT an ovarian epithelial neoplasm:

A. Serous tumor.
B. Mucinous tumor.
C. Endometrioid tumor.
D. Endodermalsinustumor.
E. Brenner tumor.
4. Metastatic tumors to the ovary rarely originate from the:

A. Breast.
B. Stomach
C. Large intestine.
D. Uterus.
E. Vagina.
5. The following are Suspicious criteria for malignancy in ovarian tumors EXCEPT:
A. Presence of Ascites.
B. Presence of cachexia.
C. Edema of the lower limbs.
D. Bilateralism.
E. ElevatedserumEstradiol.
6. Ovarian cancer is more likely to occur in all of the following EXCEPT:

A. Nulliparus women.
B. Women who have breast cancer
C. Patientswithhistoryofprolongeduseoforalcontraceptivepills.
D. Women with a family history of ovarian cancer.
E. Low socioeconomic class.
174
7. Regarding Ovarian cysts in pregnancy:

A. The dermoid accounts for up to 50% of total.
B. They are commonly malignant in origin.
C. Corpuslutealaccountsforthemajorityofcases.
D. Torsion does not occur during pregnancy.
E. They rarely cause obstructive labor.
8. Which of the following ovarian tumors is the most common:

A. Arrhenoblastoma.
B. Granulosa cell tumors.
C. Granulosa cell tumor.
D. Endometrial sinus.
E. MucinousCystadenoma.
9. In ovarian tumors all these are germ cell tumor EXCEPT :

A. Teratoma
B. Choriocarcinoma
C. Endometrioidtumor
D. Yolk sac tumor
E. Dysgerminoma
10. Suggestive ultrasound features of ovarian malignancy include following

EXCEPT :
A. Bilateral
B. Presence of ascites
C. Contain solid component
D. Unilocular
E. Capsule integrity is disrupted with projection
11. Which of the following tumors produces estrogen?

A. Endodermal sinus tumors.
B. Choriocarcinoma.
C. Granulosa-celltumors.
D. Dysgerminoma.
E. Serous cyst adenoma.
12. The tumor marker secreted by Endodermal sinus (yolk sac) tumor is
A. Alpha-Fetoprotein.
B. hCG.
C. LDH.
175
13. Which of the following types of cancer is the leading cause death form
gynecologic neoplasm:
A. Ovarian .
B. Uterine.
C. Cervical.
D. Vaginal.
E. Vulvar.
14. The most common germ cell tumor is:

A. Dysgerminoma.
B. Endodermal sinus tumor.
C. Embryonal carcinoma.
D. Choriocarcinoma.
E. Immature teratoma.
15. Which of the following hormones is most likely to be produced by Granulosa-

Cell tumors:
A. Estrogen.
B. Inhibin.
C. Both of them.
D. None of them.
16. Which of the following ovarian tumors are thought to be derived from ovarian
germinal epithelium:
A. Dysgerminoma.
B. Fibroma.
C. Theca cell.
D. Endometrioid.
E. Germ cell tumors.
17. Which of the following tumors produces estrogen:

A. Endodermal sinus tumors
B. Choriocarcinoma
C. Granulosa-celltumors
D. Dysgerminoma
E. Serous cyst adenoma
19. You are called to the operating room to evaluate a pelvic mass in infant girl.
Laparoscopy shows a 3-cm cystic mass in the broad ligament between the
fallopian tube & the Ovarian hilum. You recommend:
A. Observation.
B. Cyst aspiration.
C. Cystectomy.
D. Adenxectomy.
176
E. Laparotomy.
20. The staging of Ovarian carcinoma is based upon which of the following:
A. Pelvic examination.
B. CT imaging of the abdomen & pelvis.
C. Paracentesis of ascetic fluid.
D. Surgicalevaluationoftheextentofintraabdominaldiseases.
E. Barium enema.
21. The commonest site for metastasis form ovarian carcinoma is:
A. Pouch of Douglus.
B. Liver.
C. Uterus.
D. Peritoneum.
E. Bone.
177
Uterinecarcinoma:
1. In patient with endometrial cancer and less than 50% myometrial invasion, the
stage is at least:
A. IA.
B. IB.
C. IC.
D. IIA.
E. III.
2. Endometrial adenocarcinoma is most often preceded by:

A. Cystic hyperplasia.
B. Endometrial hyperplasia.
C. Endometrialhyperplasiawithcytologicalatypia.
D. Arias-stella phenomena.
E. Microcytic glandular hyperplasia.
3. Regarding benign endometrial polyps all are correct EXCEPT:

A. May present with postmenopausal bleeding.
B. Commonly cause inter-menstrual bleeding.
C. May present with menorrhagia.
D. Areoftenpre-malignant.
E. Can be diagnosed by hysteroscopy.
4. An increased incidence of endometrial hyperplasia & endometrial carcinoma

has been described in patients with which of the following:
A. Multiparity.
B. Chron's diseases.
C. Delayed menarche.
D. Exogenousofestrogen.
E. Combined OCCP.
5. Endometrial hyperplasia would be most likely found in:

A. Anobese,nulliparus,diabeticwoman.
B. An ovulating woman.
C. A woman on cyclic combination birth control pills.
D. A woman on depo-medhydroxyprogresterone acetate for endometriosis.
E. A woman with a IUCD.
6. Risk of endometrial cancer include all EXCEPT :

A. Nulliparity
B. Delayed menopause
C. Patient with poly cystic ovarian cancer
178
D. Historyoforalcontraceptivepills
E. Obesity
7. Endometrial adenocanthoma is best described as:

A. Adenocarcinomawithbenignsquamouscomponents.
B. Adenocarcinoma with papillary formation.
C. Squamous carcinoma with benign glandular components.
D. A mixture of malignant glandular & squamous components.
E. A mixture of benign glandular & squamous components.
8. Which of the following types of endometrial carcinoma has the BEST prognosis:
A. Adenosquamous carcinoma.
B. Clear-cell adenocarcinoma.
C. Serous carcinoma.
D. Secretorycarcinoma.
E. Squamous-cell carcinoma.
10. The most common uterine tumors in reproductive age is:

A. Sarcoma.
B. Adenocarcinoma.
C. Adenomyosis.
D. Choriocarcinoma.
E.Leiomyoma.
179
Cervicalcancer:
1. Screening is most effective in preventing which of the following cancers:
A. Vulva.
B. Cervix.
C. Endometrial.
D. Ovary.
E. Fallopian tube.
2. Untreated patients with cancer of the cervix usually die with :

A. Cachexia and starvation.
B. Bowel obstruction.
C. Renalfailureanduremia.
D. Multi organ failure.
E. Cerebrovascular accident primigravida.
3. Occult carcinoma of the cervix:

A. Stage IA.
B. Micro-invasive carcinoma.
C. Best treated by cone biopsy.
D. Foundincidentallyinasurgicalspecimenfollowinghysterectomy.
E. Frequently associated with negative cytology.
4. The following is true regarding carcinoma of the cervix EXCEPT:

A. The region originates within the transformation zone in the majority of
cases.
B. The disease is more common in multiparus women.
C. It'sunlikelytoproduceuretericobstruction.
D. The lesion is typically squamous in nature.
E. Spread to iliac nodes usually.
5. 28 year old lady P3+2 presented to the clinic with history of irregular menstrual
cycle for 2 months, no history of post-coital bleeding. She had pap smear which
showed high grade squamous cell intraepithelial lesion (CIN II). The proper
management is:
A. Follow up & repeat pap smear after 6 months.
B. Laserconebiopsy.
C. Examination under anesthesia & (D&C)
D. Colposcopic assessment & pelvic biopsy.
E. Cryotherapy & antibiotic.
180
6. The most common benign neoplasm of the cervix & endocervix is a :

A. Polyp.
B. Hematoma.
C. Nabothain cyst.
D. Cervical hood.
E. Gartner's duct cyst.
7. Risk factors of cervical cancer include all the following, EXCEPT :

A. Nulliparity
B. Multiple sexual partner
C. History of papilloma virus infection
D. Smoking
E. Sexual activity at early age
8. The most common clinical presentation of early cervical cancer is:

A. Foul-smelling vaginal discharge.
B. Asymptomatic.
C.Post-coitalBleeding.
D. Pelvic pain with leg edema.
E. Lower back pain.
9. Significant risk factor for cervical cancer are all of the following EXCEPT:
A. 1st sexual intercourse at a young age.
B.Multiparity.
C. Cigarette smoking.
D. Human papilloma virus.
E. HIV-seropositivity.
181
GestationalTrophpblasticDiseases(GTD):
1. Accurate diagnosis of Hydatiform mole can be made by

A. Elevated β-hCG
B. Ultrasound
C. Pelvic examination
D. Chest radiography
E. Absence of fetal heart in a 16 week sac
2. Risk Factors of gestational trophoblastic disease include all of the following,

EXCEPT:
A. Far East Asian
B. age under 20
C. DiethighFolicacid
D. Age above 40
E. Diet lower beta carotene
3. In complete Hydatiform mole:

A. Rarelycontainsmaternalgeneticmaterial
B. Can present with hypothyroidism
C. Prophylactic cytotoxic therapy should be given
D. Diagnosis is confirm with a very low blood level of human β
Gonadotropins
E. Pre-eclampsia is the most common symptom and occur in 97% of
patients
4. Definitive initial therapy for Hydatiform mole is most commonly:

A. Evacuation.
B. Abdominal hysterectomy.
C. Evacuation followed by Methotrexate therapy.
D. Evacuation followed by hysterectomy.
E. Radiation.
5. Evacuation of Hydatiform mole may be complicated by:

A. Hemorrhage necessitating transfusion.
B. Acute respiratory distress.
C. Both.
D. Neither.
6. After the β-hCG titer becomes undetectable, the patient treated for
Hydatiform mole should be followed with monthly titers for a period of:
A. 3 months.
182
B. 6 months.
C. 1year.
D. 2 years.
E. 5 years.
7. What is the most frequent site for metastasis from a malignant gestational
trophoblastic neoplasms:
A. Brain.
B. Liver.
C. Kidneys.
D. Vulva.
E. Lung. (cannon balls appearance).
8. If you find that a 25 –year- old patient with amenorrhea of 18 weeks duration
had an elevated serum hCG, and absent fetal heart & movement and uterine
size 28 weeks which of the following would be the most likely diagnosis ?
A. Normal pregnancy
B. Hydatiformmole
C. Twin pregnancy
D. Missed abortion
E. Ovarian carcinoma (primary)
9. Signs and symptoms of Hydatiform mole include the following EXCEPT :

A. 1st trimester bleeding
B. A Uterus larger than expected gestational age
C. Hypothyroidism
D. Pre-eclampsia
E. Nausea and vomiting
10. Hydatiform mole is characterized by all of the following EXCEPT:

A. Theca-lutein cyst of the ovary.
B. Severe Hyperemesis.
C. Uterus larger than date.
D. Hyperthyroidism.
E. Elevatedmaternalbloodsugarlevel.
11. Choriocarcinomas can occur:

A. After abortion.
B. Spontaneously.
C. After Hydatiform mole.
D. After normal pregnancy.
E. Alloftheabove.
183
424Exams:
Collected by
Musaad H. AlHamzah
1. All the following characteristics are applied to a pelvis favorable to vaginal delivery
EXCEPT:
A. Sacral promontory can not be felt.
B. Obstetric conjugate is less than 10 cm. √
C. Ischial spines are not prominent.
D. Subpubic arch accepts 2 fingers.
E. Intertuberous diameter accepts 4 knuckles on pelvic exam.
2. Complications related to preeclampsia include all the following EXCEPT:

B. Placental abruption.
C. Renal failure.
D. DIC
E. Polycythemia. √

C. Visual disturbance. √
4. Fetal assessment for IUGR includes all the followings EXCEPT:

A. Non stress test.
B. Biophysical profile.
C. Doppler.
D. Ultrasound for anomalies.
E. Fetal scalp blood sampling. √
5. Bishop score includes all the followings EXCEPT:

A. Dilation of the cervix.
B. Position of the cervix.
C. The presenting part of the fetus.
D. Length of the cervix. √
E. Consistency of the cervix.
184

delivery?
A. Prior classical incision. √
C. Prior IUFD.
7. Androgen Insensitivity Syndrome:

A. The characteristic features include normal uterus and breast development, and
ambiguous genitalia.
B. The karyotyping is 46XX.
C. They have normal female testosterone level.
D. Gonadectomy must be performed after puberty because of the increased risk of
malignancy. √
E. Estrogen replacement therapy is not indicated because they have enough
estrogens to produce breast development.
8. All of the following antihypertensives are considered safe for short term use in
pregnancy EXCEPT:
A. Captopril. √
B. Methyldopa.
C. Hydralazine.
D. Nifedipine.
E. Labetalol.
9. Postmenopausal women:
A. Malignancy is the commonest cause of postmenopausal bleeding.
B. FSH and LH are characteristically low.
C. Fibroid uterus tends to grow bigger.
D. Hormonal replacement therapy increases the risk of breast cancer. √
E. Endometrium is characteristically thick on USS.
10. Which of the following is an indication for estrogen treatment?

A. Fibroid.
C. Endometriosis.
D. Postmenopausal atrophic vaginitis. √
E. Induction of ovulation for anovulatory cycle.
11. The followings are causes of antepartum hemorrhage EXCEPT:

B. Placenta brevia.
C. Cervical polyp.
185
D. Vasa previa.
E. Rh isoimmunization. √
12. Postpartum hemorrhage can occur due to all the followings EXCEPT:
A. Fetal macrosomia.
B. Polyhydramnios.
C. Placenta brevia.
D. Abruptio placenta.
E. Postdate pregnancy. √
13. Indications for instrumental delivery include all the followings EXCEPT:
A. Prolonged second stage of labor.
B. Fetal distress.
C. Transverse lie. √
E. Maternal cardiac disease.
14. The peripheral tissues resistance to insulin in pregnant women is mediated by:
A. Human chorionic gonadotropin.
B. Human placental lactogen. √
C. Growth hormone.
D. Luteinizing hormone.
E. Follicle stimulating hormone.

A. Inaccurate gestational age. √
C. Oligohydramnios.
D. IUGR.
16. Lower abdominal pain and six weeks gestation:

A. Vaginal examination is contraindicated.
B. Right iliac fossa pain is diagnostic of appendicitis.
C. Placental abruption should be considered.
D. Could be gallstones.
E. USS has reliable diagnostic information. √
17. These are possible sites for endometriosis deposits EXCEPT:

A. Brain. √
B. Peritoneum.
D. Ovaries.
E. Scars.
186
18. These are possible symptoms caused by fibroids EXCEPT:

A. Pelvic pain.
B. Subfertility.
C. Pressure symptoms.
D. Deep vein thrombosis. √
E. Irregular vaginal bleeding.
19. Induction of ovulation agents:

A. Clomiphene citrate is an antiandrogen.
B. Clomiphene citrate is given by injection.
C. Gonadotropin is given orally.
D. Ultrasound scan is not needed with induction.
E. Causes multiple follicles. √
A. Bartholin's cyst.
B. Hematoma.
C. Condyloma.
D. Nabothian cyst. √
E. Papilloma.
21. Obstructed labor:

A. Diagnosed only when the cervix is fully dilated.
B. Usually predicted before the onset of labor.
C. More common in developed countries.
D. Mentoposterior position could be a cause. √
E. x-ray pelvimetry is essential to predict cephalopelvic disproportion in a
primigravida.
22. Which of the followings is an indication for induction of labor?

