1.

A 32-year-old woman is brought into the delivery site by ambulance 6 days following a
vaginal delivery . The pregnancy and labor had been unremarkable and the placenta was
delivered by controlled cord traction. Following delivery the woman had been discharged
home after 6 h. She reported that the lochia had been heavy for the first 2 days but it had then
settled to less than a period. However today she had suddenly felt crampy abdominal pain and
felt a gush of fluid, followed by very heavy bleeding. The blood has soaked through clothes
and she had passed large clots, which she describes as the size of her fist. She feels dizzy
When she stands up and is nauseated. What will be the diagnosis?
A. Primary PPH

B. Secondary PPH

C. Both

D. None

2. W/O Almaz delivered 1 hrs ago in Asselahospital. The placenta was complete during

delivery,uterus is firm and contracted and the episiotomy was sutured properly but she

bleeds too much .What will be the likely cause of the bleeding ?

A. Retained placenta or fragments

B. Tear of cervix
C. Atonic uterus
D. Uterine inversion

3.W/ro Alemnesh comes to your clinic for ANC follow up. This is her initial visit & on the
assessment of the breast, the primary areola becomes very dark and larger. Based on this
finding her gestational age could be ____weeks.

a. 8weeks
b. 12weeks
c. 16weeks
d. 20weeks
1. You may meet with a pregnant woman who is suffering with faintness and low blood
pressure in supine position. As a midwife what will be your initial management?
a. Open IV line with large bore canuula for resuscitation
b. Immediately turn her in left lateral position
c. Administer O2 3-4li/minute
d. Arrange urgent referral
2. During pregnancy the size of the uterus dramatically increase under the influence of
_____hormone

1
 a. Estrogen
b. Progesteroner
c. HCG
d. Prolactine
6. One of the following is not the presumptive sign of pregnancy

a. Quickening c. Morning sickness

b. Amenorrhea d. Chadwick sign

7. All are the positive sign of pregnancy except one

a. Hearing of fetal heart beat

b. Enlargement of the uterus
c. Appreciation fetal movement
d. Visualization of gestational sac by U/S

8. The most influential non-genetic maternal factor that affect fetal growth and development
both preconception and during conception is

a. Stress c. Substance abuse

b. Nutrition d. Pre-existing medical problem

9. Which one of the following part of the presentation is denominator in vertex presentation
a. Sinciput c. occiput
b. mentum d. parietal

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10. Initial evaluation of pregnant women at the first ANC visit according to FANC approach
includes all except
a. To identify the pre existing problems
b. To determine the GA
c. To appreciate the presenting part
d. To define the health of woman
11. A pregnant woman who has five alive children, had a history of two still births and two
abortions categorized as:
a. G VII, P VII, A II
b. G IX , P VII, A II
c. G X, P VII, A II
d. G X, P V, A II
12. A pregnant woman whose LNMP was on 4/3/2008;when will be her EDD & GA by date
on 10/10/2008?

a. 14/12/2008 & 30+6 weeks by date

b. 9/12/2008 & 32 +5 weeks by date
c. 10/12/2008 & 29 +6 weeks by date
d. 11/12/2008 & 30 weeks by date

13. One of the following is not the base line laboratory investigation for pregnant women
during ANC visit

a. Blood group & Rh factor

b. Hgb and VDRL

c. U/A and stool examination
d. Widal and welflex test

14. Care provision activities during providing ANC services includes all except
a. Immunization for TT, HBV ]
b. Advice on rest, activities and sexuality
c. Supplement iron and folic acid
d. PMTCT for HIV
15. A pregnant woman who was booked for basic FANC on 24th weeks of gestational age by
date, when will be appointed for her next visit?

a. 2-4weeks
b. 3- 6 weeks
c. 4 - 5 weeks
d. 6 - 8 weeks

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16. Select the correct sequence of Leopold’s maneuver
a. Pelvic palpation fundal palpation Pawlk’s grips lateral palpation
b. Fundal palpation pelvic palpation lateral palpation Pawlk’s grips
c. Lateral palpation Pawlk’s grips fundal palpation pelvic palpation
d. Fundal palpation lateral palpation pelvic palpation Pawlk’s grips
17. The purpose of lateral palpation is to determine
a. Level of presenting part
b. Attitude of the fetal head
c. Engagement of the presenting part
d. Locate the back of the fetus

