Obstetrics and Gynecology Questions - PDF

1. A 32-year-old pregnant woman presents for her ﬁrst prenatal visit. Which of the following should be included in her routine ﬁrst-trimester laboratory tests? A) Lipid panel, fasting glucose, liver function tests B) Blood type & Rh factor, CBC, rubella titer, urine culture C) Serum Beta-hCG, maternal serum AFP, Group B Strep culture D) Fetal ﬁbronectin, amniotic ﬂuid index, indirect Coombs test Answer: B) Blood type & Rh factor, CBC, rubella titer, urine culture 2. A 27-year-old woman at 16 weeks gestation reports feeling "ﬂuttering" movements in her abdomen. This sensation is best described as: A) Quickening B) Ballottement C) Braxton Hicks contractions D) Lightening Answer: A) Quickening 3. A patient at 28 weeks gestation undergoes a 1-hour glucose tolerance test (GTT). Which of the following results would require a follow-up 3-hour GTT? A) 80 mg/dL B) 105 mg/dL C) 125 mg/dL D) 145 mg/dL Answer: D) 145 mg/dL 4. Which of the following is the most common cause of postpartum hemorrhage? A) Retained placental tissue B) Uterine atony C) Uterine rupture D) Coagulopathy Answer: B) Uterine atony 5. A 36-week pregnant woman presents with painless vaginal bleeding. Which of the following is the most likely diagnosis? A) Placental abruption B) Placenta previa C) Uterine rupture D) Vasa previa Answer: B) Placenta previa 6. Which fetal heart rate pattern is most concerning for uteroplacental insuNiciency? A) Early decelerations B) Variable decelerations C) Late decelerations D) Accelerations Answer: C) Late decelerations 7. A 22-year-old pregnant woman presents with fever, uterine tenderness, and foul-smelling lochia three days postpartum. What is the most likely diagnosis? A) Endometritis B) Mastitis C) Chorioamnionitis D) HELLP syndrome Answer: A) Endometritis 8. Which screening test is performed between 15-20 weeks to assess for neural tube defects? A) Fetal nuchal translucency B) Amniotic ﬂuid index C) Maternal serum alpha-fetoprotein (AFP) D) Group B Streptococcus culture Answer: C) Maternal serum alpha-fetoprotein (AFP) 9. A 30-year-old woman presents at 10 weeks gestation with severe nausea, vomiting, and dehydration. What is the most likely diagnosis? A) Hyperemesis gravidarum B) Normal morning sickness C) Preeclampsia D) Gestational diabetes Answer: A) Hyperemesis gravidarum 10. A 28-year-old woman at 36 weeks presents with a fundal height measuring at 30 cm. What is the most likely cause? A) Polyhydramnios B) Macrosomia C) Oligohydramnios D) Normal pregnancy variation Answer: C) Oligohydramnios 11. Which of the following is an indication for Rhogam administration at 28 weeks? A) Rh-negative mother with an Rh-positive father B) Rh-positive mother with an Rh-negative baby C) Rh-positive mother with an Rh-positive baby D) Rh-negative father with an Rh-positive baby Answer: A) Rh-negative mother with an Rh-positive father 12. A 37-week pregnant woman experiences a "gush of ﬂuid" followed by continuous leakage. Which test conﬁrms rupture of membranes? A) Non-stress test B) Biophysical proﬁle C) Nitrazine test and ferning test D) Amniocentesis Answer: C) Nitrazine test and ferning test 13. A patient with gestational diabetes is at increased risk for which neonatal complication? A) Neonatal hyperglycemia B) Neural tube defects C) Shoulder dystocia D) Placental abruption Answer: C) Shoulder dystocia 14. A 20-year-old woman at 38 weeks presents with painful contractions every 3 minutes and cervical dilation of 5 cm. She is in which stage of labor? A) First stage, latent phase B) First stage, active phase C) Second stage D) Third stage Answer: B) First stage, active phase 15. Which of the following is a contraindication to vaginal birth after cesarean (VBAC)? A) One prior cesarean delivery B) Previous classical (vertical) uterine