Obstetric and gynecology - 2018 - pulse batch

The exam was two forms with repeated or similar questions between the forms.

1. About management of menorrhagia, all are true except:

A- NSAIDs decrease bleeding by 25-50%.

B -Tranexamic acid should not be given to pt with bleeding disorder
C- Progestin is used for anovulatory DUB
D- COCP is contraindicated to be used to manage menorrhagia in 45 years
female
E- Endometrial ablation is inducing iatrogenic asherman syndrome

Answer: B

It is contraindicated for thrombotic disease because it may cause intracranial

thrombosis

2 All of the following are true about cord prolapse except:

A. Late decelerations are a common finding

B. Is a known complication of AROM
C. Pushing the fetal head transvaginally is an important step in management
D. Is a common association with footling breech
E. It is a common association with prematurity and multiparity

Answer: A
(causes variable decelerations)

3 regarding fetal non-stress the change in the fetal heart associated with fetal
:movement is
.a- increased beat to beat variability
.b- transient accelerations
.c- prolonged tachycardia
.d- early decelerations
.e- variable decelerations

Answer is B
4
All of the following associated with stress incontinence except:-
A. Treated by exercise and surgery
B. Cystometry used in diagnosis
C. Avoid caffeine
D. Anticholinergic drugs the most commonly used medication

Answer: D

In another form:

E. Alpha receptors present in the body of bladder

5 About tractional forceps, one is true:

a- They are used to deliver the after-coming head

b- They have a sliding lock
C- Can be used on intact membrane
D- No cephalic curvature

Answer: A
6 Regarding premature ovarian failure all of the following is true except:

A- Autoimmune destruction is a cause

B- It is present before 40 years
C- It is diagnosed by finding hypogonadotropic hypoestroginsm

Answer: C
(there increase in GnRH due to loss of negative feedback )

7 ALL are cause of face presentation except:

A. Anencephaly
B. Branchial cyst
C. Multiple pregnancy
D. Multiparty
E. contracted pelvis

Answer: D (most likely)

9 All are changes in post-menopause except :

A. Loss weight
B. Mode change
C. Sleep disturbance
D. Hot flashes
E. Dry vaginal

Answer: A (PYQ)

10 Urge incontinence all true except:

A- tension free vaginal tape (TVT) is one of the operative option

B-

Answer: A

(used in stress incontinence)

Placement of ​tension-​free vaginal tape is surgery to help control stress urinary

incontinence
 (old PYQ about same topic)

11 Features of transfused blood for fetus for Rh-sensitized woman include all
following except:

A. low PCV
B. O negative
C. compatible for the fetus and the mother
D. irradiated
E tested for infections

Answer: A
12
The shortest distance between the sacral promontory and pubic symphysis is:

A. Biparietal diameter
B. True conjugate
C. Obstetrical conjugate
D. Diagonal conjugate
E. Interspinous diameter

Answer: C

In another form:
13 All are signs / symptoms occur in chorioamnionitis except:

A. Tender abdomen
B. Hypotension
C. Tachycardia
D. Bad CTG
E. Fever

Answer: D or B ?
 The diagnosis of clinical chorioamnionitis in pregnancy is commonly made
based on clinical findings of fever plus fetal tachycardia, maternal leukocytosis,
or purulent fluid coming from the cervical os. Additionally, the pregnant woman
with chorioamnionitis may appear ill, even toxic, and she may exhibit
hypotension, diaphoresis, and/or cool or clammy skin. However, especially
when dealing with histologic chorioamnionitis, maternal clinical signs or
symptoms of infection may be absent (silent chorioamnionitis).

