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MCQ BARD

The lymphatic drainage of the cervix is to the following lymph nodes except

A The femoral lymph nodes

B The internal iliac lymph nodes
C The paracervical lymph nodes
D Presacral lymph nodes
E Obturator lymph nodes

Ambiguous genitalia at birth may be associated with the following

A Congenital adrenal hyperplasia
B Maternal ingestion of danazol during pregnancy
C True hermaphroditism
D All of the above
E None of the above

As regard pituitary FSH hormones the following are true except

A Aglycoprotein
B Excreted in increased amount at menopause
C Stimulate spermatogenesis in male
D FSH and LH stimulate oestrogen secretion and ovulation
E Identical with human chorionic gonadotrphin

The function of mid cycle LH surge include the following except

A Enhance thecal cell androgen production
B Lutenizes granulose cells
C Intiate resumption of meiosis
D Faciltate ooocyt expulsion
E Produce luteolysis

The site of production of follicular estrogen is

A Granulosa cells
B Theca cells
C Stromal cells
D Endometrium
E Pituitary beta cells

Menopause could be diagnosed by

A history of absent menstruation

B High FSH level in young age group
C Absent menstruation for 1 year at the age of 52 year
D Hot flushes
E Insomnia
Contraindication to postmenpausal estrogen replacement therapy include the following except
A Resent deep vein thrombosis
B Acute liver disease
C High serum triglyceride
D Premenpausal mastectomy for breast cancer
E Diabetes mellitus

Hyperprolactinemia may be associated with all of the following except

A Chronic renal failure

B Hypothyrodism
C Pituitory adenoma
D Methyl dopa therapy
E Adrenogenital syndrome

The incorrect statement about a women presenting with cyclical menorrhagia at the age of 46 years
is

A Is likely to be cured by an oral progesterone

B May have uterine fibroid
C May require hysterectomy if medical treatment fails
D Shoud be treated with dilation and curettage
E May have uterine adenomyosis

The following is characteristics of Sheehan syndrome

A Profuse lactation
B Amenorrhea
C Hyperthyrodism
D Renal insufficiency
E Cushinoid faces

Accepted parameter for a normal semen analysis is

A A sperm count of 10 – 20 million per ml
B A volume of 1 ml
C 60 % motility
D 60 % abnormal forms
E A positive agglutination reaction

Suggestions of anovulation include the following except

A Flat cells with pyknotic nucleia on vaginal smears

B Distrubed menstrual cycles
C Serial ultrasound scans show show failure of follicle rupture
D Secretory changes detected at histological examination of the endometrium
E Monphasic basal body temperature
Facts about clomophene citrate include the following except
A Has antiestrogenic properties
B May be started with 50 mg dose daily
C Is useful in primary ovarian failure
D May cause cervical mucus hostility
E Multiple pregnancy may be a side effect of its use

Genital prolapse is associated with the following except

A Chronic constipation
B Prolonged second stage
C Unreparied hidden perineal tear
D Improper applied forceps
E The use of HRT at the menpause

An enterocele is best characterized by which of the following statement

A It is not true hernia

B It is herniation of the bladder floor into the vagina
C It is prolapse of the uterus and vaginal wall outside the body
D It is protrusion of the pelvic peritoneal sac and vaginal wall into the vagina
E It is a herniation of the rectal and vaginal wall into the vagina

The true statement about retroversion of the uterus is

A Is a common cause of infertility

B Should be corrected with a Hodge pessary
C May be corrected with a Fothergill operation
D Occurs in 20% of normal women
E Is caused with heavy lifting

The Manchester repair includes 193

A Amputation of the cervix

B Posterior colpoperieorrhaphy
C Anterior colporrhapphy
D All of the above
E None of the above

The following about candidal infection are correct except 196

A The infection is common with pregnancy

B Vaginal PH is usually alkaline
C Vulval itching may occur
D Vaginal isoconazol or micanzol are effective
E The organism is yeast like

