Assistant Professor / Lecturer • 2017 • Paper-II
The Induction of labour: which one of the following is false?
A)
Hyperstimulation is more common with misoprostol than prostaglandin E2 (PGE2).
B)
Cervical ‘sweeping’ from/ after 40 weeks reduces the chance of induction and postdates pregnancy.
C)
Absolute contraindications include acute fetal compromise, abnormal lie, placenta praevia or pelvic obstruction such as a pelvic mass or pelvic deformity causing cephalo-pelvic disproportion
D)
The risk of cord prolapse is decreased with induction of labour.
Induction can increase, not decrease, cord-prolapse risk in susceptible presentations; thus that statement is false.
Assistant Professor / Lecturer • 2017 • Paper-II
In ecclampsia , the treatement regimen that cause minimum effects on the fetus is
A)
diazepam therapy
B)
lytic cocktail regime
C)
MgSo4
D)
phenobarbitone therapy
The correct choice is MgSo4.
Assistant Professor / Lecturer • 2017 • Paper-II
Preterm prelabour rupture of membranes (PPROM) , which statement is appropriate
A)
PPROM occurs before one-third of preterm deliveries
B)
Infection of the placenta (chorioamnionitis) or cord (funisitis) is uncommon.
C)
If there is evidence of chorioamnionitis delivery may be delayed to give antibiotics
D)
Induction should not be performed until term
Once chorioamnionitis is present, delivery is generally indicated rather than prolonged expectant management.
Assistant Professor / Lecturer • 2017 • Paper-II
Down’s syndrome (trisomy 21) is
A)
Trisomy 21 is the most common chromosomal abnormality among live births.
B)
It usually occurs as a result of a balanced chromosomal translocation in the parents.
C)
One hundred per cent of affected infants have cardiac defects.
D)
The fetal heart is always abnormal.
Trisomy 21 is the most common autosomal chromosomal abnormality among live births; not all cases are due to translocation and not all have heart defects.
Assistant Professor / Lecturer • 2017 • Paper-II
Which of the following is NOT a symptom of postpartum depression?
A)
Energy depletion
B)
Sudden bursts of energy
C)
Mood swings
D)
Anxiety
Sudden bursts of energy are not a typical symptom of postpartum depression.
Assistant Professor / Lecturer • 2017 • Paper-II
Labour/vaginal delivery after a previous Caesarean section (VBAC), which staement is correct:
A)
If vaginal delivery is attempted about 30% of women will deliver vaginally after one Caesarean section.
B)
Emergency Caesarean section is as safe as elective Caesarean
C)
Fetal risks are increased with VBAC.
D)
Caesarean section is less likely in women who have had a previous elective Caesarean section
VBAC carries some increased fetal risk from uterine rupture, although most selected women can achieve vaginal birth.
Assistant Professor / Lecturer • 2017 • Paper-II
The most common cause of PPH is
A)
uterine atonicty
B)
cervical tear
C)
vaginal lacerations
D)
coagulation disorder
Uterine atony is the commonest cause of postpartum haemorrhage.
Assistant Professor / Lecturer • 2017 • Paper-II
Conservative management is contraindicated in a case of placenta praevia under the following situation except
A)
evidence of fetal distress
B)
fetal malformations
C)
mother in a haemodynamic condition
D)
woman in labour
In DIC, PT and aPTT are prolonged and thrombocytopenia develops; PCV is not a coagulation test.
Assistant Professor / Lecturer • 2017 • Paper-II
The following statements refer to prediction and prevention of preterm labour—which is true?
A)
Strategies for prevention of preterm birth, in those at high risk, are commenced from 23 weeks
B)
A cervical suture should only be inserted if the cervical length on transvaginal sonography (TVS) is short
C)
Antibiotics throughout pregnancy prevent preterm labour.
D)
Cervical length on TVS is a sensitive method for prediction of delivery before 28 weeks
In DIC, PT and aPTT are prolonged and thrombocytopenia develops; PCV is not a coagulation test.
Assistant Professor / Lecturer • 2017 • Paper-II
The commonest cause of occipito posterior position of fetal head during labour is
A)
maternal obesity
B)
deflexion of fetal head
C)
multiparity
D)
android pelvis
An android-type pelvis predisposes to persistent occipito-posterior position.
Assistant Professor / Lecturer • 2017 • Paper-II
In case of Forceps and ventouse delivery: which of the following is correct
A)
AFailure of instrumental delivery is more common with the ventouse
B)
Keilland’s (rotational) forceps have a ‘pelvic curve’ which follows the sacral curve and a ‘cephalic curve’ for the head
C)
If moderate traction with a ventouse does not produce immediate and progressive descent, forceps must be used.
D)
Instrumental delivery can be used once the cervix is 8 cm dilated.
Kielland forceps have pelvic and cephalic curves suited to rotational deliveries.
Assistant Professor / Lecturer • 2017 • Paper-II
Common causes of antepartum haemorrhage (APH, bleeding from the genital tract from 24 weeks gestation) include which of the following?
