Obs Papers Finalized

OBSTETRICS SEM 10 2016
1)Anti-D prophylaxis given at:

A. 28wk & 32wk of pregnancy
B. 28wk & 32wk and 72hrs after sensitizing event
2)MCC of PPH?
A. Uterine atony
B. Genital tract trauma
C. Eclampsia
3)NOT a risk factor for GDM:

A. Placenta previa
4)Difficult labor due to deep transverse arrest associated with?

A. Android pelvis
5)First step in massive obstetric hemorrhage:

A. Summon help senior multidisciplinary team
B. Arrange FFP
C. O2 by mask
6)Most important benefit of early pregnancy scan?

A. Accurate dating in women with irregular menstrual cycle
7) Aim of safe motherhood:

A. Care by skilled health personnel for child birth
8)Woman was on antihypertensive now pregnant. Which antihypertensive you give?

A. Methyldopa
9)Aim of booking visit?

a) Risk assessment
10) Which is not complication of neonate of diabetic mother? (odd one out)
a) Hypoglycemia
b)Polycythemia
c) Hypomagnesemia
d)Anemia
e) Hypobilirubinemia
11) NOT a risk factor for GDM?

A. Down syndrome
12) Chordocentesis:
a) Can be perform till 40wks
b)Karyotype culture not available
c) Risk of miscarriage is 1%
d)Transabdominal route
e) Fetal WBCs used
13) Essential HTN pt, pregnant now, develops proteinuria. Dx:

a) Superimposed Preeclampsia
14) Pregnancy-induced HTN pt, develops proteinuria. Dx:

A. Preeclampsia
15) Forcep:
a) Gestation less than 34wks should be manage with vaccume
b)Full dilatation not required
c) Head engagement not required
d)Indicated in face presentation
e) Cause vaginal tear/trauma
16) Polyhydaminos:
a) Amniotic fluid index > 95% centile
17) Pregnant lady diagnosed case of fibroid now presents with abdominal pain.
a) Red degeneration
18) Atrophic endometritis treatment

a) Estrogen cream
19) Treatment of type-IV placenta previa:

a) Emergency LSCS
20) First sign of amniotic fluid embolism:

a) Breathlessness
21) Which of the following indicates acute infection of Hep.B?

a) HBeAg
22) Method of assessing accurate weight of the baby:

a) Abdominal circumference
23) Assessment of renal function in Preeclampsia:

a) Creatinine
24) Duration of lactational amenorrhea:

a) 6 Months
25) Question regarding anemia (NOT Remembered)

a) PCV
26) Woman pregnant, breech presentation & again in next pregnancy with breech. Cause:
a) Bicornuate uterus
27) Regarding fetal skull:

a) Area of vertex bounded by two parietal bones and ant. & post. fontanelle
28) In dichorionic diamniotic twin, division occurs at:

a) 3rd Day
29) Risk in monoamniotic monochorionic twin:

a) Preterm birth
30) Screening used for:

a) High risk women
b)All women of reproductive age
c) Selected ones
31) Chin presentation, diameter?

a) 9.5 cm
32) A woman has still birth. Weight of the baby is 3.8 kg. Investigation to reach the cause for still
birth:
a) Urinalysis
b)OGCT
c) OGTT
d)RBS
33) Perinatal death:

a) No. of still birth OR death of baby in early neonatal period
34) For the dx of iron def anemia:

a) MCV + Ferritin
35) Which of the following least imp in labs of anemia:

a) Hematocrit
36) Nephrogenic cord formd at?

a) 4-5wks
b)5th wk
c) 5-6wk
37) Investigation to evaluate intra-uterine death: U/S, F.W.B
38) Woman after delivery on 3rd day developed tender swelling at right breast, fluctuation
positive. Dx:
a) Breast Abscess
b)Mastitis
39) Monochorionic twins associated with the following complication:

a) TTTS
40) Preterm baby , collapsed poor apgar score decrease breathing , immediate management:
a) O2
b)Incubation & ventilation
c) Surfactant
41) Risk of perianal pain after 3 days of delivery?

a) 20%
b)50%
c) 60%
d)80%
42) MCC of prenatal birth: infections
43) Wrong one:

a) Spermatogonia form mature sperm
44) Lady after delivery presents with dysuria & loin pain. Investigation:
a) Urine culture
b)Blood culture
c) U/S
d)X-Ray
45) Child failure to thrive lethargic irritable, investigation: a) RBS
46) Pregnant lady at 34 weeks of gestation, Hb=7. Rx:

a) Parentral iron therapy
47) Screening test for:

a) Syphilis
48) Mgmt of Preterm baby:

a) ICU Care
49) Mitral stenosis question (NOT Remembered)

a) Grade I-IV
50) Pre-pregnancy counseling in mitral stenosis:
51) Primitive streak develops at which week of gestation? 4th wk
Q’s regarding: (NOT Remembered)
52) Sickle cell crisis (hereditary)
53) Heparin & Stocking
54) Birth canal
55) Fetal skull

Rest of the short Q’s & their options are not remembered.
QUESTIONS 81 to 83
CASE: Pregnant lady with BMI > 35, etc.
81) Dx:
a) Gestational diabetes
82) Investigation for dx:

a) OGTT
83) Follow-up:
QUESTIONS 84 & 85
CASE: Case of IUGR (NOT Remembered)
84) Dx:
a) IUGR
85) Investigation:
a) US AFI
QUESTIONS 86 to 88
CASE: Abnormal labor case (NOT Remembered)
86) Dx:
a) Primary dysfunctional labor
87) Rx:
a) ARM
88) Cause:
a) Insufficient uterine contractions
QUESTIONS 89 to 91
CASE: Placenta Abruptio case (NOT Remembered)
89) Dx:
a) Placental abruption
90) Risk factor:

a) Previous C-Section
91) Complication:
a) Hypovolumic shock
QUESTIONS 92 to 94
CASE: 8 hour labour pain, chin presentation ...cm dilatation cervix effacement.
92) Mode of delivery:
a) Emergency CS
b)Vacuum assisted
c) Wait for spontaneous labor
93) Complication:
a) Obstructed labor
94) Presenting diameter:

a) 9.5 cm
QUESTIONS 95 & 96
CASE: Woman after delivery at 3rd day develops high grade fever & abdominal pain.
95) Dx:
a) Retained POC
b) Puerperal Sepsis
96) If associated with genital tract infection then the condition is:
a) UTI
b) Wound Infection
QUESTIONS 97 to
CASE: Obstetric cholestasis case (Q’s NOT Remembered)

+0
2. A 38 years old G5 P4 in second stage of labour became dyspnoeic and collapsed she was
suspected having amniotic fluid embolism. What could be the most likely associated complication?
a) DIC (TT 19TH EDITION PG 253)
b) Septicemia
c) Renal failure
d) Cerebral hemorrhage
e) Placental abruption
3. A 32 year old para 1+0 presents in OPD with complain of swelling, weakness and pain in left leg
since 3 days. She delivered by emergency LSCS 5 days back. She also complains of headache, fever
and chest pain. Which of the following is the cause of her condition
a) Mastitis
b) Pneumonia
c) Deep venous thrombosis (TT 19TH EDITION PG 91)
d) Meningitis
e) Chest infection
4. A 22 years G5P4+0 attends an antenatal clinic at 16 weeks of pregnancy. Her Hb is 8 gm/dl, MCV
69 fl, MCH 22, MCHC 28 g/dl. Cause of her anemia is?
a) Sickle cell
b) Malabsorption syndrome
c) Urinary tract infection
d) Thalassemia
e) Low iron reserve (because of low MCHC)
5. Major aneuploidies are best and early diagnosed by utilizing which laboratory technique:
a) Enzymatic analysis
b) Biochemical analysis
c) Cytogenetic analysis by FISH technique
d) Direct cytogenetic analysis
e) DNA analysis
6. Most women in developing countries are at risk during pregnancy of:
a) Anemia
b) Intercurrent illnesses
c) Short birth interval
d) Previous multiple pregnancies
e) Induced abortion
6. Regarding respiratory distress syndrome best statement is
a) Ground glass appearance on X-Ray films is pathognomonic
b) Give post natal surfactant alone
c) Occur in 100 percent of infants delivered at 26 weeks of gestation (TT 19TH EDITION PG
299)
d) Antenatal steroid alone can be beneficial
e) Diagnosis confirmed by air bronchogram
7. Commonest cause of maternal mortality worldwide is
a) Infection
b) Obstructed labour
c) Eclampsia
d) Hemorrhage (TT 18TH EDITION PG 25)
e) Unsafe abortion
8. A multigravida presents with the history of good size baby by SVD in last few hours. While
delivering, after delivery of baby’s head, basic step in managing this case of shoulder dystocia is:
a) Symphysiotomy
b) Suprapubic pressure
c) Traction on baby’s head
d) ??? anterior arm
9. Fetal skin takes the appearance of adult skin from:
a) 18 weeks of gestation
b) 20 weeks of gestation (TT 19TH EDITION PG 43)
c) 22 weeks of gestation
d) 23 weeks of gestation (TT 18TH EDITION PG 67)
e) 25 weeks of gestation
10. Acute complication of preterm baby is:
a) Hypoxia
b) Hyperglycemia
c) Hypothermia
d) Premature closure of ductus arteriosus
e) Anemia
11. The distinctive feature of fetal circulation include:
a) Oxygenation occur in lungs
b) Oxygenation occurs in placenta (IM Pg 151)
c) Right and left ventricles works in series
d) Heart lung and brain receives blood from right ventricle
e) Placenta receives blood from right ventricle alone
12. Diabetic mother usually shows following complications:
a) Vasa praevia
b) Placental abruption
c) Placenta praevia
d) Placenta accrete
e) Retained placenta
13. Regarding neonatal care select best correct statement:
a) APgar score replaced detailed examination of newborn describing the baby’s condition
b) Infant who fails to breathe after birth is due to deprivation of oxygen to brain before birth
(TT 19TH EDITION PG 283)
c) Preterm deliveries doesn’t require a trained neonatal resuscitator
d) APgar score includes color, pulse rate, respiratory rate, muscle circumference
e) Use of any medication during neonatal resuscitation is contraindicated
14. 30 years old 2nd gravid Para 1+0 previous normal vaginal delivery comes to antenatal clinic
for routine checkup. She is 41 weeks pregnant , she didnt develop spontaneous onset of labor and
refusing for induction of labor. Risk of perinatal mortality is increased after 42 weeks of pregnancy
upto:
a) 10 folds
b) No increase in perinatal mortality
c) Four folds
d) Two folds(TT 18TH EDITION Pg 141)
e) Twenty folds
15. A new born baby failed to respond to resuscitative procedure. Prognosis for infant survival
grimed if no cardiac activity is seen at CPR after:
a) 20 minutes of resuscitation (TT 19TH EDITION PG 286)
b) 25 minutes of resuscitation
c) 10 minutes of resuscitation
d) 15 minutes of resuscitation
e) 30 minutes of resuscitation
16. 30 year old primigravida presents to OPD with ?? weeks of pregnancy, generalized itching,
worst on palm and soles, pale stools and dark urine. Her routine investigation are normal with
mildly deranged LFTs. What is the probable diagnosis:
a) Pre eclampsia
b) Viral hepatitis
c) HELLP syndrome
d) Acute fatty liver disease of pregnancy
e) Obstetric cholestasis (IM PG 215)
17. Define maternal death:
a) Death of woman while pregnant
b) Death of woman in last trimester of pregnancy
c) Death of woman while pregnant or within 42 days of termination of pregnancy
d) Death of woman with 42 days of delivery
e) Death of woman while pregnant or within 42 days of delivery
18. A primigravida came at 10 weeks gestation with history of prolonged menstrual cycles. What
measurements are required to accurately assess the fetal age from 12-20 weeks of gestation?
a) Abdominal circumference, head circumference
b) Crown rump length, femur length
c) Head circumference, femur length, CRL
d) Abdominal circumference, biparietal diameter
e) Head circumference or BPD (BPD-IM Pg 161)(HC-TT 19th EDITION PG 63)
19. A 30 year old G3 P2+0 admitted with 39 weeks of gestation and in labour for 6 hours. Fetal
assessment in labor will be performed by:
a) Intermittent auscultation
b) Color of liquor
c) Fetal scalp blood sampling
d) Continuous EFM
e) CTG
20. Generally in twin pregnancy the average gestational age of delivery is:
a) 30 weeks
b) 32 weeks
c) 28 weeks
d) 35 weeks (DAMC)
21. Average gestational age at delivery in twin pregnancy is :
A. 28 weeks
B. 32 weeks
C. 35 weeks
D. 37 weeks (TT 19TH EDITION Pg 111)
E. 40 weeks
22. Mrs ABC G1 P0+0 present in ER at 34 weeks with vaginal bleeding and abdominal pain. HOF
is 36 cm. contractions are 2 in 10 minutes. Best clue to reach diagnosis:
a) Symphysio fundal height b) Engagement of head
c) Parity
d) Amount of blood loss (TT 19TH EDITION Pg 247) e) Gestational age
23. Mrs XYZ had lower section C Sec. on 2ndpost operative day she developed pain, swelling and
tenderness in right leg muscles. She is diagnosed as deep vein thrombosis. What is best treatment
for her:
a) Antibiotic cover b) Mobilization
c) Incision and drainage d) Rest and physiotherapy e) Heparin
24. During delivery by forceps. Traction should be:
a) Intermittent for 10 min
b) Intermittent with uterine contraction (TT 19TH EDITION Pg 232)
c) Intermittent with maternal expulsive efforts (TT 19TH EDITION Pg 232)
d) Continuous with contractions
e) Intermittent for 20 min
25. Regarding poor progress in first stage of labor:
a) Occurs in presence of 4-5 uterine contractions every ten minutes
b) Is not seen in women with gynecoid pelvis
c) Is seen in android type of female pelvis
d) Requires delivery by Caesarean Section
e) Requires oxytocin administration in all cases
26. You are on duty in LR. Mrs XYZ is planned for normal vaginal delivery with dilation of cervix.
Her amniotomy is performed and there is sudden gush of blood. Immediate diagnosis is?
a) Vasa praevia
b) Heavy show
c) Placental abruption
d) Placenta previa
e) Marginal bleed
27. 22 year old P1+0 history of EMLSCS 2 days back was found ??? post operative day to have
fever. Baby is admitted to NICU. On exam pulse 110, bp 110/70 , temp 101 , chest clear. Ut is intact
with dressing and clear wound. Most likely diagnosis is
a) DVT
b) Engorged breast
c) Endometritis
d) Wound infection
e) Chest infection
28. You are conducting delivery of a primigravida. She is in 2nd stage of labor for last 2 hours.
Presenting part is below ischial spine , you decided to apply ventouse cup. What would be the
appropriate pressure of the vaccum cup:
a) 0.6 kg/ cm2 (TT 19TH EDITION Pg 230)
b) 0.8 kg/ cm2(TT 19TH EDITION Pg 230)
c) 0.7 kg/ cm2
d) 0.9 kg/ cm2
e) 0.5 kg/ cm2
29. Daily iron requirement of a healthy non pregnant female is:
a) 2 mg
b) 15 mg
c) 4 mg
d) 3 mg
e) 30 mg
30. Important aim of antenatal care is
a) Provide support to woman
b) Provide health education
c) Detect and manage factors adversely affecting health
d) Provide general health screening
e) Treatment of minor ailment in pregnancy
31. A 38 year old para 5+2 present in emergency with 38 weeks pregnancy having abdominal
pain and heavy bleeding P/V since 1 hour. She gives history of chronic hypertension, CTG was done
which showed deceleration of fetal heart rate. Emergency C-Section under regional anaesthesia
was planned. But the anaesthetist decides to give general anaesthesia, after reviewing laboratory
investigations which are as follows:
HB 8.5 gm, plts: 56x109/L, INR 2.2 HELPP
Which of the following is most probable reason for general anesthesia
a) Hypertension
b) Coagulopathy
c) Systemic sepsis
d) Local sepsis
e) Hypovolemia
32. Embryo remain in fallopian tube till following state:
a) Blastocyst
b) Zygote
c) Morula
d) Bilaminar germ layer
e) Trilaminal germ layer
33. APgar score is usually recorded at:
a) 1 and 5 min (TT 19TH EDITION Pg 284)
b) 1 and 10 min
c) 5 and 10 min
d) 1 and 15 min
e) 2 and 10 min
34. P1+0 previous NVD attend antenatal clinic at 38 weeks with placenta praevia type III. You will
advise her:
a) Emergency caesarean section
b) Elective caesarean section
c) Normal vaginal delivery
d) Induction of labor
e) Vaccuum delivery
4+0
35. P with normal vaginal delivery came with bleeding per vaginum for last 1 hour. She is in
state of shock. Immediate first step of management will be:
a) Sample for full blood count
b) Summon help
c) Fluid resuscitation
d) Clotting studies
e) Transfusion of blood
36. Iso immunization in Rh negative women, anti-D immuno globulin should be given at:
a) 48 hours of delivery
b) 72 hours of delivery (IM Pg 183)
c) 65 hours of delivery
d) 80 hours of delivery
37. 38 year old P3+0 with known diabetes had anomaly scan at 20 week of gestation. How much
risk she has as compared to any other pregnancy:
a) 2-4 times (TT 18TH EDITION Pg 186 ) (TT 19TH EDITION Pg 284)
b) 8-9 times
c) 10-12 times
d) 5-6 times
e) 0-1 times
38. Post partum hemorrhage
a) Most important cause, accounting for 90 % cases are uterine inversion
b) Management involves administration of ergometrine and synctocinon as 1st step
c) Defined as excess blood loss greater than 500 ml in first 24 hours as primary and 24 to 48
hours as secondary
d) Traditionally excess loss is described as >500mls which is a very accurate
e) Management involves multi disciplinary (TT 19TH EDITION Pg 244)
39. Following risk factor should not be missed from previous obstetrics history:
a) Previous 3 caesarean section
b) Intrauterine growth restriction
c) Recurrent miscarriages
d) Preterm delivery
e) Abruption placenta
40. Regarding screening of development dysplasia of hip in neonates. Following test is most
reliable in establishing a diagnosis?
a) Ultrasound of hip joint
b) Ortolani-barlow method (TT 19TH EDITION Pg 290)
c) X-ray of hip joint
d) Restricted abduction on examination of hip joint
e) Clicky hip on abduction of hip joint
41. Part of pelvis which is bounded in front by lower segment pubic symphysis, lateral walls by
descending ramus of pubic bone, ischial tuberosity, sacrotuberous ligament and posteriorly by last
piece of sacrum is:
a) Pelvic outlet (IM Pg 249)
b) Mid cavity
c) False pelvis
d) True pelvis
e) Pelvis inlet
42. 30 year old P3+0 last born 3 days back by forcep vaginal delivery came to gynaecology OPD
with complaints of fever, pain and swelling in leg. On examination pulse is 100 b/min, temp is 38 oC.
Left leg is tender what is your diagnosis:
a) Cellulitis
b) Deep vein thrombosis
c) Pregnancy induced hypertension
d) Thrombophlebitis
e) Lymphatic obstruction
43. Following changes occur due to volume expansion in pregnancy:
a) Larger increase in plasma volume leads to hemoconcentration
b) It Usually begin after implantation at 6th day
c) Overall total body water increase 8-10 L by the end of pregnancy
d) In this process of expansion plateau occur at 32-34 weeks (TT 19TH EDITION Pg 21)
e) The plasma osmolality increases by 10 m Osmol/kg
44. Kleiuhauer test is used to see:
a) Fetomaternal hemorrhage (TT 19TH EDITION Pg 106)
b) Fetal thrombocytopenia
c) Autoimmune anaemia
d) Fetal anemia
e) Maternal anaemia
45. Female with previous baby having down syndrome, wants to know risk of down syndrome in
current pregnancy . What test are appropriate in 11 to 15 weeks of gestation:
a) HCG, PAPPA & AFP
b) HCG ,PAPPA (IM pg 174)
c) HCG ,AFP
current pregnancy. NTS should be done in what weeks:
a) 11-14 weeks
b) 10 -14 weeks
c) 11-13 weeks (IM Pg 149)
d) 19-22 weeks
e) 15-18 weeks
47. Pregnant female in her early pregnancy present with BP 150/100. U/S showed a single alive
fetus with IUGR. What would be your next investigation:
a) CTG
b) Umblical artery Doppler
c) FBS
d) BPP
48. Beta agonist is given in labor. It will:
a) Delay the labor for 48 hours (TT 19TH EDITION Pg 139)
49. Placenta praevia type 1 is:
a) Placenta near os but not covering it
b) Greater than 5 mm away from internal os
c) Less than 5 mm away from internal os
d) Cover whole os
e) Cover some but not all os
50. Women delivered baby 4 weeks back , now came to gynaecology OPD for contraceptive
advice. You will give her:
a) POP
b) IUCD (IM Pg 301)
c) Copper T
d) Tube ligation
e) COCP
51. Female pregnant having high BP, low plts, increase LFTs. Your diagnosis:
a) AFLD
b) HELLP
c) Eclampsia
d) Cholestasis
52. Symptoms of fulminating pre eclampsia include:
a) Headache and blurred vision
b) Epigastric pain
53. Case of gestational hypertension, drug of choice is:
a) Methyldopa
54. Case of gestational hypertension. Which drug should not be given:
a) ACE inhibitors
55. Case of eclamptic fit. Drug of choice:
a) MGSO4
56. Cause of death in eclampsia is:
a) Intracerebral hemorrhage (TT 19TH EDITION Pg 250)
b) Convulsions
57. About neonatal resuscitation, select best statement:
a) No drug should be given
b) Terminal apnea is last stage
c) ETT should be given to any apnoeic baby
d) Rate of transient apnea is greater than terminal apnea
58. Heart beat of healthy baby is:
a) Greater than 100 (TT 19TH EDITION Pg 284)
b) 110-160 (TT 19TH EDITION Pg 67)
59. Diabetic mother is at risk to develop what complication most likely:
a) Nephropathy
b) Retinopathy
c) Coronary heart disease
60. Cause of hematuria and proteinuria in pregnancy:
a) DIC
b) Renal failure
c) Renal stone
d) UTI
61. Aim of 2nd trimester u/s:
a) Detect fetal anomaly
b) Accurate dating in women with irregular cycles
c) Fundal height
62. Total number of germ cells in female at birth:
a) 2 million (LANGMAN)
b) 8 million
c) 1 million
d) 10 million
63. Female with history of preterm birth in last pregnancy at 34 weeks. Now wants to know
chances of preterm birth in this pregnancy. She is in her 23 week of gestation. Her cervical length
would be:
a) 2 cm
b) 6 cm
c) 1.5 cm
d) 3-4 cm
64. Second degree perineal tear involves:
a) Skin + muscle (TT 19TH EDITION Pg 225)
65. Women with pancreatitis in pregnancy what would be your next step:
a) Conservative treatment
66. Severe hypertension effect which organ:
a) Kidney
67. Women with twin pregnancy. One fetus dead one alive. He has oligohydramnios what organ
is affected in his body:
a) Kidney
b) Brain (TT 19TH EDITION Pg 112)
c) Heart
d) Liver
e) Adrenal Gland
68. Fetus born with blue extremities and pink face, his shows grimace, his R.R is irregular, H.R is
greater than 100, muscles show some flexion. What will be his aPgar score:
a) 6 (TT 19TH EDITION Pg 284)
b) 8
69. Women 10 weeks pregnant presents in ER with fits. Most likely cause is:
a) Eclampsia
b) Epilepsy
70. Investigation not required in AFLP:
a) Ultrasound
b) LFT
c) X-Ray
d) Liver biopsy
71. Female presented after delivery with fever, cough and excellent wound healing, diagnosis?
a) Chest infection
b) TB
c) COPD
d) Its normal
72. Causes of perinatal mortality ?
a) Malnutriton
73. Not a feature of cholestasis?
a) Rash
b) Itching
c) Pale
SBL For Questions 73 to 75

SCENARIO
(A 24 year old G2P1+0 comes to antenatal clinic with gestational amenorrhea, tachycardia and
shortness of breath. She has childhood history of high grade fever, sore throat and joint pain.)
74. What is the diagnosis of this patient?
a) Aortic stenosis
b) Mitral stenosis
c) Pulmonary stenosis
d) Tri-cuspid stenosis
e) Eisenmenger’s syndrome
75. In the management of second stage of labour in this patient:
a) Use prophylactic antibiotics
b) Use syntocinon judiciously
c) Keep in supine position (TT 19TH EDITION Pg 153)
d) Keep second stage short
e) Use epidural / regional anaesthesia or analgesia
76. Most useful investigation in early pregnancy is:
a) ECG
b) Echocardiography
c) ETT
d) Thallium scan
e) X-ray chest
SBL For Question 76
77. A 20 year old primigravida admitted in labor with 38 weeks of pregnancy. She is known case
of mitral stenosis corrected 10 years back, on exam pulse is ?? , bp is 100/70, temp 98. On
abdominal exam SFH is 36 weeks, cephalic presentation. Pelvic examination show cervical os
dilated 4 cm membranes intact. What would be your management in labor?
a) Spontaneous labor
b) Emergency C-Section
c) Oxytocin + artificial rupture of membrane
d) Vacuum delivery
e) Outlet forcep
SBL For Question 77
78. 32 years old G6P5+0 came in ER with complain of 37 weeks of gestation with labor. On P/V
examination cervical os is 6 cm dilated presenting part is anterior fontanelle and now presented in
brow presentation is:
a) Mento vertical (TT 19TH EDITION Pg 190)
b) Sub mento bregmatic
c) Sub mento vertical
d) Sub mento occipital
e) Sub occipito frontal
SBL For Question 78

79. A 30 year old P1+0 G 2nd underwent vaginal delivery and delivered 8 pound baby, placental was
spontaneously delivered. You have noticed unusual amount of bleeding around 700 mls. Uterine
fundus is well contracted. What is the cause of bleed?
a) Retained placenta
b) Genital tract lacerations
c) Uterine atony
d) Coagulopathy
e) Endometrial laceration
SBL For Question 79

80. A 32 year old P1+0 came at 32 weeks gestation. She had post natal depression in last
pregnancy. Her recurrence risk to develop post natal depression is:
a) 10 %
b) 25%
c) 50% (TT 19TH EDITION Pg 302)
d) 60%
e) 75%
SBL For Question 80

81. A 22 year old primigravida delivered by forceps after giving episiotomy. The single best
disadvantage of mid line episiotomy is:
a) Blood loss is more
b) Difficult to repair
c) Extending to anal sphincter (TT 19TH EDITION Pg 225)
d) Delayed healing
e) More painful in post partum
SBL For Question 81

82. Mrs ABC primigravida 29 years old presented to ER with complains of gestational amenorrhea
of ?? weeks and raised BP for 2 months with reduced fetal movements for 1 month. Ultrasound
shows single alive fetus of 32 weeks with amniotic fluid index of 5.8 cm2 . Reason of
oligohydramnios is:
a) Renal agenesis
b) Urinary tract malformation
c) Placental insufficiency
d) Preterm prelabour rupture of membrane
e) Intrauterine infection
SBL For Question 82

83. 28 years old P1+0 delivered at home by Dai after 17 days she complains of offensive lochia,
which investigation you will do:
a) Endometrial sampling
b) High vaginal swab for c/s (TT 19TH EDITION Pg 264)
c) Blood culture
d) Pap smear
e) Trans vaginal ultrasound
SBL For Question 83

84. G3P2+0 41 weeks pregnant, complaining of ??. which one of the following is appropriate
management for her:
a) Observe fetal movements
b) Emergency caesarean section
c) Biophysical profile
d) CTG monitoring
e) induction of labor

1. A 38 years old G5 P4+0 in second stage of labour became dyspnoeic and collapsed she was
suspected having amniotic fluid embolism. What could be the most likely associated complication?
a. DIC
b. Septicemia
c. Renal failure
d. Cerebral hemorrhage
e. Placental abruption
2. A 32 year old para 1+0 presents in OPD with complain of swelling, weakness and pain in left leg
since 3 days. She delivered by emergency LSCS 5 days back. She also complains of headache, fever
and chest pain. Which of the following is the cause of her condition
a. Mastitis
b. Pneumonia
c. Deep venous thrombosis
d. Meningitis
e. Chest infection
3.A 22 years G5P4+0 attends an antenatal clinic at 16 weeks of pregnancy. Her Hb is 8 gm/dl, MCV
69 fl, MCH 22, MCHC 28 g/dl. Cause of her anemia is?
a. Sickle cell
b. Malabsorption syndrome
c. Urinary tract infection
d. Thalassemia
e. Low iron reserve
4. Major aneuploidies are best and early diagnosed by utilizing which laboratory technique:
a. Enzymatic analysis
b. Biochemical analysis
c. Cytogenetic analysis by FISH technique
d. Direct cytogenetic analysis
e. DNA analysis
5. Most women in developing countries are at risk during pregnancy of:

a. Anemia
b. Intercurrent illnesses
c. Short birth interval
d. Previous multiple pregnancies
e. Induced abortion
6. Regarding respiratory distress syndrome best statement is

a. Ground glass appearance on X-Ray films is pathognomonic
b. Give post natal surfactant alone
c. Occur in 100 percent of infants delivered at 26 weeks of gestation (TT 19TH EDITION PG 299)
d. Antenatal steroid alone can be beneficial
e. Diagnosis confirmed by air bronchogram
7.Commonest cause of maternal mortality worldwide is

a. Infection
b. Obstructed labour
c. Eclampsia
d. Hemorrhage
e. Unsafe abortion
8. A multigravida presents with the history of good size baby by SVD in last few hours. While
delivering, after delivery of baby’s head, basic step in managing this case of shoulder dystocia is:
a. Symphysiotomy
b. Suprapubic pressure
c. Traction on baby’s head
d. anterior arm
9. Fetal skin takes the appearance of adult skin from:

a. 18 weeks of gestation
b. 20 weeks of gestation
c. 22 weeks of gestation
d. 23 weeks of gestation
e. 25 weeks of gestation
10. Acute complication of preterm baby is:

a. Hypoxia
b. Hyperglycemia
c. Hypothermia
d. Premature closure of ductus arteriosus
e. Anemia
11. The distinctive feature of fetal circulation include:

a. Oxygenation occur in lungs
b. Oxygenation occurs in placenta
c. Right and left ventricles works in series
d. Heart lung and brain receives blood from right ventricle
e. Placenta receives blood from right ventricle alone
12. Diabetic mother usually shows following complications:

a. Vasa praevia
b. Placental abruption
c. Placenta praevia
d. Placenta accrete
e. Retained placenta
13. Regarding neonatal care select best correct statement:

a. APgar score replaced detailed examination of newborn describing the baby’s condition
b. Infant who fails to breathe after birth is due to deprivation of oxygen to brain before birth
c. Preterm deliveries doesn’t require a trained neonatal resuscitator
d. APgar score includes color, pulse rate, respiratory rate, muscle circumference
e. Use of any medication during neonatal resuscitation is contraindicated
14. 30 years old 2nd gravid Para 1+0 previous normal vaginal delivery comes to antenatal clinic
for routine checkup. She is 41 weeks pregnant , she didnt develop spontaneous onset of labor and
refusing for induction of labor. Risk of perinatal mortality is increased after 42 weeks of pregnancy
upto:
a. 10 folds
b. No increase in perinatal mortality
c. Four folds
d. Two folds
e. Twenty folds
15. A new born baby failed to respond to resuscitative procedure. Prognosis for infant survival
grimed if no cardiac activity is seen at CPR after:
a. 20 minutes of resuscitation
b. 25 minutes of resuscitation
c. 10 minutes of resuscitation
d. 15 minutes of resuscitation
e. 30 minutes of resuscitation
16. 30 year old primigravida presents to OPD with ?? weeks of pregnancy, generalized itching,
worst on palm and soles, pale stools and dark urine. Her routine investigation are normal with
mildly deranged LFTs. What is the probable diagnosis:
a) Pre eclampsia
b)Viral hepatitis
c) HELLP syndrome
d)Acute fatty liver disease of pregnancy
17. Obstetric cholestasis Define maternal death:

a. Death of woman while pregnant
b. Death of woman in last trimester of pregnancy
c. Death of woman while pregnant or within 42 days of termination of pregnancy
d. Death of woman with 42 days of delivery
e. Death of woman while pregnant or within 42 days of delivery
18. A primigravida came at 10 weeks gestation with history of prolonged menstrual cycles. What
measurements are required to accurately assess the fetal age from 12-20 weeks of gestation?
a. Abdominal circumference, head circumference
b. Crown rump length, femur length
c. Head circumference, femur length, CRL
d. Abdominal circumference, biparietal diameter
e. Head circumference or BPD
19. A 30 year old G3 P2+0 admitted with 39 weeks of gestation and in labour for 6 hours. Fetal
assessment in labor will be performed by:
a. Intermittent auscultation
b. Color of liquor
c. Fetal scalp blood sampling
d. Continuous EFM
e. CTG

