Choose the best answer :

1. As regard Fertilization which is true

a. It is the union of The mature spermatozoon & The secondary oocyte
to form the zygote
b. It is embedding of the blastocyst into the decidua
c. It is embedding of the mature spermatozoon into the decidua
d. It is the union of The mature spermatozoon & The secondary oocyte to
form the placenta
2. All of the following are types of spontaneous abortion Except:
a. Missed abortion
b. Septic abortion
c. Recurrent abortion
d. Therapeutic abortion
3. All of the following are causes of antepartum hemorrhage Except :
a. Placenta previa
b. Accidental hemorrhage
c. Retained placenta
d. Rupture uterus
4. In HELLP syndrome all the following are present Except :
a. Hemolysis (H)
b. Elevated liver enzymes (EL)
c. Increase platelet count (LP)
d. Elevated blood pressure
5. As regard preeclampsia which is true:
a. BP ≥140/90 mm Hg for the fi rst time in pregnancy after 20 weeks, without
proteinuria
b. Gestational hypertension with proteinuria
 c. Known hypertension before pregnancy or hypertension diagnosed fi rst
time before 20 weeks of pregnancy
d. Occurrence of new onset of proteinuria in women with chronic
hypertension
6. As regard missed abortion which is true:
a. infection of any type of abortion
b. termination of pregnancy for sake of the mother
c. termination of pregnancy for illegal causes
d. retention of dead embryo or fetus inside the uterus
7. Attitude is defined as:
a. it is the 1st part of the fetus that meets the pelvic brim = 1st felt by P.V
b. It the relation of the denominator ( fixed bony point on the presenting part)
to the maternal pelvis .
c. It is the relation between the longitudinal axis of the fetus and that of the
mother.
d. It is the relation of the fetal parts to each other.
8. Utero-sacral ligaments is defined as:
a. Fibro-muscular bands between the ovaries & uterine cornua
b. 2 folds of peritoneum,From the side of the uterus to the lateral pelvic wall
c. From the anterior aspect of the supravaginal cervix to the back of the
Symphysis pubis.
d. 2 bands from back of cx to 3rd sacral piece surrounding the rectum.

9. As regared Secretory phase: which is true:

a. It is the period of life during which 2ry sex characters develop ,sex organs
mature and the individual becomes able to conceive
b. 14 days Phase of thickening and ripening of endometrium under the
effect of progesterone.
c. Phase of building up of endometrium under the effect of estrogen.
 d. 2-7 days,Periodic shedding of the endometrium occurring between
menarche & menopause

