Pregnancy OB02-OB04.

1.Diagnosis of Pregnancy.
***) Signs and symptoms of pregnancy in the 1st trimester include all of the
following, except:
A. Nausea
B. Quickening
C. Frequency of micturition
D. Soreness of breast
E. Hegar's sign
Answer: B* Quickening
***) Which of the following hormones is produced by trophoblast:
A. Luteinizing hormone
B. Follicle stimulating hormone
C. Prolactin
D. Human chorionic gonadotropin
E. Oxytocin
Answer: D* Human chorionic gonadotropin
***) Positive pregnancy test in the urine depends on the presence of:
A. Human chorionic gonadotropin
B. Progesterone
C. Estrogen
D. Calcium
E. Cortisol
Answer: A* Human chorionic gonadotropin
***) A suspicion of pregnancy at 3 wks GA may be confirmed by one of the
following:
A. History of morning sickness and nausea
B. Vaginal examination
C. Abdominal examination
D. Immunological pregnancy test (hCG)
E. Breast examination
Answer: D* Immunological pregnancy test (hCG)
***) Which of the following hormones decreases after the first trimester of
pregnancy:
A. Progesterone
B. Prolactin

C. Human Chorionic Gonadotropin (HCG)

D. Human Placental Lactogen (HPL)
E. Estrogen
Answer: C* Human Chorionic Gonadotropin (HCG)

2.Pregnancy & Physiological Changes.

***) All of the following statements are true, except:
A. The maximum weight increase in the uncomplicated pregnancy is 12.5 kg
B. The cardiac output has risen markedly by 40 percent during pregnancy
C. There is a slight increase of pulse rate about 15 percent
D. There is a decrease in red cell mass
E. Fibrinogen level increases during pregnancy
Answer: D* There is a decrease in red cell mass
***) Regarding cardiovascular system in normal pregnancy, the following are
increased except:
A. Heart rate
B. Stroke volume
C. Plasma volume
D. Hematocrit
E. Red blood cells
Answer: D* Hematocrit
***) Blood volume is increased from the total volume during pregnancy at
near term by about:
A. 10%
B. 20%
C. 25%
D. 45%
E. 100%
Answer: D*45%
***) Regarding supine hypotension one of the following is true:
A. Pressure of the gravid uterus on the aorta
B. Pressure of the gravid uterus on vena cava inferior
C. Pressure of the gravid uterus on vena cava superior
D. Constipation during pregnancy
E. Excessive heart burn
Answer: B* Pressure of the gravid uterus on vena cava inferior

***) In pregnancy concerning maternal blood the following are correct,

except:
A. Plasma transcortin concentration increase
B. Free cortisol concentration increase
C. Thyroxin binding globulin concentration increase
D. Free thyroxin index increase
E. Release of TSH is not increased
Answer: D* Free thyroxin index increase
***) In the normal pregnancy all of the following increase, except:
A. Plasma volume
B. Hepatic blood flow
C. Platelet count
D. White cells count
E. Cardiac output
Answer: C* Platelet count
***) Pregnancy leads to one of the following:
A. Prolongation of stomach emptying time and increased acidity
B. Shortening of stomach emptying time and increased acidity
C. Shortening of stomach emptying time and decreased acidity
D. Prolongation of stomach emptying time and no affection of acidity
E. Prolongation of stomach emptying time and decrease acidity
Answer: E* Prolongation of stomach emptying time and decrease acidity
***) All of the following occur in alimentary tract during pregnancy, except:
A. The gums become swollen
B. Excessive salivation may occur
C. Heartburn (reflux esophagitis) is common
D. The stomach tends to empty more rapidly
E. Slow peristalsis of the bowel
Answer: D* The stomach tends to empty more rapidly
***) The cause of heartburn in pregnancy is:
A. Increased gastric motility
B. Increased vagal nerve activity
C. Gastro-esophageal reflux
D. Duodeno-gastric reflux
E. Increased gastric emptying
Answer: C* Gastro-esophageal reflux

***) Breast tissue of 2mm nodule is normal for which gestational age:
A. 28 weeks
B. 36 weeks
C. 40 weeks
D. 42 weeks
E. 44 weeks
Answer: A* 28 weeks

Prenatal Care OB04-OB10.

1.Prenatal Visits.
***) All of the following are aims of antenatal care, except:
A. To monitor the well being of the fetus
B. To establish and maintain the physical health of the mother
C. The ideal time for first antenatal visit is before 14 weeks of pregnancy
D. Screening for fetal congenital abnormality
E. Screening for endometrial carcinoma
Answer: E* Screening for endometrial carcinoma
***) The embryonic life starts at:
A. The 3rd week after ovulation
B. The 5th week after ovulation
C. The 7th week after ovulation
D. The 9th week after ovulation
E. The 11th week after ovulation
Answer: C* The 7th week after ovulation
***) All of the following factors may reduce intrauterine death of the fetus,
except:
A. Proper antenatal care
B. Localization of placenta in the first trimester
C. Antenatal fetal monitoring
D. Correct timing of delivery
E. Prevention of prematurity
Answer: B* Localization of placenta in the first trimester
***) In preventing anemia during pregnancy the ideal oral iron compound is:
A. 20 mg of iron
B. 100 mg of iron
C. 200 mg of iron
D. 400 mg of iron

E. 1000 mg of iron
Answer: A*20 mg of iron
***) All of the following are ideal routine blood tests carried out at first visit to
an antenatal clinic, except:
A. Blood grouping and rhesus
B. Hemoglobin
C. Serological tests for syphilis
D. Rubella antibodies
E. Renal functional tests
Answer: E* Renal functional tests
***) All of the following are restriction on coitus during pregnancy, except:
A. Threatened abortion
B. History of premature labor
C. History of post partum hemorrhage
D. History of ante partum hemorrhage
E. When membranes are ruptured
Answer: C* History of post partum hemorrhage
***) Abdominal palpation in the latter half of pregnancy reveals all of the
following, except:
A. The fundal height
B. The lie of the fetus
C. Cephalo-pelvic disproportion
D. The presentation of the fetal cephalic or breech
E. Whether the presenting part in engaged or not
Answer: C* Cephalo-pelvic disproportion
***) At 16 weeks of pregnancy, the uterine fundus is felt at:
A. Just above the pubic margin
B. At the level of umbilicus
C. Midway between umbilicus and pubic margin
D. 2 cm above the pubis
E. 2 cm above the umbilicus
Answer: C* Midway between umbilicus and pubic margin
***) At 14 weeks pregnancy a uterus may felt large for dates because of the
following, except:
A. Wrong dates
B. Uterine fibroid

C. Full bladder
D. Polyhydramnios
E. Multiple pregnancy
Answer: C* Full bladder
***) A large for date uterus may be due to all of the following conditions,
except:
A. Multiple pregnancy
B. Hydatidiform mole
C. Oligohydramnios
D. Uterine fibroid with pregnancy
E. Error in dates
Answer: C* Oligohydramnios
***) Causes of large for date pregnancies are the following, except:
A. Multiple pregnancy
B. Polyhydramnios
C. Hydatiform mole
D. Intrauterine fetal death
E. Diabetes with pregnancy
Answer: D* Intrauterine fetal death
***) The following factors may lead to wrong dates of delivery, except:
A. An irregular cycle
B. Regular cycles but in excess of 28 days (35-42 days)
C. Regular cycles of 28 days
D. Patient's poor memory
E. Breast feeding
Answer: C* Regular cycles of 28 days
***) To reduce the risk of recurrence of neural tube defects in a woman
planning to get pregnancy, she should be advised to take:
A. Iron tablets 20 mg/day
B. Calcium tablets 1 gm/day
C. Vitamin E 200 mg/day
D. Vitamin B complex
E. Folic acid tablets 4 mg/day
Answer: E* Folic acid tablets 4 mg/day
***) Counseling of a pregnant woman during antenatal care should include
advice and education on all of the following except one:

A.
B.
C.
D.
E.

Smoking
Alcohol abuse
Drug abuse
Avoiding infection
Water consumption

Answer: E* Water consumption

***) The last menstrual period for a lady was June 30, the expected date of
delivery is approximately:
A. March 23rd
B. April 7th
C. March 28th
D. April 23rd
E. March 7th
Answer: B* April 7th

2.Prenatal Screening.
***) The most sensitive prognostic test in Rh-disease of pregnancy is:
A. Antibody titer
B. Past history
C. Spectrophotometric examination of the amniotic fluid
D. Urinary bilirubin level
E. Fetal movements
Answer: C* Spectrophotometric examination of the amniotic fluid
***) Indication of anti-D administration to Rh-negative mothers married to
Rh-positive husbands includes all the following except:
A. Following abortion
B. Following delivery of Rh-negative baby
C. At 28 weeks of gestation
D. Following ectopic pregnancy
E. Following amniocentesis
Answer: B* Following delivery of Rh-negative baby
***) All of the following are indications for anti-D-gamma-globulin
administration, except:
A. Abortion caused by blighted ovum
B. Abortion secondary to cervical incompetence
C. After amniocentesis
D. After attacks of ante partum hemorrhage
E. To Rh-negative unsensitized mother giving birth to Rh-positive fetus