Bad CTG might include tachycarida

Hypotension happen

U need to ask the dr’s what do they think about this qus :3

14 37 wks pregnant, on examination fundal height was 34, which is incorrect:

A- May be a normal finding

B- Head circumference is the ideal parameter to detect growth restriction.
C- Around 50% of IUGR cases are missed on abdominal exam
D- oligohydramnios
E- IUFD
 Answer: B

15 All of the following are the features of ultrasound in ovarian cancer except:

A. Solid mass
B. septation > 3 mm
C. Size more than 10 cm
D. Ascites
E. Pelvic mass

Answer: C
(from 6th year round: ​size is not imp, it does not correlate with the mass à
it might be a small mass but in it can be a tumor)
16 Which one of the following is true in regard to a cervical Smear with ASC-US:

1. Best combined with HPV triage

2. Refer to colposcopy
3. Treated by conization
4. Should be treated as CIN I CIN II
5. It's normal finding and nothing should be done (something like this)

Answer: 1

17 Minimal time required before repeating semen analysis for spermatogenesis:

15 days
30 days
60 days
90 days
10 days

Answer: 90 days

18 Regarding urodynamic study one is true:

A- flow rate more than 15 ml/ sec

B- most common cause of overflow incontinence in female in urethral outlet
obstruction
C. bladder volume 200-300 cc

Answer A

19 All of the following are features of PCOS except:

A. Increased risk of DM type II
B. Increased acne
C. It is a cause of anovulatory amenorrhea
D. Increased levels of 17α-Hydroxyprogesterone
E. They are at increased risk of atherosclerotic diseases

Answer: D (most likely,, read here:

https://www.aafp.org/afp/2003/0615/p2565.html​)
20 All of the following are contraindications for tocolytics except:

a. Active labor
b. Fetal abnormalities
c. Antepartum hemorrhage
d. Fetal compromise
e. Chorioamnionitis

Answer: C (mostly, cause for example placenta previa, u can give steroid and
tocolytics and wait for a while)

21 Regarding fibroids all are true except:

A. Red degeneration is common in pregnancy

B. HRT could be used to treat postmenopausal females with fibroids
C. Most commonly present with menorrhagia

Answer: B

Unfortunately, many postmenopausal women with fibroids then begin taking

hormone replacement therapy (HRT). I write the word "unfortunately" for a
reason. Several studies have now shown that abnormal bleeding in
post-menopausal women can occur when fibroids resume growing with the
introduction of HRT into a woman's system.

After menopause, taking estrogen and progestin replacement therapy can

 cause fibroids to grow

https://www.wdxcyber.com/nbleed14.htm

(they are asymptomatic but when they “present” they present with
menorrhagia)

22 During the first half of the menstrual cycle the endometrium thickens and
regrows/ rebuilds under the effect of:

A- Estrogen

B- Progesterone

C- LH

D- FSH

E- GnRH

Answer: A

24 Granulosa cell tumor all true except:

A- best treated with surgical rather than medical

B- Associated with endometrial hyperplasia
C- Cause precious puberty in young girls
D- It secrete progesterone
E- It is a germ cell tumor incidence is more in children and adolescent

Answer D (granulosa cell tumor secrete estrogen)

25 Absolute contraindication for OCP include all of the following except:

A. Diabetic retinopathy
B. Non focal migraine
C. Active liver disease
D. Complicated valvular heart disease
E. Smoker , with age more than 40

Answer: B (contraindicated in focal migraine)

26 All are true regarding mullerian agenesis except:

A. Females affected have short vagina

B. They have normal breasts and pubic hair
C. They have no uterus
D.t's associated with renal and skeletal abnormalities
E. Need supplemental hormones as part of treatment

Answer: E

27 The prognosis of endometrial carcinoma is worse with all except:

A-Elderly
B-hypertention and DM

Answer: B

(old PYQ)-6th y 2014

28 Good antenatal care can prevent or minimize the following conditions except:
a- Hydrops fetalis.
b- Iatrogenic prematurity.
c- Gestational thrombocytopenia.
d- Folic acid deficiency anemia.
e- pyelonephritis.

