Question 1

Which of the following obstetric conditions or situations predisposes to cord prolapse during labor?

Select one:

a. Breech presentation

b. Oligohydramnios

c. Water birth

d. Maternal diabetes

e. Placenta praevia

Question 2

The normal lochia discharge at the end of second week is called:

Select one:

a. Lochia mixed

b. Lochia serosa

c. Lochia rubra

d. Lochia alba

Question 3

Intrahepatic cholestasis, ideal time for termination of pregnancy:-

Select one:

a. - 36 weeks

b. - 34 weeks

c. - 40 weeks

d. - 38 weeks
Question 4

Which of the following describes the correct way to measure a cervical length?

Select one:

a. The shortest of three measurements should be used & Calipers should be placed at the internal and
external os

b. Patient should have a full bladder

c. The shortest of three measurements should be used

d. All them are correct

e. Calipers should be placed at the internal and external os

Question 5

The placenta of twins can be:

Select one:

a. - Dichorionic and mooamniotic in monozygotic twins

b. - Monochorionic and monoamniotic in dizygotic twins

c. - Dichorionic and monoamniotic in dizygotic twins

d. - Dichorionic and diamniotic in monozygotic twins

Question 6

All of the following diagnostic tests are typically obtained during the initial evaluation of abnormal
uterine bleeding EXCEPT:

Select one:

a. Liver function tests

b. Pregnancy test

c. Complete blood count with platelets

d. Pap test
Question 7

By transvaginal sonography, absence of an embryo in a gestational sac is suspicious or pregnancy failure

Select one:

a. 10 to 18 mm

b. 1 to 6 mm

c. 4 to 12 mm

d. 16 to 24 mm

Question 8

Which one of the following statements is correct?

Select one:

a. The greatest risk of Eclampsia is during the first 24 hours postpartum

b. HELLP syndrome is cured by delivery

c. Diazepam is useful in the treatment of Eclampsia

d. All patients who have had an Eclamptic fit should have an emergency Caesarean section

e. It is very rare for a patient to fit if they have a diastolic BP of less than 90 mmHg.

Question 9

Induction of labor is clinically indicated in which of the following conditions?

Select one:

a. - Maternal urinary tract infection

b. - Pregnancy- induced hypertension

c. - Undiagnosed antepartum hemorrhage

d. - Pathological cardiotocograph (CTG) tracing

e. - Symphysis pubis dysfunction

Which of the following is NOT a necessary component of the clinicians’ assessment prior to performing
an operative vaginal delivery?

Select one:

a. Clinical adequacy of maternal pelvis

b. Estimation of fetal weigh

c. Identification of fetal station and position

d. Adequacy of maternal effort with pushing

Question 11

The combination of nifedipine with what other tocolytic agent can potentially cause dangerous
neuromuscular blockade?

Select one:

a. - Indomethacin

b. - Atosiban

c. - Magnesium sulfate

d. - Terbutaline

Question 12

Effect of preeclampsia on glomerular filtration rate (GFR) is:

Select one:

a. - GFR can increase or decrease

b. - Decrease GFR

c. - Increase GFR

d. - GFR remains the same

When comparing electronic fetal monitoring (EFM) with intermittent auscultation of fetal heart tones,

which of the following is TRUE?

Select one:

a. Use of EFM reduces risk of cerebral palsy

b. Use of EFM decreases the risk of vacuum and forceps operative vaginal delivery

c. Use of EFM reduces risk of neonatal seizures

d. Use of EFM reduces perinatal mortality

e. All them are TRUE

Question 14

What is the karyotype of a woman with Mayer–Rokitansky– Kuster–Hauser (MRKH) syndrome (mullerian
agenesis)?

Select one:

a. 47 XXX

b. 46 XX

c. 45 XO

d. 47 XXY

e. 46 XY

Question 15

Which of the following is FALSE regarding electronic fetal monitoring (EFM)?

Select one:

a. Has low false-positive rates

b. Fetal heart rate tracing patterns provide information on current acid-base status of -

fetus

c. Has poor interobserver and intraobserver reliability

d. Has uncertain efficacy

Which of the following statement is FALSE regarding Down syndrome?

