Obs and gynae data bank

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CLINICAL OFFICERS
FINAL EXAM: GYNAE AND OBSTETRICS
DATA BANK

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SECTION A: Circle the correct answer (25 marks). You Lose ¼ mark for each
wrong answer.
1. Zambia is addressing the millennium development goal number five by the
year 2015: What is the specific reproductive health problem being
addressed?
a. Reduction of child mortality per 100,000 live births
b. Reduction of TB per 100,000 live births
c. Reduction of maternal deaths per 100,000 live births
d. Reduction of HIV deaths per 100,000 live births
e. Reduction in neonatal mortality
2. The criteria to consider for post exposure prophylaxis therapy against HIV
is:
a. Have the base line HIV test result
b. Obtain Full Blood count result
c. Establish Viral load
d. Establish CD4 Count
e. HVS smear
3. Alcohol drinking during pregnancy may lead to:
a. Fetal alcoholism during teen years
b. Neonal diabetes
c. Low Apgar score at birth
d. Neonatal withdraw seizures
e. Diabetis
4. Control of Diabetes during pregnancy is best achieved with:
a. Diabetic Diet
b. Antibiotics.
c. Insulin therapy
d. Dionil therapy
e. Malaria presumptive treament
5. Amenorrhoea at 50 years of age is commonly associated with:
a. Pregnancy
b. Family Planning
c. Dysfunction uterine bleeding
d. Endometriosis
e. Menopause
6. In uterine fibromyomata, management of labour in full term pregnancy with
normal progress of labour often is an indication for:

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a. Caesarean section
b. Vacuum assisted delivery
c. Medical augmentation of labour
d. Spontaneous vaginal delivery
e. Home delivery
7. Which of the following test does confirm diagnosis of amniotic leakage per
vagina:
a. Protein in urine
b. Fern test
c. PCR
d. Full blood count
e. Culture and sensitivity
8. Uterine couvelaire is a complication that can occur in one of the obstetric
surgical procedures. Which of the following procedure would cause the
complication?
a. Caesarean Section
b. Medical induction of Labour
c. Total hysterectomy
d. Bilateral tubal ligation
e. Shirodka suture(ciclage)
9. During Focused Antenatal care danger signs are discussed with mothers.
Which of the following is an emergency sign?
a. Productive cough once this morning
b. Vomiting once this morning
c. Insomia for one day
d. Drinking of 1litre of fluids today
e. Per vaginal bleeding twice today
10. Inevitable abortion is often associated with anomaly problems. Which
anomaly is important for clinicians to include for investigations when
abortion occurs.
a. Uterus incompetence test
b. Urine incontinent test
c. Cervical incompetence test
d. Vesical vaginal test
e. Syphilis test
11. Menopause can be caused by one of the procedure listed below.
a. Hystorotomy
b. Total Hysterectomy

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c. Bilateral Tubal Ligation
d. Mastitectomy
e. VVF repair
12. The criteria to start PMTCT always as rule follow:
a. Base line HIV positive test irregardless of consent
b. Base line HIV negative test & client consent
c. Base line HIV positive test & client consents
d. Base line Viral load and patient consents
e. Baseline Sti tests should be negative
13. Endometriosis lesion on the thigh in child bearing age can best be treated by:
a. Short term pill therapy
b. Long term pill therapy
c. Cervical Dilatation and currettage
d. Cauterisation
e. Antibiotic ointment
14. The average weight gain per week for a mother during normal pregnancy is:
a. 1.0kg
b. 2.0kg.
c. 1.5kg
d. 0.7kg
e. 0.2kg
15. What is the good practice for management of placenta previa type 3?
a. Admit at RHC and wait for SVD
b. Refer for hospital C/Section delivery
c. Give IEC and mother to come when labour starts
d. Give Oxytocin stat to induce labour
e. Allow mother to decide when to admit her for labour.
16. One Indication for induction of labour is
a. Premature labour at 3rd stage.
b. Premature labour at 2nd stage
c. Post dates
d. Premature labour in breech presentation.
e. Wrong dates for LMP
17. In Obstructed labour factors are many. Which is the common factor:
a. Diabetis.
b. Placenta previa Totalis

