WATEEN 2020 / OBS & GYNE

Final Exam
 WATEEN 2020 / OBS & GYNE
Final Exam

Q1:
All the followings can be diagnosed by ultrasound examination at 13 weeks except:
a. Uterine Fibroid.
b. Anencephaly.
c. Ovarian mass.
d. Polyhydramnios.
e. Wrong date.

ANSWER: D
Q2:
During labour, all are true except:
a. If the active management of third stage is used, the 3rd stage of labour is
considered prolonged is the placenta is not delivered after one hour.
b. The head is considered engaged when on vaginal exam the station is
more than 0.
c. The risk of malposition increases in patient with Android pelvis.
d. Patients on oxytocin should be monitored with CTG.
e. Active management of the third stage is associated with a decrease in the
risk of PPH.

ANSWER: A
Q3:
Regarding bacterial vaginosis, all the following are true except:
a. Is commonly caused by lactobacillus.
b. No need to treat the partner.
c. Whiff test is positive.
d. No vulvar itching.
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Final Exam

e. Metronidazole is the drug of choice.

ANSWER: A
Q4:
Regarding gestational trophoblastic neoplasia (GTN), all the followings are true except:
a. Malignant GTN never occur after full-term pregnancy.
b. The most common site of metastasis is the lungs.
c. Suction evacuation is the treatment of choice for complete mole.
d. Post-evacuation plateau of serum B-HCG for three readings is diagnostic of
malignant GTN.
e. Bone marrow suppression is one of the side effects of methotrexate.

ANSWER: A
Q5:
Etiology of second trimester miscarriage includes all the following except:
a. Cervical incompetence.
b. Multiple pregnancy.
c. Parental translocation.
d. Submucous fibroid.
e. Uterine anomalies.

ANSWER: C
Q6:
Regarding ovarian cancer, all are true except:
a. Bilateral salpingectomy increases the risk of ovarian cancer.
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Final Exam

b. Endometrioid adenocarcinoma of the ovary is associated with carcinoma

of the endometrium in 15-20% of cases.
c. The use of oral combined contraception reduces the risk of ovarian
cancer.
d. Epithelial carcinoma is the most common histologic type of cancer of the
ovary.

ANSWER: A
Q7:
Inhibin concentration clinically useful marker:
a. High grade serous carcinoma of the ovary.
b. Dysgerminoma.
c. Granulosa cell tumors.
d. Mucinous carcinoma of the ovary.
e. Endo dermal sinus tumor.

ANSWER: C
Q8:
Regarding gestational trophoblastic neoplasia (GTN), all following are true except:
a. The risk of malignant transformation is higher for partial mole than
complete.
b. Methotrexate is used to treat patients with low-risk GTN.
c. The serum level of B-HCG is used in the scoring system.
d. Abnormal vagina bleeding the most common presenting symptom.

ANSWER: A
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Final Exam

Q9:
All the following investigations should be done routinely during antenatal visit except:
a. OGTT.
b. Obstetric ultrasound.
c. Rubella IGG.
d. CBC.
e. Urine culture.

ANSWER: A
Q10:
Regarding normal menstrual cycle, all the following statements are true except:
a. The endometrial glands become elongated and tortuous after ovulation.
b. The LH surge occurs immediately after ovulation.
c. Regular menstrual cycles indicate ovulation in 90% of cases.
d. The average menstrual blood loss is about 50 ml.
e. The length of the luteal phase is constant.

ANSWER: B
Q11:
All the following parameters of semen fluid analysis FA considered normal according to
the latest WHO criteria except:
a. Progressive sperm motility of 20%.
b. Normal morphology of 10%.
c. Total motility of 45%.
d. Volume of 2 ml.
e. Sperm concentration of 25 million/ml.
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Final Exam

ANSWER: A
Q12:
Symptoms of menopause include all the following except:
a. Hot flashes.
b. Joint aches.
c. Decreased sexual desire.
d. Insomnia.
e. Vaginal swelling.

ANSWER: E
Q13:
All the followings may be considered in the management of urge incontinence except:
a. Tolterodine and oxybutynin.
b. Avoid based drinks.
c. Anterior vaginal colporrhaphy.
d. Sacral nerve root neuromodulation.
e. Bladder training.

