OCTOBER 2017 PART 2 MCQ
1. Primigravida with acreta bleeding from placental bed
a. Hysterectomy
b. Uterine packing
ANS: UTERINE PACKING ( HAEMORRHAGE CAN BE DEAL IN NORMAL WAY UNLESS LIFE THREATENING)
2. Pt.with Gtn shoula conceive ??
a. after chemo.
b. a/f completiin of followup
ans . PATIENT WITH GTN SHOULD DEFERRED PREGNENCY 12MONTHS AFTER Rx SO PREGNENCY AFTER 12
MONTH OF PREGNENCY
3. Post laproscopy patient came with shulder tip pain aftr 24 hour in emergency
a. Refered
b. Cut injury
c. Perforation
d. Psychlogical
answer.. REFERRED ( REFFERED PAIN AS POST LAPROSCOPY PAIN IS DUE TO CO2 INDUCED PHRENIC NERVE
IRRITATION)
4. Anesthesia with obstet safty outcome
a. Entoux
b. Halothene
c. Regional
d. KetAmine
ANS.. REGIONAL
5. common site of ureteric injury a. ascending uterin artry
b. latral ligament
c. uterosacral ligament
d. sepration of bladder peritoneum
ANS. UTEROSACRAL LIGAMENT (The most common sites of ureteral injury are at the pelvic brim,
near the infundibulopelvic ligament, and deeper in the pelvis, as it courses by the uterosacral
ligament under the uterine artery approaching the cardinal ligaments)
6. Patient with 160/120 headache epigastric pain brisk reflexes proteinuria +4
a. . Low no and deliver
b. Steroids
c. MgSo4
ANS: MgSO4 (THIS IS INCOMPLETE QUESTION, GEST AGE NOT MENTION, but its severe pre eclampsia.. need
to prevent fit by Mgso4)
7. Patient come with ho miscarrage at 6 wk now come with low positive ig M and all other
investigation normal a. Prophylatic heprin
b. Theraupatic heprin
c. Asprin
ANS : INCOMPLETE QUESTION? WHAT IS LOW POSITVE IgM?
8. Tube damage with oligospermia
a. Icsi
b. Ivf
ANS : ICSI
9. Patient collapsed after delivery due to pain,,, evaluated for adenexal mass antenatally
a. Ovarian torsion?
INCOMPLETE QUESTION
10. Ovarian tumour with coffee bean nucleus on histology.
a. brenner
ANS IS BRENNER.. BENIGN BRENNER NUCLIE HAS COFFEE BEAN SHAPE
11. Pt come 40 cm breech at brim 2 cm dilated mem intact
a. Ecv
b. C sec
c. Breach extraction
ANS.. 40 CM OR 40 WEEKS??? INCOMPLETE QUESTION
WITH EARLY LABOUR WITH MILD PAIN… GO FOR ECV… EARLY LABOR WITH MILD OR NO PAIN IN BREECH
CLUE FOR ECV
12. pt with cin 111 cone biopsy negative margin and 1mm basement membrane invasion
a. stag 1a
b. carcinoma in situ
ANS: STAGE 1A AS IN STAGE 1A DEPTH <3MM AND . ca in situ is noninvasive, which means the
cancerous cells are confined to the surface of cervix
13. cervical fibroid of 4-5 cm treatment
a. vaginal myomectomy
b. hysteroscopic myomectomy
ANS; VAGINAL MYOMECTOMY (. Vaginal myomectomy is an ideal approach as allows easy access to pedicle of
higher & big fibroid inscion on cervix can b made)
14. candidiasis treatment
a. oral nystatin
b. miconazole
ANS : INCOMPLETE QUESTION, VAGINAL OR ORAL? IN PREGNENCY NOT MENTIONED
NYSTATIN IS FDA PREG CATEGOR B, WHILE MICONAZOLE IS FDA C
15. preterm with22 week cerclage what to give
a.atosiban
b.ritodine
c. nifedipine
d. Mgso4
ANS : ATOSIBAN
16. How will u assess prev 1 for trial of labor
a. Size of fetus
b. Pelvic assessmnt
ANS:PELVIC ASSESMENT( Planned VBAC is appropriate for and may be offered to singleton pregnancy of
cephalic presentation at 37+0 weeks or beyond who have had a single previous lower segment caesarean delivery,
with or without a history of previous vaginal birth)