As regard bacterial vaginosis all of the following are true except 201
A It is the commonest cause of vaginal infection
B The vaginal PH is usually below 4.5
C It may present with a fishy smell discharge
D Its fishy smell may increased after sexual intercourse
E It can be diagnosed by clue cells on gram staining vaginal discharge

The following are true about human papulloma virus except 210

A The disease is the most common viral STD

B Infection may lead to CIN and cervical cancer
C Infection may be warty or flat condyloma
D Can be treated by trichloroacetic acid
E HPV infection is not associated with other STDs

The following confirm the diagnosis of PID 213

A Laparoscopy
B White blood cells
C Culdocentesis
D Cervical gram stain
E Pelvic ultrasound

Urethral caruncle 263

A Usually covered with transitional epithelium

B Usually asymptomatic
C May resemble urethural carcinoma
D All of the above
D None of the above

The following could be a treatment for mastalgia except 264

A Surgery
B Bromocriptine
C Danazol
D Gamaanelonic acid
E Antiprostaglandin

The following about nipple discharge are correct except 265

A It is a common complaint
B Galactorrhea is atypically bilateral
C It is usually physiological
D Duct ectesia is a benign cause for discharge
E Mammogram shoud be a part of evaluation with bloody discharge

All of the following about Bartholin gland are correct except 266

A Are remnant of mesonephric origin

B Can commonly be infected by E. coli
C Excision of the cyst when infected is contraindicated
D Are situated in the posterior part of the vagina
E Should be marsupilzed when acutely infected

The most common benign mass of the cervix and endocervix is 267

A Polyp
B Lieomyoma
C Nobothian cyst
D Cervical hood
E Gartner duct cyst

A 37 year old woman complains of postcoital leeding . The least likely cause of her bleeding 269
would be cervical

A Polyp
B Ectropion
C Carcinoma
D Nabothian cyst
E Infection

The following are risk factors to developing uterine myomata except 267

A Low parity
B Late menarche
C Negro race
D Positive family history of disease
E Associated with endometriosis

Endometriosis characteristically occurs in women who are 281

A In low socioeconomic group

B Perimenpausal
C Nulliparous
D Using IUCD
E Using oral contraceptive

The major symptoms of adenomyosis is 286

A Irregular uterine enlargement
B Menrrhagia and dysmenorrhea
C Urinary frequency
D Dysmenorrhea and infertility
E Pressure symptoms

Danazol treatment of endometriosis is associated with all of the following except 288

A Acne
B Weight gain
C Hot flashes
D Mucoid vaginal discharge
E Decreased breast size

Non- neoplastic cyst of the ovary include the following except 290
A Theca lutein cyst
B Pregnancy luteoma
C Endometritic cyst
D Corpus luteum cyst
E Dermoid cyst

In contrast to a malignant ovarian tumour benign tumor has which of the following 291
A Excrescences on the surface
B Peritoneal implant
C Intracystic papillae
D Free mobility
ECapsule rupture

The following about dermoid cyst are true except 293

A It is a germ cell tumor

B It is the commonest ovarian tumour during pregnancy
% C Malignant change occurs in 1.5
D Usually are unilateral
E Rarely causes harm to the patient when rupture

Endometrial hyperplasia could be expected in the following conditions 311

AEndodermal sinus tumor

B Cystic teratoma
C Polycystic ovary
DSertoli leydig cell tumor
E Dysgerminoma

Complex endometrial hyperplasia without atypia in a women aged 41 years could be treated 314
with the following except
A Progestin
B Estrogen
C Progestin plus estrogen
D Oral contraceptive
E Hysterectomy

Carcinoma of the vulva 322

A Usually ulcerates even if not advanced

B Is usually histologically anaplastic
C Spread initially to the iliac lymph nodes via vaginal lymphatics
D Seldom involves lymph nodes at the time of presentation
E Is equally amenable to treatment by surgery and radiotherapy

Risk factors for development of cancer cervix include the following except 326

A Early sexual activity

B Nulliparous
C HPV infection
D Smoking
E Multiple sexual partner
Microinvasion of carcinoma of the cervix involves a depth below the base of the epithelium of no 327
more than

