Q1
The risk of placenta previa in women with a history of three cesarean sections is approximately:
A
10 times higher
B
20 times higher
✓ Correct
C
30 times higher
D
40 times higher
Q2
A patient undergoes a POP-Q examination, and the first-row readings (Aa, Ba, C) are -1, 0, and -7. This indicates:
A
First-degree cystocele
B
Second-degree cystocele
✓ Correct
C
Third-degree cystocele
D
Rectal prolapse
Q3
Chronic pelvic pain is defined as:
A
Intermittent or constant pelvic pain for at least 3 months
✓ Correct
B
Pain only during menstruation
C
Pain lasting less than 1 month
D
Pain always related to intercourse
Q4
The best test for screening for proteinuria during pregnancy is:
A
Urine dipstick
✓ Correct
B
Twenty-four-hour urine collection
C
Serum creatinine
D
Microalbuminuria test
Q5
Which of the following is false about post-term pregnancy?
A
It affects about 15–20% of all pregnancies
✓ Correct
B
The success rate of membrane sweeping is about 1 in 8 women
C
The most common cause is inaccurate dating
D
It is associated with increased perinatal morbidity
Q6
Which of the following is false about induction of labor (IOL)?
A
Confirming the normal heart rate of the baby before IOL
B
Assessing the Bishop score before IOL
C
Monitoring fetal well-being with CTG during IOL
D
Confirming the presence of uterine contractions before starting IOL
✓ Correct
Q7
All of the following are associated with incision dehiscence except:
A
Obesity
B
Diabetes mellitus
C
Smoking
D
Good hydration
✓ Correct
Q8
Which of the following is not a risk index (independent predictor) of cardiac complications in pregnancy?
A
Ejection fraction <40%
B
Cyanosis
C
Left ventricular outflow obstruction
D
History of other children with cardiac disease
✓ Correct
Q9
A 27-year-old sexually active woman presents with pelvic pain and is suspected of having pelvic inflammatory disease (PID). The most common cause is:
A
Chlamydia trachomatis
✓ Correct
B
Neisseria gonorrhoeae
C
Bacterial vaginosis
D
Trichomonas vaginalis
Q10
A patient presents with vaginal discharge, and her microscopy reveals clue cells. The most likely diagnosis is:
A
Vulvovaginal candidiasis
B
Bacterial vaginosis
✓ Correct
C
Trichomoniasis
D
Chlamydial infection
Q11
Atypical endometrial hyperplasia is most strongly related to:
A
Uterine fibroids
B
Polycystic ovary syndrome (PCOS)
✓ Correct
C
Combined oral contraceptive pill (COCP) use
D
History of ectopic pregnancy
Q12
All of the following are associated with high FSH and absent breast development in primary amenorrhea except:
A
Swyer syndrome
B
Turner syndrome
C
Premature ovarian failure
D
Complete androgen insensitivity syndrome (CAIS)
✓ Correct
Q13
Which of the following is not an indication for conservative management in stress urinary incontinence?
A
Breastfeeding
B
Less than 6 weeks postpartum
C
Seeking conception
D
Previous cesarean section
✓ Correct
Q14
All of the following are conservative management options for stress urinary incontinence except:
A
Pelvic floor muscle training (PFMT)
B
Biofeedback
C
Increasing caffeine intake
✓ Correct
D
Weight loss and lifestyle advice
Q15
The most common complication of external cephalic version (ECV) is:
A
Failure of the procedure
✓ Correct
B
Compromised umbilical blood flow
C
Placental abruption
D
Uterine rupture
Q16
The most common cause of postmenopausal bleeding is:
A
Endometrial polyp
B
Endometrial hyperplasia
C
Fibroids
D
Endometrial atrophy
✓ Correct
Q17
A 9‑week pregnant woman with no documented rubella vaccination is found to be non‑immune. Which of the following is true?