ANSWER: C
Q14:
All the followings are indications to give anti-D except:
a. Abdominal trauma at 30 weeks.
b. Spontaneous miscarriage at 6 weeks.
c. Ectopic pregnancy managed by methotrexate.
d. Amniocentesis.
e. Antepartum hemorrhage.
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Final Exam

ANSWER: B
Q15:
All of the following are considered normal vaginal delivery except:
a. The estimated blood loss in the third stage was 300 ml
b. CTG monitoring was used in the first and second stage of Labor
c. The gestational age of the fetus was 35 + 6 days
d. Oxytocin was used after the delivery of the anterior shoulder of the fetus
e. Second stage of Labor lasts 2 hours in a primigravida

ANSWER: C
Q16:
Regarding hyperemesis gravidarum, all the following are true except:
a. More common in twins pregnancy
b. Is less common after 12 weeks gestation
c. May be associated with abnormal thyroid function test
d. Is typically associated with hypertension

ANSWER: D
Q17:
All of the following are contraindications for methotrexate in ectopic pregnancies
except:
a. Patient is hemodynamically unstable.
b. Quantitative B-HCG level which exceeds 3000 mIU/mL.
c. Renal dysfunction.
d. Fetal cardiac activity.
e. Adnexal mass of more than 4 cm.
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Final Exam

ANSWER: B
Q18:
Regarding antepartum hemorrhage, all the following are false except:
a. It is associated with macrosomic fetuses.
b. The majority of cases are related to Vasa previa.
c. It can be a sign of preterm labor.
d. It is defined as any vaginal bleeding during pregnancy.
e. Vasa Previa causes painful bleeding.

ANSWER: C
Q19:
In germ cell malignancies. bilateral ovarian involvement occurs in about 10-15% of:
a. Dysgerminoma.
b. Embryonal cell carcinoma.
c. Ovarian choriocarcinoma.
d. Endodermal sinus tumor.
e. Immature teratoma.

ANSWER: A
Q20:
Regarding pregnancies all the following statements are true except:
a. Monozygotic twins more common than dizygotic.
b. Congenital anomalies are seen more frequently in monochronic than in
dichorionic twins.
c. The incidence of cerebral palsy increases with the increase of fetal
number.
d. High-order multiples means triplets and above.
e. Sonographic finding of Twin Peak sign is diagnostic for dichorionicity.
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Final Exam

ANSWER: A
Q21:
Regarding Depot Medroxy progesterone acetate, all are true except:
a. It causes meaning of cervical mucus.
b. Prolonged use could cause osteoporosis.
c. It has a high failure rate.
d. Side effects weight gain.
e. Suitable for handicapped and non-compliant patient.

ANSWER: C
Q22:
Regarding twin’s pregnancy, all the following are true except:
a. The best time to determine the chorionocity is in the first semester.
b. Twin-twin transfusion syndrome usually starts in the second trimester of a
dichorionic diamniotic
twins.
c. Maternal age of > 35 years is a risk factor.
d. Conjoined twins will result if the division occurs after 12 days of fertilization.
e. All dizygotic twins are dichorionic.

ANSWER: B
Q23:
The relationship of the denominator of the fetus to the mother pelvis is called:
a. Fetal position.
b. Fetal attitude.
c. Presentation.
d. Fetal engagement.
e. Lie.
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Final Exam

ANSWER: A
Q24:
All the following are recognized risk factors for fibroids except:
a. High estrogen levels.
b. Age >40 years.
c. Nulliparity.
d. White race.
e. Family history.

ANSWER: D
Q25:
Regarding cervical cancer, all the followings are true except:
a. Below the age of 20, the incidence of cervical cancer is about 1/1000,000
b. The ovaries should be removed during surgery
c. Stage 1a1 can be treated with cone biopsy
d. History of vulvar or vaginal squamous intraepithelial neoplasia is a risk
factor
e. HPV 16 and 18 are found in over 70% of all cervical cancers

ANSWER: B
Q26:
Regarding menopause, all are true except:
a. Type 1 DM is associated with early menopause
b. Weight-bearing exercises should be avoided
c. Women with uterine fibroids usually have late menopause
d. Hot flashes occur in the majority of patients
e. Is associated with a rise in total LDL and a fall in HDL cholesterol
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Final Exam

ANSWER: B
Q27:
Causes of recurrent miscarriages include the following except:
a. Congenital deficiency of protein C
b. Uterine septum
c. Toxoplasma infection
d. Endocrine disorders like diabetes
e. Anticardiolipin syndrome

