Department of Obstetrics and Gynecology

Final Written Examination for Year III Medical Students

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College of Health Science

Question 1

Precipitated labor & delivery may lead to the following complications EXCEPT:
Select one:
a. Vagina & perineal tears
b. Amniotic fluid embolism
c. Uterine rupture
d. Constriction ring formation in the uterus
e. Uterine atony

Question 2
Followings are prerequisites of forceps delivery, EXCEPT
Select one:
a. Membrane must be ruptured
b. Empty Urinary bladder
c. presentation can be breech or face
d. Cervix dilated at least 8 cm and above

Question 3

Which of the following diagnostic tests will help us make a diagnosis of vasa previa?
Select one:
a. Cesarean section
b. Post-delivery placental evaluation
c. Kleihouer Betke test
d. Doppler Ultrasound

Question 4

Which of the following is true about mother to child transmission (MTCT) of

HIV/AIDS?
Select one:
a. Cesarean section increases the risk of MTCT
b. Prolonged rupture of membrane and prolonged labor increases the risk of MTCT
c. Shortening second stage by instrumental delivery will decrease the risk of MTCT
d. In twin pregnancy, MTCT is less for the first twin than the second twin
e. CD4 count is more important predictor of MTCT than viral load
Question 5

A 7 years old child brought by parents complaining persistent vaginal discharge after
being repeatedly treated at different health institutions. They claim that they suspect
sexual assault. Hymen intact and no laceration, scar, vaginal smear and culture are
unremarkable. What will be your next step to rule out the most likely diagnosis?
Select one:
a. MRI
b. ultrasound scanning
c. CT scan
d. X-ray of pelvis

Question 6

The observations that are routinely recorded on the partograph include the following
Select one:
a. moulding of the fetal head
b. latent stage monitoring
c. station
d. consciousness level

Question 7

Which of the following is not associated with Preterm delivery?

Select one:
a. Urinary tract infection
b. Anencephaly
c. Cigarette smoking
d. Low socioeconomic status
e. Anemia
Question 8

A gravid woman with gestational age of 33 weeks, cervix being 9cm dilated and
station 0 with ruptured membranes developed fetal bradycardia. Which one is the best
way to manage her?
Select one:
a. Vacuum delivery
b. Cesarean section
c. Episiotomy
d. Forceps delivery

Question 9

Which one of the following is false about asymptomatic bacteriuria during

pregnancy?
Select one:
a. Urine dipstick showing leukocyte positive with negative nitrite is diagnostic
b. Pregnant mothers with asymptomatic bacteriuria should be treated even no
symptoms
c. E.coli is the most common causative organism
d. Has a risk of anemia and pregnancy associated hypertension

Question 10

A 52 years old secretary presented to you with a complaint of repeated episodes of

hotness following chilliness and perspiration that has affected her day to day activity
in the past 2 months. She is not sleeping well and is quite irritable. She has missed her
period for the past 14 months. Considering the state she is in, what would be the next
course of your action?
Select one:
a. Do urine pregnancy test and look for signs of pregnancy
b. Advise her to dress light and sit by the window
c. Do thyroid function test to R/O hyperthyroidism
d. To talk to psychiatric to put her on anxiolytic
Question 11

The triad of symptoms that best describes ectopic pregnancy is: -

Select one:
a. Amenorrhea, Vaginal bleeding and Syncope
b. Amenorrhea, Vaginal bleeding and lightheadedness
c. Amenorrhea, Vaginal bleeding and Hemodynamic instability
d. Amenorrhea, Vaginal bleeding and Lower abdominal pain
e. Amenorrhea, Vaginal bleeding and Cervical Motion Tenderness

Question 12

A 50 years old woman presented with vaginal bleeding evaluated to have vaginal
cancer which involves the upper third of the vagina mucosa extending to the sub-
vaginal tissue without extending to the pelvic side wall.
Select one:
a. Stage IVA disease
b. stage III disease
c. Stage II disease
d. stage I disease

Question 13

Question text
The most important predictor of the risk for MTCT of HIV is
Select one:
a. Type of infant feeding
b. Viral load
c. Stage of the disease
d. CD-4 count
e. Mode of delivery
Question 14