A. Placenta brevia.
B. Postterm gestation. √
D. Prior classical cesarean section.

D. Observing amniotic fluid drain through the cervix during speculum examination.
E. Contractions seen on the CTG. √
187
24. Management of a patient with threatened abortion includes all the followings
EXCEPT:
A. Ultrasound.
B. Physical exam.
C. CBC.
D. Detailed menstrual history.
E. Immediate dilation and curettage. √

E. Endometritis and salpingo-oophoritis. √
26. Risk factors for shoulder dystocia include all the followings EXCEPT:
A. Maternal obesity.
B. Macrosomia.
C. Maternal diabetes.
D. Prolonged second stage of labor.
E. IUGR. √
27. In breech presentation:

A. Frank breech is the commonest type.
B. Brachial plexus injury is a recognized complication.
C. Prolapse of the umbilical cord can occur.
D. Fetal mortality is increased.
E. All of the above. √
28. While evaluating a 30-year-old woman for infertility, you diagnosed a bicornuate
uterus. You explain that additional testing is necessary because of the woman's
increased risk of congenital anomalies in which system?
A. Skeletal.
B. Hematopoietic.
C. Urinary. √
D. Central nervous.
E. Tracheoesophageal.
29. The presentation of Asherman's Syndrome typically involves:

A. Hypomenorrhea and amenorrhea. √
B. Galactorrhea.
C. Menorrhagia.
D. Metrorrhagia.
E. Dysmenorrhea.
188
30. A 48-year-woman who had two normal pregnancies 13 and 15 years ago presents
with the complaint of amenorrhea for 7 months. She expresses the desire to
become pregnant again. After exclusion of pregnancy, which of the following tests
is next indicated in the evaluation of this patient's amenorrhea?
A. Hysterosalpingogram.
B. Endometrial biopsy.
C. Thyroid function test.
D. Testosterone and DHAS levels.
E. LH and FSH levels. √
31. In postterm pregnancy all the followings are true EXCEPT:

A. Associated with meconium stained liquor.
B. The fetus has long nails.
C. May results in oligohydramnios.
D. Associated with respiratory distress syndrome.
E. It is a gestational age beyond 43 weeks. √
32. The following statements about multiple pregnancy are true EXCEPT:
A. Its occurrence in West Africa.
B. Its incidence is increased by increased age and parity.
C. Twin to twin transfusion common in monochorionic twins.
D. Can be diagnosed by ultrasound only after 12 weeks. √
E. Associated with induction of ovulation.
33. Uterine cervix:

A. Is the portion of the uterus below the isthmus. √
B. External os lining is columnar epithelium.
C. The internal os is covered with stratified squamous epithelium.
D. Can be dilated with dilators without the need of anesthesia.
A. Estrogen.
B. FSH.
C. Progestrone. √
D. LH.
E. Prolactin.
35. Polyhydramnios is commonly found with:

A. IUGR.
B. Placenta brevia.
C. Abruptio placenta.
D. Diabetes insipidus.
E. Diabetes mellitus. √
189
36. In the fetus:

A. The coronal suture lies between the two parietal bones.
B. The umbilical artery normally contains one artery and two veins.
C. Fetal lie describes the long axis of the fetus to the long axis of the mother. √
D. Entanglement of the umbilical cord is common in diamniotic twins.
E. The anterior fontanelle is usually closed by the time of labor.
37. In threatened abortion at 15 weeks gestation in a nulliparous patient:

A. Pain is characteristic.
B. The internal os is often opened.
C. Fainting is characteristic.
D. Vaginal bleeding is usually mild. √
E. Absence of fetal movements suggest non viability.
38. Which of the following terms best describes the pelvic type of small posterior
saggital diameter, convergent sidewalls, prominent ischial spines, and narrow
pubic arch?
A. Android. √
B. Gynecoid.
C. Anthropoid.
D. Platypelloid.
E. Mixed.
39. The reason of using antihypertensive treatment in pregnancy is to:

A. Reduce the placental blood flow.
B. Reduce the risk of CVA in the fetus.
C. Reduce the risk of CVA in the mother. √
D. Prevent hypertensive renal disease.
E. Prevent myocardial infarction.
40. Prerequisites for instrumental delivery include all the followings EXCEPT:
A. Cephalic presentation.
B. Engaged head.
C. Full dilation of the cervix.
D. Rupture of membranes.
E. The presence of epidural analgesia. √
41. The most common cause of uterus size-date disparity is:

A. Fetal macrosomia
B. Polyhydramnios.
C. Inaccurate last menstrual period. √
D. Multiple pregnancy.
E. Molar pregnancy.
190
42. Components of biophysical profile in addition to nonstress test include all the
followings EXCEPT:
A. Fetal movement.
B. Placental thickness. √
C. Fetal tone.
D. Fetal breathing movement.
E. Amniotic fluid pocket depth.

preeclampsia?
B. Decreased hematocrit.
D. Elevated uric acid. √
44. Ultrasound in the first trimester of pregnancy is mainly used to:

A. Localize the placenta.
B. Check for fetal well being.
C. Date the pregnancy. √
D. Check the placental blood flow.
E. Estimate the fetal weight.
45. The second stage of labor involves:

E. Expulsion of the fetus. √
46. Which of the followings is a known complication of diabetes in pregnancy?
A. Fetal microsomia (small baby).
B. Oligohydramnios.
C. Iron deficiency anemia.
D. Fungal infection. √
E. Placenta previa.
47. Regarding gestational diabetes mellitus (GDM):

C. The diagnostic test is glucose tolerance test (GTT). √
E. All patients should be delivered before term to avoid complications.
191
48. Diabetes in pregnancy can cause all the following congenital anomalies EXCEPT:
A. Sacral agenesis.
E. Yellow teeth discoloration. √
49. Regarding threatened abortion:

A. Anti-D should be given to Rh- positive mother.
B. All patients should be admitted to the hospital.
C. Ultrasound should be done to confirm the diagnosis. √
D. Vaginal examination will reveal severe pain.
E. The patient has vaginal bleeding and tissue passage per vagina.
50. Regarding missed abortion, all of the followings are correct EXCEPT:
A. The patient may present with loss of pregnancy symptoms.
B. Per vaginal bleeding may be one of the presenting symptoms.
C. Immediate evacuation should be done once the diagnosis is made. √
D. DIC may occur as a sequela.
E. Ultrasound should be done to confirm the diagnosis.

A. Vertex presentation.
B. Face presentation. √
C. Shoulder presentation.
E. Hydrocephalic baby.
52. Secondary amenorrhea is a recognized feature of:

A. Imperforated hymen.
B. Testicular feminization syndrome.
C. Pregnancy. √
E. Mullerian agenesis.
53. Vacuum extraction (ventouse):

A. Causes more maternal birth canal injuries than the forceps.
B. Can be used when the cervix is 7 cm dilated.
C. Can be applied when the vertex is minus 2 station.
D. Can cause cephalohematoma to the baby. √
E. Can be used in face presentation.
192
54. In prenatal infection:

A. Rubella can be prevented by administration of rubella vaccine during pregnancy.
B. Toxoplasma is a virus.
C. HIV virus infects the baby more readily when delivered vaginally than cesarean
section. √
D. CMV causes macrosomic babies.
E. In HIV patients, breastfeeding is encouraged.
55. In polycystic ovary syndrome patients, all the followings are true EXCEPT:
A. They are usually underweight with low body mass index. √
C. They have oligomenorrhea.
D. They have high prolactin level.
E. They have subfertility.
56. All the following prenatal infections cause fetal anomalies EXCEPT:
A. HIV. √
B. Toxoplasmosis.
C. CMV.
D. Rubella.
E. Syphilis.
57. All the followings are indications of Rh-D administration EXCEPT:

A. Artificial rupture of membranes. √
C. External cephalic version.
D. Cordocentesis.
58. Which of the following types of fibroid causes an excessive bleeding?

A. Cervical.
B. Broad ligament.
C. Submucosal. √
D. Subserosal.
E. Intramural.

A. Hemolysis.
B. Increased AST.
C. Increased platelets. √
D. Increased ALT.
193
60. All the followings can be used as tocolytic agents EXCEPT:

A. Ritodrine (β agonist).
B. Salbutamol.
C. Diazepam. √
D. Indomethacin.
E. A Ca+ channel blocker.

A. Condom. √
B. OCP.
C. IUCD.
D. Spermicide.
62. Apgar's score includes all the followings EXCEPT:

A. Skin color.
B. Muscle tone.
C. Blood pH. √
D. Heart rate.
E. Respirations.
63. Development of the embryo in the early pregnancy is best measured by:
A. CRL. √
B. HC.
C. AC.
D. FL.

A. Constitutional small mother. √

A. HIV.
B. Clamydia.
C. Gonorrhea.
D. Vaginal candidiasis. √
66. Development stage:

A. Testosterone is secreted by Sertoli cells.
B. Antimüllerian hormone is secreted by Leydig cells.
C. Antimüllerian hormone is responsible for involution of normal mullerian system.
√
194
67. All the followings are causes of preterm labor EXCEPT:

A. Multiparity. √
B. Placenta previa.
C. Polyhydramnios.
68. The drug of choice to prevent convulsions in eclampsia is:

A. Magnesium Sulfate. √
B. Hydralazine.
C. Labetalol.
69. Which is true?

A. Position – cephalic.
B. Station – level of ischial spines. √
C. Presentation – flexion.
70. PET:
A. MgSO4 is the drug of choice for eclamptic convulsions. √
B. Exaggerated knee jerk indicates MgSO4 toxicity.
71. Infertile couple:

A. Dysmenorrhea and dyspareunia are suggestive of endometriosis. √
B. Endometriosis is diagnosed by hysteroscopy.
72. Which of the followings is a contraindication for oxytocin infusion to induce labor?
A. Irregular first stage labor.
B. Transverse lie. √
73. Nuchal translucency is used is a marker used for:

A. NTD.
B. Trisomies. √
74. Menstruation:
A. Amount loss is 20-80ml. √
B. Contains shedding and fertilized ovum.
75. Sickle cell:

B. Increases the risk of urinary tract infections. √
76. DIC has a known relation with:

A. IUFD. √
77. Ovulation induction complications include:

A. Ovarian hyperstimulation. √
195
78. A 26-year-old patient presented with secondary amenorrhea, and her FSH and LH
levels were high. Your most likely diagnosis is:
A. Premature ovarian failure. √
79. The most common presentation of twins is:

A. Cephalic – cephalic. √
B. Cephalic – breech.
C. Breech – cephalic.
D. Breech – breech.
80. The most common cause of infertility is:
A. Male factor. √
B. Tubal problems.
81. All the followings are predisposing factors of breech EXCEPT:

A. Uterine anomaly.
B. Hydrocephalus. √
C. Macrosomia.
82. All the followings are predisposing factors of breech EXCEPT:

A. Prematurity
B. Submucosal fibroid
C. Previous LSCS (lower segment C/S). √
83. Fetal hydrops:

A. Rh isoimmunization is the commonest cause of nonimmune hydrops.
B. Nonimmune hydrops is diagnosed when the fluid fills at least one visceral cavity.
√
C. Nonimmune hydrops is treated with blood transfusion.
84. All the followings are causes of oligohydramnios EXCEPT:

A. Uterine anomalies
B. IUGR
C. Anencephaly
85. Expected date of delivery (EDD) is calculated by:

A. Naegele's rule
86. A 32-year-old woman with IUCD was found pregnant. On examination, IUCD
thread was protruding from the cervix. The next thing to do is:
A. Continue pregnancy
B. Remove IUCD
C. Remove IUCD and terminate pregnancy
196
87. Elevated α-fetoprotein is found in the followings EXCEPT:

A. Some ovarian cancers
B. Trisomy
C. Neural tube defects
88. Which of the followings can cause primary and secondary amenorrhea?
A. Anorexia nervosa
89. The karyotype of androgen insensitivity syndrome is:

A. 46 XY
B. 46 XX
C. 45 XO
90. All the followings are risk factors of cervical carcinoma EXCEPT:
A. Nulliparity
B. Smoking
91. All the followings are components of biophysical profile EXCEPT:

A. Fetal movement.
B. Fetal heart rate. √
C. Fetal tone.
D. Fetal breathing movement.
E. Amniotic fluid pocket depth.
92. In OCPs, all are true EXCEPT:

A. They prevent STDs
93. What is true regarding OCPs?

A. Cause menorrhagia
B. After discontinuation, may cause transient amenorrhea. √
C. Cause dysmenorrhea
94. Concerning GDM:

A. Causes delayed lung maturity compared to DM type I. √
B. Causes more congenital anomalies than DM type I.
C. The most common congenital anomaly is cleft lip.
95. Which one of the following perinatal tests is not routinely done?
A. Rubella.
B. HBV.
C. Toxoplasmosis. √
D. HIV.
E. Syphilis.
197
96. The following are used to treat endometriosis EXCEPT:

A. OCP
B. Progesterone pills
C. Danazol
D. Leuprolide
E. Estrogen
97. A 48-year-old, P6+0, presented with dysmenorrhea and deep dyspareunia. The
most likely diagnosis is:
A. Leiomyoma.
B. Adenomyosis. √
C. DUB.
D. Endometrial cancer.
98. A 28-year-old woman presented with menorrhagia. All the followings are choices
of treatment EXCEPT:
A. Hysterectomy.
99. Which test is done to measure the stored iron?

A. Transferrin level
B. Ferritin level
C. Hemoglobin level
100. Fetal heart beat is detectable by sonography at:

A. 5 weeks
B. 6 weeks
C. 7 weeks
D. 8 weeks
E. 9 weeks
101. According to WHO, a pregnant woman is considered anemic when her

hemoglobin level is less than:
A. 8
B. 9
C. 10
D. 11
E. 12
102. A young patient feels pain two weeks before menses starts. This is called:
A. Dysmenorrhea.
B. Dyspareunia.
C. Mittelschmerz ovarian pain. √
198
103. Stress incontinence:

A. Results in voiding of large amount of urine.
B. Results in voiding of small amount of urine.
C. Related to detrusor instability.
104. A 16-year-old girl with an adnexal mass, all these investigations should be done
EXCEPT:
A. USS
B. MRI
C. CT
D. Laparoscopy
105. Uterus:
A. Undergoes hyperplasia then hypertrophy with pregnancy
106. Fibroid:
A. Formed of fibrous tissue
B. Has a definite capsule. √
199
425Exams:
‫ا‬ ‫ط تا‬
1429/2008
:‫ت‬
‫ان ء‬ ‫ا‬ * ‫• ا رة‬
‫ا و‬ ‫د &ن‬ ‫وا‬ ‫ و‬.. ‫م ا د رة‬# ‫ر م‬$% ‫ و‬.. ‫ا وات ا‬ ‫ا‬ ‫• ر زو‬
‫(د م‬ ‫و &ن‬ ‫ و‬.. ‫ن ان ء‬% '‫• &و‬
Choose the mostappropriate answer:
1. Thyroid function is modulated in pregnancy by:

a. Inc metabolic demand in pregnancy
b. IncTBG(thyroidbindingglobulin)
2. In obese, PCOS pt:

a. Androstenedioneisconvertedtoestrone b.
There were many confusing options!
NB: read carefully about PCOS.. see OBGYN secrets page 40.
3. Feminize pt with short blinding vagina:

a. Androgen resistance
b. Gonadal dysgenesis
c. MRKHsyndrome
4. In DM:
a. Inc unexplained IUFD even in controlled DM
5. Pt with heavy bleeding , have an uncomplicated vaginal delivery 2weeksago.. the

cause of bleeding is most probably:
a. Uterine atony
b. Retainedplacentaltissue
c. Coagulopathy
d. Lacerations
200
6. Danazol acts by:

a. Endometrial atrophy
7. Most common complication of UTI is:

b. PROM
c. PTL
8. Which one is right?

a. Rubella fetalcongenitalcardiacanomalies b.
Herpes in vulva C/S is indicated
NB: why not herpes?.. if it says ACTIVE herpes infection.. then u can choose
it!
9. Screening test for DM is:

a. Glucosuria
b. 50mlOGTT
c. 70 ml OGTT
d. 100 ml OGTT
10. Inc growth of baby (fundal height is not corresponding with the GA) +
polyhydrominos in DM:
a. Long standing complicated DM
b. gastationalDM
c. Spina pifida
NB: in long standing complicated DM, the baby may be IUGR with
oligohydrominos.
11. Which one is associated with HTN in pregnancy:

a. Inc serum ureate
12. Pt with signs of PET, 35 weeks GA.. (constant headache, proteinuria+2, HTN
160/95).. how would you manage this pt:
a. Admit & observe
b. Start a-methyldopa
c. Inductionassoonaspossible
NB: although b is right, but the only relive for PET is delivery!
201
13. Female with infertility for 4 years, Hx of myomectomy of fibroid.. which type of
modality is the most appropriate:
a. U/S
b. Hysterosalpigiogram
NB: she might have Asherman syndrome!
14. PMS caused by:

a. Anovulation
b. Ovarianfunction
15. 18 y-o female with primary dysmenorrhea.. what medication do prescriped:

a. Ergometrine
b. Anti-prostaglandin
c. NSAID
16. Pregnant lady with a Hx of pulmonary embolism.. 5 years later she got pregnant..
how would you manage this pt:
a. Give a low dose heparin during pregnancy & preperium
17. The most common cause of ambiguous genitalia is:

a. CAH
18. 37 weeks with painless vaginal bleeding.. what to do next:

a. U/S
NB: it might be PP!
19. Sign of cardiac compromise in pregnancy:

a. Lf axis deviation
b. Systolic murmur
c. Arrhythmia
20. Pregnant lady, 30 weeks GA with Hb of 9 mg/dl:

a. Give parentral iron
b. Physiological anemia
c. Needs Blood transfusion
d. Iron deficiency anemia
202
Mid-Cycle:
1. In ovarian cycle, Wt stimulate steroid production from corpus luteum:?

• LH in luteal phase
• LH in periovulatory phase
• FSH in luteal phase
2. *Case (primary amenorrhea & Dx to have cong anomalies) .. absent

Paramesonephric duct:
• Uterus, upper vagina, oviduct
3. *Episotomy repair:
• Skin, fascia, bubococcygeus, transversalis
Too much options.. but remember that the anal sphincter &
ischiovcavernosus muscle are not included!
4. Labor is:?
• Changes in fetus position + attitude
5. *In vertex position which part of fetus is related to the symphysis pubis :
• Occipit
6. in labor:?
• inhaler analgesia in head delivery
• episotomy in crowning
• crowining is cessation b/w contraction
• internal rotation by pelvic floor muscle
7. EDD is:? (the term NEGAR or something was mentioned) >> not sure
• Calculate follicular phase
8. *Which drug used in conservative Rx of ectopic pregnancy:

• Methotrexate
9. Pudandal nerve block:

• S2+3+4
203
10. *Implantation occure in which stage:

• Blastocyst
11. fertilization:?
• proceed by second polar body
12. blood spotting .. 3000 3days 700.. wts ur Dx:?