Select one:

a. It is the most common autosomal aneuploidy

b. The severity of the syndrome can be predicted prenatally

c. Detection rates are roughly equivalent between first trimester screen and quad screen

d. . It is usually due to nondisjunction

e. It occurs at a rate of 1/800 live births

Question 17

. Which is an effective first-line treatment or women with heavy menstrual bleeding and von Willebrand
disease?

Select one:

a. Combination oral contraceptive pills

b. Nonsteroidal anti-inflammatory drugs

c. Dilatation and curettage

d. Endometrial ablation

Question 18

Which of the following is TRUE regarding dosage of insulin?

Select one:

a. Typical starting dosage is 0.7–1.0 units/day given in divided doses

b. Insulin crosses the placenta

c. Insulin glargine has a peak action of 12 h

d. Insulin lispro has a peak action of 1–2 h and therefore may be helpful in postprandial glucose control
Question 19

Which of the following interventions could decrease a patients’ risk for preterm birth?

Select one:

a. Having an interpregnancy interval of 36 months

b. All of them

c. Improved dental care during pregnancy

d. Smoking cessation

Question 20

Fetal cardiac activity is detected with transvaginal USGas early as:

Select one:

a. - 6 weeks

b. - 8 weeks

c. - 10 weeks

d. - 12 weeks

Question 21

Androgen insensitivity syndrome true is:

Select one:

a. Testes formed abnormally and receptors are normal

b. Predominantly ovarian component in gonads

c. Phenotype may be completely female

d. Always in female
Question 22

. Which of the following are components of a first trimester screen?

Select one:

a. all of them

b. PAPP-A

c. Inhibin A

d. B-hCG

e. PAPP-A & B-hCG

Question 23

Active management of third stage of labor includes all except:

Select one:

a. - Uterine massage

b. - Delivery of placenta by controlled cord traction

c. - Injection oxytocin after delivery of shoulder of baby

d. - Early cord clamping

Question 24

A 39-year-old woman asks for a hospital referral so that she can be investigated for recurrent
miscarriage, having suffered three first trimester pregnancy losses. She believes that her miscarriages
are due to stress. She works long hours as a computer programmer and smokes fifteen cigarettes a day.
Which of the following factors is the most likely cause of her recurrent miscarriages?

Select one:

a. Smoking

b. Bacterial vaginosis

c. Natural killer cells

d. Working with visual display units

e. Advanced maternal age

An abnormal attitude is illustrated by:

Select one:

a. Occiput anterior

b. Breech presentation

c. Transverse position

d. Occiput posterior

e. Face presentation

Question 26

Reduced fetal movement is associated with the following risk factors except:

Select one:

a. - Small for gestational age

b. - Fetal neuromuscular conditions

c. - Breech presentation

d. - Fetal growth restriction

e. - Placental insufficiency

Question 27

.If a woman has been delivered by caesarean section in her first pregnancy, it is good practice to read
the previous operation notes to see if there were any intraoperative complications.

In which of these indications for caesarean may the surgical details on the operation notes explain an
underlying anatomical reason for the caesarean indication?

Select one:

a. Breech presentation

b. Failed forceps delivery

c. Fetal distress

d. Cord prolapse

e. Placenta praevia
Question 28

Which procedure requires peri- operative antibiotic prophylaxis?

Select one:

a. Caesarean section

b. Oophorectomy for ovarian cyst

c. Laparoscopic removal of ectopic pregnancy

d. Perineal repair of second- degree tear

e. Forceps delivery

Question 29

Ovulatory disorders are associated with all of the following EXCEPT

Select one:

a. hyperandrogenism

b. hyperprolactinemia

c. hypothyroidism

d. Hyperparathyroidism

e. Hypergonadotropism

Question 30

A woman is recovering on the postnatal ward following an emergency caesarean

section. On the third day she complains of discomfort and swelling in her right leg,

which is clearly larger than the left leg, with a tender calf. The most appropriate

medication whilst awaiting the results of further investigation is:

Select one:

a. - Enoxaparin 1 mg per kg twice daily

b. - Graduated compression stockings

c. - Loading dose of Warfarin

d. - Enoxaparin 20 mg daily

e. - Enoxaparin 40 mg daily
Question 31

Serum levels of which hormone can be used to support a clinical impression of ectopic pregnancy but
cannot reliably distinguish an ectopic rom an intrauterine pregnancy?