10. Dysfunctional uterine bleeding (DUB) is defined as:

a. Bleeding from the female genital tract after one year after menopause
b. Abnormal uterine bleeding in absence of local or general cause
c. Frequent menses , every < 21 days
d. Excessive menstruation ↑80ml &/ or in duration > 7 days with normal cycle
duration.
11. Uterine Cervix:
a. Is the portion of the uterus below the isthmus
b. External OS cell lining is columnar epithelium
c. Laterally is attached to the round ligament
d. The cervical canal is covered with stratified squamous epithelium
e. Can be dilated with dilators without the need of anesthesia
12. The main support of the uterus is provided by
a. The round ligament
b. The cardinal ligament
c. The infandilo-pelvic ligament
d. The integrity of the pelvis
e. The broad ligament
13. The most important muscle in the pelvic floor is:
a. Bulbo cavernousus.
b. Ischio-cavernosus.
c. Levatorani.
d. Superficial transverse Perineal muscle.
e. Deep transverse Perineal muscle.
14. The pelvis includes which of the following bones:
a. Trochanter, hip socket, ischium, sacrum & pubis.
b. Ilium,ischium,pubis,sacrum&coccyx.
c. Ilium, ischium & pubis.
d. Sacrum, Ischium, ilium & pubis.
e. Trochanter, sacrum, coccyx, ilium & pubis.
15. The joint between the two pubic bones is called the:
a. Sacroiliac joint.
b. Pubis symphysis.
c. Sacrococcygeal joint.
 d. Piriformis.
e. Intervertebral joint
16. The greatest diameter of the fetal head is:
a. Occipitofrontal.
b. Occipitomental.
c. Suboccipit bregmatic
d. Bitemporal.
e. Biparietal.
17. Hyperextension of the fetal head is found in:
a. Vertex presentation
b. Face presentation
c. Shoulder presentation
d. Breach presentation
e. E.Hydrocephalic baby
18. Stages of labor
a. The first stage commences at the time of membrane rupture
b. The cervix dilates at consistent rate of 3 cm per hour in the first stage
c. The third stage end with the delivery of the placenta and membranes
d. Forceps or ventose may be useful in slow progress of the late 1st stage
e. Syntometrine is a combination of oxytocin and Ergometrine which is
used in the treatment of secondary postpartum haemorrhage (PPH)
19. All the following characteristics are applied to a pelvis favorable to vaginal
delivery EXCEPT:
a. Sacral promontory can not be felt.
b. Obstetric conjugate is less than10cm.
c. Ischial spines are not prominent.
d. Subpubic arch accepts 2 fingers.
e. Intertuberous diameter accepts 4 knuckles on pelvic exam.
20. In the fetus:
a. The coronal suture lies between the two parietal bones.
b. The umbilical artery normally contains one artery and two veins.
c. Fetal lie describes the long axis of the fetus to the long axis of the
mother.
d. Entanglement of the umbilical cord is common in diamniotic twins.
e. The anterior Fontanelle is usually closed by the time of labor.
21. The second stage of labor involves:
a. Separation of the placenta.
b. Effacement of the cervix.
c. Expulsion of the placenta.
d. Dilation of the cervix.
e. Expulsion of the fetus.
22. Which is true?
a. Position – cephalic.
b. Station–level of ischial spines.
c. Presentation – flexion.
23. A pelvic inlet is felt to be contracted if :
a. The anterio-posterior diameter is only 12 cm.
b. The transverse diameter is only10cm .
c. Platypelloid pelvis.
d. The mother is short.
e. The patient had a previous C-section.
24. During clinical pelvimerty, which of the following is routinely measured:
a. Bi-ischeal diameter.
b. Transverse diameter of the inlet.
c. Shape of the pubic arch.
d. Flare of the iliac crest.
e. Elasticity of the levator muscles.
25. At term, the ligaments of the pelvis change. This can result in:
a. Increasing rigidity of the pelvis.
b. Degeneration of pelvic ground substance.
c. Decreasing width of the symphysis.
d. Enlargement of the pelvic cavity.
e. Posterior rotation of the levator muscles.
26. During clinical pelvimetry, which of the following is routinely measured:
a. True conjugate.
b. Transverse diameter of the inlet.
c. Shape of the pubic arch.
d. Flare of the iliac crest.
e. Elasticity of the levator muscles.
27. During the delivery, the fetal head follow the pelvic axis. The axis is best
described as:
a. A straight line.
b. A curved line, 1ST directed anteriorly then caudal.
c. A curved line,1STdirected posteriorly then caudal.
d. A curved line, 1ST directed posteriorly then cephalic.
e. None of the above.
28. A head of level (one fifth) indicates:
a. Indicates that one fifth of the head is below the pelvic brim.
b. Indicates that the head is engaged.
c. Indicated that forceps may not be used.
d. Indicates that head is at the level of the ischial spines.
e. Always occur in a term brow presentation.
29. In a vertex presentation, the position is determined by the relationship of
what fetal part to the Mother's pelvis:
a. Mentum.
b. Sacrum.
c. Acromian.
d. Occiput.
e. Sinciput.
30. Signs of Placental separation after delivery include:
a. Bleeding.
b. Changes of uterine shape from discoid to globular.
c. Lengthening of the umbilical cord.
d. Presentation of the placenta at the cervical os.
e. All of the above.
31. The persistence of which of the following is usually incompatible with
spontaneous delivery at term:
a. Occiput left posterior
b. Mentum posterior.
c. Mentum anterior.
d. Occiput anterior.
e. Sacrum posterior.
32. The first stage of labor :
A. Separation of the placenta.
B. Effacement of the cervix.
C. Expulsion of the placenta.
D. Ends with fully Dilation of the cervix.
E. Expulsion of the fetus.
33. The heart rate of a normal fetus at term:
A. 80-100 bpm.
B. 100-120 bpm.
C. 120-160bpm.
D. 160-180 bpm.
E. There is no baseline heart rate.
34. Which of the following is suggestive of ovulation:
A. Basal body temperature drop at least 0.5C in the second half of
the cycle
B. Day 21 estrogen level is elevated
C. Progesterone level on day ten of the cycle is elevated
D. Regular cycle with dysmenorrhea
E. Oligomenorrhoea
35. The luteal phase of the menstrual cycle is associated with:
A. High luteinizing hormone level
 B. High progesterone levels
C. High prolactin level
D. Low basal body temperature
E. Proliferative changes in the endometrium
36. The follicular phase of menstrual cycle is characterized by:
A. Endometrial gland proliferation.
B. Decreased Ovarian Estradiol production.
C. Progesterone dominance.
D. A fixed length of 8 days.
E. A reduction in aromatase activity.
37. The following terms are appropriate:
a) Lie: cephalic.
b) Position: flexed.
c) Station: at the level of the spines.
d)Engagement: two-fifths.
e) Presenting part: shoulder
38. At 24 weeks gestation where would you expect to find the uterine fundus?
a) Halfway between umbilicus and xiphisternum
b) Symphysis pubis
c) Umbilicus
d) Xiphisternum
39. Which sign is present on this pregnant abdomen?
a) stria albicans
b) linea nigra
c) stria gravidarum
d)chloasma
40. Second trimester miscarriage:
a) Is typically painless.
b) Occurs between 12- and 28-weeks’ gestation.
c)Is diagnosed after exclusion of infection, haemorrhage and multiple pregnancy.
d) Antibiotic prophylaxis is usually given
41. The infant of a diabetic mother is at increased risk of:
a) Polycythemia.
b) Hypermagnesaemia.
c) Traumatic delivery.
d)Neonatal jaundice.
e) Hypoglycaemia.
42. Which period of gestation does the 3rd trimester represent?
a)30-41 weeks
b)28-40 weeks
c)29-40 weeks
d)27-39 weeks
43. Progress in labour is measured by:
a) The frequency of uterine contractions.
b) The force of uterine contractions.
c)Dilation of the cervix.
d) The length of time since rupture of the membranes.
44. At what stage of gestation would you expect a nulliparous women to begin
to feel fetal movements?
a) 18-20 weeks
b)22-24 weeks
c)24-28 weeks
45. What is the most common cause of postpartum haemorrhage?:
a) vulval and vaginal laceration.
b) retained placenta.
c)uterine rupture.
d)uterine atony.
46. At 36 weeks gestation where would you expect to find the uterine fundus?
a) Halfway between umbilicus and xiphisternum
b) Symphysis pubis.
c) Xiphisternum.
d) Umbilicus.