17. Hemolytic bt reaction option?
ANS: INCOMPLETE QUESTION
18. Vaccine safe during pregnancy and breast feeding? (DNA virus??)
a. Hep A
b. Hep B
c. Influenza
d. Rabies
e. Tetanus toxoids
ANS : HEP B AS ITS ONLY DNA VIRUS
HEP A IS RNA VIRUS
INFLUENZA ALSO RNA VIRUS
MMR IS CONTRAINDICATED IN PREGNENCY
TETNUS TOXOID FOR SPORE BACTERIA
19. Wound with pau de orange appearance
a. Wound hematoma
b. Dehiscence
ANS: INCOMPLETE QUESTION BUT WITH WOUND Infection of the skin and soft tissue can also result
in Peau D’Orange. Cellulitis, which is an infection of the skin and the tissues under the skin, can also
lead to Peau D’Orange.
20. Ventous application
a. Asynclitism
b. Breech
21. Severe iugr,abnormal umb doppler,At 32 week....
a. . C section
b. Weekly Doppler
c. Admit and monitor
ANS: LSCS.. if reversed umblical A doppler end diastolic after 32weeks gestation & absent end diastolic flow
after 34weeks is indication of immediate deliver (reference DH)
22. Patient with twin pregna first deliver second in transvers lie no utrine contraction fhs 100 wht will u do
a. Augmentation with synto
b. Em sec
c. Ecv
d. Ipv
ANS: EM C.SECTION other options not acceptable as CTG not satisfactory , no uterine contractions ,
augumentation also not recommended,)
23. ROT CAPUT PLUS 2 prolong second stage o station
a. Forceps
b. C sec
c. Ventous
ANS: C.section (as forceps only at OA, vaccum contraindicated in caput)
24. A pt with three days overdue...came with pain n vag bleeding..fornix tender investigation of choice for
definit diagnosis bhcg 200 iu/l.vaginal scan shows no gestational sac
a. Serial hcg
b. Laparoscopy
c. Vaginal us
ANS: for definite diagnosis laproscopy as it is ectopic.. there is sub optimal rise in beta hcg in ectopic
25. Patient bleed during c sec response to utrotonic again relax reduce blood loss on manual compression wht will u
do
a. Ballon. Tampon
b. C hstrectomy
c. Utrine artery ligation
ANS: balloon tamonade (for PPH mcq always go stepwise)
26. Post abruption scenario hb 7 platelet 80thousnd fdp raised hematuria treatment
a. Whole blood
b. pack cell
c. Ffp
ANS: PACKED CELL VOLUME
27. Following all are derivative of mesonephric duct except
a. Epioophoron duct
b. Gartener duct
c. Ureter
d. Duct of morgagni
ANS: THIS IS WRONG QUESTION, THESE R REMNENTS OF MESONEHPRIC DUCT, MESONEPHRIC DUCT FROM
WHICH MALE GONADS DEVELOPS SO THE ASKED THE REMNANTS IN FEMALE SO THEY ARE
1.EPOOPHRON
2.PAROOPHRON
3.GARTNER DUCT
4.HYDATID CYST OF MORGAGNI
SO RIGHT ANSWER IS URETER
28. 14yr old with clitoromegaly, no breast no axillary hairs, slight pubic hairs 17 OH progestron 108ng/ml
a. Adrenal hyperplasia
b. 21 hydroxylase def
c. . CAH with 12 hydroxylase def
ANS: THIS IS CAH & MOST COMON IS DEFICINCY OF 21 ALPHA HYDROXYLASE
29 Commonest site of uretric injury while performing hysterctomy?
ANSWER: The most common sites of ureteral injury are at the pelvic brim, near the
infundibulopelvic ligament, and deeper in the pelvis, as it courses by the uterosacral ligament under
the uterine artery approaching the cardinal ligaments)
30. Postopt 10day of cs fever abdominal pain peudoorange skin uterus 18week firm nt bleeding
a. Endometritis
b. Wound hematoma
c. Wound dehiscence
ANSWER :ENDOMETRITIS, AS WOUND Infection Can also result in Peau D’Orange.
