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Arab Board Ob/Gyn Part 1 study materials
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Arab Board Ob/Gyn Part 1 practice questions

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Question 1Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A 28-year-old woman is undergoing hysterectomy. The ureter is found to pass beneath which structure approximately 1.5–2 cm lateral to the uterine cervix?

  1. The uterine artery Correct answer.
  2. The internal iliac vein
  3. The round ligament
  4. The ovarian artery

Explanation

The ureter travels through the cardinal ligament and passes under the uterine artery near the cervix, the classic “water under the bridge” relationship. This site is a key landmark because it is vulnerable during hysterectomy.

Question 2Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which hormone is the principal estrogen secreted by the dominant ovarian follicle?

  1. Estriol
  2. Estradiol Correct answer.
  3. Estrone
  4. Progesterone

Explanation

Granulosa cells in the dominant follicle aromatize theca-derived androgens to estradiol, the most potent and principal ovarian estrogen. Estrone predominates after menopause, while estriol rises in pregnancy.

Question 3Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

The Müllerian (paramesonephric) ducts give rise to which structures in the female?

  1. Uterus, cervix and upper vagina Correct answer.
  2. Ovaries and ovarian ligaments
  3. Kidneys, ureters and bladder
  4. Labia majora, clitoris and hymen

Explanation

The Müllerian ducts fuse to form the fallopian tubes, uterus, cervix and upper vagina. The ovaries arise from the genital ridge, while the lower vagina and external genitalia develop from the urogenital sinus and genital tubercle/swellings.

Question 4Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which antibiotic is recommended for intrapartum prophylaxis against early-onset neonatal group B streptococcal disease?

  1. Oral amoxicillin
  2. Oral azithromycin
  3. Intravenous penicillin Correct answer.
  4. Intravenous ceftriaxone

Explanation

Intravenous penicillin is the first-line agent for intrapartum group B streptococcal prophylaxis. Ampicillin is an acceptable alternative, and clindamycin or vancomycin is used when penicillin allergy and susceptibility testing require it.

Question 5Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Methotrexate exerts its antifolate effect primarily by inhibiting which enzyme?

  1. Methylenetetrahydrofolate reductase
  2. Thymidylate synthase
  3. Dihydrofolate reductase Correct answer.
  4. Topoisomerase II

Explanation

Methotrexate inhibits dihydrofolate reductase, depleting tetrahydrofolate and blocking thymidylate and purine synthesis. This mechanism underlies its use in ectopic pregnancy and in proliferative disorders.

Question 6Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

The ovarian artery arises directly from which vessel?

  1. External iliac artery
  2. Abdominal aorta Correct answer.
  3. Internal iliac artery
  4. Uterine artery

Explanation

The ovarian artery arises from the abdominal aorta below the renal arteries and reaches the ovary through the suspensory ligament. It anastomoses with the uterine artery, which is a branch of the internal iliac artery.

Question 7Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Ovulation is triggered by a midcycle surge in which hormone?

  1. Luteinizing hormone Correct answer.
  2. Progesterone
  3. Prolactin
  4. Follicle-stimulating hormone

Explanation

A midcycle luteinizing hormone surge triggers follicular rupture about 34–36 hours later. Follicle-stimulating hormone also rises at midcycle, but the luteinizing hormone surge is the decisive ovulatory signal.

Question 8Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

What is the most common benign neoplasm of the uterus?

  1. Leiomyoma Correct answer.
  2. Lipoma
  3. Endometrial polyp
  4. Adenomyoma

Explanation

Leiomyoma, or fibroid, is a benign smooth-muscle tumor and the most common benign uterine neoplasm. Adenomyosis is a non-neoplastic condition in which endometrium is present within the myometrium.

Question 9Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which muscle forms the principal medial component of the pelvic floor and is innervated by the pudendal nerve?

  1. Levator ani Correct answer.
  2. Coccygeus
  3. Piriformis
  4. Obturator internus

Explanation

The levator ani is the broad muscular sling of the pelvic floor, comprising pubococcygeus, iliococcygeus and puborectalis. It receives innervation from the pudendal nerve and direct sacral branches.

