1) Regarding diabetes in pregnancy.

a. All pregnant ladies should be screened for

dlabetes during booking.
b. Human placental lactogen raise in GDM.
C. Fasting plasma glucose 5.2 mmol/L is consldered normal MGTT value.
d. Diabetic retinopathy is a complication of
gestational
diabetes.
e. Folic acid can reduce risk of neural tube defect.

2) Regarding management of diabetes

a. Diet modification includes change low to high glycemic index food.
b. Hypoglycemic episode is the common side effect of metformin.
C. Actrapid is a rapid acting insulin.
d. Somogyi effect is a rebound hypoglycemia.
e. Severe hypoglycaemia can cause maternal mortality.

3) Overt Diabetes
a. should be managed as pre-existing diabetes
b. The diagnosis of overt DM should be confirmed with a second test.
C. Low dose aspirin should be given to women with pre-existing diabetes from 12
weeks gestation until term.
d. Insulin suppresses the activity of glycogen
synthase.
e. Target HbA1c level is <8

4) Eclampsia
a. may occur in patients with normal blood pressure.
b. should be treated initially with IV diazepam.
C. can be prevented by the prophylactic administrationl of magnesium sulfate in
patients with severe preeclampsia
d. more than one fit occurs in most cases
e. Once the mother's condition is stabilised, emergent delivery of infant is required.
emeonu
5) Regarding antihypertensive medications
a. ACE inhibitors are contraindicated in pregnancy.
b. Methyldopa can increase risk of postpartum depression.
C. Oral antihypertensive is as effective as parenteral treatment in stabilising blood
pressure
d. The aim of therapy is to achieve a blood pressure as near as possible to normal
e. Beta blocker is contraindicated in bronchial asthma.

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6) In the assessment of severe preeclampsia
a. Uric acid is a better indicator of fetal morbidity than blood pressure.
b. if the platelet count is greater than 100 there is no need to carry out a coagulation
profile
c.HELLPsyndrome includes thrombocytosis
d. The onset of severe preeclampsia often necessitates delivery of the baby, regardless
of fetal age or maturity.
e. Epigastric pain in severe preeclampsia is due to indigestion.

7) Regarding diabetes in pregnancy

a. Women 35 years and older are at increased risk for gestational diabetes mellitus.
A woman with abnormal glucose tolerance during pregnancy is at increased risk for
developing diabetes mellitus later in life.
cMostwomen with gestational diabetes mellitus can achieve and maintain normal
blood glucose with diet and exercise.
d. Ketosis should be avoided during pregnancy.
e. GDM is considered when MGTT2 Hour postprandial 11.1

8) Regarding Severe Preeclampsia

a. Severe headache is a sign of impending eclampsia that happened due to cerebral
vasoconstriction.
b. One of the main treatments for preeclampsia is bed rest.
c Hyperreflexia is a sign of Magnesium sulfate toxicity.
d. Magnesium sulfate can be given intravenous or intramuscular
e. Woman who developed preeclampsia during her first pregnancy is at increased risk
for developing preeclampsia during her present pregnancy

9) Pregnancy induced hypertension

a. can develop as early as the first trimester.
b. is caused by abnormal invasion of cytotrophoblast
c.is diagnosed when both systolic>140 mmHg and diastolic >90 mmHg
d. During pregnancy, diuretic therapy is generally recommended for women with

hypertension.
e. May persist 6 weeks postpartum.

10) Chronic hypertension

Women with chronic hypertension are at increased risk for developing preeclampsia
b. A woman with preeclampsia is at increased risk for abruptio placenta.
C. Chronic hypertension can cause renal impairment.

-tsdiognosed after 20weeksofgestations-

e. Proteinuria prior 20 weeks gestation may due to nephropathy.

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11) Cord prolapsed
a. is associated with increased incidence of fetal abnormality
b. is more likely occur in nulliparous woman
c. must ahways be treated with emergency LSCS
d. delivery should be by classical caesarean section
e. causes vasospasm of umbilical cord

12) Shoulder dystocia

a. Risk of nerve root damage is increased in the presence of fetal hyposemia
b. Half of the babies sustaining nerve root injuries have a high birth weight below 4
C. There will be a history of delay in second stage in a third of case
d. Suprapubic pressure shoud be applied to displace anterior shaukder forward
e. Delver by caesarean section can be achieved in up to 90% of case

13) Regarding uterine inversion

a. It is common
b. Can cause vasovagal shock
May be treated with 0'sullivan technique
d. Removal of placenta should be delayed until after correction of uterine inversion
e. Will not cause Post partum haermorrhage