A.28 weeks
B. 32 weeks
C. 35 weeks
D. 37 weeks
E. 40 weeks
21. Mrs ABC G1 P0+0 present in ER at 34 weeks with vaginal bleeding and abdominal pain. HOF
is 36 cm. contractions are 2 in 10 minutes. Best clue to reach diagnosis:
a. Symphysio fundal height
b. Engagement of head
c. Parity
d. Amount of blood loss
e. Gestational age
22. Mrs XYZ had lower section C Section, on 2ndpost operative day she developed pain, swelling
and tenderness in right leg muscles. She is diagnosed as deep vein thrombosis. What is best
treatment for her:
a. Antibiotic cover
b. Mobilization
c. Incision and drainage
d. Rest and physiotherapy
e. Heparin
23. During delivery by forceps. Traction should be:

a. Intermittent for 10 min
b. Intermittent with uterine contraction Intermittent with maternal expulsive efforts
c. Continuous with contractions
d. Intermittent for 20 min
24. Regarding poor progress in first stage of labor:

a. Occurs in presence of 4-5 uterine contractions every ten minutes
b. Is not seen in women with gynecoid pelvis
c. Is seen in android type of female pelvis
d. Requires delivery by Caesarean Section
e. Requires oxytocin administration in all cases
25. You are on duty in LR. Mrs XYZ is planned for normal vaginal delivery with dilation of cervix.
Her amniotomy is performed and there is sudden gush of blood. Immediate diagnosis is?
a. Vasa praevia
b. Heavy show
c. Placental abruption
d. Placenta previa
e. Marginal bleed
26. 22 year old P1+0 history of EMLSCS 2 days back was found ??? post operative day to have
fever. Baby is admitted to NICU. On exam pulse 110, bp 110/70 , temp 101 , chest clear. Uterus is
intact with dressing and clear wound. Most likely diagnosis is
a. DVT
b. Engorged breast
c. Endometritis
d. Wound infection
e. Chest infection
27. You are conducting delivery of a primigravida. She is in 2nd stage of labor for last 2 hours.
Presenting part is below ischial spine , you decided to apply ventouse cup. What would be the
appropriate pressure of the vaccum cup:
a. 0.6 kg/ cm
B. 2.08 kg/ cm2
c. 0.7 kg/ cm2
d. 0.9 kg/ cm2
e. 0.5 kg/ cm2
28. Daily iron requirement of a healthy non pregnant female is:

a. 2 mg
b. 15 mg
c. 4 mg
d. 3 mg
e. 30 mg
29. Important aim of antenatal care is

a. Provide support to woman
b. Provide health education
c. Detect and manage factors adversely affecting health
d. Provide general health screening
e. Treatment of minor ailment in pregnancy
30. A 38 year old para 5+2 present in emergency with 38 weeks pregnancy having abdominal
pain and heavy bleeding P/V since 1 hour. She gives history of chronic hypertension, CTG was done
which showed deceleration of fetal heart rate. Emergency C-Section under regional anaesthesia
was planned. But the anaesthetist decides to give general anaesthesia, after reviewing laboratory
investigations which are as follows:
HB 8.5 gm, plts: 56x109/L, INR 2.2
Which of the following is most probable reason for general anesthesia?
a. Hypertension
b. Coagulopathy
c. Systemic sepsis
d. Local sepsis
e. Hypovolemia
31. Embryo remain in fallopian tube till following state:

A. Blastocyst
B. Zygote
C. Morula
D. Bilaminar germ layer
E. Trilaminal germ layer
32. APgar score is usually recorded at:

a. 1 and 5 min
b. 1 and 10 min
c. 5 and 10 min
d. 1 and 15 min
e. 2 and 10 min
33. P1+0 previous NVD attend antenatal clinic at 38 weeks with placenta praevia type III. You
will advise her:
a. Emergency caesarean section
b. Elective caesarean section
c. Normal vaginal delivery
d. Induction of labor
e. Vaccuum delivery
34. P4+0 with normal vaginal delivery came with bleeding per vaginum for last 1 hour. She is in
state of shock. Immediate first step of management will be:
a. Sample for full blood count
b. Summon help
c. Fluid resuscitation
d. Clotting studies
e. Transfusion of blood
35. Iso immunization in Rh negative women, anti-D immuno globulin should be given at:
a. 48 hours of delivery
b. 72 hours of delivery
c. 65 hours of delivery
d. 80 hours of delivery
36. 38 year old P3+0 with known diabetes had anomaly scan at 20 week of gestation. How much
risk she has as compared to any other pregnancy:
a. 2-4 times
b. 8-9 times
c. 10-12 times
d. 5-6 times
e. 0-1 times
37. Post partum hemorrhage

a. Most important cause, accounting for 90 % cases are uterine inversion
b. Management involves administration of ergometrine and synctocinon as 1st step
c. Defined as excess blood loss greater than 500 ml in first 24 hours as primary and 24 to 48 hours as
secondary
d. Traditionally excess loss is described as >500mls which is a very accurate
38. Management involves multi disciplinaryFollowing risk factor should not be missed from
previous obstetrics history:
a. Previous 3 caesarean section
b. Intrauterine growth restriction
c. Recurrent miscarriages
d. Preterm delivery
e. Abruption placenta
39. Regarding screening of development dysplasia of hip in neonates. Following test is most
reliable in establishing a diagnosis?
a. Ultrasound of hip joint
b. b. Ortolani-barlow method
c. C. X-ray of hip joint
d. Restricted abduction on examination of hip joint
e. Clicky hip on abduction of hip joint
40. Part of pelvis which is bounded in front by lower segment pubic symphysis, lateral walls by
descending ramus of pubic bone, ischial tuberosity, sacrotuberous ligament and posteriorly by last
piece of sacrum is:
a. Pelvic outlet
b. Mid cavity
c. False pelvis
d. True pelvis
e. Pelvis inlet
41. 30 year old P3+0 last born 3 days back by forcep vaginal delivery came to gynaecology OPD
with complaints of fever, pain and swelling in leg. On examination pulse is 100 b/min, temp is
38oC. Left leg is tender what is your diagnosis:
a. Cellulitis
b. Deep vein thrombosis
c. Pregnancy induced hypertension
d. Thrombophlebitis
e. Lymphatic obstruction
42. Following changes occur due to volume expansion in pregnancy:

a. Larger increase in plasma volume leads to hemoconcentration
b. It Usually begin after implantation at 6th day
c. Overall total body water increase 8-10 L by the end of pregnancy
d. In this process of expansion plateau occur at 32-34 weeks
e. The plasma osmolality increases by 10 m Osmol/kg
43. Kleiuhauer test is used to see:

a. Fetomaternal hemorrhage
b. Fetal thrombocytopenia
c. Autoimmune anaemia
d. Fetal anemia
e. Maternal anaemia
current pregnancy . What test are appropriate in 11 to 15 weeks of gestation:
a. HCG, PAPPA & AFP
b. HCG ,PAPPA
c. HCG ,AFP
current pregnancy. NTS should be done in what weeks:
a. 11-14 weeks
b. 10 -14 weeks
c. 11-13 weeks
d. 19-22 weeks
e. 15-18 weeks
46. Pregnant female in her early pregnancy present with BP 150/100. U/S showed a single alive
fetus with IUGR. What would be your next investigation:
a. CTG
b. Umblical artery Doppler
c. FBS
d. BPP
47. Beta agonist is given in labor. It will:

a. Delay the labor for 48 hours
48. Placenta praevia type 1 is:

a) Placenta near os but not covering it
b)Greater than 5 mm away from internal os
c) Less than 5 mm away from internal os
d)Cover whole os
e) Cover some but not all os
49. Women delivered baby 4 weeks back , now came to gynaecology OPD for contraceptive
advice. You will give her:
a. POP
b. IUCD
c. Copper T
d. Tube ligation
e. COCP
50. Female pregnant having high BP, low plts, increase LFTs. Your diagnosis:
a. AFLD
b. HELLP
c. Eclampsia
d. Cholestasis

a. Headache and blurred vision
b. Epigastric pain
c. Agitation
52. Case of gestational hypertension, drug of choice is:

a. Methyldopa
53. Case of gestational hypertension. Which drug should not be given:

a. ACE inhibitors
54. Case of eclamptic fit. Drug of choice:

a. MGSO4
55. Cause of death in eclampsia is:

a. Intracerebral hemorrhage
b. Convulsions
56. About neonatal resuscitation, select best statement:

a. No drug should be given
b. Terminal apnea is last stage
c. ETT should be given to any apnoeic baby
d. Rate of transient apnea is greater than terminal apnea
57. Heart beat of healthy baby is:

a) Greater than 100
b)110-160
58. Diabetic mother is at risk to develop what complication most likely:

a. Nephropathy
b. Retinopathy
c. Coronary heart disease
59. Cause of hematuria and proteinuria in pregnancy:

a) DIC
b)Renal failure
c) Renal stone
d)UTI
60. Aim of 2nd trimester u/s:

a. Detect fetal anomaly
b. Accurate dating in women with irregular cycles
c. Fundal height
61. Total number of germ cells in female at birth:

a. 2 million
b. 8 million
c. 1 million
d. 10 million
62. Female with history of preterm birth in last pregnancy at 34 weeks. Now wants to know
chances of preterm birth in this pregnancy. She is in her 23 week of gestation. Her cervical length
would be:
a. 2 cm
b. 6 cm
c. 1.5 cm
d. 3-4 cm
63. Second degree perineal tear involves:

a. Skin + muscle
64. Women with pancreatitis in pregnancy what would be your next step:
a. Conservative treatment
65. Severe hypertension effect which organ:

a. Kidney
b. Heart
c. brain
d. Liver
66. Women with twin pregnancy. One fetus dead one alive. He has oligohydramnios what organ
is affected in his body:
a. Kidney
b. Brain
c. Heart
d. Liver
e. Adrenal Gland
67. Fetus born with blue extremities and pink face, his shows grimace, his R.R is irregular, H.R is
greater than 100, muscles show some flexion. What will be his aPgar score:
a. 6
b. 8
68. A 24-year-old woman, gravida 2, para 1, at 16 weeks gestation comes to the physician for a
routine prenatal visit. She has had mild constipation but no nausea, vomiting, fever, burning with
urination, back pain, or other complaints. She has no history of urinary tract infections. Her
medications include iron and folic acid supplements. The patient does not use tobacco, alcohol, or
illicit drugs. She is afebrile. Her blood pressure is 124/7 4 mm Hg and pulse is 78/min. Examination
shows a uterus consistent with a 16-week gestational size. Physical examination is otherwise
unremarkable. Urinalysis is within normal limits. A routine clean-catch urine culture grows >1
00,000 colonies/ml of Escherichia coli Which of the following is the most appropriate next step in
management?
a. Ciprofloxacin for 3 days
b. Daily nitrofurantoin for the duration of pregnancy
c. Hospitalization with intravenous ceftriaxone
d. Nitrofurantoin for 7 days
e. Reassurance and routine follow-up
69. Investigation not required in AFLP:

a. Ultrasound
b. LFT
c. X-Ray
d. Liver biopsy
70. Female presented after delivery with fever, cough and excellent wound healing, diagnosis?
a. Chest infection
b. TB
c. COPD
d. Its normal
71. Causes of perinatal mortality ?

a. Malnutriton
72. Not a feature of cholestasis?

a. Rash
b. Itching
c. Pale
73. Single artery to ligate during uncontrolled PPH?

a. Internal iliac
b. External iliac
c. Carotid
d. Ovarian
e. Penetrating arteries
74. Contraindicated vaccine in pregnancy?

a. Yellow fever
b. Hepatitis B
c. Cholera
d. Rabies
e. Tetanus toxoid
75. Cause of 2nd trimester abortion?

a. Chromosomal abnormalities
b. Emotional disturbance
c. Fungal infection
d. Syphilis
e. Epilepsy
76. Most common organism for peuperial sepsis:

a. E.Coli (Most common cause is hemolytic strept but among these is E. coli WIKIpedia)
b. Pseudomonas
c. Klebsiella
d. Proteus
e. Bacteroides
77. Pregnant woman who has Hb: 12g/dL, needs iron supplements as:
a. 50mg a day orally
b. 100mg a day orally
c. 10mg a day orally
d. An apple a day
e. Regular milk intake
78. Treatment of primary unexplained infertility:

a. IVF
b. IUI
c. GIFT
d. ICSI
e. ZIFT
79. Complication of D and C:

a. Uterine perforation
b. Uterine inversion
c. Damage to perimetrium
d. Endometritis
80. Optimum uterine contractions during active labor:

a. 1-2/10 min, 30 seconds each
b. 3-4/10 min, 30-45 sec each
c. 3-4/10 min, 45-60 sec each
d. 1/10 min, 30 sec each
e. 3-4/10 min, 60-90 each
81. Management of Primary PPH involves

a. Despite proper management if patient is not improving hemodynamically, look for other causes
b. When bleeding persists despite contracted uterus, look for rcops
c. Syntocinon and ergometrine are the standard uterotonics, they don’t need to be repeated
d. PGF2α can be given directly thru foleys catheter
e. The 1st step is uterine massage or bimanual compression
82. An 8th gravid presents in ER with labor pains since 2 hours. On P/A fetal presentation is by
breech, uterine contractions are moderate, fetal HR is 140 bpm. On P/V, cervix is 5 cm dilated,
membranes are intact and foot is felt. What is the most important? Condition anticipated?
a. Obstructed labor
b. Birth asphyxia
c. Cord prolapse
d. fetal soft tissue injury
e. fetal head stuck
83. Regarding reproduction

a. meiosis only occurs in sex chromosomes
b. Spermatogenesis is the production of mature sperms
c. Primary oocyte are produced during reproductive life
d. The ova determines the sex of a child
e. The mature germs cells are diploid
84. Best statement regarding preterm labour is:

a. labour before 24 weeks
b. tocolysis causes reduction in respiratory distress syndrome
c. tocolysis is given to gain time for administering steroids
d. Twin pregnancy is not associated with preterm labour
e. bedside elastin test rapid assessment
85. Classical C-Section:

a. Straight horizontal incision.
b. midline vertical incision
c. lower transverse incision
d. lateral vertical incision
e. upper transverse incision
86. Confirmation of early pregnancy is always done by:

a. amenorrhea
b. urine tes
c. systems of nausea and vomiting
d. listening to fetal heart
e. internal examination
87. What is the most dreadful complication of obstetric cholestasis:

a. hemorrhage
b. premature labour
c. steatorrhea
d. Intra uterine death
e. meconium staining
88. What is the significant purpose of Booking visit ultra sound:

a. Dating of pregnancy
b. Confirming ectopic pregnancy
c. confirm the viability of fetus
d. Determining risk factor for threatened abortion
e. All of the above
89. A woman had undergone abortion at 14th week gestation, after 2 week she presented with
fever and abdominal pain, what would be the cause of her presenting condition
a. Uterine haemorrhage
b. uterine infection
c. Retained products of conception
d. Syphilis
e. Uterine inversion
SBL FOR QUESTIONS 90 TO 92

SCENARIO
(A 24 year old G2P1+0 comes to antenatal clinic with gestational amenorrhea, tachycardia and
shortness of breath. She has childhood history of high grade fever, sore throat and joint pain.)
90. What is the diagnosis of this patient?
a. Aortic stenosis
b. Mitral stenosis
c. Pulmonary stenosis
d. Tri-cuspid stenosis
e. Eisenmenger’s syndrome
91. In the management of second stage of labour in this patient:

a. Use prophylactic antibiotics
b. Use syntocinon judiciously
c. Keep in supine position
d. Keep second stage short
e. Use epidural / regional anaesthesia or analgesia
92. Most useful investigation in early pregnancy is:

a. ECG
b. Echocardiography
c. ETT
d. Thallium scan
e. X-ray chest
SBL FOR QUESTION 93

93. A 20 year old primigravida admitted in labor with 38 weeks of pregnancy. She is known case of
mitral stenosis corrected 10 years back, on exam pulse is ?? , bp is 100/70, temp 98. On abdominal
exam SFH is 36 weeks, cephalic presentation. Pelvic examination show cervical os dilated 4 cm
membranes intact. What would be your management in labor?
a. Spontaneous labor
b. Emergency C-Section
c. Oxytocin + artificial rupture of membrane
d. Vacuum delivery
e. Outlet forcep
SBL For Question 94

94. 32 years old G6P5+0 came in ER with complain of 37 weeks of gestation with labor. On P/V
examination cervical os is 6 cm dilated presenting part is anterior fontanelle and now presented in
brow presentation is:
a. Mento vertical
b. Sub mento bregmatic
c. Sub mento vertical
d. Sub mento occipital
e. Sub occipito frontal
SBL For Question 95

95. A 30 year old P1+0 G 2nd underwent vaginal delivery and delivered 8 pound baby, placental
was spontaneously delivered. You have noticed unusual amount of bleeding around 700 mls.
Uterine fundus is well contracted. What is the cause of bleed?
a. Retained placenta
b. Genital tract lacerations
c. Uterine atony
d. Coagulopathy
e. Endometrial laceration
SBL FOR QUESTION 96

96. A 32 year old P1+0 came at 32 weeks gestation. She had post natal depression in last
pregnancy. Her recurrence risk to develop post natal depression is:
a. 10 %
b. 25%
c. 50% (Medscape)
d. 60%
e. 75%
SBL FOR QUESTION 97

97. A 22 year old primigravida delivered by forceps after giving episiotomy. The single best
disadvantage of mid line episiotomy is:
a. Blood loss is more
b. Difficult to repair
c. Extending to anal sphincter
d. Delayed healing
e. More painful in post partum
SBL FOR QUESTION 98

98. Mrs ABC primigravida 29 years old presented to ER with complains of gestational amenorrhea
of ?? Weeks and raised BP for 2 months with reduced fetal movements for 1 month. Ultrasound
shows single alive fetus of 32 weeks with amniotic fluid index of 5.8 cm2 . Reason of
oligohydramnios is:
a. Renal agenesis
b. Urinary tract malformation
c. Placental insufficiency
d. Preterm prelabour rupture of membrane
e. Intrauterine infection
SBL FOR QUESTION 99

99. 28 years old P1+0 delivered at home by Dai after 17 days she complains of offensive lochia,
which investigation you will do:
a. Endometrial sampling
b. High vaginal swab for c/s
c. Blood culture
d. Pap smear
e. Trans vaginal ultrasound
SBL FOR QUESTION 100

100. G3P2+0 41 weeks pregnant, complaining of ??. which one of the following is appropriate
management for her:
a. Observe fetal movements
b. Emergency caesarean section
c. Biophysical profile
d. CTG monitoring
e. induction of labor
OBSTETRICS SMBBC 2016
1. P/A examination = SFH > No of weeks
2. Eclampsia D/D wrong = Diazepam overdose + MgS04 overdoes
3. Maternal mortality = death within 42 days
4. Nephrogenic cord = 4 to 5 weeks
5. Primitive streak = dorsal + cephalic end
6. From placenta to brain = ductus venosus
7. Decreased lecithin by = Diabetes
8. C/O non-respiration in > premature babies (failure to breath)
9. Premature baby risk for = RDS
10. Diabetic women increased risk for = hypoglycemia
11. “”, not present = hypoinsulinemia
12. “” “” = Potter syndrome
13. Increased risk of symptomatic hypoglycemia in = diabetic mother
14. For checking RH.AB = indirect coomb’s test IgG
15. Diagnose before 20 weeks not a/w congenital anomaly = HIV
16. Not diagnosed by U/S = Downs syndrome
17. 1 fetus dead, second = Kidney???
18. Down syndrome 1st trimester = PAPPA + BHCG
19. Down syndrome = PAPPA + BHCG + U/S (NT)
20. For C.P = ?
21. Pre eclampsia = HTN + Proteinuria in 2nd half of pregnancy (>20 weeks)
22. MCC of seizures = eclampsia
23. Risk of PPH = uterine atony
24. Risk for cardiac failure = MP
25. Female doesn’t remember her LMP = U/S in 1st trimester
26. Case (vertex) suboccipito –bregmatic = 9.5cm
27. Best = ?
28. Widest = brow presentatioin (mento-vertical/ submento bregmatic) B.S cm
29. Widest transverse diameter = pelvic inlet
30. Internal rotation causes = A.P (transverse to A.P fetal head)
31. Case : eclampsia > pulmonary edema
32. Decreased platelets > HELLP syndrome
33. D.O.C > MGSO4 for convulsions
34. Restriction of fluids = <100 ml
35. C.I in pregnancy = diuretics + ACE inhibitors
36. Mastitis = antibiotics + analgesics
37. Case of infections P/F for > manual removal of products w/o antibiotics
38. Not in puerperal sepsis = contracted non-tender uterus
39. Assessment of fetus in Pre-eclampsia = serum uric acid
40. Most important in pre eclampsia = deliver the fetus
41. Neonate not breathing, decreased H.R = ?
42. ?
43. mask = cover
44. Pt. has sickle cell = analgesics, hydrate, antibiotics
45. Decreased MCV, normal Hb electrophoresis = iron deficiency
46. Most common cause of anemia in pregnancy = iron def.
47. Pt. had swelling + pain in leg in previous pregnancy now has increased risk for =
thromboembolic disease
48. High risk pregnancy prophylaxis = stockings + heparin
49. Pt. and previous 3 pregnancy = RH antibody
50. 250 IV anti D = ECV
51. Dopple first line in = ?
52. Not a C.I to ventouse = ?
53. Only indication of ventouse in 9am cervix = 2nd twin
54. Severe pre-eclampsia =
55. Eclamptic pt. Rx = emergency C/S
56. Eclamptic pt Rx = MgSO4, Anti HTN, C/S (terminate pregnancy)
57. For VZV = vaccine
58. GBS +ve =
59. Cholesterol of pregnancy = bile acids
60. “” “” = “ + Transaminase
61. wrong for “” = most women in 1st trimester
62. preterm = labor pains
63. case = steroids
64. important for cardiac disease in pregnancy Dx =
65. not in C.F = increased BP
66. lady with 2cm cervix rx = wait for 1 hr than C/S
67. PPH cause = uterine atony
68. Case = uterine inversion
69. In “” = hemorrhage (severe)
70. Abdominal pain + bleeding = abruption placentae
71. Post natal dep = social +ethic effort
72. Most common psychiatric problem = post natal depression
73. Recurrence rate = 50%
74. AFLP (acute fatty liver of pregnancy) = no affect
75. Case = maternal hyperthyroidism
76. MCC of chronic HTN (preexisting HTN) = essential HTN
77. Rules of Forceps = lock easily
78. Case = amniotic fluid embolism
79. Breast feeding = WHO gives 10 steps
80. Antenatal care best = shared care
81. G in APGAR = grimace
82. Child initially normal APGAR, then deteriates = hypoglycemia
83. Case = uterine exploration
84. Ductus arteriosos closed by = cyclooxygenase inhibitor
85. Neonatal resuscitation = preterm
86. Disadvantage of midline episiotomy = torn anal sphincter
87. Case = PPH
88. IUD =
89. Cant lactate = Sheehan syndrome

1. A 38 OLD lady G4P3+0 previous vaginal deliveries, 26 week gestation with Hb 7.5 gm/dl. What
should be treatment option if cause is iron deficiency?
A. oral iron
B. Parentral iron
C. PCV
D. whole blood
E. PCV and FFP
2. Face presentation
a. requires C section
b. diagnosed only in labor
c. is due to deflexion of head
d. presenting diameter os submento-bregmatic
e. occurs In 1:300 labor
3. 18 yr old primi gravid presented in ER at 30 weeks gestation and 3 fits at home. Her BP is 160/110
and patient is irritable, vaginal examination shows that the patient is not in labor. the most
appropriate treatment is
A. stabilize and give anti convulsants and anti hypertensive and continue pregnancy
B. stabilize and induce labor with oxytocin
C. Emergency CS
D. stabilize and induce labor with PGs
E. stabilize and do Emergency CS
4. Optimum uterine contractions during active labor

a) 1-2/10 min, 30 seconds each
b)3-4/10 min, 30-45 sec each
c) 3-4/10 min, 45-60 sec each
d)1/10 min, 30 sec each
e) 3-4/10 min, 60-90 each
5. Management of Primary PPH involves

A. despite proper management if patient is not improving hemodynamically, look for other causes
B. when bleeding persists despite contracted uterus, look for RCOPs
C. syntocinon and ergometrine are the standard
D. PGF2α can be given directly thru Foleys cath
E. the 1st step is uterine massage or bimanual compression
6. Factors that can delay descent of fetal head

A. in coordinate uterine activity
B. fetal macrosmia
C. fetal malformation
D. inadequate bony pelvis
E. inadequate uterine activity
7. Pregnancy is dated from

A. 1st day of LMP
B. none of these
C. last day of LMP
D. day of conception
E. day of ovulation
8. Vacuum extractor
A. tentorial tearing is a complication
B. is associated with chignon formation
C. is associated with fracture of skull
D. cephal hematoma is a common complication
E. is preferred over forceps because it rotates and pulls fetus simultaneously
9. Safe motherhood project aims to provide

A. health education fro husbands
B. family planning service for safe abortions
C. community education for women their families and decision making
D. immediate referral for life threatening obstetric complications
E. care by any person before, during and after child birth
10. The most important benefit of dating scan is

A. early detection of multiple pregnancy
B. to reduce induction of labor pre maturely
C. to do appropriate tests on time to detect fetal abnormality
D. detection of failed intra uterine pregnancy
E. accurate dating with irregular menstrual cycle
11. A 38 yr old lady diagnosed of having gestational diabetes delivered a 4.3kg baby 1 hour back. The
baby was shifted to neonatal unit. Which of the following is not a cause of neonatal morbidity?
A. hyperbilirubinemia
B. hypoglycemia
C. birth asphyxia
D. polycythemia
E. hypomagnesaemia
12. Mrs. Husban is G2 P1+0 last deliveries by C section for fetal distress. Now she is 37 weeks
pregnant. best criteria for trial of scar is
A. breech presentation
B. macrosmic baby
C. IUGR
D. placenta praevia
E. adequate pelvis with cephalic presentation
13. A primigravida is admitted in labor room with term pregnancy, labor pangs and Os fully dilated.
Absent membranes and high head
A. cord is around fetal neck
B. immediate delivery is required
C. oxytocin infusions can be given if uterine contractions are inadequate
D. hydrocephalus is suspected
E. CPD is suspected
14. CPD is suspected in labor if

A. there is a heavy show
B. VE shows severe molding and caput formation
C. cervix is thick and hanging
D. fetal head s at mid pelvis
E. labor progress is slow
15. Commonest cause of delay in 2nd stage of labor is

A. epidural analgesia
B. secondary uterine inertia
C. mal presentation
D. android pelvis
E. maternal dehydration
16. Commonest cause of poor progress in labor is

a) cervical dystocia
b)cord round fetal neck
c) placenta praevia
d)Inefficient uterine contractions
e) CPD
17. The greatest presenting longitudinal diameter of fetal skull is

a. sub-occipito-bregmatic
b. mento-vertical (13cm)
c. sub-mento-bregmatic
d. sub-occipito-frontal
e. occipito-frontal
18. Best way of assessment of high risk fetus during labor is

A. intermittent auscultation
B. US
C. Kick chart
D. CTG
E. BPP (CTG + AFI)
19. An 8th gravid presents in ER with labor pains since 2 hours. On P/A fetal presentation is by
breech, uterine contractions are moderate, fetal HR is 140 bpm. On P/V, cervix is 5 cm dilated,
membranes are intact and foot is felt. What is the most imp? Condition anticipated?
A. obstructed labor
B. birth asphyxia
C. cord prolapse
D. fetal soft tissue injury
E. fetal head stuck
20. Unique complication of Monochorionic twins

a) twin to twin transfusion syndrome
b)preterm delivery
c) still birth
d)cord accident
e) conjoined twin
21. The most imp. Finding in an ideal obstetric pelvis is

