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Total questions: 150
Worksheet time: 1hrs 15mins
Persistent nausea and vomiting related to pregnancy is most indicative of which condition?
Morning sickness
Multiple gestation
Hyperemesis gravidarum
Hypertensive disorders
Which complication is associated with hyperemesis gravidarum?
Wernicke’s encephalopathy
Sheehan’s syndrome
Maurice encephalitis
Antepartum bleeding
Which specific management step is appropriate for moderate pre‑eclampsia?
Admission at first contact
Managing as an outpatient case
Admission in the intensive care unit
Encouraging plenty of oral fluids
Arched back and tightly clenched teeth are features of which stage of eclampsia?
Clonic
Tonic
Premonitory
Coma
Which combination lists causes of polyhydramnios?
Congenital abnormalities and chorioangioma
Severe fetal hypoxia and multiple pregnancy
Uncontrolled diabetes mellitus and anaemia
Rhesus D isoimmunisation and post‑datism
Which are neonatal complications of eclampsia?
Cerebral haemorrhage and pneumonia
Severe asphyxia and prematurity
Fractures and soft tissue trauma
Respiratory distress and hypoglycaemia
Recall the condition: Intense, persistent vomiting in pregnancy leading to dehydration and electrolyte imbalance is termed what?
Hyperemesis gravidarum
Ptyalism gravidarum
Morning sickness
Gastroenteritis of pregnancy
Applying concepts of management, which action best prioritizes maternal safety in moderate pre‑eclampsia when resources for close monitoring are available?
Immediate hospital admission for observation and antihypertensive planning
Home bed rest with weekly clinic reviews
Direct transfer to ICU regardless of symptoms
Oral rehydration and discharge with advice
Reasoning with seizure stages in eclampsia, which stage primarily involves sustained muscle contraction causing rigid posture?
Clonic stage
Tonic stage
Post‑ictal coma
Premonitory phase
Which maternal‑fetal association is most consistent with polyhydramnios based on the listed etiologies?
Fetal structural anomalies including chorioangioma as placental tumor
Maternal anemia as a sole cause without fetal factors
Exclusive association with post‑term pregnancy only
Hypertensive disorders as the primary determinant
Indicate whether each statement is True or False based on the listed claims: i) Prenatal tuberculosis always leads to neonatal tuberculosis. ii) Clinical features of tuberculosis prenatally are anaemia, intrauterine fetal death, and glycosuria among others.
i) True; ii) True
i) True; ii) False
i) False; ii) True
i) False; ii) False
Evaluate the twinning statements and choose the correct True/False combination: i) Congenital malformations are common in monozygotic twinning. ii) Dichorionicity only occurs in dizygotic twinning.
i) True; ii) True
i) True; ii) False
i) False; ii) True
i) False; ii) False
Productive cough, dyspnoea at rest, and generalized oedema are among the features of which condition?
Folate deficiency
Very severe anaemia
Mild iron deficiency
Severe anaemia
Incidental antepartum haemorrhage is also referred to as which of the following?
Intraplacental haemorrhage
Intrapartum haemorrhage
Extraplacental haemorrhage
Preterm haemorrhage
Chemical diabetes mellitus is a classification based on which criterion?
Symptoms are absent and abnormal specific laboratory results
Presence of symptoms and abnormal specific laboratory results
Previous congenital abnormalities and unexplained stillbirth
Previous birth of a baby weighing more than 4.3 kg and spontaneous abortion
Diamorphic anaemia results due to a deficiency of which combination?
Iron and thiamine
Iron and folic acid
Folic acid and thiamine
Liver enzymes and iron
Which of the following is identified as a major predisposing factor to cardiac disease in pregnancy?
Rheumatic heart disease
Notable peripheral oedema
Easy fatiguability
Basal crepitation
Considering the item on productive cough, dyspnoea at rest, and generalized oedema, which option best distinguishes very severe anaemia from mild iron deficiency?