Question 10Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Under the influence of progesterone, cervical mucus typically becomes:

  1. Thin, watery and shows ferning
  2. Blood-stained and friable
  3. Thick, scant and sperm-resistant Correct answer.
  4. Abundant, alkaline and shows ferning

Explanation

Progesterone makes cervical mucus thick, viscous and less abundant, forming a plug that is relatively impenetrable to sperm. Estrogen, by contrast, produces thin, watery, alkaline mucus with ferning and increased spinnbarkeit.

Question 11Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Combined oral contraceptives prevent ovulation mainly by:

  1. Directly inhibiting ovarian aromatase
  2. Suppressing pituitary gonadotropin release Correct answer.
  3. Blocking progesterone receptors in the endometrium
  4. Raising sex hormone-binding globulin

Explanation

The estrogen and progestin components provide negative feedback that suppresses hypothalamic GnRH and pituitary gonadotropin release. This prevents follicular development and the midcycle luteinizing hormone surge required for ovulation.

Question 12Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A woman has vaginal discharge with a fishy odor and vaginal pH 5.2. Microscopy shows epithelial cells covered with adherent bacteria. What is the most likely diagnosis?

  1. Trichomoniasis
  2. Vulvovaginal candidiasis
  3. Chlamydial cervicitis
  4. Bacterial vaginosis Correct answer.

Explanation

The combination of clue cells, fishy odor and vaginal pH above 4.5 is characteristic of bacterial vaginosis, typically associated with Gardnerella vaginalis and other anaerobes. Candidiasis usually has normal pH with pseudohyphae, while trichomoniasis shows motile flagellates.

Question 13Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A 16-year-old presents with primary amenorrhea, short stature and a webbed neck. Which karyotype is most likely?

  1. 47,XXX
  2. 47,XXY
  3. 46,XY
  4. 45,X Correct answer.

Explanation

The phenotype described is Turner syndrome, classically caused by monosomy X with streak gonads and elevated gonadotropins. Short stature and a webbed neck are characteristic somatic features.

Question 14Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

In female external genital development, the genital swellings give rise to which structure?

  1. Clitoris
  2. Labia majora Correct answer.
  3. Vaginal vestibule
  4. Labia minora

Explanation

The genital swellings (labioscrotal folds) develop into the labia majora in the female. The genital tubercle forms the clitoris, the urogenital folds form the labia minora, and the urogenital sinus contributes to the vestibule and lower vagina.

Question 15Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which human papillomavirus types are most strongly associated with cervical squamous cell carcinoma?

  1. 42, 43 and 44
  2. 16 and 18 Correct answer.
  3. 6 and 11
  4. 1 and 2

Explanation

High-risk human papillomavirus types 16 and 18 account for approximately 70% of cervical cancers. Types 6 and 11 are low-risk and typically cause condylomata acuminata.

Question 16Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

During early pregnancy, which hormone maintains the corpus luteum until the placenta assumes progesterone production?

  1. hCG Correct answer.
  2. Prolactin
  3. Progesterone
  4. Oxytocin

Explanation

Human chorionic gonadotropin from the syncytiotrophoblast stimulates the corpus luteum to continue progesterone production. The luteal–placental shift occurs at approximately 8–10 weeks of gestation.

Question 17Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which agent is the preferred antidote for magnesium sulfate–induced respiratory depression?

  1. Protamine sulfate injection
  2. Naloxone
  3. Calcium gluconate Correct answer.
  4. Flumazenil

Explanation

Calcium gluconate antagonizes magnesium at the neuromuscular junction and is the antidote for magnesium toxicity. Magnesium toxicity progresses from loss of deep tendon reflexes to respiratory depression and cardiac arrest.

Question 18Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A pudendal nerve block is performed by infiltrating local anesthetic near which landmark?

  1. The greater trochanter
  2. The sacral promontory
  3. The ischial spine Correct answer.
  4. The pubic symphysis

Explanation

The pudendal nerve crosses the ischial spine near the sacrospinous ligament, making the ischial spine the key landmark for a transvaginal pudendal block. Anesthetic deposited there blocks sensory and motor fibers of the perineum.

Question 19Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

What is the gold standard for diagnosing endometriosis?