Answer:
‫ﻣﺶ ﻣﺘﺎﻛﺪ ﻣﻦ اﻟﺠﻮاب‬
‫ﺑﺲ ﺑﻮاﺣﺪ ﻣﻦ اﺳﺎﻟﺔ اﻟﺴﻨﻮات اﻟﻘﺪﯾﻤﺔ ﻣﺠﺎوب‬
C

29 History about a primi came to ANC for the first time i think the question was
which of the following is the best :

A-abdominal us at 14 weeks
B-abdominal us at 16 weeks
C-transvaginal us at 8 weeks
D -bhcg

ANSWER: C?

30 Progesterone releasing IUCD all are true except:

A- inhibit fertilization as a part of it is mechanism

B -contraindicated in breast cancer
C- can be inserted for 5 years
D- can treat functional cyst
E- It's labled by the FDA as treatment for mennohragia

Answer: D
 For B: Hormone-containing methods of contraception are avoided In patients
with breast cancer, as estrogen and progesterone may have a proliferative
effect on breast tissue. This is particularly concerning With hormonal
receptor-positive breast cancer. and BRCA2 carriers tend to have estrogen
receptor-positive breast cancer.
- A copper intrauterine device (IUD) is a safe, long-term, hormone-free method
of contraception. It Is 99% effective and prevents pregnancy by creating a
chronic cytotoxic inflammatory response. A copper IUD can be placed for a
maximum or 10 years.

31 Regarding Acute fatty liver disease, which one is false:

A-Disease of third trimester

B-Treatment in intensive care setting and delivery
C-Parity is not a risk factor
D-Recurrence is 15%
E- Hyperglycemia

ANSWER: E

Because of the autosomal recessive nature of these disorders, the recurrence

risk with subsequent pregnancies is 25%, and all subsequent pregnancies
must be assiduously monitored

https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biol
ogy/acute-fatty-liver-of-pregnancy
32 All of the following are true about epidural anesthesia except:

A.It lengthens the second stage of labor

B It is recommended in cardiac patients
C.Epidural anesthesia acts faster than spinal l
D.Headache is a recognized complication of epidurals
E. can cause meningitis

ANSWER: C

32 All of the following are correct except:

A. CS is contraindicated if platelets 90000

B. CMV infection in preganancy can cause thrombocytpenia
C. IVIG can be used to treat thrombocytopenia
D. Gestational thrmobocytopenia occur during 3rd trimester
E. Platelets tranfusion is indicated if count is less than 50.000 (or something
like this)

ANSWER: A

33 IV Hydralazine in management of pre-eclampsia, cause all except:

A- Increase in co
B- Increase in heart rate
C- Increase in PVR
D- Decrease mean arterial pressure
E- Facial flushing

ANSWER: C
34 Only one of the following is Correct regarding GTN:
A- partial mole may reach term
B- partial mole is diploid
C- vagina is the most common site for mets.
D- most common chromosomal karyotype in complete mole is 46 XY
E- Embryonic tissue is part of complete mole

Answer: A

https://www.sciencedirect.com/science/article/pii/S102845591400134X

35 All are serious signs in a 38 weeks pregnant lady except:

A. Eye flashes
B. Abdominal tightness
C. vaginal bleeding
D. Severe vomiting
E. Frontal headache

Answer: B
37 All are indications for delivery in preeclampsia except:

A- Frontal headache
B- Flashes of light
C- Renal failure
D- Persistent vomiting
E -Decrease liquor “Oligohydramnios”

Answer: E

‫اول ﺧﯿﺎرﯾﻦ ﻣﺶ ﻣﺘﺬﻛﺮ اﻧﻪ ﻛﺎﻧﻮا ﺿﻤﻦ اﻟﺨﯿﺎرات‬

‫ﺑﺲ ﻛﺎن ﺧﯿﺎر‬
E
‫ﻫﻮ اﻧﺴﺐ ﺟﻮاب‬

Olighohydramonios does not indicate severe pre-eclamspia

It is the IUGR
38 Regarding asthma in pregnancy, all are correct except:
a- increased risk of SGA
b- steroids are contraindicated in pregnancy.
c- some patients improved during pregnancy.
d- status asthmaticus is treated as non-pregnant woman.
e- Delivery by CS depends on obstetric indications.