A 25 years old had bilateral oophorectomy for bilateral tubo-ovarian abscess 2 years
ago. She presented to you with a complaint of absence of menses and vaginal dryness.
She wants her menses to resume and try pregnancy once her problem resolves. The
pathophysiology of her condition is
Select one:
a. Chronic endometritis
b. Hypogonadotropic hypogonadism
c. Absence of ovarian function
d. Ovarian atresia 2ndary to turner’s syndrome

Question 15

The most common symptom of endometrial hyperplasia is

Select one:
a. Pelvic pain
b. Amenorrhea
c. Vaginal bleeding
d. Vaginal discharge
e. Abdominal mass

Question 16

A 24yrs old G2P1 Presents to the Emergency GOPD with a complaint of vaginal
bleeding which is massive since 2 hours. She is 7 months pregnant. She had
uneventful pregnancy. On examination, BP 100/40mmHg, PR 116/min, fundal height
is 34weeks with breech presentation and normal Fetal heartbeat. She has no other
symptoms. The most likely clinical diagnosis is
Select one:
a. APH due to Abruptio placentae
b. Vasa previa
c. Placenta previa
d. bloody show
Question 17

Which of the following statement is not correct about the physiology of pregnancy?
Select one:
a. The urinary tract is dilated
b. Absorption of calcium and iron from the gastrointestinal tract is changed
c. Blood volume increases 10-20% in the second trimester
d. cardiac output increases 40% in singleton pregnancy

Question 18

A 23 years old lady presented to GYN OPD with severe lower genital pain. Your first
impression from the following differential diagnosis could be
Select one:
a. Acute PID
b. Bartolin gland abscess
c. Vulvovaginal candidiasis
d. Gartner Cyst torsion
e. Sexual assault

Question 19

A 23 Years old primigravid lady presents at the GOPD with vaginal bleeding and
passage of conceptus tissue at 6 weeks of gestation. She has HCT 35%, Blood
Group& RH is A negative and a positive pregnancy test. What would be the next
course of action to prevent Rh sensitization.
Select one:
a. Rule out molar pregnancy by Histopathology
b. Administer 50microgram of Anti-D IM
c. Do kleihauer Betke test to assess the degree of feto-maternal hemorrhage
d. Do partner Blood group and RH and indirect Coomb’s test
Question 20
Absence of withdrawal bleeding during sequential estrogen - progestin challenge test
in secondary amenorrhea is consistent with
Select one:
a. Gonadal agenesis
b. Asherman’s syndrome
c. Poly cystic ovary (PCO) syndrome
d. Sheehan’s syndrome
e. Premature ovarian failure

Question 21

Reduced placental diffusion capacity is caused by all of the following EXCEPT:

Select one:
a. Gestational diabetes mellitus
b. Hypertension
c. Placenta previa
d. Smoking

Question 22

An appropriate weight gain of a pregnant woman with a pre-pregnancy BMI of 18

Kg/M2 at 39 weeks of gestation would be:
Select one:
a. 10 kg
b. 6 kg
c. 17 kg
d. 8 kg
e. 12 kg
Question 23

Which of the following is associated with postpartum urinary retention?

Select one:
a. prolonged labor
b. multiparity
c. instrumental delivery
d. manual rotation

Question 24

The most common site of metastasis in metastatic GTD is

Select one:
a. Brain
b. Lung
c. Ovary
d. Liver
e. Vagina

Question 25

All are advantages of breast feeding except:

Select one:
a. protection from Vitamin K deficiency
b. better intelligence coefficient of the babies
c. protection from necrotizing enterocolitis
d. protection from hypothermia

Question 26

The objectives of ANC at a gestational age greater than 24 weeks include all except:
Select one:
a. To evaluate for chromosomal anomalies
b. Establish diagnosis of pregnancy and gestational age;
c. Develop individualized birth plan;
d. Ascertain risk factors, medical and nutritional status of the mother;
e. To initiate prophylaxis (anemia, malaria, HIV, and immunizations)
Question 27

Question text
A 25-year-old GII woman (with vaginal delivery before) lady at gestational age of 41
weeks presents to labor and delivery complaining of rupture of membranes and
painful uterine contractions every 2 to 3 min. On digital exam, her cervix is five
centimeters dilated with breech presentation, the foot is not palpable. The position is
right sacrum anterior position. The fetus’s estimated weight is about 3.2 kg and the
fetal heart rate is 140. What is the best method to achieve delivery?
Select one:
a. Perform an emergency cesarean section
b. Deliver the baby vaginally after external cephalic version
c. Perform an internal podalic version
d. Deliver the fetus vaginally by assisted breech delivery

