You are on page 1of 63

The principle supports of the uterus include:

a) The iliosacral ligaments.

b) The pyriformis muscle.
c) The transverse cervical ligaments.
d) The infundibulo pelvic ligaments.
e) The anterior longitudinal ligament.

Which the following statements are not true?

a) The ovary is attached to the broad ligaments.
b) The ureter lies beneath the uterine artery.
c) The mucosa of the fallopian tube is lined by ciliated cells.
d) The pouch of Douglas lies between the bladder & the uterus.
e) The polar body of the oocyte contains 23 chromosomes.

One of the following is correct regarding the follicular phase of the menstrual cycle :
a) The granulosa cells produce androstenedione & testosterone.
b) The endometrial glands become straight.
c) Oestradiol inhibits the production of LH at the end of the follicular phase.
d) The theca cells produce oestradiol & secrete follicular fluid.
e) The nucleus of the oocyte contains 23 chromosomes.

Second degree uterine prolapse:

a) Is diagnosed when two fingers could be approximated at the base of the prolapsed
mass at the introitus.
b) Is diagnosed when the cervix lies below the level of ischial spines.
c) Always associated with supravaginal elongation of the cervix.
d) Occurs in multiparous & nulliparous females.
e) Corresponds to 2nd degree retroversion.

Endometriosis is characterised by one of the following:

a) 65 percent of patients have ovarian involvement.
b) Fixed retroversion of the uterus is a variant of normal.
c) Disease severity is an indicator of the amount of pain experienced by the patient.
d) The incidence is highest in those investigated for chronic abdominal pain.
e) Commonly presents with superficial dyspareunia.

An enterocele is best characterized by one of the following statements?

a) It is not a true hernia.
b) It is a herniation of the bladder floor into the vagina.
c) It is the prolapse of the uterus & vaginal wall outside the body.
d) It is the protrusion of the pelvic peritoneal sac & vaginal wall into vagina.
e) It is a herniation of the rectal & vaginal wall into the vagina.

Non-neoplastic cysts of the ovary include the following except on:

a) Follicular cyts.
b) Cystoma simplex.
c) Endometriotic cysts.
d) Corpus luteum cysts.
e) Theca lutein cysts.
Absolute contraindications of combined oral contraceptive pills include the
following except one:
a) Thrombo-embolic disease.
b) History of thrombo-embolic disease.
c) Coronary heart disease.
d) Age above 35 years.
e) Pregnancy.

The majority of paediatric cases of vulvo-vaginitis are due to:

a) Candidiasis.
b) Chlamydia.
c) Allergic reactions.
d) Gonorrhea.
e) Nonspecific.

Endometrial carcinoma is characterized by:

a) Is usually a clear cell carcinoma.
b) Usually occurs before menopause.
c) Is less common in obese postmenopausal females.
d) Is accurately diagnosed by biopsy.
e) Is related to use of combined oral contraceptive pills.

The single most important prognostic factor in endometrial carcinoma is:

a) Grade of the disease.
b) Age of the patient.
c) Size of the uterus.
d) Abnormal pap smear.
e) Abnormal hysterography.

Risk factors for endometrial hyperplasia include the following except:

a) Use of sequential oral contraceptive pills.
b) High parity.
c) Anovulation.
d) Estrogen secreting ovarian tumours.
e) Obesity.

A patient complains of post coital bleeding & no growth is seen on the cervix per
speculum examination.The best next step should be:
a) Colposcopy.
b) Conization.
c) Pap smear.
d) Culdoscopy.
e) Biopsy.
In an infertile woman, endometrial biopsy reveals proliferative changes.Which
hormone should be preferred?
a) Medroxy progesterone acetate.
b) Desogestrel.
c) Danazol.
d) Cyproterone acetate.
e) None of the above.

In an amenorrheic patient who has had pituitary ablation for craniopharyngioma,

which of the following regimens is most likely to result in an ovulatory cycle?
a) Clomiphene citrate.
b) Pulsatile infusion of GnRH.
c) Continuous infusion of GnRH.
d) Human menopausal or recombinant gonadotropin.
e) Human menopausal or recombinant gonadotropin followed by hCG.

An intrauterine pregnancy of approximately 10 weeks gestation is confirmed in a 30-

year-old G3P2 woman with an IUD in place. On examination, the string of IUD is noted
to be protruding from the cervical os .Which of the following is the most appropriate
course of action?
a) Leave the IUD in place without any other treatment.
b) Leave the IUD & continue prophylactic antibiotics throughout pregnancy.
c) Remove IUD immediately.
d) Terminate the pregnancy because of the high risk of infection.
e) Perform a laparoscopy to rule out a heterotopic ectopic pregnancy.

Your patient is 43 years old & is concerned that she may be too close to menopause
to get pregnant. You recommend that her gonadotropin levels be tested. Which is the
best day of menstrual cycle to check?
a) Day 3.
b) Day 8.
c) Day 14.
d) Day 21.
e) Day 26.

During the evaluation of a 30-year-old female complaining of infertility, a

hysteronsalpingogram showed evidence of Asherman syndrome. Which one of the
following symptoms would expect this patient to have?
a) Oligmenorrhea.
b) Menorrhagia.
c) Metrorrhagia.
d) Hypomenorrhea.
e) Dysmenorrhea.
In the evaluation of a 26-year-old patient with 4 months secondary amenorrhea,
serm prolactin & β-hCG assays were requested. The β-hCG test is positive, & the
prolactin level is 100 ng/ml. This patient requires which of the following?
a) Routine obstetric care.
b) Computed tomography (CT) scan of her sella turcica.
c) Repeat measurements of serum prolactin.
d) Bromocriptine to suppress prolactin.
e) Evaluation for possible hypoyhyroidism.

A 50-year-oldwoman is diagnosed with cervical cancer, which lymph node group

would be the 1st involved in metastatic spread of the disease beyond the cervix &
a) Common iliac nodes.
b) Parametrial nodes.
c) External iliac nodes.
d) Para cervical or uretral nodes.
e) Para aortic nodes.

The following potential treatments culd be used in the initial care of secondary
postpartum haemorrhage except:
a) Methylergonovine maleate (Methergin).
b) Oxytocin injection (Pitocin).
c) Ergonovine maleate (Ergotrate).
d) Prostaglandins.
e) Dilatation & curettage.

Asynclitism is best defined as:

a) Inability of the fetal head to pass through the pelvic inlet.
b) Failure of the descent because of inadequate uterine contractions.
c) Inability of internal rotation of the fetal head has reached the ischial spines.
d) Failure of the sagittal suture to lie exactly midway between the symphysis & sacral
e) Flexion of the descending fetal head from pelvic floor resistance.

Factors that hinder long anterior rotation of the occiput (in occipito-posterior)
include the following except:
a) Weak uterine contractions.
b) Strong uterine contractions.
c) Shape of the pelvis (contracted pelvis).
d) Rigid pelvic floor.
e) Rupture of membrane & drained amniotic fluid.

Earliest sign of pre-eclampsia is:

a) Hypertension.
b) Albuminuria.
c) Pedal edema.
d) Excessive weight gain.
e) Scanty liquor.
In pre-eclampsia, body fluid changes are characterized by:
a) An increase in the intravascular fluid compartment.
b) An increase in the extracellular compartment.
c) A balanced decrease in both intravascular & extracellular fluid compartments.
d) A decrease in the intravascular fluid compartment.
e) A decrease in the extracellular fluid compartment.

The most important measurement in clinical pelvimetry of the inlet is:

a) Diagonal conjugate.
b) External conjugate.
c) Interspinous diameter.
d) Intertuberous diameter.
e) Subpubic arch.

Which of the following exibitis the strongest association with pre-eclampsia ?

a) Race.
b) Socioeconomic status.
c) Parity.
d) Body habitus.
e) Age.

Regarding engagement of the presenting part , all the following is true except:
a) It is the passage of widest transverse diameter of the presenting part through the
plane of inlet.
b) Can be diagnosed by 2nd pelvic grip.
c) Is commonly delayed with malpresentations.
d) Commonly occurs early with frank breech.
e) Can be assessed by vaginal examination when the occiput is felt at or below the
level of pelvic inlet.

Indications of Cesarean section with placenta previa include all of the following
a) Placenta previa centralis.
b) Placenta previa marginalis anterior.
c) Failure of amniotomy to control bleeding &/or induce contractions.
d) Contracted pelvis.
e) Placenta previa incomplete centralis associated with intra uterine fetal death.

The term "parity"describes:

a) Total number of pregnancies.
b) Total number of foetuses delivered.
c) Number of live foetuses delivered.
d) Number of vaginal deliveries.
e) Number of full term deliveries.
An abnormal attitude is illustrated by:
a) Breech presentation.
b) Face presentation.
c) Transverse lie.
d) Occiput posterior.
e) Occiput anterior.
All of the following would be indications that the patient is receiving too much
MgSO4 & needs her infusion dose lowered except:
a) Hyper-reflexia.
b) Disappearnce of patellar reflexes.
c) Respiratory depression.
d) Somnlence.
e) Slurred speech.

A woman presents with amenorrhea of 2 months duration, lower abdominal pain,

facial pallor, fainting & shock, & β-hCG is positive.The most likely diagnosis is:
a) Ruptured ovarian cyst.
b) Ruptured ectopic pregnancy.
c) Threatened abortion.
d) Septic abortion.
e) Missed abortion.

One of the following statements is correct regarding β-hCG:

a) β-hCG begins to rise 2 weeks after fertilization.
b) β-hCG is measured using antibody radioimmunoassay.
c) The β-subunit is the same as TSH & FSH.
d) β-hCG level continues to rise till the end of pregnancy.
e) β-hCG is a polypeptide protein produced by hypothalamus.

A cystocele:
a) Is always associated with constipation.
b) Contains bladder.
c) Contains rectum.
d) Is best treated by antibiotics.

What percentage of term labours present with a longitudinal lie?

a) 20.
b) 50
c) 70.
d) 99.5.

Most common cause of 1st trimesteric abortion is:

a) Chromosomal abnormalities.
b) Syphilis.
c) Rhesus isoimmunisation.
d) Cervical stenosis.

Primary treatment of molar pregnancy is which of the following?

a) Hysterotomy.
b) Suction curettage.
c) Cesarean section.
d) Misoprostol induction.
What is the relationship of the long axis of the fetus to that of the mother called?
a) Presentation.
b) Lie.
c) Attitude.
d) Posture.

Vaginal candidiasis is predisposed to by:

a) Diabetes mellitus.
b) Pregnancy.
c) Oral contraceptives.
d) All of the above.

The pathophysiology of pre-eclampsia is characterised by:

a) Vasodilatation.
b) Vasospasm.
c) Hemodilution.
d) Hypervolemia.

Sonographic evidence of an ectopic pregnancy includes which of the following?

a) Adnexal mass.
b) Fluid in the cul de sac.
c) Lack of intra-uterine gestational sac.
d) All of the above.

What is the mean doubling time for serum βhCG levels in early pregnancy?
a) 24 hours.
b) 48 hours.
c) 72 hours.
d) 96 hours.

During the 3rd stage of labour:

a) The baby born.
b) Maximal cervical dilataion occurs.
c) The beginning of cervical dialtaion occurs.
d) The regular onset of contractions occurs.
e) The placenta is delivered.

During labour in left occiput anterior position, the occiput has to rotate to the
symphysis pubis how many degrees (internal rotation)?
a) 45 (1/8th of a circle).
b) 90 (2/8th of a circle).
c) 135 (3/8th of a circle).
d) 180 (4/8th of a circle).
Complete molar pregnancy most commonl;y have which of the following genetic
a) 45,XO.
b) 47,XXX.
c) 46,XX.
d) 47,XXXY.
Fertilization of the ovum by a sperm normally occurs in the :
a) Fimbria of the fallopian tube.
b) Isthmus of the fallopian tube.
c) Ampullary region of the fallopian tube.
d) Uterine cornua.
e) Uterine trigone.

Pregnant patient with HELLP syndrome, all are found except:

a) Hemolysis.
b) Decreased platelets.
c) Raised liver enzymes.
d) Hepato-splenomegaly.

Habitual spontaneous abortion is defined as:

a) Four or more abortions.
b) Three or more consecutive abortions.
c) Five or more abortions.
d) Total of ten abortions.
e) None of the above.

What is the mean duration of pregnancy from the first day of the last menstrual
period (LMP)?
a) 240 days.
b) 260 days.
c) 280 days.
d) 300 days.

a) Is a prolapse of the rectum.
b) Gives an impulse on cough on PV.
c) May resolve spontaneously.
d) Diagnosed by barium enema.