A
Give rubella vaccine after birth regardless of breastfeeding
✓ Correct
B
Give rubella vaccine only after completing breastfeeding
C
Reassure that congenital rubella syndrome cannot occur at 9 weeks
D
Give rubella vaccine before 16 weeks of gestation
Q18
A pregnant woman with a previous history of placental abruption presents with preeclampsia. Her highest risk factor for recurrent abruption is:
A
Previous abruption
✓ Correct
B
Preeclampsia in the current pregnancy
C
Multiparity
D
Advanced maternal age
Q19
A 48‑year‑old woman presents with heavy menstrual bleeding and occasional intermenstrual spotting. TVS is normal and Hb is 11.2 g/dL. The most appropriate next investigation is:
A
Hysteroscopy
✓ Correct
B
Coagulation profile
C
Repeat ultrasound in 6 months
D
CT scan of the pelvis
Q20
Which of the following is false regarding physiological changes in pregnancy circulation?
A
Decreased blood flow to the legs
✓ Correct
B
Increased blood flow to the skin
C
Increased blood flow to the kidneys
D
Decreased arteriovenous oxygen difference
Q21
A 42‑year‑old woman who has completed her family wants hormone therapy for the next 5 years. First‑line option is:
A
Combined oral contraceptive pill (COCP)
B
Progestogen-only pill
C
Levonorgestrel intrauterine system (Mirena IUS)
✓ Correct
D
Mefenamic acid
Q22
Which of the following is false about lower segment cesarean section (LSCS) compared with classical cesarean?
A
LSCS is easier to repair than classical
B
LSCS has lower risk of uterine rupture
C
LSCS has higher risk of adhesions
✓ Correct
D
LSCS is associated with less postpartum pain
Q23
Which of the following decreases the risk of wound infection?
A
Smoking
B
Obesity
C
Diabetes mellitus
D
Adequate IV fluid resuscitation
✓ Correct
Q24
Which of the following is the most immediate effect of epidural analgesia in labor?
A
Toxic reaction due to dural tap
B
Motor paralysis
C
Total spinal block
D
Hypotension
✓ Correct
Q25
What is the cutoff point for diagnosing anemia in a 28‑week pregnant woman?
A
10.5 g/dL
B
10 g/dL
C
11 g/dL
✓ Correct
D
12 g/dL
Q26
A pregnant woman is rubella IgG‑negative and concerned about congenital rubella syndrome (CRS). What should you advise?
A
Take the rubella vaccine after delivery, even if breastfeeding
✓ Correct
B
Take the rubella vaccine only after stopping breastfeeding
C
Take the rubella vaccine at 28 weeks
D
No vaccine is required
Q27
Persistent vomiting typically leads to which electrolyte and acid–base disturbance?
A
Metabolic alkalosis, hypokalemia, hypernatremia
B
Metabolic alkalosis, hypokalemia, hyponatremia
✓ Correct
C
Metabolic acidosis, hyperkalemia
D
Metabolic acidosis, hyponatremia
Q28
In active management of the third stage of labor, the recommended uterotonic is:
A
Syntocinon 10 IU IM
✓ Correct
B
Syntometrine IM
C
Syntocinon 5 IU IV bolus
D
Syntocinon 40 IU slow infusion as a bolus
Q29
Which of the following is not a risk factor for venous thromboembolism (VTE) in pregnancy?
A
Previous VTE
B
Immobility
C
Parity ≥2 without other risk factors
✓ Correct
D
Thrombophilia
Q30
A 45‑year‑old woman has been on HRT for 5 years. During which year is the risk of VTE highest?
A
First year of HRT
✓ Correct
B
Second year of HRT
C
Third year of HRT
D
Fourth year of HRT
Q31
All of the following are risk factors for cervical cancer except:
A
Nulliparity
✓ Correct
B
Smoking
C
Human papillomavirus (HPV) infection
D
Multiple sexual partners
Q32
Which of the following is not a prerequisite before induction of labor (IOL)?
A
CTG to ensure fetal well‑being
B
Bishop score assessment
C
Assessment of fetal presentation
D
Ensuring uterine contractions are already present
✓ Correct
Q33
A woman with shoulder dystocia had the McRoberts maneuver performed without success. The next step is:
A
Suprapubic pressure
✓ Correct
B
Manual delivery of the posterior shoulder
C
Wood’s corkscrew maneuver
D
Zavanelli maneuver
Q34
Regarding the normal menstrual cycle, which of the following is incorrect?