Question 28

All are prerequisites for Vaginal birth after Cesarean (VBAC), EXCEPT
Select one:
a. patient opts for repeat cesarean even if she is a candidate for VBAC
b. Previous lower Segment transverse incision
c. Ability to perform emergency cesarean within 30 minutes of decision
d. Non repetitive indication for cesarean delivery

Question 29

A 24 years old Para 2 mother is diagnosed to be Rh negative during ANC. One of the
following cannot be part of work up on the mother during ANC
Select one:
a. Indirect Coombs test
b. Fetal middle cerebral artery velocimetry
c. Biophysical profile
d. Direct Coombs test
e. Amniocentesis
Question 30

A 35 years old nuliparous woman came to a clinic with the tissue diagnosis of CIN1.
What is the possible next step of management?
Select one:
a. HPV DNA test
b. Remove the uterus with surgery
c. Remove the cervix with surgery
d. Reassure and send home

Question 31
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Question text
A gravida VI, para V presented with 1 hour of “pushing down pain”. Pelvic
examination revealed 1 cm of cervical dilatation and ruptured fetal membranes.
Patient experienced vaginal bleeding which is small in amount right after the rupture
of membranes. Fetus at presentation was found dead intrauterine. She had an
ultrasound scanning just a day before and biophysical profile was 8 out of 10 with
normal amniotic fluid amount. What is the most likely diagnosis?
Select one:
a. Local causes
b. Heavy show
c. Placenta previa
d. Ruptured uterus
e. Vasa previa

Question 32
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Question text
The most preferred type of anesthesia for instrumentation for abortion is:
Select one:
a. General anesthesia
b. Paracervical block
c. Spinal anesthesia
d. Narcotic analgesic
e. Epidural anesthesia
Question 33
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Question text
Which of the following is true about physiologic/ dilutional anemia?
Select one:
a. is associated with the decrement in RBC mass during pregnancy
b. All pregnant women with normal hemoglobin level need iron supplementation
c. Is greatest in the third trimester of pregnancy
d. Greatest during first trimester of pregnancy

Question 34
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Question text
Which one of the following is not one of the leading direct causes of maternal
mortality in Ethiopia?
Select one:
a. Preterm delivery
b. Preeclampsia /eclampsia syndrome
c. Obstetric hemorrhage
d. Septic abortion

Question 35
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Question text
A 30 years old nulligravid lady presents to the gyn OPD with a complaint of irregular
menses coming every 3-4 months since the past 4 years. She has never used
contraceptives and has been trying to be pregnant for the last 2 years. She has
adequate sexual frequency. She has gained 12 kilos in the last 8 months and is on
dietary management for a newly diagnosed diabetes mellitus. On examination, BP
140/90mmHg, BMI 32Kg/m2, she has shaved her chin. She has no pallor, abdomen is
obese with no organomegaly, Pelvic exam showed normal uterine size with no
palpable adnexa. Serum progesterone was 0.2ng/dl, ultrasound showed endometrial
thickness of 12mm. The most likely lethal complication this patient is risking is
Select one:
a. Cervical cancer
b. Infertility
c. Endometrial cancer
d. Myocardial infarction

Question 36
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Question text
Which is a contraindication to lactation?
Select one:
a. mother with Hepatitis B virus infection
b. mother with active untreated TB
c. mother of a galactosemic newborn
d. Mother on progesterone only pills

Question 37
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Question text
Which one of the following is not a risk factor for Iron deficiency Anemia?
Select one:
a. diet poor in iron-rich foods
b. prolonged interpregnancy interval
c. gastrointestinal disease affecting absorption
d. diet poor in iron absorption enhancers
e. diet rich in foods that diminish iron absorption
Question 38
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Question text
A 22 years old primigravida visited emergency OPD with compliant of watery vaginal
discharge at GA of 29 weeks. The best method used to confirm the diagnosis is:
Select one:
a. Leopold maneuver
b. Ultrasound examination
c. Amniocentesis
d. Speculum examination
e. Digital vaginal examination

Question 39
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Question text
The fate of a tubal implantation of the blastocyst includes the following except: -
Select one:
a. Abdominal pregnancy
b. Tubal rupture
c. Reabsorption
d. Spontaneous resorption
e. Tubal abortion

