OBSTETRICS AND GYNECOLOGY PRE TEST SELF EXAMINATION REVIEW

INCLUDES 800 EFFECTIVE OBJECTIVE QUESTIONS (TRUE OR FALSE FORMAT) ORGANIZED IN 285 HEADINGS OF RELATIVELY HIGH LEVEL OF DIFFICULTY.

THE BOOK IS BASED ON THE MCQ BEST PRACTICE I.E. DON’T DIRECTLY LIFT PHRASES, AVOID DOUBLE NEGATIVES, USE CORRECT PHRASE FORMS, AND USE “ALL OF THE ABOVE” OR “NONE OF THE ABOVE” SPARINGLY

2011

Questions

Questions

1. The risk of familial ovarian cancer is high if: A. Two first-degree relatives have ovarian cancer. B. One woman has ovarian cancer and a first-degree relative under 50 years of age has breast cancer. C. The BRCA1 gene is detected. D. One woman has ovarian cancer and two first-degree relatives have breast cancer diagnosed before 60 years of age. E. One woman has ovarian cancer and three first-degree relatives have colorectal cancer with at least one case diagnosed before 50 years of age. 2. The following substances are safe in pregnancy: A. Chlorpheniramine. B. Aspirin. C. Vitamin A. D. Vitamin D. E. Polio vaccination. F. Tuberculosis vaccination. 3. Malpresentations: A. Face presentation is a contraindication to vacuum extraction. B. Asynclitism occurs when the vertex fails to descend with the sagittal suture in the transverse diameter of the pelvis. C. Persistent occipitoposterior (OP) position may occur if the vertex remains deflexed on entering the pelvis. D. Persistent anterior cervical lip is a sign of persistent OP position. 4. Uterovaginal prolapse: A. Nagel exercises aim to contract the pubococcygeus in order to improve the symptoms attributable to a cystocele. B. First-degree prolapse describes protrusion of the cervix through the vaginal introitus. C. Colpocliesis is commonly used to repair a rectocele. D. Rectocele presents as a protrusion of the anterior vaginal wall. E. Prolapse cannot occur after hysterectomy. F. The pelvic floor muscles form a gutter sloping downwards and forwards. G. Procidentia describes descent of the anterior vaginal wall through the vaginal introitus. H. Urethrocele describes prolapse of the lowest third of the anterior vaginal wall. I. Prolapse of the pouch of Douglas is called an enterocele. J. Vaginal hysterectomy is the treatment of choice for procidentia in a patient fit for theatre. K. Rectocele is the commonest form of prolapse. L. Ring pessaries rest within the posterior fornix and over the symphysis pubis. M. A Manchester repair involves cervical amputation and anterior and posterior repairs. N. An enterocele contains small bowel or omentum.

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5. The following drugs are known teratogens: A. Danazol. B. Warfarin. C. Methotrexate. D. Tetracycline. E. Lithium. 6. In the treatment of eclampsia: A. Phenytoin is the anticonvulsant of choice. B. Magnesium sulphate is less efficient than phenytoin at preventing recurrent seizures. C. Diazepam has no place in modern management. D. Hydralazine is used in preference to labetalol to control severe hypertension. E. The use of labetalol may cause fetal distress. 7. Hair: A. The cyclical phases of growth take up to 6 months. B. Hair grows at a rate of 1 mm per month. C. Androgens provoke terminal hair growth on the scalp. D. Lanugo hair may be seen in women with anorexia nervosa. E. Acanthosis nigricans is normally found on the face and trunk. F. Hypertrichosis is excessive growth of fine vellus hair. G. Hypertrichosis responds well to anti-androgens. 8. Neonatal lupus erythematosus (NLE): A. Is probably due to fetal antibodies. B. Incidence: 1:2000 live births. C. Characterized by scaling annular or elliptical plaques on the extremities. 9. Diagnosis of preterm labour: A. The presence of fibronectin in cervical samples means that the onset of labour is less likely. B. Home uterine activity monitoring has been proven to decrease preterm deliveries. C. In cases of spontaneous rupture of the membranes at term, diagnosis by nitrazene swabs is accurate in more than 95 per cent of cases. 10. Group B haemolytic Streptococcus (GBS) A. Is a facultative aerobic organism. B. Is an encapsulated bacillus. C. Stains Gram positive. D. Is usually arranged in chains on Gram stain. E. Definitive identification is based on microscopic examination of material suspended in 10 per cent potassium hydroxide. F. The gastro-intestinal tract is the major primary reservoir.

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Questions

11. Recognized risk factors for placental abruption include: A. Increasing parity. B. Cocaine use. C. Preterm premature rupture of membranes. D. Cigarette smoking. E. Maternal anxiety. F. Fibroids underneath the placenta. G. Advanced age. 12. Fetal well-being: A. In the second half of pregnancy fetal growth is determined to a greater degree by environmental factors than by genetic factors. B. Male babies weigh more than female babies on average at term. C. Smoking marijuana during pregnancy is associated with maternal hypotension. D. Smoking marijuana during pregnancy is associated with a low birth weight (LBW) baby. E. Regarding Doppler studies of the placenta, a dichotic notch in the uterine artery waveform is indicative of low resistance within the vessel. F. Birth weight tends to decrease from the first to the second pregnancies. 13. Dichorionic twin pregnancy: A. The incidence of fetal abnormality is no different per fetus compared to a singleton pregnancy. B. Different-sex fetuses are always dichorionic. C. The rate of fetal loss before 24 weeks is 12 per cent. 14. Vacuum extraction: A. The incidence of neonatal scalp injuries is not related to the type of vacuum extractor cup. 2 B. The recommended operating vacuum pressure is between 6.0 and 8.0 kgm/cm . C. The flexion point is located 2 cm anterior to the posterior fontanelle. D. The desired vacuum pressure may be achieved in one step and traction commenced after 2 min. 15. Endometriosis: A. 65 per cent of patients have ovarian involvement. B. Biopsies of suspicious tissue must include endometrial stroma and glands in order to diagnose the condition. C. Disease severity is an indicator of the amount of pain experienced by the patient. D. The incidence is highest in those investigated for chronic abdominal pain. E. Commonly presents with superficial dyspareunia. F. Findings are constant throughout the affected population. G. Is easily diagnosed by clinical examination in an outpatient setting. H. Fixed retroversion of the uterus is a variant of normal.

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16. Thalidomide: A. Is a hypnotic/sedative drug. B. Maternal ingestion has resulted in the teratogenic effect known as phocomelia. C. Phocomelia is absence of the short bones of the upper and/or lower limbs. D. Is used in the treatment of tuberculosis. 17. In the infant of the diabetic mother: A. The incidence of respiratory distress syndrome is increased because insulin antagonizes the action of cortisol on sphingomyelin synthesis. B. The presence of acidic phospholipid phosphatidylglycerol (PG) is a final marker of fetal lung maturity. C. Respiratory distress syndrome may occur despite a ‘mature’ lecithin:sphingomyelin ratio (>2). 18. Placenta accreta: A. The optimum management is Caesarean hysterectomy. B. Is commonly associated with placenta praevia. C. Is associated with placenta praevia in over 50 per cent of cases. 19. Diabetes mellitus in pregnancy: A. Is defined if the 2-h glucose is >11 mmol/L. B. During labour, glucose should be given as a vehicle for an oxytocin infusion. C. During labour, blood glucose concentration should be maintained