Presence of generalized oedema and dyspnoea at rest suggests very severe anaemia
Both conditions present identically; laboratory tests are the only distinction
Mild iron deficiency commonly presents with productive cough and oedema
Mild iron deficiency exclusively causes dyspnoea at rest
Which choice best explains why the term 'chemical diabetes mellitus' emphasizes laboratory criteria?
Because diagnosis relies on abnormal specific lab results in the absence of symptoms
Because it is defined by patient-reported symptoms alone
Because it is triggered by congenital anomalies irrespective of lab values
Because it is diagnosed only after a macrosomic birth and spontaneous abortion
If incidental antepartum haemorrhage is termed 'extraplacental', what inference can be made about 'intraplacental' bleeding?
It would denote bleeding originating within the placental tissue itself
It would refer to bleeding after delivery rather than before
It would indicate bleeding confined to the cervix only
It would be synonymous with preterm labour without bleeding
According to the listed New York Heart Association classifications, which clinical feature corresponds to cardiac disease grade III?
Patient is comfortable even at rest
Patient is asymptomatic initially
Marked limitation of physical activity
Absolute limitation of physical activity
Which organism is identified as the most common cause of acute pyelonephritis in pregnancy in the provided options?
Streptococcus faecalis
Escherichia coli
Proteus vulgaris
Staphylococcus aureus
For uncomplicated malaria during the second trimester, which approach is stated as the priority management regarding route and drug?
Oral quinine
Parenteral quinine
Artemether lumefantrine
Sulphadoxine pyrimethamine
During vaginal examination, which finding is indicative of an abnormal labour pattern as per the options provided?
The vagina is warm and moist
Cervical canal is long and thick
Cervical canal is short and thin
The vagina is hot and dry
Which statement correctly characterizes secondary postpartum haemorrhage according to the item set?
Mostly occurs between the 8th–14th day post-partum
Results due to bleeding immediately after delivery
Can extend up to the first 46 days following delivery
Is diagnosed by presence of persistent lochia serosa
Which option represents a non-pharmacological measure of pain relief in labour among the choices listed?
Entonox
Cyclothane
Homeopathy
Considering the classification of functional capacity in heart disease, which option best contrasts grade I with grade IV based on the provided choices?
Grade I: asymptomatic initially; Grade IV: comfortable at rest
Grade I: comfortable even at rest; Grade IV: absolute limitation of physical activity
Grade I: marked limitation of physical activity; Grade IV: asymptomatic initially
Grade I: absolute limitation of physical activity; Grade IV: marked limitation
Based on the antimalarial options provided, which regimen is not indicated as the priority management for uncomplicated malaria in the second trimester?
Artemether lumefantrine
Oral quinine
Parenteral quinine
Sulphadoxine pyrimethamine
From the options about vaginal examination findings, which pair correctly matches normal versus abnormal with respect to labour pattern as implied by the item?
Normal: cervix short and thin; Abnormal: cervix long and thick
Normal: vagina hot and dry; Abnormal: vagina warm and moist
Normal: cervix long and thick; Abnormal: cervix short and thin
Normal: absolute limitation of physical activity; Abnormal: marked limitation
Which timing statement is least consistent with the definition of secondary postpartum haemorrhage within the provided options?
Mostly occurs between days 8–14 post-partum
Can extend up to day 46 after delivery
Results from bleeding immediately after delivery
Is associated with the late puerperium timeframe
Indicate whether the statement is TRUE or FALSE: The most common cause of immediate postpartum haemorrhage is trauma to the genital tract during delivery.
True
False
Indicate whether the statement is TRUE or FALSE: There are four major principles to follow in the specific management of a mother with immediate postpartum haemorrhage.
True
False
In monozygotic twinning, splitting after the twelfth day of fertilization is highly associated with which outcome?
Fetal papyraceous
Premature birth
Siamese twin
Diamniotic twin
Which drug is the agent of choice in the management of eclampsia?
Phenobarbitone
Magnesium sulphate
Calcium gluconate
Sodium bicarbonate
The main clinical feature in Hyperemesis gravidarum is best described as which of the following?
Persistent vomiting or nausea
Persistent sight-related problems
Persistent diarrhea and vomiting
Frequency or urgency of micturition
Wernicke’s encephalopathy and Mallory–Weiss syndrome are among the complications of which condition?