14) Regarding Post partum Haemorrhage

a. Blood loss>1000ml in vaginal delivery
b. Most common cause is uterine atony
c. Endometritis is common cause of secondary post partum haemorrthage
d. Can cause hypovolemic shock
e. Can cause disseminated intravascular coagulation

15) Risk factors for PPH include:

a. Maternal obesity
b. Fetal macrosomia
c. Maternal age
d. Grand multiparity
e. Previous post partum haemorrhage

16) Signs of uterine rupture

a. Fetal distress/bradycardia
b. Hematuria
Uterine hyperstimulation
d. Change in uterine shape
Signsof haemodynamic instabitity-
17) In severe abruption placenta
a. Blood clotting time less than 5 minutes
b. Most sensitive lab test is fibrinogen degradation product (FDP)
C. Couvelaire uterus is one of the clinical findings
d. Delivery by caesarean section is mandatory
e. Macerated still birth is one of the complication

18) Regarding third/fourth degree perineal tear

a. More common when midline episiotomy is performed
b. Pelvic floor exercise helping to hasten healing process
c. Prophylactic antibiotic is recommended
d. The repair is best performed under general anaesthesia
e. Vicryl rapid is the suture of choice in the repair of sphincter

19) Disseminated intravascular coagulation is associated with

a. Severe preeclampsia
b. Factor VIll deficiency
C. Idiopathic thrombocytopenia purpura
d. Amniotic fluid embolism
e. Abruptio placenta

20) Regarding Antepartum Haemorrhage

a. Bleeding from os into the genital tract occurs from 24+0 weeks of pregnancy and prior to

birth of baby
b. Previous history of abruption is a risk of recurrent abruption
c. Maternal thrombophilia is associated with placenta abruption
d. Vasa previa have good fetal survival rate

e. Smoking is a risk factor for placenta previa

21) In acute management of obstetric haemorrhage

a. Couvelaire uterus is a common cause of failure of myometrial contraction
b. A caesarean hysterectomy is the first line of management of persistent post partum
haemorrhage in association with placenta previa
C. An intramuscular injection of Carboprost should be glven in cases of uterine atony in
responsive to oxytocin
d. With the majority of cases of uterine rupture, repair of uterus is preferable to
hysterectomy
e. The early signs of a liver haematoma in pregnancy may mimic severe abruption placenta
 (Lz aunnsu
F

22) Iron supplementatlon In pregnancy

a. The fall in Hb concentratlon and hematocrit in pregnancy results from differential

changes In red cell mass and plasma volume.

b. Ferrous gluconate causes fewer gastrolntestinal complications than ferrous sulphate
The haematological response to parenteral iron is no better than with oral iron
c.
d. In healthy, well fed women, routine Iron supplementation has beneficial effects on the
outcome of pregnancy
e. Women with high level of Hb In pregnancy have less tendency to postpartum

haemorrhage

23) Regarding Caesarean section

a. Maternal mortallty is Increased compared with normal labour and delivery
b. It is not assoclated with subsequent placenta accrete
c. Planned caesarean section may reduce the risk of hysterectomy caused by postpartum
haemorrhage
d. All preterm and SGA babies need an elective caesarean deliveries
e. There is increased chance of adjacent visceral injury with subsequent caesarean section

24) Regarding multiple pregnancy

a. The absence of twin peak' or lambda sign at 20 week confirm monochorionicity
b. The lambda sign of the separating membrane is suggestive of MCDA pregnancy
c. Preterm labour is decreased by bed rest in twin pregnancy
d. Fetal growth scans should be done forthnightly in uncomplicated MCDA pregnancies
from 20 weeks onwards till delivery
e. The prospective risk of stillbirth in twins between 37 and 42 weeks is no greater than
singletons.

25) Regarding breech presentation

a. Preterm breech presentation is less common than term breech presentation
b. Delivery is best conducted by caesarean section in preterm breech presentation
c.Elective caesarean section should be performed at 37-38 weeks to avoid labour
d. ECV is ideally performed between 36 and 37 weeks gestation
e. ECV is successful in 50-80% of cases

26) The following are features of Sheehan's syndrome

a. Fallure of lactation
b. Secondary amenorrhea
C. Hypothyroldism
d. Hyperpigmentation
e. Polyurla
fer ntial 27) Instrumental delivery
a. Forceps can be used for face presentation with mento anterior position
b. Vacuum assisted delivery can be used in less than 34 weeks gestation
C. Higher failure rate associated with occipito anterlor position
d. Wringley's forceps is midcavity forceps
e. Assisted vaginal delivery should be performed by experienced operator

28) Small for Gestational Age (SGA) foetuses are associated with
a. Maternal diabetes with vascular disease
b. Drug (cocaine) user
c. Maternal age >40 years old
d. Maternal chronic hypertension
e. Fetal echogenic bowel

