Obstetrics & Gynecology 2

1. Question

The following vaccines can be safely given during pregnancy

Hepatitis B vaccine
Mumps
Polio
Rubella vaccine
None of the above

2. Question

Primary dysmenorrhea

Is also known as spasmodic dysmenorrhea
The lower abdominal pain usually start with the menses
There may be nausea and vomiting
There is usually a previous history
Treatment include antibiotics

3. Question

Cervical incompetence, which is false

May result from vaginal delivery
May result from the use of uterine sound
Involves the extreme cervical os
May result from cervical cautery
May result from chronic cervicitis

4. Question

Which of the following factors are associated with reduction in risk of ovarian cancer

High parity
Use of oral contraceptive pills
Breastfeeding
Increased age
Bilateral tubal ligation

5. Question

The treatment of a patient with a hydatidiform mole could include all of the following except:

Periodic assays of serum beta-HCG
Periodic clinical examinations for the detection of malignant changes
Radiotherapy
Prophylactic chemotherapy
Evacuation of the uterus

6. Question

Uteroplacental insufficiency can be due to

Maternal diabetes
Uterine hyperstimulation
Post-datism
Rhesus iso-isoimmunization
Placenta accrete

7. Question

Regarding abruptio placenta, which is true

Hypotension is a predisposing factor
Fore-water rupture in oligohydramnios is a predisposing factor
External cephalic version is a predisposing factor
It is associated with low incidence of perinatal mortality
May be associated with postpartum hemorrhage

8. Question

Pelvic inflammatory disease

Acute appendicitis is a differential diagnosis
Ectopic pregnancy is not a differential diagnosis
Treatment should be for at least 10-14 days
It is not a risk factor for ectopic pregnancy
It is not a cause of infertility

9. Question

The objectives of antenatal care include the following except:

Health promotion
Health education
Disease prevention
Early detection of complications arising in pregnancy
Preparation for delivery

10. Question

Bone marrow suppression is a common side effect of

Alkylating agents
Anti-tumour antibiotics
Plant alkaloids
Anti-metabolites
Progesterone

11. Question

In Obesity, which is false

May result in macrosomia
Worsens control of medical conditions in pregnancy
May result in secondary amenorrhea
Is a risk factor for poor wound healing
Is a risk factor for endometrial hyperplasia

12. Question

The following are true of colposcopy

It involves visualization with naked eye
Normal cells appears whitish with acetic acid
Normal cells show positive schiller’s test
Abnormal cells stain blue-black with Lugol’s iodine
Can detect CIN cases

13. Question

Primary postpartum hemorrhage

Is best prevented by ergometrine alone in routine practice
Is due to trauma to the genital tract in 10% of cases
Is more common in women with myotonic dystrophy
Is related to fetal weight
When the cause of maternal death is often due to delay in performing hysterectomy

14. Question

The following are relevant for normal reproductive function except

The pineal body
The thymus gland
The adrenal gland
The thyroid gland
The liver

15. Question

Regarding intrauterine devices, which among these is false

May be inserted without a plunger
Tail-less or threadless types may reduce the incidence of infection
The mode of action is by preventing fertilization
The levonorgestrel releasing device is more effective than copper IUCD
Overall incidence of ectopic pregnancy reduces with increased use

16. Question

In pregnancy

A hemoglobin of 11 g/dl is the lower limit of normal according to WHO guidelines
A low serum iron with a total iron binding capacity suggests iron deficiency
The overall total iron requirement is approximately 1000mg
Iron absorption from the jejunum is increased
Iron should be advised for all women

17. Question

Which of the following is a parameter in Bishop score for cervical status

Parity
Effacement
Station
Lie
Labour duration

18. Question

Regarding contraception

Progesterone only contraceptives is available in a wider variety than combined oral pills
By all routes of administration, progesterone affect both the quantity and physical characteristics of cervical mucus
The dose of progesterone in progesterone only pill is significantly lower than in equivalent combined preparations
Erratic bleeding is the commonest cause for discontinuation of progesterone only pill
Women weighing more than 70 kg have higher failure rates with progesterone only bill

19. Question

A 14 year old girl with menorrhagia and a hemoglobin of 8 g/dl

Requires diagnostic curettage
Will have a clotting disorder in 10% of cases
Is best treated with the combined contraceptive pill
Is more likely to have a hysterectomy than a girl without adolescent menorrhagia
Is due to increased prostaglandin production by the endometrium

20. Question

Concerning cardiac disease in pregnancy, which of the management modalities is advisable:

Management must be multidisciplinary
Surgical interventions are contraindicated
Shortening of second stage of labour is advisable
Peripartum cardiomyopathy can present 6 months following delivery
Treatment of cardiac failure in pregnancy is similar to treatment outside pregnancy

21. Question

The following statements about reproductive health are incorrect

Reproductive health is synonymous with family planning
Nigeria total fertility rate is 4.2
Maternal mortality ratio for Nigeria is fair
Contraceptive use prevalence for Nigeria is high
Prevention and treatment of infertility is one of the componenets of reproductive health

22. Question

Twin pregnancy shows an increase in the following complications except:

Placental abruptio
Pre-eclampsia
Oligohydramnios
Polycythemia
Post-partum hemorrhage

23. Question

Which of the following is matched incorrectly

Zidovudine- nucleoside reverse transcriptase inhibitor
Chlamydia- doxycycline
Gonorrhea- pelvic inflammatory disease
Viral hepatitis- acyclovir
None of the above