• threatened abortion
13. DNA by:?

• Chorionic villous sampling
14. Gestation ANC at 16 week:?

• Serum alpha phetoprotein
15. Sign of PROM:

• Copious leakage in underwear & pants
• Ferning+ve
Read the tests carefully ‫ا ه‬ ‫ه‬ ‫"م ا‬# ‫ا‬
16. *Pt with PROM developed inc temperature, inc WBC, inc fetal distress:
• Intra amniotic infection
17. *Cardinal movement of labor:

• Engagement, flexion, extension, external rotation
( 8 9: .. 6# ‫ ن‬#' +7‫ا‬ ‫ ا‬+, ‫ ورة‬/ 0 1 23 ‫ ن‬#' 5# .. ‫ ھ‬%& ' (‫ھ و‬ ‫ا‬

; <6'
18. *28 ws with oligohydrominus:

• Obs renal disease
3 => , > ? ‫ارت ا‬ ‫ا‬1
19. *Pt with tenderness in the Rt renal angle, protein in urine, no dysuria:
• Exaggerated physiological hydronephrosis
204
20. *Pregnant women with SOB because by:

• (deepen)respiration
• Inc lung capacity
• Inc tidal volume
21. Cause of late IUGR:

• Uteroplacental insufficiency
22. Consider fetoplacental unit:

• Spiral artery invaded by trophoplast cause dilataion
23. Breast lactation should be avoided in:

• Minipill
• Progesterone acetate
• Inc dose of estriadiol
24. *Endometrial regeneration occur from:

• Zonabasalis
• Zona functionalis
• Zona pellucida
25. Ovarian cycle begin FSH in follicular phase by:

• LH surge
• Estradiol
26. Lower abdominal pain to the inner thigh:

• Round ligament
27. BPP include:

• Fetal movement, respiration, tone, non stress test
• Variabledecelerationmostlyduetocordcompression
28. BHCG In ruptured tubal pregnancy:?

• Highlyvariable
• Gradually inc
205
29. Pregnant women with recurrent abortion in 16, 18, 20 ‫س دك‬ ‫)ى را ر م‬
(‫ا ص‬ ‫ا "!ث ور ا‬:
• Chromosomal abnormalities
• Uterineanomalies
Why not the first??? in the first trimester
30. *Postpartum depression & crying relived after one week:

• Blues
Final:
1. First endocrine influence in 2ry sexual characters:
a. Secretion of delta-4 Androstenedione from the adrenal gland
b. Pineal body maturation
c. Pituitary maturation
d. Hypothalamicdownregulation???
NB:
“The beginning of puberty is caused by a decrease in high gonadostate
sensibility to prepubertal levels of sexual steroids. What produces this
change and timing is still unknown. However, it seems that the adrenal
(delta-4 Androstenedione) as well as the pineal may play an important role.”
Pubmed
Downregulation dec steroid sensitivity + feedback
2. Activin
3. Effect of estrogen on the Cx mucous:

a. Increasetheglycoproteinlevel&thusallowthepenetrationofthe
sperms???
b. Decrease the watery content
c. Something about (spinnbarkeit)
4. Apgar score values given (2 groups, one at the time of the delivery & the other 5
minutes after) .. calculate the score of both.
5. Strongly discouraged pregnancy in: (pregnancy Contraindication)

a. ASO (atrial)
b. VSD (ventricular)
c. Eisenmenger’ssyn (nobody told us about it .. so, u must read a lot!)
206
6. Case of labor with muconium stained amniotic fluid .. wt would u do:

a. Amnioinfusion
b. Close observation
c. Fetal scalp blood sample
d. Immediate C/S
7. Active vulval herpes infection .. how would u manage the pt?

a. Give acyclovir & then deliver
b. Deliver & give the baby prophylactic acyclovir
c. C/S
An absolute indication of C/S is an active genital herpes infection
8. Estrogen is the treatment of choice in:

a. Vulvar atrophic vaginitis
9. CVS is done for:

a. Trisomy
NB: + down syndrome Dx
10. Rubella’s eye manifestation on the newborn is mainly:

a. Cataract???
b. Microcephaly
c. Retinopathy
11. (induction) .. lady at 41 “postdate” 3cm cervical dilatation wt to use for

induction:
a. Prost E2
b. Misoprostol
c. Laxative for uterine massage
d. Syntocinon
12. hypochromic, microcytic with normal serum iron:

a. IDA
b. Thalassemia
c. SCA
207
13. Which one is true about the placenta:

a. 10% maternal contribution only
b. U.C covered with chorion
c. U.C contain wharlton jell
d. Placentallobesarethefunctionalunits
14. Major factor for the fetal RBC to cross to the mother:
a. Labor&delivery?
b. Spontaneous abortion
c. Low Abruptio placenta
NB: Because the dose we given after delivery is higher than other conditions
like bleeding “as far as I know”
15. In order to examine a 19 y-o pt.. u as a student will: ‫م ا و‬$% ‫&د ا‬

a. Take a permission from the parent
b. Take a permission from the consultant
c. Takeapermissionfromher
16. Wt keep the corpus luteum after 14 days is: ' " ‫م ا‬$% ‫&د ا‬
a. hCG
b. FSH
c. LH
17. Qs about gyneciod pelvis.
18. CI of epidural anesthesia: ‫ن * و ت ا ط‬ $ ‫ھي ذ‬

a. Anticoagulation therapy
19. BhCH 7 days 300, yesterday 400: ( '/ ‫ وات ا‬$ ‫)ا‬
a. Missed abortion
b. Ectopicpregnancy???
c. Threatened abortion
6> .. &<6 ‫ ت‬F H6 ‫ و‬.. ‫@ة‬:@A ‫ م‬B‫ ر‬8C' :‫ دا‬E F ‫ھ ي ا‬
20. Spotting at 8th week.. (BhCG=320.000).. On examination, the fundal height was
corresponding with 14 weeks.. ur Dx is:
a. Molarpregnancy
b. Abortion
208
c. Ectopic pregnancy
21. Anovulation + 4 cm unilocular cyst:

a. Follicularcyst
b. Luteal cyst
c. Theca cyst
22. McRobert maneuver in shoulder dystocia is done by: (‫) * د‬

a. Flexion of the maternal thigh
23. Rx of Trichomoniasis: (came on OSCE too!)

a. Ceftrixone
b. Clindamycin
c. Metronidazole
24. most significant factor for DVT is:‫وي &*ب‬

a. 75 kg weight
b. General anesthesia
c. 8 hr fasting preoperative
d. Significant blood loss
e. UTIpostpartum?
NB: Infection is a risk factor for DVT
25. Which one is true about oocipito-anterior presentation.. or posterior.. I don’t

remember!
26. Which one is true about forceps delivery: (‫)ا طور‬

a. 2/5 engaged head
b. Well contracted uterus in 2nd stage
27. Old lady, have 6 children.. with extensive endometriosis.. how would u manage her?
(‫ ن ز‬.‫* د‬1‫را‬ ‫ ت‬% ‫)ا‬
a. OCP
b. Resection
c. TAH/BSO
28. Which one is true about sterilization:

a. Success rate can be achieved immediately after vasectomy
209
b. Success rate can be achieved immediately after tubal ligation (bilateral)

c. Ligation can be done postpartum
29. 19 pt on OCP with a Hx of migraine headache.. her grand mother was recently
diagnosed with breast cancer.. & her mother had DM.. u will tell her that she OCP
will:
a. Cause DM
b. Inc incidence of breast cancer
c. Incthemigraineheadache?
d. Cause post-pill amenorrhea
NB: Read about the CI of OCPs.
30. A pt got pregnant recently concerning about her pregnancy.. the radiologist said that
she was exposed to
250 microrads.. that will cause:
a. Noeffect
b. Abortion
c. Fetal malformation
NB: The threshold level is >10 rads.. & comparing to the above, of course It’ll
have no effect.
31. Scanty vaginal bleeding (too much) & papsmear is –ve: ???
a. Estrogentherapy
b. Colposcopy
32. to assess ovulation, we measure:

a. day 11 LH
b. day22progesterone
33. the most common cause of death in .. ‫* ق‬ ‫ س‬.. ‫ؤال‬$ ‫ ن ا‬6 ‫ ط شا‬/ '$
‫' ت‬9 &:
a. hemorrhage???
b. eclampsia
34. easy scenario of: Physiological hydronephrosis
210
35. nullipara came for routine examination.. she will have:?

a. mammogram
b. papsmear
c. endometrial biopsy
36. commonest cause of pathological amenorrhea is:

a. Turnersyn
b. Hypothalamic-pitutary axis
37. How to Rx Turner syn: (came in OSCE too!)

a. Estrogen therpy
38. Vagina is formed of:

a. Urogenital sinus+mullarian duct
39. Seizures in pregnancy: (‫) * د‬

a. Increase the dose of the antiepileptic drugs
40. Thyroid:
a. Estrogen increase the TBG
b. Progesterone increase the TBG
41. Most common type of ovarian cancer in postmenopausal women is:‫ ل‬$‫( و ا‬came in
OSCE too!)
a. Germ cell tumor
b. Sex cord tumor
c. Epithelialtumor
42. Most common DDx of PROM is: (‫); ا م‬

a. Urine
b. Leukorrhea???
43. FSH: ‫ ط‬/ < ='& ‫ر‬6 ‫ ل س ا‬$ ‫ ن‬6 ‫ؤ ال‬$ ‫ا‬
a. Follicular maturation
44. Cause of DUB is:

a. Progesterone deficiency
211
45. Thromoxane is different from prostacyclin in:

a. Vasoconstrictor
NB: this point is related to recurrant pregnancy loss.. the mechanism of

antiphospholipid Ab & lupus anticoagulant.. see secrets pag 104.
46. in anterior pituitary failure (sheehan syn), the Rx is:

a. hMG
b. GnRH agonist
47. Papsmear revealed Cx Ca (CIN III).. macroscopically invisible.. wts ur next step:
a. Colposcopy
b. Wide excision
48. In molar pregnancy, when to add chemotherapy:

a. Platue in the first week
b. IncreaseBhCG
c. Normal after 6 weeks
49. Old women, (healthy), DEXA was done & showed 3 standard deviation.. wt would u
prescribe or her?
a. Estrogen
b. Progesterone
c. Vitamin D & Ca
d. Bisphosphonate
50. Vegetarian women: (‫) * د‬

a. Vit B12
51. In post term baby: (‫و‬/‫) * د ر‬

a. Long nails
52. Cx Ca .. how does it lead to death: (most of the options were reasonable but the
correct answer was)
a. Matastasis to the brain
b. Metstasis to the bone
c. Obstructionoftheureters nephropathy
212
53. Method of Dx of Vasa previa is: (‫> و‬$ ‫ ل‬: $ ‫ا‬ ‫رت‬6‫ن ذ‬6 ‫ةر و‬/ : ‫ا‬ ‫ر‬6‫) م ذ‬
a. Kleihauer-betke test
54. X linked recessive … ‫س ا دوا 'ر‬ ‫د و‬%* ‫ؤ ال‬$
55. Which is true about Cx Ca & Cx dysplasia:

a. Linked to HPV
b. Strongly related to smoking
56. Adverse effect of heparin is:

a. Osteoporosis
57. PMS diagnosed by: (‫) * د‬

a. Cyclical occurrence
58. Case of ectopic pregnancy with deterioration of vital signs

(hg tachycardia+hypotension).. wt would u do:
a. Observation
b. Methotrexate
c. Surgery
213
426Exams:
Mid-Cycle:
426 Group C, Girls 1431 - 2010
Collected by: Monerah Almohideb
Thanks To: Hanan Alomran, Aurobah Almufleh, Nada Alrashed, Basha'er Albloshi, Auhoud Assery, Afnan
Almarshedi, Lama Amer, Eman Almaghaslah, Nora Alshehri, Dana Albassam and Wessam Althawab
A. Rubella can be prevented by administration of rubella vaccine uring pregnancy
C. HIV virus infect the baby more readily when delivered vaginally than
caesarean section
2. Uterine Cervix
A. Is the portion of the uterus below the isthmus
B. External OS cell lining is columnar epithelium
C. Laterally is attached to the round ligament
3. The Commonest uterine fibroid to cause excessive bleeding is

A. Submucous fibroid
B. Subserous fibroid
C. Intramural fibroid
D. Cervical fibroid
E. Broad ligament fibroid
4. All the following infection can be transmitted through sexual intercourse, EXCEPT:
A. Genital herpes
C. Chlamydia
D. Gonorrhea
E. Vaginal Candidiasis

A. Amenorrhea
B. Hegar's sign
D. Auscultation of fetal heart
214
6. All these tests can be useful in management of intrauterine fetal growth restriction
IUGR except:
A. Fetal kick chart
C. Chorionic villous sampling
7. 14 weeks pregnant woman had abor0on and she was told that it is a complete
D. After complete abortion there is minimal or no pain and minimal or no
bleeding
E. Follow up with BHCG for one year
stage is at least:
A. IA
B. 1B
C. IC
D. IIA
E. III
9. If your pa0ent is 8 weeks pregnant which one of the following USS measurement is
most useful?
B. Biparital diameter
C. Femur length
D. Placental site

B. Flexion at hip joint and flexion at knee joint
E. Flexion of one leg at hip joint and extension of the other leg at the hip joint
11. Untreated patients with cancer of the cervix usually die with
A. Cachexia and starvation
B. Bowel obstruction → this is in ovarian cancer
C. Renal failure and uremia
215
D. Multi organ failure

E. Cerebro vascular accident primigravida

A. A chromosomal structure of 45 XY is characteris7c
C. Ovaries are streak
13. Which of the following tumors produces estrogen?

B. Choriocarcinoma
C. Granulosa-cell tumors
D. Dysgerminoma

A. To diagnose PCO hormonal analysis can be done at any time of the cycle
D. Can only be diagnosed after it has ruptured
E. Is a complication of assisted conception.
A. No treatment
B. Myomectomy during pregnancy if red degeneration occurs
C. Myomectomy
D. Hysterectomy
E. GnRH agonist
We will request it at any time → only if she present with amenorrhea, otherwise
we have to request the hormonal levels at 2nd, 3rd and 4th of the
cycle.
216
17. Evaluation of infertile couples

B. History of severe dysmenorrhea and dyspareunia is suggestive of
endometriosis
18. Treatment of pelvic inflammatory disease include the following,

EXCEPT:
A. Oral doxycycline
B. Removal of IUCD
C. Clindamycin
D. Tetracycline
E. Dilatation and curettage (D & C)
19. Antenatal booking investigations include all of the following,

EXCEPT:
B. Blood sugar
D. Toxoplasmosis
E. liver function
20. Which of the following is known to be the commonest presentation in twins

A. Breech, cephalic
B. Cephalic, breech
C. Cephalic, cephalic
D. Breech, breech
21. All the following are possible causes of polyhydramios,

EXCEPT:
A. Diabetes
E. IUGR
22. Uterine fibroid is:

A. Composed of fibrous tissue
B. Surround by a false capsule
C. The most common cystic tumor in women
D. Progestogen dependent
217
E. Managed by myomectomy in most of the cases
A. Transferrin level
E. Serum Iron

B. Syphilis
E. Bifurcate uterus
25. ABer menopause

A. There is increase vaginal acidity
B. Gonadotrophines level falls
C. There is increase in bone density
D. The size of an existing fibroid increases
E. Any post menopausal bleeding should be investigated by endometrial
Sampling
26. Which instrument in no a basic component of a laparoscopy

A. Trochar
B. ventous cup
C. Veres needle
D. Light source
E. CO2 insufflation set

EXCEPT:
C. May cause amenorrhae
D. Should not be given to lactating mother
E. Does not carry a risk of venous thrombosis

C. Increase peripheral resistance
218
29. The following are presump0ve skin signs of pregnancy except:

A. Chloasma
B. Maculo papular rash
C. Linea Nigra
D. Stretch Marks
E. Spider Telangiectases

C. Visual disturbance.

D. Observing amniotic fluid drain through the cervix during speculum
examination.
F. Contractions seen on the CTG.

E. Endometritis and salpingo-oophoritis.
33. The luteal phase of the menstrual cycle is associated with

B. High progesterone levels
34. Ovula0on induction complications include:

A. Ovarian hyperstimulation.
219
C. The ovaries will be very small in size have unilateral cyst

D. It can be diagnosed clinically and by ultrasound
36. According to WHO, Hb in a pregnant woman shouldn't be less than:

A. <8
B. <10
C. <9
D. <11
E. <13
37. According to WHO, Sperm count shouldn't be less than :

A. 50 million /ml
B. 60 million/ml.
C. 90 million/ml.
D. 20 million/ml.
E. 10 million/ml.
38. Compound malpresentation most commonly occur with:

A. Prematurity
B. Advanced maternal age
C. Large pelvic vessels
D. Diabetic pregnancy
39. Placenta previa all help in diagnosis of except:

A. Constant lower abdominal pain
B. Mal presentation
C. Painless vaginal bleeding
D. US
40. Cervical incompetence one true:

A. Cone biopsy is not a predisposing factor
B. Cerculage is contraindicated
C. In not encountered with uterine anomalies
D. Best diagnosed by Hx
E. Is a cause of early pregnancy abortion
D. Post coital test
E. Prolactin level
220
42. The predisposing factor to ( case of burning micturation, loin pain) is:
A. Hydroureter because of progesterone effect
B. Compression of ureter in the 3rd trimester by enlarging uterus
44. Immediate complication of C/S include all except:

A. Bladder injury
B. Hemorrhage
C. Thromboembolism (also DM is not immediate)
D. Complication of anesthesia
45. Amniohook (artificial ROM) may cause all except:

A. Amniotic fluid embolus
B. IUGR
D. Fetal distress
E. Cord prolapse
46.Most common cause of anesthesia death in pregnancy:

A. Aspiration pneumonia
B. medication reaction
C. stroke
D. hemorrhage
E. failed intubation
47. Risk factors to preeclampsia include all the following EXCEPT:

B. Placental abruption.
C. Renal failure.
D. DIC
E. Polycythemia.
48. All are contraindications to VBAC except:

A. Lower segment c/s
B. Classical CS
C. Rupture uterine
D. ??
E. ??
49. karyotype of Androgen Insensitivity Syndrome:

A. 46xx
B. 46xy
C. 47xxy
D. 45x0
221
E. 45 xy
50. Hyperemesis gravidarum in 1st trimester is seen with increased frequency in all of
the following except
A. H. Mole
B. Twins
C. Missed Abortion
D. Primigravida
E. Patient with history of hyperemesis
51. Regarding missed abortion, all of the followings are correct EXCEPT:
A. The patient may present with loss of pregnancy symptoms.
B. Per vaginal bleeding may be one of the presenting symptoms.
C. Immediate evacuation should be done once the diagnosis is made.
D. DIC may occur as a sequel.
E. Ultrasound should be done to confirm the diagnosis.