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c. Full bladder
d. Cephalo pelvic disprortion
e. Twin pregnancy
18. The first breast milk after delivery is a yellowish fluid and nutritious for
the neonate. What is it called:
a. Haemacele.
b. Lactalbumin
c. Caseinnogen
d. Colostrum
e. Protein
19. Breast cancer when diagnosed early is:
a. Curerable with surgery
b. Curerable with antibiotic
c. Curerable with vitamin therapy
d. Curerable with hormone therapy
e. Curerable with chemotherapy for 3months
20. The Choice management for premature rupture of membranes are 36 weeks
pregnancy is:
a. Start antibiotics and plan for delivery in hospital
b. Admit to hospital and augment labour.
c. Start Antibiotics and treat as outpatient until labour starts
d. Antibiotics and order emergency caesarean section
e. Give analgesics and bed rest
21. Zambia is addressing the millennium development goal number five by the
year 2015: What is the specific reproductive health problem being
addressed?
a. Reduction of child mortality per 100,000 live births
b. Reduction of TB per 100,000 live births
c. Reduction of maternal deaths per 100,000 live births
d. Reduction of HIV deaths per 100,000 live births
is:
a. Do base line HIV testing
b. Do a Full Blood count
c. Do Viral load
d. Do CD4 Count

6
b. Neonal diabetes
a. Diabetic Diet
b. Antibiotics.
c. Insulin therapy
d. Dionil therapy
25. Luteum gravidate Test is true positive following Amenorrhoea at:
a. 2 weeks history of amenorrhoea
b. 21 days post coitus.
c. after 4 weeks of amenorrhoea
d. 10 weeks of amenorrhoea
26. In uterine fibromyomata, management of labour in full term pregnancy with
normal progress of labour often is an indication for:
a. Caesarean section
b. Vacuum assisted delivery
c. Medical augmentation of labour
d. Spontaneous vaginal delivery
27. Which of the following test does confirm diagnosis of amniotic leakage per
vagina:
a. Protein in urine
b. Fern test
c. PCR
d. Full blood count
28. Uterine couvelaire is a complication that can occur in one of the obstetric
surgical procedures. Which of the following procedure would cause the
complication?
a. Caesarean Section
b. Medical induction of Labour
c. Total hysterectomy
d. Bilateral tubal ligation
29. During Focused Antenatal care danger signs are discussed with mothers.
Which of the following is an emergency sign?
a. Productive cough once this morning
b. Vomiting once this morning

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c. Insomia for one day
d. Drinking excessive water, 4litres today
30. Inevitable abortion is often associated with anomaly problems. Which
anomaly is important for clinicians to include for investigations when
abortion occurs.
a. Uterus incompetence test
b. Urine incontinent test
c. Cervical incompetence test
d. Vesical vaginal test
31. Menopause can be caused by one of the procedure listed below.:
a. Hystorotomy
d. Mastitectomy
d. Cauterisation
a. 1.0kg
b. 0.2kg.
c. 0.5kg
d. 0.7kg
35. What is the good practice for Cord controlled traction of the placenta?
a. Give Antibiotics after delivery of the placenta
b. Give diazepam before procedure
c. Give IV Fluids during procedure
d. Give Oxytocin stat if uterine atony occurs.

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36. One Indication for Augmentation of labour is
c. Premature labour at latent phase
a. Stool Impaction.
c. Full bladder
38. The first breast milk after delivery is a yellowish fluid and nutritious for
the neonate. What is it called:
a. Haemacele.
b. Lactalbumin
c. Caseinnogen
d. Colostrum
39. The Fibrods in young women:
a. Are main cause of primary infertility
b. Are main cause of early abortion
c. Are mainly symptom free
d. Are main cause of pre-eclampsia
40. The Choice management for premature rupture of membranes are 36 weeks
pregnancy is:
c. Start Antibiotics and treat as out patient until labour starts
d. Antibiotics and order emergency caesarean section.
41. The cervical assessment is good guide for a positive response to induction of
labour. What is the quantitative method employed:
a. Apgar score
b. Bishop score
c. Third degree score
d. Four hour interval score
42. Which strategy would reduce unplanned pregnancies among the
adolescents?
a. Encourage abstinence education messages only.
b. Encourage one partner messages only.
c. Encourage Parents to choose partners for their daughters.