Placenta praevia
Hypertensive disorders
Vitamin B deficiency
Hyperemesis gravidarum
Uterine apoplexy is associated with which of the following?
Incidental haemorrhage
Postpartum endometritis
Puerperal sepsis
Subinvolution of the uterus
Immediate postpartum haemorrhage most commonly results from which cause?
Uterine atony
Trauma to the genital tract
Retained placenta
Coagulation disorders
For eclampsia management, which of the following statements is most accurate regarding first-line therapy?
Phenobarbitone is preferred due to rapid sedation
Magnesium sulphate is preferred to prevent and control seizures
Calcium gluconate is used to induce diuresis
Sodium bicarbonate corrects hypertension
Late splitting in monozygotic twinning (after day 12) most likely results in conjoined twins because the embryonic disc separation is incomplete. Based on this, which description aligns with the expected chorionicity and amnionicity?
Dichorionic, diamniotic with two placentas
Monochorionic, diamniotic with two amniotic sacs
Monochorionic, monoamniotic with a single sac
Dichorionic, monoamniotic with fused placentas
Which condition is a common cause of uterine bleeding in early pregnancy?
Placental abruption
Multiple pregnancy
Placenta praevia
Ectopic pregnancy
A positive fasting blood sugar and a positive oral glucose tolerance test, in a symptomatic patient, are diagnostic of which condition?
Potential diabetes mellitus
Gestational diabetes mellitus
Clinical diabetes mellitus
Chemical diabetes mellitus
A neonate born to a diabetic mother should be fed within the first 15 minutes primarily to prevent which complication?
Hypocalcaemia
Hypoglycaemia
Hyponatraemia
Hypokalaemia
Which option is associated specifically with dizygotic twinning?
Conjoined twins
Polyhydramnios
Superfecundation
Foetus compressus
On percussion, which finding is considered a diagnostic factor of polyhydramnios?
Muffled fetal heart sounds
Presence of a dull sound
Excessive fetal movements
Presence of a fluid thrill
What is the immediate management for a neonate whose mother is TB smear positive at birth? Choose the correct isoniazid regimen.
Isoniazid 5 mg/kg daily for 3 months
Isoniazid 5 mg/kg daily for 3 weeks
Isoniazid 5 mg/kg daily for 6 weeks
Isoniazid 5 mg/kg daily for 6 months
Complete placenta praevia is also referred to as which type?
Type I (low-lying)
Type II (marginal)
Type III (partial)
Type IV (total)
In polyhydramnios, which clinical feature listed is least helpful for percussion-based diagnosis and more related to auscultation?
Muffled fetal heart sounds
Presence of a dull sound
Presence of a fluid thrill
Tympanic note over bowel loops
Which complication is more characteristically linked with placenta praevia rather than placental abruption?
Painful vaginal bleeding with uterine tenderness
Painless vaginal bleeding in late pregnancy
Rigid, board-like uterus with concealed bleed
Fetal distress from abrupt hypoxia
Superfecundation in the context of twinning most accurately describes which scenario?
Fertilization of two ova by sperm from separate acts of intercourse
Division of a single embryo leading to monozygotic twins
Fusion of two embryos resulting in conjoined twins
Compression of one twin causing foetus compressus
Haematinics, dietary advice, and close surveillance are management plans for which condition?
Moderate anaemia
Mild anaemia
Severe anaemia
Anaemia prevention
Which is a predisposing factor to cardiac disease in pregnancy?
Pulmonary oedema
Easy fatigability
Basal crepitation
Severe anaemia
Which clinical feature is suggestive of acute pyelonephritis in pregnancy?
Kinking of the ureters
Vesico-ureteric reflux
Fishy smell in urine
Uncontrolled diabetes
A pregnant woman with acute pyelonephritis is advised on a high fluid intake primarily to:
Promote enough rest
Correct dehydration
Relieve irritability
Increase urine output
The priority management of uncomplicated malaria during the second trimester includes administration of:
Oral quinine
Parenteral quinine
Artemether lumefantrine
Sulfadoxine pyrimethamine
In the context of anaemia in pregnancy, which severity level typically warrants haematinics and dietary counselling rather than transfusion?
