and Janesh Gupta2
(1)
Fetal Medicine, Rainbow Hospitals, Hyderabad, Telangana, India
(2)
University of Birmingham Birmingham Women’s Hospital, Birmingham, UK
MMD1
Clinical signs suggestive of sepsis include all of the following except:
A.
Hypothermia
B.
Polyuria
C.
Pyrexia
D.
Tachycardia
E.
Tachypnoea
MMD2
What is false about immunisation and antibiotic prophylaxis in women at risk of transfusion related infections?
A.
All women who have undergone a splenectomy should take penicillin prophylaxis or equivalent.
B.
All women who have undergone a splenectomy should be vaccinated for pneumococcus and Haemophilus influenzae type B if this has not been done before.
C.
Hepatitis B vaccination is recommended in HBsAg-positive women who are transfused or may be transfused.
D.
Hepatitis C status should be determined.
E.
The pneumococcal vaccine should be given every 5 years.
MMD3
Which of the following features are not a hallmark of acute fatty liver of pregnancy?
A.
Disseminated intravascular coagulation
B.
Elevated liver enzymes
C.
Hypoglycaemia
D.
Hyperuricaemia
E.
Proteinuria
MMD4
Of the following symptoms, mark the one ‘not’ included in the classical symptomatology of Wernicke’s encephalopathy:
A.
Ataxia
B.
Blindness
C.
Confusion
D.
Convulsions
E.
Nystagmus
MMD5
The following are known complications of obstetric cholestasis in pregnancy except:
A.
Intrauterine deaths
B.
Maternal pruritus
C.
Meconium staining of liquor
D.
Neonatal jaundice
E.
Preterm birth
MMD6
All the following are category C drugs in pregnancy except:
A.
Aspirin
B.
Cyclophosphamide
C.
Hydroxychloroquine
D.
Sulphasalazine
E.
Tacrolimus
MMD7
All of the following statements about the thyroid hormones in pregnancy are true except:
A.
Free T3 level is unchanged.
B.
Increased thyroid binding globulin in blood.
C.
Total T3 and T4 levels are increased.
D.
TSH rises in the third trimester.
E.
T3 crosses the placental barrier.
MMD8
Of the following statements about hyperthyroidism in pregnancy, select the correct one:
A.
During pregnancy, treatment should be aimed at keeping the thyroid hormones at the lower limit of normal range.
B.
Fetal hypothyroidism is a common complication in these patients.
C.
Pregnancy worsens thyroid status especially in the third trimester.
D.
Propylthiouracil and carbimazole can be safely continued in pregnancy.
E.
Propylthiouracil and carbimazole do not cross the placenta.
MMD9
Hypopituitarism presents with all of these features except:
A.
Adrenocortical insufficiency
B.
Amenorrhoea
C.
Anosmia
D.
Failure to lactate
E.
Hypothyroidism
MMD10
Hyperprolactinemia can be caused by all of the following except:
A.
Dopamine antagonists
B.
Hyperthyroidism
C.
Pituitary adenomas
D.
Polycystic ovarian disease
E.
Pregnancy
MMD11
All of the following are true regarding carbohydrate metabolism in pregnancy except:
A.
Decrease in insulin sensitivity in early pregnancy.
B.
Fasting blood sugars are 10–20 % lower.
C.
Hyperplasia of islets of Langerhans.
D.
Increase in free fatty acids and ketones bodies in circulation.
E.
Insulin resistance increases as pregnancy advances.
MMD12
The target range for blood sugars during labour for a pregnancy complicated by pre-existing diabetes is:
A.
2–4 mmol/L
B.
4–6 mmol/L
C.
6–8 mmol/L
D.
8–10 mmol/L
E.
10–12 mmol/L
MMD13
The following statement is true regarding metformin use in pregnancy:
A.
It has no reported adverse fetal outcomes.
B.
It is licensed for use during pregnancy.
C.
It is effective in achieving good glycaemic control in pregnancy.
D.
It is classified as a category C drug.
E.
Lactic acidosis is a common complication.
MMD14
In GDM, maternal hyperglycaemia is independently and significantly linked to all of the following adverse outcomes except:
A.
Caesarean delivery
B.
Early miscarriages
C.
Fetal hyperinsulinism
D.
Macrosomia
E.
Neonatal hypoglycaemia
MMD15
All of the following are pre-existing risk factors for development of type 2 diabetes except:
A.
Assisted reproduction
B.
Increasing parity
C.
Maternal age
D.
Maternal BMI
E.
Twin pregnancy
MMD16
Increase in the risk of pulmonary thromboembolism in women with BMI >30 is:
A.
Same as women with BMI <30
B.
3–5 times increased
C.
5–10 times increased
D.
10–12 times increased
E.
15 times increased
MMD17
Which of the following statements best describes the role of serum ferritin in pregnancy?
A.
An unstable glycoprotein involved in iron transport.
B.
An acute phase reactant and levels rise in infection.
C.
Best test parameter to assess any type of anaemia in pregnancy.
D.
Ferritin levels steadily reduce as pregnancy progresses.
E.
Treatment should be started when ferritin levels are below 50 μg/l.
MMD18
The risk of recurrent urinary tract Infection in pregnancy is:
A.
1–2 %
B.
4–5 %
C.
10–15 %
D.
15–18 %
E.
20%
MMD19
A 30-year-old woman, who is 36 weeks pregnant, is seen in antenatal clinic. This is her first pregnancy. She is HIV positive. She has been fully compliant with her HAART (highly active antiretroviral therapy) throughout her pregnancy. Her latest serum viral load is <50 copies/mL. Apart from HIV, her pregnancy has been uncomplicated, and she has an appropriately grown cephalic presentation fetus. She is concerned about vertical transmission of HIV and is keen to avoid surgery if possible. Which one of the following is recommended management and advice?
A.
Elective caesarean at 38 weeks gestation.
B.
Elective caesarean at 39 weeks station.
C.
Induce vaginal birth at 38 weeks gestation.
D.
Offer spontaneous vaginal birth.
E.
Postnatally, breastfeeding is considered safe as viral copy number is low.
MMD20
A 38-year-old woman is 12 weeks pregnant with a twin pregnancy. This is her second pregnancy, with her previous pregnancy complicated by gestational hypertension. Her booking blood pressure, at 12 weeks, is 135/85 mmHg. Her BMI is 34 kg/m2. She smokes 10 cigarettes/day. Which one of the following is considered a significant (high) risk factor for the development of pre-eclampsia as her pregnancy progresses?
A.
Age >35
B.
BMI >30
C.
Hypertensive disease during previous pregnancy
D.
Multiple pregnancy
E.
Smoking
MMD21
A 28-year-old woman is 12 weeks pregnant with a singleton pregnancy. This is her first pregnancy. Her booking blood pressure, at 12 weeks, is 140/90 mmHg. Her BMI is 34 kg/m2. She smokes 10 cigarettes/day. Her mother suffered from pre-eclampsia in her pregnancies. Which one of the following is considered a significant (high) risk factor for the development of pre-eclampsia as her pregnancy progresses?