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d. Encourage Family Planning activities of ABC.
43. The common disorder in embryology abortion during the first trimester is:
a. Drugs
b. Uterine anomalies
c. Genetic causes
d. Cervical incompetence
44. Which of the complaints is not a danger sign during the first 6 days of Post
partum period?
a. Swollen tender calf
b. Red and swollen Breast
c. Red Lochia
d. Moderate per vaginal bleeding
45. The dye test in gynaecology practice is ordered to exclude or confirm:
a.
b. Vesical vaginal fistula
c. Bladder schistosomiasis
d. Endometriosis
e. Anal abscess
46. The management of hydatidiform mole recommends that:
a. Patient stays at least 2 years pregnant free
b. Patient stays at least 1 years pregnant free
c. Patient stays at least 3years pregnant free
d. Patient stays at least half a year pregnant free.
is:
f. Have the base line HIV test result
g. Obtain Full Blood count result
h. Establish Viral load
i. Establish CD4 Count
j. HVS smear
b. Neonal diabetes
e. Diabetis
f. Diabetic Diet

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g. Antibiotics.
h. Insulin therapy
i. Dionil therapy
j. Malaria presumptive treament
44. Amenorrhoea at 50 years of age is commonly associated with:
f. Pregnancy
g. Family Planning
h. Dysfunction uterine bleeding
i. Endometriosis
j. Menopause
45. In uterine fibromyomata, management of labour in full term pregnancy with normal
progress of labour often is an indication for:
f. Caesarean section
g. Vacuum assisted delivery
h. Medical augmentation of labour
i. Spontaneous vaginal delivery
j. Home delivery
46. Which of the following test does confirm diagnosis of amniotic leakage per vagina:
f. Protein in urine
g. Fern test
h. PCR
i. Full blood count
j. Culture and sensitivity
47. Uterine couvelaire is a complication that can occur in one of the obstetric surgical
procedures. Which of the following procedure would cause the complication?
f. Caesarean Section
g. Medical induction of Labour
h. Total hysterectomy
i. Bilateral tubal ligation
j. Shirodka suture
48. During Focused Antenatal care danger signs are discussed with mothers. Which of the
following is an emergency sign?
f. Productive cough once this morning
g. Vomiting once this morning
h. Insomia for one day
i. Drinking of 1litre of fluids today
j. Per vaginal bleeding twice today
49. Inevitable abortion is often associated with anomaly problems. Which anomaly is important
for clinicians to include for investigations when abortion occurs.
f. Uterus incompetence test
g. Urine incontinent test
h. Cervical incompetence test
i. Vesical vaginal test
j. Syphilis test

11
50. Menopause can be caused by one of the procedure listedbelow.:
a. Hystorotomy
d. Mastitectomy
e. VVF repair
e. Baseline Sti tests should be negative
d. Cauterisation
e. Antibiotic ointment
a. 1.0kg
b. 2.0kg.
c. 1.5kg
d. 0.7kg
e. 0.2kg
54. What is the good practice for management of placenta previa type 3?
a. Admit at RHC and wait for SVD
b. Refer for hospital C/Section delivery
c. Give IEC and mother to come when labour starts
d. Give Oxytocin stat to induce labour
e. Allow mother to decide when to admit her for labour.
55. One Indication for induction of labour is
c. Post dates
e. Wrong dates for LMP
a. Diabetis.
c. Full bladder
e. Twin pregnancy
57. The first breast milk after delivery is a yellowish fluid and nutritious for the neonate.
What is it called:

12
a. Haemacele.
b. Lactalbumin
c. Caseinnogen
d. Colostrum
e. Protein
58. Breast cancer when diagnosed early is:
a. Curerable with surgery
b. Curerable with antibiotic
c. Curerable with vitamin therapy
d. Curerable with hormone therapy
e. Curerable with chemotherapy for 3months
59. The Choice management for premature rupture of membranes are 36 weeks pregnancy is:
c. Start Antibiotics and treat as outpatient until labour starts
d. Antibiotics and order emergency caesarean section
e. Give analgesics and bedrest
60. The cervical assessment is good guide for a positive response to induction of labour. What is
the quantitative method employed:
a. Apgar score
b. Bishop score
c. Third degree score
d. Four hourinterval score
61. Which strategy would reduce unplanned pregnancies among the adolescents?
a. Encourage abstinence education messages only.
b. Encourage one partner messages only.
c. Encourage Parents to choose partners for their daughters.
d. Encourage Family Planning activities of ABC.
62. The common disorder in embryology abortion during the first trimester is:
a. Drugs
b. Uterine anomalies
c. Genetic causes
d. Cervical incompetence
63. Which of the complaints is not a danger signduring the first 6 days of Post partum period?
a. Swollen tender calf
b. Red and swollen Breast
c. Red Lochia
d. Moderate per vaginal bleeding
64. The dye test in gynaecology practice is ordered to exclude or confirm:
a. Vesical vaginal fistula
b. Bladder schistosomiasis
c. Endometriosis
d. Anal abscess
65. The management of hydatidiform mole recommends that:

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a. Patient stays at least 2 years pregnant free
b. Patient stays at least 1 years pregnant free
c. Patient stays at least 3years pregnant free
d. Patient stays at least half a year pregnant free.
Answer True or False on each statement – 1mark each correct answer
About informed choice in Family Planing - 1mrk each
 Provide the Family Planning method the client desires __true
 Tailor information to what you think as a provider_ __________
 Clients have the right to turn down Family Planning ___true_________
 Husbands have fewer rights to Family Planning__ _false___________
 Depo provera is reserved for working clients only__false__________
A criterion for use of LAM in mothers is advised if:
 Fully breastfeeding TRUE
 is more than 6 months post partum TRUE
 Menses have not returned yet TRUE
 Less than 6 months post partum TRUE
 Is HIV positive TRUE
Breast cancer when diagnosed early is:
 Curerable with surgery T
 Curerable with antibiotic F
 Curerable with vitamin therapy F
 Curerable with hormone therapy T
 Curerable with chemotherapy for 3months T
1. Early abortion
Occurs in at least 10% of all the pregnancies T
Can be prevented with a cerclage of the cervix T
The prognosis for a next pregnancy is poor T
Is in most cases due to chromosomal abnormalities T
2. Chronic PID
Can cause dyspareunia T
Is frequently caused by Chlamydia infection T
Makes enlargement of the adnexes F
Is accompanied by severe lower abdominal pain T

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3. Ectopic Pregnancy
Can cause shoulder pain T
Can be treated with Metothrexate in early stages T
Is found mainly in women after multiple pregnancies T
Is mainly caused by damaged tubes after repeated T
4. Male infertility
Is very rare …F…………………..
Can be caused by heavy smoking………T…………..
Is improving with different sexual partners…F………..
Can be caused by the varicosis of the spermatic vein…T…………
5. Cervicalcarcinoma
Can cause contactbleedings T
Is usually causing some lower abdominal pain T
Is preventable through vaccination T
Is rare in southern African countries F
SECTION C: SHORT ANSWER QUESTIONS. CHOOSE and write focused
short notes on any THREE (3) of the questions listed below (5mrks EACH)
1. Endometriosis therapy in child bearing
2. Cervical cancer
3. Discuss early abortion and focused management
4. Outline the diagnosis of Hydatidi formmole
5. Abruptio Placentae
6. List the indications for cone biopsy
7. Stage placenta previae and indicate the focused intervention
8. Counselling process for Prevention of mother to child transmission
9. Elective Caesarean Section
10. Staging of endometrial carcinoma
11. Emergency contraceptives and their indications
12. Complications of Diabetes in pregnancy
13. Use of Vacuum Extraction in labour
14. Postpartum Psychosis
15. Ectopic Pregnancy
16. Ruptured Uterus
17. Molar pregnancy
18. Prolapsed Cord
19. Preterm lab
20. Featal distress in first stage of labour
21. Urine incontinency in women during puerperium
22. Family Planning Services for the Youth in Zambia

