Dr Kamar'S CTG

1. Pregnant40 weeks does not feel fetal movement for 36 hours,

CTGnormal fetal heart rate 140, the mother is still worried and not
convinced with the CTG:
a) amniotomy
b ) repeat CTG
c) Come back in next routine followup
d) Come back in 24hr
2. 32 years old lady , 39 weeks pregnant presents wth complaint of did not feel fetal
movement for past 12 hours .She was seen 2 weeks ago and everything was normal. what do
you do?
A. CTG
B. USG
C. Reassure
D. Review in 24 hours
E. Admit and observe
3. 39 wk pregnant lady comes to you because she did ’t feel fetal movement for 2 days,
general condition good. No pain and no loss per vagina. A CTG was given showing normal
pattern. How will you advice her?
a. Come back in 24hr
b. Come back in next routine followup
c. Admit and induce
d. Admit and observe
e. Continuous CTG
4. A pregnant of 37weeks gestation comes with complains of reduced fetal movements for
the last 24hrs..CTG done it was normal and pt was sent home with reassurance…she now
comes again after 3days that she is not feeling any baby movements..what’s the most
appropriate next step?
a-immediate CTG
b-obstetric USG
c- reassure that its normal at this gestation
d-Amniotomy
e-induction with prostaglandins
5.Pregnant woman 40 weeks , no fetal movement , CTG
normal.....what to do Next :
A)Reassure and ask her to come after 24 hours
B)Induction of labour
C)C section
D)Reassure and ask her to come in the next visit
Q. Women came in labour (labour pain was there). Cervix 4cm full
effaced.Ctg monitoring was ongoing. Suddenly no heart rate. Usg
confirmed baby was dead. What to do?
A. Amniotomy
B. Allow spontaneous progress of labour
Lady presents at 34 wks GA , worried that her baby has not made any movement d last 48
hours. What is the best next step ?
A.Usg
B. Ctg
C. Intermittent auscultation
D. CS
E. Reassure

Pregnant woman 40 weeks , no fetal movement , CTG normal.....what to do Next :

A)Reassure and ask her to come after 24 hours
B)Induction of labour
C)C section
D)Reassure and ask her to come in the next visit
5: patient in labour, amniotmy done, Irregular contraction..CTGgiven BHR DROP to 80..for
few min.Diagnosis asked
1:Amniotc fluid emoblism
2:Placenta abruption
3:cord prolapse
4:vasa previa
24/pregnant lady – CTG showed deceleration with fetal heart dropped to 70/min at 4min and
then
improved.
What to do Stop synto
a. Continue
b. Iv normal saline
Patient is in labor and fetal heart rate dropped down to 70... but after 2 minutes came back to
normal.
A. Stop oxytocin
B. IV fluids
C. Continue monitoring CTG
D. C/S
1. Pregnant woman had 4 cm cervical dilatation, pethidine given to her 3 times.the fetal
head is lop. What is the cause of ctg abnormality?
a. prolonged Labour
b. Sedative drugs
c. Elevated resting uterine pressure
d. molding of fetal head

8. A 34 year old primi came at term with rapture membranes and meconium stained
lecor , you did a CTG , in review of the CTG wts the next best step ?
a. CS
b. Fetal scalp ph
c. Induce labour at once with cintocynon
d. Wait for normal delivary
e. High forceps
2. 24/pregnant lady – CTG showed deceleration with fetal heart dropped to 70/min at
4min and then
improved.
What to do Stop synto
a. Continue
 b. Iv normal saline

A case of spontaneous rupture of membrane at term . Now cervix is 8cm dilated and
head at ischial spine. CTG shows heart dropping to 70 for 3 minutes with baseline
heart rate 110bpm. What next?
a.Fetal scalp ph
b. Immed CS
c.Ventous delivery d
3. 12. A 26 week antepartum patient comes to clinic due to watery vaginal discharge. On
examination, CTG tracing is unremarkable, speculum exam revealed fluid pooling
which was straw colored.
What’s your next step?
A. IV antibiotics
B. Salbutamol
C. IV betamethasone
D. Send patient home
E. Tocolysis