ANSWER: D
Q28:
Regarding ectopic pregnancy, all the following are false except:
a. More common in the left than right tube
b. May present as vaginal bleeding
c. Bathroom sign is present in most cases
d. The account for approximately 20% of maternal deaths
e. A negative urinary pregnancy test rules out early ectopic pregnancy

ANSWER: B
Q29:
All the following are risk factors for endometrial hyperplasia except:
a. Tamoxifen
b. Granulosa cell tumor of the ovary
c. PCOS
d. Combined hormonal contraceptives
e. Obesity
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Final Exam

ANSWER: D
Q30:
Regarding vulvovaginal candidiasis, all the following are true except:
a. Less common in pregnancy
b. Increased risk with steroid use
c. The vulva is usually swollen and inflamed
d. Culture is diagnostic
e. Is usually associated with severe vulval itching

ANSWER: A
Q31:
Regarding endometrial cancer, all the following are false except:
a. Combined oral contraceptives is a well-recognized predisposing factor
b. Adenocarcinoma is the usual histologic type
c. Serous papillary type has better prognosis than endometrioid type
d. Often diagnosed at Advanced stage
e. Usually presents with recurrent lower abdominal pain

ANSWER: B
Q32:
All the following are indication of immediate delivery for premature rupture of
membranes (PROM) except:
a. Abruptio placentae
b. Chorioamnionitis
c. Fetal distress
d. Cord prolapsed
e. Fetal death
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Final Exam

ANSWER: E
Q33:
Regarding stress incontinence, all are true except:
a. Electrical stimulation of pelvic floor muscle is used in the treatment of some
cases
b. Patients usually have involuntary leakage of urine that occurs with
sneezing, coughing or laughing
c. Sphincter damage is the most common cause
d. Nocturia is not a common symptom
e. Suburethral veginal tape is the most common surgical procedure used to
treat stress incontinence

ANSWER: D
Q34:
Patient with preeclampsia who developed atonic PPH all the following oxytocics can be
safely used except:
a. Syntocinon
b. Misoprostol
c. Prostine E2
d. Ergometrine
e. Carbetocin

ANSWER: D
Q35:
In twins pregnancy, cesarean section is usually recommended in all the following
except:
a. Both fetuses are breech
b. Acardiac twins
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Final Exam

c. Triplet pregnancy
d. The first is cephalic and the second is breech
e. None of the above

ANSWER: D
Q36:
Regarding postpartum hemorrhage (PPH), all the following are true except:
a. Placenta accreta, is abnormally implanted placenta, is a risk factor
b. Call for help is the first step of management
c. Ruptured uterus is a possible cause
d. Secondary PPH occurs after 12 hours of delivery
e. It is defined as blood loss of more than 1000 ml after cesarean section

ANSWER: D
Q37:
Regarding endometriosis, all the following are true except:
a. Is a benign disease
b. Ultrasound is reasonably good in detecting endometrioma
c. Pelvis is the most common site
d. Mirena can be used to treat endometriosis
e. CA125 is rarely elevated

ANSWER: E
Q38:
Regarding postmenopausal bleeding, all the following are true except:
a. Endometrial biopsy is indicated if endometrial thickness is 5 mm
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Final Exam

b. Can be caused by endometrial polyp

c. Trans-vaginal scanning is the gold standard investigation
d. Defined as any bleeding from vagina after 12 months of cessation of
menstruation
e. The commonest cause is endometrial cancer

ANSWER: E
Q39:
Regarding placental abruption, all the following are false except:
a. Smoking is a protective Factor
b. It rarely coexist with postpartum hemorrhage
c. Best managed by steroids Administration and bed rest
d. All patients with abruption present with veginal bleeding
e. It can occur during labor

ANSWER: E
Q40:
Side effects of progestogens treatment include all the following except:
a. Ovarian cyst
b. Breakthrough bleeding
c. Endometrial cancer
d. Headache/ depression
e. Weight gain

ANSWER: C
Q41:
Regarding the second stage of Labor, all are true except:
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Final Exam

a. The need of episiotomy should be assessed at the time of crowning

b. You assess the progress of Labor by assessing the descend and the rotation
of the presenting part
c. The patient should be encouraged to push as soon as the cervix becomes
fully dilated
d. If primigravida has epidural, 3 hours may be allowed for the second stage
e. Midline episiotomy is associated with a higher risk of anal sphincter injury