Answer: A* Abortion caused by blighted ovum

***) Regarding the prevention of Rh-isoimmunization, all the following are
true except:
A. All Rh-negative women should marry Rh-negative husbands
B. Anti-D to be given at 28 weeks or 32 weeks for pregnant patient with Rhpositive husband
C. Anti-D to be given within 72 hours after delivery in a patient with Rhpositive fetus
D. Anti-D to be given in Rh-negative patients with abortion (blighted ovum)
E. Anti-D immunoglobulin causes severe neonatal jaundice
Answer: D* Anti-D to be given in Rh-negative patients with abortion (blighted
ovum)
***) The most common cause of fetal death in uterus in Rh-isoimmunization
is:
A. Jaundice
B. Heart failure
C. Respiratory distress syndrome
D. Congenital anomalies
E. Kernicterus
Answer: E* Kernicterus

Prenatal Diagnosis.
***) The following information may be obtained from aspiration of amniotic
fluid in the 2nd and 3rd trimester of pregnancy, except:
A. Cytogenetics
B. Fetal maturity
C. Detection of neural tube defect by measurement of alpha fetoprotein
D. Polydactyly
E. Rhesus disease
Answer: D* Polydactyly
***) Amniotic fluid is used to check up all of the following, except:
A. Chromosome analysis
B. Neural tube defects
C. Lung maturity of the fetus
D. Fetal hemoglobin
E. Inborn metabolic disease
Answer: E* Inborn metabolic disease

***) Which one of the following karyotyping is not matching:

A. Normal male - 46 XY
B. Turner syndrome - 45 XO
C. Female Down syndrome - 47 XX, +21
D. Female Edwards syndrome - 47 XX, +13
E. Klinefelter syndrome - 47 XXY
Answer: D* Female Edwards syndrome - 47 XX, +13

Medical Conditions in Pregnancy

OB13-OB23.
1.Iron Deficiency Anemia.
***) The most common anemia during pregnancy is:
A. Iron deficiency anemia
B. Pernicious anemia
C. Sickle cell anemia
D. Thalassemia
E. Hemolytic anemia
Answer: A* Iron deficiency anemia
***) Regarding iron deficiency anemia in pregnancy, all the following are true
except:
Is related to social class
Is very common in multiple pregnancy
Is prevented with adequate diet only
Can usually be treated with oral iron
Is more common in multi parous women
Answer: C*Is prevented with adequate diet only
***) Factors causing iron deficiency anemia in pregnancy are all of the
following, except:
Sickle cell disease
Lack of iron supplements
Poor diet
Bleeding
Mal absorption
Answer: A* Sickle cell disease

***) All of the following are causes of iron deficiency anemia during
pregnancy, except:
Inadequate iron in the diet
Excessive blood loss
Infrequent pregnancies
Abnormal demand as in multiple pregnancy
Mal absorption
Answer: C* Infrequent pregnancies
***) Effects of iron deficiency anemia in pregnancy include all of the
following, except:
Increased plasma volume
Increased cardiac output
Decreased peripheral resistance
Oxygen dissociation curve shifted to the left
Heart failure may occur in severe cases
Answer: D* Oxygen dissociation curve shifted to the left

Folate Deficiency Anemia.

***) Folic acid deficiency during pregnancy may occur from the following,
except:
Multiple pregnancies
Low HCl acid in the stomach
Grand multi-parous women
Poor diet
Anticonvulsant therapy in epileptic pregnant women
Answer: B* Low HCl acid in the stomach
***) In folic acid deficiency during pregnancy the earliest changes are:
Erythrocyte macrocytosis
Megaloblastic anemia
Low concentration of serum folate
Increased urinary formiminoglutamic acid (FIGLA)
Hypersegmentation of neutrophils
Answer: C* Low concentration of serum folate
***) Megaloblastic anemia in pregnancy is mainly due to:
Iron deficiency
Vitamin B12 deficiency
Folic acid deficiency
Vitamin B1 excess

Hypoxia
Answer: C* Folic acid deficiency

Diabetes Mellitus DM.

***) In a pregnant patient with diabetes mellitus, all the following are true
except:
Glucosuria is unreliable sign of control
Insulin requirement usually increases
Blood sugar should be maintained at approximately 160 mg/dl
Persistent hyperglycemia is worse than occasional hypoglycemia
Glycosylated Hb gives indication of previous long-term blood sugar levels
Answer: C* Blood sugar should be maintained at approximately 160 mg/dl
***) In diabetes mellitus associated with pregnancy all of the following
statements are true, except:
There is higher risk of congenital abnormality
There is higher risk of fetal death during the last weeks of pregnancy
Usually insulin requirement is increased
Delivery is always by caesarian section
Stabilization of diabetes should be done as early as possible during
pregnancy
Answer: D* Delivery is always by caesarian section
***) All of the following are adverse effect of diabetes on pregnancy, except:
Increased risk of microsomia
Increased risk of placenta previa
Increased risk of abortion
Increased risk of congenital abnormalities
Increased risk of candidial vulvovaginitis
Answer: B* Increased risk of placenta previa
***) All of the following are effects of diabetes on pregnancy, except:
Pre-eclampsia
Intrauterine fetal death
Increased incidence of fetal congenital abnormalities
Oligohydramnios
Shoulder dystocia
Answer: D* Oligohydramnios

***) All of the following are associated with complications in pregnant patient
with diabetes mellitus, except:
Maternal ketoacidosis
Intrauterine fetal death
Trichomonas infection
Polyhydramnios
Pre-eclamptic toxemia
Answer: C* Trichomonas infection
***) Indications of glucose tolerance test during pregnancy include all
following, except:
Family history of diabetes
Renal glucosuria
Unexplained stillbirth
Polyhydramnios
Delivery of 4.5 kg baby
Answer: B* Renal glucosuria
***) In a pregnant patient with history of diabetes in both parents, the
probability of abnormal glucose metabolism is:
10%
25%
50%
75%
100%
Answer: C*50%
***) Which one of the following contributes to good control of diabetes in
pregnancy:
300 mg carbohydrate per day diet
Good control of protein intake
Oral hypoglycemic drugs in mild cases
Twice daily mixture of short and medium acting insulin
Bed rest in the last 3 months of pregnancy
Answer: D* Twice daily mixture of short and medium acting insulin
***) In diabetes with pregnancy, there is an increased incidence of:
Traumatic delivery
Maternal death
Maternal head trauma
Normoglycemia
Delivery at home

Answer: A* Traumatic delivery

Hypertension.
***) Pre-existing raised blood pressure before pregnancy or in early
pregnancy may be due to the following, except:
Pre-eclampsia
Essential hypertension
Renal artery stenosis
Pheochromocytoma
Coarctation of aorta
Answer: A* Pre-eclampsia
***) Concerning pregnancy induced hypertension, all the following are true
except:
Common in women with diabetes mellitus
Treatment includes furosemide (Lasix)
Albuminuria is due to this condition
Delivery usually cure this condition
Will recur in 30% of cases in subsequent pregnancies
Answer: B* Treatment includes furosemide (Lasix)
***) Concerning gestational hypertension, all the following are true except:
The blood pressure rises all through pregnancy
The blood pressure decreases few days after delivery
The hypertension is not necessarily to be associated with proteinuria
The pregnancy should not exceed more than 40 weeks
The blood pressure rises in the third trimester
Answer: A* The blood pressure rises all through pregnancy
***) One of the following statements regarding pregnancy induced
hypertension is true:
Can be relieved by use of diuretics
Post partum pregnancy induced hypertension is the most dangerous
Relief of pregnancy induced hypertension is achieved by anti-tetanus toxoid
Death of the fetus is usually followed by complete improvement
Fetus is usually large for date
Answer: B* Post partum pregnancy induced hypertension is the most
dangerous

Eclampsia and Pre-eclampsia.

***) All of the following conditions are more likely to be associated with preeclampsia, except:
Multiparity
Multiple pregnancy
Chronic kidney disease
Diabetes mellitus
Vesicular mole
Answer: A* Multiparity
***) The following conditions are associated with high frequency of preeclampsia, except:
Diabetes
Multiple pregnancy
Polyhydramnios
Hydatiform mole
Placenta previa
Answer: C* Polyhydramnios
***) The following statements regarding ante partum pre-eclampsia toxemia
are true, except:
Treatment with diuretics is of great value
Primary treatment with diazoxide is contraindicated
Plasma uric acid level is elevated
Materno-placental blood flow falls to less than 50%
There is increased incidence of PET in future pregnancies
Answer: A* Treatment with diuretics is of great value
***) The following about a patient developing proteinuric hypertension (preeclampsia) in pregnancy are true, except:
Serum uric acid concentration increases
The plasma volume decreases
Placental function tests values decrease
Hb concentration increases
Creatinine clearance increases
Answer: E* Creatinine clearance increases
***) One of the following is a grave sign of severe pre-eclampsia:
A PCV (Packed cell volume) of 55%
BP 160/100 mm HG
Proteinuria of 2 g/24h
Deep tendon reflex with 3+/4+
Edema of lower limbs up to the knees

Answer: D* Deep tendon reflex with 3+/4+

***) All the following are symptoms or signs of impending eclampsia, except:
Severe headache
Polyuria
Epigastric pain
Exaggerated reflexes
Visual disturbances
Answer: B* Polyuria
***) Signs and symptoms of impending eclampsia include all of following,
except:
Headache
Sacral edema
Epigastric pain
Hyperreflexia
Blurring of vision
Answer: B* Sacral edema
***) Signs of fulminating pre-eclampsia include the following, except:
Hyperreflexia
Epigastric tenderness
Poor urine output
Maternal weight loss
Proteinuria
Answer: D* Maternal weight loss
***) The usual manner of death in case of eclampsia is:
Cerebral hemorrhage
Congestive heart failure
Cardiac arrest during convulsions
Uremia
Hemorrhagic pneumonia
Answer: A* Cerebral hemorrhage
***) The complications of pre-eclampsia include all of the following, except:
Abruption placenta
Polyhydramnios
Intrauterine growth retardation
Decreased renal blood flow
Abnormal liver enzymes

Answer: B* Polyhydramnios
***) In a case of pre-eclamptic toxemia at 40 weeks, the best management
is:
Induction of labor
Cesarean section
Give methyldopa only
Give diuretics (Lasix) only
Give hydralazine only
Answer: A* Induction of labor
***) The most worrisome sign or symptom of serious pathology in late
pregnancy is:
Swollen ankles
Constipation
Visual changes
Nocturia
Heartburn
Answer: C* Visual changes

Heart and Pregnancy.