Answer: B

39 In a pregnant with type 1 diabetes all of the following are true except

A. Could present with polyhydramnios

B. They are at increased risk of shoulder dystocia
C. They are at increased risk of aneuploidy
D. Increased risk of IUFD

Answer: C (most likely)

40 Regarding dizygotic twin all true except:

A- always dichorionic
B- can be concordant or discordant gender
C- it is a result of one egg fertilized by two sperms

Answer: C

41 Complete mole associated more than partial mole in all of the following except:
A- complete mole ass. with hyperthyroidism
B- focal rather diffuse trophoblast proliferation

Answer B

43 Regarding endometrial only one of the following is correct:

a- clinical examination is usually very suggestive of the diagnosis.
b- radiotherapy is very effective primary therapy.
c- lymph node involvement is related to the grade of the tumor and the depth of
the myometrial invasion.
d- Type 2 carcinoma is HPV related.
e- serous papillary type carries a better prognosis than endometroid type.

Answer: C
44 One is false:

A- submento-bregmatic ---> Hyperextended.

B- Mentovertical ---> well flexed head
C- Biparietal diameter is 10 cm
D- Occipito frontal → Vertex
E- Suboccipitobragmatic → flexed

Answer: B

45 All are true regarding cholestatic disease of pregnancy except:

A-Itching is the most common complaint

B-Abnormal liver function is diagnostic
C-Leads to meconium stained liquor
D-High rate of recurrence
E-No skin lesions

Answer: B

Liver function is normal

Elevation of bile acids only

------------------------------------
I had it like all are false except:

A. Itching is mostly in the abdomen

B. Leads to preterm labor
C. Commonly occurs in the first trimester
D. Leads to acute fatty liver

Answer: B

ICP has been found to be associated with increased risk of preterm delivery,
meconium ​staining​ of ​amniotic fluid​, fetal bradycardia, fetal distress and fetal
demise
46 A question about peripartum cardiomyopathy, all are true except:

A. More with Multiparity

B. More with multiple pregnancy
C. Need fluid restriction
D. U have to shorten the second stage
E. Epidural is preferred

Answer: E?

‫ﻛﺎﻧﻪ ﻛﺎﻧﻪ ﻛﺎن ﻓﻲ ﺳﺆاﻟﯿﻦ ﻋﻦ اﻟﻜﺎردﯾﺎك ﺑﯿﺮﯾﺒﺎرﺗﻢ ﻣﺶ واﺣﺪ اﻟﻤﻬﻢ اﻟﺨﯿﺎرات اﻟﻠﻲ ﻣﺘﺬﻛﺮﻫﺎ ﻛﻤﺎن‬
 Regarding peripartum cardiomyopathy, all are correct except:

a- cerebral embolization is a major cause of morbidity.

b- recurrence rate is high.

c- anticoagulants is may be required.

d- more common in multiple pregnancy.

e- more common in multiparous.

Answer: Might be A cause ​cerebral embolization is a major cause of death

‫ ﺑﺲ اﻟﺠﻮاب ﻛﺎن‬3: ‫ﻛﺎن ﻓﻲ ﺳﺆال ع ﻧﻔﺲ اﻟﻤﻮﺿﻮع ﺑﺲ ﻣﺎ ﺣﺪ ﻗﺪر ﯾﺘﺬﻛﺮ اﻟﺴﺆال‬

antibiotics are always needed

47 All of the following regarding gynecological surgeries are true except:

A. Uterosacral ligament could be viewed in laparoscopy

B. Fallopian Ostia could be viewed by hysteroscopy
C. Preprocedural counseling is optional
D. Total hysterectomy includes the removal of uterus and cervix only
E. Subserosal fibroids could be removed by laparoscopy

Answer: C

48 All are contraindications of vaginal hysterectomy except:

A​- Cervical cancer

B- Large cystocele
C- Tight vagina
D- Previous 3 CSs
E- Ovarian cancer

Answer: D (might be the answer but it is better to make sure from the dr’s
during 6th year seminar)
49 A 75 year old Japanese lady complaining of hematemsis was found to have
bilateral ovarian masses. She most likely has:

1. Krukenberg tumor
2. Fibroma
3. Granulosa cell tumor
4. Teratoma
5. Clear cell carcinoma

Answer: 1

50 All are indicators of lower success rates of VBAC except

1. Obesity
2. Macrosomia
3. Preterm delivery
4. Maternal diabetes
5-Inducution of labor

Answer: 3

51 Regarding antiphospholipid syndrome, all are correct except:

a- two positive antiphospholipid antibody tests (6 weeks apart) are needed for
diagnosis.
b- Aspirin and Heparin are needed to overcome the potential complications.
c- Previous one IUFD at 34 weeks is an enough clinical presentation to confirm
the diagnosis.
d- one previous missed miscarriage is an enough clinical presentation to
confirm the diagnosis.
e- It's a risk factor for DVT.

Answer: 2 options can be the answer, A or D

52 All of the following risk factor for preeclampsia except:
A- Smoking
B- First question
C- Previous preeclampsia
D- Age < 19 years

Answer: A

53 All of following risk factor for fibroid except :

A. COCP
B. black race
C. nulliparity
D. family history
E. increased estrogen level

Answer: A

54 All of the following can be seen through a HSG except:

A-Asherman's
B-Subserosal fibroid
C-Septate uterus
D-Proximal tubal obstruction (ostium)
E- ​assess the contour and the adequacy of the uterine cavity.

Answer: B
55 Regarding HPV all true except: ( this Q in form 2)

A- HPV is double stranded DNA

B- HPV vaccine is contraindicated during lactation
C- HPV 16 and 18 account for 70% of cases
D- Most of HPV infections resolve after 12 months

Answer: b

66 Not teratogenic drug?

A.Heparin
B.Warfarin
C. Phenytoin
D. Ciprofloxacin
E. Lithium carbonat

ANSWER: A
67 All of the following are risk factors for preterm labour except:

A. Bacterial vaginosis
B. Age >35
C. Anemia
D. white race
E.smoking
F. meconium
G.antepartum hemorrhage

Answer:

This qus came in the two forms in two different ways so maybe there will be 2
answers

‫ وﻫﯿﻚ ﺑﻠﺸﺖ اﻻﺳﺎﻟﺔ ﺗﺨﺶ ﻓﻲ ﺑﻌﺾ‬:P

68 All of the following are contraindication of induction of labor except:

A- abnormal CTG
B- breech presentation
C- active labor
D- vaginal prolapse
E- antepartum hemorrhage

Answer: D (old PYQ)

69 The most common presenting symptom/ complaint of endometriosis is:

a. Chronic pelvic pain

b. Infertility
c. Chocolate cyst
d. Dysmenorrhea
c. Oligomenorrhea

Answer: D

70 All of the following matches except :

a. banana sign in neural tube defect

b. anencephaly and polyhydramnios
c. esophageal atresia and oligohydrominos
d. nephropathy obstruction and pulmonary hypoplesia

Answer: C

71 Which of the following is wrong: (PYQ)

Answer: ​Leukoplakia is something benign and should be ignored

72 Which of the following is correct:

A-​Cervical ectropion is a benign condition and requires no managemen

B- Adenomyosis is diagnosed by endometrial biopsy
C- Adenomyosis is more in nullparous women

Answer: A (mostly)
 ‫دﺑﺤﻨﺎ ﺑﻌﺾ ﻋﺎﻟﺴﺆال ﻫﺎد ﺑﻌﺪ اﻻﻣﺘﺤﺎن ﺑﺲ اﻻﻏﻠﺐ اﻟﺠﻮاب‬
A

Check here
https://www.healthline.com/health/womens-health/cervical-ectropion#symptom
s

73 Which of the following is wrong:

Answer: LMWH causes thrombocytopenia more than unfractionated

74 32 w with anemia, the following is the best step regarding management of her
anemia?

a. Give blood transfusion

b. Start intramuscular iron
c. Give IV iron
d. No action needed
e. Treat with oral iron and vitam

Answer: E

75 All the following concider mild pre-eclampsia except:

a- BP 140/95 and trace protein in urine.
b- BP 140/90, +1 protein in urine and headache with blurred vision.
c- BP 150/100 and +2 protein in urine.
d- BP 140/90 and +1 protein in urine.
e- BP 150/100 and 1 gram protein in urine.