Fullterm female in oxytocin suddenly fetal heart raye decreased to 70 and returned to
baseline of145 after 2minutes
_stop oxytocin
_continue oxytocin
_continuous ctg
_immediate cs now
4. 34 weeks pregnant lady comes with bleeding per vagina, about 1000 ml. Uterus is
tense and tender and it's about 38 weeks size. After fluid resuscitation, which is the
next appropriate management?
Left lateral position
USG
Speculum examination
Intubation
CTG
5. 39 weeks pregnant lady came with labour pain..she was put in left lateral position
having oxygen mask in place.iv fluids with syntocinon is running 5 unit in 500 ml of
Ringer latate. Ctg was done which shows heart rate of 140 which dropped to 70 and
came back to 140 in 2min.asking next appropriate treatment.
A. Fetal scalp sampling
B. stop syntocinon
C. C section
D. Give 1 L of ringer lactate
E. Titrate to increase
6. A pregnant of 37weeks gestation comes with complains of
reduced fetal movements for the last 24hrs..CTG done it was
normal and pt was sent home with reassurance…she now
comes again after 3days that she is not feeling any baby
movements..what’s the most appropriate next step?
a-immediate CTG
 b-obstetric USG
c- reassure that its normal at this gestation
d-Amniotomy
e-induction with prostaglandins
7. 8 year old primi comes in labour at term , she told u she wants no interference in the
labour process whether medical or surgical , she was 3 cm dilated head at 0 station ,
after 4 hours she is 9 cm dilated and head at +1 station , she is ok , u gave some
analgesic only and the CTG is normal , wts the best next to be done ?
a. CS
b. Ventouse
c. Re examin her in an hour or 2
d. Give oxytocin drip
e. Episiotomy
A woman with 38 wk pregnancy complained of absence fetal movement for 2 days.
CTG shows normal FHR 140/min.She comes back after 12 hr complaining of absence
fetal movement again . What will u do?
LSCS
Continuous CTG monitoring
Admit & observe
Induction of labour
8. 41 weeks pregnant lady was admitted for induction.Patient is in left lateral position
and oxytocin is running.Her CTG revealed heart rate decelerations for 4
minutes.Cervix is 8 cm dilated.What's next?
a)Fetal scalp sample
b)Stop Oxytocin
c)Do cesarean section
d)Ventouse delivery
http://www.kemh.health.wa.gov.au/development/manuals/O&G_guidelines/sectionb/2/b2.15.pdf
https://geekymedics.com/how-to-read-a-ctg/
file:///C:/Users/Ravia/Downloads/Cardiotocography_July2015.pdf
A scenario of Lithium toxicity, the patient came with disturbed level of conscious, the level was given
(Cannot recall) what’s the treatment?
A. Dialysis
B. Activated charcoal
C. NaHCO3
if the person comes with in one hour of ingestion so we can do gastric lavage otherwise fluid therapy. if
lithium level is less than 3 than normal saline therapy.

If lithium level is more than 3 hemodialysis and if there are symptoms of convulsion or comma than again
do the Dialysis .. if patient has liver kidney and congestive cardiac failure than again do Dialysis

111) A 32 year old woman has increasing white vaginal discharge. She is 7 weeks pregnant. Her
Chlamydia swab is positive. All other tests are normal. What is the single most appropriate treatment?

a. Amoxicillin

b. Clindamycin

c. Doxycycline

d. Erythromycin

e. Metronidazole
pg+bacterial veginosis by gerdenella=clindamycin

pg+trichomonus vaginitis=clotrimazole vaginal tablet

pg+candida=topical fluconazole/clotrimazole vaginal tablet. jm 1160

1. IOL planned due to pre-eclampsia... Bishop score 2...what to do next..

A. Arm nd oxytocin

B. Elective lscs

C. Induce nd arm at 4 or 24 hrs

2. 39 weeks pregnant female with Mild Preeclampsia With Bishop score 2. Best MX-

a.PGE2and amniotomy in 6 hr.

b.PGf2 and amniotomy in 12 hrs

c.Syntocinon

d.CS

3. 37 wk preg with mild PE for induction of labour. Bishop score 2 . What will u do ?

El LSCS

Induction with PGE1 & ARM after 4 hr

Induction with PGE2 & ARM after 12 hr

Urgent LSCS

Synto infusion

7. Pt is on low dose OCP, complaining of break through bledding, what to

give….confusing options

a. increase estrogen…

b. increase progesterone…

c. advice high dose of both

PREGNANT LADY PRESENTS WITH BRUISHES ON HER ARM AND LEGS, NO ASSAULT WAS MENTIONED,
ASKING NEXT TO TO ? A) COAGULATION PROFILE, B) FBC, C) DOMESTIC ASSAULT.
29. 23 year ole woman with breast mass, scenario of fibroadinoma, what
advice to give….

a. reassurance

b. reassurance and follow up after 6 months

c. reassurance and follow up after 1 year