ANSWER: C
Q42:
Regarding preterm labor, all the following are true except:
a. NSAIDs are recommended after 32 weeks
b. Weekly steroids are recommended between 28 and 34 weeks of gestation
c. Beta-agonists are used to support labor
d. Oxytocin antagonists are effective in suppressing labor, but are expensive
e. Erythromycin is recommended in preterm premature rupture of
membranes (PPROM)

ANSWER: A
Q43:
Regarding uterine inversion, all are true except:
a. Abdominal examination shows uterine fundus reaching the umbilicus
b. Majority of cases occurred during the third stage of Labor
c. Management is by manual replacement
d. Infusion should be started after replacement of uterus
e. Subacute inversion occurs within first week after delivery
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Final Exam

ANSWER: A
Q44:
Regarding genital prolapse, all the following are true except:
a. Broad ligaments give good support to uterus
b. More common in Caucasian compared to Black
c. Cystocele is the descent of the upper 2/3 of anterior vagina wall
d. Enterocele is a true hernia
e. Pelvic floor fascia gives good support the vagina

ANSWER: A
Q45:
Regarding drugs in pregnancy, one of the following association's is false:
a. NSAIDs = oligohydramnios
b. Prednisolone = facial clefts
c. Ferrous = category A
d. Methotrexate = category X
e. Smoking = macrosomia

ANSWER: E
Q46:
All the following signs and symptoms are considered serious at 38 weeks except:
a. Eye flashes
b. Vaginal bleeding
c. Abdominal tightness
d. Frontal headache
e. Repeated vomiting
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Final Exam

ANSWER: C
Q47:
Regarding purpureum, all the following are true except:
a. After 2 weeks of delivery, the uterine fundus will be at the level of the
symphysis pubis
b. The best empirical treatment in mastitis is flucloxacillin
c. There is usually diuresis in the first 5 days after delivery
d. Methyldopa increases the risk of postpartum depression
e. Feeding is not allowed in women taking prophylthiouracil

ANSWER: E
Q48:
Regarding Turner syndrome, all the following are false except:
a. The gonads are testes
b. Breast development is normal
c. A chromosomal structure of 45 XY is characteristic
d. Are usually tall
e. Coarctation of the aorta may occur

ANSWER: E
Q49:
Regarding induction of Labor, all the following are true except:
a. Prolonged pregnancy is the most common cause
b. Failed induction of Labor is higher in primygravida
c. Active genital herpes infection is a contraindication
d. The use of prostaglandins is preferred of the cervix is unfavorabl
e. The use of cervical ripening balloon is contraindicated in patient with
previous lower segment cesarean section
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Final Exam

ANSWER: E
Q50:
In testicular feminization, all the following are false except:
a. The patient adopts a male hair distribution
b. Uterus is present
c. Breasts are absent
d. The gonads should be removed
e. The chromosome structure is XXY

ANSWER: D
Q51:
A G3P2 a woman who could be all the following except:
a. Has no living children
b. Has previous history of missed miscarriage
c. Has a stillbirth in the second pregnancy
d. Has never had ectopic pregnancy

ANSWER: B
Q52:
Regarding missed miscarriage, all are true except:
a. Regression of early symptoms of pregnancy is a possible presentation
b. Is diagnosed if ultrasound showed CRL > 6mm with no fetal heart activity
c. Platelets count should be measured to exclude the risk of DIC
d. Dilatation and curettage (D & C) is the treatment of choice if the
gestational age is 15 weeks
e. Most of cases are diagnosed during routine ultrasound in early pregnancy
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Final Exam

ANSWER: D
Q53:
Risks of cord prolapse include all the following except:
a. Oligohydramnios
b. Fetal malpresentation
c. Multiparity
d. Multiple gestation
e. Prematurity

ANSWER: A
Q54:
All the following reduce the incidence of cervical cancer except:
a. Condom
b. Quitting smoking
c. Combined oral contraceptive pills
d. Bi-valent HPV vaccine
e. Pap smear

ANSWER: C
Q55:
All of the following are fetal complications of preeclampsia except:
a. Prematurity
b. IUGR
c. Cerebral hemorrhage
d. Oligohydramnios
e. Placental abruption
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Final Exam