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Write the answer to each of the statement/condition (A) below:
Condition/Statement(A) Treatment/Answer (2mrk each)
1. Antidote for Magnesium Sulphate toxicity _____________________
2. What common organism causes Perineal ulcerations _____________________
3. What urine test is helpful to diagnose Pre – eclampsia ____________
4. First line drug of choice to treat Treponema Pallidum is__________________
5. First line drug to treat Vaginal Candidiasis is____________________
State the causative organism/factor associatedwith the disease or condition – 1
mark each
Condition State causative or associatedcause
1. Abruptio Placenta ___________________________
2. Haemolytic disease of baby at birth ___________________________
3. Chancroid ___________________________
4. Mastitis in Breast feeding ___________________________
5. Drug associatedwith multiple pregnancy ____________________
6. Cervical cancer ___________________________
7. Early Abortion ___________________________
8. Chronic diarrhoea in AIDS ___________________________
9. Jaundice of a new born who is stable ___________________________
10. Preterm Labour ____________________________
SECTION D: ESSAY OR CASE STUDY QUESTION TO ANSWER (15mrks)
Essay (2000 words)
1. Focused Anti natal services are important for pregnant mothers. Discuss the
services that are offered and appropriate information and education that ought
to be given to mothers during the first visit
2. What does millennium development (MDG) goal number five address? What
is being done in Zambia to attain this MDG’s objectives?
3. Ante partum Haemorrhage is common in pregnancy. What is the importance
of this condition in Obstetrics?

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4. Discuss the detailed management of a para one with advanced uterine
mayomentrial fibromatous.
5. Discuss the management of a 30 yrs old woman with an abnormal pap smear
result at the first level health facility
6. Outline the focused management of the active third stage labour
7. What is the necessity of the partograph and what are the parameters covered
during it`s use?
8. Discuss the augmentation of labour and it`s contra indications
9. What is Bishop Score in obstetric practice? When is the Bishop Score
favourable?
10. Outline the appropriate management of confirmed case of Eclampsia in full
term viable pregnancy
11. Discuss management of obstetric shock due to haemorrhage in a mother who
has just delivered at your labour room.
A case study
12. Mrs OBGY delivered one month ago uneventfully. She opted to exclusively
breast feed her baby. For 2days now she has felt unwell. She has a painful
right breast. Night temp is 37.8ْ C. She has failed to nurse her baby on the
breast for 5 hrs today. She decided to consult you the clinical officer.
Answer the following in the spaces provided (Total 15mrks)
1. What is your focused diagnosis? 2mrks
2. What Lab investigation would you order to confirm the causative
organism? 2mrks
3. State the common causative agent for her breast condition
______________________________________________________________(1mark)
4. Prescribe the appropriate management (5mrks)

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5. State two common complications of the diagnosis?
a. ______________________1mrk b ___________________1 mrk
6. What specific IEC would you tell the mother as regards breast feeding
the infant taking into account the right breast is painful (3mrk).
Case presentation:
6. A new mother para 1, delivered normally 10hrs ago and was discharged home
uneventful with the baby. While at home resting in bed, the husband discovered
she suddenly developed seizures and became unconscious. She was rushed to the
hospital. Vitals were Temperature 37ْ C, Bp 130/90, Comatose. During exam she
began seizuring again. Answer the following:
b. What is your Primary Diagnosis?___________________________ 2marks
c. What differential diagnosis would you worry about?
___________________________________________ 2marks
d. What laboratory test would you order to exclude the differential diagnosis?
____________________________________________ 2marks
e. What drug would you order to control the seizures immediately and by what route
would you give it?
Drug______________________________________ 2marks
Route_____________________________________ 2marks
f. What would you do about her Blood pressure?
____________________________________________________2mrks
g. List two complications of the diagnosis?
1.________________________________________ 1mrk
2.________________________________________ 1mrk
h. Prescribe the nursing care for this patient? List. 6mrks
____________________________________________________________

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