31. Previous 4 scar wid abdominal pain,vomiting, baby iud, abd tense tender, memb ruptured, 5cm dilated
a. Uterine rupture
b. abruption
ANSWER: UTERINE RUPTURE (S/S ALMOST SAME SAME FOR BOTH PLACENTA ABRUPTIO AND RUPTURE BUT HERE
5CM DIALTED IS HINT THAT PATIENT IN LABOUR, SO CONTRACTIONS IN PREV IV MAY LEAD TO RUPTURE)
32. Phenotypically normal male with uterus tubes and ovaries
a. Absence of MIF
ANSWER: INCOMPLETE QUESTION
PHENOTYPICALLY MALE WITH UTERUS & OVARY IS DUE TO PRESISTENCE OF MULLERIAN DUCT OR
INHIBITION OF ANTI MULLARIAN HORMONE IN MALE
33. 6 days after c s pt present swollen leg pain dignosis is DVT extended to popliteal vein management options
a. I v haprin
b. Warafarin
ANSWER; HEPARIN
34. Rh neg, titer 1:32 best predictive of outcome
a. FBS .
b. Ultrasound
c. MCA
ANSWER: DOPPLER MCA
35. need of drain placement
a. ureteric end to end anastomosis
b. small gut repair
c. ascites after debulking
d. myomectomy
ANSWER ; MYOMECTOMY (AS uterus may bleeds from the sites where the fibroids were removed)
36. Patient with mucopurent discharge also went to DAI
a. Chlaymedia
b. Gonorrhea
c. Male screening
ANSWER: THIS IS INCOMPLETE QUESTION, MUCOPURELENT DISCHARGE IS CAUSED BY
CHLYMADIA, GONORRHEA, HSV, T. VAGINALIS & CONTACT SCREENING REQUIRED TOO IN STI BUT MOST
COMONEST CAUSE IS CHLAMYDIA
37. Pt with g4 p1+2 with hx of shoulder dystocia n still birth...presently she is ftp best option
a. Elective llscs
b. Spontaneous labour
c. Induction of lab
ANSWER. ELECTIVE C/S (CESAREAN SECTION IS ADVOCATED FOR PREGNENCIES AFTER SEVERE SHOULDER
DYSTOCIA, PARTICULARLY WITH A NEONATAL POOR OUTCOME, REFFERNCE GUIDELINES)
38. Women 55 yr old with history of mastectomy with depression and hot flushes
a. Antidepressants and symptomatic treatment
b. COCs
c. . Estrogen only
d. . Calcium supplement
e. SERMS
ANSWER : a. Antidepressants and symptomatic treatment (as mastectomy seems to be cause of depression
& symptomatic Rx of menopause as estrogen contraindicated in Ca breast)
COCs CANOT BE GIVEN, due to mastectomy (Ca breast)
ESTROGEN ONLY CANOT BE GIVEN AS PT HYSTERECTOMY NOT MENTION & mastectomy (Ca breast)
Ca SUPPLEMENTS ALSO NOT SUITABLE
SERMs increases hot flushes & also slight increase risk of Ca breast
39. Painfull multiple ulcer on With lymphadenopathy
a. Herpes
b. Syphilis
ANSWER: HSV AS MULTIPLE ULCER ARE CLASSICAL CHARACTERSTIC OF HSV, ALSO ADENOPATHY PRESENT
SPHYLLIS NON TENDER & NO ADENOPATHY
41. Multigravida wd incomplete uterin invertion
a. Uterin replacement wd placenta wd oxytocin
b. Fluids and tocolytics
ANSWER: a. Uterin replacement wd placenta (Once reduced, maintain hand in uterine cavity until a firm
contraction occurs, and IV oxytocin is being given. Then remove the placenta and explore the cavity gently for
trauma)
42. A pt with thick meconium station 1+ roa.caput +
a. Neville forces
b. Outlet forces
c. Ventouse
d. Cs
e. Wait
ANSWER: a. Neville forces (MID CAVITY FORCEP)
43. 32 weeks hydrops , Rh negative
a. intra peritoneal blood transfusion
b. intr uterine ,
c. immediate delivery
d. iv immunoglobulin
ANSWER: STEPWISE TRANSFUSION (REFERNCE DH)
44. Patient with previous 2 c sec dignosis increta placental bed bleeds few suture aplied stil bleed wht will b
option a. B lynch
b. Internal liac atery ligation
c. Packing
d. Hystrectomy
ANSWER: hysterectomy (refernce guidelines as consent for hysterectomy has been taken before surgery with
known morbidly adherent placenta)
45. Patient with recurrent discharge wound infection
a. Inapropriate sutur techni
b. Forein body
c. In appropriate antibiotic
d. Dressing poor
ANSWER: INCOMPLETE QUESTION??