A. Vertex presentation.
B. Face presentation.
C. Shoulder presentation.
E. Hydrocephalic baby.
53. All the followings can be used as tocolytic agents EXCEPT:

A. Ritodrine (β agonist).
B. Salbutamol inhaler .
C. Diazepam ( vallum )
D. Indomethacin.
E. A Ca+ channel blocker.

A. Constitutional small mother.
55. Mother with hepatitis B positive:

A. we give the baby both immunoglobulins and live attenuated vaccine when
born
A. Combined oral contraceptive pills
222
B. Male condom
C. Female condom
D. Diaphragm

B. On danazol therapy
D. Patient on oral contraceptive pills
A. Polyhydramnios
B. Abortion
C. Preterm labor
A. Sheehan syndrome
C. Premature ovarian failure

C. Gesta7onal diabetes on insulin at 39 weeks
E. Chorioamnionitis
61. Regarding cervical incompetence, all of the following are true,

EXCEPT:
A. Typically causes painful abortions
C. Is treated by Shirodkar suture (cervical cerclage) which is best
preformed early in the second trimester
223
62. A 16 year old girl with imporferated hymen present with:

A. Secondary Amenorrhia
B. Hematocolpous
63. A 20 year old lady pregnant in 1st trimester came complaining of lower abdominal
pain, in examination a mass continued with the uterus was found what is the
diagnosis:
A. Red degeneration of fibroid
C. Uterine rupture
D. Rupture placenta
E. Placenta previa
64. All of the following causes oligohydrominas except:

A. Renal agenesis
B. Poor placental perfusion
C. Post term pregnancy
D. Anencephaly
E. Urinary obstruction
65. PCO, all true EXCEPT:

A. Hirsutism.
B. Imporforated hymen,
C. Infertility.
D. Acne.
E. Amenorrhea
67. In Gestational diabetes :

A. Fetal lung surfactant matures later (more late) than in a non diabetic mother.
B. More associated with congenital malformation than Insulin Dependant
Diabetes.
C. ??
D. ??
E. ??
68. Side effects of β sympathomimetics include all of the following, Except?

A. Tachycardia
B. Pulmonary oedema
C. Headache
D. Premature closure of ductus arteriosus
E. Palpitation
224
69. The most common congenital anamoly associated with diabetes is:
A. Congenital heart disease.
B. Neural tube defect.
C. Sacral agenesis.
D. Renal agenesis
E. Caudal regression
70. In cases with premature rupture of membranes, all the following

are acceptable in the conservative management except:
A. Frequent vaginal examination to assess cervical dilatation.
71. Pateint complaining of dysmenorrhea and heavy menstrual bleeding what the
diagnosis :
A. endometriosis
B. fibroid
C. ?
D. ??
E. ??

A. Uterine fibroid
B. Adenomyosis
E. Combine oral contraceptive pills
73. At which week we can detect the first fetal heart (they add "we mean intravaginal
US":
A. 12
B. 6
C. 17
D. 18
E. 19

A. Uterine fibroid
B. Maternal pulmonary hypertension
C. Placenta previa
225
74. Criteria of severe preeclampsia include all Except:

A. Diastolic BP of 110 mmHg or more
B. Pro7enurea more than 5g/24 hours
C. Presence of epigastric pain
D. Decreased hematocrit
E. Oliguria
75. What is the associa0on of ovula0on induc0on for fer0lity and multiple births?
A. Decreased multiple pregnancy
B. Increased multiple pregnancy
C. Increased only dizygotic twins
D. Doesn’t affect the incidence of twins
76. The most antigen which would account for fetal hydrops is
A. C
B. D
C. Keu
D. Lewis
E. Duffy
78. Breast feeding:

B. Should be started immediately in case of maternal HIV infection
C. Has a rule in involution of uterus
D. Should be replaced by bottle feeding if the patient had caesarean section
E. Contain adequate of iron
79. Physiological changes in the reproductive system include:

A. There is no changes in the vagina
B. The uterus first enlarge by hyperplasia then by hypertrophy
C. There is no change in the cervix
D. Estrogen has no role in any changes during pregnancy
E. Lower segment of the uterus will be formed in the first trimester
80. all are risk factors associated with macrosomia, except:

A. Prolonged pregnancy
B. Previous large infant
C. Short stature
D. GDM
E. Maternal obesity
81. Risk and complica0ons of induction of labor include all of the following EXCEPT:
A. Failed induction
B. Atonic PPH
226
C. Uterine hyperstimulation leading to fetal hypoxia

D. Prostaglandin may cause hypothermia due to its direct effect on thermo
regulatory centers in the brain
E. Rupture uterus in grandmultipara of patients with previous CS
82. The normal development sequance of puberty is :

A. Thelarche , adrenarch, growth, menarche.
B. Menarch, adrenarch, thelarche ,growth.
C. Growth. thelarche, adrenarch, menarche
D. Adrenarch , thelaeche, growth, menarche
E. Thelarche , menarche, adrenarche, growth.
83. 33 year female at 37 weeks gesta0on confirmed by early sonography presents with
moderate severe vaginal bleeding, she is noted to have placenta previa, which of the
following is the best management for her :
B. CS
C. Expectant management
D. Artificial rupture of membrane
E. Give tocolytic drugs
84. Permanent steriliza0on includes all of the following EXCEPT:

A. Vasectomy
B. Tubal ligation
C. Mirena IUCD
D. Hysterectomy
89. The second stage of labor involve:

A. Separation of placenta
B. Effacement of the cervix
C. Expulsion of placenta
D. Expulsion of the fetus
E. Dilatation of the cervix
90. Bishop score include all except:

A. Station of fetal head
B. Cervical effacement
C. Cervical position
D. Cervical dilatation
E. Cervical length
227
91. The fetal heart rate of normal fetus in term is :

A. 80-100 bpm
B. 100-120 bpm
C. 120-160 bpm
D. 160-180 bpm
E. There is no baseline HR
92. Anti-D prophylaxis

B. Should be given to all Rhesus negative women after amniocentesis
negative babies.
D. Should be given to all women who's babies are Rhesus negative
E. Is contra-indicated during pregnancy if the women is Rhesus
Negative
93. The following are absolute contraindications to the combined oral contraceptive
pills
A. Varicose veins
B. Ischemic heart disease
C. history of DVT
94. Mul0ple pregnancy increases

B. With advancing maternal age
C. With bromocriptine use for infertility treatment
95. The most common cause of uterine size – date disproportion

A. Fetal macrosomia
B. Polyhydramnios
C. Inaccurate last menstrual period date
E. Molar pregnancy

most likely reveal.
B. Feral heart motion in the adnexa
228
E. An intact gestational sac with fetal

A. History of pelvic inflammatory disease
B. Congenital anomalies of the tube
C. Endometriosis
D. Tubal surgery
E. Prnarcheevious sterilization
98. All these tests can be useful in management of intrauterine fetal growth restriction
IUGR except:
A. Fetal kick chart
Mid-Cycle:
Males
1. Anti-D prophylaxis
B.ShouldbegiventoallRhesusnegativewomenafteramniocentesis
negative babies.
E. Is contra-indicated during pregnancy if the women is Rhesus negative
2. Uterine fibroid: Which is true?

A. Is commoner in white people than black
B. All should be treated immediately
C. Sarcomatous change occurs in 1%
D.Cancauseobstructedlabor
E. In pregnancy should indicate caesarian section

B. Gonadotrophin secretion falls
C.Recurrentvaginalbleedingshouldbeinvestigatedbyendometrialbiopsy
D. Malignancy is the leading cause of post menopausal bleeding
E. Bone mineral density increases
229
4. The combined contraceptive pills: Which is true?

A. Pre-dispose to pelvis inflammatory disease
B. Predispose to ovarian cyst
C. Predispose to benign breast cyst
D.ContraindicatedinapatientwithhistoryofDVT E.
Failure rate is 2 per hundred woman years
5. The following are absolute contraindications to the combined oral contraceptive

pills
A. Varicose veins
B. Previous history of viral hepatitis
C.Prostheticheartvalve
6. In placenta previa: Which is true?

A. It is common primigravida
B.Maycauseabnormallie
C. Causes recurrent painful bleeding
D. All patients should be induced with prostaglandin pessaries
E. Digital examination is mandatory to exclude local causes
7. Abruptio placenta: Which is true?

A. It is bleeding from abnormally situated placenta
B. Has minimum effect on the fetus
C. Causes painless bleeding
D.Canbeacauseofpostpartumhemorrhage
E. All should deliver by caesarean section

B. common in post term labor
C. Vacum extraction can be used when cervix is fully dilated
D.Forcepscanbeusedforaftercominghead
E. External cephalic version is best performed between 32-34 weeks gestation.
9. Turner syndrome: Which is true?

A. Genetically is 46 X O
B. Has testis in inguinal area
C.Usuallypresentswithprimaryamenorrohoea
D. Has low I.Q
E. Usually tall
230
10. Androgen insensitivity syndrome: Which is true?

A. Genotype is 46 X X
B. Phenotype they are female but with ill developed breast
C. Usually have secondary amenorrhoea
D. They have testes that should be kept to produce hormones
E.Theyhavenouterus

B.Antiprogesterone
C. Beta sympathomimetic agonist
D. Synthetic oestrogen
E. Medroxy progesterone
12. Patients with the following conditions present with primary amenorrhoea
A. Bicornuate uterus
B. Polycystic ovary syndrome
C.Imperforatehymen D.
Sheehan’s Syndrome E.
Anorexia nervosa
13. In fetal circulation

A. Oxygenated blood goes along the umbilical arteries
B. The fetal lung is bypassed by means of ductus venosus
C. The foramen ovale connects the two ventricles
D.Mostofthebloodenteringtherightatriumflowsintotheleftatrium
E. The blood in the umbilical arteries is more oxygenated that blood in umbilical
vein
14. The following ultrasonic measurements may be used to confirm or establish

gestational age
A.Crownrumplength
B. Nuchal pad thickening
C. Amniotic fluid volume
D. Yolk sac volume
E. Biophysical profile
15. During normal pregnancy: Which is true?

A. Estradiol is the principal circulating oestrogen
B. The blood pressure increases in first and second trimester
C. The tidal volume is reduced
D.Thesecondhalfofpregnancyamnioticfluidismostlycontributedfetalurine
E. Maternal hydro ureters should be taken always as a serious pelvic condition
231
16. The following conditions are aggravated by oral contraceptive pills

A. Hirsutisum
B. Endometriosis
C. Dysmenorrhoea
D. Pre-menstrual syndrome
E.Genitalfungalinfection
17. Intra uterine contraceptive device (IUCD)

A. Reduces pelvic inflammatory disease
B. Inhibits ovulation
C. Increases incidence of endometrial cancer
D.Ifpregnancyoccursthereisincreasedriskofectopicpregnancy
E. Failure rate is 0.1%
18. The following values of semen analysis indicates abnormal semen quality
A.Volumelessthan2ml B.
Count of 40 million / ml C.
Motility 60%
D. Abnormal form 40%
E. Liquefaction complete in 30 minutes

A. Basal body temperature drop at least 0.5C in the second half of the cycle
B. Day 21 oestrogen level is elevated
C. Progesterone level on day ten of the cycle is elevated
D.Regularcyclewithdysmenorrheal
E. Oligomenorrhoea

A.Chromosomalabnormalities
E. Pre-eclampsia
21. The following are always indications for Caesarean Section

A. Hydrocephalus
B. Abruptio placentae
C. Preterm Labor
D.Activeprimarygenitalherpes
E. Sever pre-eclamsea
232
22. Obstructed labor: Which is true?

D.Mentoposteriorpositioncouldbeacause
primigravida

A.Maternalfebrileillness
C. Labetaiol ingestion
D. Post maturity
24. Prolapse of umbilical cord: Which is true?

A. Not an indication for caesarean section when baby viable at 36 weeks
B. Diagnosed when membranes are still intact
C.Ismorecommonwhenfetusacquiresanabnormallie
D. Incidence is 5%
E. Causes severe respiratory alkalosis
25. Regarding human fertility: Which is true?

A.Fertilizationusuallyoccurs5-7daysbeforeimplantationandbeforethe
extrusionofthesecondpolarbody
B. Subfertility only treated with IVF
C. An adverse male factor is detectable in 60% of couples with low fertility
D. Mumps in adulthood has no effect on male fertility
E. Oligo spermia means that sperm shape is abnormal

E.Ergometrineshouldbeavoidedinthethirdstageoflabor

B.Withadvancingmaternalage
C. With bromocriptine use for infertility treatment
233
28. In twin deliveries: Which is true?