ANSWER: C
Q56:
Regarding post term pregnancy, all the following are true except:
a. Anencephaly will always result in post term pregnancy
b. The majority of post term pregnancies have no known etiology
c. Associated with higher risk of macrosomia
d. Early ultrasound assessment of gestational age reduces the prevalence of
post term pregnancy
e. It increases the risk of meconium aspiration

ANSWER: A
Q57:
Regarding clomiphene citrate, all the following are true except:
a. Is effective in patient with premature ovarian failure
b. Increases pituitary gonadotrophin secretion
c. Can cause ovarian hyperstimulation syndrome
d. Can cause hot flushes
e. Is associated with a multiple pregnancy rate of 8%

ANSWER: A
Q58:
All the following are possible complications of pelvic inflammatory diseases except:
a. Dyspareunia
b. Ectopic pregnancy
c. Infertility
d. Cervical stenosis
e. Dysmenorrhea
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Final Exam

ANSWER: D
Q59:
All the following are presentation of RH- Isoimmunization except:
a. Polyhydramnios
b. Enlarged fetal heart
c. Fetal death
d. Abnormal CTG
e. Postterm pregnancy

ANSWER: E
Q60:
Regarding uterine atony, all the following are true except:
a. It is more common in multiparous than in primigravid woman
b. Prostaglandin E1 (misoprostol) can enhance contraction
c. It is the most common cause of primary PPH
d. Inhalational halothane should be avoided
e. Beta Agonist medications are the first line of management

ANSWER: E
Q61:
Regarding cardiotocograph (CTG), all the following are true except:
a. Normal fetal heart rate Baseline is 90 to 160
b. A normal variability should be 5 bpm
c. It can demonstrate decelerations
d. It is part of modified biophysical profile
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Final Exam

ANSWER: A
Q62:
All the following are recognized causes of primary amenorrhea except:
a. Turner syndrome
b. Androgen insensitivity syndrome
c. Sheehan's syndrome

ANSWER: C
Q63:
Regarding inherited thrombophilia in pregnancy, all the following are true except:
a. Anti Thrombin III deficiency is associated with bad obstetric outcome
b. Heparin will prevent all possible complications related to pregnancy
c. Factor V (FVL) is one form of inherited thrombophilia
d. It is associated with early pre-eclampsia
e. It is associated with fetal loss

ANSWER: B
Q64:
The most significant risk factor for preterm delivery is:
a. Bacteriuria
b. Heavy maternal work
c. Uterine anomaly
d. Previous second-trimester miscarriage
e. Previous preterm birth
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Final Exam

ANSWER: E
Q65:
Regarding diabetes and sugar control in pregnancy, all the following are true except:
a. Insulin levels are higher in pregnant women than in non-pregnant women
b. Insulin cross the placental barrier easily
c. Postprandial sugar readings are expected to be higher in pregnant
women than in non-pregnant women
d. High levels of steroids hormones in pregnancy is responsible for the
increased insulin resistance
e. +2 glucosuria can be a physiological finding in pregnancy

ANSWER: B
Q66:
Predisposing factors to preeclampsia include all the following except:
a. Higher socioe-conomic status
b. Age
c. Parity
d. Previous pre-eclampsia
e. Genetic predisposition

ANSWER: A
Q67:
Regarding estimation of gestational age (GA), all the following are true except:
a. At the time of expected date of delivery (EDD) the GA is 40 weeks
b. Ultrasonic estimation is most accurate in the first trimester by measuring
Crown rump length
c. In lactating woman ultrasonic estimation is mandatory
d. Is calculated from the last day of the last normal menstrual.
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Final Exam

e. An accurate estimation of GA can reduce unnecessary post-term induced

deliveries

ANSWER: D
Q68:
The most common cause of maternal mortality in developing countries is:
a. Eclamptic fits
b. Hypertension
c. Ectopic pregnancy
d. Hemorrhage
e. Embolism

ANSWER: D
Q69:
Regarding cholestasis of pregnancy, all the following are true except:
a. Amniotic fluid embolism is a known complication
b. Is associated with fetal distress in labor
c. Is a diagnosis of exclusion
d. Patient typically present with itching mainly in the palm and sole
e. Is associated with an increased risk of preterm Labor

ANSWER: A
Q70:
All the following factors are preventing trans-placental drug transfer, except one:
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Final Exam

a. Low serum maternal concentration of the drug

b. Molecular size of more than 1000 Da
c. Lipophilic property
d. Highly ionized drug
e. Strong protein binding

ANSWER: C