Obstetrics & Gynecology 20

1. Question

Multiple pregnancy increases:

In white people more than black
With advancing maternal age
With Bromocriptine use for infertility treatment
If first pregnancy
After ovarian diathermy for polycystic ovary syndrome

2. Question

Missed abortion may cause one of the following complication:

Bone marrow depression
Rupture uterus
High positive serum β-hCG
Skin allergies
Coagulopathy

3. Question

Cervical cerculage:

Closure of incompetence cervix
Effective in prevention of all types of abortion
Should be removed at 32 weeks of pregnancy
Protect against exposure of the pregnant lady to infection
Should applied after 9 weeks of pregnancy

4. Question

Multiple Gestation is frequently associated with all of the following EXCEPT:

Hypertension.
Hydramnios.
Fertility drugs.
Post-maturity.
Pre-term labor.

5. Question

Management of a patient with threatened abortion includes all the followings EXCEPT:

Ultrasound.
Physical exam.
CBC.
Detailed menstrual history.
Immediate dilation and curettage.

6. Question

A 25 primigravida with 8 weeks threatened abortion. The US would most likely reveal :

Thickened endometrium with no gestational sac.
Fetal heart motion in the adnexia.
Empty gestational sac.
An intact gestational sac with fetal heart motion.
Collapsed gestational sac.

7. Question

Regarding missed abortion, all of the following are CORRECT, EXCEPT:

Patient may present with loss of the symptoms of pregnancy
Per vaginal bleeding may be one of the presenting symptom
Immediate evacuation should be done once the diagnosis is made
Disseminated intra-vascular coagulation may occur as a sequele of missed abortion
Ultrasound should be done to confirm the diagnosis

8. Question

In threatened abortion at 15 weeks gestation in a nulliparous patient:

Pain is characteristic.
The internal os is often opened.
Fainting is characteristic.
Vaginal bleeding is usually mild.
Absence of fetal movements suggest non viability.

9. Question

14 weeks pregnant woman had abortion and she was told that it is a complete abortion. This is true regarding complete abortion:

Uterus is usually bigger than date
Cervical OS is opened with tissue inside the cervix
Need to have evacuation of the uterus
After complete abortion there is minimal or no pain and minimal or no bleeding
Follow up with β-hCG for one year.

10. Question

14 weeks pregnant woman had abortion and she was told that it is a complete abortion. This is true regarding complete abortion:

Uterus is usually bigger than date
Cervical OS is opened with tissue inside the cervix
Need to have evacuation of the uterus
After complete abortion there is minimal or no pain and minimal or no bleeding
Follow up with β-hCG for one year.

11. Question

Regarding threatened abortion:

Anti-D should be given to Rh- positive mother.
All patients should be admitted to the hospital.
Ultrasound should be done to confirm the diagnosis.
Vaginal examination will reveal severe pain.
The patient has vaginal bleeding and tissue passage per vagina.

12. Question

Regarding Cervical incompetence, one is true:

Cone biopsy is not a predisposing factor
Cerculage is contraindicated
In not encountered with uterine anomalies
Best diagnosed by Hx
Is a cause of early pregnancy abortion

13. Question

Twins pregnancy :

Presentation of the second twin dictate the mode of delivery
Internal podalic version should not be performed for the second twin
Monozygotic twins always bearing same sex
ommonly goes post mature
Should be delivered by caesarean section

14. Question

In patients with three consecutive spontaneous abortion in the second trimester the most useful investigation is:

Chromosomal analysis
Hysterosalpingogram
Endometrial biopsy
Post coital test
Prolactin level

15. Question

Therapy in threatened abortion should include:

Progesterone IM
D & C
Prolonged bed rest
Restricted activity
Prostaglandin suppositories

16. Question

In patients with three consecutive spontaneous abortion in the second trimester the most useful investigation is:

Chromosomal analysis
Hysterosalpingogram
Endometrial biopsy
Post coital test
Prolactin level

17. Question

The following are fetal complications in multiple pregnancy EXCEPT :

Increase incidence of perinatal mortality & morbidity
Increase incidence of prematurity
Increase incidence of mal-presentation
Increase incidence of congenital abnormalities particularly sacral agenesis
Increase incidence of prolapsed cord during labor

18. Question

Regarding cervical incompetence, all of the following are true, EXCEPT:

Typically causes painful abortions
Typically causes mid-trimester abortions
Is treated by Shirodkar suture (cervical cerculage) which is best preformed early in the second trimester
May lead to premature rupture of the membrane
Can occur in patient with history of cone biopsy

19. Question

During the first & second trimester of pregnancy, the most common pathologic cause of vaginal bleeding :

Hydatiform mole
Abruptio placenta
Ectopic pregnancy
Abortion
Uterine rupture

20. Question

Therapy for threatened abortion should include:

Progesterone IM.
D & C.
Prolonged bed rest.
Restricted activity.
Prostaglandins suppository.

21. Question

The following are true for dizygotic twins EXCEPT:

Fertilization of more than one egg by more than one sperm
Most common type of twins represents 2/3 of cases
Both twins are identical & of the same sex.
There are two chorions & two amnions
Placenta may be separated or fused

22. Question

Causes of first trimester abortionGestational hypertension

Chromosomal abnormalities
Cervical incompetence
Bicornuate uterus
Gestational hypertension
Pre-eclampsia

23. Question

Which of the following items may be associated with a mid trimester abortion:

Recurrent pelvic infection
Maternal smoking
Uterine anomalies
Sickle cell disease
Hyperemesis gravidarum

24. Question

The following factors affect the incidence of dizygotic multiple pregnancy EXEPT :

Induction of ovulation
Increase maternal age
Heredity
Race
Nuliparity

25. Question

Management of a patient with threatened abortion includes all of the following, EXCEPT:

Ultrasound
Physical examination
CBC
Derailed menstrual history
Dilatation and curettage.