incision C) Gestational age >37 weeks D) Breech presentation Answer: B) Previous classical (vertical) uterine incision 16. What is the gold standard for diagnosing gestational diabetes? A) 1-hour glucose tolerance test B) 3-hour glucose tolerance test C) Random blood glucose D) HbA1c Answer: B) 3-hour glucose tolerance test 17. What is the ﬁrst-line medication for treating eclampsia? A) Methyldopa B) Labetalol C) Magnesium sulfate D) Hydralazine Answer: C) Magnesium sulfate 18. A pregnant patient has a positive Group B Strep (GBS) culture at 36 weeks. What is the appropriate management? A) Immediate induction of labor B) IV penicillin during labor C) Oral antibiotics until delivery D) No treatment needed unless symptomatic Answer: B) IV penicillin during labor 19. Which condition is characterized by hypertension, proteinuria, and hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome)? A) Gestational hypertension B) Chronic hypertension C) Preeclampsia with severe features D) Eclampsia Answer: C) Preeclampsia with severe features 20. A 34-week pregnant woman has sudden severe abdominal pain, vaginal bleeding, and a ﬁrm, tender uterus. What is the most likely diagnosis? A) Placenta previa B) Placental abruption C) Uterine rupture D) Vasa previa Answer: B) Placental abruption 21. A 40-week pregnant woman is undergoing labor induction. Which is the most commonly used agent? A) Misoprostol B) Oxytocin C) Magnesium sulfate D) Terbutaline Answer: B) Oxytocin 22. Which fetal heart rate tracing pattern is associated with umbilical cord compression? A) Early decelerations B) Variable decelerations C) Late decelerations D) Sinusoidal pattern Answer: B) Variable decelerations 23. Which hormone is responsible for maintaining the corpus luteum and supporting pregnancy? A) Estrogen B) Progesterone C) Human chorionic gonadotropin (hCG) D) Oxytocin Answer: C) Human chorionic gonadotropin (hCG) 24. Which maneuver is used to determine fetal lie and position in late pregnancy? A) Leopold’s maneuvers B) McRoberts maneuver C) Bimanual examination D) Bishop score Answer: A) Leopold’s maneuvers 25. Which prenatal test is used to assess fetal lung maturity? A) Amniocentesis B) Quad screen C) Non-stress test D) Doppler ultrasound Answer: A) Amniocentesis 26. A 25-year-old primigravida at 30 weeks gestation presents with a blood pressure of 160/110 mmHg, 5 g of protein in a 24-hour urine collection, and complaints of headaches and visual disturbances. What is the most appropriate next step? A) Immediate delivery regardless of gestational age B) Magnesium sulfate for seizure prophylaxis and antihypertensive therapy C) Send home with strict blood pressure monitoring and follow-up in one week D) Observation without intervention until 34 weeks Answer: B) Magnesium sulfate for seizure prophylaxis and antihypertensive therapy 27. What is the primary function of the foramen ovale in fetal circulation? A) Shunts blood from the umbilical vein to the inferior vena cava B) Allows oxygenated blood to bypass the fetal lungs C) Directs blood from the right ventricle to the aorta D) Supplies blood to the placenta Answer: B) Allows oxygenated blood to bypass the fetal lungs 28. Which of the following statements about gestational trophoblastic disease (molar pregnancy) is true? A) Partial moles contain only paternal chromosomes B) Complete moles present with an abnormally low beta-hCG C) Both complete and partial moles are associated with increased risk of choriocarcinoma D) Complete moles typically have a normal fetal heartbeat Answer: C) Both complete and partial moles are associated with increased risk of choriocarcinoma 29. Which of the following increases the risk of ectopic pregnancy? A) Multiparity B) Previous pelvic inﬂammatory disease (PID) C) Prolonged breastfeeding D) Prior