Obstetrics Set 1

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This set of Obstetrics Multiple Choice Questions & Answers (MCQs) focuses on Obstetrics Set 1

Q1 | Which is the least frequent site of an ectopic pregnancy?
  • Fallopian tube
  • Cervix
  • Ovary
  • Abdominal cavity
  • Between the leaves of broad ligament
Answer: Abdominal cavity
Explaination:
Fallopian Tubes:96% , Ovaries:2% & Cervix:<1%
Q2 | Perforation tends to occur earliest when an ectopic pregnancy is located in whichportion of fallopian tube ?
  • Isthmic
  • Interstitial
  • Ampullary
  • Infundibular
  • No difference
Answer: Isthmic
Explaination:
If the implantation is located in the narrow isthmic portion of the tube(the narrowest part), it will rupture very early, within 6 to 8 weeks; the distensible interstitial portion may be able to retain the pregnancy up to 14 weeks of gestation, while the ampulla is the widest portion.
Q3 | Which of the following does not occur in post partum pituitary necrosis :
  • signs of hypoglycaemia
  • Asthenia
  • Amenorrhoea
  • Galactorrhoea
  • Decreased libido
Answer: Amenorrhoea
Explaination:
failure of lactation occurs due to decreased prolactin secretion due to anterior pituitary insufficiency_ans_key_- Hypoglycemia is due to 2ry adrenal insufficiency_ans_key_- Amenorrhea and decreased libido are due to gonadotropin insufficiency_ans_key_- Asthenia is the easy fatigability due to – GH >> -- muscle bulk
Q4 | The most dangerous symptom during pregnancy is:
  • PV bleeding
  • Ankle swelling
  • Hyperemesis
  • Cramps
  • none
Answer: PV bleeding
Q5 | The Arius-Stella reaction may be seen with all except :
  • Ectopic pregnancy
  • Birth control pills
  • Abortion
  • Trophoblastic disease
  • none
Answer: Birth control pills
Explaination:
Arius – Stella reaction is a benign change in the endometrium associated with the presence of chorionic tissue.
Q6 | The passage of decidual cast in cases of ectopic pregnancy usually means :
  • Impending tubal rupture
  • Reabsorption of embryo
  • Pregnancy was intrauterine
  • Death of embryo
  • none
Answer: Death of embryo
Q7 | What is the most common side effect with MTX therapy for ectopic pregnancy
  • Transient pelvic pain 3 - 7 days after starting treatment
  • Stomatitis
  • Bone marrow suppression
  • Gastritis
  • none
Answer: Stomatitis
Q8 | Prenatal diagnosis at 16 weeks of pregnancy can be performed using all of thefollowing, except:
  • Amniotic fluid
  • Maternal blood
  • Chorionic villi
  • Fetal blood
  • none
Answer: Fetal blood
Q9 | A primigravida presents to casualty at 32 weeks gestation with acute pain abdomen for 2 hours, vaginal bleeding and decreased fetal movements. She should be managed by;
  • Immediate cesarean section
  • Immediate induction of labor
  • Tocolytic therapy
  • Magnesium sulphate therapy
  • none
Answer: Immediate cesarean section
Explaination:
Bleeding that affects the fetal condition(manifested here by fetal distress) is an indication of CS in Ante Partum Hemorrhage
Q10 | Placenta previa, all true except :
  • Shock out of proportion of bleeding
  • Malpresentation
  • Head not engaged
  • Painless bleeding
  • none
Answer: Shock out of proportion of bleeding
Explaination:
Low lying placenta in the LUS interferes with normal adaptation of the fetal head to the female pelvis>>head is usually not engaged
Q11 | A 34wk GA lady presented with vaginal bleeding of an amount more of that of her normal cycle. O/E uterine contracts every 4 min, bulged membrane, the cervix is 3 cm dilated, fetus is in a high transverse lie and the placenta is on the posterior fundus. US showed translucency behind the placenta and the CTG (Cardiotocography) showed FHR of 170, the best line of management is:
  • C/S immediately.
  • give oxytocin.
  • do rupture of the membrane.
  • amniocentisis
  • none
Answer: C/S immediately.
Q12 | Most important cause of immediate post partum hemorrhage:
  • laceration of cervix
  • laceration of vagina
  • uterine atony
  • placental fragment retention
  • none
Answer: uterine atony
Q13 | Factors favoring long anterior rotation include all except
  • Correction of the deflexion
  • Adequate pelvis
  • good pelvic floor
  • rupture of membranes
  • none
Answer: rupture of membranes
Explaination:
Adequate liquor is a factor favoring Long Anterior Rotation, not ROM
Q14 | All following are indications for CS in OP except
  • Persistent oblique op
  • Long anterior rotation
  • Deep transverse arrest
  • Contracted pelvis
  • none
Answer: Long anterior rotation
Explaination:
POP, DTA are obstructed and indications of CS Long Anterior Rotation of the head is a good sign and the baby can be delivered vaginally
Q15 | Which vitamin deficiency is most commonly seen in a pregnant mother who is on phenytoin therapy for epilepsy?