Mild anaemia
Moderate anaemia
Severe anaemia
No anaemia
Which factor listed is most directly a cardiac complication rather than a predisposing factor in pregnancy?
Pulmonary oedema
Easy fatigability
Basal crepitation
Severe anaemia
Which urinary finding best indicates an underlying mechanism for acute pyelonephritis in pregnancy?
Kinking of the ureters due to uterine enlargement
Vesico-ureteric reflux promoting ascending infection
Fishy odour suggesting bacterial vaginosis
Hyperglycaemia associated with uncontrolled diabetes
For acute pyelonephritis in pregnancy, the rationale for high fluid intake most closely aligns with which physiological goal?
Enhancing diuresis to flush bacteria
Improving sleep quality to aid recovery
Correcting electrolyte abnormalities primarily
Reducing uterine irritability
Which antimalarial is preferred as first-line for uncomplicated malaria specifically in the second trimester?
Quinine (any route) due to historical safety
Artemether-lumefantrine as combination therapy
Primaquine because it targets hypnozoites
Sulfadoxine-pyrimethamine as intermittent preventive therapy
Which statement about malaria prophylaxis during pregnancy is correct according to the excerpt?
Sulfadoxine–Pyrimethamine should be given to all pregnant women in malaria endemic zones
All pregnant women in malaria endemic zones are assumed free of malaria parasites until tested
Sulfadoxine–Pyrimethamine should be administered with each alternate visit after quickening
All antenatal clients in Kenya should receive intermittent presumptive treatment of at least six doses
The excerpt lists a commonly used inhalational analgesic during labour. Which option matches it?
Entonox
Trilene
Oxygen
Nitrous oxide
Which feature in the list is indicative of an abnormal labour pattern?
Presence of the retraction ring
Presence of the bandl’s ring
Cervical canal short and thin
Vagina is warm and moist
Post‑partum haemorrhage is noted as likely to lead to acute renal failure due to which mechanism?
Sheehan’s syndrome
Disseminated intravascular coagulation
Hypovolaemia leading to tubules necrosis
Asherman’s syndrome
Placental parasitisation is associated with which antenatal condition, as stated in the list?
Malaria prenatally
Candidiasis prenatally
Tuberculosis prenatally
Multiple gestation
Complete placenta praevia is also referred to as which type in the classification given?
Type 4
Type 2
Type 1
Type 3
Based on the options provided, which choice best distinguishes an analgesic gas from a supportive gas in labour management?
Nitrous oxide functions primarily as an analgesic agent when used appropriately
Oxygen serves as the standard inhalational analgesic for pain relief
Entonox is avoided because it has no analgesic properties
Trilene is preferred because it improves tissue oxygenation rather than analgesia
Using the stated prophylaxis guidance, which approach aligns with public‑health practice in malaria‑endemic pregnancy care?
Administer Sulfadoxine–Pyrimethamine broadly to pregnant women in endemic regions as prophylaxis
Delay prophylaxis until quickening, then give at alternate visits
Withhold prophylaxis until a positive parasitaemia test is obtained
Limit intermittent preventive treatment to a maximum of two doses
What complication pathway is explicitly linked to acute renal failure in the text?
Massive haemorrhage causing hypovolaemia and tubular necrosis
Pituitary infarction characteristic of Sheehan’s syndrome
Intrauterine adhesions known as Asherman’s syndrome
Peripheral clotting defects unrelated to blood loss
Which anatomical sign signals pathologic uterine activity during labour as per the list?
Bandl’s ring
Warm and moist vagina
Short and thin cervical canal
Retraction ring as a normal variant
Bruised and oedematous appearance of the uterus associated with placental abruption is collectively referred to as which condition?
Wernicke’s encephalopathy
Uterine prolapse
Couvelaire uterus
Asherman’s syndrome
What is identified as the main feature of hyperemesis gravidarum?
