Obstetrics & Gynecology 3

1. Question

Which of these is not a characteristics of normal labour

Spontaneous in onset
descent of the presenting part
Induced labour is normal labour
Progressive cervical effacement
Augmented labour is normal labour

2. Question

Concerning ovary: which of these is false

Ovary has blood supply from branches of uterine artery
The right ovarian vein drains to inferior vena cava
The left ovarian vein drains to inferior vena cava
Ovarian lymphatics drains to para-aortic lymph node
Ovary has both sympathetic and parasympathetic nerve supply.

3. Question

Which of the following statements are true about twin pregnancy

Fetuses of the same sex are always monozygotic
The perinatal mortality rates are higher in the first twin
There is lower incidence of dizygotic twinning in the Africans than in Caucasians
Oligohydramnios does not appear
The commonest presentation is breech-cephalic

4. Question

In patient with sickle cell trait (HbAS) there is an increased

Incidence of spontaneous abortion.
Incidence of low birth weight babies.
Incidence of preterm births.
iIncidence of Urinary tract infection.
Perinatal mortality.

5. Question

Concerning labour, which of these is not true

Normal latent phase lasts 8hours
A parturient with regular contractions and cervical os dilatation of 4cm is in active phase
Second stage has 3 phases
Third stage of labor should not last more than 30minutes
Prolonged latent phase can be contractile

6. Question

Which of these is not anatomical relation of the ovary

Medially to fallopian tube
Laterally to pelvic wall
Inferiorly to the ovarian fossa
Superiorly to small intestine
The ureter has no relation to it

7. Question

Concerning acute cystitis in pregnancy

It is commonly caused by gram positive bacteria
Fever is a prominent feature
Catheter specimen of urine should be collected for culture and sensitivity
It is also known as asymptomatic bacteriuria
All of the above

8. Question

The following are single agents that can cause pelvic inflammatory disease (PID) except:

Nessieria gonorrhoea
Chlamydia trachomatis
Bacteriodes
Ureaplasma urealytica
Mycobacterium tuberculosis

9. Question

Mechanism of labor include the following except

Flexion
Descent
Restitution
Engagement
Internal rotation

10. Question

Pelvic floor include the following except

Levator ani and its facial coats
The triangular ligament
The perineal muscles
Pelvic peritonium
The uterus

11. Question

Regarding urinary retention in early pregnancy, which is false

Typically occurs at 20 weeks of gestation
It is commonly associated with uterine retroversion
It may be secondary to the presence of pelvic tumour
It is commonly caused by a urinary tract infection
Does not require surgical intervention

12. Question

In dystocia:

Brow presenting fetus can be delivered per vaginum
The presentation in oblique lie is shoulder
The presenting diameter in face presentation is not the same as in vertex presentation.
In face presentation, vaginal delivery is impossible.
Mc Robert’s maneuver is not a method of delivery in shoulder dystocia

13. Question

The levator ani muscles include the following except:

Ischiococcygeus
Iliococcegeus
Pubourethralis
Puborectalis
Pubovesicalis

14. Question

Concerning metastatic trophoblastic disease

It is tumour of the uterus
In long standing cases, it can become endometrial carcinoma
Hemoptysis may be a presenting symptom
Uterine evacuation does not reduce complications
Metastasis to the brain is uncommon

15. Question

Concerning precipitate labor

Active phase is more than 3hrs
Genital laceration is not a complication
Postpartum hemorrhage is not a complication
Fetal injury is rare
Cervix dilates at 5cm per hour in Active phase

16. Question

Folic acid:

The folate requirement in pregnancy rises to 350–400 micrograms per day
Megaloblastic anemia in pregnancy is a common complication.
Folic acid store is decreased rapidly with increases frequency of pregnancy
Folate levels are not affected by sickle-cell disease
In maternal folate deficiency, the fetus also usually develops folate deficiency.

17. Question

Regarding pelvic inflammatory disease

It is more common after induced abortion
It cannot occur following a spontaneous abortion
Diagnosis is best made from a high vaginal swab
Ciprofloxacin is the recommended drug of treatment
Tetracyclines have no place in the treatment of this condition

18. Question

Partograph:

Its current use is limited to Primary Health Centre
Its use can’t reduce incidence of CephaloPelvic Disproportion & its seqnallae.
Cervicogram is its only component
WHO is yet to approve its universal use in labor monitory
Helps in early detection of abnormal progress in labor

19. Question

Detrusor instability:

Is a cause of over flow incontinence
Anticholinergic agents are effective but are limited by side effects.
Most cases of urinary incontinence are attributed to detrusor instability.
Patients often have increased bladder capacity.
Urine leakage is associated with increased intra-abdominal pressure.