A
As age increases, the cycle tends to shorten
B
The duration of bleeding tends to decrease with age
C
Normal duration of bleeding is 2–5 days
✓ Correct
D
Cycles may be irregular for a short period after menarche
Q35
Which of the following is false regarding chronic hypertension in pregnancy?
A
Postnatal care and counseling are important
B
ACE inhibitors should be stopped 1 month prior to pregnancy
✓ Correct
C
Blood pressure should be controlled before conception
D
Low‑dose aspirin may be indicated
Q36
Which score is used to assess risk of thromboembolism after cesarean section?
A
Wells score
B
Caprini score
✓ Correct
C
Bishop score
D
Apgar score
Q37
All of the following can cause uterine atony except:
A
Breech presentation
✓ Correct
B
Multiple pregnancy
C
Polyhydramnios
D
Prolonged labor
Q38
The most common cause of thrombocytopenia in pregnancy is:
A
Immune thrombocytopenic purpura
B
Gestational thrombocytopenia
✓ Correct
C
HELLP syndrome
D
Aplastic anemia
Q39
Which drug is contraindicated in pregnancy?
A
Labetalol
B
Methyldopa
C
Valsartan
✓ Correct
D
Nifedipine
Q40
A woman has had 4 girls, 2 boys, one twin delivery, and 1 miscarriage. What are her gravida and para?
A
G7 P7+1
B
G8 P7+1
✓ Correct
C
G7 P6+1
D
G8 P6+2
Q41
Which of the following is not a storage (filling phase) lower urinary tract symptom?
A
Urgency
B
Frequency
C
Nocturia
D
Hesitancy
✓ Correct
Q42
In a woman with a regular 33‑day menstrual cycle, ovulation most likely occurs on:
A
Day 11
B
Day 14
C
Day 19
✓ Correct
D
Day 21
Q43
Which of the following statements about LMWH administration is false?
A
It is used for prophylaxis of VTE in high‑risk women
B
It is safe in breastfeeding
C
It should be withheld before neuraxial anesthesia
D
It can be given immediately after removal of the epidural catheter
✓ Correct
Q44
Which of the following is not a contraindication to epidural analgesia in labor?
A
Coagulopathy
B
Sepsis at the injection site
C
Hypovolemia
D
Chronic hypertension
✓ Correct
Q45
Regarding urodynamic testing, which of the following is false?
A
First sensation of bladder filling is usually around 150 mL
B
Strong desire to void occurs around 400–600 mL
C
Pain on filling is abnormal
D
First sensation normally at >80 mL is always pathological
✓ Correct
Q46
Which of the following is not a risk factor that increases the chance of pregnancy during lactational amenorrhea?
A
Introduction of supplemental feeds
B
Decreased frequency of breastfeeding
C
Complete cessation of breastfeeding
D
Increase in breastfeeding frequency
✓ Correct
Q47
Which of the following is relatively safe in pregnancy?
A
ACE inhibitors
B
Warfarin
C
Valproate
D
Labetalol
✓ Correct
Q48
Which of the following is not true about primary postpartum hemorrhage (PPH)?
A
Uterine atony is a common cause
B
Trauma is a possible cause
C
Coagulopathy can contribute
D
Subinvolution of the placental site is mostly seen in primary PPH
✓ Correct
Q49
Which of the following is incorrect about obstetric cholestasis?
A
It presents with pruritus
B
It is associated with raised bile acids
C
It presents with skin rash as the primary feature
✓ Correct
D
It may increase risk of stillbirth
Q50
Which of the following does not increase the risk of deep vein thrombosis (DVT) in pregnancy?
A
Previous VTE
B
Immobility
C
Parity ≥2 without other risk factors
✓ Correct
D
Obesity
Q51
Which of the following is correct regarding gestational trophoblastic neoplasia (GTN)?
A
Diagnosis always requires histopathology
B
Diagnosis does not require histopathology in all cases
✓ Correct
C
Serum hCG is not useful
D
It never follows a non‑molar pregnancy
Q52
Regarding treatment of VTE with LMWH in pregnancy, which of the following is correct?
A
Stop treatment at delivery
B
Treat for 6 weeks postpartum and at least 3 months total
✓ Correct
C
Do not treat postpartum
D
Oral anticoagulants are preferred during pregnancy
Q53
Regarding gestational diabetes screening with 50‑g glucose challenge, which is correct?