A)
Vasa praevia
B)
Uterine rupture
C)
Placental abruption
D)
None of these
Placental abruption is a major recognized cause of antepartum haemorrhage.
Assistant Professor / Lecturer • 2017 • Paper-II
The agravating factor for subinvolution of uterus
A)
retained products of conception
B)
uterine sepsis
C)
(a) & (b)
D)
all of these
Retained products and uterine infection both promote subinvolution.
Assistant Professor / Lecturer • 2017 • Paper-II
Investigations and management of preterm labour: which one of the following is true?
A)
Fetal fibronectin as a test for preterm labour is highly specific
B)
WBC count and CRP estimation are indicated
C)
Steroids reduce perinatal mortality by promoting pulmonary maturity.
D)
Caesarean section reduces the incidence of respiratory distress syndrome (RDS) in the neonate.
Antenatal corticosteroids reduce neonatal morbidity and mortality by accelerating fetal lung maturation.
Assistant Professor / Lecturer • 2017 • Paper-II
The statement appropriate for Placenta praevia:
A)
Placenta praevia complicates about 0.4% of pregnancies at term.
B)
Placenta praevia cannot be diagnosed with ultrasound
C)
The majority of ‘low-lying’ placentas diagnosed at 20 weeks will remain so at term
D)
The patient should be routinely managed under in-patient care with delay of delivery until the patient labours, at which time an emergency Caesarean section will be performed
Participatory Rural Appraisal emphasizes incorporating local people's knowledge, experience and priorities.
Assistant Professor / Lecturer • 2017 • Paper-II
Prelabour, term rupture of the membranes: which of the following is true?
A)
The incidence of membrane rupture before the onset of labour after 37 weeks is 50%.
B)
Risk of neonatal infection is reduced by vaginal examinations, the presence of group B streptococcus and increased duration of membrane rupture
C)
Induction of labour does not increase the risk of Caesarean section, and is associated with a lower chance of maternal infection.
D)
Erythromycin should be prescribed
Routine erythromycin is not indicated for uncomplicated term rupture; management focuses on infection prevention and induction when appropriate.
Assistant Professor / Lecturer • 2017 • Paper-II
A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa?
A)
Infection
B)
Hemorrhage
C)
Chronic hypertension
D)
Disseminated intravascular coagulation
The correct choice is Hemorrhage.
Assistant Professor / Lecturer • 2017 • Paper-II
Which of the following is NOT a cause of infertility in women?
A)
ovulation midway through the menstrual cycle
B)
endometriosis
C)
thick cervical mucus
D)
PID (pelvic inflammatory disease)
Ovulation normally occurs mid-cycle and is not a cause of infertility.
Assistant Professor / Lecturer • 2017 • Paper-II
Aetiological factors in spontaneous preterm labour is
A)
Delivery before 34 weeks occurs in 20% of twins
B)
Spontaneous preterm labour is more common in the presence of fetal compromise.
C)
Uterine abnormalities such as fibroids or müllerian abnormalities are a cause of first-trimester miscarriage, but not preterm delivery.
D)
Cervical surgery and recurrent terminations of pregnancy protect against preterm delivery
Fetal compromise and multiple pregnancy are associated with spontaneous preterm birth; the other statements are incorrect.
Assistant Professor / Lecturer • 2017 • Paper-II
All the following are causes of intruterine growth retardation
A)
anemia
B)
pregnancy induced hypertension
C)
maternal heart disease
D)
gestational diabetes
The correct choice is gestational diabetes.
Assistant Professor / Lecturer • 2017 • Paper-II
True features of malpresentation include
A)
Labour is often slower and more painful in occipito-anterior position, with back ache and an early urge to push
B)
Extension of the fetal head on the neck, resulting in a large (13 cm) presenting diameter (brow), will still normally deliver vaginally
C)
Vaginal delivery with a face presentation is possible only in the mento-anterior position
D)
Malpresentation is more common in nulliparous women
Face presentation can deliver vaginally only when the chin (mentum) rotates anteriorly.
Assistant Professor / Lecturer • 2017 • Paper-II
The preventive measures for breastengorgement is
A)
correct latch on
B)
late initiation of breast feeding
C)
to introduce prelateal feed
D)
none of these
Correct latch and effective early feeding reduce breast engorgement.
Assistant Professor / Lecturer • 2017 • Paper-II
For manual removal of placenta the hand is introduce into the uterus in the shaped of
A)
cone
B)
vertical
C)
straight
D)
none
The correct choice is cone.
Assistant Professor / Lecturer • 2017 • Paper-II
The commonest cause of breech presentation
A)
prematurity
B)
hydrocephalus
C)
placenta praevia
D)
polyhydramnios
Breech presentation is associated with a higher incidence of fetal abnormality and complications.
Assistant Professor / Lecturer • 2017 • Paper-II
Cervical changes in pregnancy are all except
A)
increased collagen
B)
increased hyaluronic
C)
increased glands
D)
increased vascularity
Pregnancy causes increased vascularity, glands and softening; collagen is remodeled rather than simply increased.