***) Regarding changes in the heart during pregnancy, all the following are
true except:
Third sound
Diastolic murmur
Soft systolic murmur
Increased pulse rate
Slight displacement of the apex
Answer: B* Diastolic murmur
***) Which of the following signs is diagnostic of heart disease in pregnancy:
Diastolic heart murmur
Soft systolic heart murmur
Tachycardia
Arrhythmia
Accentuated first heart sound
Answer: A* Diastolic heart murmur
***) Which of the following physical signs is least likely to indicate organic
heart disease in pregnant woman:

Systolic murmur
Diastolic murmur
Atrial fibrillation
Cardiac enlargement
Palpation of a thrill
Answer: A* Systolic murmur
***) The following are factors which may lead to heart failure in patient with
heart disease in pregnancy, except:
Tachycardia
Emotional upset
Physical exercise
A systolic murmur
Lower limbs edema
Answer: D* A systolic murmur
***) In a pregnant patient with mitral stenosis, all the following are true
except:
To have labor induced at 38 weeks
Sit upright in labor
Could be considered for mitral valvotomy during pregnancy
Should not be given ergometrine (oxytocin) in the third stage of labor
Should have elective forceps delivery unless spontaneous delivery is very
rapid
Answer: A* To have labor induced at 38 weeks
***) Pregnancy is contraindicated in all of the following conditions except:
Uncorrected atrial septal defect
Marfan's syndrome
Uncompensated cardiac failure
Eisenmenger's syndrome
Severe mitral stenosis
Answer: A* Uncorrected atrial septal defect

Hyperemesis Gravidarum HG.

***) Concerning hyperemesis gravidarum, all the following are true except:
Usually occurs in the first trimester
Is associated with hydatiform mole
Is associated with multiple pregnancy
Occurs most commonly in multigravida
May require admission to the hospital

Answer: D* Occurs most commonly in multigravida

Jaundice in Pregnancy.
***) The following may cause jaundice during pregnancy, except:
Acute fatty atrophy of the liver
Viral hepatitis
Severe pre-eclampsia
Chlorpromazine
Erythromycin
Answer: D* Chlorpromazine

Urinary Tract Complications.

***) The likely organism to cause urinary tract infection in pregnancy is:
Group B streptococcus
Klebsiella pneumonia
Chlamydia trachomatis
Proteus species
Escherichia coli
Answer: E* Escherichia coli
***) Asymptomatic bacteriuria means one of the following:
Urine contains more than 1,000 organisms per milliliter
Urine contains more than 2,000 organisms per milliliter
Urine contains more than 5,000 organisms per milliliter
Urine contains more than 10,000 organisms per milliliter
Urine contains more than 100,000 organisms per milliliter
Answer: E* Urine contains more than 100,000 organisms per milliliter
***) Regarding acute pyelonephritis with pregnancy, all the following are true
except:
Right kidney is more affected than the left
Temperature is usually over 39C
Antibiotic should be started before bacteriological results are available
The incidence of pre-term labor is increased
Intravenous pyelography IVP should be done promptly
Answer: E* Intravenous pyelography IVP should be done promptly
***) In acute pyelonephritis during pregnancy the most common causative
organism is:
Pseudomonas

Klebsiella
E.Coli
Proteus
Shigella
Answer: C* E.Coli
***) The following encourage pyelitis in pregnancy, except:
Urinary stasis
Abnormalities of the renal tract
Constipation
Dehydration
Diabetes mellitus
Answer: D* Dehydration
***) Management of acute pyelonephritis during pregnancy includes all of the
following, except:
Admission to the hospital
IV fluids
Antibiotics
Intravenous pyelogram (IVP) following delivery
Induction of labor
Answer: E* Induction of labor
***) Pregnant patients with chronic renal disease have an increased of all of
the following, except:
Pre-eclampsia
Abortion
Stillbirth
Intrauterine growth retardation
Postmaturity
Answer: E* Postmaturity
***) All of the following may cause proteinuria during pregnancy, except:
A result of contamination
Urinary tract infection
Pre-eclampsia
Cardiac disease in pregnancy
Varicose veins in pregnancy
Answer: E* Varicose veins in pregnancy

***) All of the following complications of urinary tract may occur during
pregnancy, except:
Asymptomatic bacteriuria
Ureteric colic
Lower urinary tract infection is uncommon
Hematuria due to varicose veins in the bladder (hemangioma)
Acute urine retention
Answer: C* Lower urinary tract infection is uncommon
***) Urinary estriol during pregnancy is mainly derived from:
Fetal kidneys
Maternal kidneys
Fetal adrenals
Maternal adrenals
Maternal liver
Answer: C* Fetal adrenals
***) An appropriate choice of antibiotics therapy for urinary tract infection in
15 weeks pregnant is:
Doxycycline
Tetracycline
Ciprofloxacin
Nitrofurantoin
Metronidazole
Answer: D* Nitrofurantoin

Infections in Pregnancy.
***) Treponema pallidum is the cause for one of the following venereal
diseases:
Chancroid
Condyloma acuminata
Lymphogranuloma venerum
Syphilis
Granuloma inguinalis
Answer: D* Syphilis
***) Transplacental transmission occurs in which of the following:
Shigella
Syphilis
Diphtheria
Typhoid

Cholera
Answer: B* Syphilis
***) All of the following statements concerning congenital rubella infection
are true, except:
Most congenital infection occur during the first 8 weeks of pregnancy
Congenital infection includes congenital cataract, patent ductus arteriosus
and congenital deafness
If contracted during the last trimester it will lead to intrauterine growth
retardation
Gamma globulin given to the mother offers protection against fetal damage
Congenital infection can lead to fetal death or prematurity
Answer: D* Gamma globulin given to the mother offers protection against
fetal damage
***) The effects of rubella on the fetus include the following, except:
Blindness
Deafness
Hutchinson teeth
Intrauterine growth retardation
Hepatosplenomegaly
Answer: C*Hutchinson teeth
***) One of the following viral diseases may cause cataract, deafness and
heart lesion of newborn:
Measles
Rubella
Coxsackie virus
Cytomegalic inclusion bodies
Herpes zoster
Answer: B* Rubella
***) In a patient exposed to rubella infection in early pregnancy the proper
management is:
To give rubella vaccine
To advise the patient to have immediate termination
To give immunoglobulin and assure the patient
To do rubella titre IgG, IgM and repeat after two weeks
To ignore patient's complaint
Answer: D* To do rubella titre IgG, IgM and repeat after two weeks

***) A patient has been discharged following normal delivery, discharge

counseling and would include one of the following:
No driving for 4 weeks
No coitus for 6 weeks
Return to work only after 6 weeks
Rubella immunization for non-immune patients
No place for breast feeding in the puerperium
Answer: D* Rubella immunization for non-immune patients

Deep Vein Thrombosis.

***) In venous thrombosis, all the following are true except:
Less common antenatally than in puerperium
Require treatment with warfarin at all stages of pregnancy
Is uncommon diagnosis during pregnancy
Is frequently asymptomatic
Is more dangerous antenatally than postnatal
Answer: B* Require treatment with warfarin at all stages of pregnancy
***) The treatment of choice of deep vein thrombosis during pregnancy is:
Aspirin
Bed rest and crepe bandage
Physiotherapy
Oral anticoagulants
Heparin
Answer: E* Heparin

Disseminated Intravascular Coagulopathy.

***) Coagulation defects in pregnancy occur with all of the following
conditions, except:
Intrauterine fetal death
Placenta previa
Abruption placenta
Amniotic fluid embolism
Severe pre-eclampsia
Answer: B* Placenta previa
***) Clinical disseminated intravascular coagulopathy may occur in any of
the following conditions, except:
Missed abortion
Incomplete abortion
Amniotic fluid embolism

Septic abortion
Abruptio placenta (accidental hemorrhage)
Answer: B* Incomplete abortion
***) Disseminated intravascular coagulation is characterized by all of the
following, except:
Thrombocytopenia
High fibrinogen level
High levels of fibrinogen degradation products
Bleeding tendency
Low PO2
Answer: B* High fibrinogen level
***) Hypofibrinogenemia is characterized by:
A failure of blood to clot in vitro
Plasma fibrinogen of 500 mg percent
Decreased platelets count
Decreased leukocytes mobility
A decrease in erythrocytes
Answer: A* A failure of blood to clot in vitro
***) A major hazard of fetal demise after 20 weeks is:
Increase in human chorionic gonadotropin values
Systemic allergies
Bone marrow depression
Coagulopathy
Toxemia
Answer: D* Coagulopathy

Maternal Risks in Pregnancy.