Ectopic pregnancy:
a) Is treated surgically only.
b) Pain is always before vaginal bleeding.
c) Incidence is 1:100 of spontaneous conception.
d) Gives an increased risk of hyperemesis gravidarum.

The most common cause for 2ry amenorrhea is:

a) Pregnancy.
b) Menopause.
c) Lactation.
d) Severe exercise.
Maternal complications of placenta previa include all except:
a) Postpartum haemorrhage.
b) Polyhydramnios.
c) Placenta accreta.
d) Cesarean delivery.

Diagnosis of placenta previa:

a) Bleeding is always painless, causeless & recurrent.
b) Most common presentation is state of shock.
c) Vaginal ultrasonography is preferable than abdominal ultrasonography.
d) PV examination is allowed in some, not all, cases undergoing active management.

Uterine prolapse in a surgically fit old aged patient is best treated by:
a) Classical repair with shortening of Machenrodt's ligaments.
b) Vaginal hysterectomy with repair of pelvic floor.
c) Fothergill operation.
d) Le Fort's operation: Partial colpocleisis.

Commonest site for fibroids:

a) Subserous.
b) Cervical.
c) Interstitial.
d) Submucous.

In occipito-posterior, long anterior rotation is favoured by:

a) Rupture membranes.
b) Strong uterine contraction.
c) Weak pelvic floor.
d) Contracted pelvic outlet.

a) Is associated with development of endometrial cancer later in life.
b) A well known cause for postmenopausal bleeding.
c) Is associated with subfertility.
d) Benign neoplastic lesion rare to turn malignant.

Maternal risks of pre-eclampsia include:

a) Oligohydrmnios.
b) Premature rupture of membranes(PROM).
c) Uteroplacental insuffiency & IUGR.
d) Dissimenated intra-vascular coagulopathy & its complications.

Endometrial cancer:
a) Occurs in postmenopausal females at the age of approximately 60 years.
b) Never occurs before the age of 40years.
c) More common in smokers.
d) Not related to obesity, diabetes & hypertension.
Most important & common presenting symptom with ectopic pregnancy is:
a) Abdominal pains.
b) Vaginal bleeding.
c) Fever.
d) Nausea & vomiting.

Most important, serious & common cause for accidental haemorrhage is:
a) Sudden premature rupture of membranes.
b) Short umbilical cord.
c) External trauma.
d) Maternal pre-eclampsia,

Cervical cancer:
a) May lead to ureteric obstruction.
b) Unusual to spread to the iliac nodes.
c) Arises from the transformation zone in most cases.
d) More common in virgins.

Hysterosalpingogram: HSG is unable to diagnose:

a) Intra-uterine adhesions.
b) Pelvic endometriosis.
c) Tubal obstruction.
d) Bicornuate uterus.

Which of the following causes of infertility is generally the most successfully

diagnosed & treated:
a) Ovulation disorders.
b) Tubal obstruction.
c) Endometriosis.
d) Intra-uterine adhesions.

Delivery of the fetal head occurs in extension in:

a) Face to pubis.
b) After coming head in breech delivery.
c) Right occipto-anterior position.
d) Right mento-anterior presentation.

Risk factors for endometrial cancer includes all except:

a) Obesity.
b) Polycystic ovarian syndrome.
c) Unopposed estrogen therapy.
d) Progestegens therapy.

A drug not used in the management of atonic post-partum haemorrhage:

a) Methergine.
b) Atropine.
c) Oxytocin.
d) PG F2 alpha.
Internal os is closed in:
a) Incomplete abortion.
b) Threatened abortion.
c) Inevitable abortion.
d) All of the above.

The most common clinical presentation of polycystic ovarian syndrome (PCOS) is:
a) Hirsutism.
b) Amenorrhea.
c) Infertility.
d) Obesity.

The following ligament support the uterus:

a) Round ligament & broad ligament.
b) Broad ligament & ovarian ligament.
c) Round ligament & ovarian ligament.
d) Cardinal ligament & uterosacral ligament.

Absolute contra-indications to intra-uterine device(IUD) insertion:

a) Confirmed or suspected pregnancy.
b) Acute or chronic infections.
c) Known or suspected pelvic malignancies.
d) All of the above.

The combined oral contraceprive pills are:

a) Taken continuously for 28 days.
b) Can be used as a form of post-coital contraception.
c) Can be used to reduce menorrhagia & dysmenorrhea.
d) If a pill is forgotten (e.g. 12hours late), other contraception must be used for 7 days.

Which of the following regarding progesterone only pills is incorrect:

a) Must be taken at the same time (within 3 hrs) each day.
b) This pill is preferred to the combined oral contraceptive pill for use in smokers.
c) Can be used as a form of post-coital contraception.
d) Main contraceptive mode of action is inhibition of ovulation.

Part of the uterus that forms the lower uterine segment in pregnancy:
a) Cervix.
b) Corpus.
c) Cornua.
d) Isthmus.

Cystocele in a 34 years old patient is best managed by:

a) Anterior colpoperinioraphy.
b) Classical repair.
c) Fothergils operation.
d) Posterior colpoperinioraphy.
Which of the following is used to investigate an infertile couple?
a) Hysterosalpingogram.
b) Rhesus blood group status of both partners.
c) Day 25 progesterone level in the female with 28 day cycles.
d) Chlamydia investigation of the male partner.

What is the mean number of oocytes in a woman over age 36?

a) 3400.
b) 34000.
c) 340000.
d) 3400000.

What is the average biparietal diameter of a full term fetus?

a) 9.5 cms.
b) 9 cms.
c) 10.5 cms.
d) 10 cms.

Placenta accreta is associated with all except:

a) Uterine scar.
b) Placental insufficiency.
c) Postpartum haemorrhage.
d) Retained placenta.

Which of the following is the most potent of the naturally occurring estrogens
a) Estriol.
b) Estrone.
c) Estradiol.
d) Ethinyl estradiol.

The hCG receptor is also the receptor for:

a) LH.
b) FSH.
c) Estriol.
d) Progesterone.
Gender of the fetus is first evident by the gestational age (weeks) of:
a) 6.
b) 8.
c) 12.
d) 16.

Androgen insensitivity syndrome is not characterised by:

a) Female phenotype.
b) Short blind-ending vagina.
c) Ovarian remnants on one side.
d) No uterus or faollpian tubes.
Which of the following is thought to be mediator of dysmenorrhea?
a) Interleukin-8.
b) Enkephlinase.
c) Prostaglandin F2alpha.
d) Monocyte chemotactic factor-1.

Vesicular mole:
a) Is not diagnosed by ultrasound.
b) First trimester bleeding is not the presenting symptom.
c) May be complete mole or partial mole with a fetus.
d) Very low B-HCG levels.
Spontaneous fetal movements begin at the gestyational age (weeks) of:
a) 6.
b) 12.
c) 16.
d) 20.

Progesterone action can be blocked by:

a) Steriods.
b) RU-486.
c) Aspirin.
d) B-blokers(Propranolol).

Oxytocin is synthesized in:

a) Adrenal gland.
b) Posterior pituitary.
c) Placenta.
d) Ovary.

Causes of 2ry post partum haemorrhage:

a) Uterine atony.
b) Choriocarcinoma.
c) Hypofibrinogemia.
d) Acute puerperal inversion.

A woman has had 2 pregnancies, both ending in abortion.Her obstetrical designation

a) Multipara.
b) Nullipara.
c) Nulligravida
d) None of the above.

A primi parous woman:

a) Pregnant once, regardless of outcome.
b) Delivered once of a fetus at least 20 weeks gestation.
c) Delivered once of a fetus weighing at least 550 grams.
d) Has had one pregnancy lasting at least 12 weeks.
Obstetric code 3-1-0-2 indicates a history of:
a) 2 abortions.
b) 3 living children.
c) 3 term deliveries.
d) 0 preterm deliveries.

A nutrient during pregnancy not adequately provided diet alone:

a) Calcium.
b) Magnesium.
c) Iron.
d) Folate.

Influenza vaccine during pregnancy:

a) Given IM one dose.
b) Given after 1st trimester during flu season in average risk women.
c) Given any trimester in women at a high risk of pulmonary complications.
d) All of the above.

Post partum haemorrhage is characterised by all except:

a) Atony is the main cause.
b) Excessive blood loss during or after the third stage of labour.
c) Classified as primary & secondary.
d) Loss of 500 cc during a Cesarean section.

Incidence of hyterotropic pregnancies increased due to:

a) Obesity.
b) Assisted reproduction.
c) Progesterone only pills.
d) Dietary factors.

Sonographic evidence of ectopic pregnancy:

a) Intra-uterine sac & an adnexal luteal cyst.
b) Lack of intra-uterine sac & an adnexal mass.
c) Snow storm appearance & theca lutin cyst.
d) None of the above.

Clinically molar pregnancy is associated with all except:

a) Absent fetal heart sounds.
b) Iron deficiency anemia.
c) Uterine size larger than gestational age.
d) Harsh maternal systolic cardiac murmur.

Methods for detection of fetal congenital anomalies include all except:

a) Chorion villus sampling.
b) Triple marker.
c) Fetal biophysical profile.
d) Amniocentesis.
The genetic composition of partial mole is:
a) 45,XO.
b) 46,XY.
c) 47,XXY.
d) 69,XXY.

Most common fetal malpresentation (malposition) during labour is:

a) Right occipitoposterior.
b) Shoulder presentation.
c) Frank breech.
d) Face presentation.

Complications of accidental haemorrhage include all except:

a) Intra-uterine growth retardation (IUGR).
b) Acute renal failure.
c) Surgical shock.
d) Consumptive coagulopathy.

In pre-eclampsia blood volume:

a) Increase.
b) Decrease.
c) Unchanged.
d) Decreased than increased.

Complications of pre-eclmpsia:
a) Heart failure.
b) Renal failure.
c) Recurrent eclampsia.
d) Polyhydramnios.

a) Means increased fetal head flexion.
b) Means 2 parietal bones are on same level.
c) Facilitates engagement.
d) Is more marked with preterm labour.

In normal labour of a primigravida:

a) Cervical dilatation & effacement occur simultaneously.
b) Head always engage in 1st stage.
c) Duration of 3rd stage is equal to that in multipara.
d) Rate of cervical dilatation is constant.

Management of the 1st stage of labour include:

a) Heavy sedation to minimize pain.
b) Frequent pelvic examination.
c) Plenty of sugary drinks all through 1st stage.
d) Evacuation of bladder & rectum.
Progress of labour is measured by:
a) Frequency of uterine contractions.
b) Strength of uterine contractions.
c) Descent of the presenting part & cervical dilatation.
d) State of membranes whether intact or ruptured.

Causes of mal-presentations include all EXCEPT:

a) Abnormal shape of the pelvis.
b) Cord prolapse &/or presentation.
c) Laxity of abdominal wall.
d) Intra-uterine fetal death.

Etiological factors of occipito-posterior include:

a) Hydrocephalus.
b) Flat pelvis.
c) Rachitic pelvis.
d) Android pelvis.

Earliest clinical manifestation of Sheehan's syndrome is :

a) Adrenal insufficiency.
b) Asthenia.
c) Loss of libido.
d) Failure of lactation.

Metropathia hemorrhagica:
a) Present with minimal vaginal bleeding.
b) Is rare cause of dysfunctional uterine bleeding.
c) Associated with anovulation.
d) Surgery is the main line of treatment.

Gonadotropins used for ovulation induction:

a) Given by intra-venous route.
b) Low risk of multiple pregnancies.
c) Effective in cases of Sheehan's syndrome.
d) Taken from blood of menopausal females.

Intra-uterine insemination:
a) Indicated in cases of azospermia.
b) May be used in cases of unexplained infertility.
c) Ineffective in cases of hostile cervical muscous.
d) Done in early proliferative phase.

As regarding in vitro fertilization:

a) Success rate is more than 50%.
b) Doesn't require ovulation induction.
c) Used in cases of tubal obstruction.
d) Not increased risk of ectopic pregnancy.
Bacterial vaginosis:
a) The organism is a protozoa.
b) Rare form of vaginitis.
c) The vaginal PH < 4.5.
d) Foul odour discharge & increase with intercourse.

Candidial infection: all are true EXCEPT:

a) The organism is fungus yeast like.
b) Vaginal PH is alkaline.
c) Affects 1/3 of pregnant women.
d) Leads to itching ,soreness & dyspareunia.

Acute pelvic inflammatory disease is:

a) Postpartum infection is the commonest.
b) Associated with Fitz-Hugh Curtis syndrome.
c) Unilateral in most cases.
d) IUD is not a known risk factor.

