Final Year MBBS

Continental medical college

Obsetrics test
Topic: Cardiac disease in pregnancy, Diabetes in
pregnancy, Anemia in pregnancy
Q1. A 24 years old teacher in first trimester presents with breathlessness without history of
cardiac disease. The following statement is true regarding the physiological changes in CVS:

a) Increase in heart rate

b) Decreased peripheral resistance

c) Increased cardiac output

d) Grade III systolic murmurs

e) Apex beat shifts laterally and superiorly

Q2. A 38 year old G4P3A0 with previous SVD came in the OPD at 28 weeks of gestation. She
needs how much of iron:

a) 15-20 mg/day

b) 20-25 mg/day

c) 25-30 mg/day

d)30-35 mg/day

e) 40 mg/day

Q3. The following drugs should be offered to all women with diabetes to reduce the risk of pre-
eclampsia from 12 weeks of pregnancy:

a) Calcium
b) Iron

c) Metformin

d) Aspirin

e) Insulin

Q4. The most common cause of heart disease in Pakistani preganant women is:

a) Congenital heart disease

b) Rheumatic heart disease

c) Cardiomyopathy

d) Myocardial infarction

e) Cardiomegaly

Q5. Anemia can be best defined as:

a) Lack of iron stores

b) A genetic defect

c) Deficiency of folic acid

d) Haemoglobin level below 11g/dl

e) Low blood volume

Q6. Fetal loss around 30% and congenital anomaly risk is increased in pregnancy complicated by
diabetes if HbA1c:

a) <42 mmol/mol

b) <62 mmol/mol

c) >85 mmol/mol

d) >70 mmol/mol
e) <60 mmol/mol

Q7. A G2P0A1 presented in antenatal clinic at 24 weeks of gestation. She is a known

case of congenital heart disease. What investigation will you advise to screen fetus for
cardiac abnormalities.

a) Serum α fetoprotein

b) Serum βhCG

c) Fetal nuchal translucency

d) Obstetric USG

e) Fetal echocardiography

Q8. Screening for gestational diabetes is recommended by NICE (National Institute for
Clinical Excellence) guidelines by using:

a) HbA1C level

b) Fasting blood glucose

c) 75gm oral glucose tolerance test

d) Random blood glucose

e) Urinary glucose level

Q9. The most common anemia in pregnancy is due to:

a) Vitamin B12 deficiency

b) Folate deficiency

c) Iron deficiency

d) Sickle cell anemia

e) Hemolytic anemia
Q10. Cardiac output is maximum in:

a) 1st trimester

b) 2nd trimester

c) 3rd trimester

d) During labour

e) During delivery

Q11. In well controlled diabetic pregnancy without any fetal or maternal complication,
delivery can be planned at

a) 28-30 weeks

b) 32-34 weeks

c) 36-37 weeks

d) 38-39 weeks

e) 40-42 weeks

Q12. Which value is increased in iron deficiency anemia;

a) Hb

b) MCV

c) MCH

d) MCHC

e)TIBC

SEQ
Q1. A 25 year old G2P0A1, known case of Rheumatic heart disease had prosthetic
valve at the age of 15 years. She is 10 weeks pregnant, on clinical examination is
NYHA class I.

a) What anticoagulant therapy is best for her during pregnancy and why.

b) Outline her antenatal care plan.

c) How will you manage her in labour?

Q2. 35 year old woman with known congenital heart disease comes for pre-pregnany
advice.

a) What issues will be discussed?

b) What risk factors increase her chance of having heart failure in pregnancy?

Q3. A G8P4A8 comes in OPD at 32 weeks of gestation with complaints of palpitation

and weakness. She looked pale with 7g/dl.

a) What is our diagnosis?

b) How will you investigate?

c) Give management plan.

Q4.A 32 year old g2P1A0 with previous history of IUFD at term came in OPD at 32
weeks of gestation. Her fasting blood glucose level is 180 mg/dl

a) What is the most likely diagnosis?

b) What are maternal and fetal complications?

c) What risks are expected after the birth of neonate?

Q5. A 30 year old PG with history of type 1 diabetes mellitus came for antenatal booking
at 5 months gestation.

a) What investigations would you advise her?

b) How will you manage her pregnancy?

Q6. A G2P4+2 has presented in emergency labour room at 37 weeks of gestation with
complaints of tachycardia, weakness and easy fatigability. Her pulse 106/min and blood
pressure is 110/70 and pallor is ++.

a) What is your diagnosis?

b) What investigations will you advise her?

c) What are the risks of anemia to mother and fetus?