***) All of the following can be categorized as high risk pregnancy, except:
Diabetes mellitus
Hypertension disease
Mal presentation of the fetus
Previous cesarean section
Edema of the lower extremities
Answer: E* Edema of the lower extremities
***) In early pregnancy, lower abdominal pain could be caused by all the
following, except:

Cystitis
Threatened abortion
Ectopic pregnancy
Mole pregnancy
Twisted ovarian cyst
Answer: D* Mole pregnancy
***) All of the following are the features of complication of grand multiparous woman, except:
Iron deficient anemia
Increased incidence of antepartum hemorrhage
Infertility
Ruptured uterus
Post partum hemorrhage
Answer: C* Infertility
***) The treatment of choice in a patient with a cystocele during pregnancy
is:
Anterior repair operation in the first trimester
Repair 2 weeks after delivery
Anterior repair operation in the second trimester
Immediate repair after delivery of the placenta
Re-evaluation six weeks after delivery
Answer: E* Re-evaluation six weeks after delivery

Bleeding in Pregnancy OB23-OB24.

First and Second Trimester Bleeding.
***) Currently the leading cause of maternal mortality is:
Hypertensive disorders of pregnancy
Hemorrhage
Sepsis
Obstetric anesthesia
Instrumental delivery
Answer: B* Hemorrhage
***) Vaginal bleeding in early pregnancy can be due to the following, except:
Early abortion
Threatened abortion
Ectopic pregnancy
Hydatidiform mole

Pregnancy with ovarian cyst

Answer: E* Pregnancy with ovarian cyst
***) The most likely cause of abnormal genital bleeding in a 22 year old
woman is:
Cervical cancer
Anovulation
Uterine cancer
Systemic bleeding disease
Threatened abortion
Answer: E* Threatened abortion

Third Trimester Bleeding (Ante partum

Hemorrhage).
***) All of the following may cause ante-partum hemorrhage, except:
Placenta previa
Abruptio placenta
Vaginal varicose
Cervical carcinoma
Moniliasis
Answer: E* Moniliasis
***) 32 weeks intrauterine pregnancy with mild vaginal bleeding, which
appeared suddenly, uterus is soft, good FSH, oblique lie, one of the following
is the proper management:
Vaginal examination with starting of blood transfusion
Hospitalization, bed rest, ultrasound exam, prepare blood
Immediate CS
Examination under anesthesia, than rupture of membranes and oxytocin drip
Induction with prostaglandin vaginal supports
Answer: B* Hospitalization, bed rest, ultrasound exam, prepare blood
***) Mild painless vaginal bleeding at 33 weeks of pregnancy should be
treated by:
Artificial rupture of membranes
Expectant conservative treatment
Cesarean section
Immediate vaginal delivery
Pelvic examination
Answer: B* Expectant conservative treatment

***) In ante-partum hemorrhage fetal blood cells could be identified in one of

the following conditions:
Placenta circumvallate
Placenta marginalis
Placenta membranacea
Battledore insertion of the cord
Velamentous insertion of the cord
Answer: E* Velamentous insertion of the cord

Spontaneous Abortions.
***) In inevitable abortion, all the following are true except:
The cervical os will be dilated
The pain is colicky in nature
The conceptual sac may be felt by pelvic examination
Usually there is no vaginal bleeding
The uterine size is compatible
Answer: D* Usually there is no vaginal bleeding
***) One of the following is true in a case of incomplete abortion:
The internal cervical os is closed
The fetal heart activity is heard
Human chorionic gonadotropin (hCG) injections should be given
The vaginal bleeding is painless
Evacuation of the uterus is needed
Answer: E* Evacuation of the uterus is needed
***) A major hazard of missed abortion is:
Pulmonary embolism
Systemic allergies
Bone marrow depression
Coagulopathy
Toxemia
Answer: D* Coagulopathy
***) All of the following are signs of missed abortion, except:
Vaginal bleeding
Distorted gestational sac
Absence of fetal heart activity
Small for gestational age uterus
Absence of fetal movements

Answer: A* Vaginal bleeding

***) In missed abortion all of the following are true, except:
The uterus is larger than date
The uterus is smaller than date
The fetus is dead
Can cause coagulopathy
Menstruation does not occur
Answer: A* The uterus is larger than date
***) The most common type of bacteria present in septic abortion is:
E.Coli
Pseudomonas
Beta-hemolytic streptococcus
Bacteroids
Peptostreptococcus (anaerobic streptococcus)
Answer: E* Peptostreptococcus (anaerobic streptococcus)
***) The most common cause of abortion in the 1st trimester is:
Physical trauma
Uterine retroversion
Abnormality of the conceptus
Systemic maternal infection
Incompetent cervix
Answer: C* Abnormality of the conceptus
***) The most common cause for 2nd trimester abortion is:
Fetal abnormality
Placental insufficiency
Incompetent cervix
Fibroid uterus
Rh isoimmunization
Answer: C* Incompetent cervix
***) One of the following is the commonest cause of vaginal bleeding during
the first half of pregnancy:
Hydatiform mole
Abruptio placenta
Ectopic pregnancy
Abortion
Placenta previa

Answer: D* Abortion
***) Criteria for abortion due to cervical incompetence include all of the
following, except:
First trimester abortion
Water before blood
Short and minimal labor pains
Cervix admits number 8 hegar dilator
Barrel-shaped cervix by H.salpingogram
Answer: A* First trimester abortion
***) With cervical incompetence, all the following are true except:
May be congenital
It is associated with previous dilatation
It is associated with painless premature labor
It is diagnosed by follicular phase hysterography
It is common cause of second trimester abortion
Answer: D* It is diagnosed by follicular phase hysterography
***) If a patient who has threatened abortion did not abort, the risk of the
fetus being abnormal is:
The same as in patient without bleeding
Slightly increased
Moderately increased
Markedly increased
99 to 100%
Answer: B* Slightly increased
***) A 23 year old lady G1P0, 6 weeks pregnant has developed bleeding over
the past 2 days. Which of the following is the likely cause of her bleeding:
Hydatidiform mole
Abruption placenta
Ectopic pregnancy
Abortion
Uterine rapture
Answer: D* Abortion
***) Therapy for threatened abortion should include:
Progesterone injection
Dilatation and curettage
Prolonged bed rest

Restricted activity
Prostaglandins suppositories
Answer: D* Restricted activity
***) Extrusion of an abortus from the fimbriated end of the tube is called:
Spontaneous abortion
Delivery
Tubal abortion
Decidual cast
Aria-Stella phenomenon
Answer: C* Tubal abortion
***) A 26 year old woman whose last menstrual period was 2.5 months ago
develops bleeding, uterine cramps, and passes tissues per vagina. Two hours
later she is still bleeding heavily, the most likely diagnosis is:
Twin pregnancy
Threatened abortion
Inevitable abortion
Premature labor
Incomplete abortion
Answer: E* Incomplete abortion
***) A 24 year old woman, 10 weeks pregnant presented with vaginal
bleeding, lower abdominal pain and temperature 39.5 degrees and a history
of introducing sharp object per vagina for self abortion. The most likely
diagnosis is:
Choriocarcinoma
Hydatidiform mole
Pelvic inflammatory disease
Septic abortion
Twisted ovarian cyst
Answer: D* Septic abortion
***) Definitive initial therapy in septic abortion is:
Curettage after antibiotics
Hysterectomy
Bed rest and antibiotics
Hysterotomy
Outpatient antibiotics
Answer: A* Curettage after antibiotics

***) The treatment of incomplete abortion in a patient of 10 weeks gestation

is:
Administration of syntocinon only
Administration of ergometrine only
Hysterectomy
Evacuation of the uterus
Prostaglandin vaginal pessary
Answer: D* Evacuation of the uterus
***) The clinical features of threatened abortion include all the following
except:
Slight bleeding per vaginal
Size of the uterus corresponds to period of amenorrhea
Mild abdominal pain
The cervix is closed
The cervix is opened
Answer: D* The cervix is closed

Molar and Ectopic Pregnancy OB24OB26.