A. shallow and straight side walls
B. sacrospinous ligaments at least 3.5 cms
C. no great projection of ischial spines
D. ischial bi-spinous diameter measuring 10 cms
E. smooth sacral curve
22. A primigravida presents in early labor with vertex presentation. What will be the most likely
normal position of presenting part
A. left occipito-anterior
B. right mento-transverse
C. left mento-anterior
D. right occipito-transverse
E. right occipito-posterior
23. A lady G4 P2+1, 30 week gestation presents with polyuria and polydipsia. Her SFH corresponds to
36 week gestation. On H/O symptoms a diagnosis of gestational diabetes is made, which investigation
is the best reliable test in pregnancy for diabetes mellitus
A. OGCT
B. RBS on 2 different occasions
C. OGTT
D. FBS on 2 different occasions
E. Urine glucose
24. A lady had polyhydramnios, immediate after delivery she complains off severe chest pain,
becomes dyspnoeic and collapses. Pulse was 140 bpm, BP is 80/40, chest is full of crepitations,
diagnosis
A. cardiac failure
B. ARDS
C. amniotic fluid embolism
D. MI
E. Pulmonary embolism
25. Regarding reproduction

a. meiosis only occurs in sex chromosomes
c. Primary oocyte are produced during reproductive life
d. the ova determines the sex of a child
e. the mature germs cells are diploid
26. A 52 women presents with C/O spotting/vagina, dysuria and dyspareunia. She has had D & C 2
months back and report showed atrophic endometrium. Best treatment for her
A.progesterones
B. Hysteroscopy and biopsy
C. Hysterectomy
D. estrogen creams
E. OCPs
27. The etiology of congenital defects is mainly due to

a. congenital
b. environmental
c. heterogeneous
d. genetic
e. viral infections
28. A 30 y old G6 P5+0 presents at 32 week gestation with essential HTN. She is taking ACE inhibitors,
which drug is most appropriate for her?
A. methyl dopa
B. ACE inhibitors + nifedipine
C. atenolol
D. labetolol
E. Hydralazine
29. A lady 36 yr old G4 P3+1 presents with swelling around legs, erythema and mild discomfort. She
has past History of DVT 3 years back. She is labeled as
A. intermediate risk
B. high risk
C. low risk
D. none of above
E. immediate risk
30. 21 yr old lady primigravida 30 weeks presents with headache and blurring of vision for 2 days. Her
BP is 160/100. Urine dipstick shows protienuria ++. What is the most reliable test which confirms pre
eclampsia?
A. deranged clotting profile
B. thrombocytopenia
C. raised serum urea and creatinine
D. urine protein > 300mg/day
E. Hb<10gm/dl
31. A para 2+0 woman, presents in ER with 37 week gestation and severe pre eclampsia and reactive
CTG. She had past 2 vaginal deliveries and now bishop score of 6/10 while other inv. Are normal. The
best option for her
A. wait for spontaneous labor
B. control BP and wait up to 40 weeks
C. C section
D. Induction of labor
E. MgSO4 prophylactically and wait for spontaneous labor
32. The pattern of follow up of antenatal visits

a) schedule is offered regardless of choice of care
b)should be tailored according to the wishes if individual
c) 4 weekly up till 36 weeks
d)minimum 5 visits as advised by RCOG
e) weekly after 32 weeks
33. The most common cause of IUGR

a. maternal viral infections
b. drug addiction
c. chromosomal anomalies
d. maternal diseases
e. maternal malnutrition
34. When an HIV +ve women becomes pregnant

a) mother should breast fed in any condition and in any setup
b)amniocentesis should be done to rule out fetal anomalies
c) she should be counseled for termination of pregnancy
d)ZVT therapy should be started from 2nd month
e) feSO4 tablets should be started from 1st month
35. An A-ve woman primigravida (husband status B+ve) presented at 12 weeks of pregnancy. The
recommended prophylaxis of Rh iso immunization is anti D IgG at
A. 500IU within 72 hours if fetus is Rh +
B. 500IU at 28 weeks and 32 weeks and within 72 hours if fetus is Rh +
C. 500IU at 28 weeks and 32 weeks
D. 500IU 28 weeks and 32 weeks and within 72 hours if fetus is Rh + and kleihauer +
E. 500IU within 72 hours if fetus is kleihauer +ve
36. Imp. Factors affecting fetal birth weight

a. paternal height
b. maternal height
c. parity
d. fetal sex
e. maternal age
37. Vertex is defined as

A. area of skull bounded by anterior and posterior fontanelle and occipital bone
B. area of skull bounded by 2 parietal eminences only
C. area of skull bounded by anterior and posterior fontanelle and 2 parietal eminences
D. area of skull bounded by face brow and anterior fontanelle
E. area of skull bounded by anterior fontanelle and chin
38. Regarding changer in breast during pregnancy

A. nipples become larger and more erectile
B. breast increase in size because of hyperplasia and hypertrophy
C. the hypertrophied sebaceous gland are montog
D. size of breast increase due to deposition of fat
E. the sweet and sebaceous glands activity is increased
39. Regarding perinatal death

A. it should be notified to identify risk factors
B. it means all still births + death in 1st 28 days of life
C. it is an important tool to know the level of health care provided tow women
D. it is defined similarly in all countries
E. for audit purpose
40. A 25 yr old primigravida was diagnosed as having Toxoplasmosis at 12 weeks of pregnancy. Most
appropriate treatment
a. vancomycin
b. penicillin
c. gentamicin
d. spiramycin
e. amikacin
41. A para 7+1 has delivered a 3.7 kg baby 2 hours back at home after prolonged pushing efforts. She
is brought to hospital in unconscious state. Abdomen is tense and tender, and bright fresh blood is
coming thru vagina. Diagnosis
A. uterine perforation
B. uterine rupture
C. uterine inversion
D. Primary PPH
E. RCOP
42. A normotensive 2nd gravid presents in OPD at 36 weeks gestation with breech presentation. Her
1st delivery was uneventful. Now her US shows flexed breech, fundoposterior placenta, and EFW
about 3 kg. she should be offered
A. IPV
B. ECV
C. LSCS
D. Ventouse delivery
E. wait & NVD
43. A 32 weeks pregnant diabetic mother is having SFH of 36 cms. Most likely cause is
a) polyhydramnios
b)Macrosmia
c) Twin pregnancy
d)mistaken date
e) fetal malformation
44. In TTTS, donor fetus is at risk of which organ failure?

A. Heart
B. Kidney
C. Liver
D. Brain
E. adrenal gland
45. Most important sign of severe pre-eclampsia

a. agitation
b. hyper reflexia
c. severe headache
d. poor urine output
e. papilloedema
46. Contraindication to Ventouse delivery

a) vertex presentation
b)3rd degree perineal tear
c) face presentation
d)1st degree molding
e) operator is inexperienced
47. Blood glucose levels after 90 min of OGCT will be

a. 130 mg/dl
b. 120 mg/dl
c. 140mg/dl
d. 80mg/dl
e. 110mg/dl
48. Most common cause of perinatal mortality

A. infections
B. maternal malnutrition
C. maternal underage
D. obstructed labor
E. preterm birth
49. A pregnant lady comes next day having contact with an HSV infected patient. What is the most
appropriate management
A. acyclovir for 1 week
B. anti HSV globulins and acyclovir
C. anti HSV vaccine
D. anti HSV globulins and avoid contact for 48 hours
E. none of above
50. LSCS is increasingly done in women because of

a. increased survival of neonates
b. faster mod of birth
c. education
d. decreased stress period
e. reduced pain perception
51. M. Imp point in Obstetrical History is

a) maternal age
b)last menstrual period
c) recurrent abortions
d)counting of fetal kicks
e) late 2nd trimester miscarriages
52. The value of triple assessment test in Down’s Syndrome is

A.↑ AFP ↑HCG ↑estriol
B. ↓AFP ↓HCG ↓estriol
C. ↑AFP ↓HCG ↑estriol
D. ↓AFP ↑HCG ↑estriol
E. ↓AFP ↑HCG ↓estriol
53. A pregnant lady presents with congenital heart disease. Examination will not focus on
a) edema
b)fetal lie
c) pulse
d)Rhythm
e) basal crepitations
54. Regarding varicose veins during pregnancy

A. affect about one in three women
B. are more prone to bleed than in normal individuals
C. are more symptomatic
D. always return to normal after pregnancy
E. are caused by pressure of enlarged uterus on IVC
55. Deep transverse arrest associated with

a) anthropoid pelvis
b)gynecoid pelvis
c) platypoid pelvis
d)android pelvis
e) both A and D
56. The maternal mortality is highest in

A. Mitral stenosis
B. VSD
C. Ischemic Heart diseases
D. Coarctation of aorta
E. Pulmonary HTN
57. Most common cause of primary hemorrhage

A. uterine atony
B. uterine inertia
C. infections
D. RCOP
E. none of above
58. A lady para 6+0 delivered vaginally a baby 2 hours back at home, is brought by DAI, she is actively
bleeding. Diagnosis
A. Primary PPH
B. Uterine rupture
C. uterine inversion
D. RCOP
E. secondary PPH
59. Internal rotation occurs because
a) alignment of head in transverse axis of body
b)alignment of head in longitudinal axis of body
c) alignment of head in opposite direction of body
d)internal pelvis shape
e) to rotate the head anteriorly so that sagittal suture lies in AP axis of pelvis
60. Ideal progress of labor in primigravida

a. 1
b. 1.8
c. 1.4
d. 1.2
e. 1.3
61. Brow presentation is

A. mento vertical
B. occipito-mental
C. has diameter of 11 cm
D. is always impossible to deliver by Vagina
E. more than half of the cases are delivered by CS
62. A lady is in prolonged 1st stage of labor. CTG shows fetal stress. What will be the next step
A. BPP
B. CS
C. fetal scalp blood sampling
D. auscultation by Pinard stethoscope
E. oxytocin infusion
63. A lady presents comes after 1 week of delivery, having fever and pus discharge from the
episiotomy site, wound is not healed. Appropriate management
A. wound dressing with pyodine
B. wash wound with Normal saline and do dressing
C. wound wash by NS, dressing and antibiotic cover
D. apply antibiotic to wound after washing it
E. all of above
64. 2nd degree perineal tear involves

a) skin and perineal muscles with les than 50 % anal sphincter involved
b)skin involved only
c) involves skin extending to perineal muscles
d)involves skin extending to perineal muscles but not the anal sphincter
e) involves all layers except anal sphincter
65. A CTG of having FHR 155 BPM, baseline variability of 5 BPM, no acceleration and no deceleration
would be regarded as
A. abnormal CTG
B. reactive CTG
C. normal CTG
D. suspicious CTG
E. low normal CTG
66. Bishop score Is used for
a. induction of labor
b. augmentation of labor
c. preparation of cervix
d. none of above
e. favorable cervix
67. The most common compression neuropathy in pregnancy

a. cubital tunnel syndrome
b. piriformis syndrome
c. tarsal tunnel syndrome
d. pudendal nerve entrapment
e. carpal tunnel syndrome
68. 28 year old G3 P1+1 comes with onset of labor, but after 8 hours vaginal exam shows dilatation of
6 cm. best way to assess fetal stress
A. CTG
B. BPP
C. FBS
D. FHS
E. all of above
69. Components of biophysical profile include all except

a) CTG
b)fetal breathing movements
c) amniotic fluid volume
d)FBS
e) fetal tone
70. Most common complication of IUGR

A. low birth weight
B. severe infections
C. low mental status
D. meconium aspiration syndrome
E. abnormally high hematocrit
71. Anemia in pregnancy occurs due to

66. A. decreased iron stores
B. increase volume intravascular
C. increased requirement of fetus
D. low MCV
E. none of above
72. US in 3rd trimester is done for

A. assessing amniotic fluid volume
B. locate the site of placenta
C. to assess fetal well being
D. to screen for adverse pregnancy outcomes
E. to assess detailed anatomical survey
73. In CVS, the cells are usually taken from

A. maternal villi cells
B. fetal trophoblast cells
C. maternal RBCs
D. fetal RBCs
E. none of above
74. CASE: A 3 yr old diabetic multipara lady presents at 33 weeks and distension. On abdominal
examination the fetus is engaged. On vaginal exam the Os is open, cause is
A. PPROM
B. Renal agenesis
C. cervical insufficiency
D. FGR
E. twin pregnancy
75. Which investigation will you do?

A. vaginal smear
B. fetal fibronectin
C. amniotic fluid CS
D. TVS for cervical length
E. urine CS
76. CASE: 37 old pregnant female of 32 weeks and 4 days gestation presents to the emergency room
because of significant vaginal bleeding over the past hour. The patient also reports some
contractions, but denies any continuing abdominal pain. She denies any recent trauma. What is the
diagnosis?
A. Placenta praevia
B. placental abruption
C. vasa praevia
D. Genital tract infections
E. ectropion
77. Most common cause of this condition is

a. multiple gestation
b. previous CS
c. Uterine structural anomaly
d. assisted conception
e. advanced age
78. Regarding Placenta praevia

a) incidence is decreasing due to ↑ CS rate
b)is a placenta which is sited at lower segment of uterus
c) is dangerous for fetus
d)is a contraindication to CS
e) Couvelaire Uterus is a classical feature
79. Which of the following clinical conditions is not an indication for induction of labor?
A. Intrauterine fetal demise
B. Severe preeclampsia at 36 weeks
C. Complete placenta praevia
D. Chorioamnionitis
E. Post term pregnancy
80. In comparing laparoscopic salpingostomy vs. laparatomy with salpingectomy for the treatment of
ectopic pregnancy, laparoscopic therapy results in
A. Decreased hospital stays
b. Lower fertility rate
c. Lower repeat ectopic pregnancy rate
d. Comparable persistent ectopic tissue rate
e. Greater scar formation
81. A 27-year-old has just had an ectopic pregnancy. Which of the following events would be most
likely to predispose to ectopic pregnancy?
a. Previous tubal surgery
b. Pelvic inflammatory disease (PID)
c. Use of a contraceptive uterine device (IUD)
d. Induction of ovulation
e. Exposure in utero to diethylstilbestrol (DES)
82. A 33-year-old has an infection in pregnancy. Which of the following is a reinfection, and therefore
not a risk to the fetus?
a. Group B coxsackievirus
b. Rubella virus
c. Chickenpox virus
d. Shingles
e. Herpes virus hominus type 2
83. A 20-year-old female at 34 weeks of gestation develops a lower urinary tract infection. Which of
the following is the best choice for treatment?
a. Cephalosporin
b. Tetracycline
c. Sulfonamide
d. Nitrofurantoin
e. Ciprofloxacin
84. A 30-year-old class D diabetic is concerned about pregnancy. She can be assured that which of the
following risks is the same for her as for the general population?
a. Preeclampsia and eclampsia
b. Infection
c. Fetal cystic fibrosis
d. Postpartum hemorrhage after vaginal delivery
e. Hydramnios
85. 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
E. None of above
86. A primipara is in labor and an episiotomy is about to be cut. Compared with a midline episiotomy,
an advantage of mediolateral episiotomy is
a. Ease of repair
b. Fewer breakdowns
c. Less blood loss
d. Less dyspareunia
e. Less extension of the incision
87. In the mother, suckling leads to which of the following responses?

a) Decrease of oxytocin
b)Increase of prolactin-inhibiting factor
c) Increase of hypothalamic dopamine
d)Increase of hypothalamic prolactin
e) Increase of luteinizing hormone–releasing factor
88. A 26-year-old patient has had three consecutive spontaneous abortions early in the second
trimester. As part of an evaluation for this problem, the least useful test would be
a. Hysterosalpinogram
b. Chromosomal analysis of the couple
c. Endometrial biopsy in the luteal phase
d. Postcoital test
e. Tests of thyroid function
89. In terms of birth defect potential, the safest of the following drugs is
A.Alcohol
B. Isotretinoin (Accutane)
C. Tetracyclines
D. Progesterones
E. Phenytoin (Dilantin)
90. Rates of successful pregnancy following three spontaneous losses (habitual abortion) are
a. Very poor
b. Slightly worse than those in the baseline population
c. No different from those in the baseline population
d. Just under 50%
e. Good unless cervical incompetence is diagnosed
91. 24-year-old woman is in a car accident and is taken to an emergency room, where she receives
a chest x-ray and a film of her lower spine. It is later discovered that she is 10 weeks pregnant. She
should be counseled that
a. The fetus has received 50 rads
b. Either chorionic villus sampling (CVS) or amniocentesis is advisable to check for fetal chromosomal
abnormalities
c. At 10 weeks, the fetus is particularly susceptible to derangements of the central nervous system
d. The fetus has received less than the assumed threshold for radiation damage
e. The risk that this fetus will develop leukemia as a child is raised
92. A 41-year-old had a baby with Down syndrome 10 years ago. She is anxious to know the
chromosome status of her fetus in a current pregnancy. The test that has the fastest lab processing
time for karyotype is
a. Amniocentesis
b. Cordocentesis
c. Chorionic villus sampling (CVS)
d. Doppler flow ultrasound
e. Cystic hygroma aspiration
93. A 39-year-old wants first-trimester prenatal diagnosis. Advantages of early amniocentesis over
CVS include
a. Amniocentesis can be performed earlier in pregnancy
b. Amniocentesis is usually less painful
c. Second-trimester diagnosis allows for safer termination of pregnancy when termination is chosen
by the patient
d. CVS has a higher complication rate than midtrimester amniocentesis
e. CVS has a higher complication rate than first-trimester amniocentesis
94. A 17-year-old primipara at 41 weeks wants an immediate cesarean section. She is being followed
with biophysical profile (BPP) testing. Which of the following is correct information to share with the
patient?
a. BPP testing includes amniotic fluid volume, fetal breathing, fetal body movements, fetal body tone,
and contraction stress testing.
b. The false-negative rate of the BPP is 10%.
c. False-positive results on BPP are rare.
d. Spontaneous decelerations during BPP testing are associated with significant fetal morbidity.
e. A normal BPP should be repeated in 1 week to 10 days in a post-term pregnancy.
95. A 28-year-old G1 presents to your office at 8 weeks gestation. She has a history of diabetes since
the age of 14. She uses insulin and denies any complications related to her diabetes. Which of the
following is the most common birth defect associated with diabetes?
a. Anencephaly
b. Encephalocele
c. Meningomyelocele
d. Sacral agenesis
e. Ventricular septal defect /caudal regression syndrome
96. All of the following represent part of routine neonatal care in a healthy infant except
A.Administration of silver nitrate to the eyes for prophylaxis for gonorrhea and chlamydia
B. Administration of vitamin K to prevent bleeding problems
C. Administration of hepatitis B immune globulin for routine immunization against hepatitis B
D. Keeping the infant in a heated, warm crib
E. Application of an identification band immediately to the infant
97. True statements regarding postpartum depression include which of the following?
a. A history of depression is not a risk factor for developing postpartum depression
b. Prenatal preventive intervention for patients at high risk for postpartum depression is best
managed alone by a mental health professional
c. Young, multiparous patients are at highest risk
d. Postpartum depression is a self-limiting process that lasts for a maximum of 3 months
e. About 10 to 12% of women develop postpartum depression
98. A patient at 17 weeks gestation is diagnosed as having an intrauterine fetal demise. She returns
to your office 5 weeks later and her vital signs are: blood pressure 110/72 mm Hg, pulse 88 beats per
minute, temperature 36.38°C, respiratory rate 16 breaths per minute. She has not had a miscarriage,
although she has had some occasional spotting. Her cervix is closed on examination. This patient is at
increased risk for which of the following?
a. Septic abortion
b. Recurrent abortion
c. Consumptive coagulopathy with hypofibrinogenemia
d. Future infertility
e. Ectopic pregnancies
99. Advantages of ultrasound nuchal translucency over biochemical screening for Down syndrome
include
a) Uses transvaginal approach
b)More consistent measurements than lab tests
c) Better in multiple gestation
d)Wide gestational age range
e) More convenient for patients
100. A 17-year-old primipara at 41 weeks wants an immediate cesarean section. She is being followed
with biophysical profile (BPP) testing. Which of the following is correct information to share with the
patient?
A.BPP testing includes amniotic fluid volume, fetal breathing, fetal body movements, fetal body tone,
and contraction stress testing.
B. The false-negative rate of the BPP is 10%.
C. False-positive results on BPP are rare.
D. Spontaneous decelerations during BPP testing are associated with significant fetal morbidity.
E. A normal BPP should be repeated in 1 week to 10 days in a post-term pregnancy.
1. Contraindication to ventouse delivery: Gestation less than 34 weeks

2. Most dreadful complication of gestational cholestasis: Intrauterine death
3. Regarding 2nd degree perineal tears: Involve perineal muscle
4. A woman at 32 weeks gestation with arrested 2nd stage of labour, what would you do: Forceps
delivery
5. Puerperial sepsis: Genital tract infection following delivery
6. How will you diagnose mitral stenosis: Echo
7. Main support of vagina: Uterosacral ligament
8. Normal OGTT value: 7.8mmol/L
9. Gestational diabetes is due to: Increased insulin resistance (Receptor dysfunction)
10. Regarding NTDs: Spina Bifida are detectable on 20th week scan
11. Woman with acute fatty liver in pregnancy, what are consequences post-delivery: No serious
consequences
12. Down's syndrome's most characteristic feature: Macroglossia/Flat facies
13. Ethical principle if a woman comes for hysterectomy: Ablative therapies are available
14. Woman with a previous cessarian, now intends to go NVD. If augmentation and induction
method is used, what are the consequences: Rupture of previous scar
15. Safe motherhood includes all except: Free access to induced abortions
16. Signnificant purpose of booking visit: Confirming the viability of fetus
17. A woman had an abortion at 14th weeks gestation, after 2 weeks she presented with fever and
abdominal pain, state the cause: Retained products of conception
18. A lady presented for caessarian section had an HB level of 7mg/dl, immediate management:
Transfusion of packed red cells
19. Most important for examining in lithotomy position: Sterilize the instruments
20. Most reliable test for diagnosis of Down's syndrome: PAPPA, HCG and NTD
21. True regarding spermatogenesis: 4 haploid spermatozoa are formed via meiosis
22. A woman with initially normal labour with cervical dilatation of 6 cm but after 4 hours
contractions remained same but dilatation stopped. Diagnosis: Cervical dystocia
23. Patient with history of epilepsy wants to become pregnant, your advice: Half the dose of
antiepileptics
24. Side-effect of syntocinon with previous CS: Rupture of CS scar
25. Most common cause of IUGR: Maternal malnutrition
26. Which bones make vertex: Parietal bones
27. Regarding fetal skull: Face, base, vault
28. Vertex presentation diameter: Suboccipito-bregmatic
29. Landmark to determine fetal station: Ischial spine
30. Regarding pelvic inlet, choose the wrong one: Transverse diameter is 11.5
31. Most important aspect of booking visit: Confirmation of viability/risk assessment? (not sure)
32. Most common cause of APH: Hypertension
33. Most potential sensitizing event for rh incompatibility: Miscarriage
34. Commonest cause of massive PPH: Uterine atony
35. If a prostaglandin inhibitor is given, effect would be: Closure of ductus arteriosus
36. Maneuver for delivery of shoulders in breech presentation: Loveset's
37. Safest incision for episiotomy: Mediolateral
38. During first phase of 2nd stage there is no maternal urge to push, why: Fetal head is high in pelvis
39. Regarding placenta accreta: Villi attached to myometrium
40. Commonest cause of vaginal discharge in women of child-bearing age: Bacterial vaginosis
41. Large fundal height for gestational age, choose the wrong one: IUGR
42. Woman presents at 30th week of gestation with history of 2 bleeding episodes per vagina. Her BP
is 120/70, pulse 78, heart rate normal. Regarding her management: Admit her and prepare for
emergency CS upon another bleeding episode
43. Most important factor that makes CTG suspicious: Absence of accelerations
44. Most common cause of IUD: Undernutrition/infection??
45. A para 1+0 rh negative female comes for antenatal visit. First step: Husband blood group
46. Drug for seizures in eclampsia: Magnesium sulphate
47. On vaginal examination the most reassuring sign of fetus is: Vertex at ischial spine
48. Paramesonephric duct gives rise to: Uterus, fallopian tubes and vagina
49. Most important complication of polyhydramnios: Preterm labour
50. During pregnancy, physiological increase in: ESR
51. Regarding complications in monoamniotic twins: Cord accidents
52. Primigravida in the labour room, cervix is 7cm dilated and loop of pulsating cord is felt through
intact membrane. Management: Do emergency CS?
53. Ooocytes present at birth: 2 million
54. Investigation of choice in VTE: Venography
55. Chorionic villus sampling done at: 10th week
56. Psychiatric disorder after delivery: Depression
57. First step in managing uterine atony: Uterine massage
58. Female with polyhydramnios immediately after delivery developed chest pain and dyspnea.
Diffuse creptitations are heard all over chest. BP is 90/60 and pulse rate 140/min. Most probably she
has: Amniotic fluid embolism? (Key says myocardial infection)
59. Most important aim of safe motherhood project: Fmily planning
60. Of the following used in screening program: Syphilis
61. Most common cause of secondary PPH: Retained products of conception
62. Nutrition in pregnancy: High fiber and fat
63. Investigation for pre-eclampsia: 24 hour urinary collection
64. Average gestational age at delivery in twin pregnancy: 37 weeks
65. Preterm labour: Tocolysis is given to get a time window for steroids
66. Diabetic mother with 32 weeks gestation and fundal height of 36 cm: Macrosomia (32 - 34
normal)
67. Woman para 1+0 in her 2nd stage of labour for more than an hour. Regular fundal height,
cephalic presentation, mentoanterior position and regular uterine contractions, management:
Observe for progress of labour
68. Mitosis and meiosis: Cell division occurs twice in meiosis
69. Regarding rubella: Rubella susceptible women are advised to avoid exposure to virus
70. Oogenesis: one diploid cell produces mature haploid cells during meiosis
71. Hep C infected mother, breastfeeding advice: Continue feeding, no risk of transmission
72. 32 year old primigravida, normal uterine contractions for 6 hours labour but head not engaged,
state the reason: CPD
73. Before shifting a woman from labour room to ward, ensure that: Mother is in good condition
74. 35 years old multigravida bleeds heavily with red protracted mass, diagnosis: Uterine prolapse
75. Preterm labour diagnosed by: Cervix effacement and dilatation
76. Measurement of maternal height and weight is important in antenatal clinic because: Perinatal
mortality is high with BMI >30
77. 30 years old lady with 36 weeks gestation, has a history of a previous spontaneous delivery. She is
normotensive and on examination presentation is breech. Your management: ECV
78. Cannot diagnose antenatally by ultrasound only: Down's sydrome
79. Android pelvis predisposes to: Deep transverse arrest
80. A lady para 2, A -ve with husband B +ve has positive coomb's test after 3rd delivery: Doesn't
require anti D anymore
81. Ideal pelvis: Smooth sacral curve
82. Primigravida with 42 weeks pregnancy and 20 hours labour gives birth to a still-born. State the
cause: Intrapartum asphyxia
83. Commonest cause of maternal death in HELLP: Hemorrhage due to DIC
84. 34 year old pregnant lady with 36 weeks gestation, fetal distress. On examination a prolapsed
mass is found, management: Forceps delivery/CS?
85. Diagnosis of Hep C by: HCV RNA
86. Classical CS: Midline vertical incision
87. Pregnant lady, MCV <80: Iron deficiency anemia
88. Pulmonary embolism, investigation of choice: Ventilation/Perfusion scan
89. Defecation in utero, meconium seen in amniotic fluid, reason: Post term pregnancy
90. Pregnant lady with headache, nausea, vomiting, jaundice, abdominal pain, hypoglycemia and
coagulopathy: Acute fatty liver of pregnancy
91. Most common cause of hypertension in pregnancy: Essential hypertension
92. Confirmation of early pregnancy: Urine test
93. Iron deficiency anemia diagnosis: Serum ferritin
94. Dreadful complication of uncontrolled diabetes in pregnancy: Nephropathy
95. Neonatal physiotherapist: Preterm birth
96. Iron deficiency anemia at 36th week, treatment: Packed Cells
97. Pregnant lady at 34 weeks gestation, fetal head in right iliac fossa, possible lie: Oblique
98. Normal primipara cervical dilatation rate: 1cm/hr
1. Regarding complications of monoamniotic twins:

a. Cord accidents
b. Twin twin transfusion
c. Early death
d. IUGR
e. Difficult labour
2. Primigravida admitted in labour room, on PV exam cervix is 7 cm dilated and loop of pulsating
cord felt through intact membrane. Most appropriate management for this patient is:
a) Do artificial membrane rupture
b)cut the cord and apply vacuum
c) external cephalic version
d)allow to procees for NVD
e) do emergency caesarian section
3. How many oocytes are present at birth: (wikipedia says 1-2 million)
a) 1 million
b)2 million
c) 5 million
d)8 million
e) 10 million
4. Investigation of choice in VTE

a) xray
b)ct scan
c) Doppler
d)mri
e) venography
5. Chorionic villous sampling is done at :

a. 10th week (10-13th wks)
b. 15th week
c. 20th week
d. 5th week
e 12th week
6. Most common psychiatric disorder after delivery is

a. Depression
b. anxiety
c. schizophrenia
d. mania
e. bipolar disorder
7. First step in stopping bleeding after uterine atony:

a. uterine massage
b. bimanual compression
c. administer vitamin K
d. Iv oxytocin
e. uterine packing
8. A female with polyhydramnios. Immediately after labour developed chest pain and dyspnea.
Diffuse crepitations are heard all over the chest. Her bp is 90/60 mmhg and pulse rate 140/min. Most
probably she has:
a. Myocardial infarction
b. pulmonary embolism
c. amniotic fluid embolism
d. cardiac failure
e. adult respiratory distress syndrome
9. The most important aim of safe motherhood project is:

a. community education for women
b. health education and services for adolescents
c. family planning
d. care by skilled health personnel before during and after child birth
e. prevent and manage unsafe abortions
10. Safe motherhood includes all except:

a. antenatal care
b. free access to induced abortions
c. obstetric care
d. family planning
e. prepregnancy counseling
11. Of the following which one is used in screening program

a) GBS
b)toxoplasma
c) Syphilis
d)paramyxovirus
e) herpes
12. Most common cause of secondary pph :

a) Retaine placental parts
b)Uterine atony
c) uterine inversion
d)genital lacerations
e) coagulation defects
13. Best statement regarding nutrition of mother during pregnancy:

a) vitamin A supplementation are avoided
b)calcium requirement increases from 200mgto 400 mg
c) high fibe + fat
d)low calorie diet
e) low folate and iron
14. Which of the following is an investigation for preeclampsia

a) Urine dr
b)Urine creatinine and electrolytes
c) 24 hour urine for protein and creatinine
d)LFTs
e) Full blood count

a) 28 weeks
b)32 weeks
c) 35 weeks
d)37 weeks
e) 40 weeks
16. Best statement regarding preterm labour is :

a. labour before 24 weeks
b. tocolysis causes reduction in respiratory distress syndrome
c. tocolysis is given to gain time for administering steroids
d. Twinpregnancy is not associated with preterm labour
e. bedside elastin test rapid assessment
17. A diabetic mother comes with 32 weeks gestation and symphysio-fundal height of 36cm .Most
likely cause is :
a. Macrosomia
b. Molar pregnancy
c. leimyoma
d. Multiple pregnancy
e. polyhydramnios
18. A 35 year old female para 1+ 0 in her second stage of labour for more than an hour. She has
regular symphysio-fundal height, cephalic presentation, mentoanterior position and regular uterine
contractions. Management should be:
a. observe for progress of labor
b. immediate caesarean section
c. induce labour by oxytocin
d. Delay labour by oxytocin
e. Give prostaglandin analogues
19. mitosis and meiosis:

a. Meiosis begins with diploid cells
b. Meiotic division leads to 4 haploid daughter cells
c. unlike mitosis, cell division occurs twice in meiosis
d. During 2nd division, no dna replication occurs
e. 23 single stranded chromosomes will be there (wrong)
20. oogenesis:
a. one diploid cell produces mature haploid cell during meiosis
b. one diploid cell produces mature haploid cell duing mitosis
c. one haploid cell produces mature diploid cell during mitosis
d. one haploid cell produces diploid cells during meiosis
e. none of the above
21. Regarding rubella:

a. it is not necessary that every infected mother is cause of transmission to fetus
b. rubella susceptible women are advised to avoid exposure to the virus
c. girls vaccinated before pregnancy don’t get the disease
d. vaccination time is 2nd and 3rd trimester
e. infection in 1st trimester is not severe
22. If a pregnant lady delivers baby and she is used as infected with hep C , what should be she
advised
a. Don’t hadle and feed the baby
b. take antiviral rx and then breast feed
c. continue breast feed completely as there is minimal chance of viral transmission via breast milk
d. should take interferon
23. A 32 year old primigravida with normal uterine contractions s under labour process for last 6
hours fetal head is not engaged, what is cause of the poor progress
a. deflexed head
b. cpd
c. inefficient uterine contractions
d. malposition
e. placenta previa
24. 1 35 year old lady grand multigravida, she bleeds heavily and red mass protracted out at vulva at
the end of this process, cause:
a. uv prolapsed
b. uterine inversion
c. uterine rupture
d. pph
e. detached placenta
25. Before shifting a woman fom labour room to ward, please ensure that
a. bladder is empty
b. mother is in good condition
c. perineum has been completely speared
d. no pain
e. bleeding is controlled
26. Pre term labour is diagnosed by:

a) dilatation and effacement of cervix
b)painful, tender abdomen
c) regular contractions
d)show
e) painful contractions
27. Measurement of maternal weight and height is important in antenatal clinic because:
a) perinatal mortality is high if BMI > 30
b)height is a predictor of labour problem
c) BMI has to be calculated on each visit
d)it has no role In labour
e) nutritional status can be assessed
28. 30 year old lady, present in opd with 36 week gestation. She has preious hx of spontaneous
delivery, she is normotensive, on examination presentation is breech, what would you offer:
a) immediate c section
b)immediate laparotomy
c) ECV
d)Reassurance
e) termination of pregnancy
29. Of the following, which one cannot be diagnosed prenatally by Ultrasound:

a. Renal agenesis
b. Down syndrome
c. neural tube defect
d. clubfoot
e. omphalocele
30. Regarding android pelvis, it predispose to:

a. OP position
b. occipito-transverse position
c. Deep transverse arrest
d. normal labour
e. none pf the above
31. A lady para 2+, blood group A-ve. Husband b+ve, is admitted to labour room. Her first baby is
alive and had history of neonatal jaundice. Her second baby is alive and required exchange blood
transfusion. She has no history of infection anti-D. After delivery of 3rd baby, her coomb’s test is found
to be positive
a. She requires inection anti D
b. she requires injection Anti D in high doses
c. She doesn’t require injection Anti D
d. She requires kleuheir betke test to determine dose of injection anti D
e. she requires rhesus antibody titre to determine dose of injection Anti D
32. The most important finding in an ideal obstetric pelvis at cavity level is:
a. Shallow and straight side walls
b. No great projection of the ischial spines
c. ischial bispinous diametr measuring 10 cm
d. smooth sacral curve
e. sacrospinous ligament at least 3.5 cm
33. A. primigravida presented in emergency with 42 weeks pregnancy, having labour pain since 20
hours at home and delivered a still born baby by forceps in hospital. The most likely causeof still birth
is:
a. postmaturity
b. prolonged labour
c. intrapartum asphyxia
d. infection
e. forceps application
34. The commonest cause of maternal death in Hellp syndrome is due to:
a. Thromboembolism
b. ruptured uterus
c. Hemorrhage due to dic
d. hepatic failure
e. obstructed labour
35. The commonest cause of Massive pph:

a. Uterine atony
b. Eclampsia
c. Uterine inversion
d. Trauma to genital tract
36. A 34 year old pregnant lady, 36 week gestation, with fetal distress. On examination a prolapsed
mass Is found. What you should do:
a. Continue with labour
b. Forcep delivery
c. Ventousedelivery
d. Emergecy CS
e. do nothing
37. Diagnosis of Hep-C infective state in pregnancy is by detection of:

a. High titres of HCV
b. HCV RNA
c. HCV antibodies
d. HEV antibody
e. HBV dna
38. Classical C-Section:

a. Straight horizontal incision.
b. midline vertical incision
c. lower transverse incision
d. lateral vertical incision
e. upper transverse incision
39. A pregnant lady with MCV<80, most common cause of anemia is :

a. thalassemia
b. iron deficiency anemia
c. Megaloblastic anemia
d. pancytopenia
e. Sickle cell anemia
40. Patient suspected of pulmonary embolism, investigation of choice is:

a. Ventilation/perfusion scan
b. U/s
c. Doppler US
d. duplex
e. CT angiogram
41. Defecation inu tero i-e meconium is seen in the amniotic fluid, likely cause is :
a. post term pregnancy
b. PPH.
c. Antipartum haemorrhage
d. Preterm delivery
e. Macrosomia
42. A pregnant lady is seen with C/o headache, nausea, vomiting, progressive jaundice, abdominal
pain, hypoglycemia and coagulopathy, most likely cause is:
a. acute fatty liver of pregnancy
b. HEV infection
c. budd chiari syndrome
d. eclampsia
e. HELLP syndrome
43. Most common cause of hypertension in pregnancy:

a. Pregnancy induced htn
b. essential hypertension
c. renal hypertension
d. pre-eclampsia
e. chronic hypertension

a. amenorrhea
b. urine test
c. systems of nausea and vomiting
d. listening to fetal heart
e. internal examination
45. How will you diagnose iron deficiency anemia
a. serum iron
b. serum transferring
c. serum ferritin
d. urinary transferrin
e. serum hb
46. dreadful complication of uncontrolled diabetes in pregnancy:

a. infection
b. ketoacidosis
c. retinal problems
d. renal problems
e. hypertension
47. Most important role of neonatal physiotherapist is for:

a. macrosomic child
b. postterm birth
c. preterm birth
d. Twin births
e. jaundiced child
48. A lady came to you at 36th week of gestation, with iron deficiency anemia . You would give
a. oral iron
b. iron + folate
c. parenteral iron
d. whole blood
e. packed cells
49. A pregnant lady at 34 weeks gestation, on examination baby’s head is found at Right iliac fossa,
possible lie is:
a. transverse
b. Oblique
c. Breech
d. Footling
e. Twin pregnancy
50. In normal primipara, the cervical dilatation is:

a. 2 cm/hr
b. 1 cm / hr
c. 4 cm/ hr
d 0.5 cm/ hr
e. 5cm/hr
51. Contraindication to ventouse delivery:

a. Head presentation
b. Gestation less than 34 weeks
c. head engaged
d. cervix dilated
e. maternal respiratoty disorders
52. What is the most dreadful complication of obstetric cholestasis:

a. hemorrhage
b. premature labour
c. steatorrhea
d. Intra uterine death
e. meconium staining
53.Regarding 2nd degree perineal tears:

a. involves skin
b. involves anal epithelium
c. involves anal sphincter complex
d. involves perineal muscles
54. A woman at 32 weeks gestation with arrested 2nd stage of labour, what you should do:
a. ventouse delivery
b. forceps delivery
c. Cessarian section
d. episiotomy
55. Puerperial sepsis:

a. it is due to endometritis
b. it is defined as temperature above 38degree C
c. it refers to genital tract infection following delivery
d. causes pnumonia
e. caused by previous UTI
56. How will you diagnose mitral stenosis

a. ECG
b. Echocardiography
c. serum troponin
d. Stress test
e. duplex scan
57. Main support of vagina is from:

a. uterosacral ligament
b. uterus
c. fascia
d. pubococcygeus
e. Urethra
58. Normal OgTT value is :

a. 7.8 mmol/l
b. 11.1 mmol/l
c. 15mmol/l
d. 18 mmol/l
e. 20 mmol/l
59. Gestational diabetes is due to:

a. increased glucagon
b. decreased insulin secretion
c. Increased IGF
d. Relative insulin resistance
e. Increased insulin metabolism
60. Regarding NTDs.

a. Have a recurrence rate of 25% when a parent or previous sibling is involved
b. It doesnot present with spinda bifida
c. Encephalocele is not detectable on 1sttrimester ultrasound
d. Spina bifida are detectable at routine 20 weeks scan
61. A woman presents with acute fatty liver disease in pregnancy, what will be the consequences
after pregnancy
a. HCC
b. Chronic liver disease
c. No serious consequences
d. Progressive acute on chronic
e. Cirrhosis
62. Down’s syndrome’s most characteristic feature:

a. macroglossia/flat facies
b. cranial defects
c. congenital heart defects
d. mental retardation
e. renal agenesis.
63. What would be the ethical principle if a woman is coming to you with the intent of hysterectomy:
a. Ablative therapies are available
b. Send her home with reassurance
c. Prompt her for hysterectomy
d. advice radiotherapy
64. A woman had undergone a cessarian delivery, she now presents with a new pregnancy and
intends to undergo a NVD, what would be the risk factor if we use
“ Augmentation and induction” technique in this patient:
a. High BP.
b. Obstructed labour
c. Rupture of the previous cessarian section scar
d. Fetal hypoxia
e. Uteroplacental insufficiency
65. Safe motherhood includes all except:

a. antenatal care
b. free access to induced abortions
c. obstetric care
d. family planning
e. prepregnancy counseling
66. What is the significant purpose of Booking visit ultra sound:

A. Dating of pregnancy
B. Confirming ectopic pregnancy
C. confirm the viability of fetus
d. Determining risk factor for threatened abortion
e. All of the above
67. A woman had undergone abortion at 14th week gestation, after 2 week she presented with fever
and abdominal pain, what would be the cause of her presenting condition
a. Uterine haemorrhage
b. uterine infection
c. Retained products of conception
d. Syphilis
e. Uterine inversion
68. A lady presented was scheduled for cessarian section, in her lab reports her hb was 7 mg/dl, what
would be the most appropriate management in her case:
a. Whole blood
b. fresh frozen plasma
c. packed red cell
d. oral iron
e. parenteral iron
69. What is the most important prerequisite for examining a patient in the lithotomy position :
a. Warm the instrument
b. Sterilize the instrument
c. Wash the instrument
d. Presence of senior surgeon
e. Presence of an attendant
70. What is the most reliable test for prenatal diagnosis of Down’s syndrome
a. PAPPA
b. HCG
c. PAPPA, HCG
d. PAPPA, HCG and NTD
e. AFP
71. What is true regarding spermatogenesis:

a. 3 spermatids are formed
b. 2 polar bodies are formed
c. 4 haploid spermatozoa are formed by meiosis
d. 4 diploid spermatozoa are formed
e. 4 haploid spermatozoa are formed by mitosis
72. A woman in labour had normal uterine contractions of normal intensity and frequency, her cervix
was dilated to 6 cm. After 4 hours the uterine contractions were in the same state but her cervix was
not dilated greater than 6 cm, what would be the cause:
a. Uterine atony
b. Insufficient oxytocin
c. enlarged fetal head
d. CPD
e Cervical dystocia
73. A patient with hx of epilepsy, she wishes to become pregnant, she is currently on antiepileptic
medicine, what would you advice as a doctor:
a. 4 mg Folic acid
b. Halve the dose of epileptic medicines
c. Counter advice her for pregnancy
d. Add another antiepileptic medicine.
e. Reassure and advice her on getting pregnant
74. What would be the side effect of syntocinon with the previous history of CS.
a. Fetal hypoxia
b. Maternal exhaustion.
c. fetal distress
d. Rupture of CS scar
e. uteroplacental insufficiency.
75. What is the most common global cause of IUGR.

a. Maternal undernutrition
b. preeclampsia
c. Uteroplacental insufficiency
d. chromosomal defects
e. infections.
76. Which bone makes the vertex:

a. Occipital
b. partietal
c. frontal
d. temporal
77. Regarding fetal skull:

a. Mandible, occiput
b. Bones and cartilage
c. Face, vault and base
d. bregma and vertex
e. bregma, vertex and mandible.
78. Vertex presentation is found in:

a. Occipitomental
b. Suboccipito bregmatic
c. submento bregmatic
d. frontooccipital
79. What landmark is used in the determination of fetal station:

a. pubic symphisis
b. ischial tuberosity
c. obturator fascia
d. ischial spine
e. pubic rami
80. Regarding pelvic inlet, choose the wrong one:

a. AP diameter is 11
b. Transverse diameter is 11.5
c. Transversediameter is 13.5
d. Pelvis makes an angle 60 degrees to the horizontal and erect position
e. Bounded anteriorly by pubic symphisis
81. What is the most important aspect of booking visit:

a. Confirmation of pregnancy
b. confirmation of fetal viability
c. Assessment of risk factor
d. Determination of ectopic pregnancy
e. Aria stella reaction
82. What is the most common cause of APH:

a. Smoking
b. HTN
c. African race
d. Age above 40
e. None of the above
83. What is the most potential sensitizing event for rh incompatibility:

a. APH
b. Delivery of the fetus
c. Miscarriage
d. Termination of pregnancy
e. All of the above
84.The commonest cause of Massive pph:

a. Uterine atony
b. Eclampsia
85. If a prostaglandin inhibitor is given the effects seen will be:

a. closure of ductus arteriosus
b. opening of ductus arteriosus
c. immunosuppression
d. dec secretion of glands
e. Vasodilation
86. Which of the following maneuvers aids in the delivery of shoulders during breech presentation:
a. Perinauds
b. Internal podalic version
c. External podalic version
d. Loveset maneuver
e. non of the above
87. What is the most safest incision for episiotomy:

a. Mediolateral
b. midline
c. lateromedial
d. circumferential
88. During first phase of second stage of labor there is no maternal urge to push beause:
a. Uterus is intensive
b. crowning has not occurred
c. fetalhead is high
d. Cervix is not dilated
e. Contractions pare painful
89. Regarding placenta accrete:

a. Villi invade into the myometrium
b. Villi invade into to uterine serosa
c. villi invade into the bladder
d. villi are attached to the myometrium
90. What is the commonest cause of abnormal vaginal discharge in woman of childbearing age:
a. Vaginal candidiasis
b. Bacterial vaginosis
c. Chlamydia
d. gonorrhea
e. herpes.
91. Large SFH, for gestational age:

a. Macrosomia
b. polyhydramnios
c. Term pregnancy
d. IUGR
e. Multiple pregnancy
92. A female patient present at 30 weeks of gestation with hx of 2 bleeding episodes per vagina.
Her BP is 120/70, pulse 78 heart rate is normal. Regarding her management
a. Admit her, prepare for emergency CS in case of massive bleeding occurs
b. Terminate pregnancy at once
c. Reassurance
d. Transfuse blood and offer medications
e. Induction of labor
93. The most important factor which makes CTG suspicious

a. Reduced variability
b. Variable deceleration
c. Abnormal baseline rate
d. Shallow deceleration
e. Absence of Accelerations
94. Most common cause of IUD

a. Un-explained
b. Infections
c. Genetic disorder
d. trauma
e. Undernutrition
95. A para 1+0, rhesus negative female comes for antenatal visit. First step would be to investigate
for?
a. Husband blood group
b. Fetal blood group
c. Atypical antibody screen
d. Amniocentesis
e. US
96. what drug is administered to treat seizures in eclampsia?

A. Magnesium hydroxide
B. Sodium sulphate
C. Potassium Phosphate
D. Magnesium sulphate
E. Phenytoin
97. On vaginal examination,the reassuring sign of fetus is?

A. Vertex presentation
B. Clear Amniotic fluid
C. Vertex at ischial spine
D. Pelvis adequate
E. Blood on PV exam
98. Paramesonephric ducts give rise to:

A. Uterus
B. vagina
c. fallopian tubes
d. ovaries
e. uterus, fallopian tubes and vagina
99. Most important obstetric complication in polyhydromnios:

a. malpresentation
b. pregnancy induced htn
c.preterm labour
d. placenta previa
e. ectopic pregnancy
100. During normal pregnancy a physiologic increase is seen in

a. Hb conc
b. plasma folate conc
c. RBC
d. ESR
e. hematocrit

1. hep C, can breast feed
2. fetal skull.......... vault anatomy
3. anatomy ... sub occipito bregmatic diameter (2-3 questions like)
4. u/s age viability
5. most common psychiatric... depression in pregnancy
6. most common risk factor for fetal compromise ... IUGR
7. sex can be found at conception
8. down feature... flat facies
9. IUGR..... fetal hypoglycemia
10. before delivery breech... ECV is done
11. ceaserean section upper segment.. vertical
12. spermatids are haploid
13. progresss of labour 1 cm/hr
14. one question was of diabetes values in mmol... please read that
15. premature delivery ...steroid is given in 48hrs window period for lung maturity
16. cord prolapse risk is increased in monoamniotic
17. at term, cord prolapse ... indication for c/s section
18. in iron deficiency ... ferritin levels are investigated.. question not remembered
19. at 32 weeks labour pains.... Rx is tocolytics and steroids
20. topic of epilepsy in pregnancy... monotherapy
21. features of heart failure....
22. poor progress in second stage... ventouse
23. gestational diabetes ... resolve completely 6 weeks
24. 1 que from Rx of hep C in preganancy
25. 1 que of inlet.... transverse anantomy
26. uterine massage is done ... PPH
27. post term ... meconium
28. apgar score... grimace... lengthy line
29. pelvic floor anatomy... 2nd degree tear muscle... que not remembered
30. ventouse contra... face presentation
31. diabetic mother... macrosomia
32. folic for neural tube
33. cordocentesis at 20 weeks
34. investigation of syphilis
35. fiber/fat.... for constipation
36. RNA virus hep C
37. PAPP-A/ nuchal
38. 1 que of intrapartum asphyxia
39. twin delivery at 32 or 37 weeks ?????? it was line from 10 teacher obs
40. ????? is complication of IUGR
41. amniotic fluid embolism ......
42. rhesus.... Miscarriage
1. NTDs:
a. Include anencephaly, encephalocele and spina bifida
b. Encephalocele is universally lethal
c. Can be detected by measuring amniotic fluid folate level
d. U/S scan is unable to detect NTDs
e. All are detected in 1st trimester scan
2. 38 week pregnant, female has presented in labor room, while palpating abdomen, 1 st step to is to
check:
a. Fundus
b. Lie
c. Engagement
d. SFH
e. Adequacy of liquor
3. Which of the following leads to super imposed pre eclampsia?
a. BP 160/100 mmHG in early pregnancy
b. Co existing diabetes
c. Primigravida
d. Old age
e. Chronic renal disease
4. Commonest cause of abruption placenta is:
a. Hypertension
b. Anti coagulants
c. Trauma
d. Vigorous exercise
e. Low socioeconomic group
5. Regarding breast changes in pregnancy:
a. Size of breast increases due to hypertrophy and hyperplasia
b. Size of breast increases due to fat deposition
c. Enlarged sebaceous glands are known as montogomertry’s tubercles
d. Estrogen increases the no of alveoli
e. Areola becomes lighter in color
6. Fetus responds to anoxia by:
a. Auto regulation
b. Placental enlargement
c. Microsomia
d. Anaerobic respiration
7. What is done in the management of the frist stage of labor?
a. Emotional support and mobilized
b. Observation with timely intervention
c. Adequate hydration
d. Oxytocin
e. Instrumentation
8. Most common cause of periatal mortality world wide:
a. Congenital disease
b. Immaturity
c. Ante partum fetal death
d. Infection
e. Intra partum anoxia
9. Most important step taken to reduce maternal mortality
a. Antenatal care
b. Hospital deliveries
c. Hand hygene
d. All deliveries in tertiary care
e. Home deliveries
10. Alert on line on a partogram indicates:
a. Progress of 1 cm/hr
b. Ideal progress in labor
c. Slow progress of labor
d. Latent phase of labor
e. Strength of uterine contractions
11. Commonest cause of loss of conscioiusness:
a. Simple faint
b. Eplectic faint
c. Hypoglycemia
d. Profound hypoxia
e. Intra cerebral bleed
12. All are contraindication to ventouse except: Incomplete? – both are right
a. Face presentation
b. Gestation less than 34 weeks
13. In a pregnant woman hemorrohoids may develop commonly due to
a. Venous stasis
b. Pressure of the uterus on the inferior vena cava
c. Obstructed/difficult labor
d. Portal vein HTN
e. Progesterone effect
14. A lady is given tocolytic for preterm labor, suddenly she develops difficulty in breathing and
froths at the mouthm she should be given:
a. Salbutamol
b. NSAIDS
c. Nifidepine
d. Digoxin
e. Alosiban
15. Ventouse is applied at the:
a. Ant fontanelle
b. Post fontanelle
c. Area of fetal skull bounded by 2 parietal emineces and ant and post fontanells
d. Midline placement over the occiput
e. At the inter section of sagittal, frontal and coronal suture intersection
16. Serum BHCG:
a. Found in maternal blood in the 3rd week after implantation
b. Commercial kits are sensitive to detect 50 iu/l of B HCG
c. Level of > 15 iu/L usually denotes +ve for pregnancy
d. HCG doubles approximately every 48-72 hr
e. B HCG +ve in urine before its +ve in the serum
17. During labor CTG is found to be slightly abnormal. What should be done
a. E/R c section
b. Do nothing and wait for NVD
c. Continuous fetal cord sampling
e. Continuous fetal scalp sampling
18. 4t degree tears occurring at labor:
a. Involve the rectum
b. 3rd degree tear with torn anal epithelium
c. Includes episiotomy
d. Involves skin, perineal muscle and anal sphincter
e. Is very common
19. Post term babies mortality is due to:
a. CPD
b. Placental insufficiency
c. Malpresentation
d. Hypoglycemia
e. Birth asphyxia
20. A morphine addict becomes pregnant, effect of drug abuse on the fetus would result in
a. Preterm
b. IUGR
c. Anemia
d. Placental abruption
e. Congenital anomaly
21. At which cut off value of serum fasting glucose level would you label a patient as gestational
diabetes, according to WHO
a. > 7.8 mmol/L
b. > 7.6 gm/dl
c. > 11.1 mmol/L
d. >11.1 gm/dl
e. >7.5 mmol/L
22. Patient had an OGTT was diagnosed as having gestational diabetes. Other than this she had an
uneventful pregnancy and later delivers a healthy baby of 3.2 kilos. Now when should you perform a
full glucose tolerance test of the mother to ensure diabetes has resolved:
a. Right after the delivery
b. 2 hours after the delivery
c. a week after the delivery
d. a month after the delivery
e. 6 weeks after the delivery
23. The rate of maternal mortality in Pakistan
a. 800
b. 100
c. 200
d. 300
e. 600
24. Perinatal mortality rate:
a. All stillbirths plus deaths in the first week after birth
b. No of all still births and early neonatal deaths per 1000 live births and still births
c. Rates of neonatal and infant deaths expressed as rates per 1000 live births (ie does not include still
births and late fetal losses)
d. No of all stillbirths and early neonatal deaths per 100,000 live births and stillbirths
e. Rates of neonatal and infant deaths expressed as rates per 100,000 live births (ie doe not include
stillbirths and late fetal losses)
25. A baby is born at 20 weeks and 3 das. This is known as
a. Mildly preterm birth
b. Very preterm birth
c. Very very preterm birth
d. Extermeley preterm birth
e. Abortion
26. A women had a previous abnormal child now comes at 20 weeks and is offered amniocentesis
to identify any chromosomal abnormality. The cells to be picked up from the amniotic fluid is/are
a. Fetal wbc’s
b. Maternal fibroblasts’s
c. Fetal fibroblasts
d. Maternal and fatal rbc’s
e. Fetal wbc’s
27. In antenatal screening U/S which will not be picked up
a. Renal agenesis
b. Duodenal atresia
c. Cleft palate
d. NTDs
e. Cardiac defects
28. Dosage of folic acid to be taken by a pregnant lady, who is known diabetic and had a child born
with NTD is:
a. 5mcg
b. 0.5 mg
c. 4 mcg
d. 4 mg
e. 0.3 mcg
29. Regarding the administration of oxytocin
a. Delay in 2nd stage of labor with adequate uterine contractions
b. At the time of the crowning of the head of the 1st of the twins
c. 10 min after the delivery of the 1st fetus in a twin delivery vaginally
d. In PPROM to delay the labor
e. Should administered all women at the beginning regardless of any factors
30. Which of the following is considered to be a normal labor
a. Multiple gestation
b. Malposition
c. Malpresentation
d. Induced labor
e. 2nd stage of labor lasting for 16 hr
31. Commonest risk factor for poor progress of labor
a. Small women and big baby
b. Breech
c. OP position
d. Early membrane rupture
e. Soft tissue and pelvic malformation
32. Women found to be Hepatitis C +ve, what measures to be taken
a. C section as vertical transmission rate is higher than that of hepatitis
b. Abort pregnancy
c. AROM
d. Try to shorten 2nd stage of labor and avoid fetomaternal transfusion
e. Give interferons
33. Common cause for recently increasing incidence of multiple pregnancies
a. Increasing age of women
b. Multi parity
c. Use of ovulation inducing drugs
d. Maternal history of twins
e. Race
34. Hemolytic disease of the new born is most common when
a. Mother is D rhesus –ve and baby is D rhesus +ve
b. Mother is D rhesus +ve and baby is D rhesus +ve
c. Mother is D rhesus –ve and baby is D rhesus –ve
d. Mother is D rhesus +ve and baby is D rhesus –ve
e. Mother is E rhesus –ve and baby is E rhesus –ve
35. Predict the genetic composition of a father having a blood group: Incomplete?
a. All would be AB rhesus +ve
b. Could be either A or B with half + and half –ve
c. Could be either A or B but all rhesus +ve
d. Could be either A or B or O with half rhesus + and half –ve
e. All would be AB rhesus –ve
36. About cardiovascular changes in pregnancy:
a. Heart rate decreases by 10-20%
b. Stroke volume increases by 60%
c. Cardiac output increases by 30-50%
d. Mean arterial pressure decreases by 90%
e. Peripheral resistance increases by 35%
37. Most important investigation considered in a woman presenting with late second trimester
miscarriage
a. Full blood count
b. Fibronectic level
c. TVS for cervical length
d. Nitrazine test
38. Most common minor disorder of pregnancy is
a. Edema
b. Back pain
c. Carpel tunnel syndrome
d. Varicose vein
e. Nose bleed
39. Criteria for vaginal delivery in twin pregnancy
a. Cephalic presentation of twin 1
b. Monochorionic twins
c. 1 twin having congenital anomaly
d. Twin 1 smaller than twin 2
e. Spontaneous onset of labor
40. PG admitted in labor room, on P/V exam cervix in 7cm dilated and a loop of pulsating cord is
felt through intact membranes. Most important in the management of this patient is
a. Do AROM
b. Cut cord and apply vacuum
c. ECV to shift loop
d. Allow to proceed to normal vaginal delivery
e. Do emergency C section
41. PG at 32 weeks came in antenatal clinic with U/S report showing increased amount of amniotic
fluid. This finding is most likely linked with
a. Anencephaly
b. Posterior urethral valves
c. Fetal cardiac anomaly
d. IUGR
e. Placenta previa
42. Which of the following is an investigation for pre eclampsia
a. Urine D/R
b. Urea, creatinine, and electrolytes
c. 24 hr urine for protein and creatinine
d. LFTs
e. FBC
43. A pregnant female comes to antenatal clinic at 25 weeks , BP is 150/100, pulse 90, but is not
experiencing fits nor has proteinuria. You will
a. Give her methyldopa to stabilize BP
b. Stabilize and do E/R C-section
c. Give prophylactic anti-epileptics
d. Terminate pregnancy
e. Induction of delivery
44. A woman with a history of 3 previoius C section. On U/S placenta is found to be 1cm away
from the cervical os, the best management in such situation?
a. Hysterectomy
b. Vaginal delivery
c. Admit and do C section
d. Deliver via giving classical mid line vertical incision to the abdomen and uterus
e. Deliver via giving upper horizontal incision to the abdomen and uterus
45. Regarding vertex
a. Area of fetal skull bounded by 2 parietal eminences and ant and post fontanelle
b. Highest point of fetal skull
c. Another name of skull vault
d. Area between an and post fontenelle
e. Formed by sagittal, frontal, and coronal suture intersection
46. Upon fetal blood sampling, following ph would indicate fetal hypoxia and acidosis in labor
a. <6.5
b. >7.2
c. <7.2
d. <7.5
e. <6.2
47. A 30 yr lady, 34 wks gestation, history of breech delivery vaginally, normotensive and on P/A
exam the presentation is breech. Offer?
a. ECV
b. Immediate C section
c. Reassurance
d. Termination of pregnancy
e. Induction of labor
48. Paramesonephric ducts form:
a. Uterus and vagina only
b. Complete female genital tract
c. Complete female urinary system
d. Uterus, vagina, and fallopian tubes
e. Uterus, vagina, fallopian tubes, and ovaries
49. HELLP syndrome is characterized by:
a. Hemorrhage, deranged LFTs, and thrombocytopenia
b. Hepatic damage, elevated LFTs and low platelets
c. Less clotting factors, jaundice and very high platelets
d. Hemorrhage, elevated clotting factors and platelets
e. None of the above
50. Regarding blood gas and acid base changes in pregnancy
a. PCO2 decreases
b. PCO2 increases
c. O2 saturation increases
d. O2 saturation decreases
e. Is similar to non pregnant state
51. Investigative choice for DVT
a. Venography
b. U/S
c. CT angiogram
d. Color Doppler
e. Duplex U/S
52. A young para 2+0 had delivered alive healthy baby of 3 kgs two hours back. She has been
found to be Hep C +ve on routine screening. She should be
a. also screened for coexistent HIV infections
b. Asked not to handle or breast feed the baby and put on anti viral drugs
c. Asked to continue breast feeding the baby if she recovered anti viral drugs
d. Given immunoglobulin and then breast feed the baby
e. Counseled to continue breast feeding as the risk of transmission via breast milk is low
53. At 34 weeks, mrs abc, had developed severe jaundice followed by coma. She died on the 7 th
day. Since she had no history of blood transfusion and was vacinnated against hep B, cuase of death?
a. Hep A
b. Hep B
c. Hep C
d. Hep E
e. Inra hepatic cholestasis of pregnancy
54. Characteristic feature of downs syndrome
a. Flat facies, macroglossia
b. Cardiac septal defects
c. Mental retardation, short sightedness
d. Prematurity
e. Leukemia
55. Important to ask in the medical history of a 1st degree relative during pregnancy is:
a. Diabetes
b. Epilepsy
c. Jaundice
d. Pulmonary TB
e. Twin pregnancy
56. Difficult labor with deep transverse arrest is associated with:
a. Good size baby
b. Patlypid pelvis
c. Short statured mother
d. Anthropoid pelvis
e. Android pelvis
57. Secondary PPH
a. Is associated with fibroid uterus complimenting pregnancy
b. Is a result of RPOC and or uterine infection
c. Requires immediate evac of uterus
d. Is a rare cause of massive bleeding
e. Requires hysterectomy
58. Prenatal screening and diagnosis of neural tube defects
a. Presence of raised mid trimester maternal serum AFP level and U/S exam
b. Presence of lemon shape skull and banana sign fetal brain on U/S
c. U/S exam is very sensitive
d. Presence of acetyl cholinesterase is amniotic fluid
e. Needs a two step procedure with maternal serum AFP and acetyl cholinesterase
59. A PG with post date pregnancy needs induction of labor her bishop score is <5 best option is:
a. Mechanical sweeping of membranes
b. Amniotomy
c. Vaginal misoprostol
d. Oral misoprostol
e. Oxytocin infusion
60. Regarding amniotic fluid:
a. Volume is decreased in fetal growth restriction
b. AFI alters throughtout pregnancy
c. Fetal kidneys contribute to amniotic fluid volume
d. AFI gives a reliable index of amniotic fluid volume
61. Commonest cause of pereterm labor
a. Bacterial vaginosis and other other infections
b. Over distention
c. Antepartum hemorrhage
d. Appendicitis
e. Cervical weakness
62. A newborn of 2 weeks acquires pneumonia. The commonest etiology at this age is
a. Listeria
b. E coli
c. Streptocci
d. Gram –ve cocci
e. Heamophilus influenza
63. Most important manifestation of severe pre eclampsia is
a. Agitation
b. Epigastric pain
c. Hyper reflexia
d. Edema
e. Oliguria
64. Regarding the treatment of pre term labor the best statement is
a. Antibiotics given prophylactically prevents preterm labor
b. Beta agonist tocolytic drugs are the treatment of choice
c. Steroids are absolutely contra-indicated in preterm rupture of membranes
d. Tocoltyic drug’s are given to gain time for the effect of steroids
e. Cervical cerclage is applied in emergency
65. If a prostaglandin inhibitor indomethacin is given the effects seen will be
a. Closure of ducts arteriorsus
b. Opening of ductus arteriosus
c. Closure of ductus venosus
d. Opening of ductus venosus
e. Opening of formaen ovale
66. Glucose cross the placenta by
a. Diffusion
b. Osmosis
c. Facillated diffusion
d. Active transport
67. Clinical signs of heart disease in pregnancy is
a. Ejection of systolic murmur
b. Diastolic murmur
c. Presence of S4
d. Presence of S3
e. Arrhythmia
68. At 5th week of gestation, down syndrome can be diagnosied by
a. Increased Hcg and decreased PAPP-A
b. Decreased AFP and increased HCG
c. Decreased AFP and decreased HCG
d. Increased PAPP-A
e. Increased AFP and decreased HCG
69. A pregnant lady is presented to you, upon taking history you find out that her husband has a
cardiac disease, you will council the lady
a. Fetus is at the risk of congenital heart anomaly
b. There is no risk to the fetus
c. Fetus can have downs syndrome
d. Fetus can have limb anomalies
e. There is no method to detect cardiac anomaly prenatally
70. When would you administer vitamin K to a neonate
a. As soon as the baby is delivered /before the cord is cut
b. After the cord is cut but before taking baby out of the delivery room
c. A day after birth
d. 6 hours after birth
e. later along with other vacinnations
71. best assessment of age of the fetus at 12 weeks and before:
a. crown rump length
b. bipartial diameter, head circumference and femur length
c. abdominal circumference
d. CRL, HC, FL, and AC
e. Head to toe length
72. A women with a past history of hypertension, became pregnant, had uncontrolled blood
pressure throughout pregnancy. The is labeled as
a. Gestational hypertension
b. Eclampsia
c. Pre eclampsia
d. Chronic hypertension
e. Pregnancy induced hypertension
73. Using the abdominal U/S, the fetal heart rate will be seen to be beating at:
a. 5th week after LMP
b. 6th week after LMP
c. 7th week after LMP
d. 8th week after LMP
e. Between 5-6th week after LMP
74. Women in her 35th week of gestation, found to be anemic with a Hb of 8 g/dl, due for surgery
needs treatment with:
a. Whole blood
b. Oral Fe
c. Inj Fe
d. I/V Fe
e. Normal saline
75. An obese women of age 35, para 3, with a history of DVT has undergone a C section recently.
What preventive measures would you take in her case
a. Advise early mobilization
b. Appropriate hydration
c. Subcutaneous heparin
d. Leg stockings
e. All of the above
76. Commonest cause for symphsyio fundal height greater than gestational age is
a. Multiple pregnancies
b. Mistaken dates
c. Polyhydraminos
d. Uterine fibroids
e. Ovarian mass
77. All of the following are a cause of neonatal morbidity in a baby of diabetic mother
a. Hypoglycemia
b. Hypomagnesimia
c. Hypermagnesemia (odd one out)
d. Hyperbilirubinimea
e. Polycythemia
78. Any of the following may happen to a baby born to a diabetic mother:
a. NTD’s
b. Cardiac defects
c. Potts syndrome
d. Macrosomia
e. Spina bifida
79. Emergency protocol in a women developing massive postpartum hemorrhage
a. Summon senior multidisciplinary help
b. Resuscitate
c. Replace and maintain fluid volume
d. Investigate status and cause of bleeding
e. Arrest blood loss
80. 2 months amenorrhea, pregnancy test +ve and no fetal poles felt, fetal heart beat –ve. Next
investigation?
a. TVS
b. Abd U/S
c. P/V exam
d. Urine analysis
e. Laproscopy
81. Most common cause of massive postpartum hemorrhage is
a. Uterine atony
c. Genital tract lacerations
d. D/C
82. A 28 year old female, para 1+0, with history of previous abnormal fetus comes at 12 weeks
gestation, the prenatal diagnosis recommended is:
a. Fetal anomaly scan
b. Nuchal translucency test
c. Amniocentesis
d. Chorionic villus sampling
e. Cordocentesis
83. A patient under prolonged labor for 8 hrs delivers a 4 kilo baby at home. She is brought to the
hospital in comatose condition. On exam the abdomen is tense and tender and fresh streak of blood
is coming out of vagina.
a. 3rd degree perineal tear
b. cervical tears
c. RPOC
d. Uterine atony
e. Uterine rupture
84. Best statement regarding chorionic villus sampling is
a. Commonly done after 10 weeks
b. It is a screening test
c. Karyotyping results after 48 hrs
d. Risk of abortion is 5%
e. Commonly done trans abdominally
85. A gravid women with abdominal distention complains of severe vomting and excessive fetal
movements. Cause?
a. Choriocarcinoma
b. Threatned abortion
c. Ectopic pregnancy
d. Multiple gestations
e. Molar pregnancy
86. Commonest congenital anomaly loading to perinatal death
a. Cardiac anomalies
b. NTDs
c. Gastrointestinal anomalies
d. Downs syndrome
e. Metabolic acidosis
87. Following lab tests are done routinely during antenatal period in Pakistan
a. Rubella
b. Toxoplasmosis and CMV
c. Hep B
d. Hep A and E
e. All of the above
88. Correct statement regarding reproduction is:
a. The mature germ cells are diploid
c. Primary oocyres are produced during reproductive life
d. Meisosis only occurs in sex chromosomes
e. Ova determines the sex of a child
89. Most common cause of primary dysfunctional labor is
a. Inefficient uterine contractions
b. Malpresentatioin
c. Malposition
d. Cepalo pelvic disproportion
e. Prolonged latent phase
90. Most common reason for induction of labor
a. Maternal hypertension
b. Fetal growth restriction
c. Uncontrolled maternal diabetes
d. IUGR
e. Post dates pregnancy
91. The commonest complication presented in a twin pregnancy is
a. Preterm birth
b. polyhydramnios
c. IUGR
d. Twin to twin transfusion
e. Congenital anomalies
92. Correct statement regarding meiosis:
a. During meiosis DNA replication does not occur
b. Primary oocyte completes 1st meiotic division at birth
c. Occurs in both somatic and germ cell
d. Unlike mitosis, cell division occurs twice in meiosis
e. Meiosis is completed at ovulation