Chronic cervicitis:
a) Usually caused by anaerobic organism.
b) May cause subfertility
c) May cause spasmodic dysmenorrhea.
d) Antibiotics are the main line of treatment.

Retroversion of the uterus:

a) Occurs in 15% of normal women.
b) Common cause of infertility.
c) Mobile type is a common cause of abortion.
d) Corrected by Fothergill operation.

All are complications of fibroids EXCEPT:

a) Anaemia.
b) Polycythemia.
c) Obstructed labour.
d) Endometrial carcinoma.

Fetal complications of triplets pregnancy may include the following EXCEPT:

a) Congenital anomalies.
b) Prematurity.
c) Intra-uterine growth retardation (IUGR).
d) Postmaturity.

The following is essential for diagnosis of endometriosis:

a) Hysterosalpingogram.
b) Laparoscopy.
c) CA-125.
d) Ultrasonography.
Comparing endometrial carcinoma to cancer cervix:
a) Endometrial cancer incidence is less.
b) Average age of endometrial cancer is 10 years less.
c) Main line of treatment of endometrial cancer radiotherapy.
d) Prognosis of endometrial cancer is better.

Most common pathological type of cancer cervix is:

a) Adenocarcinoma.
b) Melanoma.
c) Squamous cell carcinoma.
d) Lymphoma.

In contrast to a malignant ovarian tumour, a benign tumour grossly show:

a) Free mobility.
b) Ruptured capsule.
c) Peritoneal implants.
d) Tumour implants on the surface.

All are complications of D&C EXCEPT:

a) Cervical incompetence.
b) Perforation of the uterus.
c) Asherman syndrome.
d) Ectopic pregnancy.

a) Is indicated in case of unexplained infertility.
b) Is done only in the immediate post menstrual period.
c) Can accurately diagnose adenomyosis.
d) Not accurate in diagnosis of endometriosis.

Midline incisions compared to lower incisions, all are true EXCEPT:

a) Exposure is less adequate.
b) Cosmotic result is worse.
c) Incisional hernia is more common.
d) Dehiscence of the scar is more likely.

Large asymptomatic fibroid of the supra-vaginal portion of the cervix is best treated
a) No treatment.
b) Abdominal hysterectomy.
c) Abdominal myomectomy.
d) Vaginal myomectomy.
Fibroids are:
a) The commonest pelvic tumours in females.
b) Accounting for 80% of all hysterectomies.
c) More common in white race.
d) Most common between women age 20-30 years.
a) Contains bladder & urethra.
b) Leads to polyuria.
c) Inability to complete micturition is common.
d) Always associated with stress incontinence.

Body of the uterus is formed emberiogically from:

a) Upper 1/3 of the Mullerian ducts.
b) Sinovaginal bulb.
c) Middle fused parts of the Mullerian ducts.
d) Wollfian system.

In the early detection of cancer ovary, which the followings is of no value:

a) Vaginal ultrasonography.
b) Fractional curettage.
c) Tumour markers.
d) Oncogenes & oncoproteins.

In normal vaginal delivery the followings are correct except.

a) The head is delivered by a movement of extension.
b) The head rotates after expulsion 90 degrees.
c) Delivery of the posterior shoulder precedes the anterior one.
d) Episiotomy is not mandatory.
e) The first movement after delivery of the head is called external rotation.

A fundal level higher than calculated gestational age is possibly caused by.
a) Generalized edema.
b) Obesity.
c) Intrauterine growth retardation.
d) Breech presentation.
e) Associated ovarian cyst.

The following statements regarding complete hydatidiform moles are correct

a) Usually have female karyotype (90%).
b) Clinically evident hyperthyroidism may develop in 7% of cases.
c) In about 25 to 60% of cases the ovaries contain multiple theca-lutein cysts.
d) α-feto-protein is a good marker of disease post-evacuation.
e) Due to absence of fetus, uterine size is always less than the expected period of gestation.

Treatment of hydatidiform mole by hysterectomy:

a) Is only indicated if patient is less than 40 years old.
b) Should include removal of the cystic ovaries.
c) Does not prevent metastasis.
d) Should be associated with prophylactic chemotherapy in all cases.
e) Is better than evacuation as no follow up is needed afterwards.
After treatment of hydatidiform mole:
a) Incidence of malignancy (persistent trophoblastic tumor) is 20%.
b) The average to achieve the first normal hCG is about 9 months.
c) Intrauterine device is the prime method suggested for contraception.
d) Pregnancy should be avoided for 5 years.
e) The prime follow up tool is repeat pelvic ultrasound in every visit.

Diagnosis of engagement of the head is achieved by:

a) Palpating the occiput at the level of pelvic inlet.
b) Palpating the occiput at the level of ischial spine.
c) Palpating the occiput at the level of pelvic outlet.
d) Only vaginal examination.
e) Best by vaginal ultrasound.

Complications of multiple pregnancy commonly include the followings except:

a) Abnormal presentation.
b) Hyper emesis gravidarum.
c) Preterm labor.
d) Feto-pelvic disproportion.
e) Postpartum hemorrhage.

Locked twins:
a) Is a common complication of twin pregnancy.
b) Usually occurs when the 1st twin is cephalic & the 2nd twin is breech.
c) Can only occur when both twins are in transverse lie.
d) Can only occur when the 1st twin is breech & the 2nd twin is cephalic.
e) Disimpaction under anesthesia is always successful.

In Occipito-posterior the followings are true, EXCEPT:

a) It is more common in android pelvis.
b) It is a mal-position rather than a mal-presentation.
c) Incidence is 25% early in labour.
d) Left position (LOP) is more common than right position (ROP).
e) The head after long rotation is delvered by extension as in normal labour.

Factors interfering with long anterior rotation in OP include one of the followings:
a) Good uterine contractions.
b) Early correction of deflexion.
c) Contracted pelvis.
d) Very wide pelvis.
e) Intact membranes.
Cervical dystocia may follow all of the following EXCEPT:
a) Fothergill's operation.
b) Repaeted shirodkar's or McDonald's cerclage.
c) Conization of the cervix.
d) Over cauterisation.
e) Previous IUD insertion.
As regards Vasa Previa:
a) It is common condition.
b) It occurs with circumvallate placenta.
c) It is the only cause of ante partum hemorrahge of fetal origin.
d) The fetal mortality is only 10%.
e) It can be treated in a conservative way.

Causes of acute abdomen with pregnancy include the followings EXCEPT:

a) Placenta abruption.
b) Complicated fibroid.
c) Ruptured tubal pregnancy.
d) Acute pyelonephritis.
e) Vasa previa.

The risk factors for an ectopic pregnancy include the followings EXCEPT:
a) History of pelvic inflammatory disease.
b) Previous ectopic pregnancy.
c) Use of combined oral contraceptives.
d) Assisted reproductive techniques.
e) Use of IUD as the method of contraception.

Ultrasound criteria of diagnosis of isthmic incompetence during pregnancy:

a) Should be looked for between 18 to 20 weeks of gestations.
b) Includes shortening of the cervical canal length to less than 3.5 cm.
c) Includes widening of the cervix & /or bulging of membranes through the dilated
cervical canal.
d) Is better achieved by trans-abdominal ultrasound probe.
e) None of the above.\
Indications of trial vaginal delivery following previous C.S. include one of the
a) No tenderness over the C.S. scar.
b) When only previous C.S. were less than 3 times.
c) If previous C.S. was classical upper segment.
d) Previous myomectomy.
e) Previous puerperium with moderate complications.
Neurogenic shock in obstetrics may occur secondary to:
a) Concealed accidental hemorrahge.
b) Acute inversion of the uterus.
c) Early undisturbed tubal pregnancy.
d) Difficult internal version.
e) Repeat rough attempts at Crede's method.

Retained placenta:
a) Is a condition in which placenta fails to be expelled within 2 hours after delivery.
b) Is a condition in which the placenta fails to be separated from the uterus.
c) Its incidence is about 5% of all pregnancies.
d) Is a condition in which the placenta fails to be expelled within 30 minutes after
e) More common to happen when placenta is fundal posterior.
The followings are predisposing factors for rupture uterus at the site of previous scar EXCEPT:
a) Improper hemostasis during previous surgery.
b) Post operative infection.
c) Preterm start of labour.
d) Implantation of placenta over the scar.
e) Use of stimulants in a scarred uterus.

Induction of abortion in the 1st trimester:

a) Commonly achieved by using high dose of oxytocin infusion.
b) Commonly achieved by vacuum aspiration to evacuate the uterus.
c) Better achieved by abdominal hysterectomy.
d) Better achieved by abdominal hyterotomy.
e) Cannot be achieved except by surgical means.

The Bishop score:

a) Is an accepted method of recording dilatation of the cervix.
b) Is an accepted method of recording dilatation of the cervix & cervical length.
c) Is an accepted method of recording dilatation of the cervix & level of fetal head.
d) Is an accepted method of recording consistency of the cervix & cervical length.
e) Is an accepted method of recording cervical length, cervical dilatation, consistency
of the cervix & the level of fetal head.

Pelvic thrombophlebitis in the puerpurium commonly:

a) Occurs in the 1st week post delivery.
b) Occurs in the 2nd week post delivery.
c) Occurs in the 3rd week post delivery.
d) Occurs in the 4th week post delivery.
e) Occurs onlt after operative delivery.
The most common cause of pregnancy related hypofibrinogenaemia include one of
the followings:
a) Amniotic fluid embolism.
b) Acute fatty liver.
c) Retained dead fetus.
d) Sepsis.
e) Placental bruption.

In haemorrhagic shock:
a) Pulse is slow.
b) Patient is apathic & quiet.
c) Superficial veins are collapsed.
d) Respiration is slow & shallow.
e) There is always hemoconcentration.

The elderly primigravidas:

a) Applied to the primigravidas whose age is above 30 years.
b) Applied to pregnant woman with less than 2 pregnancies & above of 30 years.
c) Applied to primigravidas whose age above 35 years.
d) Applied to any pregnant women above the age of 40 years.
e) Applied to primigravidas whose age is above 45 years.
Complications of multifetal pregnancy include the followings EXCEPT:
a) Hyperemesis gravidarum.
b) Pressure symptoms.
c) Post partum haemorrhage.
d) Prolonged labour.
e) Abnormal presentations.

Indications of expectant management in placenta praevia include one of the

a) Pregnancy more than 37 weeks.
b) Mild bleeding.
c) Fetus is distressed.
d) Presence of major gross fetal anomlies.
e) Placenta previa centralis.

Septic abortion could be attributed to the following organisms EXCEPT:

a) Hemolytic streptococci.
b) Staphylococci.
c) E-coli.
d) Clostridium welchii.
e) Herpes virus type one.

Etiology of post abortive bleeding could be attributed to the followings EXCEPT:

a) Uterine atony.
b) Cervical lacerations.
c) Retroversion of the uterus.
d) Retained products of conception.
e) Choriocarcinoma.

The commonest site for extra-uterine pregnancy is:

a) The cervix.
b) The ovary.
c) The corneal part of the tube.
d) The ampulla of the tube.
e) The omentum.

Advantages of vaginal hysterectomy include the followings EXCEPT:

a) Absence of abdominal scar.
b) Lower incidence of intestinal complications.
c) An associated genital prolapse can be treated at the same time.
d) Lower incidence of peritonitis.
e) It is safe & easier in the presence of pelvic adhesions.

Regarding the progesterone only pills, one of the followings is not correct:
a) A large proportion of women using it will ovulate.
b) Ideally it should be taken at a fixed time per day.
c) Contra-indicated in lactating women.
d) It affects mainly the cervical mucous.
e) Should be used continuously irrespective of the menstrual cycle.
Hyper prolactinaemia may clinically present by one or more of the followings
a) Breast pain & tenderness.
b) Dysmenorrhea.
c) Menstrual disorders.
d) Infertility due to anovulation.
e) Galactorrhea.

In red degeneration of a myoma, all of the followings are correct EXCEPT:

a) It is due to thrombosis of blood vessels of the capsule.
b) Commonly occurs during pregnancy.
c) Is a state of incomplete necrosis from which the tumour is capable of recovery.
d) Management is essentially surgical.
e) Clinically the tumour becomes enlarged, tender with acute abdominal pain.

Alpha fetoprotein is used as a tumour marker for the detection of:

a) Cancer cervix.
b) Cancer vulva.
c) Serous cystadenocarcinoma.
d) Endodermal sinus tumour.
e) Endometrial carcinoma.

Causes of symmetrical enlargement of the uterus include all of the followings

a) Localized adenomyosis.
b) Metropathia hemorrhagica.
c) Pyometra.
d) Submucous myoma.
e) Ectopic pregnancy in a rudimentary horn.