Question 40

A 30 years old unmarried abortion I induced presented to a clinic for the general
checkup. She was told to have uterine fibroid incidentally. She has regular cycles and
no change in menstrual flow. What is your management plan?
Select one:
a. Do CT scan
b. Medical treatment
c. Advise and Follow up
d. Surgical treatment

Question 41
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Question text
The frequency of dizygotic twins is affected by
Select one:
a. Age
b. Race
c. Maternal BMI
d. Height
e. All
Question 42
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Question text
Which of the following is not a risk factor for vulvar cancer
Select one:
a. HSV infection
b. HPV infection
c. Smoking
d. Lichen sclerosis

Question 43
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Question text
The use of parthograph during labor includes all except
Select one:
a. For appropriate patient referral
b. Reduce maternal mortality
c. Reduce perinatal mortality
d. Reduce obstructed labor
e. None

Question 44
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Question text
Which one of the following statements is NOT TRUE about primary dysmenorrhea?
Select one:
a. Pain relieved by abdominal massage, counter-pressure, or movement of body
b. It is typically associated with anovulatory cycles
c. Mainly affects the younger age group
d. Pain usually begins few hours before or just after onset of menstrual period
e. Prostaglondin F is the responsible agent.
Question 45
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Question text
A 40 years old para 4 woman presented with a cyclic pain which starts a week before
her menses and ends after cessation of menses for one year. Menses has been frequent
and heavy for the past 2 years. Uterus is 12 weeks sized and has no other abnormality
over the pelvis. Which one is the most likely diagnosis?
Select one:
a. Congenital pelvic malformation
b. Adenomyosis
c. Pelvic inflammatory disease
d. Endometriosis

Question 46
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Question text
A 35 years old nulliparous woman presented to gynecology outpatient department
with the complaints of dull aching and back pain of 2 years duration. Has a regular
cycle with moderate flow. Physical exam revealed 14 weeks sized pelvic mass with
solid consistency. What is your first line diagnostic investigation?
Select one:
a. CBC
b. Tumor markers
c. Hormonal profile
d. Ultrasound

Question 47
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Question text
Which of the following is the true statement regarding primary cervical cancer
prevention?
Select one:
a. Cytological screening
b. Human papilloma virus treatment
c. Condom use
d. Treatment of low-grade lesions

Question 48
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Question text
Which one of the following is true about drugs and medications during pregnancy and
lactation?
Select one:
a. Don’t prescribe FDA category ‘D & X’ drug between 4-8 weeks of gestation
for critically ill mother in the absence of any other options
b. Prescribe maximum dose of the drug during pregnancy and lactation
c. Prescribe minimum dose and multiple medications
d. Avoid medications during organogenesis

Question 49
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Question text
A 45 years old G6P5 lady at GA of 12 weeks presents with headache and blurring of
vision. On P/E she has BP of 160/120mmHg and has a uterine size of 22 weeks. On
pelvic ultrasound bilateral multicystic ovarian masses were seen. What is the best way
to terminate this pregnancy?
Select one:
a. Hysterotomy
b. Electrical suction curettage
c. MVA
d. D and E

Question 50
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Question text
Which of the following complications is not associated with Placenta previa?
Select one:
a. Postpartum hemorrhage
b. Intrauterine growth restriction
c. Congenital malformations
d. Higher risk of alloimmunization

Question 51
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Question text
The peak time for maternal death is:
Select one:
a. Immediate postpartum period
b. The first trimester due to complications of abortion
c. The intrapartum period
d. The antepartum period in the third trimester

Question 52
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Question text
Which of the following is a correct combination?
Select one:
a. Brow, mentum
b. Breech, ischium
c. Face, frontum
d. Shoulder, acromion

Question 53
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Question text
Which of the following statement does not accurately describe the role of steroid in
the mechanism of parturition?
Select one:
a. Estrogen has the highest impact in parturition
b. Progesterone inhibits the formation of estrogen receptors in the myometrium
c. A rise in progesterone level proceeds the onset of labor
d. Administration of anti-progesterone can induce preterm labor

Question 54
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Question text
DIC & Couvelaire uterus arise as complications of
Select one:
a. Placenta previa
b. Abruptio placenta
c. preeclampsia
d. Vasa previa

Question 55
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Question text
Which of the following obstetric conditions are associated with lower risk of Feto-
maternal hemorrhage?
Select one:
a. Manual aspiration of conceptus tissue
b. Breech presentation
c. Chorioamnionitis
d. Preterm labor

