3rd - 5th yr 1

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    1. An example of direct maternal death is:

    A. Death from complications of mitral valve prolapse

    B. Death from exsanguination after uterine rupture

    C. Death from motor vehicle accident

    D. Death from pulmonary embolism due to antithrombin III deficiency

    E. Death from gunshot wound to the abdomen

    2. The least likely bacteria isolated from patients with septic shock is:

    A. Staphylococcus Aureus

    B. Bacteroides

    C. Escherichia coli

    D. lebsiella pneumonia

    E. !seudomonas aeruginosa

    3. Which second trimester ultrasound finding is most indicatie of Trisomy 21!

    A. "uchal fold #$mm

    B. Shortened femur 

    C. Choroid plexus cyst

    D. !yelectasis

    E. Shortened humerus

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    ". What is the most likely complication from induction of a #$A%!

    A. %terine &upture

    B. Admission of neonate to special care nursery

    C. &epeat cesarean

    D. 'etal distress

    E. %terine dehiscence

    &. What is the most likely outcome of deliery in a patient at "2 3'( weeks

    gestation!

    A. %teroplacental insufficiency

    B. (econium aspiration

    C. (acrosomic infant

    D. Intra ) uterine infection

    E. *ow umbilical artery p+

    ). What is the most appropriate management of ular carcinoma in situ!

    A. ,ide local excision

    B. - fluorouracil

    C. &adical vulvectomy

    D. *aser ablation

    E. Aldara Cream

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    (. A fetus is found to hae loops of bowel protruding through an abdominal wall

    where the umbilicus is to the left of the defect. What are the other associated

    anomalies!

    A. Cleft lip and !alate

    B. "o other anomalies

    C. Aneuploidy

    D. Bec/with,iedemann syndrome

    E. Esophageal atresia

    *. What is the most common histological type of endometrial cancer!

    A. Endometrioid

    B. !apillarySerous

    C. Carcinosarcoma

    D. Clear cell

    E. (ucinous

    +. A 1+ year old presents with ,-/0 on cytology from a family practice physician.

    The next best step is:

    A. excisional biopsy

    B. &epeat cytology is 0 months

    C. +!1 testing

    D. Colposcopy

    E. &eturn for pap at age 23

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    1. A 22 y'o presents with allmans syndrome and infertility. What is the best

    drug to prescribe if she wants to conceie

    A. Clomiphene citrate

    B. Estrogen and progesterone

    C. !rogesterone

    D. 4onadotropins

    E. +uman chorionic gonadotropin

    .

    11. What is the mechanism of action of pironolactone:

    A. Androgen receptor agonist

    B. Binds to androgen receptor as an antagonist

    C. Inhibits - alpha reductase type I and II

    D. Inhibits ornithine decarboxylase

    E. Insulin sensiti5er 

    32. A patient presents at & weeks post partum with altered mental status. he is

    examined by the neurologist and found to hae increased intracranial pressure. 4n

    exam5 her uterus is 1612 cm with a bulging mass on the aginal wall. What is the

    next step:

    A. (&I of the brain

    B. Serum beta +C4

    C. %ltrasound

    D. C6 of the abdomen and pelvis

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    E. 7bservation

    13. The most common thrombophilia in the caucasian population is

    A. (utation of 428238A

    B. 'actor 1 *eiden mutation

    C. !rotein C deficiency

    D. !rotein S deficiency

    E. A6 )III deficiency

    1". 4peratie aginal deliery is contraindicated if a lie fetus is known to hae the

    following condition 78%79T:

    A. 7steogenesis imperfecta

    B. Alloimmune thrombocytopenia

    C. 1on ,illebrands

    D. +emophilia

    E. Suspected (acrosomia

    1&. Therapeutic agents known to be associated with growth restriction include each

    of the following 78%79T:

    A. 6rimethadione

    B. +eparin

    C. ,arfarin

    D. !henytoin

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    E. (ethotrexate

    1). $ased on the pharmacokinetic studies of synthetic oxytocin5 uterine response to

    oxytocin ensues after how many minutes:

    A. *ess than $8 seconds

    B. $898 seconds

    C. 0- minutes

    D. $: minutes

    E. 38 minutes

    1(. 6 /n the 9rophylaxis of hesus ;isease5 all are true except

    A. 2-; of failures to administer antiD occur after miscarriage

    $. 2-8 I.%. antiD neutralises approximately 2 ml. fetal blood

    %. routine provision of antiD during pregnancy is recommended by "ICE

    ;. prophylaxis is unnecessary in threatened miscarriage at : wee/s

    7. 6he routine dose of antiD is 2-8 I.%.

    1*. The least likely ultrasound finding suggestie of prehydropic fetal anemia:

    A. !ericardial effusion

    B. Dilation of cardiac chambers

    C. 7ligohydramnios

    D. !lacental thic/ness #

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    1+. All of the following factors affect the interpretation of the

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    22. What is the most indicated treatment for anaphylaxis!

    a. Steroids

     b. Epinephrine

    c. Benadryl

    d. 1asopressin

    e. 4lucocorticoids

    23. An infant you >ust deliered has ambiguous genitalia5 there are fused

    labioscrotal folds as well as an enlarged clitoris. ?o gonads are palpable. The most

    likely genotype is:

    A. >

    B. ?

    C. 7

    D. > 23

    E. ??

    2". What is the most common etiology of a false positie serum pregnancy test in

    that the h%- is deried from non6trophoblastic tissue:

    A. Dysgerminoma

    B. *ung carcinoma

    C. (olar pregnancy

    D. +eterophilic antibodies

    E. Antinuclear antibodies

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    2&. A hirsuite patient has a serum testosterone of 13 pg'm0. What is the most

    likely diagnosis!

    A. Adrenal tumor 

    B. 7varian tumor 

    C. !olycystic ovarian syndrome

    D. Cushing syndrome

    E. Adult onset congenital adrenal hyperplasia

    2). -roup $ treptococcus infection is seen least likely with which of the following:

    A. Chorioamnionitis

    B. (astitis

    C. !ostpartum endometritis

    D. %rinary tract infection

    E. "eonatal sepsis

    2(. )& year old otherwise healthy woman presents for pre6operatie ealuation for

    hysterectomy. The least important test to order is:

    A. E4

    B. CBC

    C. B%"

    D. Electrolytes

    E. Cervical cytology

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    2*. Which of the following is least likely to cause neonatal thrombocytopenia=

    A. Alloimmune thrombocytopenia

    B. Immune thrombocytopenia

    C. +ydrala5ine

    D. 4estational thrombocytopenia

    E. fetal inection

    2+. $eta mimetic agents are least likely associated with which of the following:

    A. Cardiac Arrhythmia

    B. +ypergylcemia

    C. +ypo/alemia

    D. 6achycardia

    E. +ypocalcemia

    3. A 1& year old primagraida woman with nausea5 omiting and abdominal pain.

    ,ow would you rule out appendicitis!

    A. Computed tomography

    B. 4raded compression ultrasound

    C. Doppler ultrasound

    D. %ltrasound

    E. ,hite blood cells count

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    31. Which of the following is least likely associated with second stage syphilis:

    A. &ash

    B. Condyloma *atum

    C. Chancre

    D. *ymphadenopathy

    E. all of the above

    32. A cystic mass is seen on the lateral wall of the agina. These lesions are most

    commonly=

    A. Cyst in the canal of nuc/ 

    B. +idrandenitis

    C. Inclusion cyst

    D. 'ibroma

    E. S/enes duct cyst

    33. 4ral contracepties should be stopped in which of the following scenarios:

    A. 6rauma related Deep venous thrombosis

    B. (orbid obesity

    C. B&CA 3 positive

    D. Essential hypertension stable

    E. (igraine headache with aura

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    0

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    0@ Which of the following amplitude range in fetal heart rate @=, monitoring

    defines minimal ariabilty !

    A. %ndetectable

    B. # undetectable - beats per minutes bpm

    C. $2- bpm

    D. #2- bpm

    E. 38 to 3- bpm

    3*6 Bou delier a depressed fetus whose skin is noted to be meconium stained.

    When did meconium passage most likely occur in utero

    A. 0 hours

    B. 0$ hours

    C. 323: hours

    D. 2< hours

    E.

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    CE!6:

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    A 1aricellaoster immune globulin J1I4K should be administered to the newborn if

    the mother developed chic/enpox within - days prior to or 2 days following delivery

    B (aternal administration of 1I4 reduces the occurrence of congenital varicella

    syndrome

    C 1I4 can be considered to treat the pregnant women herself to prevent the

    complications of chic/enpox

    D All of the above

    E "one of the above

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    D. 6ransobturator tape 676

    E. !ubovaginal sling with autologous fascia

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    -3 %A612& is !

    A. A mucintype glycoprotein

    B. A ganglioside

    C. A tumorspecific transplantation antigen

    D. %seful for ovarian cancer screening in the general patient population

    E. An antigen which is commonly expressed by mucinous ovarian carcinomas

    -2 All of the following are aderse pregnancy outcomes associated with

    maternal hypothyroidism except !

    A. Impairment in fetal intellectual development

    B. !lacental abruption

    C. !reeclampsia

    D. !reterm delivery

    E. 4estational diabetes mellitus

    &36 regarding thyroid gland and pregnancy one of the following is wrong

    A. 6hyroid Stimulating +ormone 6S+ level is the best screen forhypothyroidism in pregnancy

    B. 'ree 6< level is the most useful to diagnose hyperthyroidism in

     pregnancy

    C. 6S+ level is increased normally in late second and third trimeseter of pregnancy

    D. !rophyltiouracil !6% is the first line of treatment of hyperthyroidismduring pregnancy

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    E. 'ree 60 is the active form of thyroid hormone

    -lin/ed

    B. Affected pregnancies can be detected by chorionic villus biopsy.

    C. (ost affected males are infertile.D. affected individuals are at increased ris/ of diabetes mellitus

    E. Affected individuals are at ris/ of fat malabsorption.

    -- 6 9re6eclampsia. All are true except

    A. is more common in women with a first degree relative who had !E6

    $. Development of abdominal pain is a serious sign.

    %. 6he condition is more common in women who smo/e cigarettes.

    ;. &egular full blood counts are helpful in monitoring the progress of

    the condition.

    7. 6he onset of !E6 is an adverse development for the baby.

    &)6 $reech 9resentation. 4ne is false

    A. occurs in 2-; of pregnancies at 2: wee/s

    $. is associated with postpartum hemorrhage%. Is associated with raised perinatal mortality and morbidity.;. Is a ground for Caesarean section.

    7. 6he ris/ of vaginal delivery increases at the extremes of fetal

    weight.

    &(6 The bladder is at risk of damage at the time of in all of the following

    procedures except

    A. lower segment Caesarean section$. &epair of enterocoele.

    %. Classical Caesarean section.

    ;. *aparoscopy.

    7. %terine myomectomy

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    &*6 Discarriage at 1 weeks. 4ne is true

    A. Is usually due to hormone deficiency.B. is due to an abnormal /aryotype in L -; of cases

    C. Always needs evacuation.D. Is unli/ely if an ultrasound scan shows a pregnancy of normal si5e and

    fetal heart activity.

    E. intrauterine pregnancy cannot coexist with tubal pregnancy

    -9 econdary amenorrhoea. 4ne is true

    A. is defined as cessation of menstruation for more than 32 months

    $. Should not be investigated unless persisting for # 32 months.%. (ay be due to AshermanMs syndrome.

    ;. Is commonly due to stress.7. may be due to testicular femini5ation syndrome

    $8 ,yperprolactinaemia. All are true except

    A. Is an absolute contraindication to pregnancy if due to a pituitary

    adenoma.

    $. may be associated with phenothia5ine therapy%. (ay be associated with acromegaly.

    ;. (ay be due to hypothyroidism.

    7. (ay cause male infertility.

    )1 $leeding continuing for four weeks after deliery. 4ne is true

    A. is most li/ely to be due to retained products of conception

    $. may be physiological%. is associated with cancer of the endometrium

    ;. is commonly due to choriocarcinoma7. contraindication for contraception

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    $2 0ost intra6uterine contraceptie deice. 4ne is false

    A. a beta +C4 should always be arranged to exclude pregnancy$. alternative contraception should be arranged until the I%CD has

     been located

    %. the threads may be retrieved in most cases from within the cervical

    canal

    ;. an extrauterine I%CD should be removed by laparoscopy or

    laparotomy

    7. may be removed using hysteroscope

    )36 ?ormal 0abour. 4ne is false

    a6 the latent phase may last for more than four hours

    b6 the active phase should be associated with cervical dilatation at arate of at least 3 cm. per hour 

    c6 the active phase starts when the cervix is effaced and 0 cm. dilatedd6 is best charted using a partogram

    e- epidural anaesthesia has an adverse effect on the rate of progress in

    the 3st . stage of labour 

    )" The %erical mear. 4ne is true

    A. should be performed routinely every five years

    $. should show suamous cells to illustrate that the suamocolumnar

     Nunction has been sampled

    %. may show evidence of endometrial cancer ;. inflammatoryO smears should be repeated after three years

    7. accurately reflects cervical pathology

    )& ,aemoglobin alues of less 1g'dl in pregnancy one is wrong

    A. Are a recognised sideeffect of anticonvulsant therapy

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    $. Are associated with urinary tract infection%. &espond rapidly in most cases to oral iron supplements

    ;. Are complications of multiple pregnancy7. "one of the above

    )) ecognised complications of external cephalic ersion include all of

    the following except

    A. !ositive leihauer test

    $. 'etal bradycardia

    %.  maternal hypotension

    ;. !lacental abruption

    7. !remature rupture of the membranes

    )( ,irsutism. 4ne is true

    A. is synonymous with virilisation

    $. is pathological in most cases

    %. is a side effect of dana5ol

    ;. androgens in women are produced solely in the adrenal

    7. is a side effect of cyproterone

    )* $enefits of breast feeding include5 all are true except

    A. decreased infant infection$. reduced ris/ of sudden infant death syndrome

    %. reduced incidence of Nuvenile diabetes;. reduced incidence of maternal breast and ovarian cancer 

    7. reduced incidence of neonatal Naundice

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    )+ 6 Trisomy 1*. All are correct except

    A.  It is /nown as EdwardPs syndrome

    $. is almost universally lethal%. is associated with choroid plexus cysts

    ;. is associated with raised maternal A'!F but low +C4 and oestriol

    levels7. is associated with I%4& 

    ( 6 enal physiology in pregnancy. 4ne is false

    A. renal blood flow increases by # 28 ;$. glomerular filtration rate increases

    %. urea levels fall;. creatinine levels fall

    7. tubular reabsorption of glucose declinesF causing glycosuria in the

     presence of normal blood glucose levels

    (1 7lectie episiotomy. 4ne is true

    A. is advocated in primigravid patients

    $. is advocated in patients who have had a previous 0rd. degree tear 

    %. is advocated in patients who have had a previous 0rd. degree tear ;. is advocated in premature vaginal delivery to protect the fetal head

    7. is advocated in patients who have previously had episiotomy

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    (2 9ulmonary oedema is a recognised complication of all of the following

    except

    A. syntocinon infusion$. mitral stenosis

    %. betasympathomimetic use for premature labour ;. preeclampsia

    7. phenyl/etonuria

    (3 =ragile 8. all are true except

    A. is the commonest inherited form of mental handicap

    $. is associated with clitoral enlargement

    %. is associated with prognathism;. 6he main feature is intellectual impairment

    7. unaffected male carriers are at ris/ of dementia in middle age

    (" The following soft markers and chromosomal abnormalities are

    linked except

    A. duodenal atresia Q 623B. Bright bowelR Q triploid

    C. cystic hygroma Q 7.

    D. Sandal gap and 623.

    E. Choroid plexus cysts Q 63:.

    @- A raised maternal serum alpha6fetoprotein @DA=9 leel at 1) weeks5 all are correct

    except:

    A. (ay be due to incorrect assessment of gestation.

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    B. (ay be due to gastroschisis.

    C. increases the ris/ of a Osmall for datesO baby

    D. should be investigated by amniocentesis

    E. increases the ris/ of placental abruption

    @$ Twins pregnancy all are true except

    A. +as increased in incidence in recent decades.

    $. +as five fold perinatal mortality compared to singleton pregnancies

    %. is associated with hyperemesis

    ;. Is suitable for biochemical screening for DownMs syndrome.

    7. Is usually di5ygous.

    @@ 7ndometriosis all are true except

    A. is one of (edicineMs enigmas

    $. may occur as an implantation phenomenon after surgery

    %. does not occur under the age of eighteen

    ;. may cause thic/ening of the uterosacral ligaments

    7. may cause bowel problems

    @: 9elic examination: which statement is wrong

    A. should be performed routinely in the antenatal boo/ing clinic

    $. Accurately determines gestation between : and 32 wee/s.

    %. !erformed annually is useful in the detection of ovarian cancer.

    ;. Can be used to diagnose endometriosis.7. All of the above

    @9 $eta6,%- in early pregnancy5 one of the following is true

    A. production pea/s at 28 wee/s

    $. levels are below normal in hydatidiform mole

    %. always detect a healthy pregnancy by the day the next period is due

    ;. modern pregnancy tests may become negative after 28 wee/s

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    7. none of the above

    * Acute 9yelonephritis in pregnancy5 all are true except

    A. has reduced in incidence in recent decades

    $. treatment should await identification of the infecting organism and its sensitivity

    %. carries significant ha5ard to the baby

    ;. is usually due to E coli

    7. may cause sic/le cell crises

     

    477D *%C 

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