18. The 1st prong of PMTCT is to address:

a. Prevention of unintended pregnancies among HIV-infected women
b. Prevention of HIV transmission from HIV-infected women to their infants
c. Primary prevention of HIV infection
d. Care & support of HIV-infected women, their infants & families
19. Select wrong statement about option B+ of PMTCT
a. CD4 cell count test is must used for initiation of ART
b. All HIV positive pregnant women should start ART
c. All infants born to HIV-infected women should receive ARV prophylaxis until the
age of 6 week
d. In postnatal period , when women found positive should start ART immediately
20. The preferred anti retroviral regimen for a pregnant woman in option B+

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 a. TDF +3TC + EFV
b. NVP +3TC + EFV
c. TDF +3TC + AZT
d. NVP +3TC + AZT
21. Which one of the following is not the cause of vaginal bleeding in late pregnancy
a. Placenta previa b. molar pregnancy

C. Placenta abruption d. vasa previa

22. Non-obstetrical cause of ante partum hemorrhage includes all exceptone

a. cervical cancer b. cervicitis

c. cervical polyps d. uterine rupture

23. Which one of the following types of bleeding in abruptio placenta is more serious?

a. Mixed b. concealed

c. revealed d. visible

24. Diastolic blood pressure ≥ 90 mm Hg before 20 weeks of gestation is a sign of:

a. Mild pre-eclampsia
b. Chronic hypertension
c. Superimposed mild pre-eclampsia
d. Severe preeclampsia
25. A pregnant woman presented with severe pre- eclampsia she may have the following
sign except
a. Hyper reflexia
b. Anuria
c. Blurred vision
d. Epigastric pain
26. Eclamptic fits may occur in the
a. antepartum period only
b. intrapartum period only
c. postpartum period only
d. antepartum, intrapartum or postpartum periods
27. . The loading dose of magnesium sulfate is given via
a. IV over 5 minutes, followed by deep IM injection into each buttock
b. IV over 5 minutes, followed by deep IM injection into one buttock
c. IM injections
d. IV bolus, followed by deep IM injection into each buttock
28. The maintenance dose of magnesium sulfate should continue for 24hrs
a. After initiation of loading dose of magnesium sulfate
b. After delivery or last convulsion

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 c. After repeating half dose of loading dose in case of recurrence of convulsion
d. After initiation of maintenance dose
29. The concentration of IV loading dose of magnesium sulfate must be
e. 10%
f. 50%
g. 20%
h. 40%

30. Select wrong statement about breech presentation

a. Oligohydramnious leads to breech presentation
b. Complete flexed leg inhibit spontaneous version and the fetus presented with his
buttock
c. Any condition that change the shape of the fetus associated with breech
presentation
d. Prematurity is one of the risk factor for breech presentation

31. The clinical finding in breech presentation is

a. Caudal pole occupies the fundus
b. Hard round movable part felt in the upper pole of the uterus
c. Fetal heart beat heard far at the flank
d. The fundus is lower than the estimated gestational age.
32. In a breech presentation, the fetal heart beat
a. can usually be heard at a location higher than expected for a vertex presentation
b. can usually be heard at a location lower than expected for vertex presentation
c. can usually be heard in the same location as for a vertex presentation
d. is not able to be heard
33. The engaging diameter in face presentation is
a. Sub-mentobregmatic c. Mentobregmatic
b. Sub- occiputobregmatic d. Occiputobregmatic
34. Which one of the following diagnostic approach is contraindicated in PROM
a. Ultrasonograpy c. Nitrazine test
b. Vaginal examination d. Fern test
35. All are the signs of infection in PROM except
a. Uterine tenderness
b. Foul smelling vaginal discharge
c. Increase maternal pulse
d. maternal WBC count ≥ 10,000

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 36. The Knowledge about the natural family planning methods help the couples to
identify:
A. The fertile period of the menstrual cycle
B. The infertile period of the menstrual cycle
C. The time during which pregnancy is likely to happen
D. All of the above
37. A biological marker for a woman using basal body temperature as a means of family

planning is____

A. Temperature shiftB. Change in cervical mucus

C. Change in the menstrual pattern D. All of the above

38. The peak of fertility (i.e., the estimated time of ovulation) is not indicated by one of

the following biological indicators:

A. The last day of clear, watery, stretchy and/or slippery mucus

B. A rise in the resting body temperature of .2 to .5 Centigrade
C. Peak levels of luteinizing hormone (LH surge) detected in the urine
D. None of the above
39. The end of fertility among natural family planning methods users is determined by:
A. Counting 4 days after the last day of clear, watery, stretchy and
slippery mucus is recorded.
B. Counting 4 days after the resting body temperature of 0.2 to 0.5 Centigrade is
recorded
C. Subtracting 11 days from the length of the longest of the last 6-12 cycles
D. All of the above
40. Among the natural methods of contraceptives the one which comes first in terms of

its effectiveness is:

A. BBT B. Cervical mucus method C. Abstinence D. With drawal

41. The IUCD is not an appropriate contraceptive method for a woman who:

A. Is taking anti TB B. Gave birth 48 hrs ago

C. On ART D. Un explained vaginal bleeding

42. Which of the following conditions are not warning signs that we should explain to an IUCD

User client:

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 A. Heavier vaginal bleeding than the usual for a few weeks

B. Foul vaginal discharge for some times

C. String is longer than the usual following menses

D. Pain during intercourse

43. IUCD is not contraindication for one of the following condition:

A. Uterine septate B. Un explained vaginal bleeding

C. Past history of PID D. Short uterine depth

44. The most common type of IUCD used here in Ethiopia is_____

A. CU T 380A B. CUT 250 C. ML375 D. Mirena

45. Which of the following isnota way by which the combined oral contraceptive pill works to
prevent conception?

A) It forms a localized inflammatory reaction at the site of implantation

B) Prevents the ovaries releasing eggs

C) It changes the lining of the uterus so a fertilized egg is less likely to implant .

D) It thickens mucus at the opening of the uterus so it is harder for sperm to penetrate.

46. How many types of hormones are in the mini-pill?

A) One B) Two C) Five D) None

47. A Breakthrough bleeding after ovulation in a woman who have been taking COC can be
managed by_____

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A)Increasing progestin dose

B) Increasing estrogen dose

C) Increasing dose of COC

D) Stopping use of hormonal contraceptive at all

48. Which hormonal contraceptive method has relatively the highest grace period?

A) Implants B) oral contraceptives C) Depoprovera D) IUCD

49. How many ejaculations does it generally take for a man's vas deference to be free of sperm
after a vasectomy?

A) Up to 10, but only semen test can tell for sure.

B) Up to 20, but only a semen test can tell for sure.

C) Up to 30, but only a semen test can tell for sure.

D) One month regardless of the number of ejaculation.

50. The emergency contraceptive can be taken for a maximum _____hours after unprotected
intercourse?

A) 24 hours B) 36 hours.

C) 72 hours D) 120 hours

51. To which of the following patients would you prescribe combination OCP’s?

A) 35 years old female who smokes more than 15 cigarettes/day

B) 20 years old female with irregular menstrual cycle
C) 29 years old female who is 2 weeks postpartum
D) 19 years old female with history of DVT

9
52. Which of the following drugs bring about higher rate of contraception failure due to
increased metabolism of both ethinyl estradiol and progestins ?
A)Phenobarbital B) phenytoin C) Refampicillin D) all of the above
53. Which one of the following is not a principle of good client-provider interaction during
family planning counseling?
A. Encourage the client to ask questions
B. Use and providing memory aids
C. select method for client
D. Provide just key information & instructions

54. To uphold confidentiality a provider must:

A. Counsel clients in areas where the client cannot be seen
B. Counsel clients in areas where the discussion cannot be heard
C. Not share medical information with the client’s family members without client’s permission
D. All of the above
55. The appropriate time for performing post partum tuba ligation include all except :
A) 48hrs-6wks post partum B) with in 48 hrs of delivery
C) After 6weeks of delivery D) None of the above
56.VDRL is an investigation/screening test routinely performed for pregnant mothers
during first visit of ANC to detect:
A. Malaria
B. Syphilis
C. Gonorrhoea
D. Anaemia
57. Of the following alternatives, which one is mis-matched about sexual transmitted
infections:
A. Sexual transmitted bacterial infection - syphilis
B. Sexual transmitted viral infection – Hepes simplex
C. Sexual transmitted bacterial infection – Gonorrhea D. None of the above
58. According to Ethiopian medico legal laws safe termination of pregnancy is permitted
under the following conditions Except
A. Pregnancy from rape
B. pregnancy which is unwanted/unplanned
C. Pregnancy from incest
D. Gross malformation of developing fetus
59. Removal of part or all of the external genitalia and stitching and/or narrowing of the
vaginal opening is classified as :
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A. Infibulation
B. Clitoridectomy
C. Excision
D. None of the above

