Q.1 Which is the first-line drug for managing postpartum hemorrhage?
Oxytocin
Misoprostol
Ergometrine
Tranexamic acid
Explanation - Oxytocin is the first-line uterotonic agent used to prevent and treat postpartum hemorrhage by promoting uterine contractions.
Correct answer is: Oxytocin
Q.2 A pregnant woman presents with sudden severe abdominal pain and vaginal bleeding. The most likely diagnosis is:
Placenta previa
Placental abruption
Ectopic pregnancy
Preterm labor
Explanation - Placental abruption presents with sudden onset abdominal pain, uterine tenderness, and vaginal bleeding, usually in the third trimester.
Correct answer is: Placental abruption
Q.3 Which maneuver is used to relieve shoulder dystocia during delivery?
McRoberts maneuver
Kristeller maneuver
Valsalva maneuver
Fundal pressure
Explanation - The McRoberts maneuver involves hyperflexing the mother's legs to widen the pelvis and facilitate delivery of the impacted shoulder.
Correct answer is: McRoberts maneuver
Q.4 In eclampsia, the first drug of choice to control seizures is:
Magnesium sulfate
Diazepam
Phenytoin
Labetalol
Explanation - Magnesium sulfate is the preferred anticonvulsant in eclampsia to prevent and treat seizures.
Correct answer is: Magnesium sulfate
Q.5 Which is the most common cause of maternal shock in the postpartum period?
Sepsis
Hemorrhage
Pulmonary embolism
Amniotic fluid embolism
Explanation - Postpartum hemorrhage is the leading cause of maternal shock and mortality worldwide.
Correct answer is: Hemorrhage
Q.6 A 32-week pregnant woman has sudden onset shortness of breath, hypotension, and cyanosis. The most likely obstetric emergency is:
Amniotic fluid embolism
Pulmonary edema
Myocardial infarction
Pneumothorax
Explanation - Amniotic fluid embolism is characterized by sudden respiratory distress, hypotension, and coagulopathy, often in late pregnancy or postpartum.
Correct answer is: Amniotic fluid embolism
Q.7 In shoulder dystocia, which action should be avoided?
Applying suprapubic pressure
Attempting internal rotation
Pulling on the fetal head
McRoberts maneuver
Explanation - Excessive traction on the fetal head can cause brachial plexus injury; maneuvers like McRoberts and suprapubic pressure are preferred.
Correct answer is: Pulling on the fetal head
Q.8 Which of the following is a sign of uterine rupture?
Fetal heart rate deceleration
Gradual abdominal enlargement
Hyperpigmentation
Edema of hands and feet
Explanation - Uterine rupture often presents with sudden abdominal pain, vaginal bleeding, loss of uterine tone, and fetal heart rate decelerations.
Correct answer is: Fetal heart rate deceleration
Q.9 The initial management of eclampsia includes:
Seizure control, airway support, blood pressure management
Immediate cesarean section
Fluid restriction
Observation only
Explanation - Immediate management focuses on controlling seizures, securing airway, and stabilizing blood pressure before delivery.
Correct answer is: Seizure control, airway support, blood pressure management
Q.10 Which is a risk factor for developing postpartum hemorrhage?
Multiple gestation
Prolonged labor
Polyhydramnios
All of the above
Explanation - Risk factors include multiple gestation, prolonged labor, polyhydramnios, high parity, and use of uterine relaxants.
Correct answer is: All of the above
Q.11 For a woman with placenta previa, the safest mode of delivery is:
Vaginal delivery
Cesarean section
Instrumental delivery
Induction of labor
Explanation - Placenta previa obstructs the cervical os, making cesarean section the safest delivery method to prevent hemorrhage.
Correct answer is: Cesarean section
Q.12 Which medication is used to treat severe pre-eclampsia before delivery?
Labetalol
Methyldopa
Furosemide
Atenolol
Explanation - Labetalol is a first-line antihypertensive used to control severe hypertension in pre-eclampsia safely.