Question 56
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Question text
58 years old women is presenting with a complaint of postmenopausal bleeding for
the last 2 weeks. The most essential investigation would be
Select one:
a. Pap smear
b. Colposcopy
c. Curettage
d. Cone biopsy

Question 57
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Question text
Which one of the following is wrong about carbohydrate metabolism during
pregnancy?
Select one:
a. Increase in insulin requirements and anabolic state in early gestation
b. Placenta glucose transport is through facilitated diffusion
c. Late pregnancy is characterized by diabetogenic effect and postprandial
hyperglycemia
d. Normal pregnancy is characterized by fasting hypoglycemia and hyperinsulinemia

Question 58
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Question text
One of the following statements is true regarding the role of HPV in cervical cancer
pathogenesis.
Select one:
a. About 50% of the HPV types are strongly associated
b. HPV 16, 18, and 42 are strongly associated
c. HPV 6 and 11 are moderate risks
d. High risk types are strongly associated

Question 59
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Question text
A 32 years old presented to the gyn OPD with a complaint of heavy and prolonged
menses since the past one year. She is para 2 and is on calendar method of
contraception for the past 2 years. She feels tinnitus and light headedness. On
examination, vitals are stable, pale conjunctivae, no palpable abdominal mass or area
of tenderness. Pelvic exam showed 10wks irregular uterus with no adnexal mass.
According to the PALM COEIN Classification the cause of the abnormal bleeding of
the case is
Select one:
a. Coagulopathy
b. Symptomatic myoma
c. Endocervical polyp
d. Pregnancy complications

Question 60
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Question text
Which of the following is the immediate precursor for cervical epithelial neoplastic
change?
Select one:
a. Latent infection
b. Proliferative changes
c. Integration to host genome
d. Persistent infection

Question 61
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Question text
58 years old women is presenting with a complaint of postmenopausal bleeding for
the last 2 weeks. The most essential investigation would be
Select one:
a. Pap smear
b. Colposcopy
c. Curettage
d. Cone biopsy

Question 62
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Question text
Which one of the following is wrong about carbohydrate metabolism during
pregnancy?
Select one:
a. Increase in insulin requirements and anabolic state in early gestation
b. Placenta glucose transport is through facilitated diffusion
c. Late pregnancy is characterized by diabetogenic effect and postprandial
hyperglycemia
d. Normal pregnancy is characterized by fasting hypoglycemia and hyperinsulinemia

Question 63
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Question text
One of the following statements is true regarding the role of HPV in cervical cancer
pathogenesis.
Select one:
a. About 50% of the HPV types are strongly associated
b. HPV 16, 18, and 42 are strongly associated
c. HPV 6 and 11 are moderate risks
d. High risk types are strongly associated

Question 64
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Question text
A 32 years old presented to the gyn OPD with a complaint of heavy and prolonged
menses since the past one year. She is para 2 and is on calendar method of
contraception for the past 2 years. She feels tinnitus and light headedness. On
examination, vitals are stable, pale conjunctivae, no palpable abdominal mass or area
of tenderness. Pelvic exam showed 10wks irregular uterus with no adnexal mass.
According to the PALM COEIN Classification the cause of the abnormal bleeding of
the case is
Select one:
a. Coagulopathy
b. Symptomatic myoma
c. Endocervical polyp
d. Pregnancy complications

Question 65
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Question text
Which of the following is the immediate precursor for cervical epithelial neoplastic
change?
Select one:
a. Latent infection
b. Proliferative changes
c. Integration to host genome
d. Persistent infection

Question 66
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Question text
Which of the following is not a sign of placental separation in third stage of labor
Select one:
a. Lengthening of the cord
b. Increased uterine height
c. Cessation of vaginal bleeding
d. Gush of bright red blood

Question 67
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Question text
A 25 years old G 2 P1 mother diagnosed diabetes for the first time during the current
pregnancy. She wants to know the complications on the fetus/newborn and herself due
to the diabetes. What should she be told?
Select one:
a. Neonatal hyperglycemia
b. Substantially increased congenital anomaly
c. Increased risk of intrapartum interventions
d. Fetal growth restriction

Question 68
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Question text
A mother came to your office on her six postpartum week seeking for initiation of
contraception. What is the best method at this time?
Select one:
a. IUCD
b. Condom use
c. Lactational amenorrhea method
d. Calendar method