Select one:

a. Estradiol

b. Luteinizing hormone

c. Progesterone

d. Follicle-stimulating hormone

Question 32

During colposcopy and lesion grading, terms used to describe abnormal vascular patterns may include
which of the following?

Select one:

a. All of them

b. Mosaicism

c. Punctation

d. Atypical vessel(s)

Question 33

Pearl index is

Select one:

a. - Failure rate/1000 women years

b. - Failure rate/1 women years

c. - Failure rate/100 women years

d. - Failure rate/10 women years

A pregnant woman from your GP practice with insulin- dependent diabetes is referred to the hospital
diabetic obstetric clinic for antenatal care.

How often should she be scanned for growth and amniotic fluid volume?

Select one:

a. Fortnightly from 24 weeks of gestation

b. Monthly from 28 weeks until term

c. Monthly from 28 weeks of gestation until 36 weeks

d. No growth scans necessary unless the symphysial- fundal height measures ‘small for dates’

e. Fortnightly from 28 weeks until term

Question 35

Patients with gestational diabetes should ideally have a caloric allotment of:

Select one:

a. None of them

b. Carbohydrates 60%, protein 30%, fat 10%

c. Carbohydrates 40%, protein 20%, fat 40%

d. Carbohydrates 40%, protein 40%, fat 20%

e. Carbohydrates 60%, protein 20%, fat 20%

Question 36

Which one of the following represents the “presentation” of a fetus?

Select one:

a. None of them

b. Transverse

c. Longitudinal.

d. Face

e. Oblique.
Question 37

.A nulliparous 22-year-old woman presents with a 3- month history of intermenstrual bleeding. She is
healthy with no other medical problems and is using the withdrawal method for contraception.

Select the most likely diagnosis:

Select one:

a. Chlamydia infection

b. Endometrial polyp

c. Nabothian follicle on the cervix

d. Cervical cancer

e. Ovarian granulosa cell tumor

Question 38

Which f the following statements about premenstrual syndrome (PMS) is true?

Select one:

a. Symptoms begin 3 to 7 days after menstruation

b. Women with fibroids are more commonly affected

c. Fluoxetine (Prozac ) can be used in treatment

d. Diuretics have no beneficial role in treatment

e. Niacin has been shown to help reduce symptoms

Question 39

The amount of fetomaternal hemorrhage at which women can become

alloimmunized is approximately:

Select one:

a. 10 mL-

b. 0.1 mL-

c. 1 mL-

d. 5 mL-
Question 40

Below the arcuate line, the anterior rectus sheath represents the conjoined aponeuroses of which of the
following muscles?

Select one:

a. Rectus abdominis and external oblique

b. Transversus abdominis and pyramidalis

c. External and internal oblique plus the transversus abdominis

d. External oblique plus the transversus abdominis

e. External and internal oblique

Question 61

All of the following anticoagulants are compatible with breastfeeding, EXCEPT:

Select one:

a. Unfractionated heparin

b. None of them are safe with breastfeeding

c. All of them are safe with breastfeeding

d. Warfarin

e. Low-molecular-weight heparin

Question 62

You are reviewing the investigation results of a couple with primary subfertility.

Which one of the following components of semen analysis is abnormal?

Select one:

a. Concentration: 40 million/ml

b. Motility: 20% motile

c. Volume: 4 ml

d. Liquefaction time: 20 minutes

e. Morphology: 50% normal forms

What are the most common side effects that patients complain about when using oral oxybutynin or
tolterodine?