cesarean delivery Answer: B) Previous pelvic inﬂammatory disease (PID) 30. A 35-year-old G2P1 woman at 36 weeks gestation presents with severe upper abdominal pain, nausea, and headache. Her labs reveal hemolysis, elevated liver enzymes, and a platelet count of 85,000. What is the best management? A) Outpatient observation with weekly platelet monitoring B) Immediate delivery C) Low-dose aspirin and bed rest D) Magnesium sulfate only Answer: B) Immediate delivery 31. At what gestational age does fetal lung surfactant production become suNicient to support extrauterine life? A) 20 weeks B) 24 weeks C) 28 weeks D) 34 weeks Answer: D) 34 weeks 32. A pregnant patient is diagnosed with oligohydramnios. Which of the following is a potential cause? A) Maternal diabetes B) Fetal renal agenesis C) Twin-to-twin transfusion syndrome D) Neural tube defects Answer: B) Fetal renal agenesis 33. Which of the following is a normal adaptation of pregnancy? A) Increase in systemic vascular resistance B) Decrease in cardiac output C) Increase in blood volume by 45% D) Decrease in coagulation factors Answer: C) Increase in blood volume by 45% 34. Which of the following tests should be performed at 35-37 weeks gestation? A) Quad screen B) Amniocentesis C) Group B Streptococcus (GBS) culture D) Non-stress test Answer: C) Group B Streptococcus (GBS) culture 35. What is the most signiﬁcant risk factor for placenta previa? A) Prior cesarean delivery B) Advanced maternal age C) Multiparity D) Tobacco use Answer: A) Prior cesarean delivery 36. Which of the following is an absolute contraindication to external cephalic version (ECV) for breech presentation? A) Gestational diabetes B) Prior vaginal delivery C) Oligohydramnios D) Placenta previa Answer: D) Placenta previa 37. What is the normal fetal heart rate range? A) 80-120 BPM B) 90-150 BPM C) 110-160 BPM D) 140-180 BPM Answer: C) 110-160 BPM 38. A 29-year-old woman in her third trimester is diagnosed with gestational diabetes. What is the ﬁrst-line treatment? A) Insulin therapy B) Oral metformin C) Dietary modiﬁcations and exercise D) Immediate induction of labor Answer: C) Dietary modiﬁcations and exercise 39. Which fetal heart rate pattern is most concerning and requires immediate delivery? A) Early decelerations B) Sinusoidal pattern C) Moderate variability D) Accelerations Answer: B) Sinusoidal pattern 40. A pregnant woman at 24 weeks has a fundal height of 28 cm. What is the most likely cause? A) Intrauterine growth restriction B) Polyhydramnios C) Oligohydramnios D) Fetal demise Answer: B) Polyhydramnios 41. Which of the following medications is used to promote fetal lung maturity in preterm labor? A) Magnesium sulfate B) Betamethasone C) Nifedipine D) Terbutaline Answer: B) Betamethasone 42. A patient presents with rupture of membranes and fetal distress. What is the most appropriate next step? A) Immediate induction with oxytocin B) Expectant management and observation C) Emergency cesarean delivery D) Administer tocolytics to delay labor Answer: C) Emergency cesarean delivery 43. Which of the following is a contraindication to breastfeeding? A) Maternal age over 40 B) Maternal tuberculosis C) Previous history of gestational diabetes D) Vaginal delivery Answer: B) Maternal tuberculosis 44. Which of the following correctly describes the normal sequence of labor? A) Descent → Extension → Internal rotation → Expulsion B) Engagement → Descent → Flexion → Internal rotation → Extension → Expulsion C) Flexion → Descent → Engagement → Expulsion D) Internal rotation → Engagement → Expulsion Answer: B) Engagement → Descent → Flexion → Internal rotation → Extension → Expulsion 45. What is the leading cause of maternal mortality in the postpartum period? A) Postpartum hemorrhage B) Sepsis C) Pulmonary embolism D) Stroke Answer: A) Postpartum hemorrhage 46. A 40-year-old woman is attempting a vaginal birth after cesarean (VBAC). What is the greatest risk? A) Shoulder dystocia B) Postpartum hemorrhage C) Uterine rupture D) Cord prolapse Answer: C) Uterine rupture 47. A newborn presents with meconium-stained amniotic ﬂuid. What is the greatest concern? A) Sepsis B) Neonatal jaundice C) Meconium aspiration syndrome D) Transient tachypnea of the newborn Answer: C) Meconium aspiration syndrome 48. Which method is used to estimate gestational age most accurately in the ﬁrst trimester? A) Fundal height measurement B) Crown-rump length on ultrasound C) Maternal serum AFP D) Amniotic ﬂuid index Answer: B) Crown-rump length on ultrasound 49. A 28-year-old woman at 20 weeks gestation presents for routine prenatal care. Fundal height is measured at 26 cm. What is the most likely cause? A) Oligohydramnios B) Incorrect dating C) Fetal demise D) Gestational hypertension Answer: B) Incorrect dating 50. A 34-year-old woman at 37 weeks gestation presents with a blood pressure of 160/100 mmHg, proteinuria, and complaints of headache and blurry vision. Which of the following ﬁndings would indicate progression to eclampsia? A) Platelet count of 200,000 B) Persistent right upper quadrant pain C) Tonic-clonic seizures D) Absence of deep tendon reﬂexes Answer: C) Tonic-clonic seizures 51. What is the most common cause of ﬁrst-trimester spontaneous abortion? A) Maternal hypertension B) Chromosomal abnormalities C) Infection D) Uterine abnormalities Answer: B) Chromosomal abnormalities 52. Which test is the most accurate for determining fetal lung maturity? A) Amniotic ﬂuid index B) Lecithin-sphingomyelin (L/S) ratio C) Non-stress test D) Quad screen Answer: B) Lecithin-sphingomyelin (L/S) ratio 53. A 36-year-old woman at 28 weeks presents with persistent nausea, vomiting, and hypertension. Lab results reveal elevated liver enzymes, low platelets, and hemolysis. What is the best next step? A) Administer corticosteroids and monitor B) Immediate delivery C) Magnesium sulfate only D) Antihypertensive therapy and bed rest Answer: B) Immediate delivery 54. Which of the following is an absolute contraindication to the use of methotrexate for ectopic pregnancy? A) Beta-hCG >5000 B) No fetal heartbeat C) Stable vitals D) Ruptured ectopic pregnancy Answer: D) Ruptured ectopic pregnancy 55. What is the most common cause of postpartum fever within the ﬁrst 10 days? A) Wound infection B) Endometritis C) Urinary tract infection D) Mastitis Answer: B) Endometritis 56. Which of the following is a normal cardiovascular change during pregnancy? A) Decreased cardiac output B) Increased systemic vascular resistance C) Increased blood volume by approximately 45% D) Decreased heart rate Answer: C) Increased blood volume by approximately 45% 57. A 38-week pregnant woman presents with painful contractions and fetal bradycardia. The nurse notes a palpable fetal part on vaginal exam. What is the most likely diagnosis? A) Placenta previa B) Placental abruption C) Uterine rupture D) Cord prolapse Answer: C) Uterine rupture 58. A 33-year-old woman at 28 weeks has a fundal height of 22 cm. What is the most likely cause? A) Polyhydramnios B) Macrosomia C) Intrauterine growth restriction D) Twin pregnancy Answer: C) Intrauterine growth restriction 59. Which of the following medications is most commonly used for preterm labor tocolysis? A) Magnesium sulfate B) Methyldopa C) Misoprostol D) Oxytocin Answer: A) Magnesium sulfate 60. A newborn has a heart rate of 95, irregular breathing, some muscle tone, grimaces to stimulation, and pink body with blue extremities. What is the APGAR score? A) 3 B) 5 C) 7 D) 9 Answer: B) 5 61. Which fetal heart rate pattern is associated with umbilical cord compression? A) Early decelerations B) Variable decelerations