A
Plasma glucose ≥140 mg/dL at 1 hour is abnormal
B
Plasma glucose ≥180 mg/dL at 1 hour is diagnostic
✓ Correct
C
Fasting value alone is sufficient
D
Testing is only done postpartum
Q54
A Bishop score of 7 in a term pregnancy indicates:
A
No induction required
B
Induction with prostaglandin only
C
Amniotomy and oxytocin for induction
✓ Correct
D
Elective cesarean section
Q55
Which of the following is false about intrauterine growth restriction (IUGR)?
A
It is associated with increased perinatal morbidity
B
Asymmetrical IUGR usually has normal head circumference
C
Maternal hypertension is a risk factor
D
Hyperglycemia is a typical cause of IUGR
✓ Correct
Q56
Which of the following is not a cause of primary dysmenorrhea?
A
Excess prostaglandin production
B
Ovulatory menstrual cycles
C
Endometriosis
D
Endometrioma
✓ Correct
Q57
All of the following are suggestive of cephalopelvic disproportion (CPD) in labor except:
A
Failure of head descent
B
Persistent molding and caput
C
Arrest of cervical dilatation
D
The fetal head is well applied to the cervix
✓ Correct
Q58
Which of the following statements about LMWH and neuraxial anesthesia is wrong?
A
Timing of last dose should be considered before epidural
B
Platelet count should be checked if on heparin long term
C
Epidural catheter can be removed immediately after the last LMWH dose
✓ Correct
D
LMWH is safe in breastfeeding
Q59
Which of the following is correct regarding miscarriage?
A
Less than 5% of clinically recognized pregnancies miscarry
B
About 10% of clinically recognized pregnancies miscarry
C
About 15% of clinically recognized pregnancies miscarry
✓ Correct
D
More than 50% of clinically recognized pregnancies miscarry
Q60
In suspected missed miscarriage with uncertain viability, the recommended management is:
A
Immediate surgical evacuation
B
Repeat scan after 7 days
✓ Correct
C
Repeat scan after 24 hours
D
No follow‑up is needed
Q61
All of the following are indications for classical cesarean section except:
A
Transverse lie with back down and impacted head
B
Anterior placenta previa with poorly formed lower segment
C
Posterior placenta previa
✓ Correct
D
Dense adhesions preventing access to lower segment
Q62
Which of the following is false regarding anti‑D immunoglobulin?
A
Given after ectopic pregnancy managed surgically in Rh‑negative women
B
Given after spontaneous miscarriage after 12 weeks in Rh‑negative women
C
Given after evacuation of molar pregnancy in Rh‑negative women
D
Not needed in any first‑trimester loss regardless of gestation
✓ Correct
Q63
Which of the following statements about lactational amenorrhea method (LAM) is true?
A
It is effective only if breastfeeding is less than 4 times per day
B
It is effective up to 6 months if criteria are met
✓ Correct
C
It is effective regardless of return of menses
D
Formula supplementation does not affect its efficacy
Q64
Which of the following increases the success rate of the lactational amenorrhea method?
A
Reducing the number of feeds per day
B
Introducing early formula feeds
C
Increasing the frequency of breastfeeding
✓ Correct
D
Early introduction of solid foods
Q65
A 40‑year‑old multiparous woman presents with heavy menstrual bleeding. The best initial management is:
A
Hysterectomy
B
Endometrial ablation
C
Levonorgestrel intrauterine system (Mirena)
✓ Correct
D
Immediate myomectomy
Q66
Nuchal translucency measurement that is increased most commonly suggests:
A
Turner syndrome
B
Down syndrome (trisomy 21)
✓ Correct
C
Edwards syndrome only
D
Neural tube defect
Q67
The most common cause of postmenopausal bleeding is:
A
Endometrial polyp
B
Endometrial hyperplasia
C
Endometrial atrophy
✓ Correct
D
Endometrial carcinoma
Q68
Which of the following does not reduce the effectiveness of the lactational amenorrhea method (LAM)?