  1. Laparoscopy with biopsy Correct answer.
  2. Transvaginal ultrasound imaging
  3. Serum CA-125 measurement
  4. Magnetic resonance imaging

Explanation

Direct laparoscopic visualization with histologic confirmation remains the diagnostic gold standard for endometriosis. Ultrasound and MRI can identify endometriomas or deep disease but cannot exclude peritoneal implants.

Question 20Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A woman has a strong family history of early-onset breast and ovarian cancer. Pathogenic variants in which genes confer the highest inherited risk of ovarian cancer?

  1. MLH1, MSH2 and MSH6
  2. FMR1 and DMD
  3. BRCA1 and BRCA2 Correct answer.
  4. CFTR and HBB

Explanation

BRCA1 and BRCA2 are high-penetrance tumor suppressor genes inherited in an autosomal dominant pattern and confer a markedly increased lifetime risk of ovarian cancer. They are central to hereditary breast and ovarian cancer syndrome.

Question 21Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which gene on the short arm of the Y chromosome initiates testicular differentiation?

  1. WT1
  2. SRY Correct answer.
  3. DAX1
  4. SOX9

Explanation

SRY, located on Yp11.3, encodes the testis-determining factor that initiates Sertoli cell differentiation and testis formation. SOX9 acts downstream in this pathway, while DAX1 and WT1 modulate gonadal development.

Question 22Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

According to the two-cell, two-gonadotropin theory, which statement best describes ovarian steroidogenesis?

  1. Granulosa cells aromatize theca androgens under FSH Correct answer.
  2. Theca cells produce estradiol under LH stimulation
  3. Granulosa cells synthesize androgens under LH stimulation in the ovary
  4. Theca cells aromatize estrogens under FSH stimulation

Explanation

Luteinizing hormone stimulates theca cells to produce androgens such as androstenedione. Follicle-stimulating hormone induces granulosa cell aromatase, which converts these androgens to estradiol.

Question 23Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A postmenopausal woman taking tamoxifen for breast cancer is at increased risk of which gynecologic malignancy?

  1. Ovarian germ cell tumor
  2. Vulvar melanoma
  3. Cervical adenocarcinoma
  4. Endometrial carcinoma Correct answer.

Explanation

Tamoxifen is a selective estrogen receptor modulator with agonist activity on the endometrium, increasing the risk of endometrial hyperplasia and carcinoma. Postmenopausal bleeding in a tamoxifen user requires endometrial evaluation.

Question 24Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

The lymphatic drainage of the ovary primarily follows the ovarian vessels to which nodal group?

  1. Deep inguinal nodes
  2. Internal iliac nodes
  3. Superficial inguinal nodes
  4. Para-aortic nodes Correct answer.

Explanation

The ovaries drain chiefly along the ovarian vessels to para-aortic nodes near the renal vessels. Internal iliac nodes drain the lower uterus, cervix and upper vagina, while superficial inguinal nodes drain the vulva and lower vagina.

Question 25Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which statement about Chlamydia trachomatis is correct?

  1. It is an obligate intracellular bacterium Correct answer.
  2. It is a DNA virus of the herpesviridae family
  3. It is a flagellated protozoan
  4. It is a Gram-positive extracellular coccus that grows on blood agar

Explanation

Chlamydia trachomatis is an obligate intracellular bacterium with a biphasic life cycle of elementary and reticulate bodies and characteristic inclusion bodies. Genital serotypes D–K cause urethritis, cervicitis and pelvic inflammatory disease.

Question 26Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

In a normal menstrual cycle, fertilization of the oocyte most commonly occurs in which part of the fallopian tube?

  1. Ampulla Correct answer.
  2. Isthmus
  3. Uterine cavity
  4. Fimbriae

Explanation

After ovulation, the oocyte is picked up by the fimbriae and transported toward the uterus. Fertilization usually takes place in the ampullary portion of the fallopian tube, where sperm and oocyte meet. The isthmus is narrower and more distal, while the uterine cavity is the site of implantation rather than fertilization.

Question 27Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which hormone is secreted by the syncytiotrophoblast and is used to detect early pregnancy?