One of the following is not correct regarding endometrial hyperplasia:

a) Best diagnostic tool is endometrial biopsy.
b) Human papilloma virus has been discovered to be a possible etiology.
c) First line of treatment when no atypia is detected is synthetic gestagen.
d) May present clinically with abnormal uterine bleeding.
e) Is realted to unopposed hyperestrogenism.

Tumour markers are reliable for the diagnosis & follow up of the followings EXCEPT:
a) Choriocarcinoma.
b) Epithelial cancers of the ovary.
c) Dysgerminoma.
d) Endodermal sinus tumours.
e) Metastatic tumours of the ovary.
Luteal phase defect is associated with all of the followings EXCEPT:
a) Short cycles.
b) Hypo prolactinaemia.
c) Biphasic body temperature chart with short luteal phase.
d) Endometrial biopsy.
e) Low midluteal progesterone levels.
Gynecological causes of acute abdominal pain include all of the followings EXCEPT:
a) Disturbed ectopic pregnancy.
b) Acute salpingitis.
c) Rupture corpus luteum.
d) Metropathia hemorrhagica.
e) Red degeneration in a fibroid.

Regarding Asherman syndrome one of the following is not correct:

a) May follow delivery or abortion.
b) Galactorrhea is a characteristic symptom & sign.
c) Can lead to infertility.
d) Can lead to recurrent abortion.
e) Is diagnosed & treated by hysteroscopy.

Regarding uterine perforation during D&C one of the followings is not correct:
a) May occur with the use of sound, dilator or curette.
b) Is more liable to occur during evacuation of pregnant uterus.
c) Is more liable to occur in the presence of uterine malignancy.
d) May result in severe bleeding.
e) Always treated conservatively.

Complications of fibroid include the followings EXCEPT:

a) Infection.
b) Red degeneration.
c) Malignant transformation into carcinoma.
d) Rarely intra-peritoneal haemorrhage.
e) Recurrent abortions.

Regarding endometriosis one of the followings is not correct:

a) It is the presence of functioning glands without stroma outside the endometrial cavity.
b) Dysmenorrhea & dyspareunia are common presentations.
c) Some lesions may be visible by naked eye.
d) Pelvic examination may reveal no abnormality.
e) The definitive diagnosis is at laparoscopy.

Hysteroscopy is important for diagnosis of the following:

a) Intra-uterine adhesions.
b) Subserous fibroid.
c) Peri-tubal adhesions.
d) Polycystic ovarian disease.
e) Pelvic endometriosis.

Follicular cysts of the ovary characterized by the followings EXCEPT:

a) The commonest functional cysts of the ovary.
b) Spontaneous regression is the fate of such cysts.
c) Cysts are usually bilateral, multiple & multilocular.
d) Are commonly encountered with metropathia haemorrhagica.
e) Are usually asymptomatic.
The following surgical treatment of amenorrhea is correct EXCEPT:
a) Cruciate incision for imperforate hymen.
b) Excision of transverse septum in cases of cryptomenorrhea.
c) Reconstruction of a functional neo vagina in cases vaginal agenesis.
d) Reconstruction of a functional neo vagina in cases with testicular feminization
syndrome before marriage.
e) Gonadectomy in patients with Y containing gonads.

Pituitary insufficiency causing 2ry amenorrhea can be managed by:

a) Intra-muscular gonadotropin therapy (HMG/hCG) for induction of ovulation as a
primary treatment to regain normal menstrual cycle.
b) Cyclic combined replacement therapy (HRT) to establish regular menstrual cycle.
c) IM gonadotropin therapy (HMG/hCG) only in cases proved to be fertile.
d) Corticosteriods therapy in an interrupted pattern.
e) Only progesterone therapy for 2 weeks every month.

The most common cause of 2ry amenorrhea is:

a) Menopause.
b) Pregnancy.
c) Prolonged lactation.
d) Ovarian failure.
e) Sheehan's syndrome.

2ry amenorrhea is cessation of menstruation:

a) More than 3 months.
b) More than 6 months.
c) More than 9 months.
d) More than one year.
e) More than 2 years.

Anterior pituitary disorders causing amenorrhea include the followings EXCEPT:

a) Pituitary micro-adenoma.
b) Pituitary insufficiency.
c) Empty sella syndrome.
d) Emotional stress & psychological disturbances.
e) Prolactinomas.

In luteal phase vaginal cytology, the followings are detected EXCEPT:

a) Intermediate cells with rolled edges.
b) Many lymphocytes.
c) Maturation index 0-70-30.
d) Matuartion index 0-30-70.
e) Basophilic cytoplasm.

Normal pubertal changes start by the age of:

a) 7-8 years.
b) 8-9 years.
c) 10-11 years.
d) 11-12 years.
e) 6-7 years.
Menopause is:
a) A partial cessation of menses between the age of 48-52 years.
b) Retrospectively defined when cessation of menses continues for one year after last
menstrual period.
c) The few years that precedes cessation of menstruation.
d) Due to decreased levels of FSH to levels that cannot stimulate further ovulation.
e) Due to block of the feedback between ovarian hormones & pituitary hormones.

A mass protruding from the cervix can be any of the followings EXCEPT:
a) A cervical polyp.
b) An inverted fallopian tube.
c) Endometrial polyp.
d) Products of conception.
e) An inverted uterus.

Indications of hysteroscopy include all of the followings EXCEPT:

a) Removal of missed IUD.
b) Habitual abortions.
c) Resection of submucous myoma.
d) Diagnosis of para-ovarian cyst.
e) Irregular uterine bleeding.

The 1st step to locate a missing –string IUD is:

a) To sound the uterus.
b) Abdominal/pelvic X-ray.
c) MRI.
d) Hysteroscopy.
e) Laparoscopy.
Which disorder is an example of hypothalamic amenorrhea?
a) Sheehan's syndrome
b) Cushing's syndrome.
c) Resistant ovary syndrome.
d) Asherman's syndrome.
e) Kallmann's syndrome.

The most common benign condition causing postmenopausal bleeding is:

a) Atrophic vaginitis.
b) Cervical polyps.
c) Myomas.
d) Endometrial hyperplasia.
e) Cervical erosion.

In anorexia nervosa the following statements are correct EXCEPT:

a) Patients may have bulimia (induced vomiting).
b) Is an excessive weight gain with primary amenorrhea.
c) Is an excessive weight loss with secondary amenorrhea.
d) It may affects 1% of young women.
e) Needs reassurance & psychological support.
Obesity may be associated with:
a) Polycystic ovarian disease.
b) Use of hormone releasing IUD.
c) Spasmodic dysmenorrhea.
d) An increased risk of cervical cancer.
e) Uterine fibromyoma.

Anovulatory menstrual cycles are characterised by the followings EXCEPT:

a) Being irregular with periods of oligomenorrhea.
b) Dysfunctional uterine bleeding.
c) Association with menstrual pain.
d) Monophasic BBT.
e) May be association with hirsutism.

Classical repair is composed of:

a) Anterior colporrhaphy.
b) Anterior colporrhaphy & shortening of Machenrodts ligaments.
c) Anterior colporrhaphy & posterior colpoperineorrhaphy.
d) Anterior colporrhaphy & amputation of the cervix.
e) Anterior colporrhaphy & posterior colpoperineorrhaphy with amputation of cervix.

The primary management of postmenopausal bleeding is:

a) Hysterectomy.
b) Cervical cone biopsy.
c) Endometrial biopsy.
d) Laparoscopy.
e) Hysteroscopy.

Predisposing factors for vaginal infections are the followings EXCEPT:

a) Acidic vagina.
b) Routine vaginal douching.
c) Treatment with broad spectrum antibiotics.
d) Decreased estrogen as in menopause.
e) Suppression of immune system.

Causes of recurrent abortion in early pregnancy include all the following EXCEPT:
a) Progesterone insufficiency.
b) Rh incompatibility.
c) Chromosomal anomalies of the fertilized ovum.
d) Submucous fibroid.
e) Anti-phospholipid antibodies.

Diagnosis of concealed accidental haemorrhage:

a) The main presenting symptom is vaginal bleeding.
b) Blood pressure is always low due to haemorrhage.
c) The fundal level is lower than the corresponding gestational age.
d) Oliguria or anuria are commonly met.
e) The uterus is hypotonic.
Manchester repair for genital prolapse includes the followings except:
a. Anterior colporrhaphy.
b. Posterior colpoperineorrhaphy.
c. Kelley's suture.
d. Shortening of the transverse cervical ligaments.
e. D & C.

Which of the following is not correct about theca lutein cysts?

a. They arise more frequently in patients with complete moles.
b. They should be removed surgically if hysterotomy is indicated for evacuating mole.
c. These cysts may result in acute abdomen.
d. Cysts are filled with serious fluid.
e. Cysts are filled with serosanguinous fluid.

Interstitial uterine myomas most often cause menorrhagia due to:

a. Secondary degeneration.
b. Rupture into endometrial cavity.
c. Pressure necrosis.
d. Inhibition of uterine contractility.
e. Prolapse.

The most common symptom associated with adenomyosis is:

a. Infertility
b. Menorrhagia.
c. Haematometra
d. Dyspareunia.
e. Metrorrhagia.

Clinical findings of PCOD include the followings except:

a. Obesity
b. Oligomenorrhoea.
c. Amenorrhoea.
d. Infertility
e. Tall stature.

Chronic vulvovaginitis frequently caused by:

a. Trichomonas
b. Gonococcus.
c. Herpes simplex virus.
d. Candida albicans.
e. H. vaginalis.

Clomiphene therapy is most specific for the induction of the ovulation in patients
a. Sheehan's syndrome.
b. Turner's syndrome.
c. Kallmann's syndrome.
d. Hypothalamic hypogonadorophism.
e. Simmond's disease.
Dysfunctional uterine bleeding is most often caused by:
a. Tumours.
b. Endocrine disorders.
c. Inflammation.
d. Pregnancy.
e. Adrenal cortex.
Vaginal bleeding at the time of ovulation is thought to be due to:
a. Increase in progesterone.
b. Decrease in oestrogen.
c. Follicular haemorrahge.
d. Implantation.
e. Passage of ovum.

Failure of withdrawal bleeding following oestrogen to an amenorrheic woman

a. Uterine factor.
b. Ovarian factor.
c. Pituitary factor.
d. Hypothalamic lesion.
e. Ovarian tumour.

The commonest cause of death in cancer cervix is:

a. Infection.
b. Uraemia.
c. Haemorrhage.
d. Cachexia.
e. Distant metastases.
Risk factors of endometrial hyperplasia include the followings except:
a. Nulliparity.
b. Obesity.
c. Anovulation.
d. Estrogen secreting ovarian tumors.
e. Use of combined oral contraceptive pills.

Subnuclear vacuoles in the endometrial mucosa are evidence of activity of:

a. Cholesterol.
b. Progesterone.
c. Pregnendiol.
d. Androstenedione.
e. Oestrogen.

Turner's syndrome (Karyotype 45-X0) is associated with the followings except:

a. Abnormal breast development.
b. Infantile lymphedaema.
c. Increased incidence of bone fractures.
d. Coarctation of the aorta.
e. Secondary amenorrhoea.
A 32-year-old woman presents to the gynaecology clinic with infrequent periods.
A hormone profile is done and all of the followings are consistent with polycystic
ovarian syndrome, apart from:
a. Increased androgen levels.
b. Normal FSH.
c. Elevated oestrone.
d. Decreased LH.
e. Low progesterone levels.

Regarding the menstrual cycle, which is true statement?

a. Menstruation occurs with vasodilatation of the spiral arteries.
b. The LH surge triggers menstruation.
c. The Graafian follicle develops during the luteal phase.
d. Both the follicle and the corpus luteum secrete oestradiol.
e. Progesterone levels fall after the onset of menstruation.

Disadvantages of myomectomy include the followings except:

a. Intra operative bleeding.
b. Persistent menorrhagia.
c. Early menopause.
d. Pelvic adhesions.
e. Rupture of the scar in subsequent pregnancy.

All of the following factors in this patient's history are risk factors for cervical dysplasia except:
a. Young age at initiation of sexual activity.
b. Multiple sexual partners.
c. Previous history of Chlamydia.
d. Use of Depo-Provera.
e. Smoking.

Which of the followings is not an absolute contraindication for combined pills?

a. Thrombophlebitis.
b. History of DVT.
c. Coronary heart disease.
d. Strokes.
e. History of liver disease.

Non contraceptive benefits of combined COCs include the followings except:

a. Treatment of DUB.
b. Postponing next menstruation.
c. Less risk for PID.
d. Less risk for functional cysts of the ovary.
e. Less risk for cervical carcinoma.