Question 69
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Question text
A 19 years old high school student presented to the Gyn OPD with a complaint of
absence of menses since the past 8 months. She had regular menses and never used
contraceptives. A Year back, she had dilatation and curettage twice 5 days apart
following a septic termination of 3 months old pregnancy. She has currently stable
vital signs, no pallor, no abdominal tenderness and pelvic exam showed normal
uterine sized with no palpable adnexea and normal vaginal discharge on examining
fingers. The most likely cause of her problem is
Select one:
a. Turner’s syndrome
b. Asherman syndrome
c. Shehann’s Syndrome
d. Klenfelter’s syndrome

Question 70
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Question text
Which one of the following is unlikely to cause asymmetric IUGR?
Select one:
a. Chronic hypertension
b. Gestational diabetes
c. Maternal cardiac disease
d. Preeclampsia

Question 71

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Question text
Advantage of a median episiotomy includes the following EXCEPT:
Select one:
a. Avoidance of major perineal lacerations.
b. Less blood loss compared to mediolateral technique.
c. Decreased risk of injury to the anal sphincter and mucosa.
d. Greater ease of repair compared to mediolateral technique
e. Increased area of vaginal outlet to facilitate delivery.

Question 72
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Question text
A Pathologist sends you a histopathology result of endometrial sample with the
following report “normal stromal to glandular ratio, the glands exhibit a regular
tortuosity and are clearly oriented from the base to the surface of the endometrium;
subnuclear glycogen vacuoles are clearly visible”. Your interpretation of the report is
Select one:
a. Proliferative endometrium
b. Chronic endometritis
c. Luteal phase defect
d. Secretary endometrium

Question 73
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Question text
The mode of delivery in women diagnosed with obstructed labor with IUFD is
Select one:
a. Laparotomy
b. Cesarean section
c. Craniotomy
d. Destructive delivery under direct vision of the uterus through opened abdomen
without opening the uterus

Question 74
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Question text
The true conjugate in the assessment of female pelvis is the distance between,
Select one:
a. Sacral promontary and inferior point of symphysis pubis
b. Sacral promontory and the midpoint of symphysis pubis
c. Sacral promontory and superior point of symphysis pubis
d. Tip of sacrum and inner margin of symphysis pubis

Question 75
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Question text
A 26 years old G3 P2 at gestational age of 34 weeks presented with nausea, vomiting
and progressive jaundice of two days duration. Previous delivery was uneventful.
Laboratory results showed total bilirubin 8 mg/dl; AST &ALT =800 U/l ; Creatinine
4.2 gm/dl; RBS= 56 mg/dl. What is the most likely diagnosis?
Select one:
a. HELLP syndrome
b. Intrahepatic cholestasis of pregnancy
c. Acute viral hepatitis
d. Acute fatty liver of pregnancy
Question 76
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Question text
Which one of the following statements is NOT TRUE about endometriosis?
Select one:
a. GnRh agonists can be used to cure the condition
b. It is a disease of the reproductive age women
c. It can occur nearly anywhere in the body
d. It is an estrogen-dependent disorder
e. It is present in multiple areas in most patients

Question 77
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Question text
Which of the following tests is the most accurate to detect ROM if ROM cannot be
detected by speculum?
Select one:
a. Nitrazine test
b. Ferning test
c. Digital vaginal examination
d. dye test

Question 78
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Question text
Which of the following is true in a menstrual cycle with 24 days duration?
Select one:
a. Progesterone production decreases after the 22nd day
b. Secretory phase lasts less than 12 days
c. Graffian follicle is seen before 14th day of cycle
d. Proliferative phase lasts about 10 days
e. Ovulation occurs between 12 to 14 days of cycle
Question 79
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Question text
The least likely cause of first-trimester pregnancy loss
Select one:
a. Autoimmune diseases
b. Anti-phospholipid antibody syndrome
c. Chromosomal abnormalities
d. Mullerian abnormalities

Question 80
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Question text
Rotation
Select one:
a. Ventouse
b. Simpson forceps
c. Piper forceps
d. Kielland forceps
e. Wrigley forceps