  1. Human placental lactogen
  2. Human chorionic gonadotropin Correct answer.
  3. Estriol
  4. Progesterone

Explanation

Human chorionic gonadotropin is produced by the syncytiotrophoblast soon after implantation and maintains the corpus luteum in early pregnancy. It is the hormone measured in standard pregnancy tests. Human placental lactogen rises later, progesterone is initially corpus luteum–derived, and estriol production depends on the fetoplacental unit.

Question 28Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A woman with severe postpartum hemorrhage from uterine atony is given carboprost. Which pre-existing condition most strongly cautions against its use?

  1. Diabetes mellitus
  2. Asthma Correct answer.
  3. Hypertension
  4. Epilepsy

Explanation

Carboprost is a prostaglandin F2α analogue that stimulates myometrial contraction but can also cause bronchoconstriction. It should therefore be avoided or used with great caution in women with asthma. Hypertension is more relevant to ergot alkaloids, while epilepsy and diabetes are not the principal contraindications to carboprost.

Question 29Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

Which statement about group B streptococcus in pregnancy is correct?

  1. A single oral dose of metronidazole reliably eradicates colonization.
  2. Colonization is an indication for elective cesarean delivery.
  3. It is a leading cause of early-onset neonatal sepsis. Correct answer.
  4. It is a Gram-negative diplococcus.

Explanation

Group B streptococcus is a Gram-positive coccus that commonly colonizes the vagina and rectum. Vertical transmission during labor can cause early-onset neonatal sepsis, pneumonia, and meningitis, so intrapartum antibiotic prophylaxis is offered to colonized women. Cesarean delivery does not reliably prevent transmission, and metronidazole is not the standard agent for eradication.

Question 30Basic and applied sciences relevant to obstetrics and gynecology (anatomy, physiology, pathology, pharmacology, microbiology, genetics, embryology)

A 46,XY fetus has complete failure of Sertoli cell function. Which internal genital structure is most likely to persist?

  1. Wolffian ducts
  2. Labioscrotal folds
  3. Urogenital sinus
  4. Müllerian ducts Correct answer.

Explanation

Sertoli cells secrete anti-Müllerian hormone, which causes regression of the paramesonephric ducts in the male fetus. If Sertoli cell function fails, anti-Müllerian hormone is absent and Müllerian derivatives can persist. Wolffian duct development depends on testosterone from Leydig cells, while the labioscrotal folds and urogenital sinus are external or urogenital structures.

Question 31General obstetrics, antenatal care and intrapartum management

A woman with a previous pregnancy affected by a neural tube defect is planning conception. What daily folic acid dose should she take before conception and through the first trimester?

  1. 10 mg
  2. 0.4 mg
  3. 1 mg
  4. 5 mg Correct answer.

Explanation

Women with a previous neural tube defect-affected pregnancy require high-dose folic acid, 5 mg daily, starting at least one month before conception and continuing through the first trimester. The standard 0.4 mg dose is for average-risk women.

Question 32General obstetrics, antenatal care and intrapartum management

A woman's last menstrual period began on 10 March 2024. Using Naegele's rule, what is her estimated date of delivery?

  1. 24 December 2024
  2. 3 December 2024
  3. 10 December 2024
  4. 17 December 2024 Correct answer.

Explanation

Naegele's rule adds 7 days to the first day of the last menstrual period, subtracts 3 months, and adds 1 year. For 10 March 2024 this gives 17 December 2024.

Question 33General obstetrics, antenatal care and intrapartum management

Between 7 and 13 weeks of gestation, which ultrasound measurement is the most accurate for dating a pregnancy?

  1. Abdominal circumference
  2. Biparietal diameter
  3. Crown-rump length Correct answer.
  4. Femur length

Explanation

Crown-rump length is the most accurate single measurement for dating in the first trimester, with an accuracy of about 3 to 5 days. Biparietal diameter, femur length, and abdominal circumference are used later in pregnancy.

Question 34General obstetrics, antenatal care and intrapartum management

A non-sensitised Rh-negative woman gives birth to an Rh-positive infant. Within what time should anti-D immunoglobulin be given after delivery?