Pallor or cyanosis of mucous membranes
Inability to eat or retain food throughout
Weakness due to a severe state of shock
Smaller fundal height compared to dates
Which factor can lead to placenta praevia?
Grandmultiparity
Preeclampsia
Placenta fenestrate
Placenta increta
Mallory–Weiss syndrome is a complication of which condition?
Placenta praevia
Cardiac disease
Postpartum haemorrhage
Hyperemesis gravidarum
Bishop’s score is based on which combination of parameters?
Descent, presentation and cervical dilatation
Position, attitude and cervical length
Descent, cervical length and dilatation
Cervical dilatation, lie and effacement
Total loss of polarity and fundal dominance leads to which labour pattern?
Precipitate labour
Hypotonic uterine inertia
Uterine tetany
Incoordinate uterine action
Placenta accreta variants include increta and percreta. Which listed option is not a risk factor for placenta praevia according to the set?
Grandmultiparity
Preeclampsia
Placenta increta
Placenta fenestrate
Which terminology corresponds to the bluish, ecchymotic infiltration of the uterine musculature due to extravasation of blood in placental abruption?
Asherman’s syndrome
Couvelaire uterus
Uterine inversion
Subinvolution of the uterus
Hyperemesis gravidarum most directly predisposes to which mucosal tear syndrome from severe vomiting?
Boerhaave syndrome
Mallory–Weiss syndrome
Cervical laceration
Esophageal variceal rupture
In evaluating labour readiness, which element is NOT part of Bishop’s score as presented?
Effacement
Cervical dilatation
Lie
Presentation
Which condition is characterized by dysfunctional cervical opening during labor?
Colicky uterus
Spontaneous labour
Cervical dystocia
Uterine atony
Among the major predisposing factors of cardiac disease prenatally, which pair is most appropriate?
Rheumatic heart disease and leukaemia
Ischaemic heart disease and dehydration
Uncontrolled hypertension and obesity
Smoking and peptic ulcer disease
Which of the following is NOT a source of pain in labour?
Uterine contractions
Socio-cultural norms
Cervical dilatation
Pelvic floor stretching
Placenta praevia is also referred to as unavoidable haemorrhage because:
Bleeding results as the segment preparations for true labour
Bleeding results from pathological processes of the placenta
Bleeding always occurs after a gestation of 37 complete weeks
Of the high morbidity and mortality rate to the mother and neonate
The commonest causative organism of pyelonephritis is:
Streptococcus faecalis
Proteus vulgaris
Staphylococcus pyogene
Escherichia coli
Effects of pregnancy on malaria are best summarized as:
Development of severe anaemia and severe jaundice
Blood smear is always positive and severe anaemia
Therapy limitation and few parasites in severe case
Loss of pregnancy and severe condition in few parasites
Management plans that include haematinics, dietary advice, and close surveillance are indicated for which severity?
Severe anaemia
Moderate anaemia
Mild anaemia
Physiological anaemia only
Which option best explains why socio-cultural norms are not considered a physiological source of labour pain?
They are unrelated to perception and coping mechanisms
They do not contribute to tissue stretch or ischemia
They decrease uterine contractility directly
They primarily cause cervical dystocia
Select the pair that incorrectly lists a prenatal cardiac risk factor with an unrelated condition.
Rheumatic heart disease and leukaemia
Ischaemic heart disease and dehydration
Uncontrolled hypertension and obesity
Smoking and peptic ulcer disease
Why is Escherichia coli considered the most common agent in pyelonephritis during pregnancy?
It is the predominant skin flora contaminant
It commonly colonizes the gastrointestinal tract and ascends
It is transmitted primarily via transplacental routes
It is resistant to all first-line antibiotics
Effects of preeclampsia on the reproductive systems include which combination below?
Development of infarcts and placental abruption
Lowered vaginal discharge pH and haemorrhage
Congestive cardiac failure and fetal hypoxia
Poor placental anchorage and severe infarction
Which statement about polyhydramnios is correct?