A. The first twin is at greater risk than the second
B. They usually go post date
C. Epidural analgesia is best avoided
D. Commonest presentation is cephalic and second breach
E.Thereisincreasedriskofpostpartumhemorrhage

C.Maybecausedbycervicalcarcinoma
30. Polyhydramnios is associated with the following condition

A. Intrauterine growth restriction
B. Fetal kidney agenesis
D.Tracheooesophagealfistula
E. Hind water leakage
31. All of the following associated with increase incidence of breech presentation,
EXCEPT:
A. Placenta previa
B. Mullerian anomaly
C. Uterine leiomyoma
D.Nulliparity
E. Prematurity
32. Components of biophysical profile include all of the following, EXCEPT:

A. Fetal movement
B.Placentalthickness
C. Fetal tone
D. Fetal breathing movement
E. Amniotic fluid volume assessment
33. Risk factors of post partum endometritis include all of the following, EXCEPT:
A. Prolonged labor
B. Prolonged rupture of membranes
C. Multiple vaginal exams
D. Prolonged monitoring with an intrauterine pressure catheter
E.Gestationaldiabetes
234
EXCEPT:
A. Cesarean section
C. Fetal macrosomia
E.Intrauterinegrowthrestriction
35. Control of gestational diabetes is accomplished with the following, EXCEPT:

A. Insulin
B. Diet
C.Oralhypoglycemicagents
D. Exercise
E. Insulin and diet
36. Combined Oral Contraceptive Pills contain

A. A synthetic estrogen alone
B. A progestin alone
C.Bothestrogenandprogestin
D. Bromocryptin
E. Androgen
37. Mechanisms of Oral Contraceptive Pills include all of the following except:
A. Ovulation suppression
B.Enhancedovarianandrogenproduction
C. Altered cervical mucus
D. Altered endometrium
E. Altered tubal motility
A.Alteredtubalmotility B.
Altered endometrium C.
Altered cervical mucus
39. Antenatal booking investigations include all of the following, EXCEPT:

B. Blood sugar
D. Toxoplasmosis
E.Thyroidfunction
235
40. The most common cause of uterine size – date disproportion

A. Fetal macrosomia
B. Polyhydramnios
C.Inaccuratelastmenstrualperioddate
E. Molar pregnancy
41. Immediate appropriate response to an initial eclamptic seizure include of the

following, EXCEPT:
A.Ultrasoundforfetalgrowth
B. Maintain adequate oxygenation
C. Administer maganesium sulphate
D. Prevent maternal injury
E. Monitor the fetal heart rate
B. Incidence of oligohydramnios
E.Riskofmaternalcomplicationssuchasstroke
43. Management of a patient with threatened abortion includes all of the following,
EXCEPT:
A. Ultrasound
B. Physical examination
C. CBC
D. Derailed menstrual history
E.Dilatationandcurettage

most likely reveal.
B. Feral heart motion in the adnexa
E.Anintactgestationalsacwithfetal
45. Acceptable managment of ruptured ectopic pregnancy

A. Observation followed by methotrexate
B. Diagnostic laparscopy followed by observation
C. Repeat ultrasound next 24 hours to confirm the diagnosis
D.Exploratorylaparotomyandsalpingectomy
236
E. Dilatation and curettage
46. Infants of mother with gestational diabetes have an increased risk of the following,
EXCEPT:
A. Hypoglycemia
B.Hypoinsulinemia
C. Hypocalcemia
D. Hyper bilirubine
E. Polycythemia
47. The best screening test for gestational diabetes

A. Fasting blood sugar
B. Random blood sugar
C.Glucosechallengingtest
D. Glucose tolerance test
E. Blood sugar series
48. Risk factors for pre- elcamsia include all of the following, EXCEPT:
D. Positive history of pre- elcampsia in previous pregnancies
E.Positivehistoryofmacrosomicbaby
49. Early clinical evidence of magnesium sulfate toxicity would show

A. Flushing
B. Diplopia
D. Lossofdeeptendonreflexes E.
Headache
50. Pre-eclampsia is associated with an increase risk of all of the following, EXCEPT:
A. Delivery of a small for gestational age infant
B. Placental abruptio
C. Pulmonary edema
D.Prolongeddurationoflabor
E. Cerebral vascular accident (CVA)
51. The volume of amniotic fluid is:

A. Is closely related to the fetal crown-rump length in the 3rd trimester of
Pregnancy
B.MaybepredictedbyUltrasound
C. Is reduced in sever rhesus disease
D. Increases following amniocentesis
237
E. Is increased in sever pre-eclampsia
52. Which of the following is known to be the commonest presentation in twins

A. Breech, cephalic
B. Cephalic, breech
C. Cephalic, cephalic
D. Breech, breech
53. The commonest cause for infertility

A. Tubal obstruction
B.Malefactor
C. Chronic anovulation
D. Hyper androgens
E. Hypothyroidism
54. The following are factors affecting the choice of methotrexate as a choice of
C. Level of BHCG
D.Parityofthepatient
55. All the following are possible of premature labor, EXCEPT:

B. Polyhydramnios
C. Bicorrnuate utures
D.Anecephaly
E. Perinatel infection

A.Historyofpelvicinflammatorydisease
C. Endometriosis
D. Tubal surgery
57. Accurate diagnosis of hydatiform mole can be made by

A. Elevated BHCG
B.Ultrasound
C. Pelvic examination
D. Chest radiography
E. Absence of fetal heart in a 16 week sac
238
58. All the following are possible causes of polyhydramios, EXCEPT:

A. Diabetes
E.IUGR
59. Uterine fibroid is:

A. Composed of fibrous tissue
B.Surroundbyafalsecapsule
C. The most common cystic tumor in women
D. Progestogen dependent
E. Managed by myomectomy in most of the cases
60. The following is true regarding degenerative changes in uterine fibroids

A. Sarcoma occurs in 2%
B. Cystic degeneration is common with the use of oral contraceptive pills
C. Hyaline degeneration causes acute pain
D. Torsion is common in intramural fibroid
E.Reddegenerationshouldbemanagedconservatively
61. The karyotype of patient with Androgen insensitivity Syndrome is

A. 46xx
B.46xy
C. 47xxy
D. 45x0
E. 45 xy
62. All are the risks associated with macrosomia, EXCEPT:

A. Maternal obesity
B. Prolonged Pregnancy
C. Previous large infant
D.ShortStature
E. Gestational Diabetes Mellitus
63. Risk Factors for DVT includes all, EXCEPT:

A. Smoking
B. Operative delivery
C. Lupus anticoagulation
D. Maternal weight over 80 kg
E.Hyperthyroidism
239
64. Risk Factors of gestational trophoblastic disease include all of the following,
Except?
A. Far East Asian
B. age under 20
C.DiethighFolicacid
D. Age above 40
E. Diet lower beta carotene
65. Side effects of B sympathomimetics include all of the following, Except?

A. Tachycardia
B. Pulmonary oedema
C. Headache
D.Prematureclosureofductusarteriosus
E. Palpitation
66. Hyperemesis gravidarum in 1st trimester is seen with increased frequency in all of
the following except
A. H. Mole
B. Twins
C.MissedAbortion
D. Primigravida
E. Patient with history of hyperemesis
A.Transferrinlevel
E. Serum Iron
68. All the following are possible causes of anovulation,

EXCEPT:
A. High body mass index
B. Anorexia nervosa
C. Polycystic ovarian syndrome
D. Premature ovarian failure
E.Sicklecelltrait

A. Uterine fibroid
B. Adenomyosis
E.Combineoralcontraceptivepills
240
70. The puerperium:

A. Refer to the first 6 months after delivery
B. The lochia usually persist for 7 weeks
C.Theuterinefundusshouldnotbepalpableabdominallyby14daysafter
delivery
D. The incidence of post partum depression is 50%
E. Fever due to engorged breast occurs on the second day after delivery
71. Regarding incomplete abortion, all are true, EXCEPT:

A. There is a history of tissue passed per vagina
B. The cervix is open on vaginal examination
C. Ultrasound shows retained product of conception
D.Ultrasoundshowsintactgestationalsacnon-viablefetus
E. Management include evacuation
72. Which of the following factors predispose to genital prolapse

A. Repeated LSCS
B.Multiparty
D. Endometriosis
E. Repeated candidiasis
73. Treatment of infertility:

A. Clomiphene citrateis helpful in patients with anovulator premature ovrian
failure
B. ovarian drilling is helpful in the treatment of infertility endometriosis
D.Hyperstimulationsyndromecanoccursinpatienttreatedbygonadotropins
E. Spontaneous pregnancy can occur in patients with Mullerian agenesis
74. The luteal phase of the menstrual cycle is associated with

B.Highprogesteronelevels
75. Feature characteristically associated with an imperforate hymen in a patient aged

16 years includes:
A. Absence of secondary sexual
B.Acuteretentionofurine
C. Hirsutism
D. Short stature
241
E. Present with secondary amenorrhea

A.Chromosomalabnormalities
B. Syphilis
E. Bifurcate uterus
77. A pregnant woman presents with a placenta praevia of a major defect and fetus is
malformed. Which of the following will be the best management?
A.Caesariansection
B. Oxytocin drip
C. Rupture of membranes
D. Induce with PG E2
E. Forceps delivery in the second stage to accelerate delivery
78. Polycystic ovarian diseases, all of the following can be seen, EXCEPT:
A. Acne
B.Streakovaries
D. Hirsutism
E. Glactorrhoea

A. Is due to pelvic anatomic defect
B. patient loses small amount of urine
C. can be diagnosed with stress test
D.Canbetreatedmedically
80. Breast feeding

B. Should be started immediately in case of maternal HIV infection
C.Hasaruleininvolutionofuterus
D. Should be replaced by bottle feeding if the patient had caesarean section
E. Contain adequate of iron
81. After menopause

A. There is increase vaginal acidity
B. Gonadotrophines level falls
C. There is increase in bone density
D. The size of an existing fibroid increases
242
E.Anypostmenopausalbleedingshouldbeinvestigatedbyendometrial
sampling
82. The treatment of cystocele in a 32 years old may include the following, EXCEPT:
A. Pelvic floor exercise
B. Weight loss
C.Vaginalhysterectomy
D. Anterior colporrhaphy
E. Vaginal Pessary
83. Which instrument in no a basic component of a laparoscopy

A. Trochar
B. Hegar dilator
C. Veres needle
D. Light source
E. CO2 insufflation set
84. Which of the following is contra indication for delivery using vacuum extraction:
A.Facepresentation
E. Chorio amnionitis

A.IUFD
C. Iron deficiency
D. Diabetic mother
86. Regarding injectable progesterone conteaception, all of the following is true,

EXCEPT:
C. May cause amenorrhae
D.Shouldnotbegiventolactatingmother
E. Does not carry a risk of venous thrombosis
87. The following are contraindication to external cephalic version, EXCEPT:

A.Contractedpelvis
B. Placenta previa
D. Presence of cervial suture in site
243
E. Scared uterus
88. An Utrasound in the 1st trimester of pregnancy is done for

A. Placental localization
B. Detecting of fetal weght
C. Assessment of amniotic fluid volume
D. Detection of fetal breathing
E.Datingofthepregnancy
89. Incompetent cervix

A. Is a casue for early pregnancy loss
B.Isbestdiagnosedbyhistory
C. Is a cause for fetal congenital abnormalities
D. Is not encounted with uterine anomities
E. Can be treated with tocolytics
90. In complete hydatidiform mole

A.Rarelycontainsmaternalgeneticmaterial
B. Can present with hypothyroidism
C. Prophylactic cytotoxic therapy should be givien
D. Diagnosis is confirm with a very low blood level of human beta
gonadotrophine
E. Pre-eclampsia is the most common symptom and occur in 97% of patients
91. The best uterine scar a patient can have for Caesarian section is
A. Transverse upper segment
B. Longitudinal upper segment
C.Transverselowersegment
D. Longitudinal lower segment
E. A T-shaped incision
92. The diagnosis of endometriosis is often strongly suspected from patient's initial
history expressing the following except:
A. Infertility
B. Dysmenorrheal
C. Vaginal dryness
D. Dyspareunia
E. Chronic Pelvic pain
93. The following are true about Leiomyomas except:

A. Usually multiple
B.Usuallymalignant
C. Usually discrete
D. Usually spherical or irregular lobulated
244
E. Usually easy enucleated from the surrounding myometrium
94. Stages of labour

A. The first stage commences at the time of membrane rupture
B. The cervix dilates at consistent rate of 3 cm per hour in the first stage
C.Thethirdstageendwiththedeliveryoftheplacentaandmembranes D.
Forceps or ventose may be useful in slow progress of the late 1st stage
E. Syntometrine is a combination of oxytocin and ergometrine which is used in
the treatment of secondary postpartum haemorrhage (PPH)
95. The main support of the uterus is provided by

A. The round ligament
B.Thecardinalligament
C. The infandilo pelvic ligament
D. The integrity of the pelvis
E. The broad ligament

C.Increaseperipheralresistance
97. High alpha feto protein found in? EXCEPT

A. IUFD
C. Some Ovarian Cancer
D.Trisomy21
E. Neural tube defect
98. Urinary stress incontinence is:

A. The loss is of large amount of urine when intra abdominal pressure
B. The loss is of small amount of urine when intra abdominal pressure C.
Inability to control the bladder of all urine
99. Menorrhagia is:

C.Heavymenstrualcyclemorethan80ml
245
100. The following are presumptive skin signs of pregnancy

except:
A. Chloasma
B.Maculopapularrash
C. Linea Nigra
D. Stretch Marks
E. Spider Telangiectases
Final:
A. IUFD
C. Iron deficiency
D. Diabetic mother
A. Rubella can be prevented by administration of rubella vaccine during
pregnancy
C. HIV virus infect the baby more readily when delivered vaginally than
caesarean section
3. Uterine Cervix
A. Is the portion of the uterus below the isthmus
B. External OS cell lining is columnar epithelium
C. Laterally is attached to the round ligament
4. Polyhydramnios is commonly found with

A. IUGR
B. Placenta previa
D. Fetal renal agenesis
E. Diabetes mellitus

A. Vertex presentation
B. Face presentation
246
C. Shoulder presentation
D. Breach presentation
E. Hydrocephalic baby

A. Combined oral contraceptive pills
B. Male condom
C. Female condom
D. Diaphragm
7. The Commonest uterine fibroid to cause excessive bleeding is

A. Submucous fibroid
B. Subserous fibroid
C. Intramural fibroid
D. Cervical fibroid
E. Broad ligament fibroid
8. All the following infection can be transmitted through sexual intercourse,

EXCEPT:
A. Genital herpes
C. Chlamydia
D. Gonorrhea
E. Vaginal Candidiasis

C. Immediate evacuation should be done once the diagnosis is made
D. Disseminated intra-vascular coagulation may occur as a sequele of
missed abortion

B. On danazol therapy
D. Patient on oral contraceptive pills
247
A. Polyhydramnios
B. Abortion
C. Preterm labor
12. All these drugs can be used as tocolytic to stop labor, EXCEPT:
B. Diazepam (valium)
E. Ritodrine (beta agonist)
A. Sheehan syndrome
C. Premature ovarian failure

A. Amenorrhea
B. Hegar's sign
D. Auscultation of fetal heart
15. All these tests can be useful in management of intrauterine fetal growth
restriction IUGR except:
A. Fetal kick chart
248
D. After complete abortion there is minimal or no pain and minimal or no

bleeding
E. Follow up with BHCG for one year
stage is at least:
A. IA
B. 1B
C. IC
D. IIA
E. III
18. In patients with three consecutive spontaneous abortion in the second

trimester the most useful investigation is:
D. Post coital test
E. Prolactin level
19. If your patient is 8 weeks pregnant which one of the following USS
measurement is most useful
B. Biparital diameter
C. Femur length
D. Placental site

E. Chorioamnionitis

B. Flexion at hip joint and flexion at knee joint
E. Flexion of one leg at hip joint and extension of the other leg at the hip
joint
249
22. Untreated patients with cancer of the cervix usually die with
B. Bowel obstruction
C. Renal failure and uremia
E. Cerebro vascular accident primigravida
23. Regarding cervical incompetence, all of the following are true, EXCEPT:
A. Typically causes painful abortions
C. Is treated by Shirodkar suture (cervical cerclage) which is best preformed
early in the second trimester

A. A chromosomal structure of 45 XY is characteristic
C. Ovaries are streak
25. Which of the following tumors produces estrogen:

B. Choriocarcinoma
C. Granulosa-cell tumors
D. Dysgerminoma
C. The ovaries will be very small in size have unilateral cyst
D. It can diagnosed clinically and by ultrasound

A. To diagnose PCO hormonal analysis can be done at any time of the cycle
250
D. Can only be diagnosed after it has ruptured
E. Is a complication of assisted conception
A. No treatment
B. Myomectomy during pregnancy if red degeneration occurs
C. Myomectomy
D. Hysterectomy
E. GnRH agonist
30. Evaluation of infertile couples

B. History of severe dysmenorrhea and dyspareunia is suggestive of
endometriosis
31. Treatment of infertility

A. Clomiphene citrateis helpful in patients with anovulator premature
ovarian failure
B. Ovarian drilling is helpful in the treatment of infertility endometriosis
D. Hyperstimulation syndrome can occurs in patient treated by
gonadotropins
E. Spontaneous pregnancy can occur in patients with Mullerian agenesis

A. Uterine fibroid
B. Maternal pulmonary hypertension
C. Placenta previa
33. All of the following possible causes of infertility, EXCEPT:

A. Previous laparotomy for any reason
B. Smoking
C. High body mass index
D. PCO
E. Uterine subserous fibroids
251
34. All are true, about acute pyelonephritis in pregnancy, EXCEPT:

A. Occur in 60% of pregnant women
B. Can be preceded with asymptomatic bacteriuria
C. In severe form there should be administered and I.V. antibiotics should
be started
D. when recurrent should be investigated
E. May lead to premature labor
35. Antepartum haemorrhage may be caused by the following, EXCEPT:

A. Placenta previa
B. Cervical cancer
D. Ectopic pregnancy
E. Vasa praevia
36. Sexual differentiation

A. Development of male genitalia depends on the presence of functioning
testes and responsive end organs
B. Due to the absence of testes XX fetus exposed to androgens in uteri will
NOT be masculinized
C. The development of the female genital requires presence of the ovary
D. 45 XO fetus will have normal ovaries
E. The development of the testes does not require presence of the Y
chromosome

A. Cytomegalo virus
B. Toxoplasma
C. Rubella
D. Syphilis
E. Gonorrhea
38. Each of the following typical feature of placenta previa, EXCEPT:

A. Painless bleeding
B. First episode of bleeding is usually self limited
C. May be associated with post coital bleeding
D. Commonly associated with coagulopathy
E. The uterus tends to be soft and tender
39. A 33-year old woman at 37 weeks gestation confirmed by early sonogram

presents with moderate to sever vaginal bleeding, and is note by sonogram to
have placenta previa, which of the following is the best management for her.
B. Give tocolytic drugs
252
C. Caesarean section
D. Expectant management
E. Artificial rupture of the membrane
40. Screening is most effective in preventing which of the following cancers.