47. Neonatal jaundice is a recognized feature of:

a) Sickle cell disease.
b) Glucose-6-phosphate dehydrogenase.
c) Rhesus incompatibility.
d)Beta-thalassemia.
e) Meningitis

48. Which period of gestation does the 2nd trimester represent?:

a) 14-29 weeks
b)13-28 weeks
c) 10-2- weeks
d)15-30 weeks

49. The following statements apply to the human female pelvis:

a) The Fallopian tubes are lined by cilia to aid egg transport.
b) The middle portion of the Fallopian tube is called the ampulla.
c) The ovary is the only abdominal structure not covered by peritoneum.
d)The ovary is attached to the uterus by the round ligament.

50. Which of the following are causes of postpartum haemorrhage?

a) uterine atony.
b) birth canal lacerations
c) retained placenta
 d)coagulopathy
e) all of the above

51. Which of the following are risk factors for pre-eclampsia?

a) maternal age ≥ 40
b)1st pregnancy
c)family history
d)obesity (BMI ≥35)
c) all of the above

52. Which of the following is a prostaglandin commonly used in induction of

labour?
a) labetalol
b) atenolol
c)misoprostol

53. At 28 weeks gestation where would you expect to feel the uterine fundus?
a) umbilicus
b) Halfway between xiphisternum and umbilicus
c)xiphisternum
d)symphysis pubis

54. Definitions:
a) Polymenorrhoea is defined as prolonged increased menstrual flow.
b) Oligomenorrhoea is defined as menses occurring at a 21-day interval.
c) Hypermenorrhea is defined as excessive regular menstrual loss.
d)Amenorrhea is defined as absence of menstruation for more than 12 months.
e) Menorrhagia is defined as menses at intervals of 35 days.

55. Which period of gestation does the 1st trimester represent?:

a) 1-12 weeks
b)1-13 weeks
c)1-14 weeks
d)1-10 weeks

56. At 12 weeks gestation where would you expect to feel the uterine fundus?
a) symphysis pubis
b) xiphisternum
c) umbilicus
d) Halfway between umbilicus and xiphisternum

57. Which of the following methods is the correct way to calculate the
estimated date of delivery (EDD)?
a) Last day of LMP + 8 months and 1 week
 b) First day of LMP + 9 months and 1 week
c) First day of LMP + 9 months
d) First day of last menstrual period (LMP) + 8 months and 1 week

58. Concerning disorders of early pregnancy:

a) in inevitable abortion the cervix is opened
b) in threatened abortion the cervix is opened
c) in missed abortion the cervix is opened
d) treatment of abortion always surgical evacuation

59. With regard to miscarriage:

a) Total loss of conception after fertilization is around 50–70 per cent.
b) The total rate of clinical miscarriage is around one-quarter to one-third of
all pregnancies.
c)The rate of miscarriage is the same in women over 40 years of age compared
with women under 40.
d) The most common cause of spontaneous miscarriage is infection.
60. In relation to molar pregnancy:
a) The uterus often appears smaller on palpation than one would expect for
gestation.
b) Ultrasound is useful in the diagnosis of molar pregnancy and the
diagnosis is usually made on histology.
c)Complete hydatidiform molar pregnancies have a maternal complement.
d) Partial molar pregnancies are usually having no maternal complement

61. Considering ectopic pregnancy:

a) The rate of ectopic pregnancy is 0.5 per cent of all pregnancies.
b) Ectopic pregnancy is associated with Group B streptococcus infection.
c) Laparoscopic salpingectomy is the treatment of choice if the other tube
is normal.
d)The rate of persistent trophoblast is increased if the patient has a laparoscopic
salpingotomy rather than salpingectomy.
e) Methotrexate is contraindicated if the mass is 1 cm in diameter on ultrasound.