Select one:

a. Nausea and vomiting

b. Dry mouth and constipation

c. Skin irritation and pruritus

d. Headaches and tinnitus

Question 64

A 25-year-old primigravida at 34 weeks and 5 days’ gestation by certain dating criteria is found to have
preterm rupture o the etal membranes.

What is the most appropriate management strategy?

Select one:

a. - Administer a course of corticosteroids followed by delivery

b. -Expectant management unless fetal lung maturityis confirmed

c. - Expedited delivery

d. - Expectant management

Question 65

Your patient was recently diagnosed with gestational diabetes. She asks you what you recommend in
terms

of management of gestational diabetes for the rest of her pregnancy. You counsel her:

Select one:

a. To check her glucose 3 times a day, 1 or 2 h postprandial

b. To eat three meals a day and limit snacks

c. To initiate a moderate exercise program

d. All of them
Question 66

In treating uterine atony after delivery, which of the following is true?

Select one:

a. - Fundal massage should be performe-

b. - All of them

c. - Oxytocin diluted in a crystalloid solution at a concentration of 200 U/min should be administered

d. - A 20-unit oxytocin bolus should be administered intravenously.

Question 67

Lactationalamenorrhoea is due to:

Select one:

a. . Prolactin induced inhibition of FSH

b. Prolactin induced inhibition of GnRH

c. Oxytocin induced inhibition of FSH

d. Oxytocin induced inhibition of GnRH

Question 68

Theories of the histogenesis of endometriosis do NOT include:

Select one:

a. Basal cell transformation

b. Lymphatic dissemination

c. Celomic metaplasia

d. Hematogeneous spread

e. Transtubal regurgitation of menstrual blood

44. A 24-year-old woman whose scan reveals polycystic ovarian syndrome (PCO)

consults you about management of her facial hirsutism. Her serum testosterone is

within normal limits and she does not wish to conceiv-

Which of these treatments for PCO is the most appropriate management option?

Select one:

a. - Combined oral contraceptive pill containing estrogen and cyproterone acetate (Diane35)

b. - Ovarian drilling

c. - Cyproterone acetate

d. - Metformin

e. - Clomiphene citrate

Question 70

Which of the following is an appropriate treatment of a 35-year-old woman with the diagnosis of
complex endometrial hyperplasia without atypia?

Select one:

a. All of them

b. Combination oral contraceptive pills

c. Medroxyprogesterone acetate

d. Levonorgestrel-releasing intrauterine system

Question 71

When describing uterine contractions, it is important to do which of the following

Select one:

a. To describe whether or not hyperstimulation is occurring

b. To quantify the number of contractions in a 10-min window, averaged over a 60-min period

c. All of them

d. To note whether the contractions are associated with fetal deceleration

Hysteroscopy can diagnose all, except:

Select one:

a. - Submucous polyp

b. - Asherman’s syndrome

c. - Septate uterus

d. - Adenomyosis

Question 73

An obstetric anesthetist will be unwilling to site an epidural until they have seen a

recent normal platelet count and clotting screen for a woman whose pregnancy is

complicated by:

Select one:

a. - Intrauterine fetal death

b. - Maternal diabetes

c. - Previous caesarean section

d. - Induction of labor

e. - Twin pregnancy

Question 74

You are filling out a thromboprophylaxis risk form in the preoperative assessment clinic, for a woman
about to undergo a pelvic floor repair.

Which of the following does not contribute to her risk score for venous thromboembolism?

Select one:

a. The woman has inflammatory bowel disease

b. The woman has a BMI of 44

c. The woman has protein S deficiency

d. The woman has a history of recent breast cancer

e. The woman has essential hypertension

Formation of endometrium pinopods for embryo implantation, is dependent on which of the following
hormones?

Select one:

a. TSH

b. Progesterone

c. Estradiol

d. Estriol

e. Cortisol

Question 76

Which one of the following statements with regard to CIN is true?

Select one:

a. CIN 1 will need treatment if persistent for long time

b. CIN 1 always needs treatment when detected on colposcopy

c. CIN 2 and 3 can be left for 2 years before treatment.

d. Almost 90% of low-grade cytological abnormalities that are not treated at a first visit will revert to
normal cytology and colposcopy.

e. CIN 1 progression to invasive cancer is quicker than CIN 2 and CIN 3.