Answer: B
76 All are true about RH- isoimmunization, except:
a. Intrauterine blood transfusion is one of the treatment options
b. Fetal hydrops is a recognized fetal complication
c. Middle cerebral artery Doppler is used in the follow up of affected fetus
d. Unlikely to happen in the first pregnancy
e. Anti- D should be given to all sensitized patients

Answer: E (PYQ)

78 All are true regarding DIC except

a- it's a recognized complication of prolonged missed miscarriage.
b- FDP will drop.
c- platelet count will drop.
d- multidisciplinary team work is needed to manage DIC.
e- PT and PTT will prolong.

Answer: B

79 In vaginal examination of a pregnant lady in labor you feel a nose and a mouth.
The chin is towards the left hip of the mother. What is true about the position?

1.mentum transverse position

2.brow presentation

3.vertex presentation

4.transverse lie

5- occipitotransverse position

Answer: 1

80 All are causes of postpartum hemorrhage except:

1. Meconium
2. Instrumental delivery
3. Multiparty
4. antepartum hemorrhage
5. Anemia

Answer: 1
81 A 20 weeks pregnant female presents to the clinic. On ultrasound there is no
fetal heart beat, your next step in management is:

1. Vaginal PGE1
2. Oxytocin
3. D and C
4.

Answer: 1

82 Not preeclampsia complication:-

a. hemoconcentrate
b. decrees plasma volume
C.Increase renal perfusion

Answer: C

83 ll of the following are performed at 13 weeks in a chronic DM patient except:

1. OGTT
2. Rubella IgG and IgM
3. CBC
4. Urine culture
5. Obstetric US

Answer: 1

84 female with hypogonadotropic hypogonadism seeking fertility which is the best

step in her management:

1. LH and FSH
2. Clomiphene citrate
3.​low dose estrogen
4.bromocrptien

Answer: 1
85 couple with infertility charecterized by semen analysis with a sperm count of 14
million/ml, 25% motility and 23% normal forms, present to your clinic. The
remaining routine tests are normal. What is the most appropriate initial therapy?
a- insemination with donor sperm.
b- IVF
c- Intrauterine insemination with washed husband's sperm.
d- varicocelectomy.
e- clomiphene citrate.

Answer: B or A?

‫ اﻻﺣﺴﻦ ﺣﺪ ﯾﺴﺎل دﻛﺎﺗﺮة اﻟﻤﺆﺳﺲ‬,‫ﻫﺎد اﻟﺴﺆال ﻣﺨﺘﻠﻒ ﻋﻠﯿﻪ‬

‫ﺑﺴﺎدﺳﺔ ﺣﻜﻮﻟﻨﺎ‬

?when to use IUI *

if there is small decrease in count, like 30 million to 10 million -

‫وﻛﺎن ﻣﻄﻠﻮب اﻟﺴﺆال‬

INITIAL therapy
Best way to manage ‫وﻟﯿﺲ ال‬

86 All of the following can be diagnosed by ultrasound at 13 week except:-

A-Polyhydramnios
B-Miscarriage
C-Ovarian cyst
D-Multiple pregnancy
E-Anencephaly

Answer: A

87 All are causes of primary amenorrhea except :

a. ashrmann syndrome
b.Turner's Syndrome
c. mullarian agnesis
d.kallman syndrome
e. gonadal dysgensis

Answer: A
88 All of the following cause increased in alpha feto protein :
A. Omphalocele
B. Turner
C. Trisomy 18
D. Trisomy 21
E. Meningocele