Molar Pregnancy (Hydatidiform mole).
***) Regarding hydatidiform mole, all the following are true except:
Commoner in women of blood group A married to blood O men
Group AB women have the worst prognosis
Are commoner in older gravida
Are complicated by ovarian cyst
Can be diagnosed by chest X-ray
Answer: E* Can be diagnosed by chest X-ray
***) In hydatiform mole pregnancy, all the following are true except:
Uterine size is larger than dates
Bilateral ovarian cysts (Lutein cysts) is common
Aggravated morning sickness
Treatment is by suction, curettage regardless of the size of the uterus
Pregnancy is allowed after 6 months
Answer: E* Pregnancy is allowed after 6 months
***) The complications of hydatiform mole include all the following except:
Hemorrhage

Sepsis
Perforation of the uterus
Inversion of the uterus
Choriocarcinoma
Answer: D* Inversion of the uterus
***) Hydatiform mole (vesicular mole) is usually treated by:
Hysterectomy
Prostaglandin induction
Syntocinon induction
Methotrexate
Suction-evacuation of the uterus
Answer: E* Suction-evacuation of the uterus

Ectopic Pregnancy.
***) Regarding ectopic pregnancy all of the following statements are true,
except:
It is a pregnancy that implants outside the uterus
The most common site of implantation is the abdominal cavity
It may occur in the cervix
Previous infection is a major cause
There is an increase incidence among IUCD users
Answer: B* The most common site of implantation is the abdominal cavity
***) In ectopic pregnancy, all the following are true except:
Pain usually proceeds bleeding
Shoulder pain is an important symptom
The isthmus of the tube is the commonest site of implantation
Is often not diagnosed by os
The incidence is greater in women with IUCD
Answer: C* The isthmus of the tube is the commonest site of implantation
***) The commonest site for tubal ectopic pregnancy is:
Fimbria
Ampulla
Isthmus
Intramural
Paratubal
Answer: B* Ampulla

???) All of the following may be etiological factors of ectopic pregnancy,

except:
Previous infection of the tubes
Delayed passage of the fertilized ovum down the tube
Progesterone pills for contraception
Intrauterine contraceptive device IUCD users
Irregular periods
Answer: E* Irregular periods
***) All of the following may increase the incidence of ectopic pregnancy,
except:
Previous pelvic infection
Use of birth control pills
Tubal surgery
Previous appendicitis
Tubal abnormalities
Answer: B* Use of birth control pills
***) The ectopic pregnancy may be due to:
Chronic salpingitis
Short fallopian tube
Long uterine cavity
Use of vaginal diaphragm
Contraceptive pills
Answer: A* Chronic salpingitis
***) All of the following are the clinical features of tubal pregnancy, except:
The patient may have evidence of peritoneal irritation
Lower abdominal pain
Abdominal rigidity
Fainting
Severe vaginal bleeding
Answer: E* Severe vaginal bleeding
***) The most important symptom of ectopic pregnancy is one of the
following:
Severe bleeding
Pain
Amenorrhea
Fainting
Pelvic heaviness

Answer: B* Pain
***) Vaginal bleeding in ectopic pregnancy is due to:
Rupture of the fallopian tube
Rupture of the uterus
Vaginal laceration
Peritoneal hemorrhage
Hormone withdrawal
Answer: E* Hormone withdrawal
***) The following features suggest a diagnosis of ectopic pregnancy, except:
Amenorrhea of 6-10 weeks
Acute abdomen
Enlarged uterus
Decidual tissue at curettage
Vaginal bleeding
Answer: C* Enlarged uterus
***) Regarding ectopic pregnancy, all the following are true except:
Amenorrhea
Vaginal bleeding
Abdominal pain
Elevated hCG
Endometrium has always secretory changes
Answer: D* Elevated hCG
***) All true about ectopic pregnancy, except:
Attacks of abdominal sharp stabbing pain
Fainting attacks
Vaginal bleeding
Period of amenorrhea
Pregnancy test is always positive
Answer: A* Attacks of abdominal sharp stabbing pain
***) Signs of ruptures ectopic pregnancy include the following, except:
Rebound tenderness in the abdomen
Heavy vaginal bleeding
Cervical excitation on vaginal examination
Localized tenderness in the pelvis
Tachycardia
Answer: B* Heavy vaginal bleeding

***) Ectopic pregnancy is confirmed by one of the following:

Ultrasound examination
Vaginal examination
Culdocentesis
hCG urine pregnancy test
Laparoscopy
Answer: E* Laparoscopy
***) Which of the following can be a definite diagnosis of intrauterine
pregnancy to rule out ectopic pregnancy:
Decidual reaction at D&C pathology specimen
Aria-stella phenomen at D&C pathology specimen
Chorionic villi at D&C pathology specimen
Positive pregnancy test
Positive -hCG assay
Answer: C* Chorionic villi at D&C pathology specimen
***) Differential diagnoses of ectopic pregnancy are the following, except:
Acute salpingitis
Acute appendicitis
Acute red degeneration of fibroid
Rupture ovarian cyst
Vesicular mole
Answer: E* Vesicular mole
***) Differential diagnoses of ectopic pregnancy are the following, except:
Rupture of a corpus luteum cyst
Uterine abortion
Torsion of fallopian tube
Acute appendicitis
Spasmodic dysmenorrhea
Answer: E* Spasmodic dysmenorrhea
***) Of the following, which woman is at greater risk for ectopic pregnancy:
Healthy woman on birth control pills
A woman with a past history of three incidents of pelvic inflammatory
disease
Woman with a history of endometriosis
Woman with irregular menses
Woman with a past history of several attacks of UTI

Answer: B* A woman with a past history of three incidents of pelvic

inflammatory disease
***) The most common implantation site for ectopic pregnancy is the:
Abdominal cavity
The ovarian surface
The cervix
Ampulla of the fallopian tube
The interstitial portion of the fallopian tube
Answer: D* Ampulla of the fallopian tube
***) A 24 year old patient married since 2 years. She is having 6 weeks
amenorrhea and unilateral anneal pain, acute abdomen, rapidly falling
hematocrit, hypertensive and positive pregnancy test. The most likely
diagnosis is:
Endometriosis
Appendicitis
Urinary tract infection
Threatened abortion
Ectopic pregnancy
Answer: E* Ectopic pregnancy

Placenta OB26-OB29.
The Placenta.
***) Where does fertilization take place:
In the ovary
In the fimbrial end of the fallopian tube
In the ampullary region of the fallopian tube
In the uterus
In the isthmic region of tube
Answer: C* In the ampullary region of the fallopian tube
***) Implantation of the blastocyte occurs after:
1-2 days
3-5 days
6-8-days
9-10 days
12-14 days
Answer: C* 6-8-days

***) The method of choice of placental localization is:

Ultrasonography
Angiography
Soft tissue placentography
Use of radioactive isotopes
Amniography
Answer: A* Ultrasonography
***) All of the following are placental hormones, except:
Follicular stimulating hormone
Human placental lactogen
Progesterone
Estrogen
Somatotropine (growth hormone)
Answer: A* Follicular stimulating hormone
***) Human Placental Lactogen (hPL) can be elevated in all of the following,
except:
Diabetes
Twins
Hypertension
Erythroblastosis
Bronchogenic carcinoma
Answer: C* Hypertension

Abnormalities of the Placenta.

***) Placental abnormality characterized by an accessory lobe is termed:
Placenta membranacea
Placenta circumvallate
Placenta succenturiata
Placenta fenestrata
Placenta increta
Answer: C* Placenta succenturiata
***) One of the following is true concerning placenta succenturiata:
The placenta is surrounded by a fibrous ring
The placenta contains fenestration in its center
The placenta is connected to an accessory lobe by a small vessels and
membrane
The chorionic plate is surrounded by a membranous structure
The placenta is horse-shaped in appearance

Answer: C* The placenta is connected to an accessory lobe by a small

vessels and membrane
***) One of the following is true concerning a battledore placenta:
The umbilical cord is attached to its central part
The umbilical cord is attached to the central membranes
The umbilical cord is attached to the margin of the placenta
The umbilical cord is attached to an accessory lobe of the placenta
The umbilical cord is attached to two lobes of placenta
Answer: C* The umbilical cord is attached to the margin of the placenta
***) All of the following are common causes of placental insufficiency, except:
Prolonged hypertension disease in pregnancy
Obesity
Chronic renal disease
Severe anemia
Prolonged pregnancy
Answer: B* Obesity
***) Placental insufficiency is caused by the following, except:
Smoking in pregnancy
Dieting in pregnancy
Hypertensive disorders in pregnancy
Post maturity
Multiple pregnancy
Answer: B* Dieting in pregnancy
***) All of the following are causes of large placenta, except:
Multiple pregnancy
Chronic renal disease
Syphilis
Diabetes mellitus
Hydrops fetalis
Answer: B* Chronic renal disease

Placenta Previa.
***) In placenta previa all of the following statements are true, except:
Causes painless vaginal bleeding
Vaginal examination is contraindicated
Is managed by caesarian section if covering the cervical os

Presents with a woody hard uterus

Predisposes to postpartum hemorrhage
Answer: D* Presents with a woody hard uterus
***) All of the following are commonly associated with placenta previa,
except:
Sudden onset of fresh bleeding
Abnormal presentation
Unengaged head
Absence of fetal heart
Soft abdomen
Answer: D* Absence of fetal heart
***) Vaginal examination is contraindicated in one of the following situations
during pregnancy:
Carcinoma of the cervix
Gonorrhea
Prolapsed cord
Placenta previa
Active labor
Answer: D* Placenta previa

Abruptio Placenta.
***) Concerning abruptio placenta, all the following are true except:
It is a premature separation of normally implanted placenta
The uterus is tender
In severe cases a central venous pressure line should be inserted
The vaginal bleeding is painless
The management of choice is termination of pregnancy
Answer: D* The vaginal bleeding is painless
***) Abruptio placenta can be secondary to all of the following, except:
Hypertensive disorders
Following delivery of first twin
In severe car accident
After rupture of membrane in oligohydramnios
External cephalic version
Answer: D* After rupture of membrane in oligohydramnios
***) In abruptio placenta, all of the following may occur, except:

Shock
Vaginal bleeding
Uterine tenderness
Convulsions
Fetal distress
Answer: C* Uterine tenderness
***) The most common complication of abruptio placenta is:
Hepatic failure
Heart failure
Post partum hemorrhage
Adrenal failure
Cerebral edema
Answer: C* Post partum hemorrhage
***) The following are complications of placental abruption, except:
Renal cortical necrosis
Eclampsia
Afibrinogenemia
DIC (Disseminated Intravascular Coagulopathy)
Intrauterine growth retardation
Answer: B* Eclampsia
***) The most consistent factor predisposing to abruption placenta is:
Maternal hypertension
Trauma
Uterine decompression
Maternal parity
Maternal age
Answer: A* Maternal hypertension
***) Treatment for severe placental abruption at term with 3cm dilated cervix
is:
Heparin
Blood transfusion
Steroid therapy for fetal lung maturity
Tocolytic therapy
Urgent CS
Answer: E* Urgent CS

Placental Tumors.
***) Choriocarcinoma is a primary tumor of:
Decidua
Undifferentiated gonadal cells
Myometrium
Trophoblast
Ovaries
Answer: D* Trophoblast
***) Choriocarcinoma may result from all of the following, except:
Hydatidiform mole
Endometriosis
Term pregnancies
Ectopic pregnancies
Abortions
Answer: B* Endometriosis
***) The following are clinical features of choriocarcinoma, except:
Irregular vaginal bleeding after pregnancy
Metastases may present as lumps in the vagina
Choriocarcinoma is self-limited disease
May cause intraperitoneal hemorrhage
May cause amenorrhea
Answer: C* Choriocarcinoma is self-limited disease
***) Choriocarcinoma is treated by:
Surgery
Chemotherapy
Antibiotics
Hormones
Radiotherapy
Answer: B* Chemotherapy

Multiple Gestation OB29-OB30.

