The consequences of Rh-incompatibility are not serious during the first pregnancy because the immune response is weak. Anti-D immunoglobulin should be given to unimmunized Rh-negative women at 28 weeks and within 72 hours of delivery to prevent sensitization. IgM is the first antibody to appear after Rh alloimmunization. The average duration of lochia discharge is 5-15 days. Common routes of spread of puerperal sepsis are lymphatic and direct invasion. Hysterectomy is the best management for postpartum haemorrhage due to placenta increta. Tissue trauma is a common predisposing factor for puerperal sepsis.

1. 1. The consequences of Rh-incompatibility are notseriousduringthe firstpregnancy because:
1. Inthe firstpregnancy, only IgMantibody isformed
2. Antibody titerisvery low duringaprimary immune response
3. IgG generated isineffectiveagainstfetalredcells
4. Massive hemolysis iscompensated byincreased erythropoiesis.
2.In nonimmunisedRh-Negative primigravidaanti Dshould be givenat
1. 28 weeks
2. 24 w
3. 28 weeks andwithin72hoursafterdelivery
4. 1 and3 are right
3. Whichisthe firstantibody toappearafterRh alloimmunization
1. IgG
2. IgA
3. IgM
4. Ig E
4.A patientpresents servedepression onthe fourthdayfollowingdelivery. The most
appropriate diagnosisis
A. Postpartumdepression
B. Postpartumblues
C. Postpartumpsychosis
D. Postpartummania
5.The uterusreturns tonongravid size afterhow manyweeks afterdelivery byultrasaond
a. 2 w
b. 4w
c. 6w
d. 8
6.The average duration of lochiadischarge is
a.5-15 days
b. 10-25 d
c. 25-35 d
d. upto 60 daysfromdelivery

2. 7.Whichisthe common route of spreadof puerperal sepsis
a. Lymphatic
b. Directinvasion
c. Gematogenous
d. Both B and C
8.A multiparous womanpresentingwithpostpartumhaemorrhagedue toplacentaincretaisbest
managed by:
a. Hysterectomy withthe removalof the adherentplacenta
b. Internal iliacartery ligation
c. Hysterectomy
d. Packingthe uterusfollowed byacourse of methotrexate
9.Commonestcause predisposingtopuerperal sepsis is:
a. Irondeficiency
b. Poornutrion
c. Maternal exhaustion
d. Tissue trauma
10.A mostcommoncause of postpartumendometritis is:
a. Coli
b. Gonococcus
c. Streptococcus
d. proteus
11. Postpartumdecidual secretions presentare referred toas:
a. lochia
b.bleedingpervagina
c. vasa- previa
d. decidua- capsularis

3. 12. the weightof the uterus immediately afterdelivery is
a. 300 g
b. 100 g
c. 1000g
d. 500g
13. Whichof the followingstepsforproven benefitindecreasingpuerperalinfectionfollowing
caesareansection?
a. Nonclosure of peritoneum
b. Single layeruterineclosure
c. Administration of single dose of ampicillin or1st
generation cephalosporinatthe time of
cesareandelivery
d. Skinclosure withstaplesthanstatue
14. Lactational amenorrheaisdue to:
a. prolactin- suppressingGnRH
B. Prolactin increases FSHandLH
C. Prolactin increases estrogenandprogesterone
d. all of the above
15. Breastfeedingcanbe encouraged despitewhichof the following
a. Maternal hepatitis b
b. Maternal reduction mammoplastywithtransplantation of the nipples
c. Maternal acute puerperal mastitis
d. Maternal treatmentwithlithiumcarbonate
16. Rupture of the membrane issaidtobe premature whenitoccurs
a. 38 weeksof pregnancy
b. 32 w
c. Priorto the 1st
stage of labour
d. II stege of labour
17. Bloodwill interfere withthe nitrazinetestfordetectingruptured membranes because:
a. it isacid
b.it isalkaline

4. 3. itcontains increased of sodiumchloride
4. itcontains decreased amountof sodiumchloride
18. Placentaincretameans
a. villi are attachedtoloweruterinesegment
b. villi are attachedtothe myometrium
c. villi invademyometrium
d.villi invadethroughthe myometrium
19. Whichof the followingisfalse regardingvasapraevia:
a. maternal mortality isaround80%
b. seeninthe velamentous insertion of placenta
c. unsupported bloodvesselsare belowthe presentingpart
d. the APTtestis diagnostic
20. All are done inmassive PPHexcept
a. Hysterectomy
b. Thermal endometrial ablation
c. Internal iliacA. ligation
d. Ballontamponade.
21. B Lynch suture isapplied on
1. cervix
2. uterus
3. fallopian tube
4. ovaries
22. Selectthe true statementregardingHydatidiformmole
a. Complete molehasadual setof maternal genes
b. The uterus islargerthan the period of amenorrhea

5. c. Fetal partare feltseparately fromthe molartissue
d. All the above are true
23. Whichone of the followingstatements isfalse regarding“partial hydatidiformmole”?
a. Chance of choriocarcinoma<5%
b. Demonstrates diploid karyotype
c. May containfetus
d. Has milderelevationof HGC
24. Drug of choice forlow-grade choriocarcinoma
a.methotrexate
b. oncovin
c. cyclophosphamide
dd.chlorambucil
25. A gestational choriocarcinomaoccursmostcommonly after:
a. Termpregnancy
b. Complete mole
c. Abortion
d. Ectopicpregnancy
26. Motherwithchickenpox delivery after2weeks of acquisition,whatintervention isnecessary for
the newborn:
a. V. acyclovir
b. Varicella- zosterimmunoglobulin
c. OphthalmicexaminationP
d. All of the above
27. False statementaboutmumpsduringpregnancy
a. It causessterility inthe fetus
b. Incidence islow afterthe introduction of MMR vaccine
c. MMR vaccine iscontraindicated duringpregnancy
d. It generaly doesnotaffectthe course of pregnancy
28. Whichisnot true about toxoplasmosisduringpregnancy
a. Maximumtransmissionanddamage duringthe firsttrimester
b. Maximumtransmission inthe firsttrimesterandmaximumdamage inthe thirdtrimester
c. Maximumdamage inthe firsttrimesterandmaximumtransmission inthe thirdtrimester
d. Maximumtransmissionanddamage duringthe thirdtrimestser.

6. 29.The riskof fetal varicellasyndrome ismaximumwhen the motherisinfectedbetween
a. 6-10 w
b. 8-12 weeks
c. 13-20 weeksq¹¹
d. 20-38 weeks
30.whichisnotincluded inthe tetradof toxoplasmosis
a. convulsion
b. chorioretinitis
c. intracranial calcification
d.anaemia
31. whena newborn isseenwithlimbhypoplasiaand skinlesions thenthereisahighchance
that the motherissufferingfrom
a. rubella
b. cytomegalovirus
c. chickenpox
d. toxoplazmosis