Acute polyhydramnios has a gradual onset as from 20 weeks
Multiple pregnancy is a cause especially in dizygotic twinning
Chronic polyhydramnios has a gradual onset as from 30 weeks
On inspection, the abdomen is ovoid instead of being globular
Which one of the following is a cause of oligohydramnios?
Absence of fetal urine production
Excessive fetal urine production
Blockage of the fetal gastro-intestinal tract
Dizygotic twinning leading to twin-to-twin transfusion
T.B. in pregnancy predisposes a mother to premature labour primarily due to which factor?
Poor maternal appetite
Severe anaemia experienced
Adverse reactions of anti-T.B. drugs
The fever experienced
A client diagnosed with gestational diabetes at 24 weeks is scheduled for antenatal care (ANC) how often?
Weekly up to 28 weeks
Two weekly up to 28 weeks
Four weekly up to 28 weeks
Three weekly up to 28 weeks
Which therapy is most incorporated in the management of clients with gestational diabetes?
Therapeutic diet alone
Long-acting insulin
Exercise only
Short course oral hypoglycemics without monitoring
Considering the pathophysiology implied, which maternal finding best supports a diagnosis of chronic polyhydramnios rather than acute polyhydramnios?
Rapid abdominal distension within days
Gradual increase in amniotic fluid volume after 30 weeks
Severe pain with sudden respiratory distress in the second trimester
Marked reduction of fundal height over one week
Which fetal condition most plausibly leads to oligohydramnios among the choices provided?
Renal agenesis causing minimal urine output
Duodenal atresia resulting in fluid accumulation
Placental chorioangioma increasing transudation
Fetal polyuria due to maternal hyperglycemia
In tuberculosis-complicated pregnancy, which targeted intervention most directly addresses the mechanism leading to preterm labor noted in the material?
Aggressive antipyretic therapy to curb fever
Iron supplementation to correct severe anaemia
Immediate cessation of all anti-T.B. drugs
High-calorie diet to reverse poor appetite
For a woman with gestational diabetes established at mid-pregnancy, which follow-up plan aligns with the stated ANC schedule and aims to balance resource use with risk?
Arrange weekly visits until 28 weeks to detect hypoglycemia early
Plan two-weekly visits with home glucose logs until 28 weeks
Schedule four-weekly visits up to 28 weeks with education on diet and warning signs
Set three-weekly visits to coincide with insulin titration only
Bipartite placenta and succenturiate lobe are identified as causes of which obstetric complication?
Placenta abruptio
Placental calcification
Placenta praevia
Placental insufficiency
Prenatally, malaria parasites primarily hide in which maternal-fetal site?
Bone marrow
Placental bed
Fetal circulation
Uterine muscle
Cardiac disease Grade 1 is also referred to as which of the following?
Organic disease
Mitral stenosis
Ventricular failure
Vascular disease
Homeopathy, music therapy, and hydrotherapy are categorized under which pain relief approach?
Systemic methods of pain relief
Regional analgesia methods of pain relief
Inhalational analgesia method of pain relief
Non-pharmacological methods of pain relief
The commonest causative agent of pyelonephritis is which organism?
Proteus vulgaris
Escherichia coli
Neisseria gonococci
Streptococcus faecalis
During induction of labor with syntocinon (oxytocin), the increase in infusion drops is stopped prematurely upon achieving which clinical sign?
Achieving three moderate contractions
Realizing normal maternal observations
Achieving progressive cervical dilatation
Detecting regular fetal movements
Which drug class is appropriate for immediate glycemic control due to its rapid onset?
Long-acting insulin
Oral hypoglycaemics
Short-acting insulin
Glucagon-like peptide agonists
Which placental abnormality involves an accessory lobe connected by membranes and is linked to placenta praevia risk?
Circumvallate placenta
Succenturiate lobe
Velamentous cord insertion
Placenta accreta
Which site best explains why malaria in pregnancy can persist despite maternal peripheral blood clearance?
Sequestration within hepatic sinusoids
Dormancy in the placental bed
Replication within maternal lymph nodes
Encystment in amniotic fluid
Which therapy among the following is least likely to involve medications when used for labor pain relief?