Multiple Pregnancy.
***) The following about twins pregnancy are true, except:
Dizygotic are more common than monozygotic
Dizygotic incidence increases with maternal age
In monozygotic twins a split at the 2 cells stage result in two placentas

All twins are at risk of growth retardation

Polyhydramnios is commoner in dizygotic than in monozygotic twins
Answer: C* In monozygotic twins a split at the 2 cells stage result in two
placentas
***) Multiple pregnancy predisposes to the following, except:
Placenta previa
Diabetes mellitus
Acute pyelonephritis
Placental insufficiency
Mal presentation
Answer: C* Acute pyelonephritis
***) All of the following are possible complications of multiple pregnancy,
except:
Abnormal presentation
Dysfunctional labor
Umbilical cord prolapse
Cephalo-pelvic disproportion
Postpartum hemorrhage
Answer: B* Dysfunctional labor
***) In multiple pregnancy all of the following are possible risk, except:
PET (Pre-eclampsia toxemia)
Preterm labor
Oligohydramnios
Anemia
Ante partum hemorrhage
Answer: C* Oligohydramnios
***) Twin pregnancy shows an increase in the following complications,
except:
Accidental hemorrhage
Pre-eclamptic toxemia (PET)
Polyhydramnios
Post-partum hemorrhage
Polycythemia
Answer: E* Polycythemia
***) Compared with single pregnancies, multiple pregnancies have a higher
rate of the following except:

Abortion
Abnormal presentation
Prolapsed cord
Lung maturity
Preterm delivery
Answer: D* Lung maturity
***) Multiple pregnancy is usually associated with increased incidence in all
the following except:
Ante partum hemorrhage
Anemia
Toxemia of pregnancy
Premature labor
Monilial genital infection
Answer: E* Monilial genital infection
***) The incidence of dizygotic twins is influenced by all of the following,
except:
Race
Maternal age
Parity
Paternal age
Heredity
Answer: D* Paternal age
***) In uniovular twins, all the following are true except:
The first fetus commonly presents by the breech
Anemia is common
There is only one placenta
Polyhydramnios is frequently present
Pregnancy induced hypertension is common
Answer: A* The first fetus commonly presents by the breech
***) Regarding monozygotic twins, all the following are true except:
They are always identical
They have only one placenta
They make up 1/3 of all twin pregnancies
They are usually separated from one another by amnion and chorion
They are more common if there is family history
Answer: D* They are usually separated from one another by amnion and
chorion

Delivery in Multiple Pregnancy.

***) In twin delivery all are correct statements, except:
The 2nd twin is at greater risk than the 1st
Labor usually occurs before term
The commonest presentation is verte and vertex
Post partum hemorrhage is rare
Labor is not prolonged
Answer: D* Post partum hemorrhage is rare
***) In twin pregnancy the second twin has higher perinatal mortality
because of all of the following, except:
High incidence of intrauterine anoxia
High incidence of mal presentation
High incidence of abruptio placenta
More surgical intervention
The second twin is heavier
Answer: E* The second twin is heavier

Growth Discrepancies OB30-OB33.

Intrauterine Growth Restriction IUGR.
***) All of the following maternal factors are associated with IUGR, except:
Poor nutrition with anemia
Heavy smoking
Toxemia
Gestational diabetes
Alcohol consumption
Answer: D* Gestational diabetes

Macrosomia.
***) With fetal macrosomia all of the following complications are increased,
except:
Fetal asphyxia
Brachial plexus injury
Post partum hemorrhage
Cord prolapse
Neonatal hypoglycemia
Answer: D* Cord prolapse

Polyhydramnios.
***) All of the following may cause polyhydramnios, except:
Diabetes mellitus
Multiple pregnancy
Anencephalic fetus
Fetal renal atresia
Fetal esophageal atresia
Answer: D* Fetal renal atresia
***) Polyhydramnios could be associated with all of the following, except:
Renal agenesis
Esophageal atresia
Anencephaly
Duodenal atresia
Illeal atresia
Answer: A* Renal agenesis

Oligohydramnios.
***) All of the following anomalies are associated with severe maternal
oligohydramnios, except:
Potter's syndrome
Dysplastic kidneys
Pulmonary hypoplasia
Musculoskeletal abnormalities
Gastrointestinal tract obstructions
Answer: E* Gastrointestinal tract obstructions
***) All of the following are associated with oligohydramnios, except:
Renal agenesis
Esophageal atresia
Pulmonary hypoplasia
Urethral atresia
Amnion nodosum
Answer: B* Esophageal atresia

Fetus and Delivery OB33-OB35.

Pelvis.
***) The shortest antero-posterior diameter of the pelvis is:
True conjugate

Diagonal conjugate
Obstetrical conjugate
Antero-posterior diameter of plane of midpelvis
Antero-posterior diameter of inferior straight
Answer: C* Obstetrical conjugate
***) In young women the most common type of pelvis is:
Anthropoid pelvis
Android pelvis
Platypelloid pelvis
Gynecoid pelvis
Rachitic pelvis
Answer: D* Gynecoid pelvis
***) The android pelvis characteristically has the following, except:
A narrow sacroischiatic notch
A parallel pelvic side walls
A narrow sub-pubic angle
A prominent ischial spines
A narrow outlet A-P diameter
Answer: B* A parallel pelvic side walls

Fetal Skull.
***) Regarding the head vertex, all the following are true except:
It is bounded in front by the anterior fontanel and the coronal sutures
It is the area between the 2 halves of the frontal and the 2 parietal bones
It is the area bounded behind by the posterior fontanel and the lambdoidal
suture
It is the area bounded laterally by lines passing through the parietal
eminences
It is felt in the majority of cases during vaginal examination
Answer: B* It is the area between the 2 halves of the frontal and the 2
parietal bones
***) The posterior fontanel is defined:
The area lies between the sagittal suture and the lambdoid suture
The area lies between the coronal and sagittal sutures
The area lies between the coronal and temporal sutures
The area lies between the anterior and lambdoid sutures
The area lies between the sagittal suture and biparietal bones

Answer: A* The area lies between the sagittal suture and the lambdoid
suture
***) The longest anterio-posterior diameter of the fetal head is:
Occipito-frontal diameter
Suboccipito-pregmatic diameter
Occipito-mental diameter
Submento-pregmatic diameter
Mento-vertical diameter
Answer: E*Mento-vertical diameter
***) In normal developing fetus at 36 weeks pregnancy, the most like
measurement of the BPD (biparietal diameter) of the head is:
9.5 cm
9 cm
12 cm
8.5 cm
8 cm
Answer: A* 9.5 cm
***) Regarding biparietal diameter, all the following are true except:
The biparietal diameter is the distance between the parietal eminences
The measurement is 9.5 cm
In vertex presentation it is the largest presenting diameter
It is measured by ultrasound scanning for the maturity of fetus
It has no relation to the engagement of the head in the pelvis
Answer: E* It has no relation to the engagement of the head in the pelvis
***) Engagement of the fetal head refers to the relationship between:
Biparietal diameter and ischial spines
Biparietal diameter and pelvic brim
Vertex and pelvic outlet
Vertex and ischial spine
Head and pelvic outlet
Answer: B* Biparietal diameter and pelvic brim
***) In primigravida at full-term in labor, the most common position of the
head is:
ROT (right occiput transverse)
LOT (left occiput transverse)
LOA (left occiput anterior)
ROA (right occiput anterior)

DOP (direct occiput posterior)

Answer: C* LOA (left occiput anterior)
***) Cephalohematoma is most commonly found over the:
Frontal bone
Temporal bone
Parietal bone
Occipital bone
Ethmoid bone
Answer: C* Parietal bone

Malpresentation and Malposition.