Normal labor includes the following:

a. Delivery of a 39 weeks baby.
b. Delivery by mid forceps.
c. Breech delivery.
d. Twin pregnancy delivered vaginally.
e. Delivery of a stillborn foetus.
One of the following is not correct regarding Occipito-posterior position:
a. is common in high assimilation pelvis.
b. Occipito-frontal is the presenting diameter.
c. Accounts for 10-20% of vertex presentations in late pregnancy and early labour.
d. A certain degree of deflexion is present.
e. About 30% rotate to direct occipito- position as labour progresses.

During antenatal care the use of which vaccine is absolutely contraindicated?

a. Hepatitis B.
b. Cholera.
c. Yellow fever.
d. Rabies.
e. Influenza.

Secondary sites of infection in puerperal sepsis include the followings except:

a. Peritonitis.
b. Infected lacerations.
c. Pelvic cellulites.
d. Salpingo- Oophoritis.
e. Pelvic thrombophlebitis.

Foetal death is defined as the death of:

a. A foetus in utero weighing 1000 grams or less.
b. A non viable foetus before and after death.
c. An infant weighing 2500 grams or less
d. Any conceptus before birth.
e. A foetus in utero weighing 500 gram or more.

Separation of the placenta occurs in:

a. Spongiosa layer of decidua vera.
b. Compacta layer of decidua basalis.
c. Spongiosa layer of decidua basalis.
d. Compacta layer of decidua capsularis.
e. Muscularis layer of placental site.

Which of the followings is not a symptom or sign of impending eclampsia?

a. Headaches.
b. Epigastric pain.
c. Blurring of vision.
d. Hyper reflexia.
e. Marked oedema of the lower limbs.

Which of the followings is a complication of pre-eclampsia?

a. Foetal macrosomia.
b. Pulmonary oedema.
c. Prelabour preterm rupture of membranes.
d. Polyhydramnios.
e. Foetal malposition.
In the fetal skull:
a. The biparietal diameter is approximately 10.5 cm at the term.
b. The lambdoidal suture runs between the frontal and parietal bones.
c. The bregma is the area lying between the parietal and occipital bones.
d. The sub-occipito frontal is the engaging diameter when the head is fully flexed
in a vertex presentation.
e. The occiput is the denominator in a vertex presentation.

A 16 yr old primigravida at term, not in labour, has a sudden onset of continuous

lower abdominal pain, rapid pulse, no fetal heart tones, low BP and a tender
uterus. The most likely diagnosis is?
a. Abruptio placentae.
b. Placenta praevia.
c. Amniotic fluid embolism.
d. Perforation of the uterus by hydatidiform mole.
e. Supine hypotensive syndrome.

One of the followings is not an indication of cesarean section in multifoetal pregnancy:

a. Non vertex presentation of the first twin.
b. Vertex presentation of the first twin.
c. Triplets or more fetuses.
d. Monoamniotic twins.
e. Elderly primigravida.

Regarding hydatidiform moles.

a. In complete moles, all nuclear genes are inherited from the mother.
b. The incidence in Asia is the highest in the world.
c. Most partial moles are haploid.
d. In 20% of cases hydatidiform moles develop into choriocarcinoma.
e. Pregnancy should be avoided for at least 24 months.

Which of the followings is not a cause of recurrent miscarriage?

a. Parental chromosomal abnormality.
b. Activated protein C-resistance.
c. Uncontrolled hypothyroidism.
d. Chlamydia infection.
e. Submucosal fibroids.

Risk factors for placenta accreta include the followings except:

a. Prior cesarean section.
b. Placenta praevia.
c. Circumvallated placenta.
d. Asherman's syndrome.
e. Submucous leiomyomata.
Locked twins.
a. Is a common complication of twins pregnancy?
b. Usually occurs when the first twin is cephalic and the second twin is breech.
c. Usually occurs when both twins are in transverse lie.
d. Can only occur when the first twin is breech and the second twin is cephalic.
e. Dis-Impaction under anesthesia is always successful.
As regards vasa praevia.
a. It is a common condition.
b. It occurs with circumvallate placenta.
d. It is the only causes of ante partum hemorrhage of fetal origin.
c. The fetal mortality is only 10%.
e. It can be treated in a conservative way.

Warning symptoms that are given to a pregnant lady include the followings
a. Bleeding per vagina.
b. Excessive salivation (ptyalism).
c. Sudden loss of fluid per vagina.
d. Abdominal pain.
e. Leg cramps.

During follow up after evacuating molar pregnancy the best contraceptive is:
a. Combined oral contraceptive pills.
b. Progesterone only pills.
c. Progestin I.M.
d. Subdermal implants.
e. Intraauterine contraceptive device.

Human chorionic gonadotrophin (hCG) is characterized by the followings except:

a. Being a glycoprotein hormone.
b. Maintains early pregnancy.
c. Produced by the syncytio-trophoblasts.
d. The a-subunit is specific.
e. Intrauterine contraceptive device.

Which of the followings is not correct regarding magnesium sulfate used for
cases of pregnancy induced hypertension?
a. It is given to cases of imminent eclampsia
b. The aim is reduction of blood pressure.
c. Acts as CNS depressant.
d. Toxicity should be checked before giving the next does.
e. Should be continued for about 24 hours after delivery.

In diagnosis of pregnancy, all of the followings are true EXCEPT:

a) Frequency of micturition starts early in pregnancy.
b) Breast changes are all reversible by the end of pregnancy.
c) Nausea and vomiting start 4-6 weeks after the missed period.
d) Beta hCG can be detected in the blood 1 week before the missed period.
e) Beta hCG can be detected in urine few days after the missed period.

Pigmentation of the skin of cheeks and a part of the nose during pregnancy is called:
a) Striae gravidarum.
b) Linea nigra.
c) Chloasma.
d) Melasma.
e) None of the above.
During the return visits of antenatal care, all of the followings are true EXCEPT:
a) The patient is asked about any complaints.
b) The patient is asked about warning symptoms.
c) The fundal level should be measured and recorded at each visit after 12 weeks.
d) Blood pressure should be measured and recorded every visit.
e) Ultrasonography should be done every other visit.

During pregnancy, diet alone does NOT provide the requirements of:
a) Iron.
b) Calcium.
c) Magnesium.
d) Vitamin c.
e) Folic acid.

The recommended daily dose of folic acid during the preconceptional period and
early pregnancy is:
a) 10 μg
b) 40 μg
c) 100 μg
d) 400 μg
e) 1000 μg

The major cause of first trimester abortion is:

a) Maternal trauma.
b) Progesterone insufficiency.
c) Maternal infection by toxoplasmosis.
d) Exposure to teratogens.
e) Chromosomal anomalies of the fertilized ovum.

Differential diagnosis of tubal ectopic pregnancy includes all of the following EXCEPT:
a) Abortion.
b) Acute salpingitis.
c) Hemorrhage in a corpus luteum cyst.
d) Cystitis.
e) Other causes of ante partum hemorrhage.

Regarding management of placenta previa, all of the followings are true EXCEPT:
a) Cases presenting with severe bleeding require immediate CS.
b) Active management is indicated after 37 weeks.
c) Cases presenting with persistent moderate bleeding require active management.
d) Oxytocin may be given before amniotomy to avoid inertia.
e) Amniotomy helps to control bleeding.

Criteria of severity of preeclampsia include all of the following EXCEPT:

a) Systolic blood pressure more than 160 mmHg.
b) Diastolic blood pressure more than 110 mmHg.
c) Heavy proteinuria of more than 5 mg %.
d) Thrombocytopenia.
e) Visual symptoms.
In preeclampsia, the blood volume:
a) Increases.
b) Remains the same.
c) Decreases.
d) Varies markedly.
e) Initially decreases then increases.

Which of the following does NOT contribute to increased perinatal morbidity

and mortality in pregnancies complicated by diabetes.
a) Birth injuries.
b) Neonatal hyperglycemia.
c) Respiratory distress syndrome.
d) Neonatal hypocalcaemia.
e) Neonatal hyperbilirubinemia.

A woman is classified as a nulligravida if she has:

a) Never been pregnant.
b) Had one abortion.
c) Had one pregnancy.
d) Never delivered a full term baby.
e) Never delivered a live-born baby.

Regarding engagement of the presenting part, all the following is true EXCEPT:
a) Is passage of widest transverse diameter of the presenting part through the plane of the inlet.
b) Always takes place during the second stage of labor.
c) Is commonly delayed with malpresentations.
d) Commonly occurs early with frank breech.
e) Can be assessed by PV.

The station at which the lowermost part of presenting part lies at the level of the
ischial spines is defined as:
a) -2.
b) -1 .
c) 0 .
d) +1 .
e) +2 .

Factors favoring long anterior rotation in case of occipito posterior include all of
the following EXCEPT:
a) Well flexed head.
b) Wide pelvic cavity.
c) Strong uterine contractions.
d) Rotation by forceps.
e) Elastic pelvic floor muscles.

With multifetal pregnancy, there is a higher incidence of all of the following

a) Precipitate labor.
b) Preeclampsia.
c) Malpresentations.
d) Postpartum hemorrhage.
e) Polyhydramnios

A 23 years old patient, 4th G, p2, presents with mild vaginal bleeding and
suprapubic colics following a period of 2 months amenorrhea. She has no fever.
PV examination reveals a closed cervix. Pregnancy test is positive. The most
likely diagnosis is:
a) Threatened abortion.
b) Inevitable abortion.
c) Missed abortion.
d) Septic abortion.
e) Isthmic incompetence.

Polycystic ovarian disease is characterized by all of the following EXCEPT:

a) Elevated LH level.
b) Elevated testosterone levels.
c) Oligohypomenorrhea or amenorrhea.
d) Dyspareunia.
e) Insulin resistance & hyperinsulinemia.

Clomiphene citrate:
a) Is a non steroidal agent.
b) Regarding benefits versus risks, its empirical use is justified.
c) Increases prolactin level.
d) Serious side effects are commonly encountered.
e) May be used to treat ovarian cysts.

Human menopausal gonadotropins (HMG):

a) Are extracted from blood of menopausal females.
b) Is the drug of choice for induction of ovulation in patients with PCO.
c) Unlike purified FSH, its administration does not require monitoring by serial
d) May result in ovarian hyperstimulation.
e) Human chorionic gonadotropin is usually given before HMG to induce follicular rupture.

Endometrial hyperplasia is associated with:

a) Dermoid cyst.
b) Dysgerminoma.
c) Polycystic ovarian disease.
d) Sertoli cell tumor.
e) Corpus luteum cyst.

Which of the following is a functional ovarian cyst:

a) Follicular cyst.
b) Endometriotic cyst.
c) Dermoid cyst.
d) Bartholin, s cyst.
e) Struma ovarii.
Primary dysmenorrhea is characterized by:
a) Symptoms are related to release of prostaglandins.
b) Is more common in multiparous women.
c) Symptoms start 2 days before the onset of menses.
d) Onset occurs with menarche.
e) Bilateral lower abdominal colicky pain.

Contact bleeding is not characterized by one of the following:

a) May occur with fibroid polyp extruding through the cervix.
b) May occur with cervical erosion.
c) May occur with cervical carcinoma.
d) is usually associated with pelvic pain.
e) Usually requires a cervical smear.

Causes of primary amenorrhea include:

a) Pregnancy.
b) Menopause.
c) Asherman syndrome.
d) Transverse vaginal septum.
e) Premature ovarian failure.

One is NOT correct regarding calcification in a fibroid:

a) Is more common after menopause.
b) Starts at the periphery of the tumor.
c) Is premalignant.
d) Appears in X-ray as well as ultrasonography.
e) Due to deposition of calcium phosphate and carbonate

Regarding dysfunctional uterine bleeding (DUB)

a) It is a diagnosis of exclusion.
b) Menorrhagia is only is the cause in only 10% of cases.
c) May be diagnosed at early pregnancy.
d) Always caused by hidden pathology.
e) Treated best by hysterectomy.

The commonest secondary change in uterine fibroids is:

a) Sarcomatous change.
b) Myxomatous degeneration.
c) Necrobiosis.
d) Hyaline degeneration.
e) Calcification.

In Human papillomavirus infection of the cervix (HPV) chose the most

appropriate statement:
a) Mostly asymptomatic.
b) Subtypes 6 and 11 are associated with CIN and cervical neoplasia.
c) Subtypes 16 and 18 are associated with genital warts (condylomata acuminate).
d) Is an RNA virus.
e) Routine vaccination against it is not yet recommended.
The functions of mid-cycle LH surge include the following EXCEPT:
a) Enhances thecal cell androgen production.
b) Luteinizes granulose cells.
c) Produces luteolysis.
d) Initiates resumption of meiosis.
e) Facilitates oocyte expulsion.