  1. 72 hours Correct answer.
  2. 48 hours
  3. 24 hours
  4. 1 week

Explanation

Anti-D immunoglobulin should be administered within 72 hours of delivery of an Rh-positive infant to prevent alloimmunisation. Giving it as early as possible is advised, but the 72-hour window is the standard limit.

Question 35General obstetrics, antenatal care and intrapartum management

Using the 75-g oral glucose tolerance test, what fasting plasma glucose level is diagnostic of gestational diabetes?

  1. 7.0 mmol/L
  2. 6.1 mmol/L
  3. 5.6 mmol/L
  4. 5.1 mmol/L Correct answer.

Explanation

The International Association of Diabetes and Pregnancy Study Groups criteria diagnose gestational diabetes when fasting plasma glucose is 5.1 mmol/L or higher. The 1-hour and 2-hour thresholds are 10.0 and 8.5 mmol/L, respectively.

Question 36General obstetrics, antenatal care and intrapartum management

Low-dose aspirin for prevention of pre-eclampsia in a high-risk woman should ideally be started at which gestational age?

  1. 28 weeks
  2. At the onset of labour
  3. 12 to 16 weeks Correct answer.
  4. After 20 weeks

Explanation

Prophylactic low-dose aspirin is most effective when started before 16 weeks, commonly between 12 and 16 weeks, and continued until about 36 weeks. Starting later misses much of the benefit for placentation.

Question 37General obstetrics, antenatal care and intrapartum management

The active phase of the first stage of labour is best defined as cervical dilatation from:

  1. 3 to 4 cm
  2. 0 to 3 cm
  3. Full dilatation to delivery of the placenta
  4. 4 to 6 cm up to full dilatation Correct answer.

Explanation

The active first stage begins at about 4 to 6 cm dilatation and ends at full dilatation, with regular painful contractions. The latent phase precedes it, and the second stage begins at full dilatation.

Question 38General obstetrics, antenatal care and intrapartum management

On the modified WHO partogram, the action line is placed how many hours to the right of the alert line?

  1. 4 hours Correct answer.
  2. 3 hours
  3. 2 hours
  4. 1 hour

Explanation

The action line lies four hours to the right of the alert line and prompts reassessment and possible intervention for slow progress. The alert line itself represents the expected rate of cervical dilatation.

Question 39General obstetrics, antenatal care and intrapartum management

Recurrent late decelerations on cardiotocography most directly indicate which fetal condition?

  1. Fetal head compression
  2. Maternal pyrexia
  3. Uteroplacental insufficiency Correct answer.
  4. Umbilical cord compression

Explanation

Late decelerations begin after the peak of a contraction and recover after it ends, reflecting transient fetal hypoxaemia from uteroplacental insufficiency. Variable decelerations suggest cord compression, and early decelerations reflect head compression.

Question 40General obstetrics, antenatal care and intrapartum management

Which manoeuvre is the first-line intervention for shoulder dystocia after calling for help?

  1. Internal podalic version
  2. Cleidotomy
  3. McRoberts' manoeuvre Correct answer.
  4. Symphysiotomy

Explanation

McRoberts' manoeuvre, usually combined with suprapubic pressure, is the first-line manoeuvre for shoulder dystocia and resolves most cases. More invasive manoeuvres are reserved for failure of first-line measures.

Question 41General obstetrics, antenatal care and intrapartum management

A woman at 8 cm dilatation has a pulsating umbilical cord visible in the vagina after spontaneous rupture of membranes. What is the most appropriate immediate management?

  1. Replace the cord into the uterus manually
  2. Start a tocolytic infusion and observe
  3. Await full dilatation for an assisted vaginal birth
  4. Elevate the presenting part and arrange immediate delivery Correct answer.

Explanation

Cord prolapse is an obstetric emergency requiring elevation or filling of the bladder and immediate delivery, usually by category 1 caesarean section if vaginal delivery is not imminent. Handling the cord and delaying delivery worsen fetal hypoxia.

Question 42General obstetrics, antenatal care and intrapartum management

Which manoeuvre is used to deliver the after-coming head by flexing it with fingers on the fetal maxilla?