1. The most important finding in an ideal obstretric pelvis at cavity level is:
a. Shallow & straight side walls
b. Sacrospinous ligament at least 3.5cms
c. No great projection of the ischial spines
d. Ischial bispinous diameter measuring 10cms
e. Smooth sacral curve/nerve
2. Basic rule for ventouse delivery include:

a. Patient should have good uterine contractions
b. Cup should not be reapplied
c. Forceps should not be tried after failure
d. The head not just the scalp should descend with pull
e. Delivery should be completed in 10 minutes of application
3. Following statements about neural tube defects are correct

a. Recurrence risk is 5%-10% with a previously affected child
b. Can be diagnosed from maternal serum markers eg. Serum alpha fetoprotein
c. Diagnosis can only be confirmed by U/S in first trimester
d. U/S can diagnose 95% of cases with good sensitivity & specificity
e. Includes encephalocele, anencephaly & spina bifida
4. For a women progressing normally in labor it is necessary to:

a. Do intermittent monitoring of her vital signs
b. Record fetal heart sounds after every 15 minutes
c. Maintain partogram
d. Make note of cervical dilatation
e. Keep drug record
5. Investigations to evaluate the cause of intrauterine death includes:

a. Autopsy as the basic investigation
b. Autopsy and detailed examination of infant
c. Placenta for culture and histopathological examination
d. Detailed, documented external examination of infant
e. Detailed documented examination of infant, placental culture and histopathological examination
6. A primigravida presents in early labor with vertex presentation. The most of the presenting part at
inlet will be:
a. Left occipito anterior
b. Right mento transverse
c. Left mento anterior
d. Right occipito transverse
e. Right occipito posterior
7. Following is the reliable test for screening diabetes in pregnancy

a. Oral glucose tolerance test
b. Random blood sugar
c. Oral glucose challenge test
d. Urinary glucose
e. Fasting blood sugar
8. Regarding perinatal death the best option is

a. It is defined similarly in all countries
b. It means all still births plus deaths in first 28 days of life
c. For audit purposes
d. It should be notified to identify the risk factors
e. It is an important tool to know the level of health care provided to pregnant women
9. Regarding conception and implantation in humans all are true except:

a. Spermatogensis occurs in the seminiferous tubules of the testis
b. Primordial germ cells divide to produce spermatogonia
c. In humans it take two months for mature sperms to complete the cycle of spermatogenesis
d. The differenton of round spermatids to motile spermatozoa is called spermatogenesis
e. Spermatogonia are mature sperm cells
10. Common cause of delay in 2nd stage of labor is:

a. Malpresentation
b. Maternal dehydration
c. Secondary uterine inertia
d. Android pelvis
e. Epidural analgesia
11. The paramesonephric duct will form (mullerian – all female, mesonephric – wolfian)
a. Oviduct, uterus and upper vagina
b. Upper vagina only
c. The uterus
d. The prostate, utricle
e. Seminal vesicles
12. A patient had poly hydraminios, immediately after delivery she complains of severe chest pain,
becomes dyspnoeic and collapses. Pulse is 140/min, BP 80/40 mm Hg, chest full of crepitations.
Cause could be?
a. Cardiac failure
b. Adult respiratory distress syndrome
c. Amniotic fluid embolism
d. Myocardial infarction
e. Pulmonary embolism
13. Regarding estimated date of delivery:

a. If ovulation occurs on day 18 then EDD will be 280 day minus 4 days
b. U/S defined dates after 20 weeks are less lilely reliable if LMP not sure
c. It is commonly calculated from LMP by most obstetricians.
d. It is estimated by adding 280 days to LMP if cycle length is 30 days
e. It is best calculated by pregnancy calculator wheels

a. Meiosis only occurs in sex chromosomes
c. Primary oocytes are produced during reproductive life
e. The mature germ cells are diploid
15. Hepatitis B and C transmission can be reduced by

a. HBV vaccination in pregnancy
b. Immunoglobulin to all neonates born to Hepatitis B and Hepatitis C reactive women
c. Screening of high risk group and blood products screening
d. Universal screening of hepatitis B&C in pregnancy
e. Immunoglobulin administration to all exposed individuals
16. Bishop score is used to assess:

a. Fetal condition
b. Favorability of cervix for induction of labor
c. Favorability for instrumental delivery
d. Progress of labor
e. Cervical incompetence
17. Rupture of uterus with pre-existing lower segment scar is likely to occur
a. In association of medical disorders in pregnancy
b. With instrumental delivery
c. After induced or augmented labor
d. In first stage of labor
e. With large size baby
18. Maternal risk in cardiac disease are increased proportionately in:
a. Women with acquired heart disease
b. Women with all forms of cardiac disease
c. Women with congenital heart disease only
d. Women with mitral stenosis & pulmonary hypertension
e. Women with fallots tetralogy only
19. Regarding cordocentesis:

a. Fetal blood sample is obtained
b. 1% risk of miscarriage
c. Culture karyotype can be performed
d. Trans abdominal route
e. Performed up till 40 weeks
20. A women presented in gyne OPD with C/O sporting per vaginal, dysuria, dyspareunia, she had
had a diagnostic D&C 2 months back and endo biopsy report shows atrophic endometrium.
Appropriate treatment?
a. Progestogens
b. Hysteroscopy and endometrial biopsy
c. Hysterectomy
d. Estrogen creams
e. Oral contraceptive pills
21. The first step of abdominal palpation in a 38 weeks primigravida is:

a. Measure the symphysio-fundal height
b. Palpate the fundus
c. Assess engagement of head
d. Assess the lie
e. Palpate the fetal poles
22. At term gestation of G12P11+0 had brady cardia of fetus at full dilatation of cervix face
presentation. Forceps delivery was recommended over ventouse due to
a. Ventouse results in cervical tear
b. Ventouse takes longer time for delivery
c. Face presentation is contra indicator for ventouse vacuum CI – face pst. <34 wks
d. Full dilatation of cervix in contra indicator for ventouse
e. Fetal distress is contra indicator for ventouse
23. Abrupt placenta

a. Is associated with low lying placenta
b. Is associated with a malpresentation
c. Is associated with marked fetal hypoxia
d. Is associated with abdomen pain
e. Coagulation disorder and renal failure are common complications
24. Commonest cause of smaller for dates symphysis fundal height is

a. Engaged head
b. IUGR
c. Congenitally abnormal fetus
d. Mistaken dates
e. Oligohydramnios
25. Superimposed pre eclampsia on essential hypertension is predisposed by:
a. Renal disease
b. Maternal obesity
c. Maternal age > 30 years
d. Acute partum hemorrhage
e. Thyroid disorders
26. The etiology of congenital defects is mainly due to following factors:

a. Chromosomal
b. Environmental
c. Heterogenous
d. Genetic
e. Viral infections
27. Abnormal labor is

a. When the process is too quick
b. Occurrence of labor with face presentation
c. When labor occurs in patients with previous uterine scar
d. When fetus shows signs of compromise
e. Poor progress in labor as evidenced by delay in cervical dilatation and descent of fetal head
28. Mrs XYZ, is G2P1+o last delivery by C-section for fetal distress. Now she is 37 weeks pregnant.
Best criteria for trial of scar is
a. Macrosomic baby
b. Placenta praevia
c. IUGR baby
d. Breech presentation
e. Adequate pelvis with cephalic presentation
29. 20 yrs old PG with blood group O- attends OPD with 20 weeks of pregnancy. There is no H/O
blood transfusion in the past. Next investigation?
a. Blood group RH factor of husband
b. No need of any test
c. Non invasive assessment of fetus
d. Klenhuaser test
e. Amount of D antibodies
30. Regarding female pelvis

a. The pelvic inlet is ovoid
b. The pelvic outlet is ovoid
c. The pelvic outlet is wider in transverse than in AP diameter
d. The pelvic inlet is wider in transverse than in AP diameter
e. Pelvis measurement may widen during labor
31. 22 years old, primipara, history of delivery 3 days back, presents with complains of heavy
vaginal bleeding with clots for 1 day, o/e, pulse 90/min BP 100/60 mm Hg, anemia moderate, P/A
uterus 16 weeks size, P/V: OS open, products felt. Management?
a. Uterine exploration
b. Broad spectrum antibiotics
c. Correctons of anemia
d. Injection syntomethergin I/V stat
e. Screening the patient for coagulopathy
32. A 38 year old G4P 3+0 previous vaginal deliveries, 24 weeks gestation with Hb% 8.5gm. What
should be treatment option if cause of anemia is iron deficiency?
a. Parental iron
b. Oral iron
c. Whole blood transfusion
d. Packed cell transfusion
e. Packed cell and fresh frozen plasma
33. Anemia in pregnancy is most commonly due to:

a. Low levels of folate
b. Haemolysis
c. Low levels of iron
d. Chronic bood loss
e. Chronic renal disease
34. Most important manifestation of severe pre eclampsia is:

a. Oliguria
b. Epigastric pain
c. Edema
d. Agitation
e. Hyper reflexia
35. The pelvic brim is the inlet of the pelvis and is bounded in front by
a. Inner aspect of ischial bone
b. Symphysis pubis
c. Descending ramus of pubis bone
d. Upper margin of the pubic bone
e. The illiopectirical line
36. Infants at risk of developing serious symptomatic hypoglycemia are:

a. Infants born to mothers with sepsis
b. Infants of diabetic mothers
c. Baby weighing less than 2.5kg
d. Small for dates babies
e. Baby weighing more than 3.5 kg
37. A 30 year old P5+0 presented at 32 weeks of gestation with chronic hypertension, blood
pressure is 150/105. U/S shows normal fetal growth. She is taking inhibtors for blood pressure control.
What should be the preferred anti hypertensive therapy:
a. Methyldopa
b. ACE inhibitors
c. Atenolol
d. Propranolol
e. ACE inhibitors
38. Regarding prenatal diagnosis:

a. All women should be screened for identification of high risk group
b. U/S examination is included in diagnostic tests
c. Invasive diagnostic tests should be performed in all high risk patients
d. Invasive diagnostic test are associated with risk of hemorrhage
e. Invasive diagnostic test include amniocentesis. Chorionic villus sampling & cordocentesis
39. After the last menstrual periods, when should the gestation sac be visible on abdominal U/S
a. 4-5 weeks
b. 6-7 weeks
c. 7-8 weeks
d. 5-6 weeks
e. 8-9 weeks
40. The commonest cause of poor prognosis in labor is

a. Inefficient uterine contractions
b. Placenta praevia
c. Cervical dystocia
d. Cord round fetal neck
e. Cephalo pelvic disproportion
41. The active phase of labor is describe as:

a. The time from full dilatation till maternal urge to push
b. The time between the end of the latent phase and full dilatation
c. The time between the onset of labor till 3cm of cervical dilatation
d. The time from outset of labor till full dilatation of cervix
e. The time from full dilatation till delivery of fetus and placenta
42. Regarding determination of chorionicity of twins the best option is:

a. Most reliably determined in early first trimester
b. In monochorionic twin V-shaped extension of placental tissue is seen
c. It is very important because highest risk is seen in monochromic twins
d. Chorionicity can be number of placenta
e. Same sex twins are always monochorionic
43. 30 years old, para 3+0, history of delivery 3 days back followed by primary PPH, has failed to
establish lactation. The most probable cause is
a. Cracked nipples
b. Dopamine antagnoists drugs
c. Puerperal sepsis
d. Anemia
e. Sheehans syndrome
44. Uterine rupture:

a. Occurs in association with previous scar
b. Immediate laparotomy, with hysterectomy, is the appropriate management
c. Signs of uterine rupture: abdominal pain, vaginal bleeding, CTG abnormalities, absence uterine
contractions
d. Can occur without a previous scar
e. In second stage of labor are quickly recognized
45. Following risk factor if present before pregnancy, increases risk of thrombo embolism
a. Varicose veins
b. Thrombophilia
c. Diabetes
d. Hypertension
e. Over weight (obesity)
46. A 20 year old primi gravid presented at 34 weeks of pregnancy with pre-clampsia. Abdominal
examination showed a height of fundus of 28 weeks. The most appropriate test to rule out
intra-uterine growth restriction is to advise U/S for:
a. Head circumference
b. Uterine artery Doppler
c. Abdominal circumference + oligo hydramnios
d. Bi parietal diameter
e. Unblical artery Doppler
47. A 28 years old para 1+0 with past history of abnormality in child presents in OPD at ? weeks
gestation. Which investigation you will advise to exclude fetal anomaly:
a. Blood sugar
b. Anomaly U/S scan
c. Blood group
d. Nuchal translucency scan
e. Maternal serum alpha fetoprotein
48. A primigravida has delivered after prolonged second stage of labor. She is heavily bleeding.
Uterus is 24 weeks size. Likely cause is:
a. Coagulation disorder
b. Retained placenta
c. Para vaginal hematoma
d. Uterine atony
e. Vaginal tear
49. Measurement of maternal height and weight is important in antenatal clinic because?
a. Satisfactory weight gain in women with BMI < 20 is associated with increased perinatal risk
b. Nutritional status can be assessed
c. Height is a predictor of labor problems
d. BMI has to be calculated on each visit
e. Risk of perinatal mortality is high BMI is greater than 30
50. Issues in pre-pregnancy counseling of women with heart disease

a. Risk of IUGR
b. Risk of maternal death
c. Maternal and fetal monitoring during labor
d. Reduction in maternal life expectancy
e. Need for frequent hospital attendance and possible admission
51. To achieve successful delivery with Ventouse, coup should be applied on

a. Anterior fontanelle
b. Parietal bone
c. Midline over the occiput
d. Fontal bone
e. Vertex
52. Venous thromboembolism is an important cause of maternal mortality

a. Risks are greater after vaginal delivery than after cesearen section
b. Obesity (>75 kg & <80 kg) is a risk factor
c. Diagnosis is made of abnormal coagulation profile
d. Risks are increased in women with thrombophilia
e. Prophylactic anticoagulant therapy is recommended in all women with thrombophilia
53. Following is the risk factor for the development of heart failure in cardiac diseases pregnant
women?
a. Arrhythmias
b. Fluid over load
c. Pain related stress
d. Multiple gestation
e. Hypertension
54. Which blood test is taken periodically to monitor the renal function of a pregnant patient with
hypertension
a. Blood complete picture
b. Serum electrolytes
c. Serum creatnine
d. Urine detail report
e. Serum urea
55. Regarding the abdominal palpation best statement is:

a. If one fetal pole is over the pelvis and other is lying more to the left then lie is longitudinal
b. Symphsio fundal height when plotted on SFH chart fundal height in cm equals to number of we?
c. Presenting part is said to be engaged if its 3/5th palpable abdominally
d. Fetal parts are difficult to feel in oligohydraminios
e. Fetal positon should be determine
56. A primigravida with bid gp O-ve delivers male baby whose blood gp is O+ve. Next step?
a. Administration of anti D immunoglobulin to mother after 1 wk of delivery
b. Administration for anti D immunoglobulin to mother any time after delivery
c. Administration of anti D immunoglobulin to new born baby with in 72 hours
d. Intramuscular administration of anti D immunoglobulin to mother with in 72 hrs of delivery
e. Administration of anti D immunoglobulin to baby at 6 weeks
57. During normal pregnancy

a. Stroke volume decreases by 10%
b. Heart rate increases by 50%
c. Mean arterial pressure increases by 10%
d. Cardiac output increases by 30-50%
e. Peripheral resistance increases by 35%
58. What factors are responsible to increase the number of women with congenital heart disease
in pregnancy? (incomplete)
a. Advances in pediatric cardiac surgery
b. Antibiotics for streptococcal infection
c. Anti hypertensives for hypertension
d. Anticoagulation for valvular disease
e. Prophylactic valvular surgery
59. 21 years old, PG presented with history 30 weeks pregnancy and headache and blurring of
vision for 1 day. O/E her BP is 160/90 mmHG. Diagnosed as a case of pre-eclampsia. Relevant
investigation diagnosis?
a. Deranged coevaluation profile
b. Thrombocytopenia
c. Raised serum urea and creatinine levels
d. Significance protein urea > 300mg/2units
e. HB < 10gm/dl
60. On partogram basic record of labor includes

a. Pulse rate
b. BP
c. Intake out/input
d. Dilation and effacement of cervix
e. Temperature
61. Pre requisites of delivery with ventouse

a. Dilation of cervix
b. Cooperation of patient
c. Full engagement of head
d. Good contractions
e. Delay in 2nd stage
62. Regarding amniotic fluid, the best statement is

a. Amniotic fluid index alters throughout pregnancy
b. Volume is increased in twin pregnancy
c. Fetal kidney’s contribute to amniotic fluid volume
d. Amniotic fluid index gives reliable index of amniotic fluid volume
e. Volume is decreased in fetal growth restriction
63. Common cause of maternal death during pregnancy include death due to
a. Cardiac disease during pregnancy
b. Postpartum hemorrhage
c. Anemic failure during pregnancy
d. Abortion
e. Accident during pregnancy
64. In Oogenesis
a. Second polar body persists
b. One diploid oogonium produces one haploid mature egg
c. First polar body fails to degenerate
d. Only one meiotic division occurs
e. One diploid oogonium after
65. Best statement regarding antenatal depression is:

a. The vulnerable women tend to be primigravida
b. Between 5 and 10% of women develop depression during pregnancy
c. These women are less likely to develop postnatal depression
d. These women have good social support
e. These women are anxious about the health of their fetus
66. In a normal pregnancy which of the following is true?

a. Tidal volume decreases
b. Arterial PCO2 level fails
c. Renal blood flow increases by 20%
d. Serum aldosterone decreases
e. Serum urea rises
67. In monozygotic twin pregnancies, dichorionic diamniotic pregnancies result from splitting of
the single fertilized ovum between days:
a. 1-3
b. >12
c. 10-12
d. 4-6
e. 7-9

a. Headache an visual disturbances
b. Haematemesis
c. Asymptomatic in 60% of patients
d. Pedal edema
e. Excessive nausea and vomiting
69. High dependcy intensive care are for babies

a. Requiring oxygen and weighting <1500 gms
b. Receiving respiratory support via a tracheal tube
c. Requiring parenteral nutrition
d. Having frequent apneic attacks
e. Having convulsions
70. Regarding second division in meisosis:

a. Begin with diploid cell
b. Ends in 23 single stranded chromosomes
c. There is no DNA replication
d. Typically occurs in germ cell
e. Ends in four haploid daughter cells
71. Benefits of dating scan:

a. Detection of failed intrauterine pregnancy
b. To detect multiple pregnancies
c. Accurate dating in women with irregular menstrual cycles or poor recollection of LMP
d. Maximzing the potential for serum screening to detect fetal abnormality
e. Reducing incidence of induction of labor for prolonged pregnancy
72. Regarding the polyhydramnios the best statement is

a. Cord prolapse is a common complications
b. Dizygotic twin is more frequently associated with polyhydramnios
c. Diagnosed on U/S if AFI >8
d. Preterm labor occurs due to associated fetal anomalies
e. Uncontrolled diabetes mellitus is usually associated with polyhydraminios
73. The principles of management of 1st stage of labor are

a. Adequate pain relief
b. Adequate hydration
c. Observation of progress of labor with timely intervention and fetal hear rate monitoring
d. Emotional support to mother
e. Monitoring of fetal well being
74. A para 2+0 woman presents in ER with 37 weeks gestation and preeclampsia reactive CTG. She
had past 2 vaginal deliveries and now having 6/10 while other investigations are normal. The best
option for her?
a. Wait for spontaneous labor
b. Control BP and fetal monitoring upto 40 weeks
c. Deliver by C-section
e. Give prophylactic magnesium sulphate and wait for spontaneous labor
75. Major aneuploides are best and early diagnosed by utilizing which laboratory tests
a. Biochemical analysis
b. Direct cytogenetic analysis
c. DNA analysis
d. Enzymatic analysis
e. Cytogenetic analysis with FISH technique
76. A 40 year old lady G4 P3+0 was planned for termination of pregnancy at gestation due to high
BP and IUGR. What medications should be considered be considered before termination before
termination of pregnancy?
a. Anti hypertensive drugs
b. Anti hypertensive and sedative
c. Antibiotics
d. Anti hypertensive and steroid
e. Anti hypertensive and anti convulsant drugs
77. Regarding heart disease in pregnancy the best statement is

a. I/V ergmetin is harmless in 3rd stage of labor
b. Women suffering from class II heart disease should be counseled for termination
c. Combined oral contraceptive pills are safe in patients with class II heart disease
d. Anticoagulation with warfarin is contraindicated in first trimester
e. Risk of heat failure is maximum immediately after delivery
78. The pattern of follow up antenantal visits:

a. Similar schedule is offered regardless of the choice of care
b. Should be tailored according to the wishes of individual
c. Four weekly up till 36 weeks
d. Five minimum visits as advised by royal college of obs and gyne
e. Weekly after 32 weeks
79. Globally the major extrinsic cause of IUGR is

a. Maternal viral infections
b. Drug addiction
c. Chromosomal anomaly
d. Maternal diseases
e. Maternal under nutrition
80. When an HIV +ve patient becomes pregnant

a. Mother should breast feed in any condition and in any setup
b. Amniocentesis should be done to rule out fetal anomalies
c. She should be counselled for termination of pregnancy
d. Zidovudine therapy should be started from 2nd months
e. Ferrous sulphate tabs should be started from 1 month
81. Difficult labor due to deep transverse arrest is associated with:

a. Short statured mother
b. Narrow pelvis
c. Android pelvis
d. Deflexed fetal head
e. Good size fetus
82. Regarding obstetric history, most important data is:

a. Previous history of abortion
b. RH isoimmunisation
c. Previous history of preterm labor
d. LMP
e. Previous history of ectopic pregnancy
83. 35 yrs old, pm, presented at 38 weeks pregnancy with BP 140/100 mmHG, and urine dipstick
showed +++ proteinuria. Patient also complaining of epigastric pain and blurring of vision for 2 days.
Management? Severe preeclampsia
a. Resuscitation
b. Catheterize the patient
c. Hydrate the patient
d. Immediately delivery
e. U/S pelvis to determine amount of liquor
84. An A-negative primigravida (husbands blood group B-postive) presented at 12 weeks

pregnancy. The recommended prophylaxis for Rh iso immunization is anti-D IgG:
a. 500 IU within 72 hours of delivery if fetus if Rh positive
b. 500 IU at 28 and 32 weeks and within 72 hours of delivery if fetus is Rh-positive + kleihauser test
c. 500 IU within 72 hours of delivery if fetus is Rh positive + a kelihauser test
d. 500 IU at 28 and 32 weeks
e. 500 IU at 28 and 32 weeks and within 72 hours of delivery if fetus is Rh positive
85. Aim of safe motherhood is

a. To give care during pregnancy, labor and puerperium and to decrease mortality
b. State of delivery
c. Use of contraceptive methods
d. Good antenatal care
e. Health education
86. A PG is admitted in labor room with term pregnancy, labor pains, os ?, dilated, absent
membranes and high head
a. Immediate delivery is required
b. Cephalo pelvic disproportion is suspected
c. Cord round fetal neck is a cause
d. Hydrocephalus should be excluded
e. Oxytocin infusion can be given if uterine contractions are inefficient
87. Use of oxytocin infusion in less safe in multiparous women because of risk of:
a. Uterine hyperstimulation
b. C-section
c. PPH
d. Uterine inertia
e. Fetal compromise
88. A 28 years old PO+O delivered at 33 weeks of gestation by emergency LSCS, O/E baby is
tacypnoic, grunting with peripheral cyanosis. Likely cause?
a. Hypothermia
b. Congenital heart disease
c. Respiratory distress syndrome
d. Intracranial hemorrhage
e. Hypoglycemia
89. Regarding the rhesus iso-immunizatioin the best statement is

