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WorksheetsPreeclampsia and Eclampsia MCQs
Total questions: 59
Worksheet time: 42mins
Which of the following is NOT a component of the Modified Obstetric Early Warning Score (MEOWS)?
A. Respiratory rate
B. Urine output
C. Fundal height
D. Oxygen saturation
Which of the following is NOT a component of the obstetric shock index?
Heart rate
Systolic blood pressure
Respiratory rate
Shock index calculation (HR/SBP)
Which is the most specific indicator of end-organ perfusion in shock?
Blood pressure
Pulse rate
Urine output
Capillary refill time
What is the most likely consequence of untreated prolonged hypovolemic shock in pregnancy?
Polyhydramnios
Uterine rupture
Acute tubular necrosis
Pulmonary embolism
Which of the following is the best method for early recognition of impending septic shock in obstetrics?
Serum lactate >2 mmol/L
Blood pressure <90/60 mmHg
Platelet count <100,000
WBC >15,000/mm³
The Swansea criteria for diagnosis of acute fatty liver of pregnancy include all of the following EXCEPT:
Hypoglycemia
Leukocytosis
Hyperbilirubinemia
Hypercalcemia
The pathophysiological mechanism of intrahepatic cholestasis of pregnancy is primarily due to:
Autoimmune destruction of bile ducts
Genetic variants affecting bile salt export pump (BSEP) and multidrug resistance protein 3 (MDR3)
Viral hepatitis
Microvascular thrombosis
Which of the following statements about ursodeoxycholic acid (UDCA) use in intrahepatic cholestasis of pregnancy is CORRECT?
UDCA has been proven to reduce the incidence of stillbirth
UDCA primarily improves pruritus and biochemical markers but impact on fetal outcomes is uncertain
UDCA is contraindicated in pregnancy due to teratogenicity
UDCA increases serum bile acids
The primary mechanism of hepatic injury in acute viral hepatitis E infection during pregnancy is thought to be:
Direct viral cytopathic effect
Immune-mediated hepatocyte injury
Ischemic injury due to shock
Autoimmune antibody-mediated injury
Which of the following is the most sensitive test for detecting hemolysis in HELLP syndrome?
Lactate dehydrogenase (LDH)
Total bilirubin
Haptoglobin
Reticulocyte count
In the pathogenesis of preeclampsia, what role does endothelial dysfunction play?
Increased vascular permeability and hypertension
Decreased blood pressure and hypovolemia
Enhanced placental perfusion
Reduced coagulation and bleeding tendency
A woman with preeclampsia with severe features develops acute pulmonary edema. Which of the following is the best immediate management?
IV fluids bolus
IV furosemide and oxygen supplementation
Continue magnesium sulfate without modification
Start oral nifedipine
When should low-dose aspirin be started for preeclampsia prevention in high-risk women?
After 20 weeks gestation
Before 16 weeks gestation
At 28 weeks gestation
Only after preeclampsia develops
Which of the following is NOT a contraindication for expectant management in severe preeclampsia?
Uncontrolled severe hypertension
Oliguria (<500 mL/day)
Stable maternal and fetal condition at 32 weeks
Eclampsia
Which of the following findings mandates urgent delivery in a patient with hypertensive disorder of pregnancy?
Mild proteinuria and controlled BP
Severe thrombocytopenia with evidence of DIC
Controlled severe hypertension without symptoms
Stable maternal and fetal monitoring
The main cause of convulsions in eclampsia is:
Hypocalcemia
Cerebral edema and vasospasm
Hypernatremia
Hypoglycemia
Pritchard regimen for MgSO₄ includes loading dose:
4 g IV + 10 g IM (5 g each buttock)
4 g IM + 10 g IV
5 g IV + 5 g IM
10 g IV only
Toxic level of serum magnesium is above:
2 mEq/L
5 mEq/L
8 mEq/L
10 mEq/L
Antidote for magnesium toxicity is:
Calcium carbonate
Calcium gluconate
Calcium chloride
Potassium chloride
PPH is defined as blood loss more than:
300 mL after delivery
400 mL after delivery
1000 mL after delivery
500 mL after delivery
Most common cause of PPH is:
Trauma to genital tract
Retained placenta
Uterine atony
Coagulopathy
Secondary (late) PPH occurs:
Within 6 hours of delivery
Within 12 hours of delivery
after 24 hours to 6 weeks after delivery
Ergometrine is contraindicated in:
Diabetes
Preeclampsia
Heart disease
Asthma
Tranexamic acid should be given within:
1 hour
3 hours
6 hours
12 hours
Antepartum hemorrhage is defined as:
Bleeding before 20 weeks of pregnancy
Bleeding after 20 weeks and before onset of labor
Bleeding during labor
Bleeding within 24 hours after delivery
Most common cause of APH is:
Placenta previa
Abruptio placentae
Local cervical causes
Vasa previa
Painless, bright red bleeding in third trimester is characteristic of:
Placenta previa
Abruptio placentae
Vasa previa
Cervical polyp
Painful, tense uterus with dark blood and fetal distress suggests:
Placenta previa
Abruptio placentae
Cervical erosion
Vasa previa
Couvelaire uterus is seen in-
Placenta previa
Abruptio placentae
Cervical erosion
Vasa previa
The maternal mortality ratio (MMR) is defined as:
Number of maternal deaths per 1000 live births
Number of maternal deaths per 100,000 live births
Number of neonatal deaths per 100,000 live births
Number of maternal deaths per 10,000 pregnancies
Which of the following is a common indirect cause of maternal mortality?