  1. Burns-Marshall manoeuvre
  2. Mauriceau manoeuvre Correct answer.
  3. Løvset manoeuvre
  4. Pinard manoeuvre

Explanation

The Mauriceau manoeuvre flexes the fetal head by placing fingers on the maxilla while the other hand supports the shoulders, controlling delivery of the after-coming head. Løvset and Pinard manoeuvres address extended arms and breech legs, respectively.

Question 43General obstetrics, antenatal care and intrapartum management

Primary postpartum haemorrhage after a vaginal birth is traditionally defined as blood loss of at least:

  1. 1000 mL
  2. 500 mL Correct answer.
  3. 750 mL
  4. 300 mL

Explanation

Primary postpartum haemorrhage is blood loss of 500 mL or more within 24 hours of vaginal birth, or 1000 mL or more after caesarean birth. Any blood loss causing haemodynamic instability also qualifies.

Question 44General obstetrics, antenatal care and intrapartum management

Which package constitutes active management of the third stage of labour?

  1. Cord drainage before placental delivery
  2. Immediate manual removal of the placenta
  3. Uterotonic plus controlled cord traction Correct answer.
  4. Expectant management with no uterotonic and no traction

Explanation

Active management combines a prophylactic uterotonic, controlled cord traction, and uterine massage to reduce postpartum haemorrhage. Expectant management awaits signs of placental separation.

Question 45General obstetrics, antenatal care and intrapartum management

What is the standard loading dose of magnesium sulphate for eclampsia?

  1. 6 g intramuscularly in each buttock
  2. 2 g intravenously over 10 minutes
  3. 4 g intravenously over 10 to 20 minutes Correct answer.
  4. 8 g intramuscularly as a single divided dose

Explanation

The standard regimen is a 4 g intravenous loading dose over 10 to 20 minutes, followed by 1 g per hour as maintenance. This achieves therapeutic serum magnesium concentrations rapidly.

Question 46General obstetrics, antenatal care and intrapartum management

Antenatal corticosteroids reduce neonatal respiratory distress syndrome most reliably when given at least how long before delivery?

  1. 1 hour
  2. 12 hours
  3. 24 hours Correct answer.
  4. 6 hours

Explanation

A full course of antenatal corticosteroids requires at least 24 hours before delivery for maximal benefit, although some benefit begins within hours. The standard betamethasone course is two doses 24 hours apart.

Question 47General obstetrics, antenatal care and intrapartum management

Which antibiotic is first-line for intrapartum prophylaxis against early-onset group B streptococcal disease?

  1. Penicillin G Correct answer.
  2. Clindamycin
  3. Ceftriaxone
  4. Vancomycin

Explanation

Intravenous penicillin G is first-line for group B streptococcal prophylaxis, with ampicillin as an acceptable alternative. Ceftriaxone, vancomycin, and clindamycin are reserved for specific allergy or resistance situations.

Question 48General obstetrics, antenatal care and intrapartum management

A woman at 30 weeks' gestation has a confirmed proximal deep vein thrombosis. Which anticoagulant is preferred for ongoing treatment?

  1. Aspirin
  2. Low-molecular-weight heparin Correct answer.
  3. Warfarin
  4. A direct oral anticoagulant such as apixaban

Explanation

Low-molecular-weight heparin is the anticoagulant of choice in pregnancy because it does not cross the placenta and has a predictable dose response. Warfarin and direct oral anticoagulants are avoided in pregnancy.

Question 49General obstetrics, antenatal care and intrapartum management

A woman is found to be non-immune to rubella after delivery. When may she safely conceive after rubella vaccination?

  1. After 1 week
  2. Immediately
  3. After 3 months
  4. After 4 weeks Correct answer.

Explanation

Rubella vaccination is avoided during pregnancy, and pregnancy should be avoided for 28 days, or 4 weeks, after vaccination. The vaccine is a live attenuated virus.

Question 50General obstetrics, antenatal care and intrapartum management

Which substance, taken with oral iron, improves its absorption in pregnancy?

  1. Milk
  2. Tea
  3. Calcium supplements
  4. Vitamin C Correct answer.

Explanation

Vitamin C and acidic foods enhance absorption of non-haem iron. Milk, tea, and calcium supplements reduce absorption by chelating iron or competing for transport.