Obstetrics & Gynecology 22

1. Question

Which of the following is NOT a complication of abruptio placenta:

Postpartum hemorrhage.
Consumptive hemorrhage.
Fetal demise.
Acute renal failure.
Subsequent ectopic.

2. Question

All of the following maternal antibodies may cause erythroblastosis fetalis in the fetus EXCEPT:

Anti-nuclear antibodies
Anti-E
Anti-D
Anti-lewis

3. Question

Post-partum hemorrhage may have higher incidence in all the following conditions EXCEPT:

Multiple pregnancies
Polyhydramnios
Macrosomic baby
Placenta previa
Pregnancy induced hypertension

4. Question

Placenta previa is more likely to be found in a pregnancy associated with:

Multiple pregnancy.
Previous manual removal of placenta.
Pyometra.
IVF pregnancy.
Previous C-section.

5. Question

If blood must be given without adequate cross matching, the best to use is:

AB Rh-positive.
AB Rh-negative.
O Rh-positive.
O Rh-negative.
A Rh-positive.

6. Question

All the following are causes of DIC in pregnancy, EXCEPT :

Fetal demise.
Abortion.
Placental abruption.
Placenta previa.
Sepsis.

7. Question

In placenta previa:

Common in primigravida.
Presents with vaginal bleeding with abdominal pain.
Hx. Of repeated C-section is a risk factor.
Characterized by bleeding at 10weeks gestation.
Associated with fetal anomalies.

8. Question

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:

100% of her babies will be Rh positive.
Immunoglobulin should not be given regardless of baby's Rh status.
Immunoglobulin should be given regardless of baby's Rh status.
There is 50% chance that her baby will be Rh negative.
By history alone, she should not be allowed to go after 36/52.

9. Question

Regarding postpartum hemorrhage the following are true EXCEPT:

blood loss of 500 ml or more after vaginal delivery.
Blood loss of 1000 ml or more after C-section
Atonic hemorrhage is less common than traumatic one.
Multiple pregnancy may predispose to postpartum hemorrhage.
Patient with previous history of postpartum hemorrhage are at high risk for postpartum hemorrhage after next delivery.

10. Question

Velamentous insertion of the cord is associated with an increased risk for:

Premature rupture of the membranes.
Fetal bleeding before labor.
Torsion of the umbilical cord.
Fetal malformation.
Uterine malformations.

11. Question

Regarding Postpartum haemorrhage:

May occur as a consequence of Antepartum haemorrhage.
Ends with Hypercoagulable state
Hysterectomy is the first the first line of treatment
Always complicate intrauterine fetal death (IUFD)
Diagnosed only when the placenta is still undelivered

12. Question

The following statements are correct EXCPT:

Syntometrine is composed of syntocinon & Ergometrine.
Ergometrine is contraindicated in cardiac patient.
Syntometrine is used prophylcatically in the management of 3RD stage of labor.
Syntometrine is contraindicated in cardiac patients.
Syntometrine affects the smooth muscles of blood vessels.

13. Question

Select the most correct statement about fetal and neonatal IgM:

It is almost entirely maternal in origin
It is approximately 75% maternal and 25% fetal in origin
It is 50% maternal, 50% fetal in origin
It is 25% maternal, 75% fetal in origin
It is almost entirely fetal in origin

14. Question

Regarding Secondary postpartum haemorrhage:

Is diagnosed when bleeding occurs 72 hours after delivery
Contra indicate breast feeding
The commonest cause is the cervical tears
Very common when the patient delivers a congenitally abnormal baby
Choriocarcinoma could be a cause.

15. Question

The following are always indications for Caesarean Section

Hydrocephalus
Abruptio placenta
Preterm Labor
Active primary genital herpes
Sever pre-eclampsia

16. Question

Anti-D prophylaxis:

Should be given to all sensitized Rhesus negative women after delivery
Should be given to all Rhesus negative women after amniocentesis.
Should be given to all Rhesus positive women who give birth to Rhesus
negative babies.
Should be given to all women who's babies are Rhesus negative

17. Question

In Abruptio placenta: Which is true?