A 1 mm
B 2 mm
C 3 mm
D 4 mm
E 5 mm

The following factors increased risk of a women developing endometrial cancer except 335

A Early age of menarche

B Late menopause
C Combined hormonal replacement therapy
D Diabetes mellitus
E A history of polycystic ovary disease

Which of the following germ cell tumor is associated with ambiguous genitalia 360

A Choriocarcinoma
B Gonadoblastoma
C Dermoid cyst
D Carcinoid tumor
E Endodermal sinus tumor

Elevated alfa fetoprotein is used for detection of 361

A Cancer vulva
B Cancer cervix
C Endodermal sinus tumor
D Serous cystoadenocarcinoma
E Mucinous cystoadenocarcinoma

Non –contraceptive benefits of COC pills include the following except 436

A Improve the rhythm of menstrual flow

B Decrease the amount of menstrual blood flow
C Used to improve endometriosis
D Prevent functional ovarian cyst
E Reduced risk of cervical cancer

The side effects of combined OCP include the following except 441

A Nausea
B Dizziness
C Vaginal discharge

D Menorrhagia
E Weight gain

Which of the following is an absolute contraindication for oral progesterone only contraceptive 444
pills

A Cigarette smoking
B Depression
C Gall bladder stone
D Mild hypertension
E Unexplained vaginal bleeding

All of the following statements with regard to the copper IUCD are correct except 451

A Modern copper IUCD is effective and safe for at least five years
B It reduce s the number of sperm reaching the fallopian tube and their capacity to fertilize the eggs
C The risk of pelvic infection is low and does not increase with long term use
D Is contraindicated in women with irregular vaginal bleeding
E Levenorgestrel releasing devices are associated with menorrhagia

At the eights weeks gestation a women has an IUCD and the strings are visible at the external 455
os. The best management is

A Antibiotics
B Progestrone
C Dilation and curettage
D Removal of IUCD
E Bed rest

The following vessels contains oxygenated blood except 501

A Umbilical artery
B Ductus venosus
C The inferior vena cava as enters the right atrium
D Carotid artery
E Umbilical veins

Physiological anemia of pregnancy is due to 506

A Increase iron Requirement
B Increase folic acid requirement
C Disproportionate increase in plasma volume compared with RBCS mass
D Repeated blood loss
E Nausea and vomiting

Physiological changes in pregnancy include the following except 507

A Dilation of the renal pelvis

B Increase in the size of the kidneys
C Increase frequencies of micturition
D Decrease of the renal plasma flow
E More compression of the right ureter than the left one

Which of the following is not a characteristic of a 28 weeks pregnancy 510

A Viability
B A fetal weight of 1000g
C Lecithin to spphingmyelin ratio of less than 2 / 1
D The absence of type two fetal lung alveoli cells
E The presence of phosatidylgylcerol

The following investigations are component of routine antenatal care except 514
A Rh type
B Hemoglobin
C Urine analysis for sugar and protein
D Blood grouping
E Urine culture

During normal pregnancy which of the followings statement is false 516

A Daily requirement of iron is about 4 mg / day

B Iron supplement is needed even if the diet is adequately enriched in heme iron
% C The percentage of iron absorbed from the GIT is decreased by 20
D Daily requirement of folic acid is about 1 mg / day

E Folic acid supplement decrease the incidence of neural tract defect

The correct statement about biophysical profile is 527

A It is made up of four components

B A score of 6 is satisfactory
C Perinatal mortality rises with falling biophysical profile score
D Amniotic fluid volume is an important sign of acute asphyxia
E It consists of Doppler flow readings of the umbilical cord

Ultrasound can be helpful in the diagnosis of all of the following except 535
A Incompetent cervix
B Fetal cardiac anomalies
C Type of twins
D Site of implantation
E Placental location