Systemic opioids
Epidural anesthesia
Nitrous oxide inhalation
Hydrotherapy
Which drug is identified as the drug of choice in the management of eclampsia?
Phenobarbitone
Calcium gluconate
Magnesium sulphate
Sodium bicarbonate
What is cited as the commonest major cause of primary postpartum haemorrhage?
Trauma of the genital tract
Blood coagulation disorder
Prolonged third stage
Atony of the uterus
Excessive bleeding from the genital tract after the first 24 hours but within the puerperium period is referred to as which type of postpartum haemorrhage?
Primary postpartum haemorrhage
Tertiary postpartum haemorrhage
Secondary postpartum haemorrhage
Incidental postpartum haemorrhage
Surgical induction of labour refers to which of the following interventions?
Cytotec and mechanical cervical dilatation
Sweeping of membranes and amniotomy
Mechanical cervical dilatation and buscopan
Artificial rupture of membranes and syntocinon
Perception and reaction to labour pain is stated to be highly influenced by which factor?
Labour preparedness and fatigue
Culture and age of the woman
Culture and level of education
Number of deliveries and anxiety
Uterine apoplexy is associated with which condition?
Postpartum haemorrhage
Hyperemesis gravidarum
Precipitate labour
In the listed options, which agent directly treats the cause of eclampsia rather than only its complications?
Calcium gluconate to reverse magnesium toxicity
Magnesium sulphate for seizure control
Phenobarbitone for mild sedation
Sodium bicarbonate for metabolic acidosis
Which scenario best matches the definition provided for secondary postpartum haemorrhage?
Bleeding within the first 24 hours after delivery
Bleeding after 24 hours and before six weeks postpartum
Spotting during active labour
Bleeding limited to the third stage only
Among the causes listed, which mechanism most directly explains the commonest cause of primary postpartum haemorrhage?
Failure of uterine muscles to contract effectively after delivery
Lacerations resulting from instrumental delivery
Inherited platelet function defects
Retention of membranes prolonging placental delivery
Which pair best represents non-surgical methods, contrasting with the defined surgical induction of labour?
Prostaglandin administration and cervical ripening balloon
Artificial rupture of membranes and oxytocin infusion
Amniotomy with membrane sweeping
Syntocinon combined with mechanical dilators
Based on vaginal examination findings, which set best indicates abnormal labour?
Bandl’s ring and oedematous vulva
Oedematous cervix and fetal hypoxia
Hot, dry vagina and arrest in descent
Maternal distress and severe moulding
Which condition is most strongly associated with inability to eat or retain feeds throughout the day prenatally?
Weight gain control
Hyperemesis gravidarum
Morning sickness
Presence of preeclampsia
In eclampsia, violent contraction and relaxation of the whole body typically occur during which stage?
Clonic stage
Coma stage
Premonitory stage
Tonic stage
A clinical diagnosis of polyhydramnios is based on amniotic fluid volume exceeding which threshold?
1500 mls
2500 mls
1900 mls
3000 mls
Which drug, when used by a pregnant woman, is most likely to lead to oligohydramnios?
Diazepam
Captopril
Ampicillin
Pethidine
Which statement correctly describes a characteristic of monozygotic twins?
Always of the same sex
Share a similar fingerprint pattern
Always share a single placenta
Always develop separate amniotic sacs
Which combination best reflects maternal and fetal signs pointing to abnormal labour on examination?
Maternal distress with severe moulding
Soft cervix with normal descent
Cool, moist vagina with rapid progress
Well-flexed head with intact membranes
Persistent vomiting severe enough to affect daily intake during pregnancy most closely aligns with which diagnosis?
Physiologic morning nausea
Hyperemesis gravidarum
Gastroenteritis unrelated to pregnancy
Food aversion due to taste changes
During an eclamptic seizure, which phase is characterized primarily by sustained muscle contraction before rhythmic jerking begins?
Tonic stage
Clonic stage
Premonitory stage
Coma stage
Among the listed volumes, which most clearly exceeds the clinical cutoff indicating polyhydramnios?