It is bleeding from abnormally situated placenta
Has minimum effect on the fetus
Causes painless bleeding
Can be a cause of post partum hemorrhage
All should deliver by caesarean section

18. Question

Obstructed labor: Which is true?

Diagnosis only when the cervix is fully dilated
Usually predicted before onset of labor
More common in developed countries
Mento-posterior position could be a cause
X-ray pelvimetry is essential to predict cephalo-pelvic disproportion in Primigravida

19. Question

In Rhesus Iso-immunization, the following test may be helpful :

Rhesus antibody titer in liquor
Maternal serum bilirubin level
Liquor bilirubin level
Maternal hemoglobin
Baby gender

20. Question

Atonic Post partum hemorrhage is best managed with :

Intra-venous progesterone
0.5 mg oral ergometrine and uterine massage
5 units oral syntocinon and uterine massage
Uterine massage
Uterine massage with 40 units syntocinon in 500 ml D5 % NS to be given Intravenously

21. Question

Prolapse of umbilical cord: Which is true?

Not an indication for caesarean section when baby viable at 36 weeks
Diagnosed when membranes are still intact
Is more common when fetus acquires an abnormal lie
Incidence is 5%
Causes severe respiratory alkalosis

22. Question

RH disease :

Occurs when the mother is Rh+
Occurs when the father is RHC.
Occurs when the fetus is Rh +ve
Can never occurs in the 1st pregnancy
Antibodies are formed against maternal RBCs

23. Question

Postpartum hemorrhage can occur due to all the followings EXCEPT:

Fetal macrosomia.
Polyhydramnios.
Placenta brevia.
Abruptio placenta.
Postdate pregnancy.

24. Question

The best uterine scar a patient can have for Caesarian section is

Transverse upper segment
Longitudinal upper segment
Transverse lower segment
Longitudinal lower segment
A T-shaped incision

25. Question

Rh isoimmunization Anti-D immunoglobulin should be given:

After every abortion occurring more than 8 weeks gestation
To all Rh negative females who have an Rh positive baby
Postpartum only to Rh negative female who are sensitized
Postpartum to Rh positive female with Rh negative husbands
After spontaneous rupture of membrane

26. Question

Disseminated intravascular coagulation (DIC) :

Can be managed by leukocyte transfusion
Can cause decrease fibrinogen degeneration products
Can cause decrease PT , PTT
Is characterized by increase platelet count
Can be encountered in case of IUFD

27. Question

Which of the following is not a basic component of an obstetric forceps ?

Blade
Handle
Lack
Stem
Shank

28. Question

RH incompatibility occurs with :

Rh –ve father & Rh+ve mother
Rh –ve mother & Rh –ve father
Rh –ve mother & Rh +ve father
Rh +ve mother & Rh +ve father
None of the above

29. Question

All of the following circumstances should alert an obstetrician to an increased likelihood of postpartum hemorrhage EXCEPT:

Prolonged labor
Rapid labor
Postdate pregnancy
Oxytocin stimulation
Twin pregnancy

30. Question

Which instrument is not a basic of a laparoscopic set :

Trochar
Hegar dilator
Veress needle
Light source
CO2 inflation set.

31. Question

The condition of placental abruption is associated with :

External cephalic version
Nulliparus women, among whom it is more common
Direct trauma which may be the main cause
A clinical diagnosis
Always presents with vaginal bleeding

32. Question

In ABO incompatibility :

The mother has to be blood group AB
The father has to be B1 group O
It doesn't protect against RH disease
It is an antigen antibody reaction
Erythroblastosis

33. Question

In DIC: Disseminating intravascular coagulation

The level of FDP (Fibrinogen degeneration products) is low
Platelet count is high
Bleeding time is prolonged
PT and PTT are normal
The Fibrinogen level is high

34. Question

Which of the followings is a contraindication to a trial of labor after cesarean delivery?