Fetal lung maturation is ensured by the presence of 538

A Lecithin
B Prostaglandin
C Sphingomyelin
D Phosphotidylgylecerol
E Cortisol

The following statements regarding the umbilical cord are correct 557
A Contains two arteries and one vein
B Abnormal long cord can lead to cord prolapse
C It is covered with amniotic membranes
D Its umbilical vein carries oxygenated blood from the placenta to the fetus
E All of the above

In human placentation the following structures lie between maternal and fetal blood 556
A Trophoblast
B Capillary endothelium
C Decidua
D All of the above
E None of the above

As regard fetal presentation , the incorrect statement is 583

A Is the part of the fetus that enters the pelvis first

B In face presentation the occiput and back comes into contact
C is usually cephalic
D The denominator is the lowest part of the presenting area
E In cephalic presentation it is more common to be vertex
The shortest diameter of the pelvic cavity is 585

A The external conjugate

B The diagonale conjugate
C The interspines
D The true conjugate
E The transverse

As regard the mechanism of labor , which of the following sequences is correct 588

A Descent , internal rotation , flexion

B Engagement , flexion , descent
C Engagement , internal rotation , descent
D Engagement , descent , flexion
E Descent , flexion , engagement

The following statements regarding ischial spines are correct except 590

A They make the beginning of the forward curve of the pelvis

B The are landmarks for pudendal nerve block procedure
C They indicate a normal pelvis when particularly prominent
D They help to assess station of the presenting part
E They lie at the level of the plane of least pelvic dimensions

Caput succedaneum 592

A Resolves spontaneously after labor

B May lead to jaundice of the baby postpartum
C Indicate traumatic vaginal delivery
D Indicates that the fetal head engaged
E Is a sign of intrauterine fetal death

Variable deceleration on fetal heart rate monitoring are usually due to 606

A Fetal head compression

B Uteroplacental isufficiency
C Fetal metabolic acidosis
D Umbilical cord compression
E Fetal distress

Epidural anaesthesia 613

A Does not affect uterine activity
B Is contraindicated in patient with heart valve lesions
C Should be routinely administerted during the first stage of labor
D Increase the risk of PPH
E Should be offered to highly selected cases in labor
The following hormone is responsible for the contraction of the myoepithelial cells of the breast 642
A Oxytocin
B Prolactin
C Progestrone
D Placental lactogen
E Estrogen

Maternal mortality refers to the number of maternal deaths that occur as the result of the 646
reproductive process per
A 1000 births
B 10.000 births
C 100.000 births
D 10.000 live births
E 100. 000 live births

The risk factors for an ectopic pregnancy include the following except 656
A History of PID
B Previous ectopic pregnancy
C Use of combined oral contraceptive pills
D Assisted reproductive techniques
E Previous tubal surgery

Contraindication to medical therapy ( Methotroxate ) in tubal pregnancy is 662

A Ectopic size 3 cm or less

B Desire for future fertility
C History of active renal or hepatic disease
D A Sonographyically non viable fetus
E Absence of active bleeding

The following is the main differences between complete and partial vesicular mole 668

A Propensity of metastases
B Tripoloidy and diploidy
C Need for chemotherapy
D Trophoblatic hyperplasia
E Androgenesis

The best contraceptive method for patients with gestational trophoblastic disease 672
A Tubal ligation
B Hystrectomy
C Combined contraceptive pills
D IUCD device
E Subcutaneous implant

The following pregnancy complications is not associated with renal cortical necrosis 680

A Eclampsia
B Placental abruption
C Endotoxin induced shock
D Placenta previa
E DIC
The management of asymptomatic bacterioria include 685

A Expectant management
B Induction of labor
C Antibiotics
D Diuretics
E Intravenous hydration

In eclampsia 699

A Peripheral edema is common

B The circulating blood volume increased
C Immediate delivery under general anesthesia is the management of choice
D Beta blocker would be the best antihypertensive drugs
E Delivery is contraindicated before 34 weeks

Obstetrics complications of diabetus mellitus include the following except 703

A Congenital fetal malformation

B IUFD
C Macrosomia
D Caput succadenum
E Preterm