Question 81
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Question text
On a routine ANC visit of a primigravid lady, her urine dipstick test showed
glycosuria of +3. What is the next step in the evaluation of this lady?
Select one:
a. Do a 50gm glucose challenge test
b. Do a 100gm OGTT
c. Do a fasting blood glucose level
d. This is physiologic in pregnancy, so no further evaluation is needed
Question 82
Not yet answered
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Question text
What is the definition of anemia during pregnancy?
Select one:
a. Hgb (g/dL) and Hct (percentage) levels below 11 g/dL and 33%, respectively, in the
3rd trimester
b. Hgb (g/dL) and Hct (percentage) levels below 11 g/dL and 33%, respectively, in
the 2nd trimester
c. Hgb (g/dL) and Hct (percentage) levels below 10.5 g/dL and 32%, respectively, in
the postpartum
d. Hgb (g/dL) and Hct (percentage) levels below 10.5 g/dL and 32%, respectively, in
the first trimester

Question 83
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Question text
Asyncilitism is best defined as;
Select one:
a. Failure of the descent purely for mechanical reasons
b. Failure of the sagittal suture to lie exactly midway between the symphysis &
sacral promontory
c. Failure of the descent because of inadequate uterine contractions
d. Inability of the fetal head to pass through the pelvic inlet
e. Failure of internal rotation after the fetal head has engaged

Question 84
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Question text
Which of the following physiologic conditions offer natural protection against RH
isoimmunization?
Select one:
a. administration of Anti-D immunoglobulin
b. desensitization by repeated and small packed RBC transfusion
c. ABO incompatibility
d. lab result showing DU + Status of the partner

Question 85
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Question text
Uterine growth during pregnancy is caused by
Select one:
a. Cellular hyperplasia
b. Stimulation by Relaxin
c. Cellular hyperthrophy
d. Cellular hyperthrophy and hyperplasia
e. Stimulation by Estrogen

Question 86
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Question text
A 33 years old primigravida women was diagnosed with NRFHRP in active phase of
the first stage of labor at GA of 34 weeks. Digital vaginal examination revealed
umbilical cord prolapse and cesarean section was done. Which one of the following
problems is more likely to recur during subsequent pregnancies?
Select one:
a. Cord prolapse
b. Cesarean section
c. Preterm labor
d. All of the above
e. None of the above

Question 87
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Question text
Which of the following best describes a complete breech presentation?
Select one:
a. Flexion of the hips and extension of the knees
b. extension of the hips and extension of the knees
c. flexion of the hips and flexion of the knees
d. Extension of the hips and flexion of the knees

Question 88
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Question text
Which of the following changes of pregnancy is not ascribed to progesterone?
Select one:
a. Increases uterine blood flow
b. Nausea
c. Constipation
d. Increased stasis of urine
e. Reduced diastolic pressure

Question 89

Which of the following is a major risk factor for ectopic pregnancy?

Select one:
a. Cigarette smoking
b. Multiple sexual partners
c. Previous elective abortion
d. Use of exogenous hormones
e. Previous ectopic pregnancy

Question 90

A 28 years old lady came to OPD just after missing her menses. Urine pregnancy test
showed positive. She is taking warfarin starting from four months ago for deep venous
thrombosis (DVT). She asked what will happen on the pregnancy due to the drug.
Select one:
a. She can continue warfarin safely
b. Had risk of warfarin embryopathy
c. It is all or none effect
d. The pregnancy should be terminated

Question 91
Complication of twin-twin transfusion includes
Select one:
a. meconium passage
b. acardiac twin
c. plethoric baby
d. macrosomia

Question 92

In the case discussed on Question 51, which of the following arteries will be
responsible in restoring menstrual cycle?
Select one:
a. Radial arteries
b. Basal arteries
c. Spiral arteries
d. Arcuate artery

Question 93
The most important diagnostic test to confirm the diagnosis of the above patient
(Question 3) is
Select one:
a. Endometrial biopsy
b. Serum progesterone
c. Trans vaginal Ultrasound
d. Urine HCG

Question 94

A 19-year-old primigravid woman at 38 weeks of gestation comes to emergency OPD

because she has passed bloody mucus discharge. On vaginal examination, the cervix
is 2cm dilated and 80% effaced. She has painful contractions every 3 minutes. The
fetal heart rate is 140 per min. One hour later the patient's cervix is 3 cm dilated.
Which of the following is the most likely diagnosis?
Select one:
a. False labor
b. Early labor
c. Vasa previa
d. Placenta previa
e. Placental abruption
Question 95

A 33-year-old class H diabetic woman is concerned about pregnancy and is looking

for counseling. Which of the following complications is the same for her as to the
general population?
Select one:
a. preterm labor
b. Hydramnios
c. Preeclampsia and eclampsia
d. Infection