A 38-year-old woman attended for a routine cervical smear during which an

asymptomatic polyp is noted on the surface of the cervix. The result of the smear was

normal.

In counselling her about the polyp, which one of the following statements is true?

Select one:

a. - It should be removed because it is likely to be malignant

b. - It is unlikely to be associated with endometrial pathology

c. - It is associated with HPV infection

d. - It could be caused by chlamydia

e. - It is most likely to be a nabothian follicle

Question 78

Which of the following has been shown to be associated with preterm PROM?

Select one:

a. Intraamniotic infectio & Prior history of preterm PROM

b. Prior history of preterm PROM

c. Intraamniotic infectio

d. Shortened cervical length

e. . All of them

Question 79

With regard to Turner syndrome the following statements are true except which one?

Select one:

a. It has karyotype 45XO.

b. It is associated with coarctation of aorta.

c. It may present with menorrhagia.

d. It is possible to conceive and have children.

e. It is associated with gonadal dysgenesis.

All EXCEPT which of the following increase a woman’s predisposition to develop preeclampsia syndrome?

Select one:

a. - Smoking

b. - Nulliparity

c. - Multiple gestation

d. - Obesity

Question 81

Placentas that lie within close proximity of the internal cervical os but do not reach it are termed low
lying.

What is the boundary threshold that defines a low-lying placenta?

Select one:

a. - 4.0 cm

b. - 3.0 cm

c. - 2.0 cm

d. - 1.0 cm

Question 82

With respect to recurrent miscarriages, which one of the following is true?

Select one:

a. Recurrent miscarriage is when there is a loss of two or more consecutive pregnancies.

b. Low-dose aspirin plus heparin are of no proven benefit in improving the

pregnancy outcome in women with antiphospholipid syndrome.

c. Pelvic ultrasound is not indicated in all cases

d. Antiphospholipid syndrome is the most important treatable cause of

recurrent miscarriages

e. Women with recurrent miscarriages should be screened routinely for

thyroid antibodies.
Question 83

Pregnancies that implant in the proximal tubal segment that lies within the muscular uterine wall are
termed which of the following?

Select one:

a. Angular

b. Interstitial

c. Ampullar

d. Cornual

Question 84

With respect to the management of gestational hypertension in a G2 para 1 woman with a blood
pressure of 145/96 mm Hg and no proteinuria at 35 weeks’ gestation, which one of the following is the
correct next step of management?

Select one:

a. - Weekly BP monitoring

b. - Admission to hospital

c. - Weekly blood tests

d. - Oral labetalol

e. - Weekly blood tests

Question 85

Fetal blood is returned to the umbilical arteries and the placenta throughthe:

Select one:

a. Ductus venosus

b. Foramen ovale

c. Ductus arteriosus

d. Hypogastric arteries
Question 86

Which one of the following statements is true in relation to women with Turner syndrome?

Select one:

a. Estrogen therapy may result in spontaneous fertility

b. They all have karyotype 46XO

c. They have no problems with learning difficulties

d. Administration of growth hormone at puberty will not produce any extra height

e. There is a high prevalence of left- sided congenital heart malformation

Question 87

You see a pregnant woman in your surgery who has just been to the hospital for a dating scan at 11
weeks of gestation, which reveals that she has monochorionic twins in separate sacs.

Which of the following statements is true about this type of twin pregnancy?