62. The following are risk factors for the development of endometrial cancer:
a) Diabetes.
b) Multiparity.
c)Early menopause.
d) Unopposed estrogen therapy.

63. A couple, both aged 25, wish to start a family. They have stopped using
contraception and are having regular sexual intercourse. How likely are
they to conceive within one year?
 A. 70-74%
B. 75-79%
C. 80-84%
D. 85-89%
E. 90-94%

64. The most common site of endometriosis is

a) The pouch of Douglas.
b) The ovary
c) The posterior surface of the uterus
d) The broad ligament
e) The pelvic peritoneum

65. regard the ovary:

a) The follicles are centrally placed in the medulla.
b) blood supply mainly from uterine artery
c) attached to the uterus by round ligament
e) ovaian artery is a branch from the aorta

66. The most frequent symptom of endometriosis

a) Infertility
b) Pain
c) Backache
d) Dyspareunia
e) All the above

67. Which structure provides the major support to the uterus and cervix:
a) Round ligament
b) broad ligament
c) cardinal ligaments
d) uterosacral ligaments

68. Which structure produces gonadotropins?

a) hypothalamus
b) anterior pituitary
c)posterior pituitary
d) ovaries
69. Which of the following is NOT a risk factor for ectopic pregnancy?
a) Prior history of pelvic inflammatory disease (PID)
b) Prior history of uterine fibroids
c) Prior history of ectopic pregnancy
d) Prior history of tubal surgery
70. A patient presents with vulvar irritation and pruritis. Speculum examination
reveals a hyperemic, edematous, vaginal vault with odorless discharge.
The pH is 4.0. What is the MOST likely diagnosis?
a) bacterial vaginosis
b) candidiasis
c) trichomoniasis
d) Gonococcal vaginitis

71. What is the MOST proven cause of recurrent pregnancy loss (RPL)?
a) Luteal phase deficiency
b) Uterine anomalies
c) Parental chromosomal abnormalities
d) Environmental toxins

72. The following have been associated with bacteriuria in pregnancy:

a) Pre-term birth
b) hypertension
c) anemia
d) Abortions

73. About ectopic pregnancy:

a) commonest site is the ovary
b) treated always medically
c) commonest site is the Fallopian tube
d) treatment always surgically

74. Active management of third stage of labour (AMSTIL) involves:

a) Using a balloon tamponade to enhance uterine involution
b) oxytocin injections only
c) observation of vital signs only
d) oxytocin and controlled cord traction

75. These methods can be used in treatment of postpartum haemorrhage

except:
a) Caesarean section
b) Total abdominal hysterectomy
c) Internal Iliac ligation
d) Cytotec
e) Syntometriene
76. The aims of the antenatal care are.
a) Promote and maintain health in pregnancy.
b) Detect and treat conditions pre-existing or arising in pregnancy.
c) Make a delivery plan.
d) Prepare for emergencies.
e) All of the above.

77.

a)1-ovary
b)2-uterus
c)5-vagina
d)3-fallopian tube

78. The following are presentations for placenta praevia.

a) bleeding in early pregnancy.
b) abortions.
c) bleeding in late pregnancy
d) always presented by abdominal pain.

79. The following are true statements about abruptio placenta.

a) Maternal conditions are always related to amount of PV bleeding.
b) Smoking has no role.
c) AROM and induction is contraindicated.
d)abdominal pain± bleeding in late pregnancy with severe fetal distress.

80. A patient at 32 Weeks was diagnoses of having a severe abruptio placenta

with intrauterine fetal death and DIC, which of the following is the best
option to deliver the patient?
a) General measures, resuscitating the patient and emergency c/section.
b) General measures, whole blood transfusion, fresh frozen plasma, IV fluids
emergency C/section.
c) General measures, whole blood transfusion, fresh frozen plasma, IV
fluids, after correction the DIC AROM and attempt to vaginal delivery by
inducing or augmenting labour.
d) None of the above.

81. Hematological findings in Iron deficiency anaemia.

a) Microcytic hyper chromic.
b) Macrocytic hypo chromic.
c) The mean corpuscular value is low.
d) Mean corpuscular hemoglobin is increased.
 82. Anatomy of the female genital tract.
a) The uterine artery is a branch of the terminal part of the aorta.
b) The uterine artery is a branch of the internal iliac artery.
c) The uterine artery is the terminal branch of the internal femoral artery.
d) The uterine artery is a branch of the obturator internus artery.

