Deck 1: Obstetrics and Gynecology: Part A

Question 1

Which is the least frequent site of an ectopic pregnancy?

A)Fallopian tube
B)Cervix
C)Ovary
D)Abdominal cavity
E)Between the leaves of broad ligament

Answer 1

Abdominal cavity

Question 2

Perforation tends to occur earliest when an ectopic pregnancy is located in which portion of fallopian tube ?

A)Isthmic
B)Interstitial
C)Ampullary
D)Infundibular
E)No difference

Answer 2

Isthmic

Question 3

Which of the following does not occur in post partum pituitary necrosis :

A)signs of hypoglycaemia
B)Asthenia
C)Amenorrhoea
D)Galactorrhoea
E)Decreased libido

Answer 3

Amenorrhoea

Question 4

The most dangerous symptom during pregnancy is:

A)PV bleeding
B)Ankle swelling
C)Hyperemesis
D)Cramps
E)none

Question 5

The Arius-Stella reaction may be seen with all except :

A)Ectopic pregnancy
B)Birth control pills
C)Abortion
D)Trophoblastic disease
E)none

Question 6

The passage of decidual cast in cases of ectopic pregnancy usually means :

A)Impending tubal rupture
B)Reabsorption of embryo
C)Pregnancy was intrauterine
D)Death of embryo
E)none

Question 7

What is the most common side effect with MTX therapy for ectopic pregnancy

A)Transient pelvic pain 3 - 7 days after starting treatment
B)Stomatitis
C)Bone marrow suppression
D)Gastritis
E)none

Question 8

Prenatal diagnosis at 16 weeks of pregnancy can be performed using all of the following, except:

A)Amniotic fluid
B)Maternal blood
C)Chorionic villi
D)Fetal blood
E)none

Question 9

A primigravida presents to casualty at 32 weeks gestation with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by;

A)Immediate cesarean section
B)Immediate induction of labor
C)Tocolytic therapy
D)Magnesium sulphate therapy
E)none

Question 10

Placenta previa, all true except :

A)Shock out of proportion of bleeding
B)Malpresentation
C)Head not engaged
D)Painless bleeding
E)none

Question 11

A 34wk GA lady presented with vaginal bleeding of an amount more of that of her normal cycle. O/E uterine contracts every 4 min, bulged membrane, the cervix is 3 cm dilated, fetus is in a high transverse lie and the placenta is on the posterior fundus. US showed translucency behind the placenta and the CTG (Cardiotocography) showed FHR of 170, the best line of management is:

A)C/S immediately.
B)give oxytocin.
C)do rupture of the membrane.
D)amniocentisis
E)none

Question 12

Most important cause of immediate post partum hemorrhage:

A)laceration of cervix
B)laceration of vagina
C)uterine atony
D)placental fragment retention
E)none

Question 13

Factors favoring long anterior rotation include all except

A)Correction of the deflexion
B)Adequate pelvis
C)good pelvic floor
D)rupture of membranes
E)none

Question 14

All following are indications for CS in OP except

A)Persistent oblique op
B)Long anterior rotation
C)Deep transverse arrest
D)Contracted pelvis
E)none

Question 15

Which vitamin deficiency is most commonly seen in a pregnant mother who is on phenytoin therapy for epilepsy?

A)Vitamin B6
B)Vitamin B12
C)Vitamin A
D)Folic acid
E)none

Question 16

Uterine inertia is due to EXCEPT?

A)Over distension of uterus
B)Presence of fibroid uterus
C)Fetal malpresentations
D)Abruptio placenta
E)repeated interautrine manipulation

Question 17

Exposure of female fetus to androgens may arrest differentiation of :

A)Mullerian duct
B)Ovary
C)Urogenital sinus
D)All of the above
E)None of the above

Question 18

The risk for development of fetal macrosomia is increased in the following, EXCEPT:

A)Primiparity.
B)Diabetes with pregnancy.
C)Post-term pregnancy.
D)Prior macrosomic infants.
E)none

Question 19

Complications of the third stage of labor include all of the following except :

A)Rupture uterus.
B)Postpartum hemorrhage.
C)Puerperal sepsis.
D)Retained placenta.
E)Obstetric shock.

Question 20

Shock is out of proportion to the amount of bleeding in :

A)1ry postpartum haemorrhage
B)Retained placenta
C)Acute puerperal inversion of uterus
D)Hypofibrinogenemia
E)none

Question 21

The gold standard in diagnosing ectopic pregnancy

A)Laparoscopy
B)Culdocenteris
C)Beta HCG
D)US
E)Progesterone

Question 22

Which method of terminating a molar gestation is never indicated

A)Suction curettage
B)Prostaglandic
C)Hypertonicsaline
D)Hysterotomy
E)Hyterectomy

Question 23

Invasive molar tissue is most commonly found in

A)Myometrium
B)Vaginal wall
C)Ovary
D)Liver
E)Lungs

Question 24

A 31-year-old, HIV-positive woman, gravida 3, para 2, at 32-weeks' gestation comes to the physician for a prenatal visit. Her prenatal course is significant for the fact that she has taken zidovudine throughout the pregnancy. Otherwise, her prenatal course has been unremarkable. She has no history of mental illness. She states that she has been weighing the benefits and risks of cesarean delivery in preventing transmission of the virus to her baby. After much deliberation, she has decided that she does not want a cesarean delivery and would like to attempt a vaginal delivery. Which of the following is the most appropriate next step in management?

A)Contact psychiatry to evaluate the patient
B)Contact the hospital lawyers to get a court order for cesarean delivery
C)Perform cesarean delivery at 38 weeks
D)Perform cesarean delivery once the patient is in labor
E)Respect the patient's decision and perform the vaginal delivery

Question 25

A 19-year-old primigravid woman at 42 weeks' gestation comes the labor and delivery ward for induction of labor. Her prenatal course was uncomplicated. Examination shows her cervix to be long, thick, closed, and posterior. The fetal heart rate is in the 140s and reactive. The fetus is vertex on ultrasound. Prostaglandin (PGE2) gel is placed intravaginally. One hour later, the patient begins having contractions lasting longer than 2 minutes. The fetal heart rate falls to the 70s. Which of the following is the most appropriate next step in management?

A)Administer general anesthesia
B)Administer terbutaline
C)Perform amnioinfusion
D)Start oxytocin
E)Perform cesarean delivery