Answer: D

‫ ﺳﻨﯿﻦ ﺑﺠﻲ وﻛﻞ ﺳﻨﺔ ﺟﻮاﺑﻪ‬10 ‫ﻓﻲ اﻛﺘﺮ ﻣﻦ ﺧﯿﺎر ﺑﺰﺑﻄﻮا ﺑﺲ ﻫﺎد اﻟﺴﺆال ﻣﻦ‬
D

‫اﻛﺜﺮ ﻣﻦ ﺣﺪ ﻧﺎدى ﻋﺎﻟﺪﻛﺎﺗﺮة ﺑﺎﻻﻣﺘﺤﺎن ﻋﺸﺎن اﻟﺴﺆال ﻫﺎد وﻛﺎن ﯾﺤﻜﻮﻟﻬﻢ ﺟﺎوﺑﻮا‬
D

Another form qus:

which one of the following causes an increases in AFP??

the answer I think is myelomeningeocele

89 G3P2 all of the following can be true except:

A- she has previous missed miscarriage

B- she has never had ectopic abortion
C- she might has no alive children
D- she had a dead child at 28 weeks
E- she had a still birth

Answer: A (cause there is no +, which indicate ectopic, molar, missed)

90 All are match about surgery in pregnancy except:

a. Gallbladder stones can cause pancreatitis

b. Appenditis is the most common cause of acute abdomen
c. complicated ovarian cyst need immediate intervention
d. Peptic ulcer ALWAYS improve in pregnancy
E. Abruptio placenta can present with abdominal pain only.

Answer D
91 Regarding thrombophila and pregnancy, All the following are correct except:
a- Protein S deficiency is a congenital thrombophila.
b- increase the risk of post-maturity.
c- increase the risk of fetal death in third trimester.
d- its adverse effect increase with maternal age.
e- increased risk of severe abruption.

Answer: B

92 About chlamydia trachomatis, all true except :

A. Its gram negative intracellular bacteria
B . Cause mucopurulent endocervical discharge
C. Sexually transmitted
D. Cause severe symptoms
E cause PID and ectopic pregnancy.

Answer: D
Usually it is asymptomatic infection

93 All are indication of delivery in preterm premature ruptue of membrane except:

a- elevated maternal WBC.
b- fetal distress.
c- chorioamnionitis.
d- reaching term.
e- abruption of placenta

Answer: A?

94 About ectopic pregnancy , all true except:

A. Remove the affected tube by salpingectomy if the other tube is healthy

B. Methotrexate can be used if bhcg <3500
C. Most common site in the fallopian is the infundibulum
D. Bleeding precedes abdominal pain
E. laparoscopy is the choice in stable pts of ectopic pregnancy

Answer: C

95 All are indications for delivery in placenta previa except :

A. Active vaginal bleeding
B. PPROM
C. Reached Term

Answer: B
96 About ovarian tumors all true except :
A. Granulosa cell tumor cause endometrial hyperplasia
B. Endometeioma cause high ca 125
C. Ca 15.3 is high in yolk sac tumor
D. Germ cell tumors are the most common ovarian cancers in children and adolescents.
E. Molar pregnancy are associated with theca luteal cyst.

Answer: C
(increase in breast cancers)

97 Regarding infertility, all of the following are correct except:

A- define as 24 months of failure conception

B - male should abstain 72 hour before semen analysis

Answer: A

98 Regarding infertility, which of the following is false:

a. Ovulation occurs 26 hours after LH peak
b. Asthenospermia is the medical term for abnormal morphology
c. Seminal fluid makes up to 90% of the ejaculation
d. Endometriosis may interfere with tubal motility
e. Cystic fibrosis may lead to congenital bilateral absence of vas deferens

Answer: Asthenospermia is the medical term for abnormal morphology

99 young women presented with SOB, found to have pleural effusion and bilateral
ovarian
masses, what is your diagnosis?