20. Question

Concerning HIV infection in pregnancy

It is an important cause of anemia in Sub-Saharan Africa
The CD4 count falls as pregnancy advances
It is a common cause of intrauterine growth restriction
Vaginal delivery is recommended
Women with a high CD4 count and undetectable viral load should not be on anti-retroviral therapy

21. Question

Which of this is not true of partograph

Current WHO partograph has no latent phase
Intervention is carried out at action line
Action line is 3hrs away from alert line
Action line is 4hrs away from alert line
It is a graphical representation of events in labor

22. Question

Anatomy and physiology of the female lower urinary tract:

In the adult the urinary bladder has a mean volume of 500 mls.
The detrusor muscle is innervated by sympathetic nerves S2–S4 and receives a rich efferents supply.
Pelvic floor striated muscles does not contributes to the maintenance of urinary continence.
The normal maximum flow rate on urodynamic testing is 5 mL/s.
Bladder contractions are caused by stimulation of the sympathetic nervous system.

23. Question

In the prevention of Mother to Child transmission of HIV/AIDS, except:

HIV positivity in pregnancy is not an absolute indication for elective cesarean section
Chorioamnionitis increases transmission of the virus
Naso-pharyngeal suction of the infant after delivery is contraindicated
Nevirapine is the drug of choice in management
Pyrimethamine may be used as malaria chemoprophylaxis

24. Question

Which of these is not an objective of partograph

It facilitates research
Early detection of abnormal progress in labor
It helps to defend action taken in the conduct of labor
It prevents prolonged labor
When used properly, vaginal delivery is guaranteed

25. Question

Hemoglobinopathies:

Consist of sickle cell trait and sickle cell anemia only.
HbA (2 alpha 2 beta) should comprise over 50 per cent of the total circulating haemoglobin in the adult.
The thalassaemia syndrome is an inherited defect of hemoglobin resulting in a structural abnormality of globin.
A patient suffering from sickle-cell anemia is more likely to be dehydrated during labour
Sickle-cell hemoglobin is a variant of the alpha globin chain where there is one amino acid substitution at the sixth position.

26. Question

Complications that may be associated with sexually transmitted infections does not include

Cervical intra-cytoplasmic neoplasia
Blindness
Carcinoma of the liver
Ovarian carcinoma
Laryngeal polyps

27. Question

Component of partograph includes

Severity of caput in the fetus
Grade of moulding in the fetus
Drugs and fluids has no provision for recording
Maternal respiratory rate recording
Urine PH recording

28. Question

One of the following is NOT a recognized cause of urinary incontinence:

Overflow incontinence.
Immobility.
Pregnancy.
Urinary tract infection.
Fecal impaction.

29. Question

Regarding the complete hydatiform mole, which is false

Diabetes is not a relevant etiological factor
It is common in women under the age of 20 years
50% will become malignant if left untreated
The initial beta HCG level is a prognostic factor
It can occur in the absence of fertilization

30. Question

The following is false except

Labia minora forms the fourchette anterioly
Bartholin’s gland has no role in vaginal lubrication
Vulval blood supply is from pudendal artery
Para-aortic lymph node drains the vulva
Posterior cutaneous nerve of the thigh does not innervate the vulva

31. Question

Urodynamic investigation:

Include Q-tip test.
Detrusor instability is the commonest cause of incontinence and is defined as the presence of spontaneous detrusor contractions during the filling phase when the patient is attempting to inhibit micturition.
Genuine stress incontinence can be diagnosed on an unlabelled urodynamic tracing.
A decreased maximum flow rate may indicate damage to the urethral sphincter.
Genuine stress incontinence (GSI) is defined as the leakage of urine per urethra due to increased intra-abdominal pressure, in the absence of detrusor activity.

32. Question

Concerning carcinoma of the endometrium

It is second most common female cancer in Nigeria
It is an aggressive tumour
The use of progesterone only contraception is protective
Chemotherapy has no place in its management
Stage 3 of the disease includes metastases to the vagina

33. Question

Which of the following is not true

Anterior length of vagina is 7cm
Posterior length of vagina is 9cm
Urethra is related to vagina in the anterior lower 2/3rd
The perineal body separate the vagina from the anal canal in posterior lower 1/3rd
The posterior 1/3rd of the vagina is related to Pouch of Douglas

34. Question

In maternal sickle cell disease:

The spontaneous abortion rate is low.
The incidence of diabetes is increased.
The incidence of spontaneous delivery preterm is increased.
The incidence of small-for-dates fetuses is unchanged
The presence of sickle cell disease in the fetus cannot be detected.