Regarding cervical polyps all the following are correct EXCEPT one:
a) May cause post coital bleeding.
b) The most common type is mucous polyps.
c) Usually they arise from the cervical canal.
d) They are usually pre cancerous.
e) Cervical polyps should be subjected to histopathological examination.

A classical C.S.
a) Should be considered in cases of breech fetus
b) Is performed when large fibroids occupying the upper segments of the uterus
c) Is performed through a transverse incision in the upper segment of the uterus
d) Is performed in most cases of placenta pravia
e) Scar is liable to rupture after 30 weeks gestation

All the following are causes of bilateral LL edema during prenancy except:
b-Renal failure
d-Deep venous thrombosis
e-Allergic reaction

Regarding Emergency Contraception the following is correct except:

a) It means protecting women from unwanted pregnancy following unprotected sexual
intercourse or contraceptive failure.
b) Can be achieved by oral intake of any contraceptive pills in high does for five days
after intercourse.
c) Can be achieved by oral intake of a single does of 1.5 mg Levonorgetrel pill.
d) Can be achieved by inserting copper intra uterine device within 120 hours
following intercourse.
e) Oral intake of a contraceptive method, as an emergency, does not provide
contraceptive cover for the remainder of the cycle.

One of the following pelvis is characterized by absence of single alum of the sacrum:
a- Roberts pelvis
b-Naegles pelvis
c-Rachitic pelvis
d-Osteomalatic pelvis
e-Flat pelvis
The last menstrual period was June 30, the expected date of delivery (EDD) is
a- March 23.
b- April 7.
c- March 28.
d- April 23.
e- March 7.

The greatest diameter of the fetal head is:

a- Occipitofrontal.
b- Occipitomental.
c- Suboccipit bregmatic.
d- Bitemporal.
e. Biparietal.

Moulding of the fetal head:

a- Usually causes brain damage.
b- Becomes progressively easier as gestational age increases.
c- Increases the difficulty of delivery.
d- Does not have time to occur in breech delivery.
e- Does not happen when maternal pelvis is inadequate.

Regarding fetal head , choose the correct answer :

a- Can be delivered vaginally in persistent mentoposterior.
b- Will show spalding's sign within 12 hours of intrauterine death.
c- Can be delivered vaginally in persistent brow presentation.
d- Is likely to be a vertex presentation when the head is deflexed.
e- Considered to be engaged when the biparietal diameter passes the level of the pelvic

Hyperextention of the fetal head is found in :

a- Vertex presentation.
b- Face presentation.
c- Shoulder presentation.
d-Breach presentation.
e- Hydrocephalic baby.
In the fetus :
a- The coronal suture lies between the two parietal bones.
b- The umbilcal artery normally contains one artery and two veins.
c- Fetal lie describes the long axis of the fetus to the long axis of the mother.
d- Entanglement of the umbilical cord is common in diamniotic twins.
e- The anterior fontanelle is usualy closed by the time of labor.
Which of the following terms best describes the pelivc type of small posterior
sagittal diameter convergent side walls, prominent ischial spines and narrow
pubic arch?
a- Android.
b- Gynaecoid .
c- Anthropoid .
d- Platypelloid.
e- Mixed.
Which of the following is not an indication for peripartum hysterectonry?
a- Uterine rupture.
b- Laceration of major uterine vessele.
c- Irreducible uterine inversion.
d- All cases with placental abruption
e- Sevre cervical dysplasia.
A head of level (one fifth) as felt abdominally:
a- Indicates that one fifth of the head is below the pelvic brim.
b- Indicates that the head is engaged.
c- Indicates that forceps may not be used.
d- Indicates that head is at the level of the ischial spines.
e- Always occurs in a term brow prescentation.

Methods of determining fetal presentation &postion include:

a- Cullen's sign.
b- Leopold's maneuver.
c- Mauriceau –Smelile-Veit'maneuver.
d- Carful history taking.
e- None of the above.

A transverse lie of the fetus is least likely in the presence of :

a- Placenta previa.
b- Pelvic contraction.
c- Grand multiparty.
d- Normal term fetus.

A primpara is in labor and an episiotomy will be cut, compared with a midline

episiotomy, an advantage of medio-lateral episiotomy is :
a- Ease of repair.
b- Fewer break downs.
c- Less extension of the incision.
d- Lower blood of the incision.
e- Less dyspareunia.
A patient sustained laceration of the perineum during delivery, it involved the
muscles of perincal body but not the anal sphineter. Such a laceration would be
classified as:
a- First degree.
b- Second degree.
c- Third degree.
d- Forth degree.
e- Fifth degree.
Repetitive late decelerations most commonly indicate:
a- Fetal academia.
b- Fetal hypoxia.
c- Fetal sleep state.
d- Fetal efforts of maternal sedation.
e- Rapid cervical dilatation.
The Bishop score is used to predict:
a- The state of the fetus at the time of delivery.
b- The success rate of the induction of the labor.
c- The fetal condition in the uterus.
d- The maternal well being in labor.
e- The maternal well being postpartum.
Which of the followings is not a presumptive symptom/sign of pregnancy?
a- Cessation of menstruation.
b- Nausea & vomiting.
c- Breast changes.
d- Quickening.
e- Darking of the skin on the palms of the hands.

Components of biophysical profile include all of the followings except:

a- Fetal movement.
b- Placenta thickness.
c- Fetal tone.
d- Fetal breathing movement.
e- Amniotic fluid volume assessment.

APGAR's score includes all the followings except :

a- Skin color.
b- Muscle tone.
c- Blood PH.
d- Heart rate.
e- Respirations.

Immediate therapy for infants with suspected meconium should routinely include :
a- Corticosteroid.
b- Antibiotics.
c- Sodium bicarbonate.
d- Clearing of the airway.
e- Giving O2 under positive pressure.
The most common cause of perinatal death in mono-amniotic twin is :
a- Cord entrapment.
b- Cord prolapse.
c- Twin transfusion syndrome.
d- Lethal congenital anomalies.
e- Placenta abruption.

In Turner's syndrome:
a- A chromosomal structure of 45 XY is characteristic.
b- Secondary amenorrhea is usual.
c- Ovaries are streak.
d- The ovaries are multicystic.
e- Phenotypically are male.

Which type of myoma should be removed in infertile women to increase their

pregnancy rates?
a- Intramural.
b- Subserosal.
c- Submucosal.
d- Broad ligamental.
e- Parasitic.

Ovarian dysgenesis is associated with the elevation of which of the following

hormones ?
a- Pituilary Gonadtropins.
b- Estradiol.
c- Estriol.
d- Pregnandiol.
e- Progesterone.

Anomalies of the uterus can be associated with the followings except :

a- Urinary tract abnormalities.
b- Recurrent pregnancies loss.
c- Preterm labor.
d- Malpresentations.
e- Polycystic ovary.

A sample of cervical mucus is taken on day 12 of the menstrual cycle. The mucus is
thin, clear, & stretchy . It is placed on a slide and allowed to air dry . when placed
under microscopic, What would you expect:
a- Calcium citrate.
b- Clear fields, devoid of bacteria
c- Thick mucus with background bacteria.
d- A fern pattern characteristic of estrogen.
e- Clearly defined para- basal cells.
Which of the followings is the best method to predict the occurrence of
a- Thermogenic shift in basal body temperature.
b- LH surge.
c- Endometrial decidulaization.
d- Profuse, thin, acellular cervical mucous.
e- Mittelschmerz.

Luteal phase deficiency:

a- Has inadequate luteal progesterone production.
b- Has inadequate follicular estrogen production.
c- Can be corrected by estrogen.
d- Associated with delayed menstruation.
e- Can lead to hypoprolactinaemia.

On examination of endonretrial obrained from a biopsy reveals simple

colummar epithelium with no sub nuclear vacuoles. the stroma is edematous &
tortuous glands contain secretions,these findings are consistent which stage of
menstrual cycle?
a- Mid-proliferative.
b- Late proliferative.
c- Early secretory.
d- Mid- secretory.
e- Non- ovulatory cycle.

Raised FSH levels are found in all of the following conditions except:
a- Postmenopausal women.
b- Turner's syndrome.
c- Women on Combined Oral Contraceptive pills.
d- Gonadal dysgenesis.
e- Peri-menopausal women who had hysterectomy with bilateral salpingo- oophorectomy.

Besides infertility, the most common symptoms of a luteal phase defect:

a- Vaginal dryness.
b- Early abortion.
c- Tubal occlusion.
d- Breast tenderness.
e- Ovarian enlargement.

The most frequent cause of acute pelvic inflammatory disease is :

a- Staphylococcus.
b- Tubercular bacilli.
c- Gonococcus.
d- Streptococcus.
e- Diphtheroid.
Presence of pyometra in post menopausal females strongly suggests:
a- Diabetes mellitus.
b- Degenerating myoma.
c- Senile endometritis.
d- Malignancy.
e- Sexual promiscuity.
The primary drainage of the lower vagina is to :
a- External iliac nodes.
b- Sacral nodes.
c- Femoral nodes.
d- Superficial inguinal nodes.
e- Internal iliac nodes.

Which of the following pubertal change appears first ?

a- Filling out of breasts.
b- Menstruation.
c- Axillary hair.
d- Public hair.
e- Decreasing rate of growth.

The main cause of dysfunctional uterine bleeding is :

a- Uterine myornas.
b- Cervical polyps.
c- Endometritis.
d- Persistent corpus luteum.
e- Endometrial hyperplasia.

The Wollfian duct in the female:

a- Develops into the fallopion tubes.
b- Forms the ovary.
c-- Forms the round ligament.
d-Retrogresses and becomes vestigial.
e- Non of the above.

The test which involves postcoital study of cervical mucus near the time of ovulation is ?
a- Rubin test.
b- Novak test.
c- Bonney test.
d- Sims-Huhner test.
e- Marshall- Marchetti test.

WHO parameters of a normal semen analysis include the followings except :

a- Volume: >2 ml .
b- Count : > 20 million / ml.
c- Motility: > 30 % with forward progression.
d- Morphology: > 30 % normal form.
e. WBC: < 1 million / mL.
The first step to locate a missing-string IUD is :
a- To sound the uterus.
b- Abdominal/ pelvic X-ray.
c- Hysteroscopy.
d- Request B-hCG assay.
e- Laparoscopy.

The most common benign condition causing postmenopausal bleeding is:

a- Atrophic vaginitis.
b- Cervical polyps.
c- Myomas.
d- Endometrial hyperplasia.
e- Cervical ectopy.

The followings are causes off antepartum hemorrhage except:

a. Abruptio placenta.
b. Placenta praevia.
c. Cervical polyp.
d. Vasa praevia.
e. Rh isoimmunization.

The most definitive treatment for preeclampsia is:

a. IV magnesium sulphate.
b. Diazepam.
c. Delivery.
d. IV hydralazine.
e. IV labetalol.

Complete breech means:

a. Flexion at hip joint and extension in knee joint.
b. Flexion at hip joint and flexion at knee joint.
c. Extension at the hip joint.
d. Flexion at knee joint and extension at the hip joint.
e. Flexion of one leg at hip joint and extension of the other leg at the hip joint.

Which of the followings is not correct regarding true labour pains?

a. Involuntary.
b. Rhythmic.
c. Relieved by sedatives.
d. They gradually increase in frequency by time.
e. Associated with progressive dilatation of the cervix.
Gestational diabetes is associated with an increased risk of all the following,
a. Cesarean section.
b. Shoulder dystocia.
c. Foetal macrosomia.
d. Intrauterine foetal death.
e. Intrauterine growth restriction.

The most common reason for postdate pregnancy is:

a. Inaccurate gestational age.
b. Foetal anencephaly.
c. Oligohydramnios.
d. IUGR.
e. Advanced maternal age.

All the following conditions result in polyhydroamnios except:

a. Duodenal atresia.
b. Spina bifida.
c. Renal agenesis.
d. Anencephaly.
e. Fetal hydrops.

The patient is 8 weeks pregnant, which one off the following U/S measurements as most
a. Biparietal diameter.
b. Femur length.
c. Placental site.
d. Crown Rump length.
e. Abdominal circumference.

The genetic makeup of complete hydatidiform mole typically is:

a. 46, XX paternal only.
b. 46, XX maternal only.
c. 46, XY paternal only.
d. 46 XX, maternal and paternal.
e. Triploidy.