  • Vitamin B6
  • Vitamin B12
  • Vitamin A
  • Folic acid
  • none
Answer: Folic acid
Explaination:
Phenytoin inhibits the enzyme intestinal conjugase, an important enzyme in folic A. metabolism inside the body, thereby causing folate deficiency
Q16 | Uterine inertia is due to EXCEPT?
  • Over distension of uterus
  • Presence of fibroid uterus
  • Fetal malpresentations
  • Abruptio placenta
  • repeated interautrine manipulation
Answer: Abruptio placenta
Explaination:
as A, B, C, E predispose to hypotonic uterine inertia
Q17 | Exposure of female fetus to androgens may arrest differentiation of :
  • Mullerian duct
  • Ovary
  • Urogenital sinus
  • All of the above
  • None of the above
Answer: Urogenital sinus
Q18 | The risk for development of fetal macrosomia is increased in the following,EXCEPT:
  • Primiparity.
  • Diabetes with pregnancy.
  • Post-term pregnancy.
  • Prior macrosomic infants.
  • none
Answer: Primiparity.
Q19 | Complications of the third stage of labor include all of the following except :
  • Rupture uterus.
  • Postpartum hemorrhage.
  • Puerperal sepsis.
  • Retained placenta.
  • Obstetric shock.
Answer: Rupture uterus.
Q20 | Shock is out of proportion to the amount of bleeding in :
  • 1ry postpartum haemorrhage
  • Retained placenta
  • Acute puerperal inversion of uterus
  • Hypofibrinogenemia
  • none
Answer: Retained placenta
Explaination:
retention of the placenta > 2h. may cause shock even in absence of haemorrhage
Q21 | The gold standard in diagnosing ectopic pregnancy
  • Laparoscopy
  • Culdocenteris
  • Beta HCG
  • US
  • Progesterone
Answer: Laparoscopy
Explaination:
The gold Standard in diagnosis of ectopic is not US alone Nor BhCG alone, rather a comiBnation of both:Absence of an intrauterine Gestational Sac + serum BhCG levels > the discriminatory zone is the GOLD STANDARD.
Q22 | Which method of terminating a molar gestation is never indicated
  • Suction curettage
  • Prostaglandic
  • Hypertonicsaline
  • Hysterotomy
  • Hyterectomy
Answer: Hypertonicsaline
Q23 | Invasive molar tissue is most commonly found in
  • Myometrium
  • Vaginal wall
  • Ovary
  • Liver
  • Lungs
Answer: Myometrium
Explaination:
Invasive molar tissue(locally invasive) invades the myometrium, while metastatic molar tissue (highly metsataic)is a different type which metastasizes to the lung, liver… .
Q24 | A 31-year-old, HIV-positive woman, gravida 3, para 2, at 32-weeks' gestation comes to the physician for a prenatal visit. Her prenatal course is significant for the fact that she has taken zidovudine throughout the pregnancy. Otherwise, her prenatal course has been unremarkable. She has no history of mental illness. She states that she has been weighing the benefits and risks of cesarean delivery in preventing transmission of the virus to her baby. After much deliberation, she has decided that she does not want a cesarean delivery and would like to attempt a vaginal delivery. Which of the following is the most appropriate next step in management?
  • Contact psychiatry to evaluate the patient
  • Contact the hospital lawyers to get a court order for cesarean delivery
  • Perform cesarean delivery at 38 weeks
  • Perform cesarean delivery once the patient is in labor
  • Respect the patient's decision and perform the vaginal delivery
Answer: Respect the patient's decision and perform the vaginal delivery
Q25 | A 19-year-old primigravid woman at 42 weeks' gestation comes the labor and delivery ward for induction of labor. Her prenatal course was uncomplicated. Examination shows her cervix to be long, thick, closed, and posterior. The fetal heart rate is in the 140s and reactive. The fetus is vertex on ultrasound. Prostaglandin (PGE2) gel is placed intravaginally. One hour later, the patient begins having contractions lasting longer than 2 minutes. The fetal heart rate falls to the 70s. Which of the following is the most appropriate next step in management?
  • Administer general anesthesia
  • Administer terbutaline
  • Perform amnioinfusion
  • Start oxytocin
  • Perform cesarean delivery
Answer: Administer terbutaline
Explaination:
Quickly administer Terbutaline(Short Acting B2 Agonist) to decrease uterine contractility (fetal HR is steeply decreasing)
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