***) The transverse lie in multipara at term in labor best treated by:
External version
Internal version and extraction
Pitocin induction
Cesarean section
Internal version, than oxytocin induction
Answer: D* Cesarean section
***) One of the following is absolute indication for cesarean section:
Brow presentation
Anterior face presentation
Occipito-posterior position
Right occipital presentation
Transverse arrest of the head
Answer: A* Brow presentation
***) In case of face presentation during labor, all of the following are felt on
vaginal examination, except:
Chin
Mouth
Nose
Anterior fontanel
Orbital ridge
Answer: D* Anterior fontanel
***) The most common cause of breech presentation is:
Polyhydramnios
Placenta previa

Prematurity
Hydrocephalus
Multiple pregnancy (twin gestation)
Answer: C* Prematurity
***) Breech presentation is associated with the following, except:
Prematurity
Polyhydramnios
Oligohydramnios
Hydrocephaly
Postmaturity
Answer: E* Postmaturity
***) Breech presentation diagnosed antenatally at 37 weeks gestation, is
best managed by:
Cesarean section
External cephalic version
X-ray maturity
Ultrasonography and observation
Oxytocin infusion of lower femoral epiphysis are seen by X-ray
Answer: B* External cephalic version
***) Non-engagement of the fetal head in the second stage of labor is due to
all of the following, except:
Mal position
Hydrocephaly
Contracted pelvis
Compound presentation
Anencephaly
Answer: E* Anencephaly
***) A high head at term could be due to the following except:
Wrong dates
Cephalopelvic disproportion
Placental abruption
An occipito-posterior position
Placenta previa
Answer: C* Placental abruption
***) In face presentation with head not engaged in mento-posterior position
the ideal treatment is:

Forceps delivery as mento-posterior

Forceps rotation to mento-anterior then forceps delivery
Vacuum delivery
Cesarean section
Internal podalic version and breech extraction
Answer: D* Cesarean section

Labor and Delivery OB35-OB38.

Labor and Cervical changes.
***) False labor pains as compared to true labor pains are characterized by
all of the following, except:
Contractions occur at irregular intervals
There is demonstrable progressive dilatation of the cervix
They are not intensified by walking
Located chiefly in lower abdomen
Short duration
Answer: B* There is demonstrable progressive dilatation of the cervix
***) Progress of labor is assessed by one of the following criteria:
Frequency of uterine contractions
Intensity of uterine contractions
Softening of the cervix
Effacement of the cervix
Dilatation of cervix
Answer: E* Dilatation of cervix

Labor Stages.
***) All of the following are signs of placental separation in third stage of
labor, except:
Appearance of contraction ring
Uterus becomes globular, firm and ballotable
Sudden gush of blood
Rise of uterine fundus
Elongation of the cord
Answer: A* Appearance of contraction ring
***) The third stage of labor follows one of the following:
Rupture of the membranes
Full dilatation of the cervix

Delivery of the fetal head

Delivery of the fetus
Delivery of the placenta
Answer: E* Delivery of the placenta

Obstetric Anesthesia.
***) All the following types of analgesia are used during first stage of labor,
except:
Pethidine
Epidural analgesia
Cervical block
Pudendal block analgesia
Inhalation analgesia
Answer: D* Pudendal block analgesia
***) All of the following are indications of epidural anesthesia, except:
Ante-partum hemorrhage
Heart disease
Pulmonary disorders
Premature delivery
Hypertension
Answer: B* Heart disease

Fetal Monitoring in Labor.

***) The normal fetal heart rate in labor is:
80-100 beats per minute
100-120 beats per minute
120-160 beats per minute
160-180 beats per minute
180-200 beats per minute
Answer: C*120-160 beats per minute
***) The most dangerous sign of imminent fetal death during fetal heart
monitoring is:
Early deceleration
Variable deceleration
Loss of beat to beat variability
Late deceleration
Fetal tachycardia
Answer: D* Late deceleration

***) All of the following may cause fetal hypoxia, except:

Maternal hypotension
Subserous fibroid
Uterine hyperactivity
Occlusion of umbilical cord
Placental insufficiency
Answer: B* Subserous fibroid

Induction of Labor.
***) The following may be used safely to accelerate labor, except:
Intravenous oxytocin
Ergometrine
Prostaglandin
Rupture of membranes
Stimulation of the nipples
Answer: B* Ergometrine

Complications & Risks of Delivery

OB40-OB49.
Preterm Labor PTL.
***) All of the following may cause premature delivery, except:
Abruptio placenta
Chronic hypertensive vascular disease
Placenta previa
Oligohydramnios
Smoking
Answer: D* Oligohydramnios
***) All of the following have been associated with an increased risk of
preterm delivery except:
Placenta previa
Oligohydramnios
Hyperemesis gravidarum
First-trimester bleeding
Multiple gestation
Answer: B* Oligohydramnios

Premature Rupture of Membranes PROM.

***) The following tests can be used for the diagnosis of premature rupture of
membranes, except:
Nitrazine test
Ferning test
Schiller's test
Nile blue sulfate
Evans blue test
Answer: C* Schiller's test
???) Premature ruptures of membranes risks include the following except:
Premature labor
Cord prolapse
Fetal pneumonia
Placental abruption
Maternal septicemia
Answer: D* Placental abruption

Prolonged Pregnancy (Postmaturity).

***) A patient presented in labor claiming to be at 43 week gestation. Which
of the following neonatal findings would support the diagnosis of a postmature infant:
Anemia
Increase in subcutaneous fat
Long fingernails
Vernix
Fusion of fetal eye lids
Answer: C* Long fingernails

Umbilical Cord Prolapse.

***) Prolapsed umbilical cord may occur in all of the following, except:
Polyhydramnios
Transverse lie
Placenta previa centralis
Breech presentation
Prematurity
Answer: C* Placenta previa centralis
***) Pulsating cord prolapse at 4 cm cervical dilatation is best managed by:
Augmentation of labor by oxytocin drip
Vacuum extraction

By giving prostaglandin vaginal tablets

By putting the patient in knee chest position and wait for vaginal delivery
Cesarean section
Answer: E* Cesarean section

Uterine Rupture.
***) The commonest predisposing factor of rupture of uterus is:
Previous CS
Use of syntocinon (Oxytocin) non properly
Forceps delivery
Internal cephalic version
Vacuum extraction
Answer: A* Previous CS
***) Uterine rupture may be associated with all of the following except:
Amniocentesis
Previous cesarean section
Myomectomy
Administration of oxytocin or prostaglandins
Difficult forceps delivery or intrauterine manipulation
Answer: A* Amniocentesis
***) The most constant early symptom in uterine rupture during labor is:
Hematuria
Hypotension
Pain
Vaginal bleeding
Cessation of contractions
Answer: C* Pain
***) The first sign of rupture uterus is:
Abdominal pain
Tender scan
Unexplained tachycardia
Fetal distress
Vaginal bleeding
Answer: A* Abdominal pain

Operative Obstetrics OB49-OB51.

Operative Vaginal Delivery.

***) Vacuum extraction is contraindicated in one of the following condition:
Occipito-posterior position
Gestational age 32 weeks
Occipito-transverse position
In patients with heart disease
In patients with previous caesarian section
Answer: B* Gestational age 32 weeks

Episiotomy and Lacerations.

***) Regarding episiotomy all of the following statements are true except:
Shorten the second stage
Reduce trauma to the fetal head
Reduce damage of the pelvic floor
It is usually followed by vaginal stenosis
Reduce the incidence of third degree tears
Answer: D* It is usually followed by vaginal stenosis

Caesarean Section CS.

***) All of the following are indications for cesarean section, except:
Transverse lie
Mento-posterior position
Fetal distress in the first stage
Twin pregnancy
Prolapsed pulsating cord
Answer: D* Twin pregnancy
***) A multigravida with mitral stenosis in labor with obvious cephalopelvic
disproportion, best delivered with:
Cesarean section
Forceps delivery in the second stage
Vacuum delivery if cervix not fully dilated
Enhance labor by syntocinon (oxytocin)
Await spontaneous vaginal delivery
Answer: A* Cesarean section
***) All of the following are possible indications for classical cesarean section,
except:
Carcinoma of the cervix
Impacted shoulder presentation
Severe adhesions in the lower uterine segment

Large cervical fibroid

Posterior placenta previa grade II
Answer: B* Impacted shoulder presentation
***) Indications for a Caesarian section include all of the following, except:
Cord prolapse
Previous Caesarian section
Fetal distress
Transverse lie
Migraine
Answer: E* Migraine
***) All the following are indications for caesarean section except one:
Prolapsed cord
Transverse lie at term
Placenta previa at term
Intrauterine fetal death at term
Previous for CS
Answer: D* Intrauterine fetal death at term
***) All of the following are indications to primary cesarean section except:
Prolapsed cord
Cord presentation
Mal presentation
Face presentation (mento-anterior)
Fetal distress
Answer: D* Face presentation (mento-anterior)
***) All of the following might be an indication to do classical cesarean
section except one:
Transverse lie at term with the back down
Severe pelvic-abdominal adhesions
Previous cesarean section with severe pelvic-abdominal adhesions
Per mortem
Cephalopelvic disproportion
Answer: E* Cephalopelvic disproportion

Puerperal Complications OB51-OB56.

Postpartum Changes.