A. Vulva
B. Cervix
C. Endometrial
D. Ovary
E. Fallopian tube
41. The tumor marker secreted by endodermal sinus (yolk sac) tumor is
A. Alph-Fetoprotien
B. HCG
C. LDH
D. Inhibin
E. Ca 125
42. Select the most correct statement about fetal and neonatal IgM
A. It is almost entirely maternal in origin
B. It is approximately 75% maternal and 25% fetal in origin
C. It is 50% maternal, 50% fetal in origin
D. It is 25% maternal, 75% fetal in origin
E. It is almost entirely fetal in origin
B. Is commonest in the third trimester
44. Permanent sterilization include all of the following, EXCEPT:

A. Vasectomy
B. Tubal ligation
C. Mirena IUCD
D. Hysterectomy
acceptable in the conservative management
A. Frequent vaginal examination to assess cervical dilatation
253

46. What is true about shoulder presentation

A. Cord prolapse is common
B. 3rd degree perineal tear is common
C. Deep transverse arrest can occur
D. More common in primigravida
E. Always end by shoulder dystocia
47. Surfactant
A. Is secreted by type I pneumocytes
B. Are glycoprotein
C. After 38 weeks the ratio to sphingomyelins is 2:1
D. Its secretion is suppressed by betamethzone
E. Its deficiency lead to adult respiratory distress syndrome
48. Treatment of pelvic inflammatory disease include the following, EXCEPT:

A. Oral doxycycline
B. Removal of IUCD
C. Clindamycin
D. Tetracycline
E. Dilatation and curettage (D & C)
49. In Pre-eclampsia, right upper quadrant part abdominal pain is due.

A. Tension of the liver capsule
B. Cholecystitis
C. Pancreatitis
D. Gastric ulcer
E. Oesophagitis

A. Is due to pelvic anatomic defect
B. patient loses small amount of urine
C. can be diagnosed with stress test
D. Can be treated medically
51. Abruptio placenta

A. Postpartum hemorrhage occurs only when there in hypofibrinogenemia
B. Maternal anemia is a major cause for abruptio placenta
C. Fetus is not usually affected
D. Associated with antecedent hypertension
254
E. On Examination the abdomen is usually soft and lax
52. Placenta previa

A. Is diagnosed when the placenta occupies the funds and start to bleed
B. Recognized to be complicated by postpartum hemorrhage
C. Has a major risk to the fetus
D. Less common in patients with repeat caesarian section
E. Diagnosis is confirmed when bleeding starts at 13 weeks of gestation
53. Postpartum haemorrhage

A. May occur as a consequence of antepartum haemorrhage
B. Ends with hypercoagulable state
C. Hysterectomy is the first the first line of treatment
D. Always complicate intrauterine fetal death (IUFD)
E. Diagnosed only when the placenta is still undelivered
54. Secondary postpartum haemorrhage

E. Choriocarcinoma could be a cause
55. A pregnant lady with polyhydramnios, the cause could be:

A. Fetus with oesophageal atresia
B. Fetus with polycystic kidney disease
C. Fetal growth restriction
D. Hyperprolactinaemia during pregnancy
E. Patient is taking anti epileptic drugs
56. The following have a recognized relation with spontaneous preterm labor
B. Oligohydramnios
D. Bacterial vaginosis
255
427Exams:
Mid-Cycle:
Ob-Gyne 427 girls’ team
1) All the following conditions result in polyhydroamnios EXCEPT :

A.Renalagenesis.
B. duodenal atresia.
C. Spina bifida.
D. Anencephaly.
E. Fetal hydrops
2) The patient is 8 weeks pregnant, which one of the following USS measurement is
most useful:
A.CrownRumplength.
B. Biparietal diameter.
C. Femur length
D. Placental site
3) Which of the following is the most certain method to determine that ovulation has
occurred:
A. Basal body temperature.
B.Pregnancy
C. Increase in LH
D. Cervical mucus is thick
E. Endometrial biopsy
4) The genetic make up of complete hydatiform mole typically is:

A.46,XXpaternalonly.
B. 46, XX maternal only
C. 46, XY paternal only
D. 46 XX, maternal and paternal.
E. Triploidy
5) First stage of labor:

A.Endwithcompletedilatationofcervix. B.
Result in separation of placenta.
C. Is more than 24 hours in primigravida.
D. Should used ergotamine in first stage
256
6) The follicular phase of menstrual cycle is characterized by:

A.Endometrialproliferation.
B. Decreased estrogen
C. Progesterone dominance.
D. Fixed length of 8 days
E. Reduction in aromatase activity.
7) The baseline Heart rate of normal fetus at term is:

A. 80-100 bpm
B. 100-120 bpm
C.120-160bpm
D. 160-180 pbm
8) Which one of the following actions COCP has:

A.Reduceriskofendometrialcancer.
B. Increase risk of ovarian cancer.
C. Reduce risk of breast cancer
D. Reduce risk of cervical cancer.
E. Worsen endometriosis
9) Which of the following is not a common site for endometerosis:

A.Bone
B. Ovaries.
D. Peritoneum
E. Oviduct
10) Fetus of GDM mother has:

A. Hypercalcemia.
B.Hypoglycemia
C. Hypobilirubinemia
D. Hypoinsulinemia
E. Anemia
11) The followings are considered normal symptoms of pregnancy EXCEPT:

A. Backache due to increased lumbar lordosis.
B. Lower abdominal pain due to stretch of round ligaments.
C.Visualdisturbances
E. Increased vaginal discharge
257
12) All of the following infection causes fetal malformation except:

A. Rubella
B. Syphilis
C. Toxoplasma
D.HIV
E. CMV
13) Bishop score includes all the following except:

A. Dilation of cervix.
B. Position of cervix
C.Thepositionofthefetus
D. Length of the cervix
E. Consistency of cervix
14) Partogram:
A.Evaluatetheprogressionoflabor. B.
Is done before diagnosis of labor.
C. Is used by the patient to record the uterine contractions.
15) All the following is true about symptoms of fibroid EXCEPT:

A.Irregularcycleswithhypomenorrhea
B. Cause anemia
C. Heavy bleed with normal length
D. Dysmenorrhea
16) The second stage of labor:

A. separation of placenta
B. effacement of cervix
C. expulsion of placenta
D. dilation of cervix
E.expulsionoffetus
17) Regrading fertilization and implantation:

A. Fertilization occurs in inner third of the fallopian tube.
B.Thespermheadpenetratesthroughthecoronaradiataandzonapellucida while
thetailremainsoutside.
C. The second meiotic division is completed before fertilization.
D. Implantation occurs in morula stage
E. The trophoblast invades the endometrium and differentiate into outer
cytotrophoblast and inner cyncytiotrophoblast.
258
18) Most common cause of postmenopausal bleeding is:

A.atrophicvaginitis
B. Endometrial cancer
C. Endometrial hyperplasia
D. Endometrial polyp
19) Most definitive treatment for preeclampsia is:

A. IV magnesium sulphate
B. Diazepam.
C.Delivery
D. IV hydralazine
E. IV labetalol
20) All of these are normal changes in pregnancy EXCEPT:

A. increase plasma volume.
B.DecreaseRBCmass
C. Increase stroke volume
D. Increase cardiac output
21) Mechanism of action of IUCD, all EXCEPT:

A. changes tube motility.
B. Endometrial changes
C. Inhibits fertilization
D. Inhibits implantation.
E.Changescervicalmucus.
(we asked dr. Amel about it)
22) Absolute contraindication to OCP, all EXCEPT:

A. smoking and over 35 years .
B.FamilyhistoryofBreastcancer C.
Undiagnosed vaginal bleeding D.
Ischemic heart disease
E. DVT
23) Early deceleration is :

A. Associated with unengaged head
B. Associated usually with brain hypoxia
C. Decrease in the fetal beat that peaks after uterine contraction
D. Indication of c-section.
E.Resultsfromincreasedvagaltonesecondarytoheadcompression.
259
24) Physiological changes in reproductive system during pregnancy:

A. No changes in vagina PH.
B.Theuterusfirstenlargesbyhyperplasiaandthenhypertrophy
C. There’s no change in the cervix
D. Estrogen has no role in changes that occurs during pregnancy
E. Lower segment of the uterus will be formed in the 1st trimester.
25) Contraindication to induction of labor:

A.classicalc-section
B. Choroamniotits.
C. Post date
D. Severe PET at 36 weeks
E. GDM
26) antenatal Booking investigations include the following EXCEPT:

A. Glucose
B. CBC
C. Hepatitis
D. Toxoplasma
E.BetaHCG
27) First sign of puberty:

A.Buddingofbreasts.
B. Pubic hair
C. Menstruation
D. Growth changes
E. Changes in voice
28) Most common cause of breech presentation:

A.Prematurity.
B. Advanced maternal age
C. Fibroid
D. Uterine anomalies
E. Polyhydraminos
29) antepartum hemorrhage maybe caused by all the following EXCEPT:

A. placenta previa
B. cervical cancer
C. abruptio plcenta
D.ectopicpregnancy
E. vasa previa
260
30) PPH:
A.maybeaconsequenceofanantepartumhemorrhage
B. always ends with DIC
C. the most common cause is retained placenta
31) Give anti-D treatment in:

A. Rh-ve non-pregnant women in amniocentesis
B. Rh+ve women with threatened abortion
C. Rh- women with Rh- baby
D. Rh+ women with Rh- father
E.Rh-vewomenwiththreatenedabortion
32) All of the following are fetal complications of perinatal Toxoplasmosis infection
EXCEPT:
A.Spinabifida
B. hepatosplenomegaly
C. Hydrocephalus
D. brain calcification
E. chorioretinitis
33) Which of the cases is considered primary amenorrhea:

A. PCO
B. Bicornate uterus
C. Sheehan syndrome
D.Imperforatedhymen
34) the time that spermatogonum takes to transform to spermatozoa:

A. 52 days
B. 62 days
C. 72 days
D. 82 days
35) The terminology of pelvic inflammatory diseases indicates:

E.Endometritisandsalpingo-oophoritis
36) Corpus luteum:

A.Supportthefirstweeksinpregnancy
B. All the way till the end of pregnancy
261
37) which statement is correct?

A. Lie → vertex
B. Position →longitudinal
C. Presentation → occipioanterior
D.Thestationofthebabyis0atischialspines
38) The order of cardinal movements in labor:

A. Engagement, internal rotation, flexion
B.Engagement,descend,flexion,internalrotation
C. Descend, engagement, flexion
D. Internal rotation, flexion, decent, engagement.
E. Engagement, flexion, internal rotation.
39) For low risk gestational trophoblastic tumor, which drug should we use:
A.Methatoxrate
B. Etoposide
C. Actinomycin D
40) The luteal phase of the menstrual cycle is associated with:

B.Highprogesteronelevels
41) Changes in the urinary tract system in pregnancy include:

A.Increasetheglomerularfiltrationrate(GFR).
B. Decrease in renal plasma flow (RPF).
C. Marked increase in both GFR & RPF when the patient is supine.
D. Increase in the amount of dead space in the urinary tract.
E. Increase in BUN & creatinine
42) The most common cause of precocious puberty is :

A.Idiopathic.
B. Gonadoblastoma.
C. Albright syndrome.
D. Abnormal skull development.
E. Granulosa cell tumor.
262
43) All the following hormones are products of placental synthesis, EXCEPT :
A. HCG.
B. HPL.
C.Prolactin.
D. Progesterone.
E. Estriol.
44) Regarding missed abortion, all of the following are CORRECT, EXCEPT:
C.Immediateevacuationshouldbedoneoncethediagnosisismade.
D. Disseminated intra-vascular coagulation may occur as a sequele of missed
abortion
45) Complete breech means:

B.Flexionathipjointandflexionatkneejoint. C.
Extension at the hip joint
E. Flexion of one leg at hip joint and extension of the other leg at the hip joint
46) Regarding Secondary postpartum hemorrhage:

E.retainedplacentaltissuecouldbeacause.
47) Obstructed labor: Which is true?

D.Mento-posteriorpositioncouldbeacause.
primigravida
48) Which of the following is known to be the commonest presentation in twins

A. Breech, cephalic
B. Cephalic, breech
C.Cephalic,cephalic.
D. Breech, breech
263
49) The following are factors affecting the choice of Methotrexate as a choice of
C. Level of BHCG
D.Parityofthepatient
50) Perinatal mortality refers to:

A. Number of stillbirths per 1,000 total births.
B.Numberofstillbirths&neonataldeathsper1,000totalbirths. C.
Number of stillbirths & neonatal deaths per 1,000 live births. D.
Number of neonatal deaths per 1,000 total births.
E. Number of stillbirths & neonatal deaths per 100,000 total births.
51) The followings are causes of Antepartum hemorrhage EXCEPT:

B. Placenta brevia.
C. Cervical polyp.
D. Vasa previa.
E.Rhisoimmunization.
52) The most common reason for postdate pregnancy is:

A.Inaccurategestationalage.
C. Oligohydramnios.
D. IUGR.
53) In patients with three consecutive spontaneous abortion in the second trimester,
B.Hysterosalpingogram
D. Post coital test
E. Prolactin level
54) Gestational diabetes is associated with an increase risk of all the following, EXCEPT:
A. Cesarean section
C. Fetal macrosomia
E.Intrauterinegrowthrestriction
264
55) Risk factors for pre- eclampsia include all of the following, EXCEPT:
D. Positive history of pre- eclampsia in previous pregnancies
E.Positivehistoryofmacrosomicbaby
56) A syndrome seen in pre-eclampsia called HELLP syndrome is characterized by all of

the following EXCEPT:
A. Elevation of Liver enzymes.
B. Hemolysis.
C. Low platelet count.
D. Prolongation of the Prothrombin time.
E.Increasefibrinogenlevel
57) Regarding gestational diabetes mellitus (GDM):

C.Thediagnostictestisglucosetolerancetest(GTT).
E. All patients should be delivered before term to avoid complications
58) Diabetes in pregnancy can cause all the following congenital anomalies EXCEPT:
A. Sacral agenesis.
E.Yellowteethdiscoloration.
59) Complications of preeclampsia include all the following EXCEPT:

B. Placenta abruption.
C. Renal failure.
D. DIC.
E.Polycythemia
60) The initial evaluation in an infertile couple should include:

A. Ovarian biopsy.
B.Semenanalysis.
C. D & C.
D. Laparoscopy.
E. Sperm penetration assay.
265
61) With regards to contraception failure, the pearl index refers to:
C.Numberofpregnanciesin100woman-year.
62) Compared with a midline episiotomy , an advantage of mediolateral episiotomy :

A. ease of repair
B. fewer break downs
C. lower blood loss
D. less dyspareunia
E.lessextensionoftheincision
63) A preterm birth is defined as:

A.before37completedweeksgestation
B. prior to the period of viability
C. weighing less than 1000 g
64) Uterus at the level of umbilicus is at:

A. 10 weeks
B. 12 weeks
C. 16 weeks
D. 20 weeks
E. 24 weeks
65) One of the following is an indication of emergency lower transverse c-section :

A. Previous lower transverse c-section
B. Patient with prolapsed cord and a dead fetus
C. Cardiac disease of the mother
D. Multiple gestation
E.Prolongedlaborduetobrowpresentation
66) All of the followings are risk factors of preterm labor except :
A. UTI
B.vaginalcandidiasis
C. multiple pregnancy
D. polyhydraminos
E. placenta previa
266
67) All the following is needed to be functional in order to have normal menstrual cycle
EXCEPT:
A. Hypothalamus
B.Posteriorpituitary
C. Endometrium
D. ovary
68) All the following are true about ovarian hyperstimulation, EXCEPT:
A.Theovarieswillbeverysmallinsizehaveunilateralcyst
B. Caused by ovulation induction
C. In severe types, admission to ICU may be required
D. Can be diagnosed clinically & by USS.
E. Patients with PCO has increased risk
69) regarding breast milk all true except: A.