24. Question

Investigation of male factor infertility

Coitus interruptus is the method of choice of collecting semen
Semen forms gel-like clot soon after ejaculation and should liquefy within 60 minutes
A persistent low semen volume may be due to congenital absence of seminal vesicles
Oligospermia is defined as sperm concentration > 20 million per ml
Agglutination of sperms indicate the presence of antibodies

25. Question

In Genuine stress incontinence in the female, which is false:

Occurs transiently during pregnancy
Is more common in parous women
Is corrected surgically
Is associated with a low urethral pressure profile amplitude on urodynamic studies
Is not always associated with utero-vaginal prolapse

26. Question

Puberty, which is false

Puberty is preceded by decreasing pulses of follicle stimulating hormone
Breast development precedes the growth spurt
Pubic hair growth precedes axillary hair growth
Menarche occurs between 9 and 17 years of age
Menstrual cycles at menarche are usually regular

27. Question

Contraceptive methods include

Sterilization
Hormone containing intra-uterine devices
Subdermal implants
Contact luminarian strips
Menstrual regulation

28. Question

The following organisms are transmitted from mother to baby during delivery

Toxoplasma gondii
HIV
Hepatitis B virus
Plasmodium falciparum
Cytomegalovirus

29. Question

In the menstrual cycle, ovulation

Occurs 2 days after the peak of LH
Occurs 14 days before the onset of the menstrual flow
Occurs when progesterone secretion is at maximum
Will only occur as a reflex response to orgasm
May be inhibited by emotional disturbance

30. Question

Causes of female infertility does not include

Uterine malformations
Pelvic adhesions
Vagismus
Polycystic ovarian disease
Tenesmus

31. Question

The following may be associated with breech presentation except

Oligohydramnios
Polyhydramnios
Placenta accreta
Prolonged pregnancy
Hydrocephaly

32. Question

The following are modifiable risk factors for adverse pregnancy outcome

Drug use
Age
Hypertension
Parity
Genetic constitution

33. Question

Infertility investigations include the following except:

Post-coital test
Hysteroscopy
Endometrial biopsy
Assessment of follicle and endometrial thickness
Thyroid function test

34. Question

Induction of ovulation can be achieved with

Clomid
Mifepristone
Tamoxifen
Metronidazole
Cyclofenil

35. Question

In focused antenatal care,

Visits are 4 weekly until 28 weeks, 2 weekly until 36 weeks and then weekly until delivery
Patients cannot have unscheduled visits
First visit after the woman has experienced quickening
It is associated with improved pregnancy outcome
Emphasis is on the number of visits

36. Question

Regarding condoms, the following are true

Relatively safe depending on techniques
Prevents HIV transmission, but not other sexually transmitted diseases
Can be used in combination with anti-spermicidal substances
Requires removal immediately after intercourse
No side effect

37. Question

The following are effective intrauterine contraceptive devices

Copper T
Progestasert
Nova-T
Yoon’s loop
Lippes loop

38. Question

Concerning HELLP syndrome

Fetal mortality is usually very low
Has a 50% risk of recurrence in subsequent pregnancies
May be complicated by abruptio placenta
Treatment is conservative if baby is term
Occurs in 25% of patients with pre-eclampsia

39. Question

All of the following may be present in ectopic pregnancy except

Bleeding per vaginum
Abdominal pains
Shoulder pain
Occasionally collapsing
Headaches

40. Question

With regards to benign hydatidiform mole, which is false

There are 2 types (complete and partial)
Hypothyroidism may be a clinical feature
The complete type is more likely to be a malignant than the partial type
Hyperemesis may be a feature
The fetus is never present

41. Question

Components of biophysical profile does not include

Contraction stress test
Fetal body movements
Placental grading
Amniotic fluid volume
Fetal breathing movement

42. Question

Vaginal discharge can be caused by all of the following except:

Bacterial
Chlamydia
Fungi
Parasites
Cervical carcinoma

43. Question

In threatened abortion, which is not present

There is associated abdominal pain
There is liquor drainage
There is bleeding per vaginum
The cervix is more than 2 cm dilated
The cervix is completely effaced with os closed

44. Question

Utero-vaginal prolapse

Is a life-threatening gynecologic condition
Affects 70% of multiparous women
The uterus is attached to the pelvic side wall by the uterosacral and transverse cervical ligaments
Defect in the anterior vaginal wall causes an enterocele
Utero-vaginal prolapse is unlikely to co-exist with a cystocele

45. Question

The following can cause urogenital prolapse

Congenital weakness
Multiple births
Obesity
Severe physical strain
Intra-uterine contraceptive devices

46. Question

A couple with infertility for 4 years has evidence of ovulation, normal semen analysis and normal tubal patency, which of the following further tests are not necessary

Hormonal assay
Testicular biopsy
Serum prolactin level
Postcoital test
Hysterosalpingography (HSG)

47. Question

The following statements are correct regarding normal semen analysis

Sperm count of 10-20 million cells/ml
10 pus cells/hpf
Volume of 7.5 ml/ejaculate
50% with progressive forward motility
7% abnormal forms

48. Question

Treatment of fibroids include does not include the following

Long term progesterone treatment
Progesterone ovulation inhibitors
Gonadotropin releasing analogues
Myomectomy
Hysterectomy

49. Question

Epidural block may result in

Severe postpartum headache
Cephalohematoma in the neonate
Delay in the second stage of labour
Hypotension
Epidural hematoma

50. Question

Laparoscopy is not useful in the following medical conditions

Pelvic pain
Ovarian cyst
Investigation of infertility
Ectopic pregnancy
Endometrisosis