Abortions:
1. Regarding missed abortion, all of the following are CORRECT, EXCEPT:
A. Patient may present with loss of the symptoms of pregnancy B. Per vaginal bleeding may be one of the presenting symptom C. Immediate evacuation should be done once the diagnosis is made D. Disseminated intra-vascular coagulation may occur as a sequele of
missed abortion
E. Ultrasound should be done to confirm the diagnosis
2. 14 weeks pregnant woman had abortion and she was told that it is a complete abortion. This is true regarding complete abortion:
A. Uterus is usually bigger than date
B. Cervical OS is opened with tissue inside the cervix C. Need to have evacuation of the uterus
D. After complete abortion there is minimal or no pain and minimal or no bleeding
E. Follow up with β-hCG for one year.
3. In patients with three consecutive spontaneous abortion in the second trimester the most useful investigation is:
A. Chromosomal analysis B. Hysterosalpingogram C. Endometrial biopsy D. Post coital test E. Prolactin level
4. Regarding cervical incompetence, all of the following are true, EXCEPT:
A. Typically causes painful abortions
B. Typically causes mid-trimester abortions
C. Is treated by Shirodkar suture (cervical cerculage) which is best preformed early in the second trimester
D. May lead to premature rupture of the membrane E. Can occur in patient with history of cone biopsy
5. Causes of first trimester abortion A. Chromosomal abnormalities B. Cervical incompetence C. Bicornuate uterus
D. Gestational hypertension E. Pre-eclampsia
6. Management of a patient with threatened abortion includes all of the following, EXCEPT:
A. Ultrasound
B. Physical examination C. CBC
D. Derailed menstrual history E. Dilatation and curettage.
7. A 25-year-old primigravida with 8 weeks threatened abortion, ultrasound would most likely reveal:
A. Thickened endometrium with no gestational sac B. Feral heart motion in the adnexia
C. Empty gestational sac D. Collapsed gestational sac E. An intact gestational sac with fetal
8. Regarding incomplete abortion, all are true, EXCEPT:
A. There is a history of tissue passed per vagina B. The cervix is open on vaginal examination
C. Ultrasound shows retained product of conception D. Ultrasound shows intact gestational sac non- viable fetus E. Management include evacuation
9. Most common cause of first trimester abortion A. Chromosomal abnormalities
B. Syphilis
C. Rhesus isoimmunization D. Cervical incompetence E. Bifurcate uterus
10. Incompetent cervix
A. Is a cause for early pregnancy loss B. Is best diagnosed by history
C. Is a cause for fetal congenital abnormalities D. Is not encounted with uterine anomities E. Can be treated with tocolytics
11. Of the proposed etiologies for recurrent pregnancy wastage, the least likely is:
A. Maternal trauma.
B. Maternal balanced translocation.
C. Paternal balanced translocation.
D. Luteal phase deficiency.
E. Autoimmune disease.
12. The most common etiology for spontaneous abortion of a recognized first trimester gestation:
A. Chromosomal anomaly in 50-60% of gestations. B.
Chromosomal anomaly in 20-30% of gestations. C.
Maternal hypothyroidism.
D. Maternal Diabetes.
E. Progesterone deficiency.
13. In threatened abortion, which one of the following items is TRUE?
A. The cervix is open
B. Evacuation is the best treatment C. All patients should be admitted
D. In the majority of cases pregnancy will continue without any complication E. Does not necessitate giving Anti-D for Rh-negative mother