60. Which one is a long term effect of FGM in a woman who is victim of Female genital
mutilation:
A. Pelvic inflammatory disease
B. Retention of urine
C. Hemorrhage and Shock
D. Infection and Septicemia

61. Promoting safer sexual behaviours is the first among STI control strategies, so which
one is considered as safe sexual behavior:
A. Inconsistent use of condom
B. Increasing the number of sex partners
C. Avoiding sexual intercourse with partner having genital ulcer
D. Sexual intercourse instead of dry kissing, hugging or masturbation

Do questions 62 and 63 based on the given information’s

1. Syphilis 2. Trichomoniasis3. Candidacies

4. Herpes simplex 1or 2 5. Chancroid6. Gonorrhoea
7. Bacterial vaginosis8. Chlamidial infection

62. Disease characterized by vaginal discharge:

A. 2, 3, 4, 5
B. 2, 4, 6,7
C. 1, 4, 5
D. 1, 3, 4, 5

63. Diseases associated with genital ulcer:

A.1, 4, 5
B. 1, 3, 7
C. 6, 7, 8 D. None of the above
64. A 14 years old girl presented with primary amenorrhea with normal secondary sexual
characteristic development. The most likely diagnosis is:
A. Imperforate hymen.
B. Turner Syndrome
C. Androgen insensitivity.
D. Hypogonadotropichypogonadism
65 .A 17-year-old girl presents to the clinic for the evaluation of primary amenorrhea.
Which would be an important aspect of her clinical history?
A. History of leukaemia during infancy

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 B. Short stature
C. History of delayed puberty in the family
D. All of the above
66.A 55-year-old woman, G- 3, P-3, who delivered all of her children by scheduled cesarean
sections, has mild Pelvic organ prolapse. She had her last period 3 years ago and since that time
has been on estrogen and progesterone vaginal tablets for treatment of hot flushes and vaginal
dryness. She has no chronic medical problems. Her family history is significant for osteoporosis
diagnosed at an earlier age than average in her mother, two sisters, and grandmother. Then based
on this scenariowhat is strongest risk factor for pelvic relaxation in this patient?
A. Parity
B. Age
C. Hormone status
D. Genetic
67. A 38 year old woman is seen for the evaluation of a swelling in her right vulva.
She has also noted pain in this area when walking and during coitus. On
examination a mildly tender fluctuant mass was noticed just outside the
introits in the right vulva. What the most likely diagnosis?
A. Bartholin's abscess.
B. Lymphogranulomavenerum.
C. Inguinal bubo.=> due to LGV D. Herpes infection.

68. Which one of the following cannot be transmitted sexually ?

A. Genital herpes
B. Chlamydia
C. Gonorrhea
D.Vaginal Candidiasis.

69. A 26 years old lady presented with secondary amenorrhea and FSH and LH are
found to be high, the possible diagnosis will be?
A. Sheehan syndrome
B. Asherman syndrome C. Premature ovarian failure.
D. Imperforated hymen
70.Chaltu is a 16 years old girl she comes to health center with complaining of primary
amenorrhea .what would be the most likely cause?
A. Bicornuate uterus
B. Anorexia nervosa
C. Imperforate hymen
D. Sheehan’s Syndrome

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71. A 19-year-old woman comes to your office with a compliant of never having had menses.
Physical examination shows that she is 1.37 m tall, & weighs 42 kg. She lacks breast & pubic
hair development. There is webbing of her neck &cubitus valgus. Which of the following
diagnosis is likely to be true?
A. Testicular feminization.
B. Normal but delayed development.
C.Turner's syndrome.
D. Congenital adrenal hyperplasia.