a. Cord blood bilirubin is a good indicator of exchanged transfusion
b. Rhesus antibody level > 15 IU/ml signifies severe disease
c. Cordocentesis is advised in all Rh-negative women
d. Anti D prophylaxis may be helpful if sensitized
e. Previous history of still born baby has great impact on future management
90. What are the important features effecting optimal fetal birth weight
a. Paternal height
b. Maternal height
c. Partiy
d. Fetal sex
e. Maternal age
91. Vertex is defined as the:

a. Area of the fetal skull bounded by anterior fontanelle & posterior fontanelle & temporal bone
b. Area of the fetal skull bonded by 2 parietal eminence only
c. Area of the fetal skull bounded by two parietal eminences and anterior and posterior fontanelle
d. Area of fetal skull bounded by face brow and anterior fontanelle
e. Area of the fetal skull bounded by anterior fontanelle and chin
92. Common cause of fundal height greater than period of gestation is

a. Multiple pregnancy
b. Full bladder
c. Mistaken dates
d. Macrosomia
e. Uterine fibroids
93. The biggest contributor to high perinatal mortality in twins is:

a. Congenital anomaly
b. Intrauterine growth restriction
c. Polyhydraminios
d. Twin to twin transfusion syndrome
e. Preterm birth
94. The fetus protects itself against anoxia by which of the following mechanisms
a. Placental enlargement
b. Polycythemia
c. Anaerobic respiration
d. Auto regulation of blood flow
e. Microsmia
95. Normal fetal birth weight is dependent on many factors. Which factor is least relevant?
a. Adequate placental perfusion
b. Appropriate maternal nutrition
c. Fetal hypoinsulinemia
d. Adequate transfer of oxygen across the placenta
e. Adequate transfer of nutrients across the placenta
96. Para 2+0 presented for 1st antenatal visits at 34 weeks. She has iron deficiency anemia with an
HB level 7gms/dl. Iron is best prescribed to her as:
a. Dietary advise and oral ferrous sulphate
b. Syrup ferrous gluconate
c. Oral ferrous gluconate at high doeses
d. Iron sucrose infusion and dietary advise (parental iron – venofar)
e. Intramuscular iron dextrin daily
97. Mrs. SH, P2 +0 arrives in emergency with labor pains for four hours. On P/A uterurs is
contracting 50-60 sec every 2 min, presenting part is breech, fetal heart rate is 150 beats/min. On P/A,
buttocks are at +3 station, membranes are absent and cervix is further dilated. Most important step
at this stage is
a. Blood should be arranged
b. Continuous CTG should be performed
c. Epidural analgesia should be given
d. Emergency c-section should be performed
e. Senior obstetricians should be summoned for breech vaginal delivery
98. Pregnancy is dated from

a. Last day of LMP
b. None of these
c. Day of conception
d. First day of LMP
e. Day of ovulation
99. Antenatal care for women with cardiac disease should include all except
a. Chorionic villus sampling to rule out congenital heart disease in fetus
b. Early correction for anemia
c. Multidisciplinar approach involving cardiologist
d. Look for early signs of cardiac failure
e. Use of anti coagulants if required
100. Required changes during pregnancy:

a. Nipples becomes larger & more erectile
b. Breast increases in size because of hyperplasia and hypertrophy
c. The hypertrophied sebaceous glands are montogometry’s follicles
d. Size of breasts increase due to increased deposition of fat
e. The sweat and sebaceous glands activity increases
OBSTETRICS 2011
Hemolytic disease of newborn = mother is D –ve and neonate D+ve (tt)
Large SPH = mistaken dates (ct)
Small SPH = mistaken dates (ct)
Aim of safe motherhood = care by skilled health personal for child birth (tt)
Risk factor of thromboembolism in preg = throbophilia ??? (written in top in tt so)
Complication revelant to twin prg = preterm (tt)
Death in placenta abruptia = antepartum hemorrhage, dic ?????
Massive PPH = uterine atony (tt)
Anemia in preg = iron deficiency (tt)
Change in preg = raised esr (tt)
Stop bleed after uterine atony = massage (tt)
Regard NTD = anecephalocele, encephalocele, spina bifida (tt)
Purpose of booking visit = risk assement (tt)
Early preg scan = confirm dates (tt)
Screening = rubella (tt)
Oogenesis =diploid cell produce haploid by meiosis (tt)
Polyhyraminons = occur in uncontrolled diabetes (tt)
Adroid pelvis = deep transverse arrest (tt)
Gravid = all preg including current (tt)
Important point in obshx = recurrent miscarriage (tt)
Reassuring sign in labour = head engaged ??? , longitudinal lie, clear amniotic fluid, adequate pelvis,
rupture membrane…..
Most common cause of still birth world wide= antepartum hemmorrahge ???
Best regarding implantation = secretion of HCG start after implanation (ct)
Alet line on partogarm = ideal labour, progress 1 cm / hour, action line drawn…. (all in tt, )
Fetal blood = reticulocyte more (ct)
Chorionic villous sampling = done after 10 week (ct, tt)
Uterine involution = return of uterus to its normal size of 100 gm (tt)
Embryonic period = 4-10 weeks (tt)
Bishop score less than 5 = vaginal pessaries (ct)
2 breeh vaginal hx, now again breech = bicornvate uterus (ct)
Fetal acidosis = FBS (tt)
Shifting patient = uterus is empty, no products ????
Women with rubella IgG –ve = susceptible women should be advised against exposure (ct)
Secondary PPH = retained product of conception (tt)
Case of uterine inversion = push it back with compression (tt)
Reproduction = spermatogenesis is formation of mature sperms (tt)
High MMR = pulmonary htn (tt)
No of prim oocyte at birth = 2 million (gTT)
Development arrest of ovum = metaphase II (tt)
Genetic sex = conception ???
Mesonephric cord = ????
Gestatinal sac visible = HCG> 1500 (tt)
Development of ovary = two week later to testis and grow slowly (gtt)
Bp during preg = decrease (tt)
Baby, tachypnoic, grunting, cyanotic = RDS (tt)
Best assessment of age at 12 week = CRL (tt)
Best assesemnt at 12-20 week = BPD, HC, FL (tt)
Identification of choronicity = monochorionic has inc mortality (tt)
Nucaltransluancy seen on u/s = 11-13 week (tt)
Cordocentesis = all true (tt)
Prenatal screen of CHD = one sibling and father affected has risk of 2% (tt)
Twin mortality 6 time more than single = pretem (tt)
Female, bp 155/105, protinuria, epigastric pain = cessarain ???
Antihypertensive in preg = methyldopa ???
Feature showing abruption = tense tender abdomen (tt)
Contraception in brest feeding =POP (tt)
Mitral stenosis patient, intervation = avoid ergotamine ???
Pre preg counseling of mitral stenosis patient = cardiac fuction ????
Screening of DM = OGTT ???
Hypethyroid female = still birth (tt)
MCV < 60, investigation = serum ferritin (tt)
Purities and sleep disturbance in preg = cholestasis of pregnancy ???
Dection of hep B = Hbsag ??
Regard hep B = brest feed immediately after active and passive immunization ???
Anatomy of female pelvis = has three planes ????
Fetal scalp = bones approximated, not fused ???
Attitude of fetus = flexion or extension of head relative to upper cervical spine (tt)
Normal duration of labour = < 8 hour in multipara (tt)
Syntocinon not given in multi = uterine rupture, uterine hyperstimulation, uterine inertia, fetal
compromise ?????
Partogaram = show events of labour ????
Best about labour = spontaneous, single, between 37-42 weeks (tt)
Contra of ventous = face presentation (tt)
Contra of forcep = head high up (tt)
Principal of ventous = head, not just scalp should descend with each pull (tt)
Brech delivery = call senior help obs ki bandi????
Secure bleeding = secure angles of incison of cs (tt)
Position in cs = tilted left lateral with head down (tt)
Previous cs, lower segment placenta now = placenta accrete
Indication of c. hysterectomy = p. previa (tt)
Female in labour since 16 hour, cervix 16 cm = cervical dystocia ???
Female 32 week, 40 week SPH, fulid thrill = polyhydramnos ???
Child died, cord felt on vaginal exam = cord prolapsed
Female in labour, raised bp and fits = termination of preg ???
Female in current preg, previous 3 birth, 2 live, one still and one miscarriage = G5 P 3+1 ???
At 34 week, hb 7 gm = infusion of iron sucrose ????
Neonatal admin in UK = 10 % (tt)
Neonate in intensive care = jaundice, mother has chd, premature ???
Apgar = grimice is response to suction cath (tt)
Lactationalamenorrha = due to dec LH pulse (tt)
Most import feature of contraception = effectiveness ????
Not cause of fits = diazepam over dose
OBSTETRICS SEMESTER 9 2009
1. A 30 years old P + 0 with previous NVD came with FTP and labor pain for 16 hours. On P/A fetal wt
is 3kg & optimum uterine contractions. On P/V cervix is 6cm dilated vertex at -1 station, caput ++,
pelvis adequate. What could be likely cause of prolong labor?
a. Cervical dystocia
b. Uterine inertia
c. Contracted pelvis
d. Macrosomic fetus
e. Relative cephalo pelvic disproportion
2. Best statement for diet in pregnancy is:
a. Most women who eat tensible diet need vitamin supplement
b. All women require iron supplement irrespective of their hemoglobin level.
c. Women should avoid vitamin supplement that contain vitamin A
d. Calcium requirement increases from 200 to 400 mg/day
e. It should be high in fiber & fat
3. The following risk features should not be missed from previous obs history
a. Normal vaginal deliveries
b. Preterm delivery
c. Intra uterine growth restriction
d. Abruption placentae
e. Recurrent miscarriages
4. Regarding perinatal death the best option is:
a. It should be notified to identify the risk factors
b. It means all still births plus deaths in first 28 days of life
c. It is an important tool to know the level of health care provided to pregnant woman
d. For audit purposes
e. It is defined similarly in all countries
5. Neonate born to a mother who is hepatitis B carrier should
a. Breast feeding should be withheld if immunoglobulin’s a hepatitis B vaccination are not given
within 1 week of birth
b. Be allowed to breast feed immediately after active and passive immunization for Hep B
c. Receive hepatitis B vaccination within 1 week of birth
d. Should be put to breast feed immediately after giving Engerix vaccination
e. Receive hepatitis B immunoglobulin within one week of birth
6. Regarding oogenesis:
a. A diploid primary oocyte produces one mature haploid ovum by meiosis
b. A diploid primary oocyte produces one mature haploid ovum by mitosis
c. Human cells contain 23 chromosomes
d. A haploid primary oocyte produces one mature haploid ovum by meiosis
e. A haploid primary oocyte produces one mature haploid ovum by mitosis
7. The pattern of follow up antenatal visits:
a. Four week up till 36 weeks
b. Similar schedule is offered regardless of the choice of care
c. Weekly after 32 weeks
d. Should be tailored according to the wishes of individual
e. Five minimum visits as advised by royal college of obs and gyne
8. Alert line on partogram
a. Demonstrate progress of 1 cm dilatation/hr
b. Action line drawn 2-4 hours to the right of this line
c. Is not meant to monitor progress of labor in active phase
d. Is drawn at the end of the latent phase
e. Predicts ideal progress of labor
9. To deal with renal complications of eclampsia the most important step is
a. Fluid challenge
b. Using blood products
c. Insertion of central venous line
d. Monitoring of blood pressure
e. Maintenance of strict input output balance
10. Prolong labor due to persistent occipitoposterior position is predisposed by:
a. Grand multiparity
b. Small size of baby
c. Anthoropoid pelvis
d. Early rupture membrane
e. Deflexed fetal head
11. Folate supplementation around conception & in first trimester of pregnancy is expected to
reduce the frequency of:
a. Neural tube defects
b. Antepartum hemorrhage
c. Anemia
d. Still births
e. Abortions
12. An 18 year old primigravida presented in emergency at 30 weeks of pregnancy and 3 fits at
home. O/E her BP is 160/110 mm Hg and patient is irritable. Vaginal exam shows that the patient is
not in labor. The most appropriate management option is:
a. Stabilize and do emergency C-section
b. Stabilize and induce labor with oxytocin infusion
c. Stabilize with anti convulsants and anti-hypertensives and continue pregnancy till term
d. Emergency C-section
e. Stabilize and induce labor with prostaglandins
13. Healthy fetal blood:
a. Has a higher prolactin level than non pregnant adult blood
b. Is warmer than adult blood
c. Has more reticulocytes than adult blood
d. Contains more CO2 than maternal blood
e. Has a higher PH than maternal blood
14. The most important change in carbohydrate metabolism during pregnancy is
a. Enhanced response to glucose tolerance in first half
b. Transplacental transfer of glucose increases
c. Relative insulin resistance
d. Fasting glucose concentration is reduced in the first half
e. Glycosuria is normal
15. Regarding estimated date of delivery:
a. It is estimated by adding 280 days to LMP if cycle length is 30 days
b. It is commonly calculated from LMP by most obstretcians
c. It is best calculated by pregnancy calculator wheels
d. Ultrasound defined dates after 20 weeks are less reliable if LMP not sure
e. If ovulation occurs on day 18 then EDD will be 280 day minus 4 days
16. Mrs. X, gravida second with H/O hydrocephalic baby in last pregnancy is anxious about
recurrence. The diagnosis of hydrocephalus is made on
a. Doppler scan at 22 weeks
b. First trimester scan
c. 20 week anomaly scan
d. 32 week scan
e. Bio physical profile scan
17. Hepatitis C screening should be offered to pregnant women
a. With history of multiple sex partners
b. Who had tissue transplantation
c. As rountine screening in antenatal clinic
d. In high risk group of HCV transmission
e. Who had history of blood transfusion
18. A 3rd gravida presents in emergency at 32 weeks of pregnancy with labor pain for 2 hours. On
P/A fetus is presenting by breech. She has history of two breech deliveries previously at 30 & 32
weeks of pregnancy. The likely cause of breech in this lady is:
a. Hydrocephalus
b. Polyhydraminos
c. Bicornuate uterus (malpres./malposition – bicornuate ut, miscarriage – uterine septate,
rupture – unicornuate uterus)
d. Oligohydraminios
e. Placenta praevia
19. The best statement about rubella infection during pregnancy in IgG –ve woman is:
a. Can lead to heart & eye abnormalities
b. Susceptible woman should be advised against exposure to virus in antenatal period
c. Can be prevented by vaccinating girls before marriage
d. Maternal infection does not always mean that fetus is affected
e. Rubella vaccination should be done in post natal period.
20. A 32 weeks pregnant diabetic woman is having symphsio-fundal height of 36 cms. Most likely
cause is:
a. Full bladder
b. Fibroids with pregnancy
c. Multiple pregnancy
d. Macrosomia
e. Oligohydramnios
21. Diagnosis of the onset of labor is made by:
a. Appearance of show
b. Dilatation of cervical OS
c. Spontaneous rupture of membrane
d. Softening of cervix
e. Uterine contraction
a. No great projection of the ischial spines
b. Sacrospinous ligament at least 3.5 cms
c. Ischial bispinous diameter measuring 10cms
d. Smooth sacral curve
e. Shallow & straight side walls
23. The most important benefit of an early pregnancy scan is:
a. Detection of fetal abnormality
b. Confirmation of cardiac flicker
c. Accurate dating in women with irregular menstrual cycles
d. Early detection of multiple pregnancies
e. Determination of fetal growth
24. When an HIV +ve patient becomes pregnant
a. Ferrous sulphate tabs should be started from 1st month
b. Amniocentesis should be done to rule out fetal anamolies
c. ZIDO VADINE therapy should be started from 2nd month
d. Mother should breast feed in any condition an in any set up
e. She should be counseled for termination of pregnancy
25. A primigravida has delivered after prolonged second stage of labor. She is heavily bleeding.
Uterus is 24 weeks size. Likely cause is:
a. Retained placenta
b. Coagulation disorder
c. Uterine atony
d. Vaginal tear
e. Para vaginal hematoma
26. During normal pregnancy a physiological increase is observed in:
a. Red cell count
b. Hematocrit
c. Hemoglobin concentration
d. Plasma folate concentration
e. Erythrocyte sedimentation rate
27. A 35 year old para 2 + 0 woman present in antenatal clinic with 20 week amenorrhea
overdistended abdomen, excessive vomiting and excessive fetal movements. The most likely
diagnosis is:
a. Fibroid uterus with pregnancy
b. Abrupt placenta
c. Hyperemesis gravidarum
d. Multiple pregnancy
e. Poly hydramnios
28. Regarding malaria in pregnancy, following statement is most appropriate
a. Prophylaxis should be offered to pregnant women in endemic areas
b. Prophylaxis should be offered to pregnant women traveling to endemic areas from non edemic
areas
c. P. falciparum is the commonest species in our region
d. May lead to maternal and fetal death
e. P.ovale and P.vivax seldom cause lethal disease
29. Regarding perineal body it is
a. Condensation of fibrous and muscular tissue
b. Soft tissue component of birth canal
c. Receives attachment of external anal sphincter
d. Involved in 1st degree perineal tear
e. Involved in an emergency
30. A Para 8+0 has delivered a 4kgs baby at home after pronlonged pushing efforts. She is brought
to hospital in collapsed state. Abdomen is distended tense and tender. There is a trickle of bright red
blood vaginally. Cause is:
a. Para vaginal hematoma
b. Vaginal tear
c. Broad ligament hematoma
d. Uterine rupture
e. Cervical tear
31. A 18 years old, non booked primigravida, weighing 38 kg presents in emergency with 33 weeks
pregnancy and labor pains. She is diagnosed on U/S as a case of twin pregnancy. Most significant
factor for her preterm labor is
a. Primi gravida
b. Twin pregnancy
c. Low maternal weight
d. Young maternal age
e. Non booked status
32. The maternal mortality is highest in women suffering from pregnancy with
a. Mitral stenosis
b. Ventricular septal defects
c. Pulmonary hypertension
d. Coarctation of aorta
e. Ischemic heart disease
33. Regarding changes during pregnancy:
a. The sweat and sebaceous glands activity increases
b. Breast increases in size because of hyperplasia and hypertrophy
c. Nipples becomes larger & more erectile
d. Size of breasts increase due to increased depositioin of fat
e. The hypertrophied sebaceous glands are montogometry’s follicles
34. Maternal mortality rate of Pakistan per 10,000 live birth is around:
a. 1000
b. 200
c. 500
d. 700
e. 300 (280-300)
35. A normotensive 2nd gravida presents in OPD at 36 weeks of pregnancy with breech
presentation. Her 1st delivery was uneventful. Now her U/S shows fetus with flexed breech
presentation, fundoposterior placenta and estimated fetal weight 3000 +-200 grams. She should be
offered
a. Elective caesarean section
b. Trial of breech delivery
c. Wait for spontaneous version
d. Emergency caesearen section
e. External cephalic version
36. A 30 yrs old primigravida presents in antenatal clinic with history of cardiac anomaly in her
husband. Her fetus is at risk of
a. Intrauterine death
b. Abortion
c. Growth restriction
d. Preterm delivery
e. Congenital heart disease
37. A 32 year old primigravida presented at 12 weeks of pregnancy. She is very concerned about
the risk of down syndrome. The most reliable screening test for down syndrome would be:
a. Maternal serum Alfa Feto-Protein & B HCG & unconjugated estriol in 2nd trimester
b. Pregnancy associated plasma protein (PAPP-A) & B HCG along with nuchal translucency in 1st
trimester
c. PAPP-A & Nuchal translucency in 1st trimester
d. PAPP-A & B HCG in 1st trimester
e. Nuchal translucency on 1st trimester U/S at 10-13 weeks
38. The best method of fetal monitoring during labor in high risk cases is by:
a. Continuous fetal cardiotocography
b. Fetal scalp blood sampling (FBS)
c. Doppler U/S
d. Intermittent fetal heart auscultation with pinard stetoscope
e. Observation of color of liquor
39. Important area of a medical history of a first degree relative during pregnancy is:
a. Pulmonary TB
b. Epilepsy
c. Diabetes
d. Smoking
e. Twin pregnancy
40. Measurement of maternal height an weight is important in antenatal clinic because:
a. Nutritional status can be assessed
b. Perinatal mortality is high if BMI is greater than 30
c. Satisfactory weight gain in women with BMI < 20 is associated with increased perinatal risk
d. BMI has to be calculated on each visit
e. Height is a predictor of labor problems
41. A 25 year old primigravida was diagnosed to have toxoplasmosis at 10 weeks of pregnancy. The
most appropriate treatment should be:
a. Sulphadiazine
b. Spiramycin
c. Vibramycin
d. Cefotaxime
e. Pyrimethamine
42. 30 yrs old, primigravida, present with C/O 36 weeks pregnancy, high blood pressure and fits.
The best management option is:
a. Termination of pregnancy
b. Inj. Dexamathosone
c. Inj. Hydralazine
d. Wait for spontaneous onset of labor
e. Induction of labor at 38 wks gestation
43. Previous obstetric features that have bad impact on future pregnancy include:
a. Early onset pre-eclampsia
b. Recurrent miscarriage
c. Preterm delivery
d. Recurrent miscarriage and preterm delivery
e. Unexplained still birth
44. A 28 years old PO+O delivered at 33 weeks of gestation by emergency LSCS d/t APH on
examination baby is tacypnoic, grunting with peripheral cyanosis. What could be the most likely
cause
a. Congenital heart disease
b. Respiratory distress syndrome
c. Hypothermia
d. Hypoglycemia
e. Intracranial hemorrhage
45. In prenatal diagnosis of thalassemia:
a. If diagnosed, fetus requires intra uterine transfusion
b. Should be offered to all women with anemia
c. Can be made by obtaining feta DNA by any of the invasive techniques
d. Screening of at risk population is possible by hemoglobin electrophoresis
e. Screening is offered only to women with previous child.
46. Emergency management for amniotic fluid embolism are:
a. Immediate circulatory support
b. Aggressive treatment for coagulopathy
c. Intubation and 100% O2
d. Immediate management in intensive care unit
e. Urgent resuscitation
47. On vaginal examination of a woman in labor, reassuring sign for the fetus is:
a. Clear amniotic fluid
b. Adequate pelvis
c. Vertex presentation
d. Intact membrane
e. Vertex at the level of ischeal spines
b. Primary oocytes are produced during reproductive life
c. Spermatogenesis is the production of mature sperms
d. Meiosis only occurs in sex chromosomes
e. The ova determines the sex of a child
49. Primary dysfunctional labor is common in:
a. Multiparous women
b. Cephalo pelvic disproportion
c. Primiparous women
d. Malposition of fetus
e. Malpresentation of fetus
50. Maternal death is defines as:
a. Death of a woman while pregnancy from any cause related to pregnancy including late death ie:
within a year
b. Death of a woman while pregnant from any cause related to, or aggravated by pregnancy or
within 42 days of termination of pregnancy but not from accidental causes
c. Death of a woman while pregnant from all direct and indirect causes
d. Death of a woman while pregnant from any cause related to or aggravated by, the pregnancy
e. Death of a woman while pregnant from any cause including puerperial complication
51. Occipito posterior position of vertex
a. Is typically associated with delay in second stage of labor
b. Leads to caput formation
c. Is associated with prolong labor
d. Always requires caesarean section
e. Is found in patients with contracted pelvis
52. Delivery at which a trained neonatal resuscitator should be present is:
a. Vacuum delivery
b. Previous prolong rupture of membranes
c. Elective ceaserean section
d. Hydrocephalic baby
e. Preterm delivery
53. Regarding second division in meiosis:
a. Ends in 23 single stranded chromosomes
b. Begin with diploid cell
c. Ends in four haploid daughter cells
e. There is no DNA replication
54. During phase 1 of 2nd stage of labor, there is no maternal urge to push as:
a. She is discouraged to push
b. Epidural anesthesia causes nerve block
c. Uterine contractions are not strong
d. Pelvic floor is relaxed
e. Fetal head is high
55. Secondary PPH
a. Requires hysterectomy
b. Is a result of retained products of conception and/or uterine infection
c. Is a rare cause of massive bleeding
d. Is associated with fibroid uterus complicating pregnancy
e. Requires immediate evacuation of uterus
56. Vertex is defined as the:
a. Area of the fetal skull bounded by anterior fontanelle & posterior fontanelle & temporal bone
b. Area of the fetal skull bounded by anterior fontanelle and chin
c. Area of the fetal skull bounded by two parietal eminences and anterior and posterior fontanelle
d. Area of the fetal skull bonded by 2 parietal eminenes only
e. Area of fetal skull bounded by face brow & anterior fontanelle
57. A primigravida presented in ER with 42 weeks pregnancy, having labor pains since 20 hrs at
home and delivered a still born baby by forceps in hospital. The most likely cause of still birth is:
a. Infection
b. Forceps application
c. Prolong labor
d. Post maturity
e. Intrapartum asphyxia
58. You have delivered a baby who’s not breathing, pale and HR < 100 bpm. Most important step
of management?
a. Start chest compression
b. Start mask ventilation
c. Dry and wrap him
d. Intubate immediately
e. Perform suction of oropharynx
59. The commonest cause of maternal death in HELLP syndrome is due to:
a. Thrombo-embolism
b. Ruptured uterus
c. Hemorrhage due to DIC
d. Obstructed labor
e. Hepatic failure (encephalopathy)
60. The principles of management of 1st stage of labor are
b. Emotional support to mother
c. Observation of progress of labor with timely intervention
d. Monitoring of fetal well being
e. Adequate hydration
61. Factor that increase the risk of poor progress in labor is:
a. Occipito posterior position
b. Breach presentation
c. Early rupture of membrane
d. Contracted pelvis
e. Estimated fetal weight of 3 kgs
62. A 30 year old para 1+0 presented at 20 weeks of pregnancy with a hepatitis B surface antibody
positive. Which of the following is appropriate?
a. Advise PCR to confirm infection
b. She has chronic infection
c. She is immune to Hep B
d. Advise hepatitis b core antigen and antibody
e. She is highly infectious
63. The commonest cause of PPH is:
a. Uterine atony
c. Ruptured uterus
d. Cervical tear
e. DIC
64. Correct statement regarding fertilization is:
a. It is followed by the acrosome reaction
b. It ends with the formation of two cell embryo called zygote
c. It occurs at the isthamal part of fallopian tube
d. It results in a return to a diploid genetic constitution of the embryo
e. It is completed within 72 hours
65. During normal pregnancy:
a. Stroke volume decreases by 10%
b. Peripheral resistance increases by 35%
c. Heart rate increases by 50%
d. Mean arterial pressure increases by 10%
e. Cardiac output increases by 30-50%
66. A case of abrupt placenta is best managed by
a. Immediate delivery
b. Blood transfusion
c. Intravenous fluids
d. Conservative treatment
e. Cesearan section
67. Most sure sign of labor is:
a. Rupture of membrane
b. Mild uterine contractions
c. Cervical effacement /Dilatation
d. Cervical dilation
e. Presence of show
68. Before shifting the patient from the labor room to ward, please ensure that
a. Perineum has been properly repaired
b. Urinary bladder is empty
c. The uterus is well contracted and contains no blood clots
d. The mother is in good condition
e. Mother is not in pain
a. Favorability of cervix for induction of labor
b. Fetal condition
c. Progress of labor
d. Cervical incompetence
e. Favorability for instrumental delivery
70. Commonest cause of loss of consciousness in recently delivered patient is:
a. Simple faint
b. Eclamptic fit
d. Post partum hemorrhage
e. Profound hypoxia
71. Mrs AB, P7+0 presents with increasing weakness and easy fatiguability during 7th month of
pregnancy. Her pulse is 80 bpm, BP is 120/70 mmHg, RR is 18/min, pallor is ++. U/S shows
anencephalic fetus. Her HB is 5.2 g/dl and MCV is 102 fl. The next appropriate test to find anemia is?
a. Hemoglobin electrophoresis
b. Serum cyanocobalamin
c. Total iron binding capacity
d. Serum ferritin
e. Serum folate &Vit B12
72. A type of pelvic shape effects the labor as
a. Anthropoid pelvis encourages occipito-posterior position
b. Platypelloid pelvis increases risk of obstructed labor
c. Platy pelloid pelvis increases chance of prolong labor
d. Android pelvis predisposes to deep transverse arrest
e. Gynaecoid pelvis is most favorable for labor
73. A 30 year old, HIV +ve woman presented at 12 weeks of pregnancy. Her CD4 count is 0.2/L. She
should be conseled that most appropriate management?
a. Monotherapy with zidovudine & induction of labor at 37 weeks
b. Monotherapy with zidovudine & vaginal delivery
c. Combination of anti-retroviral drugs & elective c-section
d. Immediate termination of pregnancy
e. Combination of anti-retroviral drugs & vaginal delievery.
74. Regarding engagement during labor:
a. It is biparietal diameter in vertex presentation
b. Occurs when widest part of the presenting passes through the inlet
c. It is bitrochanteric axis in breech presentation
d. It is biparietal diameter in face presentation
e. Never occurs with brow presentation
75. A grand multigravida has delivered a 3.5kg baby. During attempts at delivery of placenta she
cries due to excruciating pain in lower abdomen. Suddenly a bright red bleeding mass appears at
vulva , the cause is?
a. Uterine fibroid
b. Placenta
d. Fibroid polyp
e. Uterine prolapse