83. Common causes of antepartum haemorrhage (APH, bleeding from the

genital tract from 28 weeks' gestation) include which of the following:
a) placenta previa
b) vasa previa
c) uterine rupture
d) none of the above

84. Shoulder dystocia.

a) Is a common complication.
b) Associated with maternal obesity.
c) Turtle sign is not present.
d) Rubin maneuver be done to hyper flex the arms.

85. In PPH.
a) commonest cause is uterine atony.
c) coagulopathy is usually excluded.
c) treatment is usually surgical
d) treatment is usually medically

86. Managing PPH.

a) Intra vaginal Misoprostol is effective.
b) Oxytocin 10 IU after delivery of the baby is always preventive.
c) observations are important.
d) All of the above.
87) The following terms are appropriate except:
a) Lie: cephalic.
b) Position: occipito anterior.
c) Station: at the level of the spines.
d)Engagement: two-fifths.
e) Presenting part: shoulder

88) In normal pregnancy:

a) Blood pressure falls in the second trimester.
b) Plasma volume decreases throughout gestation.
c) There is a reduction in erythrocyte production.
d)50 per cent of women have a transient diastolic murmur.
e) There is an increase in the number of platelets.
89) Second trimester miscarriage:
a) Is typically painless.
b) Occurs between 8- and 24-weeks’ gestation.
c) Can be associated with rupture of the fetal membranes.
d)Is diagnosed after exclusion of infection, haemorrhage and multiple pregnancy.
e) Antibiotic prophylaxis is usually given

90) Oligohydramnios is associated with the following fetal conditions:

a) Tracheo-oesophageal fistula.
b) Maternal DM
c) Macrosomia.
d) Anecephaly.
e) Premature rupture of the fetal membranes.

91) With reference to iron deficiency anaemia in pregnancy:

a) Iron demand in pregnancy increases to 10 mg per day.
b) High levels of serum ferritin confirm the diagnosis.
c) It is more common in single than multiple pregnancy.
d)It is usually be treated with oral iron.
e) Blood transfusion should be avoided.

92) Progress in labour is measured by:

a) The frequency of uterine contractions.
b) The force of uterine contractions.
c) Descent of the fetal membranes.
d) Dilation of the cervix.
e) The length of time since rupture of the membranes.

93) In relation to the mechanism of labour:

a) Engagement is said to have occurred when the widest part of the presenting part has
passed through the false pelvis.
b) Restitution occurs after external rotation.
c) Extension occurs after internal rotation.
d) Extension occurs at ‘crowning’.
e) Descent of the fetal head is needed after flexion, internal rotation and extension can
occur.

94) Vaginal bleeding in the first stage of labour may be due to except:
a) Placental abruption.
b) Cervical tears.
c) Ruptured uterus.
d)Vaginal trauma.
e) Vasa previa.
95) The infant of a diabetic mother is at increased risk of except:
a) Polycythemia.
b) Hypermagnesaemia.
c) Traumatic delivery.
d) Neonatal jaundice.
e) Hypoglycaemia.

96) Definitions:
a) Polymenorrhoea is defined as prolonged increased menstrual flow.
b) Oligomenorrhoea is defined as menses occurring at a 21-day interval.
c) Hypermenorrhea is defined as infreguent regular menstrual loss.
d) Amenorrhea is defined as absence of menstruation for more than 12 months.
e) Menorrhagia is defined as menses at intervals of 35 days.

97) Concerning disorders of early pregnancy:

a) If the cervical os is open, it is a threatened miscarriage.
b) If transvaginal scan shows products of conception up to 20 mm in diameter, then
surgical evacuation of the uterus is essential.
c) Serum β-hCG levels are useful in dating a pregnancy up to 12 weeks.
d)Ultrasound appearances of retained products of conception of 15 mm would be
consistent with a complete miscarriage.
e) A snowstorm appearance on ultrasound is suggestive of choriocarcinoma.

98) With regard to miscarriage:

a) Total loss of conception after fertilization is around 70–90 per cent.
b) The total rate of clinical miscarriage is around 50 to 70% of all pregnancies.
c) Miscarriage is much greater before 6 weeks than after 9 weeks.
d)The rate of miscarriage is the same in women over 40 years of age compared with
women under 40.
e) The most common cause of spontaneous miscarriage is infection.

99) In relation to molar pregnancy:

a) The uterus often appears larger on palpation than one would expect for gestation.
b) Hyperemesis is often seen in patients with molar pregnancies.
c) Ultrasound is not useful in the diagnosis of molar pregnancy and the diagnosis is
usually made on histology.
d)Complete hydatidiform molar pregnancies have a triploid chromosomal constitution
owing to duplication of paternal chromosomes and no maternal complement.
e) Partial molar pregnancies are usually diploid with duplication of the maternal set of
chromosomes.

100) Considering ectopic pregnancy:

a) The rate of ectopic pregnancy is 0.5 per cent of all pregnancies.
b) Ectopic pregnancy is associated with Group B streptococcus infection.
c) Laparoscopic salpingectomy is the treatment of choice if the other tube is
normal.
d) The rate of persistent trophoblast is increased if the patient has a laparoscopic
salpingectomy rather than salpingotomy.
e) Methotrexate is contraindicated if the mass is 1 cm in diameter on ultrasound.