Select one:

a. She will not be able to have any sort of screening for Down syndrome

b. Delivery should be planned for 36 weeks if she has not labored

c. She should be delivered by caesarean section as there is a risk of cord entanglement

d. Monochorionic twins are at lower risk of twin- twin transfusion syndrome than dichorionic twins

e. Regular growth scans will be offered from 32 weeks of gestation

Question 88

Which of the following statements regarding first trimester ultrasound is correct:

Select one:

a. A gestational sac can be first seen 2 weeks after LMP.

b. Yolk sac is the first sign of pregnancy on USG

c. The accuracy of determining gestational age using ultrasound begins to decrease after first trimester

d. USG can be used to determine the sex of the baby

The following are related to ergot derivatives except:

Select one:

a. It initiates uterine contraction with increasing intensity

b. It can effectively be used for induction of abortion

c. It acts directly on the myometrium

d. It is highly effective in hemostasis following delivery

Question 90

What is the next BEST step when a growth-restricted fetus is diagnosed by ultrasound?

Select one:

a. Order weekly biophysical profiles for the fetus for the remainder of the pregnancy

b. Give steroids for fetal lung maturity and move toward delivery

c. Perform Doppler blood flow studies of the umbilical artery

d. Repeat the study in a week due to the low sensitivity of ultrasound

Question 91

With regard to Mirena IUS, which one of the following is true?

Select one:

a. Can be used with oestrogen replacement therapy for endometrial protection

b. Cannot be used to treat endometriosis

c. Associated with an increased risk of pelvic infection

d. Contains 52 micrograms of etonogestrel

e. Contraindicated in nulliparous women

37 year oldprimi Rh negative patient is very concerned about her pregnancy at this ag- Her pregnancy is
16 weeks and she is HIV negative, hepatitis B surface Ag negative, Rubella non immune and has no
complain. Her triple test report is normal but still due to her age she insists on getting an amniocentesis
don- Which of the following is the next best step in management:

Select one:

a. - Advise against amniocentesis as it will increase the risk of isoimmunization

b. - Follow Rh titres carefully and give Anti D if evidence of isoimmunization is present.

c. - Give Anti D prior to her amniocentesis

d. - Give rubella vaccine as she is Rubella non immune

e. - Give Anti D at 28 weeks f pregnancy and after delivery if baby is Rh negative

Question 93

Which of the following statements is not true about the use of the

combined oral contraceptive pill?

Select one:

a. It reduces the incidence of benign breast disease

b. It ameliorates the symptoms of premenstrual syndrome

c. It reduces the risk of ovarian cancer in later life

d. . It is associated with an increased risk of pelvic inflammatory disease

e. . It will reduce primary dysmenorrhoea

Question 94

What is the predominant estrogen during menopause?

Select one:

a. Estrone

b. Estradiol

c. Estriol

d. None of them
Question 95

In a young female of reproductive age with regular menstrual cycles of 28

Days ovulation occurs around 14th day of periods. When is the first polar

body extruded:

Select one:

a. - Accompanied by ovulation

b. - 24 hrs. prior to ovulation

c. - At the time of fertilization

d. - 48 hrs. after the ovulation

Question 96

Which of the following statements regarding bacterial vaginosis in reproductive-aged women is NOT
true?

Select one:

a. It is the most common cause o vaginal discharge.

b. Condom use lowers risk.

c. Douching after menses is preventive

d. Rates of sexually transmitted disease acquisition are increased in its presence

Question 97

Which of the following statements is true regarding the gonadotropin luteinizing hormone (LH)?

Select one:

a. It shares a common glycoprotein β-subunit with follicle-stimulating hormone (FSH).

b. Its β-subunit demonstrates approximately 80 percent homology with that of human chorionic
gonadotropin (hCG).

c. Its functional specificity is derived from the α-subunit

d. It is secreted by the posterior pituitary gland

Early clamping of the umbilical cord is indicated in all except:

Select one:

a. Postmature baby

b. Rh-incompatibility

c. Asphyxiated baby

d. During CS when the baby is delivered by cutting through the placenta

Question 99

Metformin therapy in PCOS

Select one:

a. It enhances insulin secretio

b. Reduces the risk of significant ovarian hyperstimulation syndrome (OHSS).

c. . It is safe in pregnancy as it does not cross the placenta

d. Once started should be continued in pregnancy

Question 100

What is the most common complication encountered in multifetal gestations?

Select one:

a. Stillbirth

b. Preeclampsia

c. Neonatal death

d. Spontaneous preterm birth