1900 mls
2000 mls
2500 mls
3000 mls
Which gestational age best defines postmaturity as pregnancy equal to or more than:
38 completed weeks
42 completed weeks
40 completed weeks
36 completed weeks
In marginal cephalopelvic disproportion, which statement is most accurate?
All patients will require an operative delivery
Half of the patients will require an operative delivery
The problem is always overcome during labor
The pelvis is too small for the fetus to pass through
Deep transverse arrest is best described as a situation:
Where flexion is always well maintained
Caused by strong uterine contractions throughout labor
Caused by a sacrum that is well curved
Where the level of the occiput and the sinciput is the same
Which is a recognized cause of shoulder presentation?
Macerated fetus
Postdates pregnancy
Oligohydramnios
Cephalopelvic disproportion
Diabetes in pregnancy predisposes a mother to vulvovaginitis primarily due to:
High acidity levels favoring growth of E. coli
Low acidity levels favoring growth of Candida albicans
Existing chronic hypertension
Lowered osmotic pressure
For a neonate exposed to tuberculosis with a smear-positive slide, the drug of choice for treatment is:
Rifampicin
Streptomycin
Isoniazid
Ethambutol
When considering cephalopelvic disproportion, which option best captures the meaning of the modifier “marginal”?
Disproportion so severe that vaginal birth is impossible
Disproportion that often allows trial of labor but has a higher chance of needing intervention
No true disproportion; labor always corrects the issue
Pelvis is anatomically normal and disproportion is only apparent on imaging
Which physiological change most directly explains the increased risk of Candida vulvovaginitis in pregnant patients with diabetes?
Reduced vaginal pH leading to fungal proliferation
Increased vaginal pH reducing bacterial competition
Hypertension impairing local immunity
Hyperosmolarity inhibiting neutrophil function
Which management implication follows from recognizing deep transverse arrest during labor?
Expectant management because contractions will usually resolve it
Assisted delivery or operative intervention may be required due to malrotation
Administration of tocolytics to enhance uterine relaxation
Immediate induction of labor to increase contraction strength
Which scenario most aligns with a clinical suspicion of shoulder presentation?
Palpation suggests longitudinal lie with cephalic pole in the pelvis
Findings indicate transverse lie with the acromion leading at the pelvic brim
Ultrasound shows frank breech with extended legs
Head is engaged with well-flexed occiput anterior position
In obstetrics, which complication is listed as option d) in the preceding item about causes? Choose the exact phrase.
Placental infarction
Placenta accreta
Placenta previa
Placenta abruption
The presenting diameter in brow presentation is best identified as which of the following?
Sublambdo-bregmatic
Suboccipito-frontal
Occipito-frontal
Mento-vertical
The lie of the fetus is defined as unstable when it keeps varying after which gestational age threshold?
36 weeks gestation
42 weeks gestation
38 weeks gestation
40 weeks gestation
When a hand or foot lies alongside the presenting part, the presentation is termed what?
Footling
Transverse
Compound
Cephalic
Which is a stated condition for conducting a trial of scar? Select the option exactly as phrased.
Estimated fetal weight less than 3600 g
Availability of a tertiary-care operating theater on site
Not more than two previous Caesarean section scars
An adequate pelvis with true conjugate 10.5 cm
Vaginal birth after Caesarean section is referred to as which of the following?
Spontaneous vaginal delivery
Trial of scar
Spontaneous vertex delivery
Trial of birth
Vasa praevia is most closely associated with which placental/cord condition listed here?
Velamentous insertion of the cord
Succenturiate insertion of the cord
Tripartite cord
Bipartite cord
Which pair correctly matches the abnormal presentation with its descriptor provided: brow presentation—presenting diameter?
Brow—suboccipito-bregmatic
Brow—occipito-frontal
Brow—submento-bregmatic
Brow—biparietal
Identify the term that names a presentation involving an extremity next to the presenting part, according to the list provided.
Compound
Footling
Shoulder
Vertex
Choose the correct threshold after which a varying fetal lie is labeled unstable, based on the options given.
After 36 weeks
After 38 weeks
After 40 weeks
After 42 weeks