***) The period of time from the end of delivery until the reproductive organs
have returned to normal is called:
Menopause
Puerperium
Perineum
Ante-partum
Intra-partum
Answer: B* Puerperium
***) Postpartum hemorrhage is diagnosed when blood loss exceeds:
100 cc
200 cc
300 cc
400 cc
500 cc
Answer: E* 500 cc
***) In postpartum hemorrhage the most common cause is:
Atonic uterus
Cervical tear
Uterine rupture
Retained placental tissue
Inversion of the uterus
Answer: A* Atonic uterus
***) Regarding post partum hemorrhage all of the following are predisposing
factors, except:
Multiple pregnancies
Polyhydramnios
Giving syntometrine with the delivery of anterior shoulder
Prolonged labor
Precipitated labor
Answer: C* Giving syntometrine with the delivery of anterior shoulder
***) Concerning postpartum hemorrhage, all the following are true except:
More common in twin pregnancy than single pregnancy
Less common in primigravida than multigravida
The commonest cause is laceration of the cervix
It may be caused by bleeding from non-placental site
The prevention is by active management of the third stage of labor
Answer: C* The commonest cause is laceration of the cervix

***) Postpartum hemorrhage is caused by the following, except:

Prolonged labor
Retained parts of the placenta
Cervical tear
Full bladder
Toxemia of pregnancy
Answer: D* Full bladder
***) One of the following is the most common cause of primary post-partum
hemorrhage:
Vaginal or cervical lacerations
Uterine inversion
Coagulopathy
Uterine rupture
Uterine atony
Answer: E* Uterine atony
***) The most common cause of secondary post-partum hemorrhage:
Uterine atony
Injury to birth canal
Low platelet count
Breast feeding
Retained parts of placenta superimposed by uterine infection
Answer: E* Retained parts of placenta superimposed by uterine infection
***) The most common symptom of acute inversion of the uterus is:
Postpartum hemorrhage
Uterine prolapse
Retained placenta
Retention of urine
Abdominal pain
Answer: A* Postpartum hemorrhage
***) After delivery of the baby and the placenta you discovered a firm
raunded mass in the pelvis below the level of the umbilicus. The mass is
most likely is:
Uterine fibroids
Ovarian cyst
Distended bowel
Pelvic kidney
Contracted uterus

Answer: E* Contracted uterus

***) Uterine atony might be caused by the following except:
Prolonged labor
Multiple pregnancy
Polyhydramnios
Uterine fibroids
Preterm labor
Answer: E* Preterm labor
***) Inversion of the uterus is almost always subsequent upon:
Multiple pregnancy
Polyhydramnios
Traction on the umbilical cord before separation
Abruption placenta
Difficult forceps delivery
Answer: C* Traction on the umbilical cord before separation

Postpartum Fever.
***) The commonest cause of maternal pyrexia in puerperium is:
Deep vein thrombosis
Endometritis
Engorged breasts
Subacute bacterial endocarditis
Urinary tract infection
Answer: B* Endometritis
***) The most common cause of post partum mastitis is one of the following:
Beta streptococci
E.Coli
Staphylococcus aureus
Streptococcus fecalis
Chlamydia trachomatis
Answer: C* Staphylococcus aureus
***) All of the following are possible predisposing factors for puerperal sepsis,
except:
Prolonged rupture of membranes
Carrier of group A beta streptococci
Multiple vaginal examinations

Elective cesarean section

Non-proper surgical scrub
Answer: D* Elective cesarean section
***) Factors contributing to puerperal infection are the following, except:
Prolonged labor
Precipitate labor
Instrumental delivery
Excessive vaginal examination
Home delivery
Answer: B* Precipitate labor
***) The most common bacteria causing puerperal infection is:
Escherichia coli
Anaerobic streptococcus
Anaerobic staphylococcus
Aerobic streptococcus
Clostridium perfringes
Answer: B* Anaerobic streptococcus
***) Puerperal infection may be spread by several routes. The most common
route that result in septic thrombophlebitis:
Venous
Lymphatic
Arterial
Direct extension
By inhalation of toxic materials
Answer: A* Venous
***) A patient with post-partum deep venous thrombosis complains of chest
pain and dyspnea. The helpful investigation to diagnose pulmonary
embolism is:
Lung spiral CT
Electrocardiogram (ECG)
Arterial blood gases
Chest auscultation
Chest X-Ray
Answer: A* Lung spiral CT
***) One of the following can cause subinvolution of the uterus after normal
delivery:

Urinary tract infection

Gastroenteritis
Endometriosis
Monilial infection
Endometritis
Answer: E* Endometritis
***) Which of the following is the most common site of puerperal infection:
The upper urinary tract (kidneys)
The lower genital tract (infected lacerations and episiotomies)
The lower urinary tract (bladder)
The upper genital tract (endometrium)
The cardiovascular system (bacteremia and septic thrombophlebitis)
Answer: D* The upper genital tract (endometrium)

Drugs and Pregnancy OB56-OB57.

Drugs and Pregnancy.
***) The following drugs are not given in pregnancy, except:
Tetracycline
Thiazides
Chloramphenicol
Heparin
Warfarin
Answer: D* Heparin
***) These drugs cross the placenta to the fetus, except:
Heparin
Warfarin
Tetracycline
Diazepam
Aspirin
Answer: A* Heparin
***) All of the following drugs are teratogenic, except:
Tetracycline
Paracetamol
Thiazides
Stilbestrol
Warfarin

Answer: B* Paracetamol
***) All of the following drugs are contraindicated in pregnancy, except:
Tetracycline
Iodides
Diphenylhydantoin (Epanutin)
Warfarin
Pyridoxine
Answer: E* Pyridoxine
***) One of the following drugs can be safe if used during pregnancy:
Warfarin
Septrin
Tetracycline
Erythromycin
Chloramphenicol
Answer: D* Erythromycin
***) Which of the following drugs given during pregnancy can give "Grey
Baby Syndrome":
Ampicillin
Chloramphenicol
Gentamycin
Tetracycline
Streptomycin
Answer: B* Chloramphenicol
***) Regarding drugs in pregnancy, all the following are true except:
Digitalis does not cross the placenta
Warfarin crosses the placenta
Heparin does not cross the placenta
Hydralazine causes relaxing vascular smooth muscle
Methotrexate crosses the placenta
Answer: A* Digitalis does not cross the placenta
***) Brown discoloration of the teeth can occur in infants exposed in uterus
to:
Penicillin
Tetracycline
Chloramphenicol
Gentamycin
Streptomycin

Answer: B* Tetracycline

Breastfeeding and Drugs.

***) Milk ejection reflex is affected by one of the following hormones:
Estrogens
Progesterone
Human placental lactogen
Oxytocin
Chorionic gonadotropin
Answer: D* Oxytocin
***) All of the following drugs are contraindicated during breast feeding
except one:
Cytotoxic drugs
Chloramphenicol
Iodine
Heparin
Thiouracil
Answer: D* Heparin
***) All of the following drugs are contraindicated during breast feeding
except one:
Bromocriptine
Cephalosporins
Ergotamine
Cimetidine
Tetracycline
Answer: B* Cephalosporins

Oxytocin.
***) All of the following are true regarding oxytocin, except:
Prolonged treatment can cause water intoxication
Can cause milk ejection
Single rapid IV injection can cause transient hypotension, tachycardia and
ECG changes
It is not effective when given orally
It can cause contraction of the lower uterine segments
Answer: E* It can cause contraction of the lower uterine segments
***) Regarding oxytocin, one of the following is true:

Induces vigorous sustained uterine contractions

Comes from the anterior pituitary gland
Possesses no antidiuretic activity
Has long half life
Acts on myoepithelial cells of the mammary glands
Answer: E* Acts on myoepithelial cells of the mammary glands
***) All of the following are complications of Syntocinon (oxytocin) toxicity,
except:
Headache
Nausea and vomiting
Polyuria
Coma
Weight gain
Answer: C* Polyuria

Immunizations.
***) The first immunoglobulin produced in any immune response is:
IgA
IgM
IgD
IgE
IgG
Answer: B* IgM
***) The only immunoglobulin can cross placenta:
IgM
IgA
IgG
IgE
IgD
Answer: C* IgG
***) All of the following vaccines are contraindicated during pregnancy,
except:
German measles
Tetanus
Mumps
Poliomyelitis
Hepatitis

Answer: B* Tetanus
***) All of the following vaccines can be given to the pregnant patient after
the second trimester, except:
Tetanus toxoid vaccine
Smallpox vaccine
Cholera vaccine
Vaccination against hepatitis B virus
Typhoid vaccine
Answer: B* Smallpox vaccine
***) Mumps in pregnancy is associated with:
Increase fetal wastage
Lymph reduction defect
Maternal pneumonia
No major complications
Congenital deafness
Answer: D* No major complications
???) Regarding immunization during pregnancy, which of the following
vaccines would be the safest to receive:
Mumps
Poliomyelitis
Rabies
Rubella
HIV
Answer: C* Poliomyelitis

Drugs.
***) All of the following drugs have effect on the uterine muscle, except:
Salbutamol
Cervidil
Isoxsuprine
Clomiphene citrate
Methergine
Answer: D* Clomiphene citrate
***) Regarding the actions of hydralazine, all the following are true except:
Increased renal blood flow
Increased cardiac output
Reflex tachycardia

Smooth muscle relaxation

Decreased placental perfusion
Answer: E* Decreased placental perfusion
*******************************************
425) All of the following are complications of post-maturity, except:
Meconium aspiration syndrome
Hypoglycemia
Hypocalcemia
Loss of subcutaneous fat
Hyaline membrane disease
Answer: C* Hypocalcemia (It may lead to Hypercalcemia)
***) Which of the following is characteristic feature of acute gonococcal
urethritis:
Dysuria
Genital ulceration
High fever
Generalized lymphadenopathy
Sweating
Answer: 1* Dysuria