29) Following are signs of chorioamnionitis

Maternal tachycardia heart rate >90 beats per minutes

b. Woody, hard uterus

c. Fetal tachycardia >160 bpm
d. Meconium stained liquor
e. Fever

in pregnancy
30) Regarding Group B streptococcus (GBS)
Infection to baby is more likely if the women have previously had a baby affected by GBS
a.

infection
b. A urine infection by GBS should be treated with antibiotics tablets straight away

having GBS and is planned for elective caesarean section,

not in labour,
C. Women who is
iv antibiotics should be given earlier as prophylactic

d. Can be found in rectum

e. Can be sexually transmitted

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31) ldentify layers of an IUGS

a. Decidua parietalis T
Uterine cavity T
c. Decidua basalis F gestational sac
d. Decidua capsularis T
e. Gestational sac F decidua basalis

32) Ultrasound in first trimester

a.A double decidual sign is confirmatory of an intrauterine

gestation T
b. Intradecidual sac sign is a useful feature that can identify an early intrauterine
pregnancy (1UP) as early as 22 days of gestation F as early as 25days
c. One should always see the gestational sac latest by 47
days (discriminatory level) T
d. The threshold level (the earllest one can see the sac) is 24
days T
e, A double bleb slgn is an Important feature of IUP T

33) Ultrasound findings In early pregnancy

a. Limb buds start to appear at 10 to 11 weeks F 8-9w

b. Fetal movement can be seen earllest by 11 to 12 weeks F 9-10w
C. On both TVS and TAS, when the mean sac dlameter (MSD) measures 25mm, an
embryo must be vislble T
d. OnTAS, when the MSD measures 20mm, a yolk sac should be visible T
mamms e. OnTAS, when the MSD measures 25mm,an embryo must be visible_T
34) Ultrasound in pregnancy
a. Overall accuracy of
sonographic dating in the first trimester is approximately 7 days
(95% confidence range) T
b. Pseudogestational sac or pseudosac is generally irregularly-shaped with pointed
edges and filled with debris T
C. Decidual cast refers to echogenic material in the uterine cavity in the context of an
ectopic pregnancy T
d. Heterotropic pregnancy is estimated at 1:30,000 for a naturally conceived pregnancy T
e. Incidence in ART can be higher at 1-3:1000 T
Heterotopic pregnancy - intra-uterine and extra-uterine (i.e. ectopic) pregnancy occurring simultaneously.
35) Gestational trophoblastic disease

a. Complete hydatidiform mole (CHM) is commonest up to 60% T

b. There may be a fetus in a CHM T
C. CHM is usually 46 XX or 46 XY T
d. CHM may progress to invasive mole in about 20% T
e. Risk of choriocarcinoma is less than 1% F

36) Partial hydatidiform mole (PHM)

a. PHM usually involves the paternal chromosomes only T

b. PHM may have a fetus or fetal components T
c. BHCG is markedly elevated T
d. There is atypia of cells T
e. PHM is usually 69XXX or 69XXY T

37) Gestational choriocarcinoma

a. May look identical to be PHM
b. Arises following known molar pregnancy (50%), miscarriage (30%) and normal
pregnancy (20%) T
C. Patients can present with multiple metastasis without an easily identified primary T
d. 50% of metastases occur in the lungs F 80%
e. Metastases is more common in the pelvis as compared to the vagina F vagina 30%, pelvis 20%

38) Ovarian tumours

a. Epithelial ovarian tumours account for almost 70% of all ovarlan tumours T
b. Most 8erm cell tumours are benign T
C. Brenner tumour is a type of germ cell tumour F epithelial
d. Granulosa cell tumour is a type of germ cell tumour F stromal tumors
e. Granulosa cell tumours account for approximately 10% of all ovarlan tumours F

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39) Ovarian tumours
than germ cell tumours F (same)
are rarer
a. Ovarian stromal tumours F (around
stromal tumours ocur most often in teenagers and women in their 20s menopause)
b. Ovarlan
Germ cell tumours produce the female
hormones oestrogen and progesterone F
C.
tumours are qulte rare and are usually
considered low grade cancers
d. Germ cell
Almost 70% of women with epithelial ovarlan cancer are not diagnosed until the
e.
disease is advanced T

40) Fallopian tube malignancy

serious adenocarcinoma and
a. The two main types of fallopian tube cancer are

endometrioid adenocarcinomas T
cancers can occur in women of any age T
b. Fallopian tube
c. It is more commonin those who have had few or no children T
F (reduce
Women who use birth control pills have a higher
risk of getting fallopian tube cancer
risk)
d.
The usual age of presentation is between 50 to 60 years old
T
e.

END

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