46. A pt with ectopic pregnancy less than 3 cm bhcg 980 iu/l....no fetal pole management
a. Methotraxate
b. Kcl
ANSWER: EXPECTANT MANAGEMENT ( for MTX, serum B-hCG 1500- 5000, conseratve can b done wd beta hCG 1751000, 80-90 % success rate with beta hCG <1000)
47. A pt with right labial throbbing swelling with foul smelling vag discharge investigation
a. Hvs
b. Endicervical swab
c. Male partner invest
ANSWER: HVS AS the most common medical conditions indicated by the symptoms swelling(due to itching),
vaginal discharge and vaginal odor including Vaginal yeast infection,
48. A pt with incres Afp n now 16 wks previously baby was apina bifida...most appropriate
a. Detail anomaly scan
b. Amniocentesis
ANSWER: DETAILED ANOMALY SCAN (A more conservative approach involves performing a
second MSAFP or complete triple screen test followed by a high definition ultr asound.If the
testing still maintains abnormal results, a more invasive procedure such as amniocentesis
may be perform)
49. A pt induced with tab prostaglandin contraction 6 in 10 minutes
a. Tetbutalin?
b. Stop oxytocin
ANSWER: TERBUTALINE BUT IN CASE OF PROFOUND FHR CHANGES..IMMEDIATE DELIVERY BY C.S (refernce
DH)
50. Timing of insertion and removal of ius and iucd?
ANSWER… 1ST SEVEN DAYS OF MENSTRUAL CYCLE (refernce DH)
51. Patient with mitral stenosis come in lab at 30 wk managment a. Elevtive lscs
b. Em c sec
c. Elective forceps
d. Ventous
ANSWER: ELECTIVE FORCEP (VAGINAL DELIVERY IS ROUTE OF CHOICE IN MITRAL STENOSIS UNLESS C.S INDICATED
BY OTHER OBSTETRIC REASON, HOWEVER FORCEPS CAN BE USED IN CARDIAC PT. TO SHORTEN THE 2 ND STAGE OF
LABOUR)
52. Pregnant mother with joint pain and anti RO/LA positive
a. .SLE
ANSWER : SLE (ANTI RO/LA POSTVE IN SLE)
53. post csec left costovertebral angl pain , dribbing f urine , pt febrile
a. nephrectmy
b. nephrostmy e delayed repair
c. nephrostomy
d. immediate repair
ANSWER: THIS IS INCOMPLETE QUESTION, PAIN & FEBRILE SUGGEST INFECTION, & IN INFECTION PROCEDURE IS
DELAYED,
OR IF CONTINUOS DRIBBLING THEN THIS IS VVF, BUT STILL IN VVF, 1ST CONSERATVE RX BY CATHETERIZING THE PT
& TO GIVE ANTIBIOTICS
54. vvf after hysterectomy, pt wanted immediate repair on 10th post op day
a. immediate repair
b. after 2 weeks
c. 1-3 months
ANSWER: 1-3MONTHS AS MOST OF IT HEALED BY CATHERIZATION & ANTIBIOTIC
55. A pt with prev cs want plan repeat cs....now she is 38wks
a. El lscs @ 41 wks
b. El lscs @ 40 wk
c. Rescan to documents ges age
d. Amniocentesis to document fetal lung maturity
ANSWER: EL LSCS AT 40 WEEKS (ELECTIVE C/S GENERALLY DONE AT 39WEEKS AS INCIDENCE OF
TACHYPNOEA OF NEW BORN IS MUCH LESS AFTER THIS GESTATION)
56. P2 with breech presentation in Labour intact membranes 2 cm dilated
a. ECV
b. . CESSARIAN SECTION
ANSWER : ECV (EARLY LABOUR WITH MILD PAIN EXCLUDING CONTRAINDICATION… ECV)
57. Lady with 2 packed cell trasfused what hemolytic reaction will occur
ANSWER: MOST COMON IS URTICERIA
58. Women with history of surgery due to endometriosis now having pain
a. .Adhesions
b. .cystitis
ANSWER INCOMPLETE OPTIONS, BOTH ARE WRONG
Each area of endometriosis that is excised leaves behind a base of normal tissue, which has
been uncovered of its normal peritoneal surface. This is essentially a raw tissue, which immediately
becomes swollen with the body's natural response to injury. This also involves an increase in the
local blood supply, and an infusion of defense cells such as plasma calls and white blood cells. This
surgical "injury" requires a significant amount of time to heal.