1. A 33 year old G4P3+0 previous vaginal deliveries, 28 weeks gestation with HB % 8.5 gm/dl,
treatment of anemia if iron deficient?
a. Oral iron
b. Parenteral iron
c. Packed cell and flesh frozen plasma
d. Whole blood transfusion
e. Packed cell transfusion
2. A 25 year old G1 P0 +0, presented at 28 weeks gestation with iron deficiency anemia. Her hb is
6.0gm/dl. What should be her Rx option for correctin of anemia?
a. Whole blood
b. Oral iron and folic
c. Packed cell
d. Parenteral iron and folate
e. Oral iron
3. The most important clinical features for diagnosis heart disease during pregnancy is
a. Ejection systolic murmur
b. Diastolic murmur
c. Breathlessness
d. Tachycardia
e. Third breath sound
a. Requires casearen section
b. Diagnosed only in labor
c. Is due by deflexed of head
d. Presenting diameter is submento bregmatic (9.5)
e. Occurs in 1:300 labours
5. 38 years old para 8+1 presented 10 days after delivery with pain, swelling and tenderness in left leg.
What investigation for Dx?
a. Angiogram
b. Blood ?
c. Doppler U/S of leg
d. U/S of leg
e. Venegram of leg
6. The best way to deliver after coming head of breech is
a. Mauriceio-smell-veit manuvre
b. Perform episitomy
c. Wait for spontaneous delivery
d. Harm marshall manovre
e. Forceps delivery
7. In a normal pregnancy which of the following is true?
a. Serum urea rises
b. Tidal volume decreases
c. Arterial PCO2 level fails
d. Serum aldosterone decreases
e. Renal blood flow increases by 20%
8. 20 yrs old PG with blood group O-ve attends OPD with 20 wks of pregnancy. There is no H/O blood
transfusion in the past. Next investigation?
a. Blood group/ Rh factor of husband
b. Amount of D antibodies
c. Kleihauser test
d. No need of any test
e. Non invasive assessment of fetus
9. Direct cause of maternal death during pregnancy include death due to
a. Cardiac disease during pregnancy
b. Anemic failure during pregnancy
c. Accident during pregnancy
d. Postpartum hemorrhage
e. Abortion
10. A 2nd gravida is fully dilated and diagnosed as deep transverse arrest with adequate pelvis, best
management option
a. Oxytocin infusion
b. Outlet forceps application
c. Application of vaccum extraction after an episiotomy
d. C-section
e. Wide episiotomy
11. Significant metabolic acidosis is diagnosed on fetal scalp blood sampling when
a. PH is above 7.40
b. PH is below 7.40
c. Base deficit more than 9
d. PH is below 7.20
e. Base deficit more than 8
12. 18 yr old, PG, 30 weeks gestation, BP 160/110, irritable, P/V shows not in labor, management?
a. Do Emergency C-section
b. Induce labor with prostaglandins
c. ?
d. ?
e. ?
13. Mrs. X, para 1+0, 34 wks gestation, SFH corresponding to 38 weeks, Strong family hx of
diabetes, wt of previous baby was 3 kg. Likely diagnosis?
a. Fetal macrosomia
b. Placenta previa
c. Twin pregnancy
d. Polyhydramnios
e. Fibroid in pregnancy
14. Following signs denotes placental separation in third stage of labor:
a. Uterus can not be felt
b. Cord is tight
c. ? Bleeding
d. ? Cord lengthing
e. ? Uterus up to umbilicus
15. A lady not pregnant, having had 3 miscarriages, one ectopic pregnancy and one still birth at 28
weeks, described as
a. Gravida 3, para 1
b. Para 3+3
c. Para 0+4
d. Para 0+3
e. Para 1+3 (it should be P1 + 4)
16. In a less flexed (deflexed) head the presenting diameter is:
a. Occipital meatal
b. Submento bregmatic
c. Suboccipito bregmatic
d. Something frontal (occipito frontal)
e. Suboccipito frontal
17. Regarding placental transfer of glucose which statement is accurate?
a. Simple osmosis
b. Facillated diffusion
c. Simple diffusion
d. Active transport
e. Reverse osmosis
18. Optimum uterine contractions during active labor:
a. One hour, 10 min, 30 seconds each
b. Three-four, 10 mins, 30-45 seconds each
c. Three four, 10 mins, 45-60 seconds each
d. Three four, 10 mins, 60-90 seconds each
e. One/10 min, 30 seconds each
19. Management of PPH involves
a. Appropriate measures, patient is not improving hemodynamically, look for the causes
b. Warm bleeding persists despite contracted uterus, look for retained products
c. Synctocinon and ergometrine are the standards, the need not to be repeated
d. PGF2 can be given directly through the cervix, via pipleys catheter
e. The first step is uterine massage or bimanual compensated
20. A 30 years old PG presents in antenatal clinic with history of cardiac anomaly in her husband.
Her fetus is at risk of
a. Preterm delivery
b. Growth restriction
c. Abortion
d. Congenital heart disease
e. Intrauterine death
21. Factors that can delay descent of fetal head are:
a. Incoordinate uterine activity
b. Fetal macrosomia
c. Inadequate uterine activity
d. Inadequate bony pelvis
e. Fetal malformation
22. Vaccumm extractor:
a. Textoral tearing is a complication
b. Is associated with some formation
c. Is associated with fracture of fetal skull
d. Cephal hematoma is a common complication
e. Is preferred over forceps as it rotates and pulls the fetal head simultaneously
23. Pregnancy is dated from:
a. First day of LMP
b. None of these
c. Last day of LMP
d. Day of conception
e. Day of ovulation
24. A primigravida at 34 weeks of pregnancy has severe abdominal pain, vomiting and jaundice.
Her labs were raised LFT’s and leucopenia, coagulopathy, hypoglycemia, liver disorder, suspicion
points towards
a. Hep E
b. Hep B
c. Acute fatty liver
d. Chronic hepatitis
e. Hep C
25. Safe motherhood project aims to provide:
a. Health education for husbands
b. Family planning services for safe abortion
c. Community education for women, their families and decision makers
d. Immediate referral for life threatening obstetric complications
e. Care by any person before, during and after child birth
26. A 35 yr old G7 P6+0, all normal vaginal deliveries came at 38 weeks of pregnancy with anemia
and mild labour pain. Hb % was 7.5 gm/dl. She had iron deficiency anemia. Next management?
a. Whole blood transfusion
b. Parental iron
c. Packed cells transfusion
d. Oral iron
e. Termination of pregnancy
27. Amniotic fluid
a. It is a protein free ultra-filtrate of fetal spine
b. Is a transudate of fetal serum via skin of fetus
c. Is secreted by the amnion and chorion
d. Fetal urine forms much of the amniotic fluid volume
e. Amniotic fluid volume increases in fetal renal agenesis
28. The most important neonatal complication of intra uterine growth restriction is:
a. Hypothermia
b. Sepsis
c. Necrotizing enterocolitis
d. Hypoglycemia
e. Hypoxic-ischemic encephalopathy
29. A 40 year old lady G4 P3+0 was planned for termination of pregnancy at 33 weeks of gestation
due to high BP IUGR. What medication should be considered before end of pregnancy?
a. Anti hypertensive and sedative
b. Anti hypertensive and steroid
c. Antibiotics
d. Anti hypertensive drugs
e. Anti hypertensive and anti convulsant drugs
30. The most important benefit of dating scan is
a. Early detection of multiple pregnancy
b. To reduce induction of labor prematurely
c. To time appropariate tests to detect fetal anomalies
d. Decrease of failed intrauterine pregnancy
e. Accurate dating with irregular menstrual cycle
31. Puerperal sepsis
a. Can be defined as genital tract infection following delivery
b. The most frequent causative organism is mycoplasma species
c. Full blood count usually shows anemia, leuckocytosis and thrombocytosis
d. Instrumental delivery is the commonest risk factor
e. Its coincidence is 9 percent
32. A 28 years old woman, P0+0 delivered by emergency LSCS at 34 weeks of gestation due to fetal
distress. On 1st post op day, woman is running fever, her baby is lethargic and has not passed urine.
Most likely cause of fever in mother?
a. UTI
b. Breast abscess
c. Wound infection
d. RTI
e. Post partum endomettritis
33. A 35 yrs old lady with C/O menorrhagia for 6 months, had diagnostic curettage. The
histopathology reveals proliferative endometrium. Her request for hysterectomy is ethically handled
by
a. LNG-IUS
b. Go ahead with hysterectomy
c. Give anti anemic drugs
d. Offering medical treatment
e. Proceed with endometrial ablation
34. A 38 year old, para 5+2, diagnosed of GDM, delivered a 4.3 kg baby. Baby was shifted to
neonatal unit. Whats not a cause of neonatal morbidity in this baby
a. Hyperbilirubiniema
b. Hypoglycemia
c. Birth asphyxia
d. Polycythemia
e. Hypermagnesimiea
35. Regarding height and weight measurement during pregnancy the best statement is
a. Woman with BMI < 20 are at risk having increased perinantal mortality
b. Height alone is the best predictor of normal labor
c. Women with initial body mass index > 30 are at risk of developing IUGR
d. Short height women can not be delivered vaginally
e. In women with initial normal weight repeat weight measurement is not needed.
36. 32 year old para 2+0 admitted with 40 weeks of pregnancy with labor pains since 8 hours.
After augmentation with syntocinon, FHS became 154/m-her measurement includes
a. turning the woman into left lateral positon
b. giving oxygen to the mother
c. turning off the synctocinon infusion
d. correcton of dehydration and ketosis
e. intravenous fluids
37. 18 yrs old PG came in emergency with history of 32 wks pregnancy and lower abdominal pain
since 4 hrs. she is smoker, BMI less than 20 and U/S showed twin pregnancy. Most likely diagnosis
a. red degen. of fibroid
b. UTI
c. Pre term labor
d. Placental abruption
e. Gastroenteroritis
38. Amniocentesis performed before 15 weeks
a. Casearn respiratory difficulty
b. Cause neonatal sepsis
c. Has higher cell culture failure
d. Is associated with higher rate of preterm delivery
e. Is generally best avoided
39. Fetal circulation is different from adults, which is false?
a. Oxygenation occurs in the placenta
b. Ductus venosus shifts blood away from liver
c. Right and left ventricles work in parallel
d. Right and left ventricles work in ?
e. Brain, heart and upper body receives blood from left ventricle away from the liver
40. Mrs XYZ, last delivery by C-section for fetal distress. Now she is 37 weeks pregnant. Best
criteria for trial of scar is
a. Breech presentation
b. Macrosomic baby
c. IUGR baby
d. Placenta previa
e. Adequate pelvis with cephalic presentation
41. Defecation in utero and hence meconium in the amniotic fluid is associated with
a. Pre term labor
b. Amniocentesis
c. Post term pregnancy
d. Artificial rupture of membranes
e. Preterm rupture of membranes
42. Regarding screening test for congenital anomaly is fetus the best statement is that
a. Helps in diagnosing the abnormality
b. Is performed when diagnostic test is not available
c. Is carried out on women at high risk
d. Should be non invasive
e. Carries small risk of miscarriage
43. 35 yrs old lady came at 8 weeks of pregnancy. She is known case of essential hypertension.
What will happen to her blood pressure during first trimester
a. Super imposed eclampsia
b. Super imposed pre eclampsia
c. No changed in blood pressure
d. Rise in blood pressure
e. Blood pressure would fall
44. A PG is admitted in labor room with term pregnancy, labor pains, os full dilated, absent
membranes and high head
a. Cord round fetal neck is a cause
b. Immediate delivery is required
c. Oxytocin infusion can be given if uterine contractions are inefficient
d. Cephalo pelvic disproportion is suspected
e. Hydrocephalus should be excluded
45. Uterine rupture
a. In second stage of labor are quickly recognized
b. Occurs in association with previous scar
c. Immediate laparotomy with hystertectomy is the appropriate management
d. Signs of uterine rupture, abdominal pain, vaginal bleeding , CTG abnormalities,
e. Can occur without previous scar
46. Cephalo –pelvic disproportion is suspected in labor if
a. There is heavy show
b. Vaginal examination shows severe moulding and caput sometimes
c. Cervix is thick and hanging
d. Fetal head is at mid pelvis
e. Labor room progress is slow
47. The APGAR score
a. Is an evidence of birth asphyxia only
b. Consist of heart rate, pulse, grimace activity and respiratory effort
c. Usually recorded at 1 and 10 min
d. Consist of heart rate, pulse rate, resp rate, and activity
e. Is a tool to assess successful transition of baby to extra uterine life
48. Investigation required to diagnose pulmonary embolism
a. Aterial blood gases
b. Ventilation / perfusion scan
c. Chest x ray
d. Coagualtion screen
e. Electrocardiogram
49. Common cause of delay in 2nd stage of labor is
a. Epidural analgesia
b. Secondary uterine inertia
c. Malpresentation
d. Android pelvis
e. Maternal dehydration
50. Maternal death is defined as
a. Death of a woman while pregnant from any cause related to or aggravated by pregnancy or
within any ways of termination of pregnancy but and from accidental causes
b. Death of a woman while pregnant from any cause including puerperal complication
c. Death of a woman while pregnant from all direct and indirect causes
d. Death of a woman while pregnant from any cause related to or aggravated by, the pregnancy
e. Death of a woman during pregnancy from any causes related to pregnancy including ie within a
year
51. 35 year old, para 5+0, presented 34 weeks with breathlessness due to severe polyhydramnios.
Management?
a. Indomethacin treatment
b. Induction of labor synctocinon
c. Emergency c section
d. Therapeutic amniocentesis
e. Induction of labor with amniotomy
52. Regarding puerperium
a. Oxytocin accelerate the the process of involution in all women during post partum period
b. With in a week the uterus can no longer be palpable above the symphysial pubis
c. Is the period following delivery till six weeks post partum
d. Involution is process by which uterus returns to a smaller size
e. Locia is the uterine discharge that consists of only nectrotic decidua
53. Immediately after birth
a. Oro-pharyngeal suction is not required
b. APGAR score is assessed at 5 min
c. Baby’s head should be kept higher than body
d. Baby should be sent to neonatal ICU
e. Cord need not to be clamped immediately
54. Pregnancy complicated by mitral stenosis following investigation is most important
a. CTG
b. Echocardigrapy
c. Xray chest (P/A view)
d. Ventilation perfusion scan
e. ECG
55. Regarding prenatal screening test
a. Identify high risk groups
b. Diagnostic test available
c. Some risk of miscarriage
d. Offered to all pregnant women
e. For disorders with high prevalence
56. The main supports of the vagina includes
a. Illiopectineal ligaments
b. Utersocaral ligaments
c. Arcuate ligaments
d. Obturtor ligaments
e. Round ligaments
57. The commonest cause of poor progress in labor is
a. Cervical dystocia
b. Cord round fetal neck
c. Placenta praevia
d. Inefficient uterine contraceptives
e. Cephalo pelvic disproportion
58. High dependency intensive care are for babies
a. Having frequent apneic attacks
b. Requiring parenteral nutrition
c. Requiring oxygen ad weighting < 1500 gms
d. Receiving respiratory support via a tracheal tube
e. Having convulsions
59. Regarding seminal fluid
a. It liquefies in 5 minutes
b. It has a basic PH
c. It liquefies immediately after ejaculation
d. Seminal fluid coagulation immediately after ejaculation
e. The basic PH of seminal fluid protects spontaneous from the acidity of vagina
60. Among the following cardiac disease in pregnancy highest maternal mortality is seen in
a. Fallots tetralogy
b. Severe mitral stenosis
c. Patent ductus arteriosus
d. Cardomyophathy
e. Eisenmenger’s syndrome
61. The most important diameter in pelvic mid cavity in relation to labor is
a. Anteroposterior
b. Shape of lateral walls
c. Transverse
d. Intertuberous
e. Inter ichial spinous
62. 32 yr old, para 1+0 at 12 wk of 2nd pregnancy with history of previous large baby and
unexplained stillbirth. Test recommended for GDM
a. 75 gram oral glucose tolerance test
b. 100 gram oral glucose tolerance test
c. Fasting blood sugar
d. 50 gram oral glucose challenge test
e. Random blood sugar
63. The greatest presenting longitudinal diameter of fetal skull is
a. Subocipito bregmatic
b. Mentovertical
c. Submento bregmatic
d. ?
e. occipito something?
64. Best way of fetal assessement during labor is
a. Intermittent ausculation
b. U/S
c. Kick chart
d. Cardio tocograph (it should be AFI)
e. Counting fetal movements
65. Mrs X, diagnosed as a case of eclampsia received inj MgSO4, 16 yrs back. On examination,
patellar reflex as absent. The best management option is
a. Inj Ca carbonate
b. Inj bicarbonate
c. Inj potassium aldehyde
d. Inj ca gluconate
e. Inj na citarate
66. Hep b and c transmission can be reduced by
a. Immunoglobulin administration to all exposed individuals
b. Universal screening of hep b and c pregnancy
c. Screening of high risk group an blood products screening
d. Immunoglobulin to all women born to hep b and c reactive women
e. HIV vaccination in pregnancy
67. Mrs AB, history of pains > 12 hrs in labor room, leaking membranes P/V >12 hrs. O/E the os is
5cm dilated with high fetal and hanging cervix
a. Assessment for fetal hypoxia using scalp blood ph is required
b. She has no progress of labor distal to cephalo pelvic disproportion and requires exam suction
c. Her labor is augmented with oxytocin infusion
d. Intravenous prophylactic antibiotics should be started
e. Continuous fetal monitoring using CTG is reported during labor
68. 30 year old lady presented at 20 weeks of pregnancy with anemia. Her Hb% is 7.0 gm/dl. MCV
< 800, hemoglobin electrophoresis showed HB A > 3.5 what is likely diagnosis
a. sickle cell anemia
b. b-thalasemia
c. megaloblastic anemia
d. b thalassemia
e. iron deficiency anemia
69. regarding human chorionic gonadotropin in pregnancy which is false
a. in normal intrauterine pregnancy HCG levels diabetes ever 36-48 hrs
b. it is produced by trophoblast
c. HCG levels are low in ectopic pregnancy
d. In normal intrauterine pregnancy HCg levels double after 72 hrs
e. Hcg levels > 15 Iu/L indicates pregnancy
70. The paramesonephric duct will form
a. Oviduct, uterus, and upper vagina
b. The prostate, utricle
c. The uterus
d. Upper vagina only
e. Seminal vesicles
71. An 8th gravida presents in ER with labor pains for 2 hrs. On P/A fetus is presenting by breech,
uterine contractions are moderate, fetal heart rate is 140 beats/min. On P/V, cervix is 5cm dilated,
membranes intact an foot is felt. Most important complication is
a. Obstructed labor
b. Birth asphyxia
c. Cord prolapse
d. Stuck head of fetus
e. Fetal soft tissue injury
72. Administration of prostaglandin – synthetase inhibitors to a pregnant woman can cause of the
following complications
a. Premature closure of umblical vein
b. Premature closure of ductus venosus
c. Premature closure of ductus atteriosus
d. Premature closure of umblical artery
e. Premature closure of foramen ovale
73. Definite sign of preterm labor is
a. Vaginal bleeding
b. Bulging amniotic membranes
c. Tachycardia
d. Cervical effacement and dilatiaon
e. Palpable uterine contractions
74. Regarding twin-to-twin transfusion syndrome
a. Poly hydramnios is a complication in donor fetus
b. It is a unique complication of monochromic twinning
c. Preterm delivery is a common complication
d. Cord accident can occur
e. Best treatment is amniocentesis
75. Thalassemia syndromes are genetic disorders characterized by
a. Fetal structural abnormalities
b. Obstetrical complications in every chains
c. Absence of either a or B globin chains
d. Presence of affected genes in all the siblings in a family
e. 1:6 chance of fetus being affected if both parents are carrier

1. A 30 years old Para 2 + 0 hypertensive woman present with antepartum hemorrhage, most likely
cause is?
a. Placenta previa
b. Cervical erosion
c. Abruption placenta
d. Cervical polyp
e. Ruptured uterus
2. APGAR scare is
a. Replaced by a detailed narrative describing baby’s condition
b. To be enforced in every labour ward
c. An internationally recognized way of summarizing the condition of babies at birth and there
response to resuscitation
d. Recorded at one and 10 minutes
e. A tool which assists in recognizing aphysixa
3. The most important aim of second trimester U/S is to:
a. Estimate accurate gestational age
b. Locate placental site
c. Measure cervical length
d. Establish number of fetuses
e. Detect fetal structural anomaly
4. A neonate born with hypoxic ischemic encephalopathy is receiving assisted ventilation. He requires
care in the following category
a. Special care
b. Transitional care
c. High dependcy intensive care
d. Routine care
e. Maximal intensive care
5. Commonest cause of maternal death in abrupt placenta is:
a. Amniotic fluid embolism
b. Postpartum hemorrhage
c. Disseminated intravascular coagulation
d. Antepartum hemorrhage
e. Renal failure
6. Important area of a medical history of a first degree relative is:
a. Diabetes
b. Epilepsy
c. Smoking
d. Twin pregnancy
e. Pulmonary TB
7. Regarding the polyhydraminos the best statement is:
a. Uncontrolled diabetes mellitus is usually associated with polyhydraminios
b. Preterm labour occurs due to associated fetal anomalies
c. Diagnosed on U/S if AFI is > 8
d. Cord prolapse is a common complication
e. Dizygotic twin is more frequently associated with polyhydramnios
8. Most common cause of maternal death in early pregnancy is:
a. Septic abortion
b. Molar pregnancy
c. Induced abortion
d. Accidental causes
e. Ectopic pregnancy
9. Globally the major extrinsic cause of IUGR is:
a. Drug addiction
b. Maternal viral infections
c. Chromosomal anomaly
d. Maternal under nutrition
e. Maternal diseases
10. Regarding previous obstetrical history, the data should include
a. Recurrent abortion
b. Sex of the babies
c. Previous caeseren section
d. Preterm labour
e. Post partum hemorrhage
a. A haploid primary oocyte produces one mature haploid ovum by meiosis
d. A diploid primary oocyte produces one mature haploid ovum by meiosis
12. Measurement of maternal height and weight is important in antenatal clinic because
a. Nutritional status can be assessed
b. Height is predictor of labour problems
c. If BMI is greater than 30 then perinatal mortality is high
d. Satisfactory weight gain in women with BMI < 20 is associated with increased perinatal risk
e. BMI has to be calculated on each visit
13. In prenatal diagnosis of thalassemia
a. Should be offered to all women with anemia
b. Screening is offered only two women with previous affected child
c. Screening of at risk population is possible by hemoglobin electrophoresis
d. Can be made by obtaining fetal DNA by any of the invasive techniques
e. If diagnosed, fetus requires intra-uterine transfusion
14. Infants at risk of developing serious symptomatic hypoglycemia are
a. Baby weighing less than 2.5kg
b. Infants of diabetic mothers
c. Baby weighing more than 3.5kg
d. Infants born to mothers with sepsis
e. Small for dates babies
15. Causes of fundal height greater than period of gestation includes:
a. Uterine fibroids
b. Mistaken dates
c. Macrosomia
d. Full bladder
e. Multiple pregnancy
16. Regarding the rhesus iso-immunization the best statement is:
a. Rhesus antibody level > 15 IU/ml signifies severe disease
b. Cord blood biliriubin is a good indicator of exchange transfusion
c. Anti D prophylaxis may be helpful if sensitized
d. Previous history of still born baby has great impact on future management
e. Cordocentesis is advised in all Rh-negative woman.
17. The first step of abdominal palpation in a 38 week weeks primigravida is:
a. Assess the lie
b. Measure the symphysio-fundal height
c. Palpate the fetal poles
d. Assess engagement of head
e. Palpate the fundus
a. Amenorrhea
b. Urine test
c. Symptoms of nausea and vomiting
d. Listening fetal heart sound
e. Internal examination to assess uterine size
19. Anaemia in pregnancy is most commonly due to
a. Chronic renal disease
b. Chronic blood loss
c. Low levels of folate
d. Haemolysis
e. Low levels of iron
20. Occipito posterior position of vertex
a. Is associated with prolong labour
b. Is typically associated with delay in second stage of labor
c. Always requires caesarean section
d. Leads to caput formation
e. Is found in patients with contracted pelvis
21. Pre implantation genetic diagnosis
a. Is done in early stages of human zygote/embryo development
b. Is carried out at 10 weeks of gestation
c. Should be offered to all women
d. Is done so that termination of pregnancy can be offered to couple timely
e. Carries a small risk of miscarriage
22. Regarding amniotic fluid, best statement
a. Volume is decreased in fetal growth restriction
b. Amniotic fluid index alters throughout pregnancy
c. Fetal kidneys contribute to amniotic fluid volume
d. Amniotic fluid index gives reliable index of amniotic fluid volume
e. Volume is increased in twin pregnancy
23. The commonest cause of massive PPH is:
a. Uterine atony
b. Eclampsia
24. Difficult labour due to deep transverse arrest is associated with:
a. Short statured mother
b. Good size fetus
c. Narrow pelvis
d. Deflexed fetal head
e. Android pelvis
25. Expected date of delivery can be calculated from last menstrual period by Neagle’s rule, as
follows
a. Subtract 3 months and 7 days from LMP
b. Add 9 months and 7 days to LMP
c. Subtract 9 months and 3 days from LMP
d. Add 9 month and 3 days to LMP
e. Subtract 9 months and 7 days from LMP
26. The fetus protects itself against anoxia by following mechanism:
a. Polycythemia
b. Microsomia
c. Anaerobic respiration
d. Auto regulation of blood flow
e. Placental enlargement
27. The term “gravida” means total number of:
a. Live births and still births
b. Live births only
c. Pregnancies excluding current pregnancy
d. Live births and abortions
e. All pregnancies, including current pregnancy
28. Factor that increase the risk of poor prognosis in labour is:
a. Contracted pelvis
b. Breach presentation
c. Occipito posterior postion
d. Estimated fetal weight of 3 kgs
e. Early rupture of membrane
29. Before shifting the patient from the labor room to ward, please ensure that:
a. Perineum has been properly repaired
b. Urinary bladder is empty
c. The uterus is well contracted and contains no blood clots
d. Mother is not in pain
e. The mother is in good condition
30. First step in a case of massive hemorrhage in an obstetric unit is:
a. Summon senior multi disciplinary help
b. 2 x 14 gauge intra venous lines
c. Arrange fresh frozen plasma
d. Retain catheter
e. O2 by mask
31. Regarding the treatment of preterm labor the best statement is:
a. Steroids is absolutely contraindicated in premature rupture of membranes
b. Tocolytic drugs are given to gain time for the effect of steroids
c. Cervical cerclage is applied in emergency
d. Beta agonist tocolytic drugs are the choice of treatment
e. Antibiotics given prophylactically prevents preterm labor
32. Regarding engagement during labor:
a. It is biparietal diameter in face presentatioin
b. Occurs when widest part of the presenting part passes through the inlet
c. Never occurs with brow presentation
d. It is biparietal diameter is vertex presentation
e. It is bitrochanteric axis in breech presentation
33. Haemodilution of red blood cells occur in pregnancy mainly due to:
a. Increase in stroke volume
b. Increase in erythrocyte production
c. Increase in cardiac output
d. Low iron levels
e. Marked increase in plasma volume
34. Established screening program exist to detect congenital viral infections in pregnancy for the
following
a. Cytomegalovirus
b. Rubella
c. Parovirus
d. Human papilloma virus
e. Herpes virus
35. A 28 yr para 1 + ? with past history of a abnormality in child presents in OPD at 12 weeks
gestation. Which investigation you will advise to exclude fetal anomaly?
a. Blood group
b. Maternal serum alpha fetoprotein
c. Blood sugar
d. Anomaly U/S scan
e. Nuchal translucency scan
36. Previous obstetrics features that have bad impact on future pregnancy include:
a. Recurrent miscarriage and preterm delivery
b. Recurrent miscarriage
c. Preterm delivery
d. Early onset pre-eclampsia
e. Un explained still birth
37. Cephalo-pelvic disproportion is suspected in labor if
a. Cervix is thick and hanging
b. Vaginal examination shows severe moulding and caput formation
c. Fetal head is at midpelvis
d. Heavy show
e. Labour progress is slow
38. Sheehan’s syndrome occurs from ischemic necrosis of:
a. Posterior pituitary gland
b. Hypothalamus
c. Sella turcica
d. Pituitary gland
e. Anterior pituitary gland
39. Diagnosis of the onset of labor is made by:
a. Spontaneous rupture of membrane
b. Softening of cervix
c. Dilatation of cervical OS
d. Appearance of show
e. Uterine contraction
40. A 32 weeks diabetic pregnant woman is having sympysio-fundal height of 36 cms. Most likely
cause is:
a. Fibroids with pregnancy
b. Multiple pregnancy
c. Full bladder
d. Macrosomia
e. Oligohydraminios
41. Following statements about neural tube defects are correct
a. Recurrence risk is 5%-10% with a previoiusly affected child
b. Can be diagnosed from maternal serum markers eg: serum alpha-fetoprotein
c. Diagnosis can only be confirmed by U/S in first trimester
d. U/S can diagnose 95% of cases with good sensitivity and specificity
e. Includes encephalocele, anencephaly & spina bifida
42. Most important aim of booking visit is to:
a. Find out congenital anomalies
b. Give dietary advice
c. Assess the degree of risk in pregnancy
d. Give advice regarding drugs
e. Book patient in hospital
43. During first stage of labor, descent of fetal head depends on:
a. Size of fetal head
b. Contraction of levator ani muscle
c. Voluntary use of abdominal muscles
d. Uterine contraction
e. Valsalva manouvre
a. Haemoglobin concentration
b. Plasma folate concentration
c. Red cell count
d. Erythrocyte sedimentation rate
e. Haematocrit
a. Hyper reflexia
b. Agitation
c. Odema
d. Oliguria
e. Epigastric pain
46. Well flexed fetal head, engaged in occipito posterior position:
a. Delivers vaginally as face to pubes
b. The leading part will be occiput
c. Causes prolong labor
d. Results in increased incidence of fetal hypoxia
e. Results in increased rates of instrumental delivery
a. Is due to deflexed of head
b. Presenting diameter is submento bregmatic 9.5 cm
c. Occurs in 1:300 labors
d. Diagnosed only in labor
e. Requests caeserian section
a. Favorablility for instrumental delivery
b. Fetal conditions
c. Favorability of cervix for induction of labor
49. The commonest cause of poor progress in labour is:
a. Placenta praevia
b. Inefficient uterine contraction
c. Cord round fetal neck
d. Cephalo pelvic disproportion
e. Cervical dystocia
50. The best method of screening a fetal abnormality in first trimester is:
a. Maternal serum alpha fetoprotein
b. Cordocentesis
c. Chorionic villus sampling
d. U/S
e. Amniocentesis
51. A patient had polyhydramnios. Immediately after delivery she complains of severe chest pain.
Becomes dyspnoeic & collapses. Pulse is 140/min, BP is 80/40mm hg chest is full of crepitation’s.
Cause?
a. Adult respiratory syndrome
b. Amniotic fluid embolus
c. Myocardial infarction
d. Cardiac failure
e. Pulmonary edema
a. Weekly after 32 weeks
b. Five minimum visits as advised by royal college of obs/gyne
d. Should be tailored according to the wishes of individual
e. Offered regardless of the choice of care
53. A 35 years lady with C/O menorrhagia for 6 months had diagnostic curettage the histopatho
shows proliferative endometrium. Her request for hysterectomy is ethically handled by:
a. LNG-IUR
b. Go ahead with hysterectomy
c. Offering medical treatment
d. Proposed with endometrial ablation
e. Drugs?
54. For a woman progressing normally in labor it is necessary to:
a. Maintain partogram
b. Record fetal heat sounds after every 15 mins
c. Make note of cervical dilataion
d. Do intermittent monitoring of her vital signs
e. Keep drug record
55. Most common cause of intrauterine death is
a. Congenital anomaly of fetus
b. Unexplained
c. Infection in pregnancy
56. First step to stop bleeding in atonic post partum uterus is:
a. Prostaglandin
b. Uterine massage
c. Oral mesoprostal
d. Oxytocin infusion
e. Bimanual compression
57. The principles of management of 1st stage labor are:
a. Adequeate pain relief
b. Monitoring of fetal well being
e. Observation of progress of labor with timely intervention
58. A nulliparous woman is in labor for 18 hours she is at risk for:
a. Maternal exhaustion
b. Operatively delivery
c. Fetal tachycardia
d. Chorioamniotis
e. Amniotic fluid embolism
59. Risk factor for developing super imposed pre-eclampsia is:
a. Diabetes
b. Cortication of aorta
d. Blood pressure > 160/100 mm in early pregnancy
e. SLE
a. The sweat & sebaceous glands activity increases
b. Nipples become larger and erectile
c. Breast increases in size because of hyperplasia and hypertrophy
d. The hypertrophied sebaceous glands are monotogometerys follicles
e. Size of breasts increase due to increase deposition of fat.
61. Maternal mortality:
a. Eclampsia is the leading cause
b. Sepsis is the leading cause
c. Rate is unchanged in western countries due to good antenatal care
d. Hemorrhage is the leading cause
e. Includes maternal deaths while pregnant or withing 42 days of termination of pregnancy due to
any cause
62. Definite sign of preterm labor is
a. Cervical effacement and dilatation
b. Palpable uterine contraction
c. Vaginal bleeding
d. Tachycardia
e. Bulging amniotic membranes
63. Percentage contribution of obstructed labor for maternal death world wide is:
a. 2% (not sure, can’t find it in im or ten teachers)
b. 20%
c. 8%
d. 15%
e. 4%
64. Lochia
a. If offensive should be treated with broad spectrum antibiotics
b. If offensive if there is retained products of conception
c. Is the blood stained uterine discharge that comprises of blood and necrotic decidua after delivery
d. Is sloughing of whole of decidua after delivery
e. Is red only in the first few days of delivery
65. U/S at booking visit has following benefits:
a. It excludes preterm labor
b. It establishes viability
c. Exclude multiple gestation
d. Determines the site of pregnancy
e. Excludes ectopic pregnancy
66. 25 yrs para 1+0 Rh-negative woman with past home delivery presented in antenatal clinic. The
first investigation you will advise is:
a. Rhesus antibody titer
b. Hemoglobin level
c. Amniocentesis
d. Husbands blood group
e. Baby’s blood group
67. Best statement for diet in pregnancy is:
a. Calcium requirement increases from 200 t0 400 mg/day
b. All women require iron supplement irrespective of their hemoglobin level
c. Women should avoid vitamin supplement that contain vitamin A
d. Most women who eat sensible diet need vitamin supplement
e. It should be high in fibre and fat
68. The most important change in carbohydrate metabolism during pregnancy is
a. Transplacental transfer of glucose increases
b. Fasting glucose concentration is reduced in the first half
c. Enhanced response to glucose tolerance in first half
d. Glycosuria is normal
e. Relative insulin resistance
69. Secondary PPH:
a. Is associated with fibroid uterus complicating pregnancy
b. Is a rare cause of massive bleeding
c. Requires immediate evac of uterus
d. Is a result of retained products of conception and/ or uterine infection
70. Folate supplementation around conception & in first trimester of pregnancy is expected to
reduce the frequency of:
a. Antepartum hemorrhage
b. Still births
c. Anemia
d. Abortions
e. Neural tube defects
71. A primigravida presented in emergency with 42 weeks pregnancy, having labor pains since 20
hours at home and delivered a still born baby by forceps in hospital. Most likely cause of still birth?
a. Post maturity
b. Prolong labor
c. Intrapartum asphyxia
d. Infection
e. Forceps application
72. The criteria for vaginal delivery in twin pregnancy is:
a. Cephalic presentation of twin 1
b. Monochorioninc twins
c. One twin having congenital anomaly
d. Twin 1 smaller than twin 2
e. Spontaneous onset of labor
73. Characteristic features of down’s syndrome is/are
a. Premature aging
b. Cardiac septal defects
c. Leukemia, reduced life span,
d. Mental retardation, deafness, short sightedness
e. First facies, macroglossia
74. On vaginal examination of a woman in labor, reassuring sign for the fetus is:
a. Vertex presentation
b. Intact membrane
c. Clear amniotic fluid
d. Vertex at the level of ischeal spines
e. Adequate pelvis

1. Commonest cause of smaller for dates SFH is:
a. Mistaken dates
b. IUGR
c. Congenital abnormal fetus
d. Oligohydraminios
e. Engaged head
2. Average maternal weight gain during pregnancy is:
a. 10-11lbs
b. 10-12kgs
c. 11-13kgs
d. 10-12lbs
e. 9-10kg
3. Secondary PPH:
a. Is a result of retained products of conception and or uterine infection
b. Is a rare cause of massive bleeding
c. Is associated with fibroid uterus complicating pregnancy
d. Requires immediate evacuation of uterus
4. A well flexed fetal head, if engages in occipito posterior position, then
a. Causes prolong labor
c. Delivers vaginally as face to pubes
d. Results is increased rate of instrumental delivery
e. Results is increased incidence of fetal hypoxia
5. Measurement of maternal height and weight is important in antenatal clinic because:
a. Perinatal mortality is high if BMI is greater than 30
b. BMI has to be calculated on each visit
c. Height is a predictor of labor problems
d. Satisfactory weight gain in women with BMI <20 is associated with increased perinatal risk
e. Nutritional status can be assessed
6. A 30 year old para 1+0 woman presents in antenatal clinic with complains of excessive fetal
movements. Multiple pregnancy can be best diagnosed by:
a. Greater uterine size than gestational age
b. Palpation of two fetal heads
c. Palpation of multiple fetal parts
d. U/S
e. Auscultation of two fetal heart rate
7. Embryonic period is referred to as development of fetus between:
a. 5-9 weeks from LMP
b. 4-6 weeks from LMP
c. 4-8 weeks from LMP
d. 4-10 weeks from LMP
e. 4-7 weeks from LMP
8. Commonest cause of perinatal death due to congenital anomaly is:
a. Neural tube defects
b. Gastrointestinal anomalies
c. Down’s syndrome
d. Metabolic diseases
e. Cardiac anomalies
9. A 30 year old para 1+0 woman with last born anencephalic baby presented at 10 weeks of her
second pregnancy. The best investigation to diagnose anencephaly would be:
a. Chorionic villous sampling
b. High resolution U/S
c. Maternal serum alpha fetoprotein
d. Maternal serum B HCG
e. Amniocenteisis
10. A young Para 2+0 had delivered alive healthy baby of 3.0kg two hours back. She has been
found to be hepatitis C positive on routine screening. She should be
a. Asked to continue breast feeding if she receives antiviral drugs
b. Asked not to handle or breast feed the baby and take antiviral drugs
c. Counseled to continue breast feeding as risk of transmission via breast milk in low
d. Given immunoglobulin and then breast feed the baby
e. Also screened for coexist HIV infections
11. Difficult labor due to deep transverse arrest is associated with:
a. Good size fetus
b. Deflexed fetal head
c. Android pelvis short statured mother
d. Narrow pelvis
12. The biggest contribution to high perinatal mortality to toxins is:
a. Twin to twin transfusion syndrome
b. Polyhydraminios
c. Intrauterine growth restriction
d. Congenital anomaly
e. Preterm birth
13. Most common cause of primary dysfunctional labor is:
a. Prolonged labor phase
b. Malposition of the fetus
c. Cephalo pelvic disaproportion
d. Uterine contractions
e. Malpresentation of the fetus
a. Smooth sacral curve
b. Ichial diameter measuring something?
c. Shallow and straight side walls
d. No great projection of the ischial spines
e. Sacrospinous ligament at least 3.5 cms
15. Absolute contraindication at a trial of vaginal birth after previous C-section is:
a. Previous H/O lapratomy for ovarian cyst
b. Previous H/O ectopic pregnancy
c. Previous upper segment caesrean section
d. Previous breech delivery
e. Previous H/O myomectomy without opening of uterine cavity
16. A grand multigravida has delivered a 3.5 kg baby. During attempts at delivery of placenta she
cries due to excruciating pain in lower abdomen. Suddenly a bright red bleeding mass appears at
vulva. The cause is:
a. Placenta
b. Fibroid polyp
d. Uterine fibroid
e. Uterine prolapse
17. The commonest cause of maternal death in HELLP syndrome is due to:
a. Ruptured uterus
b. Obstructed labor
c. Hepatic failure (encephalotpathy)
d. Haemorrhage due to DIC
e. Thrombo – embolism
18. Regarding neonatal transmission of hepatitis B and C infections from mother
a. Perinatal hepatitis C transmission rates are low timely immunoprophylaxis
b. Hepatitis C transmission is more common and immunoprophylaxis is required
c. Chronic liver disease will be more with Hepatitis B than with Hepatitis C
d. Hepatitis B carries significant perinatal transmission risk for newborn in absence of timely
prophylaxsis
e. Perinatal transmission will be more if HBV and HIV coexist
19. Women are increasingly demanding caeseren section to minimize the:
a. Pain during labor
b. Risk of thrombo emboloism
c. Risk of infection
d. Risk of pelvic floor trauma
e. Risk of fetal trauma
20. Correct statement regarding meiosis is
a. During mitosis, DNA replication does not occur
b. It occurs in both somatic & germ cells
c. The primary oocyte completes first meiotic division as birth
d. Meiosis is completed at ovulation
e. Unlike mitosis, cell division occurs twice in meiosis
21. Most important aim of booking visit is to:
a. Give dietary advice
b. Book patient in hospital
c. Assess the degree of risk in pregnancy
d. Give advice regarding drugs
e. Find out congenital anomalies
a. Valsalva manourvre
b. Size of fetal head
c. Uterine contraction
d. Contraction of levator ani muscles
e. Voluntary use of abdominal muscles
23. Symptomatic hypoglycemia is more common in infants
a. Of diabetic mothers
b. Wish intrauterine growth restriction
c. Suffering fetal distress
d. Suffering birth trauma
e. With apparent normal health
24. Most sure sign of labor is:
a. Presence of labor
b. Cervical effacement
c. Cervical dilatation
d. Rupture of membrane
e. Mild uterine contractions
25. Most important manifestion of severe pre eclampsia is:
a. Oliguria
b. Odema
c. Agitation
d. Hyper-relfexia
e. Epigastric pain
26. A primigravia admitted in labor room with good uterine contractions since 6 hours and
unengaged head. The most likely cause of non progress is:
a. Deflexed head
b. Malpositon
c. Incoordinate uterine contraction
d. Cephalo-pelvic disproportioin
e. Pelvic mass
27. Which of the following changes in the renal system during pregnancy affects interpretation of
laboratory results
a. GFR increases 50%
b. Glycosuria is normal
c. Renal threshold is reduced
d. Plasma urea and creatinine are reduced
e. Blood flow increases 60%
28. Partogram includes the recording of all except
a. Descends of head in fifths palpable
b. Amount and color of amniotic fluid draning
c. Uterine contractions
d. Rate of cervical dilatation
e. Cardio tocography
29. Following laboratory tests are done routinely during an antenatal period except:
a. Blood count
b. Blood group/Rh factor
c. Hepatitis B surface antigen
d. Toxoplasma antibody titre
e. Rubella antibody titre
a. 15%
b. 2%
c. 8%
d. 4%
e. 20%
b. Meiosis only occurs in sex chromosomes
c. Spermatogenesis is the production of mature sperms
e. Primary oocytes are produced during reproductive life
32. Which of the following risk factors does not have an impact on future pregnancy:
a. Induced abortion
b. Congenital anomalies
c. Unexplained still birth
d. Early onset pre-eclampsia
e. Macrosomic baby
33. Regarding second divison in meisosis:
a. There is no DNA replication
b. Ends in four haploid daughter cells
c. Benign with diploid cell
e. Ends in 23 single stranded chromosomes
34. Regarding the treatment of preterm labor the best statement is
a. Tocolytic drugs are given to gain time for the effect of steroids
b. Beta – agonist tocolytics drugs are the treatment of choice
c. Cervical cerclage is applied in emergency
d. Antibiotics given prophylactically prevents preterm labor
e. Steroids in absolutely contraindicated in premature rupture of membranes
35. Factors affecting efforts to implement program of safe motherhood
a. Chronic anemia
b. Rapidly evolving acquired immune deficiency syndrome
c. Inter current illnesses
d. Poor access to health care
e. Ability to identify mothers at risk
36. Neonatal jaundice:
a. Healthy term new born are immune from kernicterus
b. Needs urgent investigation if appears in first 24 hours of life
c. Is due to immaturity of liver’s excretory pathway
d. Neonatal jaundice is usually benign
e. Appears in two thrids of babies in first week of life
37. Level -2 intensive care is required for induction of labor is:
a. Post dates pregnancy
b. Maternal hypertension
c. Fetal growth restriction
d. Uncontrolled maternal diabetes
e. Intra uterine growth restriction
38. The most common reason for induction of labor is:
a. Post dates pregnancy
b. Maternal hypertension
c. Fetal growth restriction
d. Uncontrolled maternal diabetes
e. Intra uterine growth restriction
a. Five minimum visits as advised by royal college of obs and gyne
b. Should be tailored according to the wishes of the individual
d. Similar schedule is offered regardless of the choice of care
e. Weekly after 32 weeks
40. Percentage contribution of massive haemorrhage for maternal death worldwide is:
a. 25%
b. 35%
c. 50%
d. 15%
e. 75%
41. Commonest cause of PPH is:
a. Infection
b. Injudicious use of oxytocin
c. Uterine atony
d. Lacerations of genital tract
e. Prolonged labor
42. Best statement regarding antenatal depression is:
a. The vulnerable women tend to be primigravida
b. These women have good social support
c. These women are less likely to develop postnatal depression
d. These women are anxious about the health of their fetus
e. Between 5 and 10% of women develop depression during pregnancy
43. Expected date of delivery can be calculated from last menstrual period by Neagle’s rule as
follows:
a. Subtract 3 months and 7 days from LMP
b. Add 9 month and 3 days to LMP
c. Add 9 month and 7 days to LMP
d. Subtract 9 months and 3 days from LMP
e. Subtract 9 months and 7 days from LMP
44. A patient had poly hydramnios immediately after delivery the complains of severe chest pain,
becomes dyspnoeic and collapses. Pulse is 140 min, BP is 80/40 mm Hg, chest is full of crepitations.
Cause could be:
a. Myocardial infarction
b. Cardiac failure
d. Adult respiratory syndrome
45. Regarding obstetric history, the most important data is
a. RH-isoimmunization
b. Previous history of abortion
c. Last menstrual period
d. Previous history of preterm labor
e. Previous history of ectopic pregnancy
46. A 25 year old P0+1 attends OPD for booking at 8 weeks pregnancy, she carries a report of HB
electrophoresis showing sickle cell disease. She is married to her 1st cousin, she carries high risk of
a. Premature labor
b. Chest and UTIs
c. Miscarriage
d. Intra –uterine growth restriction
e. Pre-eclampsia
47. The best statement about rubella infection during pregnancy in IgG –ve woman is
a. Can lead to heart and eye abnormalities
b. Can be prevented by vaccinating girls before marriage
c. Maternal infection does not always means that fetus is affected
d. Rubella vaccination should be done in post natal period
e. Susceptible woman should be advised against exposure to virus in antenatal period
48. At 34 wks, Mrs. XYZ had severe jaundice followed by coma, she died on 7 th day. She had no
history of blood transfusion and was vaccinated against Hep B. Her cause of death could be
a. Hepatitis A
b. Intrahepatic cholestasis of pregnancy
c. Hepatitis E
d. Hepatitis B
e. Hepatitis C
49. Important area of a medical history of a first degree relative during pregnancy is:
a. Smoking
b. Pulmonary TB
c. Twin pregnancy
d. Diabetes
e. Epilepsy
a. A haploid primary oocyte produces one mature haploid ovum by meiosis
d. A diploid primary oocyte produces one mature haploid ovum by meisosis
51. The most important benefit of an early pregnancy scan is:
a. Detection of fetal abnormality
b. Determination of fetal growth
c. Confirmation of cardiac flicker
d. Early detection of multiple pregnancies
e. Accurate dating in women with irregular menstrual cycles
52. Which one of the following is most potential sensitizing events for Rhesus disease?
a. Antepartum hemorrhage
b. Delivery
c. Termination of pregnancy
d. Invasive prenatal testing
e. Miscarriage
53. Uterine involution:
a. Is the process by which the post partum uterus returns to its pre pregnancy state of less than 100
grams
b. Is accelerated if ergometrinc is given is post partum period
c. Is completed within 2 weeks of delivery
d. Is delayed in the women bottle feeding her baby
e. Is delayed almost always due to retained products of conception
54. A 35 years old lady with C/O menorrhagia for 6 months, had diagnostic curettage. The
histopathology reveals proliferative endometrium. Her request for hypertensive is ethically handled
by:
a. Proposed with endometrial ablation
b. Offering medical treatment
c. LNG-IUR
d. Hysterectomy
e. Give anti anemic drugs
a. Weekly after 32 weeks
b. Five minimum visits as advised by royal college of obs and gyne
d. Similar schedule is offered regardless of the choice of care
e. Should be tailored according to the wishes of individual
56. A patient had poly hydramnios. Immediately after delivery she complains of severe chest pain,
becomes dyspnoeic and collapses. Pulse is 140/min, BP is 80/40 mm Hg. Chest is full of crepitations.
Cause could be
a. Adult respiratory distress syndrome
b. Amniotic fluid embolism
c. Myocardial infarction
d. Cardiac flicker
57. The best method of screening a fetal abnormality in first trimester is:
a. Maternal serum alpha fetoprotein
b. Cardiocentesis
c. Chorionic villous sampling
d. U/S
e. Amniocentesis
58. The commonest cause of poor prognosis in labor is
a. Placenta previa
b. Inefficient uterine contraction
c. Cord around fetal neck
d. Cephalo pelvic disproportion
e. Cervical dystocia
a. Favorability for instrumental delivery
b. Fetal condition
c. Favorability of cervix for induction of labor
a. Is done by deflexed of head
b. Presenting diameter is submento bregmatic 9.5 cm
c. Occurs in 1:300 labors
d. Diagnosed only in labor
e. Requires caesarean section
61. Well flexed fetal head, engaged in occipito posterior position:
a. Delivers vaginally as face to pubes
c. Causes prolong labor
d. Results in increased incidence of fetal hypoxia
e. Results in increased rates of instrumental delivery
a. Hyper – reflexia
b. Agitation
c. Edema
d. Oliguria
e. Epigastric pain
a. Hemoglobin concentration
b. Plasma folate concentration
c. Red cell count
d. Erythrocyte sedimentation rate
e. Hematocrit
a. Size of fetal head
b. Contraction of levator ani muscle
c. Voluntary use of abdominal muscles
d. Uterine contraction
e. Valsalva manouvre
65. For a women progressing normally in labor it is necessary to:
a. Maintain partogram
b. Record fetal heart sounds after every 15 minutes
c. Make note of cervical dilatation
d. Do intermittent monitoring of her vital signs
e. Keep during record
66. Most common cause of intrauterine death is:
a. Congenital anomaly of fetus
b. Unexplained
c. Infection in pregnancy
67. First step to stop bleeding in atonic post partum uterus is:
a. Intramyometrial prostaglandin
b. Uterine massage
c. Oral mesoprostal
d. Oxytocin infusion
e. Bimanual compressioin
68. The principles of management of 1st stage of labor are:
b. Monitoring of fetal well being
e. Observation of progress of labor with timely intervention
69. A nulliparous woman is in labor for 18 hours, she is at risk for:
a. Maternal exhaustion
b. Operative delivery
c. Fetal tachycardia
d. Chorioamionitis
e. Amniotic fluid embolism
70. Risk factor for developing super imposed pre-eclampsia is:
a. Diabetes
b. Coarctation of aorta
d. Blood pressure > 160/100 mm in early pregnancy
e. SLE
a. The sweat & sebaceous glands activity increases
b. Nipples becomes larger and more erectile
c. Breast increases in size because of hyperplasia and hypertrophy
d. The hypertrophied sebaceous glands are montogometery’s follicles
e. Size of breasts increase due to increase desposition of fat
72. Maternal mortality
a. Eclampsia is the leading cause
b. Sepsis is the leading cause
c. Rate is unchanged in western countries due to good antenatal care
d. Hemorrhage is the leading cuases
e. Includes maternal deaths while pregnant or within 42 days of termination of pregnancy due to any
cause
73. Definite sign of preterm labor is:
a. Cervical effacement and dilation
b. Palpable uterine contraction
c. Vaginal bleeding
d. Tachycardia
e. Bulging amniotic membranes
a. 2%
b. 20%
c. 8%
d. 15%
e. 4%
75. Lochia
a. Is offensive should be treated with broad spectrum antibiotics
b. Is offensive if there is retained products of conception
c. Is the blood stained uterine discharge that compromises of blood and necrotic decidiua after
delivery
d. Is sloughing of whole of decidua after delivery
e. Is red only in the first few days of delivery.
OBSTETRICS NOTES
1. Contraindication to ventouse delivery: Gestation less than 34 weeks
2. Most dreadful complication of gestational cholestasis: Intrauterine death
3. Regarding 2nd degree perineal tears: Involve perineal muscle
4. A woman at 32 weeks gestation with arrested 2nd stage of labour, what would you do: Forceps
delivery
5. Puerperial sepsis: Genital tract infection following delivery
6. How will you diagnose mitral stenosis: Echo
7. Main support of vagina: Uterosacral ligament
8. Normal OGTT value: 7.8mmol/L
9. Gestational diabetes is due to: Increased insulin resistance (Receptor dysfunction)
10. Regarding NTDs: Spina Bifida are detectable on 20th week scan
11. Woman with acute fatty liver in pregnancy, what are consequences post-delivery: No serious
consequences
12. Down's syndrome's most characteristic feature: Macroglossia/Flat facies
13. Ethical principle if a woman comes for hysterectomy: Ablative therapies are available
14. Woman with a previous cessarian, now intends to go NVD. If augmentation and induction
method is used, what are the consequences: Rupture of previous scar
15. Safe motherhood includes all except: Free access to induced abortions
16. Signnificant purpose of booking visit: Confirming the viability of fetus
17. A woman had an abortion at 14th weeks gestation, after 2 weeks she presented with fever and
abdominal pain, state the cause: Retained products of conception
18. A lady presented for caessarian section had an HB level of 7mg/dl, immediate management:
Transfusion of packed red cells
19. Most important for examining in lithotomy position: Sterilize the instruments
20. Most reliable test for diagnosis of Down's syndrome: PAPPA, HCG and NTD
21. True regarding spermatogenesis: 4 haploid spermatozoa are formed via meiosis
22. A woman with initially normal labour with cervical dilatation of 6 cm but after 4 hours
contractions remained same but dilatation stopped. Diagnosis: Cervical dystocia
23. Patient with history of epilepsy wants to become pregnant, your advice: Half the dose of
antiepileptics
24. Side-effect of syntocinon with previous CS: Rupture of CS scar
25. Most common cause of IUGR: Maternal malnutrition
26. Which bones make vertex: Parietal bones
27. Regarding fetal skull: Face, base, vault
28. Vertex presentation diameter: Suboccipito-bregmatic
29. Landmark to determine fetal station: Ischial spine
30. Regarding pelvic inlet, choose the wrong one: Transverse diameter is 11.5
31. Most important aspect of booking visit: Confirmation of viability/risk assessment? (not sure)
32. Most common cause of APH: Hypertension
33. Most potential sensitizing event for rh incompatibility: Miscarriage
34. Commonest cause of massive PPH: Uterine atony
35. If a prostaglandin inhibitor is given, effect would be: Closure of ductus arteriosus
36. Maneuver for delivery of shoulders in breech presentation: Loveset's
37. Safest incision for episiotomy: Mediolateral
38. During first phase of 2nd stage there is no maternal urge to push, why: Fetal head is high in pelvis
39. Regarding placenta accreta: Villi attached to myometrium
40. Commonest cause of vaginal discharge in women of child-bearing age: Bacterial vaginosis
41. Large fundal height for gestational age, choose the wrong one: IUGR
42. Woman presents at 30th week of gestation with history of 2 bleeding episodes per vagina. Her BP
is 120/70, pulse 78, heart rate normal. Regarding her management: Admit her and prepare for
emergency CS upon another bleeding episode
43. Most important factor that makes CTG suspicious: Absence of accelerations
44. Most common cause of IUD: Undernutrition/infection??
45. A para 1+0 rh negative female comes for antenatal visit. First step: Husband blood group
46. Drug for seizures in eclampsia: Magnesium sulphate
47. On vaginal examination the most reassuring sign of fetus is: Vertex at ischial spine
48. Paramesonephric duct gives rise to: Uterus, fallopian tubes and vagina
49. Most important complication of polyhydramnios: Preterm labour
50. During pregnancy, physiological increase in: ESR
51. Regarding complications in monoamniotic twins: Cord accidents
52. Primigravida in the labour room, cervix is 7cm dilated and loop of pulsating cord is felt through
intact membrane. Management: Do emergency CS?
53. Ooocytes present at birth: 2 million
54. Investigation of choice in VTE: Venography
55. Chorionic villus sampling done at: 10th week
56. Psychiatric disorder after delivery: Depression
57. First step in managing uterine atony: Uterine massage
58. Female with polyhydramnios immediately after delivery developed chest pain and dyspnea.
Diffuse creptitations are heard all over chest. BP is 90/60 and pulse rate 140/min. Most probably she
has: Amniotic fluid embolism? (Key says myocardial infection)
59. Most important aim of safe motherhood project: Fmily planning
60. Of the following used in screening program: Syphilis
61. Most common cause of secondary PPH: Retained products of conception
62. Nutrition in pregnancy: High fiber and fat
63. Investigation for pre-eclampsia: 24 hour urinary collection
64. Average gestational age at delivery in twin pregnancy: 37 weeks
65. Preterm labour: Tocolysis is given to get a time window for steroids
66. Diabetic mother with 32 weeks gestation and fundal height of 36 cm: Macrosomia (32 - 34
normal)
67. Woman para 1+0 in her 2nd stage of labour for more than an hour. Regular fundal height,
cephalic presentation, mentoanterior position and regular uterine contractions, management:
Observe for progress of labour
68. Mitosis and meiosis: Cell division occurs twice in meiosis
69. Regarding rubella: Rubella susceptible women are advised to avoid exposure to virus
70. Oogenesis: one diploid cell produces mature haploid cells during meiosis
71. Hep C infected mother, breastfeeding advice: Continue feeding, no risk of transmission
72. 32 year old primigravida, normal uterine contractions for 6 hours labour but head not engaged,
state the reason: CPD
73. Before shifting a woman from labour room to ward, ensure that: Mother is in good condition
74. 35 years old multigravida bleeds heavily with red protracted mass, diagnosis: Uterine prolapse
75. Preterm labour diagnosed by: Cervix effacement and dilatation
76. Measurement of maternal height and weight is important in antenatal clinic because: Perinatal
mortality is high with BMI >30
77. 30 years old lady with 36 weeks gestation, has a history of a previous spontaneous delivery. She is
normotensive and on examination presentation is breech. Your management: ECV
78. Cannot diagnose antenatally by ultrasound only: Down's sydrome
79. Android pelvis predisposes to: Deep transverse arrest
80. A lady para 2, A -ve with husband B +ve has positive coomb's test after 3rd delivery: Doesn't
require anti D anymore
81. Ideal pelvis: Smooth sacral curve
82. Primigravida with 42 weeks pregnancy and 20 hours labour gives birth to a still-born. State the
cause: Intrapartum asphyxia
83. Commonest cause of maternal death in HELLP: Hemorrhage due to DIC
84. 34 year old pregnant lady with 36 weeks gestation, fetal distress. On examination a prolapsed
mass is found, management: Forceps delivery/CS?
85. Diagnosis of Hep C by: HCV RNA
86. Classical CS: Midline vertical incision
87. Pregnant lady, MCV <80: Iron deficiency anemia
88. Pulmonary embolism, investigation of choice: Ventilation/Perfusion scan
89. Defecation in utero, meconium seen in amniotic fluid, reason: Post term pregnancy
90. Pregnant lady with headache, nausea, vomiting, jaundice, abdominal pain, hypoglycemia and
coagulopathy: Acute fatty liver of pregnancy
91. Most common cause of hypertension in pregnancy: Essential hypertension
92. Confirmation of early pregnancy: Urine test
93. Iron deficiency anemia diagnosis: Serum ferritin
94. Dreadful complication of uncontrolled diabetes in pregnancy: Nephropathy
95. Neonatal physiotherapist: Preterm birth
96. Iron deficiency anemia at 36th week, treatment: Packed Cells
97. Pregnant lady at 34 weeks gestation, fetal head in right iliac fossa, possible lie: Oblique
98. Normal primipara cervical dilatation rate: 1cm/hr

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OBSTETRICS SEM 10 2016

1)Anti-D prophylaxis given at:

3)NOT a risk factor for GDM:

4)Difficult labor due to deep transverse arrest associated with?

5)First step in massive obstetric hemorrhage:

6)Most important benefit of early pregnancy scan?

7) Aim of safe motherhood:

8)Woman was on antihypertensive now pregnant. Which antihypertensive you give?

9)Aim of booking visit?

11) NOT a risk factor for GDM?

13) Essential HTN pt, pregnant now, develops proteinuria. Dx:

14) Pregnancy-induced HTN pt, develops proteinuria. Dx:

18) Atrophic endometritis treatment

19) Treatment of type-IV placenta previa:

20) First sign of amniotic fluid embolism:

21) Which of the following indicates acute infection of Hep.B?

22) Method of assessing accurate weight of the baby:

23) Assessment of renal function in Preeclampsia:

24) Duration of lactational amenorrhea:

25) Question regarding anemia (NOT Remembered)

27) Regarding fetal skull:

28) In dichorionic diamniotic twin, division occurs at:

29) Risk in monoamniotic monochorionic twin:

30) Screening used for:

31) Chin presentation, diameter?

33) Perinatal death:

34) For the dx of iron def anemia:

35) Which of the following least imp in labs of anemia:

36) Nephrogenic cord formd at?

37) Investigation to evaluate intra-uterine death: U/S, F.W.B

39) Monochorionic twins associated with the following complication:

41) Risk of perianal pain after 3 days of delivery?

43) Wrong one:

45) Child failure to thrive lethargic irritable, investigation: a) RBS

46) Pregnant lady at 34 weeks of gestation, Hb=7. Rx:

47) Screening test for:

48) Mgmt of Preterm baby:

49) Mitral stenosis question (NOT Remembered)

50) Pre-pregnancy counseling in mitral stenosis:

51) Primitive streak develops at which week of gestation? 4th wk

Q’s regarding: (NOT Remembered)

52) Sickle cell crisis (hereditary)

53) Heparin & Stocking

54) Birth canal

55) Fetal skull

82) Investigation for dx:

90) Risk factor:

94) Presenting diameter:

OBSTETRICS SEM 9 2016

SBL For Questions 73 to 75

SBL For Question 78

SBL For Question 79

SBL For Question 80

SBL For Question 81

SBL For Question 82

SBL For Question 83

OBSTETRICS SEM 9 2016

5. Most women in developing countries are at risk during pregnancy of:

6. Regarding respiratory distress syndrome best statement is

7.Commonest cause of maternal mortality worldwide is