Molar and Ectopic Pregnancy OB24-OB26.

 

Molar Pregnancy (Hydatidiform mole).

***) Regarding hydatidiform mole, all the following are true except:

Commoner in women of blood group A married to blood O men

Group AB women have the worst prognosis

Are commoner in older gravida

Are complicated by ovarian cyst

Can be diagnosed by chest X-ray

 

Answer: E* Can be diagnosed by chest X-ray

 

***) In hydatiform mole pregnancy, all the following are true except:

Uterine size is larger than dates

Bilateral ovarian cysts (Lutein cysts) is common

Aggravated morning sickness

Treatment is by suction, curettage regardless of the size of the uterus

Pregnancy is allowed after 6 months

 

Answer: E* Pregnancy is allowed after 6 months

 

***) The complications of hydatiform mole include all the following except:

Hemorrhage

Sepsis

Perforation of the uterus

Inversion of the uterus

Choriocarcinoma

 

Answer: D* Inversion of the uterus

 

***) Hydatiform mole (vesicular mole) is usually treated by:

Hysterectomy

Prostaglandin induction

Syntocinon induction

Methotrexate

Suction-evacuation of the uterus

 

Answer: E* Suction-evacuation of the uterus

 

Ectopic Pregnancy.

***) Regarding ectopic pregnancy all of the following statements are true, except:

It is a pregnancy that implants outside the uterus

The most common site of implantation is the abdominal cavity

It may occur in the cervix

Previous infection is a major cause

There is an increase incidence among IUCD users

 

Answer: B* The most common site of implantation is the abdominal cavity

 

***) In ectopic pregnancy, all the following are true except:

Pain usually proceeds bleeding

Shoulder pain is an important symptom

The isthmus of the tube is the commonest site of implantation

Is often not diagnosed by os

The incidence is greater in women with IUCD

 

Answer: C* The isthmus of the tube is the commonest site of implantation

 

***) The commonest site for tubal ectopic pregnancy is:

Fimbria

Ampulla

Isthmus

Intramural

Paratubal

 

Answer: B* Ampulla

 

???) All of the following may be etiological factors of ectopic pregnancy, except:

Previous infection of the tubes

Delayed passage of the fertilized ovum down the tube

Progesterone pills for contraception

Intrauterine contraceptive device IUCD users

Irregular periods

 

Answer: E* Irregular periods

 

***) All of the following may increase the incidence of ectopic pregnancy, except:

Previous pelvic infection

Use of birth control pills

Tubal surgery

Previous appendicitis

Tubal abnormalities

 

Answer: B* Use of birth control pills

 

***) The ectopic pregnancy may be due to:

Chronic salpingitis

Short fallopian tube

Long uterine cavity

Use of vaginal diaphragm

Contraceptive pills

 

Answer: A* Chronic salpingitis

 

***) All of the following are the clinical features of tubal pregnancy, except:

The patient may have evidence of peritoneal irritation

Lower abdominal pain

Abdominal rigidity

Fainting

Severe vaginal bleeding

 

Answer: E* Severe vaginal bleeding

 

***) The most important symptom of ectopic pregnancy is one of the following:

Severe bleeding

Pain

Amenorrhea

Fainting

Pelvic heaviness

 

Answer: B* Pain

 

***) Vaginal bleeding in ectopic pregnancy is due to:

Rupture of the fallopian tube

Rupture of the uterus

Vaginal laceration

Peritoneal hemorrhage

Hormone withdrawal

 

Answer: E* Hormone withdrawal

 

***) The following features suggest a diagnosis of ectopic pregnancy, except:

Amenorrhea of 6-10 weeks

Acute abdomen

Enlarged uterus

Decidual tissue at curettage

Vaginal bleeding

 

Answer: C* Enlarged uterus

 

***) Regarding ectopic pregnancy, all the following are true except:

Amenorrhea

Vaginal bleeding

Abdominal pain

Elevated hCG

Endometrium has always secretory changes

 

Answer: D* Elevated hCG

 

***) All true about ectopic pregnancy, except:

Attacks of abdominal sharp stabbing pain

Fainting attacks

Vaginal bleeding

Period of amenorrhea

Pregnancy test is always positive

 

Answer: A* Attacks of abdominal sharp stabbing pain

 

***) Signs of ruptures ectopic pregnancy include the following, except:

Rebound tenderness in the abdomen

Heavy vaginal bleeding

Cervical excitation on vaginal examination

Localized tenderness in the pelvis

Tachycardia

 

Answer: B* Heavy vaginal bleeding

 

***) Ectopic pregnancy is confirmed by one of the following:

Ultrasound examination

Vaginal examination

Culdocentesis

hCG urine pregnancy test

Laparoscopy

 

Answer: E* Laparoscopy

 

***) Which of the following can be a definite diagnosis of intrauterine pregnancy to rule out ectopic pregnancy:

Decidual reaction at D&C pathology specimen

Aria-stellaphenomen at D&C pathology specimen

Chorionic villi at D&C pathology specimen

Positive pregnancy test

Positive -hCG assay

 

Answer: C* Chorionic villi at D&C pathology specimen

 

***) Differential diagnoses of ectopic pregnancy are the following, except:

Acute salpingitis

Acute appendicitis

Acute red degeneration of fibroid

Rupture ovarian cyst

Vesicular mole

 

Answer: E* Vesicular mole

 

***) Differential diagnoses of ectopic pregnancy are the following, except:

Rupture of a corpus luteum cyst

Uterine abortion

Torsion of fallopian tube

Acute appendicitis

Spasmodic dysmenorrhea

 

Answer: E* Spasmodic dysmenorrhea

 

***) Of the following, which woman is at greater risk for ectopic pregnancy:

Healthy woman on birth control pills

A woman with a past history of three incidents of pelvic inflammatory disease

Woman with a history of endometriosis

Woman with irregular menses

Woman with a past history of several attacks of UTI

 

Answer: B* A woman with a past history of three incidents of pelvic inflammatory disease

 

***) The most common implantation site for ectopic pregnancy is the:

Abdominal cavity

The ovarian surface

The cervix

Ampulla of the fallopian tube

The interstitial portion of the fallopian tube

 

Answer: D* Ampulla of the fallopian tube

 

***) A 24 year old patient married since 2 years. She is having 6 weeks amenorrhea and unilateral anneal pain, acute abdomen, rapidly falling hematocrit, hypertensive and positive pregnancy test. The most likely diagnosis is:

Endometriosis

Appendicitis

Urinary tract infection

Threatened abortion

Ectopic pregnancy

 

Answer: E* Ectopic pregnancy

 

Placenta OB26-OB29.

 

The Placenta.

***) Where does fertilization take place:

In the ovary

In the fimbrial end of the fallopian tube

In the ampullary region of the fallopian tube

In the uterus

In the isthmic region of tube

 

Answer: C* In the ampullary region of the fallopian tube

 

***) Implantation of the blastocyte occurs after:

1-2 days

3-5 days

6-8-days

9-10 days

12-14 days

 

Answer: C* 6-8-days

 

***) The method of choice of placental localization is:

Ultrasonography

Angiography

Soft tissue placentography

Use of radioactive isotopes

Amniography

 

Answer: A* Ultrasonography

 

***) All of the following are placental hormones, except:

Follicular stimulating hormone

Human placental lactogen

Progesterone

Estrogen

Somatotropine (growth hormone)

 

Answer: A* Follicular stimulating hormone

 

***) Human Placental Lactogen (hPL) can be elevated in all of the following, except:

Diabetes

Twins

Hypertension

Erythroblastosis

Bronchogenic carcinoma

 

Answer: C* Hypertension