Which of the followings is correct regarding tine first stage of lalour:

a. Ends with full dilatation of cervix.
b. Results in separation of placenta.
c. Is more than 24 hours in primigravidas?
d. Ergotamine could be used to accelerate labour.
e. Rate of cervical dilatation exceeds 4 cm/hour in a primigravida.
The followings are considered normal symptoms of pregnancy Except;
a. Backache due to increased lumbar lordosis.
b. Lower abdominal pain due to stretch of round ligaments
c. Visual disturbances,
d. Calf pain .due to muscle spasm.
e. Increased vaginal discharge.

The followings are normal change in pregnancy Except:

a. Increase plasma volume.
b. Decrease RBC'S mass.
c. Increase stroke volume.
d. Increase cardiac output.
e. Increase in heart rate.

Regarding early deceleration which of the followings is correct?

a. Are associated with unengaged head.
b. Are associated usually with brain hypoxia.
c. They represent decrease in the foetal heart beats that peaks after uterine contraction.
d. An indication of cesarean-section.
e. Results from head compression.

Physiological changes in reproductive system during pregnancy include the following:

a. Alkaline vagina PH.
b. The uterus first enlarges by hyperplasia and then hypertrophy.
c. The cervix becomes firm.
d. Dry vagina.
e. Lower segment of the uterus starts to be formed in the third trimester.

Contraindications for induction of labour include:

a. Classical cesarean-section
b. Chorioamnionitis.
c. Post date.
d. Severe PET at 36 weeks.
e. GDM.

All the following hormones are products of placental synthesis, Except:

a. HCG.
b. HPL.
c. Prolactin.
d. Progesterone.
e. Estriol.
Which of the followings is not correct regarding missed abortion?
a Patient may present with loss of the symptoms of pregnancy.
b. Per vaginal bleeding may be one of the presenting symptoms.
c. Immediate evacuation should be done once the diagnosis is made.
d. Disseminated intra-vascular coagulation may occur as sequelae.
e. Ultrasound should be done to confirm the diagnosis.
Which of the followings is not an indication of CS in breech presentation?
a. Foetal weight >3.5 kg.
b. Foetal weight < 2.5 kg.
c. Footling presentation.
d. Twins where the second foetus is breech. .
e. Hyperextension of the foetal head.

Which of the followings is correct regarding secondary postpartum hemorrhage?

a. Is diagnosed only when bleeding occurs 72 hours after delivery.
b. Contra indicates breast feeding.
c. The commonest cause is the cervical tears.
d. Very common when the patient delivers a congenitally abnormal baby.
e. Retained placental tissue could be a cause.

Regarding obstructed labour; which of the followings is true?

a. Diagnosed only when cervix is fully dilated.
b. Usually predicted before onset of labor.
c. More common in developed countries.
d. Mento -posterior position could be a cause.
e. X-ray pelvimetry is essential to predict cephalo-pelvic disproportion in

The followings are factors affecting the choice of methotrexate as an option of

treatment for ectopic pregnancy, Except:
a. Size of the ectopic.
b. Presence or absence of cardiac activity.
c. Level of B-HCG.
d. Parity of the patient.
e. Integrity of the tube.

For patients with three consecutive spontaneous in the second trimester the most
useful investigation is:
a. Chromosomal analysis.
b. Hysterosalpingogram
c. Endometrial biopsy.
d. Post coital test.
e. Prolactin level.

Diabetes in pregnancy may be associated with the following congenital anomalies

a. Sacral agenesis.
b. Central nervous system abnormalities.
c. Lower limb hypoplasia.
d. Congenital heart disease.
e. Yellow teeth discoloration.
Complication of preeclampsia include the following except :
a. Premature delivery.
b. Placenta abruption,
c. Renal failure.
d. Polycythemia.
e. DIC.

Compared with a midline episiotomy, an advantage of mediolateral episiotomy is:

a. Ease of repair.
b. Fewer break downs.
c. Lower blood loss.
d. Less dyspareunia.
e. Less extension of the incision.

Which of the followings is an indication of emergency lower transverse cesarean-section?

a. Previous lower transverse cesarean-section.
b. Patient with prolapsed cord and a dead fetus.
c. Cardiac diseased of the mother.
d. Multiple gestations.
e. Prolonged labour due to brow presentation.

All of the followings are risk factors of preterm labour Except:

a. UTI.
b. Vaginal candidiasis.
c. Multiple pregnancies.
d. Polyhydroamnios.
e. Placenta praevia.

The second stage of labour:

a. Separation of placenta.
b. Separation of after birth.
c. Expulsion of placenta.
d. Dilatation of cervix.
e. Ends with expulsion of the foetus.

After birth the following changes occur in the foetus except:

a. The foramen ovale closes.
b. Lung fluid is forced out of the fetal alveoli with the first few breaths.
c. The ductus arteriosus opens.
d. Haemoglobin F is replaced by haemoglobin A.
e. The umbilical vein and artery close.
Which of the following is correct regarding ultrasound diagnosis of isthmic
incompetence during pregnancy?
.a. Should be looked for between .16 to 20 weeks of gestations.
b. Includes shortening of the cervical canal length to 3.5 cm or less.
c. Includes bulging of membranes through the dilated cervical canal.
d. Is better achieved by transabdominal ultrasound probe.
e. None of the above.
In managing patients with heart disease during delivery, which of the following
is correct?
a. No pain relief to avoid giving medications during labour.
b. Lithotomy position is preferred all the time.
c. Low forceps may be used if necessary.
d. Digitalis should be avoided until the foetus is delivered.
e. Caesarean section is the best management option.

Induction of abortion in the first trimester:

a. Commonly achieved using high dose of oxytocin infusion.
b. Commonly achieved by suction evacuation.
c. Better achieved by abdominal hysterectomy.
d. Better achieved by abdominal hysterotomy.
e. Cannot be achieved except by surgical means.

Pelvic thrombophlebitis in the puerperium" commonly:

a. Occurs in the first week post delivery.
b. Occurs in the second week post delivery.
C. Occurs in the third week post delivery
c. Occurs in the fourth week post delivery. .
e. Occurs only after operative delivery.

In shoulder presentation which of the followings is correct?

a. Contracted outlet of the pelvis is the main cause in multiparas.
b. Dorso-posterior is more common than Dorso-anterior.
c. Pendulous abdomen is the main cause in primigravidas.
d. Uterine anomalies can be a cause in recurrent shoulder presentation.
e. Commonly detected in singleton pregnancy more than twins.

A 24-year-old primigravida at 35 Weeks' gestation complains of mild headache

and Facial edema. Her blood pressure is 160/100 and her reflexes are brisk. You
suspect that she has preeclampsia. Her urine analysis is likely to show which of
the followings?
a. Proteinuria
b. Haematuria
c. Glycosuria
d. Ketonuria.
e. Leukocytes.

A 21-year-old partient is considering epidural analgesia. She would like to know

which of the followings is increased in patients with epidural analgesia:
a. Cesarean delivery.
b. Neonatal depression.
e. Prolonged labour.
d. Cerebral palsy.
e. Episiotomy.
The infant of a diabetic mother has an increased risk off the followings except;
a. Neonatal jaundice.
b. Macrocytic anaemia.
c. Hypocalcaemia.
d. Cardiomegaly.
e. Erb's palsy.

Which of the followings is not correct regarding oxytocin?

a. Is a nonapeptide.
b. Is synthesized in the posterior lobe of the pituitary gland.
c. Receptor concentration in the uterus increases towards the end of pregnancy.
d. Secretion is stimulated by suckling.
e. Has some antidiuretic action.

Which of the followings is not correct regarding external cephalic version (ECV)
of breech:
a. Usually is carried out before 37 weeks gestation.
b. Is associated with an increased risk of placental abruption.
c. Is associated with about a 1% risk of fetal mortality.
d. Can significantly reduce the incidence of caesarean section.
e. Should ideally be performed under general anaesthesia.

In cases of transverse lie which of the followings is not correct?

a. There is associated placenta praevia in about 10% of cases,
b. ECV could be performed till the onset of labour,
c. The fetal back is usually anterior.
d. The foetal head is commonly to the mother's left.
e. Of the second twin, caesarean section is the treatment of choice.

Bacteriuria in pregnancy:
a. Is associated with lower socioeconomic status.
b. Affects 15% of women.
c. If left untreated, will progress to symptomatic infection in about 75% of women.
d. Should be treated with tetracycline.
e. Is associated with increased risk of anaemia.

The pain of the second stage of labor is conveyed by which nerve?

a. Paracervical.
b. Ilioinguinal.
c. Pudendal.
d. Genitofemoral.
e. Iliohypogastric.
A-24-year-old parturient is at 24 weeks' gestation. Her past medical history is notable for
mitral stenosis secondary to rheumatic heart disease as a child. What physiologic change
of pregnancy places her at risk for the development of heart failure?
a. Decreased functional residual capacity.
b. Increased red cell mass.
c. Increased uterine blood flow.
d. Decreased creatinirie concentration.
e. Increase in stroke volume.
Acute putrid endometritis is characterised by the followings except:
a. Mild type of puerperal sepsis.
b. Caused by low virulent organism.
c. Uterine cavity is lined by a pyogenic membrane.
d. Leucocytic barrier is found under the endometrium.
e. Limited spread of infection.

The grand multipara is characterized by the followings except:

a. Higher perinatal mortality.
b. Pendulous abdomen with malpresentations.
c. A woman who had 4 or more previous deliveries.
d. Higher incidence of obstructed labor and rupture uterus.
e. Higher incidence of post partum hemorrhage.

Indications of vertical LUS incision (Kronig's incision) include the followings

a. Constriction ring.
b. Varicose veins in the broad ligaments.
c. Head deeply engaged in the pelvis.
d. Microcephalus.
e. Some cases of PTL.

Complications of amniotomy include the following except:

a. Placental abruption.
b. Prolapse of the cord. .
c. Intra-amniotic infection.
d. Soft tissue injury of the foetus.
e. Complication of anesthesia.

Foetal response to palcenttal insufficiency include the following Except:

a. Redistribution of blood flow preferentially to the brain and foetal heart.
b. Symmetric IUGR.
c. Oligohydramnios.
d. Decreased foetal movement.
e. Disturbance of foetal heart rate.

Obstetric causes of neurogenic shock include the followings Except:

a. Disturbed extrauterine pregnancy.
b. Difficult internal version.
c. Unavoidable antepartum haeorrhage.
d. Repeat rough attempts at Crede's method.
e. Acute inversion of the uterus.

Human placental lactogen (hPL) is characterised by the followings except:

a. A large protein hormone.
b. Induces maternal hyperglycemia.
c. Stimulates lipolysis.
d. Inhibits gluconeogenesis.
e. Secreted from cytotrophoblasts.
The principal supports of the uterus include:
a. The sacrospinous ligaments.
b. The obturator muscle.
c. The transverse cervical ligaments.
d. The infundibulo pelvic ligaments.
e. The sacrotuberous ligaments.

Patient complains of post coital bleeding and no growth is seen on the cervix per
speculum examination. The best next step should be:
a. Colposcopy
b. Conization.
c. Vaginal U/S.
d. Culdoseopy.
e. Iodine test.

Tumor markers are reliable for the diagnosis and follow up of the following
a. Choriocarcinoma.
b. Embryonal carcinoma. .
c. Dysgerminoma.
d. Endodermal sinus tumours.
e. Metastatic tumours to the ovary.

Regarding uterine perforation during D & C which of the followings is not

a. May occur with the use of sound, dilator or curette.
b. Is more liable to occur during evacuation of a pregnant uterus.
c. Is more liable to occur in the presence of uterine malignancy.
d. May result in intestinal injury.
e. Always treated conservatively if suction cannula was used.

Indications of hysteroscopy include all of the followings except:

A. Habitual abortions.
b. Resection of Submucous myoma.
c. Removal of extrauterine IUD.
d. Diagnosis of intrauterine synaechiae.
e. Irregular uterine bleeding.

The first step to locate a missing-string IUD is;

a. To sound the uterus.
b. Abdominal/pelvic X-ray.
c. Vaginal U/S.
d. Hysteroscopy.
e. Laparoscopy.
Which of the followings is not correct regarding anorexia nervosa?
a. Patients may have bulimia.
b. There is excessive weight loss.
c. Primary amenorrhea is usually present.
d. It may affect 1% of young women.
e. Needs reassurance and psychological support.

Which off the followings is the most certain method to determine that ovulation
has occurred?
a. Basal body temperature.
b. Pregnancy.
c. Increase in LH.
d. Thick cervical mucus.
e. Endometrial biopsy.

The follicular phase of ovarian cycle is characterized by:

a. Increasing amounts of El.
b. Progesterone dominance
c. Associated proliferative endometrium.
d. Fixed length of 8 days.
e. Reduction in aromatase activity.