101) During antenatal management, the following are true:

a) Refocused ANC involves reducing the number of visits and improving the quality of
contact time
b) All mothers must have four visits only
c) All mothers should have a birth plan as this improves decision on making
d) A and B
e) A and C

102) About ectopic pregnancy:

a) The gestational sac can be seen at an HCG level of 1500 IU/L using a
Transabdominal U/S scan
b) The gestational sac can be seen at an HCG level of 6500 IU/L using a transvaginal
U/S scan
c) A cervical ectopic pregnancy can be treated using a cone biopsy
d) Can be treated using Methotrexate
e) Can undergo resorption

103) Active management of third stage of labour (AMSTIL) involves:

a) Using a balloon tamponade to enhance uterine involution
b) Delivery of the cord by controlled cord traction with counter traction over the
supra pubic area
c) Monitoring of the Blood pressure, pulse rate, GCS, and Per vaginal bleeding every 20
minutes for one hour
d) Pelvic floor exercises (Kegel's exercise)
e) Administration of 5 IU of Oxytocin IM on the anterior thigh within 2 minutes of delivery
of the baby.

104) These methods can be used in treatment of postpartum haemorrhage

except:
a) Caesarean section
b) Total abdominal hysterectomy
c) Internal Iliac ligation
d) Cytotec
e) Syntometriene
105) The aims of the antenatal care are.
a) Promote and maintain health in pregnancy.
b) Detect and treat conditions pre-existing or arising in pregnancy.
c) Make a delivery plan.
d) Prepare for emergencies.
e) All of the above.

106) The advantages of the midline episiotomy are except:

a) Less blood loss.
b) Reduced incidence of dyspareunia.
c) Less anal sphincter damage.
d) Less pain in the postpartum period.
e) It is easier to repair.

107) With regard to the obstetric history:

a) Pregnancy is dated from conception.
b) Parity is the total number of pregnancies regardless of how they ended.
c) It is recommended that women should not be seen on their own at least once.
d) A family history of pre-eclampsia should trigger increased antenatal
surveillance.
e) The last menstrual period is reliable if the cycles are irregular.

108) The following are true statements about abruptio placenta.

a) Maternal conditions are always related to amount of PV bleeding.
b) Is frequently related with low consumption of coagulating factors.
c) Smoking has no role.
d) AROM and induction is contraindicated.
e) Is highly related to PPH.

109) Multiple pregnancies predispose to except:

a) Placenta praevia.
b) Diabetes mellitus.
c) Pre-eclampsia.
d) Malpresentation.
e) Intrauterine growth restriction (IUGR).

110) In PPH.
a) Blood transfusion is always required.
b) Blood transfusion may not be required.
c) Bleeding is from the uterus.
d) Bleeding is from vagina.
e) All of the above.
111) Managing PPH.
a) Intra vaginal-rectal Misoprostol is effective.
b) Oxytocin 10 IU after delivery of the baby is always preventive.
c) Intrauterine tampons and compression sutures.
d) All of the above.
e) None of the above.

112) With regard to the placenta all true except:

a) It receives the highest blood flow of any fetal organ.
b) It has approximately 20 cotelydons.
c) The maternal and fetal blood are separated by one layer.
d) It is a major endocrine organ.
e) Each cotelydon contains a primary stem villus.

113) Maternal effects on the physiology of the kidney include:

a) There is a 40 per cent increase in renal blood flow.
b) There is an increase in the glomerular filtration rate.
c) The urea and creatinine are higher than the non-pregnant state.
d) The upper limit of protein excretion in pregnancy is 0.6 g per day.
e) The kidneys decrease in size.

114) The combined oral contraceptive pill (COCP):

a) Inhibits ovulation.
b) Not improves cycle control.
c) Has a 3-hour window.
d) Is relatively contraindicated in patients with acute/severe liver disease.
e) Has a risk of venous thromboembolism (VTE) of 15 per 100 000 in third-generation
preparations.

115) Indications for medical treatment of ectopic pregnancy include the following
except:
a) Presence of cardiac activity
b) Beta HCG titres less than 5000mIU/ml
c) Unruptured ectopic
d) An ectopic greater than 3.5 cm
e) An ectopic less than 3.5 cm

116) Velamentous insertion of the cord is associated with an increased risk for
a. Premature rupture of the membranes
b. Fetal exsanguinations before labor
c. Torsion of the umbilical cord
d. Fetal malformations
e. Uterine malformations

117) The following are true postulate about pre-eclampsia except.

a) Commonly affecting multiparous patient.
b) Chronic hypertension, renal disease and low socioeconomic status are risk factors.
c) Earlier onset in the presence of antiphospholipid antibody syndrome.
d) Proteinuria and hypertension.
e) Haemolysis can occur.