72. Genital tract Candida occurs more frequent in all these patients, EXCEPT:
A. Diabetic.
B. On long term antibiotic therapy.
C. Thyrotoxicosis.
D. Pregnant.

73. The terminology of pelvic inflammatory diseases indicates:

A. Infection of the vagina.
B. Infection of Bartholin's glands
C. Infection of the urinary bladder
D.salpingo-oophoritis.

74. Which of the following is a basic investigation for the male infertility?
A. Semen analysis.
B. Sperm penetration assay of cervical mucous.
C. Sperm penetration assay of hamster ova.
D. Sperm antibodies test.

75. Regarding characteristic of normal semen analysis which one of the following is false?
A. Volume > 2ml
B. pH of 7.2- 7.8
C. Normal sperm morphology is <20%.
D. Sperm motility >50%

76.What is the association between ovulation induction & fertility?

A. Decreases the incidence multiple pregnancy.
B.Increases the incidence multiple pregnancy.
C. Increases the incidence of only dizygotic twins.

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 D. Doesn't affect the incidence of twins
77.the most likely cause of infertility in a 30 year old women, who had salpingitis after her last
abortion, 3 years ago is:
A. Submucous fibroid.
B. Asherman'ssyndrome .
C.Blocked tubes.
D. Tuberculousendometritis.
78.Feature characteristically associated with imperforated hymen in a 16 year old
girl include:
A. Acute retention of the urine
B. Absence of secondary sexual characteristics.
C. Hirsutism and Short stature
D. Present with primary amenorrhea

79. A 35 year lady come with complains of Secondary amenorrhea, what is the possible
diagnosis?

A. Emotional factor
B. Systemic disease
C. Nutrition
D. All of the above

80. 49 years old women comes in complaining that several years she feels as her organ are
progressively falling out her vagina" along with this, she complains of losing urine with
straining, occasional urgency, and sometimes a feeling of incomplete emptying of her bladder
with voiding. Based on this case what is the possible cause?
A. Rectocele
B. Cystocele
C. Enterocele
D. Complete uterine prolapse

81.Clinical symptoms of uterine prolapse include the following, EXCEPT:

A. Low back ache.
B. Dyspareunia.
C. Amenorrhea.
D. Urinary retention.

82. An increased risk of Osteoporosis is associated with:

A.lack of estrogen hormone.
B. Androgen excess in the female.
C. Early menarche.
D. Excessive protein intake

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83. Which one of the following is a symptom of menopause?
A .Obesity.
B. Premenstrual tension.
C. Hot flushes.
D. Menorrhagia.

84. Which of the following is NOT a physical finding associated with the menopause?
A. Atrophic vaginitis.
B. Clitoromegaly.
C. Amenorrhea .
D. Small labia minora.
85. The most common malignancy in the female reproductive organs is:
A. Carcinoma of the cervix.
B. Carcinoma of the ovary.
C.Carcinoma of the breast.
D. Carcinoma of the uterine corpus

86. The Commonest uterine fibroid to cause excessive bleeding is:

A. Submucous fibroid.
B. Subserous fibroid.
C. Intramural fibroid.
D. Cervical fibroid.

87. A 20 year old lady pregnant in first trimester came complaining of lower abdominal pain, in
examination a mass continued with the uterus was found .what is the diagnosis?

A. Red degeneration of fibroid

B. Ectopic pregnancy
C. Uterine rupture
D. Rupture placenta
88. Which of the following types of cancer is the leading cause death form gynecologic
neoplasm?
A. Ovarian.
B. Uterine.
C. Cervical.
D. Vaginal

89.Risk factors of cervical cancer include all the following. EXCEPT :

A.Nulli parity

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 B. Multiple sexual partner
C. History of papilloma virus infection
D. Sexual activity at early age

90. Which one of the following is the most common clinical presentation of early cervical
cancer?
A. Foul-smelling vaginal discharge.
B. Asymptomatic.
C. Post-coital Bleeding.
D. Lower back pain.

91.. If you find that a 25 –year- old patient with amenorrhea of 18 weeks duration
had an elevated serum hCG, and absent fetal heart & movement and uterine
size 28 weeks .which of the following would be the most likely diagnosis ?
A. Normal pregnancy
B.Hydatiform mole
C. Twin pregnancy
D. Missed abortion

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