New peritoneum must be generated to cover the raw area. The swelling must have time to
subside. The patient's nerve endings can't tell the difference between endometriosis and the
surgery to excise it: all they know is that something is causing them to fire, and the result can be
pain.
59. A pt 10/days after hysterectomy develop fistula ...best option
a. Immediately repair
b. Not bf 12 months
c. After 2 wka
d. Not bf 1_3 montha
ANSWER : NOT BEFORE 1-3MONTHS
60. Patient on tiblone co spoting aftre treatment
a. Vaginal atrophitis
b. Break throug bleeding
c. Polyp
d. Hyperplasia

ANSWER: BREAKTHROUGH BLEEDING (AS tibolone have estrogenic, androgenic and progestogenic
effects )
61. A unmarried girl heavy prolog bleeding since menarchr.PA normal.normal female thin built n tall
a. Hyperthyroidism
b. Hypothyroidism
c. Hypo fibrin of enemies
d. Hormonal imbalance
e. Thrombi cut open is
ANSWER : HORMONAL IMBALNCE
62. Patient with discharge not on gram staining causing fever cervical mobility and lpmphadenopathy
INCOMPLETE QUESTION
63. Rhesis negative mother with history of hydrops
INCOMPLETE QUESTION
64. A pt with complex adenaxal mass and 22 wks pregnancy with hx of on n off pain...mqngmnt
a. MRI n followup
b. Doppler n follow up
c. Can 125
d. Repeat scan after 4 wks
e. Remove it
ANSWER : MASS SIZE NOT MENTIONED HERE WHICH IS IMP FOR Mx (Resection of all suspected cyst/mass
at risk of rupture or undergoing torsion is recommended. Cysts measuring 10 cm in diameter should be
resected while cysts less than 5 cm could be left alone, and indeed, most undergo spontaneous resolution.
Management of cysts between 5 and 10 cm in diameter remains controversial. Some clinicians
recommend that these cysts be managed expectantly if they have cystic appearance. Others believe that if
they contain septae, nodules, papillary excrescences, or solid component, resection is recommended )
65. A white lesion on vulva biopsy shows squamous hyperplasia
a. Laser
b. 5 flurouracil
c. Phlorogluconol
ANSWER: INCOMPLETE SCINORIO , vulvar squamous cell hyperplasia ,,,POTENT STEROID IS Rx
66. Treatment of simple hyperplasia
a. Mefenmic acid
b. Progesterone
c. Danazol
d. Gnrh
ANSWER : PROGESTERONE
67. Atypical hyperplasia , histry of mastectomy for ca breast and on tamoxifen
a. Radical hystrectmy
b. Radiotherapy then tah
ANSWER: TAH AFTER RADIOTHERAPY (INCOMPLETE SCINORIO)
68. Pt wid brexton hix contraction at 35 weeks ctg shows late decelaeration, low variability, dec FM
a. Steroid deliver after 48 hr
b. Cs at 37 week
c. Immediate delivry
d. Cs
ANSWER: THAT’S INCOMPLETE QUESTION
69. Ch HTN ,h/o pre eclampsia n early onset iugr, hellp, now taking aldomet n worried fr her baby,
what test u will do
a. Nothng until bp less that 140/90
b. Weekly dopplr aftr 28 weeks
c. Weekly bpp n NST
ANSWER : DOPPLER WEEKLY & GROWTH SCAN FORTNIGHTLY
70. 60 yrs PT aftr vh , anterior and posterior repair came on 7th post op day wid c/o
a. urinary retention
b. stress incontinence
c. dyspareunia
d. vault prolapse
ANSWER: STRESS INCONTINENCE
.