35. Question

One the following investigations is NOT useful in women suspected of having PID:

Pregnancy test.
Endocervical test for Chlamydia trachomatis.
Endocervical test for Neisseria gonorrhoeae.
Erythrocyte sedimentation rate (ESR).
Plain abdominal X-ray.

36. Question

Vaginal support include the following except

Pubocervical ligament
Mackenrodt’s ligament
Uterosacral ligament
Levator ani muscle
Infundibulo-pelvic ligament

37. Question

Urogenital prolapse:

Accounts for 50 per cent of all gynecological procedures
Rarely occurs in nulliparous women.
Is not associated with lower urinary tract symptoms.
Is more common in women who had all her deliveries by Caesarean section.
Is found in 30 per cent of elderly women.

38. Question

Which of the following are NOT signs and symptoms of PID:

Lower abdominal pain.
Dyspareunia.
Generalized itching.
Abnormal vaginal discharge.
Cervical excitation.

39. Question

The following is true except

The ureter lies 5cm lateral to the lateral fornix
The Pouch of Douglas can be accessed through the posterior fornix during culdocentesis
Pudendal nerve block is effective in perineal procedure
The round ligament attaches to the cornu of the uterus anteriorly
The ovarian ligament is attached to the cornu of the uterus posteriorly

40. Question

With regard to the management of urogenital prolapse:

Physiotherapy has been shown to be very effective.
Ring pessaries are the management of choice in the elderly.
Surgical approach is the definitive treatment modalities.
Utero-vaginal prolapse UVP usually exists alone.
Anterior repair is an effective treatment for co-existent stress incontinence.

41. Question

The following are precipitating factors in vaginitis cause by Candida albicans except:

Cancer chemotherapy.
Diabetes mellitus.
Pregnancy.
Antibiotic therapy.
Contraceptives.

42. Question

Anatomical relations of the supravaginal cervix include the following except

Anteriorly related to the bladder
Posteriorly related to anterior wall of Pouch of Douglas
The ureter runs above the uterine artery lateral to the cervix
The uterosacral ligament
The cardinal ligament

43. Question

Regarding episiotomy

It is the surgical enlargement of the vaginal orifice by an incision of the perineum
The medio-lateral type is cut at 90 degrees angle from the midline towards the ischia tuberosity
Extension to the anal sphincter is more common with the medio-lateral type
It can lead to a primary ante-partum hemorrhage
Elective episiotomy is beneficial in all parturients

44. Question

One of the differential diagnosis of acute pelvic inflammatory disease limited to the pelvis except.

Ectopic pregnancy.
Acute appendicitis.
Acute urinary tract infection.
Adnexal torsion.
Lower lobe pneumonia.

45. Question

Which of these is true

Uterine artery arise from posterior division of internal iliac
Uterine artery crosses above the ureter lateral to the supravaginal cervix
Uterine artery has no descending branch
The cervix is not supplied by uterine artery
The uterine artery has no anastomosis with ovarian artery

46. Question

Concerning the oral glucose challenge test

It is best performed between 16 and 20 weeks gestation
The patient should have fasted overnight
The blood sample should be taken two hours after ingestion of 50 gm of glucose
It is a diagnostic test for gestational Diabetes Mellitus
All of the above

47. Question

In patient with sickle cell anemia there is an increase incidence

Ectopic pregnancy.
Spontaneous abortion.
Bone fracture.
Twin gestation.
None of the above.

48. Question

The following is true concerning fallopian tube except

The length of fallopian tube is 10cm
It blends medially with cornu of the uterus
The ampulla makes up ½ of the length of fallopian tube
Ovum pick up is not a function of the tube
The ovary lies posterio-inferior to it

49. Question

The following are associated with pregnancy complicated by diabetes mellitus except

Pregnancy induced hypertension
Polyhydramnios
Intrauterine death
Neonatal hyperglycemia
Shoulder dystocia

50. Question

Concerning Iron deficiency anemia in pregnancy which of the following statement is true?

One pregnancy can be an important cause of anemia in the next pregnancy.
Overt anemia can be adequately treated with100mg ferrous gluconate daily.
A daily supplement of 30mg of elemental iron is sufficient to meet the total requirement during pregnancy.
With absent iron stores iron deficiency anemia can be treated with 60mg of elemental iron daily.
The serum iron binding capacity is depressed.