118) After an initial pregnancy resulted in a spontaneous loss in the first trimester,
your patient is concerned about the possibility of this recurring. An appropriate
answer would be that the chance of recurrence
a. Depends on the genetic makeup of the prior abortus
b. Is no different than it was prior to the miscarriage
c. Is increased to approximately 50%
d. Is increased most likely to greater than 50%
e. Depends on the sex of the prior abortus

119) Abruptio Placenta. Management.

a) Mild abruption needs emergency c/section independently of the gestational age.
b) Moderate abruption at 32 WOA: Tocolytic for 24 hours waiting for steroids effects.
c) Moderate abruption, mother in shock, at 34 wks: Resuscitation, amniotomy and
induction of labour with Misoprostol.
d) Severe abruption, IUFD, with DIC: correction of DIC, amniotomy and emergency
c/section.
e) None of the entire above is true.

120) The smallest anteroposterior diameter of the pelvic inlet is called the
a. Interspinous diameter
b. True conjugate
c. Diagonal conjugate
d. Obstetric conjugate

121) The foetal heart rate during labour.

a) Increases with a contraction.
b) Decreases with a contraction.
c) Shows no changes with a contraction.
d) Starts to recover a contraction stops.
e) b) and d) above.
122) The following are immediate complications for caesarean section except.
a) Haemorrhages.
b) Secondary post partum haemorrhage.
c) Lesion of neighbour organs.
d) Anaesthetic complications
e) Amniotic fluids embolization.

123) An abnormal attitude is illustrated by

a. Breech presentation
b. Face presentation
c. Transverse position
d. Occiput posterior
e. Occiput anterior

124) The following are risk factors for PPH except:

a) Anaemia.
b) Pre-eclampsia.
c) IUFD.
d) Amniotic fluid embolization.
e) Vasa praevia.

125) Which of the following abnormalities of labor is associated with a significantly

increased incidence of neonatal morbidity?
a. Prolonged latent phase
b. Protracted descent
c. Secondary arrest of dilation
d. Protracted active-phase dilation

126) APH.
a) Any bleeding from genital tract at any gestational age.
b) Any bleeding form genital tract after 28 weeks
c) Vasa previa is the commonest cause.
d) Amniotomy and induction can be done in type II placenta previa.
e) Lovset’s manoeuvre can help during management.

127) The vulva consist of except:

a) Vaginal orifice.
b) Vestibule.
c) Urethral orifice.
d) Labia majora and minora.
e) Anal orifice.

128) About APH

a) Is any bleeding from genital tract before 28 WOA
b) Vasa praevia can not be a cause.
c) Placenta previa is more common than Abruptio placenta.
d) Is not a cause of preterm delivery
e) Is not the common cause of maternal death in Egypt

129) Human milk has the following advantages over formula milk:
a) Human milk contains more protein.
b) Human milk contains less lactose.
c) Human milk is associated with a reduction in atopic illness.
d) Human milk is a good source of iron.
e) Human milk is a good source of vitamin K.

130) All the following factors affect wound healing except.

a) Nutrition.
b) Infection.
c) Anaemia.
d) High concentrations of vitamin c.
e) None of above.

131) Objective of performing an episiotomy include except.

a) To prolong 2nd stage of labour.
b) Preserve integrity of pelvic floor.
c) Forestall uterine prolapse.
d) Save baby’s brain from injury
e) It is a routine in every primegravida.

132) Features of a medio-lateral episiotomy include except.

a) Extensions are not common.
b) Dyspareunia may be occasional.
c) Postoperative pain common.
d) More difficult to repair.
e) Blood loss is less compared to midline episiotomy.

133) Risk factors for perineal extension following episiotomy except:

a) 2 nd stage arrest.
b) Vacuum extraction.
c) Small baby.
d) Persistent occipital posterior.
e) Nulliparity.

134) Regarding perineal tears:

a) 1 st degree: involves fourchet, perineal skin, vaginal mucosa, underlying fascia.
b) 2 nd degree: involves skin, mucosa membranes, fascias, muscle of perineal body, but
not the rectal sphincter.
c) 3 rd degree: external through skin, mucosa membrane, perineal body, and involve anal
sphincter.
d) 4 th extend through rectal mucosa to expose lumen of the rectum.
e) All of the above.

135) According PPH all true except :

a) Active management of 3rd stage of labour may prevent it
b) Ruptured uterus may be a cause
c) Sheehan’s syndrome is a consequence
d) Is not a cause of maternal mortality
e) Endometritis is a cause of primary PPH.

136) Normal hemoglobin level at the first trimester of pregnancy

a) 10 gm\dl
b) 8 gm\dl
c) 11 gm\dl
d) 15 gm\dl
e) All the above

137) The following are associated with breech presentation.

a) Polyhydramnios.
b) Oligohydramnios.
c) Multiple pregnancy
d) Contracted pelvis.
e) Malformed uterus.