Has less protein than cow’s milk B.
Has more lactose than cow’s milk C.
Has less calories than cow’s milk D.
Isanexcellentsourceofiron
E. Rich in vitamin B
70) Placenta previa can result in all the following EXCEPT:

A. Malpresentation
B. Painless vaginal bleeding
C.Lowerabdominalcramps
71) cervical prolapse common in:

A.Multiparty
B. PID
C. Endometriosis
72) Which of the following does not cause amenorrhea:

A.Endometriosis
B. Anorexia nervosa
C. asherman's syndrome
D. Sheehan syndrome
73) abruptio placenta:

A. Premature separation of abnormally implanted placenta.
B. hypercoagulable state.
C.Canresultinpostpartumhemorrhage
267
74) the fetal station at the level of ischial spine is:

A. -2
B. -1
C.0
D. +1
E. +2
75) endometrosis:
A. Cause preterm menopause
B.GnRHagonistisoneofthemodalityoftreatment
76) All the following are possible causes of menorrhagia,

EXCEPT
A. Uterine fibroid
B. Adenomyosis
E.Combineoralcontraceptivepills
77) epigastric pain in pre-eclampsia is due to:

a. Stretching of the liver capsule
Final:
1) Regarding ovarian carcinoma, all are characteristics of malignancy on US EXCEPT:

A. Large size
B. Contain solid component
C.Ascitis
D. Bilateral
E. Distorted capsule
(we asked dr.Zainab about it)
2) Molar pregnancy associated with all, EXCEPT:

A. Hyperemesis gravidarum
B. Thyrotoxicosis
C. Excessive uterine size
D.Cervicaldysplasia
3) Locked twin occur in:

A. Cephalic - cephalic
B.Breech–cephalic C.
Cephalic – breech
268
D. Breech – breech
4) Urge incontinence, all are true EXCEPT:

A.Canbetreatedsurgically
B. Bladder drill can be performed
C. Needs Urodynamic testing
5) Urine retention occurs in all of the following EXCEPT:

A. Pelvic prolapse
B.Vesicovaginalfistula
C. Infection
6) Urinary Stress incontinence is:

A. The loss is of large amount of urine when intra-abdominal pressure increases.
B. The loss is of small amount of urine when intra-abdominal pressure increases. C.
Inability to control the bladder of all urine
7) A pregnant lady has 10 live children and fetal losses in the following weeks (12, 29, 20,
18, 32).estimate her G,P,A:
G16, P12, A3
8) The largest fetal head diameter is:
Mentovertical diameter
9) A fetus with Occipito- posterior position , all are true EXCEPT:

A. Associated with prolonged labor
B.Fetalscalpelectrodeiscontraindicated
C. Most of them rotates spontaneously to occipitoanterior
10) Cervical cancer:

A. Oral contraceptive reduce its incidence
B.malecondomsmayprotectfromit
11) the fundal height of a pregnant lady at the xiphoid process is at:
36 weeks
12) regarding puerperium :

A. breast feeding is contraindicated in hepatitis B s antigen positive of the
mother
B.within14daystheuterusisnotanabdominalorgananymore
C. a fever within 4 days indicates mastitis
269
13) all are used as tocolytic drugs EXCEPT:

A. Antioxytocins* (not sure)
B. Anticholinergics
C. Ca channel blockers
D. B agonists (Ritodrine)
E. Prostaglandin synthesis inhibitors
14) CTG, all are considered normal EXCEPT :

A. Increased acceleration
B.Prolongedbradycardiaisprobablyduetofetalsleep
15) In endometrial Ca, the stage when invading less than 50% of the myometrium is:
IB
16) In cervical cancer, the stage when hydronephrosis develops is:

III
17) In cervical cancer, the stage when invading the parametrium but not reaching the
lateral walls of the pelvis is:
IIB
18) Nuchal translucency is a marker of:

A. Congenital anomalies
B.trisomy
19) A 16 years girl came to you with primary amenorrhea. She scores Tanner 1 in breast
development with normal developed external genitalia. The next step is:
A.karyotyping,FSH/LHratio
B. US
20) All are associated with 2ndry amenorrhea EXCEPT:

A. Sheehan syndrome
C. PCO
D.Mullerianagenesis
21) Amenorrhea with failure to lactate is found in:

Sheehan syndrome
22) All are fetal complications of forceps EXCEPT:

A. Facial palsy
B. Sepsis*(probably this is the answer because it says fetal )
C. Intracranial hemorrhage
270
D. Convulsions*
23) All are signs of placental separation EXCEPT:

A. The uterus is rigid & globular
B. The cord is elongated
C. Gush of blood
D.Theuterusissoft&atonic
E. The fundus rises
24) The most common cause of candida infection is:

A. Sexually transmission
B.Antibioticuse
25) The most common cause of maternal mortality is:

A. Preclamsia
B.Uterinehemorrhage
C. Gestational diabetes
26) The leading cause of perinatal mortality is:

A. Congenital anomalies
B. Infections
C.immaturity
27) The most common cause of perinatal morbidity & mortality is:
preterm labor
28) Apgar score, which is true:

A.whenscorelessthan6in1minneedsresuscitation
B. the first minute score is an indication of fetal outcome for the first week
29) The mechanism of OCP is:

inhibit gonadotrophins
30) A heavy painful regular period is associated with:

A.fibroids
B. PCO
31) Episiotomy:
A. Usually done laterally
B. For all primigravida
C.Donewhenfetalheadisalreadycrowned
32) The most common cause of Secondary amenorrhea is:

Pregnancy
271
33) The following are theories of endometriosis EXCEPT:

A. Retrograde menstruation
B.Endometrialhyperplasia
C. Immunological factor
D. Coilemic metaplasia
E. Lymphatic spread
34) The treatment of endometriosis, all EXCEPT:

A. GnRH agonists
B. OCP
C. Danazol
D.estrogen
35) Beta HCG doubling occur every:
48 hrs
36) all causes urinary tract infections EXCEPT:

A. Sickle cell disease
B.Increasedpelvicbloodflow
37) The term Neonates :

From birth till 28 days
38) A pregnant lady present with a unilateral leg swelling and a suspicion of DVT, the
best diagnostic method is:
A. US Doppler* (not sure)
B. D- Dimer
C. Venography
39) Chronic pelvic pain is associated with all the following EXCEPT:
A. Endometriosis
B. PID
C.Vulvarcancer
40) All are immediate C/S complications EXCEPT:

A. Hemorrhage
B.Adhesions
C. Infection
41) All are considered vulvar lesions EXCEPT:

A. Bartholin abscess
B.Nabothiancyst
C. Syphilis chancre
272
42) A patient with recurrent Chlamydia infections presents with infertility, it is mainly
due to:
A.Tubalblockage
B. Ovarian failure
43) Testicular feminization:

A. Karyotype is 46 XX
B. There is verilization
C.Presentwithprimaryamenorrhea
D. High androgens
44) Monozygotic twins:

A. Always monochrionic monoamniotic
B. Results from 2 ovums
C.Mayleadtoconjoinedtwin
45) Forceps are used in all the followings EXCEPT:

A. Prolonged 2nd stage of labor
B.Fetaldistressin1ststage
C. After coming head in breech
46) Regarding vaginal birth after C/S, all true EXCEPT:

Prior classical C/S
47) All are considered antenatal assessments EXCEPT:

A. Non stress test
B. Biophysical profile
C.Apgarscore
48) Hyperemesis gravidarum occur in all the following EXCEPT:

A.Missedabortion
B. Multiple gestation
C. Molar pregnancy
49) Rh antibodies are given for all EXCEPT:

A. Rh –ve with threatened abortion
B. In an already sensitized Rh –ve mother
C. Within 72 hrs after delivery
50) Obstetric examination , choose the correct statement:

A. Auscultation is not important
B.Weusuallyreportthefetalengagementbythefifthofheadinrelationto pelvic
brim
273
51) Eclampsia is prevented by:

Mg sulphate
52) A 16 years old girl with a pelvic mass, all the following investigation should be done
EXCEPT:
A. US
B. Hormonal profile
C.PAPsmear
53) All are antenatal surveillance EXCEPT:

A. Biophysical profile
B. Kick chart
C. Non stress test
D.Fetalscalpsampling
54) Sex cord tumors of the ovary including:

A. Endometriod
B. Teratoma
C.Granulosacelltumor
D. Serous epithelial carcinoma
55) Androgen secreting tumor is:

Theca cell tumors
56) Endodermoid sinus secretes:

A.Alphafetoprotein
B. Estrogen
C. CA 125
D. LDH
57) Screening is most effective in preventing which of the following cancers:

A. Vulva
B.Cervix
C. Endometrial
D. Ovary
E. Fallopian tube
58) All are risk factors for endometrial CA EXCEPT:

A. Exogenous estrogen
B. Nulliparity
C. Obesity
D.OCP
274
59) Ovarian CA, choose the correct answer:

OCP reduces its incidence
60) Polyhydraminos occur in all EXCEPT:

A. GDM
B.IUGR
61) Breech presentation is common in all EXCEPT:

A. Previous breech
B.Primigravida
D. Placenta previa
62) Best C/S is:

A. Classical
B.Loweruterinetransversesection
C. Lower uterine longitudinal section
63) The most common cause of postmenopausal bleeding is:

Atrophic vaginitis
64) Estrogen is the treatment of:

A. Endometriosis
B. PCO
C.Atrophicvaginitis
D. Endometrial CA
65) In Preclampsia, all true EXCEPT:

Increase urine output
66) Untreated patients with cancer of the cervix usually die with :
B. Bowel obstruction
C.Renalfailure
E. Cerebrovascular accident primigravida.
67) In preeclampsia, the correct statement:

Increase in plasma uric acid
275
428Exams:
Mid-Cycle:
Females
These are the MCQs that came in the exam. We are not 100% sure of the
answers.
HUGE Thanks to Deema Hafez.
Good luck
Hala Alrugaib
MCQsfrom“AllaboutOB-GYNMCQs”Booklet:

A. Amenorrhea
B. Hegar's sign
D. Auscultationoffetalheart
B. Iscommonestinthethirdtrimester

B. Anti-progesterone
C. Beta sympathomimetic agonist
D. Synthetic estrogen
E. Medroxy-progesterone
4. The heart rate of a normal fetus at term:

A. 80-100 bpm.
B. 100-120 bpm.
C. 120-160 bpm.
D. 160-180 bpm.
276
5. APGAR's score includes all the followings EXCEPT:

A. Skin color.
B. Muscle tone.
C. BloodpH.
D. Heart rate.
E. Respirations
6. In cases of androgen insensitivity syndrome the following findings are true EXCEPT:
A. Thechromosomalsexis46XX
B. Scant or no pubic or axillary hair.
C. No uterus.
D. Normal female external genitalia.
E. Breast are usually well developed.
7. The normal sequence of pubertal changes in the female is:

A. Thelarche,Maximalgrowthvelocity,menarche.
B. Maximal growth velocity, Thelarche, menarche.
C. Thelarche, menarche, maximal growth velocity.
D. Menarche, maximal growth velocity, Thelarche.
E. Menarche, body weight, Thelarche.
8. An unstable lie is related to all of the following EXCEPT:

A. Prematurity.
B. Grand multiparty.
C. Placenta previa.
D. Fundalfibroid.
E. Cervical fibroid.
9. What is the station where the presenting part is at the level of the ischialspines
A. -2 .
B. -1 .
C. 0 .
D. +1 .
E. +2 .
10. The normal cord pH is :

A. 6.1.
B. 6.2.
C. 7.0.
D. 7.1.
E. 7.2.
277
11. All the following hormones are products of placental synthesis, EXCEPT :
A. HCG.
B. HPL.
C. Prolactin.
D. Progesterone.
E. Estriol.
B. Diazepam(valium)
E. Ritodrine (beta agonist).

A. Cytomegalovirus.
B. Toxoplasma
C. Rubella
D. Syphilis
E. Gonorrhea
14. The following has a recognized relation with spontaneous preterm labor:
B. Oligohydromnios
D. BacterialVaginosis
15. Anti-D prophylaxis:

B. ShouldbegiventoallRhesusnegativewomenafteramniocentesis.
negative babies.
E. Is contra-indicated during pregnancy if the women is Rhesus negative

B. Common in post term labor
C. Vacuum extraction can be used when cervix is fully dilated
D. Forcepscanbeusedforaftercominghead
E. External cephalic version is best performed between 32-34 weeks gestation.
278

E. Pre-eclampsia

C. Labetalol ingestion
D. Post maturity

20. The most common cause of uterine size-date disproportion:

A. Fetal macrosomia
B. Polyhydramnios
C. Inaccuratelastmenstrualperioddate
E. Molar pregnancy.

C. Maybecausedbycervicalcarcinoma

most likely reveal.
E. Anintactgestationalsacwithfetal
279

A. Historyofpelvicinflammatorydisease
C. Endometriosis
D. Tubal surgery
24. The most common etiology for spontaneous abortion of a recognized first
trimester gestation:
A. Chromosomalanomalyin50-60%ofgestations.
B. Chromosomal anomaly in 20-30% of gestations.
C. Maternal hypothyroidism.
D. Maternal Diabetes.
E. Progesterone deficiency.
25. The most common mass associated with amenorrhea in a reproductive age women
is:
A. Follicular cyst.
B. Corpus luteal cyst.
C. Benign cystic teratoma.
D. Leiomyoma.
E. Pregnancy.
26. Which of the following is contraindication for delivery using vacuum extraction?
A. Facepresentation
E. Chorioamnionitis
27. The risk of postpartum uterine atony is associated with:

A. Hypotension.
B. Epidural anesthesia.
C. Median episiotomy.
D. Twinpregnancy.
E. Labor associated with an active rate of change of 2.3 cm per hour.
28. Which of the following is an indication for induction of labor:

A. Placenta previa.
B. Post-termgestation.
D. Prior classical C-section.
280
29. In case of threatened abortion :

A. Fetalheartispresent B.
Cervix is dilated
C. There is a history of passing tissue per vagina.
D. Patients needs immediate evacuation
E. No need to give anti-D for Rhesus negative mothers

A. Historyofpelvicinflammatorydisease
C. Endometriosis
D. Tubal surgery

delivery?
A. Priorclassicalincision.
C. Prior IUFD.

A. Inaccurategestationalage.
C. Oligohydramnios.
D. IUGR.
33. You are called to the operating room to evaluate a pelvic mass in infant girl.
Laparoscopy shows a 3-cm cystic mass in the broad ligament between the fallopian
tube & the Ovarian hilum. You recommend:
A. Observation.
B. Cyst aspiration.
C. Cystectomy.
D. Adenxectomy.
E. Laparotomy.
34. Therapy in threatened abortion should include:

A. Progesterone IM
B. D & C
C. Prolonged bed rest
D. Restrictedactivity
E. Prostaglandin suppositories
281
35. Which of the following is correct in the treatment of a case of threatened

abortion :
A. Bedrest
B. Oral stillbosterol
C. Curettage
D. Urgent admission to hospital
E. I.M Tranexamic acid
36. Which of the following neonatal morbidities is not related to forceps delivery?
A. Fractured skull
B. Sepsis
C. Nerve palsies
D. Cephalohematoma
E. Convulsion
37. Oxytocin in the Puerperium is associated with :

A. Involutionoftheuterus
B. Initiation of lactation
C. Resumption of menses
D. Sub-involution of the uterus
E. Post partum mastitis
38. Ergometrine to control post-partum hemorrhage :

A. Iscontraindicatedinpatientwithhighbloodpressure
B. It will not act on the smooth muscle of the blood vessels
C. Intravenous root is the only way to be given
D. It can be used for induction of labor
E. Is safe in cardiac patient
39. Inhibition of prostaglandin synthesis are not generally used for tocolysis because
they:
A. Are effective
B. Produce marked hypertension
C. Maycauseprematureclosureofthefetalductusarteriosus
D. Are too expensive
E. Are associated with lactic acidosis
40. Which of the following is the most likely causes of a fever in a women on the
second day postpartum:
A. Pneumonia
B. Endometritis.
C. Mastitis
D. Cholycystitis
E. Thrombophlebitis
282
41. A 25 primigravida with 8 weeks threatened abortion. The US would most likely
reveal :
A. Thickened endometrium with no gestational sac.
B. Fetal heart motion in the adnexia.
C. Empty gestational sac.
D. Anintactgestationalsacwithfetalheartmotion.
E. Collapsed gestational sac.
42. Regarding Submucous uterine fibroids all of the following are correct EXCEPT:
A. May become polypoidal.
B. Can become infected.
C. Frequentlycauseinfertility.
D. Often present with menorrhagia.
E. Can be removed hysteroscopically.
43. In cases with premature rupture of membranes, all the following are acceptable in
the conservative management
A. Frequentvaginalexaminationtoassesscervicaldilatation
44. Which of the following causes of polyhydramnios is more common:

A. Twin pregnancy.
B. Diabetes.
C. Hydrops fetalis.
D. Anencephaly.
E. Idiopathic.

A. IUFD
C. Iron deficiency
D. Diabetic mother
EXCEPT:
A. Cesarean section
C. Fetal macrosomia
283
E. Intrauterinegrowthrestriction

E. Ergometrineshouldbeavoidedinthethirdstageoflabor
B. Incidence of oligohydraminos
E. Riskofmaternalcomplicationssuchasstroke
49. Early clinical evidence of magnesium sulfate toxicity would show:

A. Flushing
B. Diplopia
D. Loss of deep tendon reflexes E.
Headache
50. Side effects of β sympathomimetics include all of the following, EXCEPT:

A. Tachycardia
B. Pulmonary oedema
C. Headache
D. Prematureclosureofductusarteriosus
E. Palpitation
51. GDM is associated with an increased risk of all the following EXCEPT:
A. C-section.
B. Shoulder dystocia.
C. Fetal Macrosomia.
D. IUFD.
E. IUGR.
52. Sickle cell:

B.Increasestheriskofurinarytractinfections.