Answer: Fibroma

100 Regarding hysteroscopy, all the following are true except:

A-You can see the ostia of the tube

B-Best treatment for intramural fibroid

Answer: B
101 False about tocolytic drugs :

A-indomethacin is the best choice to treat preterm labor with oligohydramnios

B-ritodrine cause more side effects than nifedipine
C- there is no evidence to treat pprom by tocolytic ‫اﺷﻲ زي ﻫﯿﻚ ﻣﻮﺟﻮد ﺑﺎﻟﺴﻼﯾﺪات‬
D-steriod increase the risk of maternal hyperglycemia and infections

Answer: A (it causes oligohydramnios)

102 which is wrong about endometrial cancer:

A- 25% affect premenopausal women

B- mostly found in stage 1
‘

103 In cases of transverse lie, all are correct except:

a- of the second twin, CS is the treatment of choice.
b- the fetal head is commonly to the mother's left.
c- there is associated placenta previa in about 10%.
d- the fetal back is usually anterior.
e- there is associated cord prolapse in 15% of cases.

Answer: A (u can twist the baby :3)

104 Other Q. About molar pregnancy, all true except:

- Theca lutein cyst is always present (Answer)

105 concerning small for gestational age fetus, all the following are correct except:
a- may be concequence to maternal cigarette smoking.
b- should be delivered before 37 weeks gestation
c- may be associated fetal anomalies.
d- best diagnosed by ultrasound.
e- approximately half of the cases are missed on routine palpation.

Answer: B

106 All the following statements are true regarding screening for cervical cancer
except:
a- normal squamous epithelial cells give a mahogany brown stain after
applying lugol's iodine solution.
b- leukoplakia in colposcopy is a normal finding and should be ignored.
c- screening starts at age 21.
d- acetic acid is used in colposcopy.
 e- women with smear showing HISL should be referred to colposcopy.

Answer: B

107 Regarding anticoagulants in pregnancy. All are correct except:

a- Warfarin may cause chondrodysplasia punctata.
b- Prophylactic LMWH should be stopped about 12 hours before delivery.
c- LMWH is a risk factor for osteoporosis.
d- Warfarin and heparin are not secreted in milk.
e- LMWH can cause thrompocytopenia more than unfractionated heparin.

Answer: E

108 Regarding thromboembolic disease in pregnancy. all are correct except:

a- preeclampsia is a risk factor for DVT.
b- BMI more than 30 is a significant risk factor for DVT.
c- most DVT are left sided.
d- puerperium has lower risk for thromboembolism than during pregnancy
itself.
e- nearly half of DVT patients are asymptomatic.

Answer: D (puerperium has 10 times more risk for DVT than during pregnancy)

109 Regarding thrombocytopenia in pregnancy, All are correct except:

a- Gestatienal throbocytopenia usually occur in the 3rd trimester.
b- CMV infection is a recognized cause of thrombocytopenia in pregnancy.
c- Cesarean section is contraindicated at 90,000 platelet count.
d- IVIG can be used to increase platelet count.
e- vaginal delivery is preferred over Cesarean section.

Answer: C (can be done at 80,000)

110 A patient had Normal vaginal delivery 1 week ago, presented with fever and
chills. all the following are possilble causes except:
a- nipple cracks.
b- endomyometritis.
c- Pyelonephritis.
d- mastitis.
e- Pneumonia.

Answer: A
111 All are true about RH- isoimmunization, except:
a. Intrauterine blood transfusion is one of the treatment options
b. Fetal hydrops is a recognized fetal complication
c. Middle cerebral artery Doppler is used in the follow up of affected fetus
d. it occur when the patient don't take anti-D in previous pregnancy.
e. Anti- D should be given to all sensitized patients

Answer: E

111 Regarding accurate estimation of gestational age, all the following are correct
2 except:
a- is best done by measuring CRL in the first trimester.
b- use of COCP may associated with wrong estimation.
c- BPD is best done at 12 weeks gestation.
d- ultrasonic estimation at 26 weeks gestation is usually inaccurate.
e- reduce the risk of unnecessary preterm birth.

Answer: C