True or false .( 2 marks each one):

1. Precocious puberty : is defined as Presence of one or more of puberty signs
before age of 10 years. F
2. 1ry amenorrhea: is defined as No menses till the age of 14 without 2ry sex
characters or no menses till the age of 16 y with 2ry sex character.T
3. Menorrhagia: is defined as Excessive menstruation ↑80ml &/ or in duration > 7
days with abnormal cycle duration. F
4. Premature menopause: is defined as Permanent cessation of menstruation for ≥
one year before the age of 40. T
5. Menopause: is defined as Permanent cessation of menstruation for ≥ one year
before the age of 40. F
6. Cervical dystocia Failure of effacement and dilatation of the cervix within a
reasonable time, without uterine contraction. F
7. Utero-sacral ligaments: 2 bands from back of fundus to 3rd sacral piece
surrounding the rectum. F
8. MOLDING It is the alteration of the shape of the fore-coming head while passing
through the resistant birth passage during labor T
9. Proliferative phase: is the Phase of building up of endometrium under the effect
of progesterone. F
10. Menstruation : is the 2-7 days,Periodic shedding of the endometrium occurring
between menarche & menopause T
2. 2ry amenorrhea: is defined as Cessation of menstruation for 6 consecutive
cycles ( in regular menses) or for 3 months. T
7. Labia Minora ( single labium minus): 2 folds internal to labia majora of non-
keratinized skin . T
8. The labia majora: 2 longitudinal elliptical skin folds (containing fat) T
9. Mons Pubis (Mons Veneris): It is pad of fat covered with hair over the sacrum T
10. Uterine inertia: Inefficient uterine contraction T
11. Precipitate labor: Rapid delivery takes < 8 h. F
13. Obstructed labor Failure of the delivery of the fetus due to uterine inertia F
14. Pubo-cervical ligaments = pubo cervicovesical fascia,From the anterior
aspect of the supravaginal cervix to the back of the Symphysis pubis. T
15. Utero-sacral ligaments: 2 bands from back of fundus to 3rd sacral piece
surrounding the rectum. F
16. Mackenrodt lig.=( cardinal = transverse = great cervical lig.) Fan shaped,From
lateral side of supravaginal cervix & vaginal vault to lateral pelvic wall (white line) It
forms the base of the broad ligament T
17. CAPUT SUCCEDANEUM It is the formation of swelling due to stagnation of fluid
in the layers of the scalp beneath the girdle of contact T

Match the following terms with the most appropriate definition.

1. Missed abortion
2. Septic abortion
3. Recurrent abortion
4. Therapeutic abortion
a. Infection of any type of abortion
b. Termination of pregnancy for sake of the mother
c. Retention of dead embryo or fetus inside the uterus
d. 2 -3 successive spontaneous abortions
ANS: 1C 2A 3D 4B
Match the following terms with the most appropriate definition.
5. Hypertension
6. Proteinuria
7. Gestational hypertension
8. Preeclampsia
a. BP ≥140/90 mm Hg for the fi rst time in pregnancy after 20 weeks, without
proteinuria
b. Gestational hypertension with proteinuria
c. BP ≥140/90 mm Hg measured two times with at least 6-hour interval
d. Urinary excretion of ≥0.3 g protein/24 hours specimen or 0.1 g/L
ANS: 5C 6D 7A 8B
Match the following terms with the most appropriate definition.
9. Obstructed labor
10. Cervical dystocia
11. Precipitate labor:
 12. Uterine inertia:
a. Inefficient uterine contraction
b. Rapid delivery takes < 3 h.
c. Failure of effacement and dilatation of the cervix within a reasonable time,
with good uterine contraction.
d. Failure of the delivery of the fetus in spite of good uterine contraction due
to mechanical obstruction
ANS: 9D 10C 11B 12 A

Match the following terms with the most appropriate definition.

13. Ectopic pregnancy
14. Vesicular mole
15. Placenta previa
16. Accidental hemorrhage
a. Benign tumor of the trophoblasts in which the chorionic villi or part of it are
transformed into vesicles filled with fluid.
b. Premature separation of normally situated placenta
c. Implantation of the fertilized ovum outside the uterine cavity
d. Implantation of the placenta (partially or completely) in the lower uterine
segment
ANS:13 C 14 A 15 D 16 B
Match the following terms with the most appropriate definition.
17. Attitude
18. Lie:
19. Presentation:
20. Position:
a. It is the 1st part of the fetus that meets the pelvic brim = 1st felt by P.V
b. It the relation of the denominator (fixed bony point on the presenting part)
to the maternal pelvis
c. It is the relation between the longitudinal axis of the fetus and that of the
mother.
d. It is the relation of the fetal parts to each other.
ANS: 17D 18 C 19 A 20 B