Pulmonary tuberculosis
Placenta accreta
Abruptio placentae
Retained placenta
A pregnant woman at 30 weeks with Hb 6.8 g/dL and signs of cardiac failure. Best management according to FOGSI/GoI guidelines:
Oral iron therapy
Parenteral iron sucrose
Packed cell transfusion
Intravenous ferric carboxymaltose
A 26-year-old G2P1 presents with Hb 8.5 g/dL, MCV 72 fL, peripheral smear shows microcytic hypochromic anemia. Serum ferritin is normal, HbA2 is 5.8%. Diagnosis?
Iron deficiency anemia
Thalassemia trait
Megaloblastic anemia
Sideroblastic anemia
Under Anemia Mukt Bharat (AMB) strategy, which of the following is NOT one of the “6x6x6” interventions?
Weekly IFA supplementation for adolescents
Deworming for pregnant women
Screening and treatment of fluorosis
Intensified behavior change communication
Which of the following iron-folic acid (IFA) supplementation regimens is recommended by the Government of India for prophylaxis in pregnancy?
60 mg elemental iron + 0.5 mg folic acid daily for 100 days after first trimester
100 mg elemental iron + 1 mg folic acid daily throughout pregnancy
60 mg elemental iron + 500 µg folic acid daily from 14–16 weeks till 6 months postpartum
100 mg elemental iron + 500 µg folic acid weekly throughout pregnancy
A 22-year-old primigravida at 26 weeks presents with Hb 8.2 g/dL, MCV 70 fL, and serum ferritin 15 µg/L. She is compliant with oral IFA for 3 weeks, but her Hb has not improved. What is the next best step according to FOGSI/GoI guidelines?
Continue oral IFA for 1 month more
Switch to intravenous iron sucrose therapy
Add vitamin B12 injections
Advise blood transfusion
Which is the most common benign uterine tumor causing AUB?
Endometrial polyp
Adenomyoma
Leiomyoma
Nabothian cyst
Which laboratory test is essential in the initial evaluation of AUB in all reproductive-aged women?
Prolactin
TSH
Serum FSH
Urine pregnancy test
A 52-year-old postmenopausal woman presents with vaginal bleeding. First investigation?
Pap smear
Hysteroscopy
Transvaginal ultrasound
Endometrial sampling
The most effective long-term medical therapy for AUB in women not desiring fertility is:
Oral contraceptive pills
Tranexamic acid
Levonorgestrel IUD
Medroxyprogesterone acetate
Which of the following investigations is mandatory in all women >45 years with AUB?
Transvaginal sonography
Hormonal assay
Endometrial biopsy
Pap smear
The definitive treatment for AUB due to endometrial hyperplasia with atypia is:
LNG-IUS
Hysteroscopic polypectomy
Endometrial ablation
Hysterectomy
A 40-year-old woman with heavy menstrual bleeding has a 4 cm submucosal fibroid. Best management is:
Observation
Tranexamic acid
Hysteroscopic myomectomy
Hysterectomy
Which of the following is not a recommended use of endometrial ablation?
Completed family
Endometrial hyperplasia with atypia
Heavy menstrual bleeding
Failure of medical therapy
The best time to perform HSG is:
Day 1–3 of cycle
Day 6–10 of cycle
Day 14 (ovulation)
Day 21 (luteal phase)
Which of the following best defines infertility?
Inability to conceive after 6 months of unprotected intercourse
Inability to conceive after 12 months of regular unprotected intercourse
Inability to conceive after 18 months regardless of contraception
Inability to conceive with irregular cycles
In women >35 years, infertility evaluation should begin after:
6 months of unprotected intercourse
12 months of unprotected intercourse
3 months of trying to conceive
18 months regardless of age
Which hormone is the most reliable indicator of ovarian reserve?
Anti-Müllerian hormone (AMH)
Follicle-stimulating hormone (FSH)
Luteinizing hormone (LH)
Estradiol
First-line ovulation induction drug for PCOS-related infertility is:
Clomiphene citrate
Letrozole
Gonadotropins
Metformin
What is the WHO lower reference limit for normal sperm motility (progressive)?
20%
32%
50%
60%
Which test is considered gold standard for assessing tubal patency?
HSG
Saline infusion sonography
Laparoscopy with chromopertubation
MRI pelvis
Endometriosis most commonly causes infertility by:
Endometrial atrophy
Tubal blockage
Ovulatory suppression
Uterine anomalies
Which of the following abnormalities can be detected using hysteroscopy?
uterine polyp
uterine septum
asherman's syndrome
all of the above
What is the recommended flow rate for insufflation during laparoscopy?
1-2 l/min
2-5 l/min
5-10 l/min
10-15 l/min
Hysteroscopic fluid overload can lead to?
Hyponateremia
hypernateremia
dehydration
What is the recommended angle for inserting a laparoscope during abdominal entry?
0-30 degrees
30-45 degrees
45-60 degrees
60-90 degrees
What intra-abdominal pressure should be maintained while operating in laparoscopy?
8-10 mmhg
12-14 mmhg
16-18 mmhg
20-22 mmhg
Which of the following is NOT considered a component of Emergency Obstetric Care (EmOC)?
Administration of parenteral antibiotics
Cesarean section
Blood transfusion
Routine ultrasound scan
Which intervention has shown the greatest impact on reducing deaths due to postpartum hemorrhage?
Active management of the third stage of labor (AMTSL)
Routine cesarean section
Early epidural analgesia
Prolonged bed rest postpartum