A
Increased frequency of breastfeeding
✓ Correct
B
Introduction of bottle feeding
C
Return of menses
D
Baby older than 6 months
Q69
A woman booked for elective cesarean section at 39 weeks asks about contraception postpartum. Which of the following is correct about LAM?
A
Breastfeeding prevents conception for 6 months if fully breastfeeding and amenorrheic
✓ Correct
B
Breastfeeding prevents pregnancy for 12 months regardless of menses
C
Breastfeeding has no contraceptive effect
D
LAM works even with regular formula feeds
Q70
Which of the following is false in obstetric cholestasis?
A
Presents with pruritus, especially on palms and soles
B
Associated with raised bile acids
C
Presents primarily with skin rash and excoriation
✓ Correct
D
Associated with increased risk of stillbirth
Q71
In women with epilepsy and pregnancy planning, which statement is false?
A
Monotherapy is preferred over polytherapy
B
Folic acid supplementation is important
C
Valproate carries a higher teratogenic risk
D
Monotherapy has a higher risk than polytherapy
✓ Correct
Q72
Which of the following is true about breech vaginal delivery?
A
Crowning is when the biparietal diameter passes the outlet
B
Crowning is when the bitrochanteric diameter passes under the symphysis pubis
✓ Correct
C
Crowning is defined only by the umbilicus at the introitus
D
Crowning is not applicable to breech delivery
Q73
Which statement about uterine fibroids (leiomyomas) is false?
A
They are estrogen‑dependent
B
They may increase in size during pregnancy
✓ Correct
C
They may cause heavy menstrual bleeding
D
They may cause subfertility depending on location
Q74
Which physiological change in pregnancy is incorrect?
A
Plasma volume increases
B
Cardiac output increases
C
Serum albumin concentration increases
✓ Correct
D
Systemic vascular resistance decreases
Q75
Regarding antepartum hemorrhage (APH), which statement is false?
A
Placenta previa and abruption are main causes
B
The amount of vaginal blood loss may underestimate total loss
✓ Correct
C
Maternal vital signs help assess severity
D
Ultrasound is useful in diagnosis
Q76
Which of the following is false about physiological changes in pregnancy?
A
Blood volume increases
B
Heart rate increases
C
Albumin levels increase
✓ Correct
D
Systemic vascular resistance decreases
Q77
Regarding intrauterine growth restriction (IUGR), which of the following is false?
A
Symmetrical IUGR affects head and abdomen equally
B
Asymmetrical IUGR usually has normal head circumference
C
IUGR fetuses are more prone to hypoglycemia
D
IUGR fetuses are more prone to hyperglycemia
✓ Correct
Q78
The best diagnostic tool for placenta previa is:
A
Transabdominal ultrasound
B
Transvaginal ultrasound
✓ Correct
C
MRI
D
CT scan
Q79
Which of the following is not a cause of primary dysmenorrhea?
A
Ovulatory cycles with excess prostaglandins
B
Adenomyosis
C
Endometrioma
✓ Correct
D
No pelvic pathology on examination
Q80
All of the following are suggestive of cephalopelvic disproportion (CPD) except:
A
Failure of head engagement
B
Persistent high head in primigravida
C
Head well applied to the cervix
✓ Correct
D
Arrest of descent in second stage
Q81
Which of the following is correct regarding clinically recognized pregnancies?
A
5% miscarry
B
10% miscarry
C
15% miscarry
✓ Correct
D
40% miscarry
Q82
In suspected missed miscarriage with inconclusive ultrasound findings, recommended management is:
A
Immediate medical evacuation
B
Repeat scan after 7 days
✓ Correct
C
Repeat scan after 1 day
D
No follow‑up required
Q83
All of the following are indications for classical cesarean section except:
A
Transverse lie with impacted head
B
Anterior placenta previa with poor lower segment
C
Posterior placenta previa
✓ Correct
D
Dense pelvic adhesions preventing access to lower segment
Q84
Which of the following about anti‑D administration is false?
A
Given after surgical evacuation of ectopic pregnancy in Rh‑negative women
B
Given after spontaneous miscarriage after 12 weeks in Rh‑negative women
C
Given after all surgical uterine evacuations in Rh‑negative women
D
Never required after any late miscarriage
✓ Correct
