Obstetrics and Gynaecology (O & G) solved MCQs

1. Which is not required for the diagnosis of pregnancy induced hypertension?

a. systolic BP rise of > 30mmHg above pre pregnancy level

B. diastolic BP rise of > 15mmHg above pre pregnancy level

c. an absolute BP of >140/90

d. occur after the 20th week of gestation

e. proteinuria

2. Which is not a risk factor for preeclampsia?

a. molar pregnancy

B. multigravida

c. age < 20 years

d. multiple pregnancy

e. family history

3. Which statement is not true with regards to preeclampsia?

a. it is due to a state of fluid overload

B. the oedema must be generalized

c. the proteinuria often occurs after the odema and hypertension

d. if left untreated it can progress to eclampsia and the HELLP syndrome

e. it is characterized by ischemia and thrombosis of end organs

4. Which is not accurate with regard to management of Eclampsia?

a. seizures are usually self terminating if left untreated but will recur

B. magnesium sulphate 4gm should be given over 15 minutes for seizure control, then infused at 1gm per hour

c. the desired BP is a diastolic BP of 90mmHg

d. magnesium sulphate does not lower BP

e. hydrallazine is the agent of choice to lower BP, 5mg every 20 minutes

5. Which would be consistant with a seizure due to eclampsia?

a. there is status epilepticus

B. no proteinuria or hypertension

c. focal neurological signs

d. it responds to benzodiazapines

e. there is a persistently decreased conscious post seizure

6. Which is not a risk factor for an ectopic pregnancy?

a. fertility treatment

B. IUD in situ

c. Endometriosis

d. Previous tubal infection

e. Family history

7. .At what bHCG would the chance of an ectopic pregnancy be 90% if a transvaginal ultrasound showed anempty uterus?

a. 500

B. 900

c. 1200

d. 1600

e. 2000

8. At what bHCG can you reliably see an intrauterine pregnancy with a transabdominal ultrasound?

a. 4000

B. 5000

c. 5500

d. 6500

e. 7500

9. Which is incorrect with regards to ectopic pregnancy?

a. incidence in the standard population is 20/1000

B. the incidence of a hetertopic pregnancy in the standard polulation is 1:4000

c. the presence of abdominal or pelvic pain is the most sensitive symptom or sign

d. an intruterine gestational sac can usually be seen at 5 weeks on a TV ultrasound and at 6 weeks on a transabdominal ultrasound

e. the ectopic rate is subsequent pregnancies is 10%

10. Which is incorrect with regards to Rhesus isoimmunisation?

a. The chance of a Rh-ve mother developing antiD antibodies to a Rh+ve fetus is less than 20% (even if not given antiD)

B. Anti D must be given within 24 hours to have any substantial effect

c. The risk of maternofetal transfusion is very small in a first trimester abortion and thus a smaller dose of anti D could be given

d. The IgM anti D antibodies cannot cross the placenta but the IgG antibodies can

e. It is a blood product.

11. Which is incorrect with regards to anti D?

a. it is given IV

B. The Kleihauer test is done to determine to quantify the fetomaternal hemorrhage and thus the amount of anti D required

c. If the mother’s serum has antiD antibodies detected in her serum at 24-48 hours after injection then the dosage is adequate

d. If given from 3-10 days after fetomaternal transfusion is still has some effect

e. 1ml protects against 6ml of fetal RBC’s

12. with regards to the different categories of abortion which is incorrect?

a. in an incomplete abortion the cervix may be open or closed

B. in an inevitable abortion the cervix is open

c. in a complete abortion the cervix is closed and bleeding and pain minimal

d. in a threatened abort the cervix is open

e. in a septic abortion the pt is characteristically febrile with PV bleeding and crampy pain

13. Which statement is incorrect?

a. in the normal pregnancy the bHCG increases by 66% every two days

B. the bHCG should plateau at when it reaches 1-2 million at 20 weeks gestation

c. the current serum test can detect bHCG at 2-3 days post implantation

d. a falling bHCG does not rule out the chance of rupture in an ectopic pregnancy

e. approximately 50% of patients with a threatened abort will go on to complete the pregnancy

14. Which is not a true statement with regards to a normal pregnancy?

a. the resting heart rate increases by 15-20 beats / min by the end of the third trimester

B. the blood volume increases by 45%

c. polycythemia develops

d. there is a leucocytosis up to 18 000

e. the bladder becomes an abdominal organ

15. Which statement is incorrect with regards to radiation exposure to the fetus?

a. the minimum exposure known to cause risk o the fetus is <0.1Gy (1000microGy)

B. a CXR and Pelvic Xray are well below the minimum toxic level

c. a VQ scan falls well below the toxic level

d. a CT abdomen falls well below the toxic level

e. a CXR has the same radiation as one transatlantic air flight

16. Which is not true with regards to placental abruption and trauma in pregnancy?

a. it is the most common cause of death if the mother survives

B. the incidence in minor trauma is up to 5% and up to 50% in major trauma

c. it can occur up to 4 hours post accident

d. CTG monitoring for a 4 hours is thought to predict nearly all pts of minor trauma who will develop placental abruption

e. It is characterized by pelvic pain uterine contractions and vaginal bleeding

17. Which statement is incorrect with regards to dysfunctional uterine bleeding

a. it is very rare in the teenage years

B. it is usually due to anovulatory cycles

c. oestrogen is used acutely to slow bleeding by contracting the uterine arteries

d. cyclical progesterone is used if it is a chronic problem

e. in patients over 35 years endometrail biopsy should precede oetrogen administration

18. Which three must be present to make the diagnosis of PID?

a. temp >38.3, abdo pain, vaginal discharge

B. temp > 38.3, abdominal pain, cervical excitation

c. abdo pain, adnexal tenderness, increased CRP

d. adnexal tenderness, vaginal discharge and increased CRP

e. abdominal pain, cervical excitation and adnexal tenderness

19. Which agent is not one recommended in the 2000 antibiotic guidelines for the treatment of outpatientsexually acquired PID?

a. Metronidazole 400mg b.d orally for 14 days

B. ceftriaxone 250 mg IM stat dose

c. augmenten duo forte 875/125 b.d orally for 14 days

d. doxycycline 100mg b.d orally for 14 days

e. roxithromycin 300mg o daily for 14 days if breast feeding

20. The risk of infertility after a single episode of PID is approximately?

a. 5%

B. 10%

c. 20%

d. 25%

e. 35%

21. Non sexually acquired PID should be treated with doxycycline and what according to the 2000 AntibioticGuidelines?

a. metronidazole

B. ciprofloxacin

c. ceftriaxone

d. augmented duo forte

e. cephalexin

22. Which is an incorrect statement with regards to ovarian torsion?

a. 70% of cases occur in women less than 30 years of age

B. 20% of cases in women less than 30 are associated with pregnancy

c. it has an increased incidence in women receiving ovarian stimulation treatment

d. a tender mass is felt in 10% of cases

e. when it occurs in post menopausal women, neoplasm should be excluded

23. Which of the below is not consistent with trichamonas vaginitis?

a. flagella are seen on a wet prep

B. copious frothy grey green discharge

c. a strawberry cervix on examination

d. evidence of other sexually transmitted diseases

e. treated with doxycycline

24. Which is not a risk factor for vaginal candidiasis?

a. prepubertal

B. diabetes

c. immunosuppression

d. pregnancy

e. hormone replacement therapy

25. Which is not true with regard to bacterial vaginitis?

a. it is the most common cause of vulvovagintis in women of childbearing age

B. clue cells are seen

c. it can be a normal commensal

d. it is not sexually transmitted

e. treatment is with metronidazole

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