Which of the following actions combined oral contraceptive pills has?

a. Reduce risk of endometrial cancer.
b. Increase risk of ovarian cancer.
c. Reduce risk of breast cancer. . .
d. Reduce risk of cervical cancer.
e. Worsen endometriosis.

Which of the followings is not a common site for endometriosis:

a. Bone.
b. Ovaries.
c. Uterosacral ligaments.
d. Peritoneum.
e. Oviduct.

Regarding fertilization and implantation:

a. Fertilization occurs in the inner third of the fallopian tube.
b. The sperm head penetrates through the corona radiata and zona pellucida while the tail
remains outside.
c. The second meiotic division is completed before fertilization.
d. Implantation occurs in morula stage.
e. The trophoblast invades the endometrium and differentiates into outer cytotrophoblast
and inner syncytiotrophoblast.
SYMPTOMS of uterine myomas include the followings except:
a. Irregular cycles with hypomenorrhoea.
b. Easy fatigue resulting from anaemia.
c. Heavy bleed with normal cycle length.
d. Dysmenorrhea.
e. Pelvic congestion symptoms.

All the followings are possible causes of menorrhagia, except:

a. Submucous uterine myomas.
b. Adenomyosis uteri.
C. Pelvic inflammatory disease,
d. Endometrial hyperplasia.
e. Levonorgestrel medicated IUD.

All the followings are Mullerian in origin except:

a. Ovaries.
b. Corpus uteri.
c. Oviducts.
d. Upper vagina.
e. Cervix.

Nabothian cysts are:

a. Embryonic rests.
b. Masonephric remnants,
c. Retention cysts.
d. Endometrial implants.
e. Keratinous cysts.

Carcinoma in situ of the cervix indicates:

a. Extensive glandular involvement of cancer cells.
b. Full thickness epithelium replacement by undifferentiated cancer cells.
c. Partial epithelial replacement of stratified basal cells.
d. Reserve cell hyperplasia.
e. Nests of malignant basal cells throughout epithelium.

Gonadal Dysgenesis is treated with:

a. Thyroid extract.
b. Cortisone.
c. Oestrogens.
d. Progesterone.
e. Dexamethason
The most common complain of patient having vulval herpes is:
a. Bleeding.
b. Pain.
c. Discharge.
d. Fever.
e. Oedema.
Turner's syndrome does mot include:
a. Growth retardation.
b. Cubitus valgus.
c. Webbed neck.
d. Mature secondary sex organs.
e. Ovarian dysgenesis.

During the evaluation of infertility in a 25-year-old female a hysterosalpingogram

showed evidence of Asherman syndrome. Which one of the following symptoms
would you expects this patient to have?
a. Hypomenorrhea.
b. Oligomenorrhea.
c. Menorrhagia.
d. Metrorrhagia
e. Dysmenorrhea.

The main sensory supply to the uterus is derived from:

a. Presacral nerve.
b. Splanchnic nerve.
c. Pampiniform plexus.
d. Pudendal nerve.
e. Hypogastric nerve.

The followings are complications of fibroids in pregnancy except;

a. Malpresentations.
b. Placenta accreta.
c. Vasa praevia
d. Necrobiosis.
e. Dysfunctional labour.

Absolute contraindications of combined oral contraceptive pills include the

followings except:
a. Thrombo-embolic disease
b. Carcinoma of the breast.
c. Coronary heart disease.
d. Smoking.
e. Pregnancy.

Which of the following tumors is the least likely to be hormonally active?

a. Sertoli-lyeding cell tumor.
b. Granulosa cell tumor.
c. Hilus cell tumor.
d. Fibroma.
e. Ovarian mucinous cystadenoma.
Serum alpha-fetoprotein concentrations a clinically useful tumour marker for :
a. Brenner tumours of the ovary.
b. Mucinous cystadenocarcinoma of the ovary.
c. Endodermal sinus tumours of the ovary.
d. Granulosa cell tumours.
e. Arrhenoblastoma.

Which of the followings is not correct regarding choriocarcinoma?

a. Histological examination often shows pleomorphic cytotrophoblast but absence of
chorionic villi.
b. A third of cases present with features of distant metastatic spread.
c. The antecedent pregnancy is usually a term delivery or miscarriage
d. Lymph node metastases are common.
e. A characteristic snow-storm pattern is not seen on uterine ultrasonography.

The symptoms of epithelial ovarian cancer include the followings Except:

a. Abdominal distension.
b. Vague gastrointestinal symptoms.
c. Vaginal discharge.
d. Postmenopausal bleeding.
e. Abdominal pain.

The followings are recognized symptoms of cervical carcinoma Except:

a. Postcoital bleeding.
b. Offensive vaginal discharge
c. Pruritus vulvae.
d. Postmenopausal bleeding.
e. Pain.

Contents of the broad ligament include the followings Except

a. The ovaries.
b. The ureter.
c. Parametrial lymphatics and lymph nodes.
d. Parametrial pelvic cellular tissue and fascia.
e. Epoophoron.

Factors needed for normal sexual differentiation include the followings except :
a. Normal sex chromosomal pattern in the female.
b. Normal sex chromosomal pattern in the male.
e. Normal testicular function for male development.
d. Normal ovarian function for female sexual differentiation.
e. Responsive male end organs for testicular testosterone.
Luteal phase cervical mucus changes include the followings except:
a. Scanty.
b. Thick-viscid.
c. Absent leucocytes.
d. Negative Ferning test.
e. Negative Spinnbarkeit test.

Luteal phase vaginal cytology includes the following Except:

a. Intermediate cells with rolled edges.
b. Esinophilic cytoplasm.
c. Vesicular nucleus.
d. Many lymphocytes.
e. Maturation index 0-70-30.

True isosexual precocious puberty may associate the followings Except:

a. Glioma.
b. Meningitis.
c. Empty sella syndrome.
d. Head trauma.
e. Primary hypothyroidisin.

Risk factors for osteoporosis include the following Except:

a. Delayed menopause.
b. Heavy smoking.
c. Increased caffeine consumption.
d. Lack of exercise.
e. Low body weight.

Contraindication of hormone replacement therapy includes the followings Except:

a. Suspected breast cancer.
b. Known breast cancer.
c. History of DVT.
d. Active liver disease.
e. Obesity.

Hyperinsulineaemia leads to the followings Except:

a. Increased sensitivity of ovarian theca cells to LH.
b. Increased LH induced androgen production by the ovaries.
C. Increased aromatase enzyme activity.
d. Decreased production of SHBG.
e. Increased free androgen substrate.

Laboratory findings in PCOS include the followings except:

a. Normal FSH.
b. LH/FSH ration of >2.
c. Elevated levels of plasma E2
d. Elevated levels of plasma androstenedione.
e. Elevated levels of plasma free Testosterone.
Advantages of total hysterectomy include:
a. Less risk of post operative pelvic haematoma.
b. It is easier and quicker.
c. There is less danger of injuring the ureter.
d. There is less danger of injuring bladder.
e. Less liability for subsequent development of vaginal vault prolapse.

Causes of symmetrical enlargement of the uterus include the followings except:

a. Pregnancy.
b. Metropathia haemorrhagica.
c. Single interstitial fundal fibroid.
d. Localized adenomyosis.
e. Pyometra.

Backache caused by gynaecological lesions is characterized by the followings Except:

a. It is diffuse.
b. Situated in the mid-line.
c. It is bilateral.
d. Its level is sacral or lumbosacral.
e. Associated with localized tenderness.

The single most reliable predictor of bacterial vaginosis is:

a. Homogeneous, thin, grayish-white discharge that smoothly coats the vaginal walls.
b. Vaginal pH greater than 4.5.
c. Positive whiff-amine test.
d. The presence of Clue cells on saline wet mount,
e. Vaginal culture.

Factors associated with increased risk for PID include the followings except:
a. Young, sexually active women.
b. Women with multiple sexual partners.
c. Use of intrauterine contraceptive device
d. Use of contraceptive gel-foams.
e. Drug addicts.

Which of the followings is not associated with vulvar ulcer?

a. Syphilis.
b. Tuberculosis.
c. Herpes simplex virus type 2.
d. HPV.
e. Behcet's disease.

Urodynamic parameters of normal bladder function include the followings except:

a. Residual urine after voiding > 50 mL
b. Detrusor pressure filling < 15 cm H2O.
c. Absence of systolic detrusor contractions.
d. First desire to void at 150-200 ml.
e. Strong desire to void at 400-600 ml.
Regarding cervical myomas patients may present with the followings except:
a. Symptomless.
b. Deep dyspareunia.
d. Retention of urine.
d. Loin pain.
e. Excessive menstrual blood loss.

Which of the followings is correct regarding Inhibin?

a. A peptide produced by granulosa cells.
b. It enhances FSH production.
c. Attenuates LH-induced androgen synthesis.
d. Promotes follicular development.
e. Induces LH surge.

Which of the followings is not correct regarding Manchester (Fothergill's) operation?

a. Performed for cases having supravaginal elongation of the cervix.
b. It is a bloody operation.
c. Vaginal hysterectomy is an essential step.
d. May lead to infertility.
e. May lead to cervical dystocia.

Uterine myomas are characterized by which of the followings:

a. Whorled appearance on cut section.
b. Surrounding myometrium is paler than the tumour tissue.
c. Pseudo-capsule is a part of the tumour.
d. Van Geison stain colours the muscle cells pink and fibrous tissue cells yellow.
c. Abundant mitotic figures.

Which of the followings Is not correct regarding clomiphene citrate?

a. Has anti estrogenic properties.
B. May be started with, a 50-mg daily dose.
c. Is useful in hypergonadotropic amenorrhea.
d. May cause cervical mucus hostility.
e. May result in multiple pregnancies.

All the following statements, about genuine stress incontinence in the female, are
correct EXCEPT:
a) It occurs transiently during pregnancy.
b) It is more common in parous women.
c) It can be corrected surgically.
d) Urodynamic studies are usually normal.

The INCORRECT statement for genuine stress incontinence in the female:

a) It is a common transient condition during pregnancy.
b) It is more common in parous women than in nulliparous women.
c) It can be corrected surgically.
d) The amount of escaped urine in each event is always large.
The following are treatment modalities for overactive bladder EXCEPT:
a) Smooth muscle relaxants.
b) Para-sympathomimetics.
c) Tricyclic anti depressants.
d) Anticholinergics.
e) Behavioral therapy.

Overactive bladder gets benefit from the followings EXCEPT:

a) Suburethral sling operation
b) Smooth muscle relaxants.
c) Anticholenergic agents
d) Pelvic floor muscle exercises.

The INCORRECT statement in the treatment of urinary stress incontinence:

a) Non-surgical management is useless.
b) Reconstruction and elevation of the urethrovaginal angle cures the condition.
c) Co-existent detrusor overactivity should be treated before surgery for stress
d) Burch operation (colposuspension) is carried out through an abdominal incision.

Stress incontinence is NOT common in:

a) Nulliparous.
b) Multiparous.
c) Pregnancy.
d) State of physical activity.
e) Chronic chest infection.

The commonest cystic swelling of the vulva:

a) Endometrioma.
b) Inclusion dermoid cyst.
c) Bartholin cyst.
d) Hydrocele of the canal of nuck.
e) Hidradenoma.

The shape of the hymenal opening in normal individuals include the following
a) Annular
b) Crescentric
c) Septate
d) Cribriform
e) Segmoid

The vulval blood supply is via the:

a) Internal pudendal artery
b) Vaginal artery
c) Azygos artery
d) Superior vesical artery
e) Middle rectal artery
Lymphatic drainage of the vulva DO NOT include:
a) The femoral lymph nodes
b) The inguinal lymph nodes
c) The external iliac lymph nodes
d) The pre-sacral lymph nodes
e) The gland of Cloquet

Which DOES NOT increase the failure rate of external cephalic version in breech
a) Polyhydramnios.
b) Ritodrine infusion.
c) Short cord.
d) Hydrocephalus.
e) Frank breech.

The commonest outcome in OP position is:

a) Persistent OP.
b) Deep transverse Arrest.
c) Rotate to OA position.
d) Direct OP.

Detection of which of the following in cervicovaginal secretions is a powerful

clinical predictor of subsequent preterm birth?
a) Decidual relaxin
b) Fetal fibronectin
c) Interleukin-l
d) Tumor necrosis factor

Postterm pregnancy is defined as greater than or equal to which period of

a) 280
b) 287
c) 294
d) 300

The first step in the assessment of the postterm gestation is:

a) Ultrasound examination
b) Determination of the true length of gestation
c) Measurement of fetal heart rate (FHR)
d) Determination of amniotic fluid volume
e) Contraction stress test