Prior classical incision.
Prior cesarean delivery for dystocia.
Prior IUFD.
Ultrasound estimation of fetal weight of 3500g
Prior cesarean delivery for breech

35. Question

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?

Schedule cesarean delivery at 38 weeks.
Schedule an amniocentesis at 36 weeks & delivery by C-section if the fetal lung is mature.
Reassess placental position at 33-34 weeks.
Recommend termination of pregnancy.
Reassess placental position digitally by vaginal examination 32-34 weeks.

36. Question

Fetal RBCs can be distinguished from maternal RBCs by their :

Shape
Resistance to acid elution
Lack of Rh factor
Lower amounts of hemoglobin
All of the above

37. Question

Clinical Presentation of DIC include the following EXCEPT:

Bleeding from IV sites
Hematuria
Failure active surgical hemostasis
Increase temperature (fever)
Epistaxis

38. Question

Indications for instrumental delivery include all the followings EXCEPT:

Prolonged second stage of labor.
Fetal distress.
Transverse lie.
Breech presentation.
Maternal cardiac disease.

39. Question

The following may be signs of abruptio placenta, EXCEPT :

Vaginal bleeding.
Absence of uterine contractions.
Blood stained amniotic fluid.
Abnormal fetal heart rate.
Tense painful uterus.

40. Question

Anti-D immunoglobulin should be given:

To Rh-negative mothers after every abortion occurring beyond 6-8 week's gestation.
To all sensitized Rh-negative females who have Rh-positive.
Postpartum only to Rh-negative females who are sensitized regardless of the fetal blood type.
Postpartum to Rh-positive females with Rh-negative husbands.
None of the above.

41. Question

Clinical causes of DIC ( disseminating intravascular coagulation ) include the following EXCEPT :

Ectopic pregnancy
Septic abortion
Mild pre-eclampsia
The use of tampons
IUFD

42. Question

In Placenta previa, all help in the diagnosis, EXCEPT:

Constant lower abdominal pain
Mal presentation
Painless vaginal bleeding
US
History of repeated C-section.

43. Question

A Rh negative women has increase the chances of being immunized during pregnancy when:

Performing External cephalic version.
Maternal anemia.
Premature labor.
Maternal Thyrotoxicosis.
Multiple pregnancy.

44. Question

The treatment of DIC may include the following EXCEPT:

Heparin
Packed RBCs
Platelet transfusion
Leukocyte transfusion
Cryoprecipitate

45. Question

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 :

Induction of labor
C-Section.
Expectant management
Artificial rupture of membrane
Give tocolytic drugs

46. Question

Fetal RBCs can be distinguished from maternal RBCs by their:

Shape.
Resistance to acid elution.
Lack of Rh factor.
Lower amount of hemoglobin.
All of the above.

47. Question

Ergometrine to control post-partum hemorrhage :

Is contraindicated in patient with high blood pressure
It will not act on the smooth muscle of the blood vessels
Intravenous root is the only way to be given
It can be used for induction of labor
Is safe in cardiac patient

48. Question

Routine pelvic examination is contraindicated in which of the following situations during pregnancy:

Carcinoma of the cervix.
Gonorrhea.
Prolapsed cord.
Placenta previa.
Active labor.

49. Question

Fetal manifestations of erythroblastosis fetalis may include all of the following EXCEPT:

Kimictrus
Hepatomegaly
Placental edema
Splenic enlargement
Polycythemia

50. Question

A 28 years old patient complains of the amenorrhea after D & C for postpartum bleeding. The most likely diagnosis:

Gonadal dysgenesis
Sheehan's syndrome
Kallman's syndrome
Mayer-Rokitansky- Kuster-Hauser syndrome
Asherman's syndrome