Correct answer is: Labetalol
Q.13 Amniotic fluid embolism often leads to:
Cardiogenic shock
Respiratory failure and DIC
Hyperglycemia
Preterm labor
Explanation - Amniotic fluid embolism triggers a sudden inflammatory reaction causing respiratory failure, hypotension, and disseminated intravascular coagulation.
Correct answer is: Respiratory failure and DIC
Q.14 Which sign is earliest in detecting hypovolemic shock in postpartum hemorrhage?
Tachycardia
Hypotension
Cold clammy skin
Oliguria
Explanation - Tachycardia is the earliest compensatory sign of hypovolemic shock, preceding hypotension and other symptoms.
Correct answer is: Tachycardia
Q.15 The most effective method to prevent postpartum hemorrhage is:
Active management of the third stage of labor
Bed rest
Oral iron supplementation
Intravenous antibiotics
Explanation - Active management, including uterotonic administration, controlled cord traction, and uterine massage, reduces PPH incidence.
Correct answer is: Active management of the third stage of labor
Q.16 Which is the first action in managing shoulder dystocia after recognition?
Call for help
Apply fundal pressure
Perform episiotomy
Pull the fetal head
Explanation - Immediate recognition should prompt calling for assistance before attempting maneuvers to avoid complications.
Correct answer is: Call for help
Q.17 What is the most common maternal complication of eclampsia?
Cerebral hemorrhage
Liver failure
Renal failure
Pulmonary edema
Explanation - Eclampsia can lead to hypertensive complications such as cerebral hemorrhage, which is a major cause of maternal mortality.
Correct answer is: Cerebral hemorrhage
Q.18 During postpartum hemorrhage, the recommended fluid resuscitation is:
Isotonic crystalloids
Hypotonic saline
Colloids only
Dextrose 5%
Explanation - Rapid infusion of isotonic crystalloids helps restore circulating volume and prevent shock.
Correct answer is: Isotonic crystalloids
Q.19 Which laboratory finding is most suggestive of amniotic fluid embolism?
Leukocytosis
Thrombocytopenia and coagulopathy
Hyperglycemia
Elevated liver enzymes
Explanation - A sudden DIC pattern with low platelets and prolonged clotting times is indicative of amniotic fluid embolism.
Correct answer is: Thrombocytopenia and coagulopathy
Q.20 Which position is recommended for a mother with supine hypotensive syndrome during late pregnancy?
Left lateral tilt
Supine flat
Right lateral tilt
Standing upright
Explanation - The left lateral tilt relieves pressure on the inferior vena cava, improving venous return and cardiac output.
Correct answer is: Left lateral tilt
Q.21 In cases of uterine inversion, the initial management includes:
Manual replacement of the uterus
Immediate hysterectomy
Observation only
Administration of oxytocin first
Explanation - Prompt manual replacement is critical to restore uterine tone and prevent hemorrhagic shock.
Correct answer is: Manual replacement of the uterus
Q.22 Which factor is not typically associated with increased risk of shoulder dystocia?
Macrosomia
Maternal diabetes
Prolonged second stage of labor
Breech presentation
Explanation - Breech presentation usually presents other complications, but shoulder dystocia occurs with vertex deliveries and large fetal size.
Correct answer is: Breech presentation
Q.23 The recommended dose of magnesium sulfate for seizure prophylaxis in preeclampsia is:
4-6 g IV loading dose
10 mg IV
50 mg orally
500 mg IM
Explanation - A 4-6 g IV loading dose followed by maintenance infusion is standard for seizure prophylaxis in severe preeclampsia.
Correct answer is: 4-6 g IV loading dose
Q.24 Which is the most important monitoring parameter during management of postpartum hemorrhage?
Blood pressure, pulse, urine output
Skin temperature
Respiratory rate only
Fetal heart rate
Explanation - These parameters help assess ongoing blood loss and response to fluid resuscitation in PPH.
Correct answer is: Blood pressure, pulse, urine output