A. Is due to pelvic anatomic defect.
284
B. Patient loses small amount of urine.

C. Can be diagnosed with stress test.
D. Canbetreatedmedically.

B. Gonadotropins secretion falls.
C. Recurrentvaginalbleedingshouldbeinvestigatedbyendometrialbiopsy.
D. Malignancy is the leading cause of post menopausal bleeding.
E. Bone mineral density increases.
A. Altered tubal motility
B. Altered endometrium
C. Alteredcervicalmucus
56. Which of the following factors predispose to genital prolapse:

A. Repeated LSCS
B. Multiparty
D. Endometriosis
E. Repeated Candidiasis
relaxation?
A. Spinal block.
B. Caudal.
C. Nitrous oxide.
D. Halothane.
E. Paracervical.

EXCEPT:
C. May cause amenorrhea.
D. Shouldnotbegiventolactatingmother.
E. Does not carry a risk of venous thrombosis.
59. After menopause

A. There is increase vaginal acidity.
285
B. Gonadotropins level falls.

C. There is increase in bone density.
D. The size of an existing fibroid increases.
E. Anypostmenopausalbleedingshouldbeinvestigatedbyendometrial
sampling.
60. Menorrhagia is:

C. Heavymenstrualcyclemorethan80ml

A. HIV.
B. Chlamydia.
C. Gonorrhea.
62. Contraindication of OCP, EXCEPT:

A. IHD
B. Previous DVT
C. Previous CVA
D. Family Hx of Breast Carcinoma.
E. 35Y,smokes>15cigaretteperday.
63. Feature characteristically associated with imperforated hymen in a 16 yearold girl

include :
A. Acuteretentionoftheurine
B. Absence of secondary sexual characteristics.
C. Hirsutism.
D. Short stature.
E. Present with secondary amenorrhea.
A. Estrogen.
B. FSH.
C. Progestrone.
D. LH.
E. Prolactin.

A. Condom.
B. OCP.
286
C. IUCD.
D. Spermicide.
66. Postulated mechanism of action of IUD includes all the following, EXCEPT :
A. Alterthecervicalmucous.
B. Alter the endometrium.
C. Inhibits fertilization.
D. Alter the tubal motility.
E. Inhibition of implantation.
67. Which of the following is an absolute contraindication to the use of COCP?

A. Varicose veins.
B. DM.
C. Seizure disorders.
D. Recenthistoryofdeepvenousthrombosis.
E. Mild essential hypertension.
68. A 38 year old woman is seen for the evaluation of a swelling in her right vulva. She
has also noted pain in this area when walking and during coitus. On examination a
mildly tender flactuant mass was noticed just outside the introits in the right vulva.
What the most likely diagnosis ?
A. Bartholin'sabscess.
B. Lymphogranuloma venerum.
C. Chancroid.
D. Vulva carcinoma.
E. Herpes infection.
69. What is the association of ovulation induction for fertility and multiple births ?
A. Decreases the incidence multiple pregnancy.
B. Increasestheincidencemultiplepregnancy.
C. Increases the incidence of only dizygotic twins.
D. Doesn't affect the incidence of twins.
MCQsfromDeema:
70. case about pregnant lady came with brupto placenta + fetal death
induction of labor
71. case of 37 week pregnant woman came with severe bleeding + ultrasound showed
no placenta previa
c - section
72. all these infection came with abnormality to the fetus except :
HIV
287
73. organogenesis complete in week :

I don't know
74. about fetal circulation :

the highest oxygenation blood goes to the upper part & brain
75. the nerve that doesn’t innervate the vulva:

I’m not sure but i choose the nerve in the thigh - the other option was heamorroidal
76. predispose factor for uterine prolapse:

obesity
77. dysfunctional uterine bleeding which one is correct:

extreme age are the most affected
78. complete molar pregnancy:

46 xx paternal source only
79. hystosalpingogram:
I’m not sure I choose that it's measure the functional lf the tube but when I asked
the doctor about it he said it just shows the anatomy not the function
so I guess the answer is it used to diagnose the uterine adhesion
80. In the development of the embryo the true is:

spiral artery are found in the endometrium
81. about the physiology of pregnancy:

decrease urea in the serum
82. all of the following comes with separation of the placenta except:
fundus still high
83. we induce labor in:

post date pregnancy
84. amniotic volume:

could be predictable by ultrasound
85. Monozygotic pregnancy:

can be conjoined
288
86. fibroid:
can associates with malpresentation
87. fibroid:
most of the patient only conservative management
88. gestational trophoplastic come with all except:

cervical dysplasia
89. about head engagement:

I’m not sure I choose that it's happen in multigravida faster than the primagravida
90. 30 week pregnant woman with breech presentation. How to manage?

ignore her
91. progesteron injection all correct except:

we don't give it to woman who is lactating
92. drug that alter the OCP mechanism:

anticonvulsant
93. absolute indication for c- section:

previous classical c-section
94. primary amenorrhea:

mullerian agenesis
95. androgen insensitivity:

breast well developed
96. all can be complication in using the forceps except:

sepsis
97. hypothalamic releasing hormone:

I don't know choose that it’s a glycoprotein
98. nonimmuno hydrops include all the following except:

I don't remember
99. low dose of heparin to a lady who is going to major surgery:

I don't remember also
289
Final:
Collected by: Areej Almweisheer, Lu'lu'ah Al bakr, Rowayda Mishiddi, Deemah Al-Ateeq,
Deema Hafez, Alhanouf Alsughier, Batol Alshahrani and Hala Alrugaib
1. Early deceleration:
A. Associated with unengaged head of the fetus
B. associated usually with brain asphyxia
C. a decrease in fetal heart beat that peaks after peak of uterine contraction
D. indication of C- section
E. result from increased vagal tone secondary to head compression
2. Climacteric symptoms all accept:

A. Flashes go away after 1 month
3. Postmenopausal changes include all except:

A. Increase vaginal acidity
B. vaginal dystrophy
C. night sweats
D. Mood disturbance.
4. Most cause of maternal mortality in KSA is:

A. Thromboembolism.
B. uterine hemorrhage.
C. Septic.
D. Cardiac disease.
5. OCPs are absolute contraindication in which of the following :

A. recurrent thromboembolis
B. migrane headache
C. hypertension
6. dermoid cyst :
A. a germ cell tumor
B. are 20% malignant
7. all are epithelial cell tumor except :

A. granulose cell tumor
B. endometiod tumor
C. Serous tumor
D. clear cell tumor
E. muscinous tumor
8. Candidacies is associated with:

A. DM
290
9. Poor prognosis of gestational trophoplastic neoplasms is :

A. less than 35 y/O
B. no previous chemotherapy
C. previous term pregnancy
D. short nterval after pregnancy
10. Heavy, painful, regular cycles are with:

A. adenomyosis
B. dysfunctional uterine bleeding
C. PCO.
11. endometriosis all true except :

A. often asymptomatic
B. have a vaginal discharge
C. Is associated with infertility
12. Which is a gonadotropin :

A. FSH
B. estrogen
C. oxytocin
D. progesterone
E. Estradiol
13. 26 y/o women complaining of amenoriah and increased FSH and LH , what is the most
probable diagnosis?
A. Premature ovarian Failure
B. Sheehan syndrome
C. Asherman syndrome
14. A 16 years old girl with a pelvic mass, all the following investigation should be done
EXCEPT: *not sure of the History*
A. US
B. Hormonal profile
C. PAP smear
D. MRI
15. Induction of ovulation could cause :

A. hyperstimulation ov. Syndrome
16. Regarding puerperium:

A. fever and engorged of breasts in second day after delivery
B. post partum depression is 50%
C. uterine fundus should not be palpable abdomenally in 14 w PP
291
17. All are skin changes in pregnancy except:

A. hyperpigmentation
B. linea nigra
C. spider vavi
D. ….. eruption in pregnancy
18. Asymmetris IUGR are correct except :

A. Smaller abdomen
B. Always end by c-section
19. Obstructive labor :

A. May be caused by malpresentation of baby
B. X – primetry is necessary in primagravida
20. All causes large uterus except :

A. polyhydramnios
B. Fibroid
C. Transverse lei of the baby
21. The second stage of labor:

E. End by delivery of the baby
22. It is not given a trial for labor after a c-section of:

A. Classical incision
23. What is true about turner syndrome:

A. streak ovaries
B. phenotypically male
24. Causes of Ammenorrhea, except:

A. Sikle cell triat
25. fallopian tube are:

A. Have an isthmus which is located distaly.
B. derived from mullarian duct
C. Is lined by squemaous epitheliem.
26. All happens in preeclamplsia except :

A. seizures
292
27. Happens in pregnancy: A.

decrease iodine B.
decrease globulin C.
Increase free T3
D. Increase free T4
28. We usually do c – section rather than expectant management in premature rupture in:
A. No chorioamnionitis
B. placenta abruption
C. If the patient was 35 weeks
29. All are true about pyelonephritis except:

A. We always treat by deleivery
B. Usually is proceeded by asymptomatic bacteririts
C. May need hospitalization and IV antibiotics
30. Cervical cancer – exceed to parametrium but not the pelvis wall, which stage is it?
A. IIB
31. Molar pregnancy –> evacuation???
32. All are involved in menestration except:

A. hypothalamus
B. Ovaries
C. Endometrium
D. Posterior pituitary
33. Women who had Chlamydia infection 3 years back is now complaining of infertility,
which is the most likely cause?
A. Tubal factor
B. Anovulation
34. Anovulation in all except:

A. obesity
B. PCO
35. Urinary retention in all except:

A. uterovaginal fistula
B. after surgery to fix urine incontinence
36. Which is true about eclampsa:

A. Ergometrine is used in 3rd stage of labor
B. always do a c- section
37. A women having seizures you do US to see all except:

A. Fetal heart tone
293
B. Fetal growth
38. What is the medication used in eclampsia

A. MgSO4
39. In insulin dependent diabetes mellitus:

A. IUGR
40. Diagnostic test of GDM is:

A. Glucose tolerance test
41. Alpha-fetoprotein is increased in all except:

A. trisomy
B. IUFD
D. nural tub defect and duodenal atrasia
42. Increase in hCG in :

43. Grand multiparity is a risk of all of the following except:

A. Uterine rupture
B. Preeclampsia
C. DM
D. PPH
44. Regarding anemia:

A. The most common cause is iron defency anemia
45. A women is pregnant now, she had lost 3 fetuses in (2 at age 32 and one at age of 18
weeks of gestation:
A. G4 P2+1
B. G4 P3+0
C. G4 P0+3
D. P2+1
E. P1+2
46. Infertility:
A. You give rubella before stating the treatment
B. 5% of couples
C. Female factor is the main cause of 2ry infertility
47. Hyperplasia of the endometrium comes with which type of tumor:

A. Granulose cell tumor
294
48. IUGR may be caused by all except :

A. obesity
49. Methotrexate Treatment in ectopic is contraindicated if:

A. β-hCG < 1500
B. No fetal heart.
C. Hemoperitonium
D. Gestational sac < 3 cm
50. 2nd trimester hyperemesis is caused by all except:

B. Gastritis
C. cholistitis
51. All are chromosomal abnormalities except:

A. Congenital adrenal hyperplasia
52. Which is the pathophysiology in PET:

A. Increase uric acid

A. Increased LDH
B. Increased AST.
C. Increased platelets.
D. Increased ALT.
54. All causes PPH except:

A. IUGR
55. Which occurs in breech presentation when vaginaly Delivery:

A. Cord avultion
B. head compartment
56. Complications of D&C:

A. Asherman syndrome
57. The largest diameter in fetal head is:

A. mentovertical
58. Postpartum women with PPH and can not lactate her baby:
A. Sheehan syndrome
59. Feature of Preterm all except:

A. hyperthermic
295
60. In prenatal infection:

A. Rubella can be prevented by administration of rubella vaccine during pregnancy.
B. Toxoplasma is a virus.
C. HIV virus infects the baby more readily when delivered vaginally than
cesarean section.
D. CMV causes macrosomic babies.
E. In HIV patients, breastfeeding is encouraged.
61. Which is right regarding procedures?

A. Colposcopy – T zone
62. Most common cause of PM bleeding is:

A. Atrophic vaginitis
63. When auscultating a pregnant women all could be herd except :

A. 3rd heart sound
B. systolic murmur
C. diastolic murmur
64. With regards to contraception failure, the pearl index refers to:
C. Number of pregnancies in 100 woman-year.
65. In hydrops all except:

A. polycythemia
B. edema
C. asitis
66. Anti – D is given to all except:

A. External cephalic version
B. Threatened abortion
C. Already sensitized mom
D. Within 72 hours after delivery.
67. Kleihauer-Betke test is done for:

A. fetal blood in maternal blood
68. A pregnant lady already sensitized, you took an amniotic sample to see :
A. AB
B. Kleihauer-Betke test
C. triple test
D. spectophetometer
296
69. All in urge incontinence except:

A. With stress on exercise
70. A women complaining of sudden desire to go to the bathroom and can’t stop it:
A. Urge incontinence
71. The diagnostic test in ectopic is:

A. US?
72. A 25-year-old primigravida with 8 weeks threatened abortion, ultrasound would most
likely reveal.
E. An intact gestational sac with fetal
C. Immediate evacuation should be done once the diagnosis is made
D. Disseminated intra-vascular coagulation may occur as a sequele of missed
abortion
74. Cervical incompetence:

A. Could happen from cone biopsy
75. All are features of malignant ovaries except:

A. Uniloclar
B. ascites
C. bilateral
D. solid content
E. capsule integrity is disrupted with projections
76. Screening is most effective in preventing which of the following cancers:

A. Vulva.
B. Cervix.
C. Endometrial.
D. Ovary.
E. Fallopian tube.
77. Occipito posterior presentation
78. Forceps complication all except
297
79. Chronic pelvic pain except:

A. Endometriosis
B. Bartholine cyst
C. PID
D. Adhesions
80. The following are possible causes of Polyhydramnios, EXCEPT:

A. Diabetes
E. IUGR

C. Labetaiol ingestion
D. Post maturity
82. OCP side effects:

A. GIT disturbance
Compiled and Edited By:
298

ALL Ob-Gyn MCQS: Compiled and Edited by

Uploaded by

Copyright:

Available Formats

ALL Ob-Gyn MCQS: Compiled and Edited by

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

ALL Ob-Gyn MCQS: Compiled and Edited by

Uploaded by

Copyright:

Available Formats

ALL

424 Exams: ............................................................................................................................ 184

2. The main support of the uterus is provided by

3. The most important muscle in the pelvic floor is:

4. The pelvis includes which of the following bones:

5. The joint between the two pubic bones is called the:

6. The greatest diameter of the fetal head is:

7. Molding of the fetal head:

8. The main blood supply of the vulva is:

9. The following are typical in the female bony pelvis EXCEPT:

10. Regarding fetal head, Choose the CORRECT answer:

11. The ovarian artery is a branch of:

12. The normal lining of the fallopian tube is:

3. All the following characteristics are applied to a pelvis favorable to vaginal

6. The second stage of labor involves:

8. A pelvic inlet is felt to be contracted if :

9. During clinical pelvimerty, which of the following is routinely measured:

11. During clinical pelvimetry, which of the following is routinely measured:

13. A head of level (one fifth) indicates:

14. In a vertex presentation, the position is determined by the relationship of what

15. Signs of Placental separation after delivery include:

16. The persistence of which of the following is usually incompatible with

17. An unstable lie is related to all of the following EXCEPT:

18. The relation of the fetal parts to one another determines:

20. Engagement is strictly defined as:

23. Methods of determining fetal presentation & position include:

E. All of the above.

28. An unstable lie is associated with all the following EXCEPT :

C. Lower blood loss.

30. Which of the following statements about episiotomy if FALSE:

31. Regarding Episiotomy:

32. The first stage of labor :

33. The heart rate of a normal fetus at term:

34. Repetitive late decelerations most commonly indicate:

35. Electronic fetal monitoring:

C. Has low specificity & sensitivity.

36. What is the uterine blood flow at term:

37. Regarding Fetal blood pH:

38. The following are major indicators of fetal asphyxia:

39. Which of the following is NOT a characteristic of normal labor:

40. Bishop score includes all the followings EXCEPT:

42. Regarding Prostaglandins:

43. Early deceleration is :

44. The normal cord pH is :

45. The bishop score is used to predict :

47. The volume of amniotic fluid is:

C. Is reduced in sever rhesus disease

48. Fetal nutrition is dependent on:

49. Cephalopelvic disproportion in the absence of gross pelvic abnormality can be

50. Maternal mortality is lowest in mothers between what age groups:

4. Turner syndrome: Which is true?

5. Androgen insensitivity syndrome: Which is true?

6. The karyotype of patient with Androgen insensitivity Syndrome is

7. In Turner syndrome the following are usually present EXCEPT:

8. Regarding Androgen insensitivity syndrome all true EXCEPT:

9. Which is not true about Turner's syndrome:

10. Androgen Insensitivity Syndrome:

11. While evaluating a 30-year-old woman for infertility, you diagnosed a

12. Development stage: