Obstetrics And Gynecology For SLE Quiz

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Obstetrics And Gynecology For SLE Quiz - Quiz

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Questions and Answers
  • 1. 

     Pregnant on 36th week came with 7 cm cervical width at zero station. During birth, CTG shows late deceleration, management is: 

    • A.

      O2 and change mother position

    • B.

      Give Mg sulfate

    • C.

      Give Oxytocin

    • D.

      Give O2

    Correct Answer
    A. O2 and change mother position
    Explanation
    Late deceleration on CTG is a sign of fetal distress during labor. Administering oxygen to the mother helps to increase the oxygen supply to the baby, which can improve the fetal heart rate. Changing the mother's position can also help to relieve any pressure on the baby and improve blood flow to the placenta. Therefore, O2 and changing the mother's position is the appropriate management in this situation. Giving magnesium sulfate, oxytocin, or additional oxygen alone may not address the underlying cause of the late deceleration.

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  • 2. 

    Pregnant at 28 week, she sit with child, this child develop chickenpox, she come to you asking for advice, you found that she is seronegative for (varicella) antibody, what will be your management? 

    • A.

      Give her (VZIG) varicella zoster immunoglobulin

    • B.

      Give her acyclovir

    • C.

      Give her varicella vaccine

    • D.

      Wait until symptom appear in her

    Correct Answer
    A. Give her (VZIG) varicella zoster immunoglobulin
    Explanation
    The correct answer is to give her (VZIG) varicella zoster immunoglobulin. Since she is seronegative for varicella antibody and has been exposed to chickenpox, giving her VZIG can help prevent or reduce the severity of the infection. Acyclovir is an antiviral medication used to treat chickenpox, but it is not the best option in this scenario. Varicella vaccine is not recommended during pregnancy, so it is not the appropriate management choice. Waiting until symptoms appear is not advisable as it can lead to complications for both the mother and the unborn child.

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  • 3. 

    Regarding injectable progesterone 

    • A.

      Can cause skin problems

    • B.

      Associated with irregular bleeding and weight gain.

    • C.

      Decrease in bone mineral density

    • D.

      Delayed fertility after discontinuation

    Correct Answer
    A. Can cause skin problems
    Explanation
    Injectable progesterone can cause skin problems because progesterone can stimulate the production of sebum, which can lead to acne breakouts. Additionally, progesterone can cause skin pigmentation changes, such as darkening or discoloration of the skin. These skin problems can be bothersome for some individuals who are using injectable progesterone as a form of contraception or hormone replacement therapy. It is important for individuals using injectable progesterone to be aware of these potential side effects and consult with their healthcare provider if they experience any skin problems.

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  • 4. 

    Patient with salpingitis and there is swelling in pelvis in posterior fornix and it is fluctuant, management? 

    • A.

      Colpotomy

    • B.

      Laparoscopic

    • C.

      Continues oral thereby

    • D.

      Discharge her

    Correct Answer
    A. Colpotomy
    Explanation
    Colpotomy is the correct answer for the management of a patient with salpingitis and fluctuant swelling in the posterior fornix of the pelvis. Colpotomy is a surgical procedure in which an incision is made in the vaginal wall to access the pelvic organs. This procedure allows for drainage of the abscess and removal of infected material, providing relief to the patient. Laparoscopic surgery may also be considered, but colpotomy is a more appropriate option in this case. Continuing oral therapy and discharging the patient would not address the underlying issue of the abscess.

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  • 5. 

    Which one do you like?

    • A.

      Polymenorrhea

    • B.

      Menometrorrhagia

    • C.

      Hypermenorrhea

    • D.

      Amenorrhea

    Correct Answer
    A. Polymenorrhea
    Explanation
    Polymenorrhea refers to frequent menstrual cycles, with intervals shorter than 21 days. This condition can be caused by hormonal imbalances, stress, or certain medical conditions. It is characterized by more frequent and shorter periods. Menometrorrhagia, on the other hand, is a combination of heavy and prolonged menstrual bleeding, often irregular. Hypermenorrhea refers to abnormally heavy or prolonged menstrual periods, while amenorrhea is the absence of menstrual periods.

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  • 6. 

    Pregnant, 36 weeks, present with agitation, BP: 88/60, fetal distress, what is the diagnosis? 

    • A.

      Amniotic fluid embolism.

    • B.

      Pulmonary Edema.

    • C.

      Pulmonary embolism

    • D.

      MI

    Correct Answer
    A. Amniotic fluid embolism.
    Explanation
    The given clinical presentation of a pregnant woman at 36 weeks with agitation, low blood pressure, fetal distress, and the absence of specific symptoms such as chest pain or EKG changes suggests the diagnosis of amniotic fluid embolism. Amniotic fluid embolism is a rare but potentially life-threatening condition where amniotic fluid enters the maternal circulation, causing an inflammatory response and leading to cardiovascular collapse. This condition can present with sudden onset of dyspnea, hypotension, and fetal distress, which aligns with the symptoms described in the question. Pulmonary edema, pulmonary embolism, and myocardial infarction are less likely given the absence of typical features associated with these conditions.

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  • 7. 

    Salpingitis and PID on penicillin but not improve, what is the most likely organism? 

    • A.

      Neisseria gonorrhea

    • B.

      Syphilis

    • C.

      HSV

    • D.

      Chlamydia

    Correct Answer
    A. Neisseria gonorrhea
    Explanation
    The most likely organism causing the lack of improvement in salpingitis and PID despite penicillin treatment is Neisseria gonorrhea. Neisseria gonorrhea is a sexually transmitted infection that can cause inflammation of the fallopian tubes (salpingitis) and pelvic inflammatory disease (PID). If the infection is not effectively treated with penicillin, it can lead to persistent symptoms and complications.

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  • 8. 

    29 years old lady B-HCG 160 complaining of vomiting & abdominal pain, which is more accurate to diagnosis? 

    • A.

      Pelvic US

    • B.

      Pelvic CT

    • C.

      Laparoscopy

    • D.

      Serial beta hCG

    Correct Answer
    A. Pelvic US
    Explanation
    Pelvic US is the most accurate diagnostic option in this case. It is a non-invasive imaging technique that can provide detailed information about the pelvic organs, including the uterus and ovaries. It can help identify any abnormalities or potential causes of the patient's symptoms, such as ectopic pregnancy or ovarian cysts. Pelvic CT and laparoscopy are more invasive procedures and may not be necessary at this stage. Serial beta hCG, although helpful in monitoring pregnancy, may not provide immediate answers to the patient's symptoms.

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  • 9. 

    Patient G3 P3 all her deliveries were normal except after the second one she did D&C , Labs all normal except: high FSH, high LH, low estrogen, what s the diagnosis? 

    • A.

      Ovarian failure

    • B.

      Asherman syndrome

    • C.

      Turner syndrome

    • D.

      Sheehan syndrome

    Correct Answer
    A. Ovarian failure
    Explanation
    The patient's history of normal deliveries and the presence of high FSH, high LH, and low estrogen levels indicate ovarian failure. Ovarian failure refers to the loss of normal function of the ovaries, leading to a decrease in estrogen production and fertility issues. This condition can be caused by various factors such as genetic abnormalities, autoimmune diseases, chemotherapy, or radiation therapy.

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  • 10. 

    Breech presentation, 34 weeks treatment option: 

    • A.

      Wait

    • B.

      External cephalic

    • C.

      Induction

    • D.

      Internal cephalic

    Correct Answer
    A. Wait
    Explanation
    The correct answer is "Wait" because at 34 weeks, there is still time for the baby to naturally turn into the head-down position for a vaginal delivery. Waiting allows for the possibility of spontaneous version, where the baby turns on its own. It is a non-invasive approach that avoids unnecessary interventions or risks associated with other treatment options. However, if the baby remains in breech presentation closer to the due date, other interventions like external cephalic version or induction may be considered.

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  • 11. 

    Post-partum hemorrhage happens more commonly with: 

    • A.

      Multiple pregnancies.

    • B.

      Anemia

    • C.

      Preterm delivery.

    • D.

      Antithrombin III deficiency

    Correct Answer
    A. Multiple pregnancies.
    Explanation
    Post-partum hemorrhage refers to excessive bleeding after childbirth. Multiple pregnancies, or carrying more than one fetus, increase the risk of post-partum hemorrhage due to factors such as increased uterine size and stretching, increased blood volume, and placental abnormalities. The presence of multiple fetuses puts additional strain on the uterus, making it more difficult for it to contract and control bleeding after delivery. This increases the likelihood of excessive bleeding and the need for medical intervention to prevent complications. Anemia, preterm delivery, and antithrombin III deficiency may also contribute to post-partum hemorrhage but are not as commonly associated with it as multiple pregnancies.

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  • 12. 

    Post D&C what the most common site of perforation ?

    • A.

      Fundus

    • B.

      Anterior wall of the corpus.

    • C.

      Posterior wall of the corpus

    • D.

      Cervix

    • E.

      Lateral Wall of the corpus

    Correct Answer
    A. Fundus
    Explanation
    The correct answer is Fundus. After a dilation and curettage (D&C) procedure, the most common site of perforation is the fundus. This refers to the upper part of the uterus. Perforation can occur when there is accidental puncturing or tearing of the uterine wall during the procedure. It is important to be cautious during D&C to minimize the risk of complications such as uterine perforation.

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  • 13. 

    What is the most complication after hysterectomy? 

    • A.

      Hemorrhage

    • B.

      Pulmonary embolism

    • C.

      Ureteral injury

    • D.

      DIC

    Correct Answer
    A. Hemorrhage
    Explanation
    After a hysterectomy, the most common complication is hemorrhage. This refers to excessive bleeding, either during or after the surgery. Hysterectomy involves the removal of the uterus, which is a highly vascular organ. During the procedure, there is a risk of damage to blood vessels, leading to bleeding. Additionally, the surgical site may continue to bleed postoperatively. Hemorrhage can be life-threatening if not promptly managed, requiring blood transfusions or surgical intervention to control the bleeding. It is crucial for healthcare providers to closely monitor patients after a hysterectomy to detect and address any signs of hemorrhage.

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  • 14. 

    Recent married couples are trying to have baby for 3 months What do you tell them ? 

    • A.

      Try more

    • B.

      Semen analysis

    • C.

      Referral to Ob/Gyn

    • D.

      They can't have baby

    Correct Answer
    A. Try more
    Explanation
    The suggested answer "Try more" implies that the couple should continue trying to conceive for a longer period of time. It suggests that it is normal for it to take longer than three months to successfully conceive and encourages the couple to be patient and persistent in their efforts.

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  • 15. 

    34 years female with HIV, pap smear negative, about cervical cancer screening  

    • A.

      After 6 months if negative repeat annually

    • B.

      After 3m if negative repeat after 6m

    • C.

      After 1y if negative repeat annually

    Correct Answer
    A. After 6 months if negative repeat annually
    Explanation
    The correct answer suggests that if a 34-year-old female with HIV has a negative pap smear, she should repeat the screening annually after 6 months. This is because individuals with HIV are at a higher risk of developing cervical cancer, so regular screening is important. The 6-month interval allows for closer monitoring and earlier detection of any potential abnormalities. Annual screening is recommended to ensure continuous monitoring and early intervention if needed.

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  • 16. 

    16 weeks of gestation presented with (++) glycosuria, FBS 4.4, 1 hours PB= 8, 2 hours PB= 7.2 

    • A.

      Renal glycosuria

    • B.

      GDM

    • C.

      KM syndrome

    Correct Answer
    A. Renal glycosuria
    Explanation
    The patient in this scenario is at 16 weeks of gestation and is presenting with glycosuria (excretion of glucose in the urine). However, her fasting blood sugar (FBS) level is 4.4, which is within the normal range. Additionally, her 1-hour and 2-hour postprandial blood glucose levels are 8 and 7.2 respectively, which are also normal. This suggests that her blood glucose levels are well-controlled and not indicative of gestational diabetes mellitus (GDM). Therefore, the most likely explanation for the glycosuria is renal glycosuria, a condition where the kidneys excrete glucose into the urine despite normal blood glucose levels. KM syndrome is not relevant to this case.

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  • 17. 

    Primi at 35 weeks of gestation with pre-eclampsia, BP is high with ankle edema, the best to be done is:
 

    • A.

      Maternal-fetal monitoring with continuous hospitalization.

    • B.

      Immediate delivery.


    • C.

      Labetolol

    • D.

      Diuretic

    • E.

      Low salt diet.

    Correct Answer
    A. Maternal-fetal monitoring with continuous hospitalization.
    Explanation
    In a patient with pre-eclampsia at 35 weeks of gestation, the best course of action is maternal-fetal monitoring with continuous hospitalization. Pre-eclampsia is a condition characterized by high blood pressure and organ damage, and it can be dangerous for both the mother and the baby. Continuous monitoring in the hospital allows for close observation of the mother's blood pressure, urine output, and fetal well-being. This helps in determining the appropriate timing for delivery, as well as managing any potential complications that may arise. Immediate delivery may be necessary in severe cases, but it is not the best initial step in this scenario. Labetolol, diuretics, and low salt diet may be used as adjunctive measures, but they are not the primary management strategy in this case.

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  • 18. 

    Most common site of gonococcus infection in females in: 

    • A.

      Cervix

    • B.

      Urethra

    • C.

      Posterior fornix.

    • D.

      Uterus

    Correct Answer
    A. Cervix
    Explanation
    The cervix is the most common site of gonococcus infection in females. The cervix is the lower part of the uterus that connects to the vagina, and it is a common site for the entry of bacteria during sexual intercourse. Gonococcal infection can cause inflammation and discharge from the cervix, leading to symptoms such as pain, itching, and discomfort. Prompt diagnosis and treatment are important to prevent complications and further spread of the infection.

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  • 19. 

    It is contraindication to stop preterm delivery in the following condition: 

    • A.

      A&b

    • B.

      Preeclampsia

    • C.

      Placenta abruption

    • D.

      Aminochoronitis.


    Correct Answer
    A. A&b
    Explanation
    The correct answer is A&b. This means that it is a contraindication to stop preterm delivery in the presence of both preeclampsia and placenta abruption. Preeclampsia is a condition characterized by high blood pressure and organ damage, and placenta abruption is the separation of the placenta from the uterine wall. In these situations, stopping preterm delivery could potentially worsen the mother's condition or put both the mother and the baby at risk. Therefore, it is contraindicated to stop preterm delivery in these cases.

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  • 20. 

     A 34 weeks GA lady presented with vaginal bleeding of an amount more of that of her normal cycle. on examination uterine contracts every 4 min, bulged membrane, the cervix is 3 cm dilated, fetus is in a high transverse lie and the placenta is on the posterior fundus. US showed translucency behind the placenta and the CTG showed FHR of 170, the best line of management is: 

    • A.

      C/S immediately.

    • B.

      Give oxytocin.

    • C.

      Do rupture of the membrane.

    • D.

      Amniocentesis

    Correct Answer
    A. C/S immediately.
    Explanation
    Based on the given information, the patient is a 34-week pregnant woman who has presented with vaginal bleeding, regular uterine contractions, a dilated cervix, a fetus in a high transverse lie, and a placenta on the posterior fundus. The ultrasound shows translucency behind the placenta, and the CTG shows a fetal heart rate of 170. These findings suggest that the patient is experiencing placenta previa with vasa previa, which is a life-threatening condition. The best line of management in this situation is to perform a cesarean section immediately to ensure the safety of both the mother and the fetus.

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  • 21. 

    Before you start instrumental delivery it is important to check if there is: 

    • A.

      Cephalopelvic disproportion

    • B.

      Breech presentation.

    • C.

      Cord prolapse

    • D.

      Face presentation

    Correct Answer
    A. Cephalopelvic disproportion
    Explanation
    Before starting instrumental delivery, it is important to check for cephalopelvic disproportion. This condition occurs when the baby's head is too large to fit through the mother's pelvis. It can lead to complications during delivery, such as prolonged labor, fetal distress, and the need for a cesarean section. By checking for cephalopelvic disproportion before proceeding with instrumental delivery, healthcare providers can ensure the safety of both the mother and the baby.

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  • 22. 

     In occipito-posterior malpositioning of the fetal head, all of the following are true except: 

    • A.

      Flexion of the head helps the rotation to the anterior position.

    • B.

      Android pelvis is predisposing factor.

    • C.

      It causes significant delay of labor duration compared to the anterior presentation.

    • D.

      10% of all vertex deliveries.

    Correct Answer
    A. Flexion of the head helps the rotation to the anterior position.
    Explanation
    In occipito-posterior malpositioning of the fetal head, flexion of the head actually hinders the rotation to the anterior position, so it is not true. Occipito-posterior malpositioning refers to the position of the baby's head being towards the mother's back instead of facing towards the front. An android pelvis is a predisposing factor for this malpositioning. It can cause a significant delay in labor duration compared to the anterior presentation. Occipito-posterior malpositioning occurs in about 10% of all vertex deliveries.

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  • 23. 

     25 years old female patient who is with 2ry amenorrhea, her prolactin level is 400 ng/ml. the probability to have pituitary prolactin secreting adenoma is: 

    • A.

      50-74

    • B.

      75-85

    • C.

    • D.

      25-49

    • E.

      >85

    Correct Answer
    A. 50-74
    Explanation
    A prolactin level of 400 ng/ml in a 25-year-old female patient with secondary amenorrhea suggests a potential pituitary prolactin-secreting adenoma. The answer option "50-74" indicates that there is a probability of 50-74% for the patient to have this condition.

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  • 24. 

    Which of the following not compatible with head engagement: 

    • A.

      3/5 head felt in the abdomen

    • B.

      BPD at ischial spines

    • C.

      Crowning of the head

    • D.

      vertex at zero station

    Correct Answer
    A. 3/5 head felt in the abdomen
    Explanation
    When a baby's head engages, it means that the baby's head descends into the pelvis. This is a normal part of the birthing process. However, if 3/5 of the head is felt in the abdomen, it suggests that the baby's head is not engaged in the pelvis and is still positioned higher up in the abdomen. This is not compatible with head engagement, making it the correct answer.

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  • 25. 

     Female with recently inserted IUCD coming with watery brownish vaginal discharge & abdominal pain what is the most likely diagnosis?

    • A.

      Bacterial vaginosis

    • B.

      Uterine rupture

    • C.

      Ovarian torsion

    • D.

      Ectopic pregnancy

    Correct Answer
    A. Bacterial vaginosis
    Explanation
    The most likely diagnosis for a female with recently inserted IUCD coming with watery brownish vaginal discharge and abdominal pain is bacterial vaginosis. Bacterial vaginosis is a common vaginal infection caused by an imbalance of bacteria in the vagina. Symptoms include abnormal vaginal discharge, often watery and grayish-white in color, and abdominal pain. While the other options such as uterine rupture, ovarian torsion, and ectopic pregnancy can also cause abdominal pain, they are less likely in this case as the symptoms are more consistent with bacterial vaginosis.

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  • 26. 

    What is an absolute contraindication of OCP : 

    • A.

      History of previous DVT

    • B.

      Ovarian cancer

    • C.

      Breast cancer

    • D.

      Bladder Cancer

    Correct Answer
    A. History of previous DVT
    Explanation
    A history of previous deep vein thrombosis (DVT) is an absolute contraindication for the use of oral contraceptive pills (OCP). This means that if a person has had a previous DVT, they should not take OCPs as it can increase their risk of developing another DVT. DVT is a blood clot that forms in a deep vein, usually in the legs, and can be life-threatening if it travels to the lungs. OCPs can increase the risk of blood clots, and individuals with a history of DVT are already at a higher risk, so it is important to avoid OCPs in these cases.

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  • 27. 

    First sign of magnesium sulfate toxicity is : 

    • A.

      Loss of deep tendon reflex

    • B.

      Hypotension

    • C.

      Flaccid paralysis

    • D.

      Respiratory failure

    Correct Answer
    A. Loss of deep tendon reflex
    Explanation
    The first sign of magnesium sulfate toxicity is the loss of deep tendon reflex. This is because magnesium sulfate acts as a central nervous system depressant and can impair the function of the reflexes. The loss of deep tendon reflex is an early indicator of magnesium sulfate toxicity and can be followed by more severe symptoms such as hypotension, flaccid paralysis, and respiratory failure. It is important to monitor patients receiving magnesium sulfate closely to detect and manage any signs of toxicity.

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  • 28. 

     Regarding postpartum Psychosis: 

    • A.

      Recurrences are common in subsequent pregnancies

    • B.

      It often progresses to frank schizophrenia

    • C.

      It has good prognosis

    • D.

      It has insidious onset

    • E.

      It usually develops around the 3rd week postpartum

    Correct Answer
    A. Recurrences are common in subsequent pregnancies
    Explanation
    Recurrences are common in subsequent pregnancies because postpartum psychosis is a psychiatric disorder that occurs after childbirth and is associated with hormonal changes. These hormonal changes can affect a woman's mental health, and if she has experienced postpartum psychosis in a previous pregnancy, she is at a higher risk of experiencing it again in subsequent pregnancies. Therefore, it is important for healthcare providers to closely monitor and support women with a history of postpartum psychosis during their subsequent pregnancies to prevent or manage any recurrences.

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  • 29. 

    A pregnant female develops lesions on the vulva and vagina and she was diagnosed as genital herpes, what should be included in her future health care? 

    • A.

      Oral acyclovir to treat herpes

    • B.

      Cesarean section should be done if the lesions did not disappear before 2 weeks of delivery date

    • C.

      Termination of pregnancy because of the risk of fetal malformations

    • D.

      Avoidance of sexual intercourse for 1 month after the healing of the lesions

    Correct Answer
    A. Oral acyclovir to treat herpes
    Explanation
    The pregnant female should be given oral acyclovir to treat her genital herpes. This medication is commonly used to manage herpes outbreaks and can help to reduce the severity and duration of symptoms. It is safe to use during pregnancy and can be effective in preventing or reducing the risk of transmission to the baby. Cesarean section may be considered if the lesions have not healed before the delivery date, but this is not the primary course of action. Termination of pregnancy is not necessary unless there are other complications or concerns. Avoidance of sexual intercourse for 1 month after the healing of the lesions is a general precaution to prevent transmission to a partner, but it is not the main focus of the future health care for the pregnant female.

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  • 30. 

    Female with hirsutism,obesity,infertility.US show multiple ovarian follicles.Dx: 

    • A.

      Stein-leventhal syndrome

    • B.

      Kallman syndrome

    • C.

      Asherman’s syndrome

    • D.

      Klinefelter’s syndrome

    Correct Answer
    A. Stein-leventhal syndrome
    Explanation
    The given symptoms of hirsutism, obesity, infertility, and multiple ovarian follicles are characteristic of Stein-Leventhal syndrome. This syndrome, also known as polycystic ovary syndrome (PCOS), is a hormonal disorder that affects women of reproductive age. It is characterized by the presence of multiple cysts on the ovaries, which can lead to irregular menstrual cycles, infertility, and other symptoms such as hirsutism and obesity. Kallman syndrome is a genetic disorder that causes delayed or absent puberty, Asherman's syndrome is characterized by the formation of scar tissue in the uterus, and Klinefelter's syndrome is a genetic condition that affects males and leads to infertility and other symptoms.

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  • 31. 

    Female patient on the 3rd week postpartum. She says to the physician that the frequently visualizes snakes crawling to her baby’s bed. She knows that it is impossible but she cannot remove the idea from her head. She says she wakes up around 50 times at night to check her baby. This problem prevents her from getting good sleep and it started to affect her marriage. What is this problem she is experiencing? 

    • A.

      A postpartum psychosis

    • B.

      A hallucination

    • C.

      An obsession

    • D.

      A Delusion

    Correct Answer
    A. A postpartum psychosis
    Explanation
    The patient's symptoms of visualizing snakes crawling to her baby's bed, being unable to remove the idea from her head, and constantly checking on her baby indicate a postpartum psychosis. Postpartum psychosis is a severe mental health condition that occurs after childbirth and is characterized by hallucinations, delusions, and obsessive thoughts. It is important to recognize and treat postpartum psychosis promptly to ensure the safety and well-being of both the mother and the baby.

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  • 32. 

    Pregnant lady delivered Anencephaly still birth occurrence of neural tube defect in next pregnancy 

    • A.

      2%

    • B.

      10%

    • C.

      20%

    • D.

      8%

    Correct Answer
    A. 2%
    Explanation
    The answer is 2% because anencephaly is a type of neural tube defect, which occurs when the neural tube does not close properly during fetal development. The risk of having another pregnancy affected by a neural tube defect after having one with anencephaly is approximately 2%. This risk is higher than the general population, but it is still relatively low.

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  • 33. 

    Young pregnant lady (Primigravida), 32 weeks of gestation came to you C/O: lower limbs swelling for two weeks duration, She went to another hospital and she was prescribed (thiazide & loop diuretic) and O/E: BP: 120/70, mild edema, urine dipstick: -ve and otherwise normal, The best action is : 

    • A.

      Stop both

    • B.

      Continue both and add potassium sparing diuretic

    • C.

      Continue both & add potassium supplement

    • D.

      Continue loop diuretic & stop thiazide

    • E.

      Continue thiazide & stop loop diuretic

    Correct Answer
    A. Stop both
    Explanation
    Based on the given information, the best action would be to stop both the thiazide and loop diuretic medications. This is because the patient is a young pregnant lady with lower limb swelling and mild edema. The urine dipstick is negative, indicating that there is no proteinuria, which is a common sign of preeclampsia. The edema in this case is likely due to normal physiological changes in pregnancy and does not require diuretic treatment. Additionally, the use of diuretics in pregnancy can potentially harm the fetus. Therefore, stopping both medications would be the most appropriate action in this case.

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  • 34. 

    38 years old female came to you at your office and her pap smear report was unsatisfactory for evaluation, the best action is 

    • A.

      Repeat it after 1 year if no risk

    • B.

      Repeat it after 6 months if considered low risk

    • C.

      Repeat it as soon as possible

    • D.

      Repeat it immediately

    • E.

      Consider it normal & D/C the pt.

    Correct Answer
    A. Repeat it after 1 year if no risk
    Explanation
    The best action in this scenario is to repeat the pap smear after 1 year if there is no risk. This is because an unsatisfactory pap smear report means that the sample obtained was not adequate for evaluation. If there are no risk factors present, it is reasonable to repeat the test after a year to ensure a proper evaluation can be done. This allows for a sufficient amount of time for any potential abnormalities to develop and be detected.

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  • 35. 

     Placenta previa all true except : 

    • A.

      Tone increased of uterus

    • B.

      Lower segmental abnormality

    • C.

      Early 3rd trimester

    • D.

      Pain less vaginal bleeding

    Correct Answer
    A. Tone increased of uterus
    Explanation
    Placenta previa is a condition where the placenta partially or completely covers the cervix. It can cause painless vaginal bleeding, especially in the third trimester of pregnancy. Lower segmental abnormality is also associated with placenta previa, as the placenta implants in the lower part of the uterus instead of the upper part. However, the tone of the uterus is not increased in placenta previa. Therefore, the correct answer is "Tone increased of uterus."

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  • 36. 

    8 weeks Primigravida came to you with nausea & vomiting, choose the statement that guide you to hyperemesis gravidarm 

    • A.

      Ketonuria

    • B.

      ECG evidence of hypokalemia

    • C.

      Metabolic acidosis

    • D.

      Elevated liver enzyme

    • E.

      Jaundice

    Correct Answer
    A. Ketonuria
    Explanation
    Ketonuria refers to the presence of ketones in the urine, which is a sign of increased fat metabolism. In the context of a pregnant woman experiencing nausea and vomiting, ketonuria can indicate a condition called hyperemesis gravidarum. This condition is characterized by severe and persistent nausea and vomiting during pregnancy, leading to weight loss, dehydration, and electrolyte imbalances. Therefore, the presence of ketonuria in this primigravida patient suggests hyperemesis gravidarum as the likely cause of her symptoms.

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  • 37. 

    Pregnant women G4P3+1, 10 weeks of gestational age came to you with IUCD inserted & the string is out from O.S what is the most important measure : 

    • A.

      Leave the IUCD & send to Ob/ Gynaecologist to remove

    • B.

      Leave the IUCD & give A.B

    • C.

      Leave the IUCD

    • D.

      Do laparoscopy to see if there is ectopic pregnancy.

    • E.

      Reassurance the patient

    Correct Answer
    A. Leave the IUCD & send to Ob/ Gynaecologist to remove
    Explanation
    The most important measure in this scenario is to leave the IUCD in place and send the patient to an Ob/Gynecologist to have it removed. This is because the IUCD string being out from the cervical os indicates that the IUCD may have migrated or become displaced, which can increase the risk of complications such as infection, perforation, or unintended pregnancy. Therefore, it is crucial to have a healthcare professional with expertise in this area remove the IUCD to ensure the safety and well-being of the pregnant woman.

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  • 38. 

    Pregnancy test positive after : 

    • A.

      Positive 1 week before the expected menstruation

    • B.

      One week after loss menstrual cycle

    • C.

      10 day after loss menstrual cycle

    • D.

      One day post coital

    Correct Answer
    A. Positive 1 week before the expected menstruation
    Explanation
    The correct answer is "Positive 1 week before the expected menstruation." This means that a pregnancy test can detect the presence of pregnancy hormones in the body as early as one week before a woman's expected period. This is because the levels of the hormone hCG (human chorionic gonadotropin) start to rise after implantation of a fertilized egg in the uterus, which typically occurs about 6-12 days after conception. Therefore, taking a pregnancy test one week before the expected period can give an accurate result.

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  • 39. 

    20 year lady come to ER with history of right sever lower abdominal pain with history of amenorrhea for about 6 weeks the most serious diagnosis of your deferential diagnosis could reach by: 

    • A.

      U/S of the pelvis

    • B.

      CBC

    • C.

      ESR

    • D.

      MRI

    Correct Answer
    A. U/S of the pelvis
    Explanation
    An ultrasound of the pelvis is the most appropriate diagnostic test to reach the most serious diagnosis in this case. The patient is a young woman with severe lower abdominal pain and a history of amenorrhea, which could indicate a gynecological issue such as an ectopic pregnancy or ovarian cyst. Ultrasound is a non-invasive imaging test that can provide detailed images of the pelvic organs and help identify any abnormalities or potential causes of the symptoms. CBC (complete blood count), ESR (erythrocyte sedimentation rate), and MRI (magnetic resonance imaging) may be useful in certain situations, but in this case, an ultrasound of the pelvis is the most relevant and effective test to reach a diagnosis.

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  • 40. 

    45 year old female complaining of itching in genitalia for certain period, a febrile, -ve PMH, living happily with her husband since 20 year ago on examination no abdominal tenderness , erythema on lower vagina , mild Gray discharge, no history of UTI or pyelonephritis , Most probable diagnosis: 

    • A.

      Vaginitis

    • B.

      Cystitis

    • C.

      Malignancy

    • D.

      Urethritis

    Correct Answer
    A. Vaginitis
    Explanation
    The most probable diagnosis for this patient is vaginitis. This is supported by the symptoms of itching in the genitalia, febrile state, and the presence of erythema on the lower vagina and mild gray discharge. The absence of abdominal tenderness and history of UTI or pyelonephritis also suggest a localized infection in the vagina rather than a more systemic issue like cystitis or malignancy. Urethritis is less likely as there is no mention of urinary symptoms. Therefore, vaginitis is the most likely diagnosis for this patient.

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  • 41. 

    35 years G4P2+1, 1year history of irregular heavy bleeding O/E WNL, the most Dx is: 

    • A.

      DUB

    • B.

      Endometriosis

    • C.

      Dysmenorrhea

    • D.

      Nervous uterus

    • E.

      Early menopause

    Correct Answer
    A. DUB
    Explanation
    The most likely diagnosis in this case is DUB (dysfunctional uterine bleeding). The patient is 35 years old and has a history of irregular heavy bleeding, which is characteristic of DUB. The term "dysfunctional" refers to abnormal hormonal fluctuations that disrupt the normal menstrual cycle. This condition is common and can be caused by various factors such as hormonal imbalances, stress, or certain medications. The other options (endometriosis, dysmenorrhea, nervous uterus, early menopause) are less likely based on the given information.

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  • 42. 

    All are true about ectopic pregnancy except: 

    • A.

      Ovarian site at 20%

    • B.

      Cause of death in 1st trimester

    • C.

      Doubling time of B-hCG

    • D.

      Can be diagnosed by laparoscopy

    • E.

      Empty uterus + HCG before 12 weeks is diagnostic

    Correct Answer
    A. Ovarian site at 20%
    Explanation
    Ectopic pregnancy refers to the implantation of a fertilized egg outside of the uterus. It can occur in various locations, including the fallopian tubes, cervix, and ovaries. The given answer states that ectopic pregnancy can occur in the ovarian site at 20%, which is incorrect. Ectopic pregnancies rarely occur in the ovaries, with the majority happening in the fallopian tubes. The other statements mentioned in the question are true. Ectopic pregnancy can cause death in the first trimester, the doubling time of B-hCG (a hormone produced during pregnancy) can be used to monitor the condition, it can be diagnosed by laparoscopy, and an empty uterus with detectable levels of HCG before 12 weeks is diagnostic of ectopic pregnancy.

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  • 43. 

    Non-hormona treatment for post-menopausal flushing? 

    • A.

      Paroxetine

    • B.

      Amlodepine

    • C.

      Nortriptyline

    Correct Answer
    A. Paroxetine
    Explanation
    Paroxetine is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression, anxiety, and other mood disorders. It has also been found to be effective in reducing the frequency and severity of hot flashes and flushing associated with menopause. Paroxetine works by increasing serotonin levels in the brain, which can help regulate body temperature and reduce vasomotor symptoms. Therefore, it is a suitable non-hormonal treatment option for post-menopausal flushing.

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  • 44. 

    Concern obstructed labor one is true: 

    • A.

      Caput succedaneum and excessive molding are usual signs

    • B.

      Easily to be diagnosed before onset of Labor

    • C.

      Oxytocin is used to induced Labor

    • D.

      Common in occipito-anterior position

    • E.

      Common in primigravida

    Correct Answer
    A. Caput succedaneum and excessive molding are usual signs
    Explanation
    Caput succedaneum and excessive molding are usual signs of obstructed labor. Caput succedaneum refers to the swelling of the scalp in a newborn due to pressure during labor, which can occur in cases of obstructed labor. Excessive molding refers to the shaping of the baby's head to fit through the birth canal, which can also be a sign of obstructed labor. These signs are typically observed during or after labor and can help in diagnosing obstructed labor.

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  • 45. 

    Hyperprolactinemia associated with all of the following except: 

    • A.

      OCP

    • B.

      Hypothyroidism

    • C.

      Acromegaly

    • D.

      Pregnancy

    Correct Answer
    A. OCP
    Explanation
    Hyperprolactinemia is a condition characterized by high levels of prolactin hormone in the blood. Prolactin is responsible for milk production in women and plays a role in regulating the menstrual cycle. Oral contraceptive pills (OCPs) contain synthetic hormones that mimic the effects of natural hormones in the body, including prolactin. Therefore, OCPs can potentially cause hyperprolactinemia. However, hypothyroidism, acromegaly, and pregnancy are known to be associated with hyperprolactinemia due to their effects on hormone regulation.

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  • 46. 

    Pregnant teacher in her 20 weeks of pregnancy reported 2 of her students developed meningitis. Prophylactic treatment 

    • A.

      Rifampicin (600) mg BID for 2 days

    • B.

      Ceftriaxone 250)mg IM (or IV) once

    • C.

      Ciprofloxacin (500)mg OP once

    • D.

      Meningitis polysaccharide vaccine

    • E.

      Observe for signs of meningitis

    Correct Answer
    A. Rifampicin (600) mg BID for 2 days
    Explanation
    The correct answer is Rifampicin (600) mg BID for 2 days. Rifampicin is a broad-spectrum antibiotic that is commonly used for prophylactic treatment of meningitis caused by Neisseria meningitidis. It is effective in eliminating the bacteria from the nasopharynx and preventing the spread of infection. The recommended regimen for prophylaxis is rifampicin 600 mg twice daily for 2 days. This treatment is important in preventing the transmission of meningitis to close contacts, such as the students in this case.

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  • 47. 

    All of the following are causes of intrauterine growth restriction (IUGR) except: 

    • A.

      HSV II

    • B.

      Toxoplasmosis

    • C.

      Syphilis

    • D.

      CMV

    • E.

      Rubella

    Correct Answer
    A. HSV II
    Explanation
    HSV II (Herpes Simplex Virus Type 2) is not a cause of intrauterine growth restriction (IUGR). IUGR refers to a condition where a fetus does not grow at the normal rate during pregnancy. It can be caused by various factors such as maternal infections (Toxoplasmosis, Syphilis, CMV, Rubella), placental abnormalities, maternal health conditions, and genetic factors. However, HSV II is not known to directly cause IUGR.

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  • 48. 

    Pregnant lady 28 weeks with Chlamydia infection : 

    • A.

      Erythromycin

    • B.

      Doxcyline

    • C.

      Azithromycin

    Correct Answer
    A. Erythromycin
    Explanation
    Erythromycin is the correct answer because it is the recommended treatment for Chlamydia infection in pregnant women. Doxycycline is contraindicated in pregnancy as it can cause harm to the developing fetus. Azithromycin is also an alternative treatment option for Chlamydia infection during pregnancy, but erythromycin is the first-line choice.

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  • 49. 

     Primigravida with whitish discharge the microscopic finding showed pseudohyphae the treatment is: 

    • A.

      Meconazole cream applied locally

    • B.

      Tetracycline

    • C.

      Metronidazole

    • D.

      Cephtriaxone

    Correct Answer
    A. Meconazole cream applied locally
    Explanation
    Meconazole cream is the correct treatment for a primigravida with whitish discharge and microscopic findings of pseudohyphae. Meconazole is an antifungal medication that is commonly used to treat vaginal yeast infections caused by Candida. The cream is applied topically to the affected area and works by inhibiting the growth of the fungus. This treatment is effective in relieving symptoms and eliminating the infection. Tetracycline, metronidazole, and cephtriaxone are not appropriate treatments for a fungal infection and would not be effective in this case.

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  • 50. 

    38 weeks pregnant lady with placenta previa marginal with mild bleeding ,cervix 2cm , How to manage ?

    • A.

      Spontaneous delivery

    • B.

      CS

    • C.

      Forceps delivery

    • D.

      Do amniotomy

    Correct Answer
    A. Spontaneous delivery
    Explanation
    In the case of a 38-week pregnant lady with marginal placenta previa and mild bleeding, the management would typically involve spontaneous delivery. This is because at 38 weeks, the baby is considered full-term and ready for delivery. Spontaneous delivery allows for the natural progression of labor and minimizes the risk of complications associated with surgical interventions like cesarean section or forceps delivery. However, close monitoring of the mother and baby during labor is necessary to ensure the safety of both.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

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  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 12, 2014
    Quiz Created by
    Khwarazm
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