Obstetrics (Textbook) MCQs

Question 1

Ritodrine can cause:

a) bradycardia
b) heart block
c) left ventricular failure
d) hypotension
e) peripheral vasconstriction.

Answer 1

c) left ventricular failure
d) hypotension

Question 1

Infant respiratory distress syndrome:

a) usually occurs within 12 hours of delivery
b) usually occurs after caesarean section
c) has a better prognosis if steroids are given to the infant
d) is uncommon after 36 weeks’ gestation
e) is more common in multiple pregnancies.

Answer 1

a) usually occurs within 12 hours of delivery
d) is uncommon after 36 weeks’ gestation
e) is more common in multiple pregnancies

Question 2

The second twin becomes ‘stuck’ following the administration of ergometrine. The following drugs will reliably relax the uterus:

a) thiopentone
b) suxamethonium
c) ritodrine
d) salbutamol
e) halothane

Answer 2

e) halothane

Question 3

The idiopathic respiratory distress syndrome:

a) occurs 12 hours after delivery
b) is more common following caesarean section
c) is caused by lack of surfactant
d) is more common in babies delivered post-term
e) presents with cyanosis.

Answer 3

b) is more common following caesarean section
c) is caused by lack of surfactant

Question 4

For caesarean section under epidural:

a) never give more that 20mL of 0.5% bupivacaine
b) the block must extend from T5 to S1
c) you must give syntocinon rather than ergometrine
d) you must also do a paracervical block
e) you should preload with 500mL of Hartmann’s solution.

Answer 4

c) you must give syntocinon rather than ergometrine

Question 5

You are asked to provide anaesthesia for a patient with a breech delivery when difficulty is being experienced with the fetal head. The following are acceptable techniques:

a) spinal
b) epidural
c) cyclopropane
d) thiopentone, suxamethonium, intubation
e) ketamine.

Answer 5

d) thiopentone, suxamethonium, intubation

Question 6

In a pregnant woman at term:

a) tidal volume is increased
b) functional residual capacity is increased
c) physiological dead-space is decreased
d) total vital capacity is reduced
e) airway resistance is reduced

Answer 6

a) tidal volume is increased
c) physiological dead-space is decreased
d) total vital capacity is reduced

Question 7

Amniotic fluid embolism can cause:

a) bronchospasm
b) bleeding
c) peripheral cyanosis
d) pulmonary hypertension
e) hypertension.

Answer 7

b) bleeding
c) peripheral cyanosis
d) pulmonary hypertension

Question 8

Diazoxide is used in the treatment of pre-eclampsia because:

a) it causes a diuresis
b) given intravenously it causes hypotension
c) it prevents hypoglycaemia
d) it increases uterine contractility
e) it provides useful sedation

Answer 8

a) it causes a diuresis
b) given intravenously it causes hypotension
c) it prevents hypoglycaemia

Question 9

Pethidine is used in obstetrics because:

a) it is 75% excreted unchanged
b) it does not cross the placenta
c) it causes less respiratory depression than an equipotent dose of morphine
d) it can be used without medical supervision
e) it does not affect uterine contractility.

Answer 9

d) it can be used without medical supervision
e) it does not affect uterine contractility.

Question 10

In the management of uterine haemorrhage the following are used:

a) IV fibrinogen
b) IV ergometrine
c) aortic compression
d) uterine packing
e) bimanual compression

Answer 10

b) IV ergometrine
c) aortic compression
d) uterine packing
e) bimanual compression

Question 11

Causes of a low Apgar score (5) following lower-segment caesarean section (LSCS) are:

a) maternal hypoxia
b) uterine incision-delivery time greater than 90s
c) placental transfer of muscle relaxant
d) reduced uterine contractility
e) reduced placental blood flow.

Answer 11

a) maternal hypoxia
b) uterine incision-delivery time greater than 90s
e) reduced placental blood flow.

Question 12

Suxamethonium does not cross the placenta because of:

a) placental cholinesterase
b) high protein binding
c) it being an elongated molecule
d) its high degree of ionization
e) insufficient maternal concentration.

Answer 12

d) its high degree of ionization

Question 13

Signs of fetal distress include:

a) loss of beat to beat variation
b) transverse lie
c) fetal respiratory movements
d) early decelerations
e) late decelerations.

Answer 13

a) loss of beat to beat variation
e) late decelerations.

Question 14

In the fetal transfer of drugs given by the epidural route:

a) the placenta is an effective barrier
b) fetal bradycardia may occur with local analgesics
c) highly protein-bound drugs are transferred less
d) amide-linked local analgesics should be avoided
e) opiates should be avoided.

Answer 14

b) fetal bradycardia may occur with local analgesics

Question 15

A pregnant mother at term:

a) has increased gastric tone
b) may develop hypotension if turned on her side
c) has an increased cardiac output (compared with non-pregnant state)
d) has decreased vital capacity
e) has decreased MAC for inhalational agents.

Answer 15

c) has an increased cardiac output (compared with non-pregnant state)

d) has decreased vital capacity

e) has decreased MAC for inhalational agents.

Question 16

Amniotic fluid embolism:

a) can occur during therapeutic abortion
b) occurs only following delivery
c) may present as haemorrhage
d) definitive diagnosis can be made only at post-mortem
e) is more common in multiparous women.

Answer 16

a) can occur during therapeutic abortion
c) may present as haemorrhage
e) is more common in multiparous women.

Question 17

Apgar score:

a) is of no value in caesarean sections
b) is made one minute after delivery of the head
c) heart rate is of more use than colour
d) cannot be applied to coloured babies
e) is a sensitive index of neonatal depression.

Answer 17

b) is made one minute after delivery of the head
c) heart rate is of more use than colour

Question 18

Anti-D antibodies that develop in a rhesus-negative mother with a rhesus-positive child:

a) cause anaemia in the fetus
b) cause jaundice in the fetus
c) fetal rbc are found in maternal circulation
d) occurs during the first trimester only
e) develop because of antigen crossing the placenta.

Answer 18

a) cause anaemia in the fetus
b) cause jaundice in the fetus
c) fetal rbc are found in maternal circulation

e) develop because of antigen crossing the placenta.