14. In case of threatened abortion : A. Fetalheartispresent B. Cervix is dilated
C. There is a history of passing tissue per vagina.
D. Patients needs immediate evacuation
E. No need to give anti-D for Rhesus negative mothers
15. Missed abortion may cause one of the following complication:
A. Bone marrow depression B. Rupture uterus
C. High positive serum β-hCG D. Skin allergies
E. Coagulopathy
16. Management of a patient with threatened abortion includes all the followings EXCEPT:
A. Ultrasound.
B. Physical exam.
C. CBC.
D. Detailed menstrual history.
E. Immediate dilation and curettage.
17. In threatened abortion at 15 weeks gestation in a nulliparous patient:
A. Pain is characteristic.
B. The internal os is often opened.
C. Fainting is characteristic.
D. Vaginal bleeding is usually mild.
E. Absence of fetal movements suggest non viability.
18. Regarding threatened abortion:
A. Anti-D should be given to Rh- positive mother.
B. All patients should be admitted to the hospital.
C. Ultrasound should be done to confirm the diagnosis.
D. Vaginal examination will reveal severe pain.
E. The patient has vaginal bleeding and tissue passage per vagina.
19. Therapy in threatened abortion should include:
A. Progesterone IM B. D & C
C. Prolonged bed rest D. Restricted activity
E. Prostaglandin suppositories
20. During the first & second trimester of pregnancy, the most common pathologic cause of vaginal bleeding :
A. Hydatiform mole B. Abruptio placenta C. Ectopic pregnancy D. Abortion
E. Uterine rupture
21. Which of the following items may be associated with a mid trimester abortion:
A. Recurrent pelvic infection B. Maternal smoking C. Uterine anomalies D. Sickle cell disease
E. Hyperemesis gravidarum
22. Bleeding in early pregnancy could be causes by all of the following, EXCEPT : A. An ectopic pregnancy
B. Trophoblastic disease C. Carcinoma of the ovary
D. Invasive carcinoma of the cervix E. Threatened abortion
23. Which of the following is correct in the treatment of a case of threatened abortion :
A. Bed rest
B. Oral stillbosterol C. Curettage
D. Urgent admission to hospital E. I.M Tranexamic acid
24. Abortion :
A. Has an incidence of 15% of all pregnancy
B. 18 weeks missed abortion is usually managed with suction curettage C. In threatened abortion, the cervix is always open
D. 1st trimester abortion is usually causes by incompetent cervical os E. Pregnancy usually continue to term in cases of inevitable abortion
25. Etiological factors in spontaneous abortion include : A. Chromosomal abnormalities
B. Placental abnormalities C. Maternal disease D. Uterine abnormalities E. All of the above
26. A major hazard of a late missed abortion :
A. A positive human chorionic gonadotropin (hCG) titer B. Systemic allergies
C. Bone marrow depression D. Coagulopathy
E. Toxemia
27. A missed abortion is :
A. Death of the fetus at 36 weeks of gestation
B. In which the products of conception are expelled completely C. In which the products of conception are partially expelled D. Bleeding and cramps but the fetus still viable
E. Death of the fetus before 24 weeks gestation
28. A 26- year- old married white whose LMP was 2 ½ months ago developed bleeding, uterine cramps, and passed some tissue per vagina. Two hours later she began to bleed heavily
I. The most likely diagnosis is : A. Twin pregnancy B. Threatened abortion C. Inevitable abortion D. Premature labor E. Incomplete abortion
II. Of the option listed, the bleeding is most likely due to : A. Retained products of conception
B. Ruptured uterus
C. A systemic coagulopathy D. Vaginal lacerations
A. Bleeding hemorrhoids
III. The indicated procedure is : A. Hysterectomy B. Vaginal packing
C. Compression of the hemorrhoids D. IV fibrinogen
E. Uterine curettage
29. Cervical cerculage:
A. Closure of incompetence cervix
B. Effective in prevention of all types of abortion C. Should be removed at 32 weeks of pregnancy
D. Protect against exposure of the pregnant lady to infection E. Should applied after 9 weeks of pregnancy
30. A 25 primigravida with 8 weeks threatened abortion. The US would most likely reveal :
A. Thickened endometrium with no gestational sac.
B. Fetal heart motion in the adnexia.
C. Empty gestational sac.
D. An intact gestational sac with fetal heart motion.
E. Collapsed gestational sac.
31. 14 weeks pregnant woman had abortion and she was told that it is a complete abortion. This is true regarding complete abortion:
A. Uterus is usually bigger than date
B. Cervical OS is opened with tissue inside the cervix C. Need to have evacuation of the uterus
D. After complete abortion there is minimal or no pain and minimal or no bleeding
E. Follow up with β-hCG for one year.
32. Regarding Cervical incompetence, one is true:
A. Cone biopsy is not a predisposing factor B. Cerculage is contraindicated
C. In not encountered with uterine anomalies D. Best diagnosed by Hx
E. Is a cause of early pregnancy abortion
33. In patients with three consecutive spontaneous abortion in the second trimester the most useful investigation is:
A. Chromosomal analysis B. Hysterosalpingogram
A. 1%.
B. 10%.
C. 25%.
D. 50%.
E. 75%.
C. Endometrial biopsy D. Post coital test E. Prolactin level
34. Therapy for threatened abortion should include:
A. Progesterone IM.
B. D & C.
C. Prolonged bed rest.
D. Restricted activity.
E. Prostaglandins suppository.
35. Approximately what percentage of spontaneous 1ST trimester abortions show chromosomal abnormalities:
36. Repeated 2ND trimester abortions, especially when associated with a lack of painful uterine contractions, suggests most strongly:
A. Defective germ plasm.
B. Uterine myoma.
C. Maternal hyperthyroidism.
D. Folic acid deficiency.
E. Incompetent cervical os.
37. Inevitable abortion is usually associated with all of the following EXCEPT:
A. Pain.
B. Dilated cervix.
C. Bleeding.
D. Fever.
E. The pregnancy is almost doomed.
38. Threatened abortion is characterized by:
A. The presence of empty sac by ultrasound.
B. Disappearance of pregnancy symptoms.
C. Passage of vaginal vesicles.
D. The cervix is affected.
E. Vaginal bleeding.
39. In spontaneous abortion:
A. Uncontrolled blood sugar increases the risk of abortion in diabetic patients.
B. If the patient has mild bleeding with opened internal os this is considered to be threatened abortion.
C. Cervical incompetence is the most common cause of abortion in the 1ST trimester.
D. History of bleeding & passing of tissue per vagina indicates the need for curettage without the need for US.
E. D & C should be done immediately once missed abortion is diagnosed.
40. Early bleeding in pregnancy may be caused by the following, EXCEPT:
A. Incomplete abortion B. Cervical cancer C. Threatened abortion D. Ectopic pregnancy E. Vasa praevia