26. Question

Bleeding in early pregnancy could be causes by all of the following, EXCEPT :

An ectopic pregnancy
Trophoblastic disease
Carcinoma of the ovary
Invasive carcinoma of the cervix
Threatened abortion

27. Question

The following statements about multiple pregnancy are true EXCEPT:

Its occurrence in West Africa.
Its incidence is increased by increased age and parity.
Twin to twin transfusion common in monochromic twins.
Can be diagnosed by ultrasound only after 12 weeks.
Associated with induction of ovulation.

28. Question

A 25-year-old primigravida with 8 weeks threatened abortion, ultrasound would most likely reveal:

Thickened endometrium with no gestational sac
Feral heart motion in the adnexia
Empty gestational sac
Collapsed gestational sac
An intact gestational sac with fetal

29. Question

Which of the following is correct in the treatment of a case of threatened abortion :

Bed rest
Oral stillbosterol
Curettage
Urgent admission to hospital
I.M Tranexamic acid

30. Question

The following are complication of multiple gestation EXCEPT :

Increase incidence of pre-eclampsia toxemia
Polyhydramnios
Increase incidence of premature labor
Increase incidence of gestational diabetes
Increase incidence of placenta previa

31. Question

Regarding incomplete abortion, all are true, EXCEPT:

There is a history of tissue passed per vagina
The cervix is open on vaginal examination
Ultrasound shows retained product of conception
Ultrasound shows intact gestational sac non- viable fetus
Management include evacuation

32. Question

Abortion :

Has an incidence of 15% of all pregnancy
18 weeks missed abortion is usually managed with suction curettage
In threatened abortion, the cervix is always open
1st trimester abortion is usually causes by incompetent cervical os
Pregnancy usually continue to term in cases of inevitable abortion

33. Question

Twins can be diagnosed by :

Large uterus after delivery of the first twin
Uterus bigger than date during pregnancy
Ultrasonography
Auscultation
All of the above

34. Question

Most common cause of first trimester abortion

Chromosomal abnormalities
Syphilis
Rhesus isoimmunization
Cervical incompetence
Bifurcate uterus

35. Question

Etiological factors in spontaneous abortion include :

Chromosomal abnormalities
Placental abnormalities
Maternal disease
Uterine abnormalities
All of the above

36. Question

The following are common in twins pregnancy EXCEPT :

Increase incidence of premature labor
Increase incidence of APH
Increase incidence PPH
Increase incidence perinatal mortality
Increase incidence of GDM

37. Question

Incompetent cervix

Is a cause for early pregnancy loss
Is best diagnosed by history
Is a cause for fetal congenital abnormalities
Is not encounted with uterine anomities
Can be treated with tocolytics

38. Question

A major hazard of a late missed abortion :

A positive human chorionic gonadotropin (hCG) titer
Systemic allergies
Bone marrow depression
Coagulopathy
Toxemia

39. Question

Regarding twin pregnancies all of the following are correct EXCEPT:

It has a higher incidence of preterm labor
Mal-presentation of one of the main factors leading to increase incidence of C/S
Abruptio placenta may occur with the sudden decompression of the uterus immediately after delivery of the first twin
Dexamethasone is useful in case preterm labor
Identical or monozygotic twin arise from fertilization of two ovum

40. Question

Of the proposed etiologies for recurrent pregnancy wastage, the least likely is:

Maternal trauma.
Maternal balanced translocation.
Paternal balanced translocation.
Luteal phase deficiency.
Autoimmune disease.

41. Question

A missed abortion is :

Death of the fetus at 36 weeks of gestation
In which the products of conception are expelled completely
In which the products of conception are partially expelled
Bleeding and cramps but the fetus still viable
Death of the fetus before 24 weeks gestation

42. Question

All are true about monozygotic pregnancy, EXCEPT :

The 1st commonly presents as breech.
Pregnancy induced hypertension is common.
There is only one placenta.
Polyhydramnios is frequently present.
Anemia is common.

43. Question

The most common etiology for spontaneous abortion of a recognized first trimester gestation:

Chromosomal anomaly in 50-60% of gestations.
Chromosomal anomaly in 20-30% of gestations.
Maternal hypothyroidism.
Maternal Diabetes.
Progesterone deficiency.

44. Question

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. The most likely diagnosis is :

Twin pregnancy
Threatened abortion
Inevitable abortion
Premature labor
Incomplete abortion

45. Question

Excessive increased level of β-HCG is expected in :

Ectopic pregnancy.
Pregnancy of diabetic mothers.
Twin pregnancy.
Incomplete abortion.
Cervical carcinoma.

46. Question

In threatened abortion, which one of the following items is TRUE?

The cervix is open
Evacuation is the best treatment
All patients should be admitted
In the majority of cases pregnancy will continue without any complication
Does not necessitate giving Anti-D for Rh-negative mother

47. Question

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. Of the option listed, the bleeding is most likely due to :

Retained products of conception
Ruptured uterus
A systemic coagulopathy
Vaginal lacerations

48. Question

Regarding multiple pregnancy. All the following are true, EXCEPT :

Is frequently complicated by premature labor.
Is associated with an increased risk of post partum hemorrhage.
Occurs in approximately 1 in 80 pregnancies.
Often causes prolonged labor.
Is often diagnosed early by US.

49. Question

In case of threatened abortion :

Fetalheartispresent
Cervix is dilated
There is a history of passing tissue per vagina.
Patients needs immediate evacuation
No need to give anti-D for Rhesus negative mothers

50. Question

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. The indicated procedure is :

Hysterectomy
Vaginal packing
Compression of the hemorrhoids
IV fibrinogen
Uterine curettage