C) Late decelerations D) Sinusoidal pattern Answer: B) Variable decelerations 62. A 42-year-old woman presents with preeclampsia at 36 weeks. What is the deﬁnitive treatment? A) Magnesium sulfate and antihypertensives B) Induction of labor C) Weekly blood pressure monitoring D) Low-dose aspirin Answer: B) Induction of labor 63. Which of the following is an indication for cesarean delivery? A) History of gestational diabetes B) Breech presentation at 39 weeks C) Fundal height 3 cm above expected D) Mild preeclampsia at 38 weeks Answer: B) Breech presentation at 39 weeks 64. A pregnant patient presents with persistent nausea and vomiting leading to dehydration. What is the most likely diagnosis? A) Hyperemesis gravidarum B) Normal morning sickness C) Preeclampsia D) Gestational diabetes Answer: A) Hyperemesis gravidarum 65. A patient at 30 weeks gestation presents with preterm premature rupture of membranes (PPROM). What is the best initial management? A) Immediate delivery B) Tocolysis, steroids, and antibiotics C) Expectant management at home D) Magnesium sulfate only Answer: B) Tocolysis, steroids, and antibiotics 66. What is the most common cause of postpartum hemorrhage? A) Uterine rupture B) Retained placenta C) Uterine atony D) Coagulopathy Answer: C) Uterine atony 67. Which of the following maternal conditions is most strongly associated with macrosomia? A) Gestational hypertension B) Chronic kidney disease C) Gestational diabetes D) Hyperemesis gravidarum Answer: C) Gestational diabetes 68. A 39-week pregnant woman presents with contractions and notes that her baby “feels lower.” This is best described as: A) Quickening B) Braxton Hicks contractions C) Engagement (Lightening) D) Fetal malpresentation Answer: C) Engagement (Lightening) 69. A patient presents with fever, tachycardia, uterine tenderness, and foul-smelling vaginal discharge after cesarean delivery. What is the likely diagnosis? A) Endometritis B) Preeclampsia C) Retained products of conception D) Chorioamnionitis Answer: A) Endometritis 70. Which test is used to determine fetal well-being by measuring amniotic ﬂuid volume and fetal movements? A) Biophysical proﬁle B) Non-stress test C) Contraction stress test D) Amniocentesis Answer: A) Biophysical proﬁle 71. Which of the following is a contraindication to induction of labor? A) Oligohydramnios B) Previous vertical (classical) cesarean section C) Hypertension D) Gestational diabetes Answer: B) Previous vertical (classical) cesarean section 72. A 37-week pregnant woman presents with contractions every 5 minutes for the past hour. What additional sign conﬁrms she is in true labor? A) Irregular contractions that stop with hydration B) Cervical dilation and egacement C) Fetal movement cessation D) Absence of bloody show Answer: B) Cervical dilation and egacement 73. A 32-week pregnant woman is found to have a short cervix on transvaginal ultrasound. Which medication can help prevent preterm labor? A) Oxytocin B) Betamethasone C) Progesterone D) Magnesium sulfate Answer: C) Progesterone 74. A newborn is born limp, with no respiratory eNort and a heart rate of 90 bpm. What is the next step? A) Chest compressions B) Administer epinephrine C) Provide positive pressure ventilation D) Observe for one minute Answer: C) Provide positive pressure ventilation 75. Which of the following is an expected cardiovascular change in pregnancy? A) Decreased blood volume B) Increased systemic vascular resistance C) Increased cardiac output D) Decreased heart rate Answer: C) Increased cardiac output 76. A patient at 34 weeks gestation presents with contractions and cervical dilation of 3 cm. What is the best initial management? A) Administer corticosteroids and tocolytics B) Immediate induction of labor C) Send home with bed rest D) Perform an emergency C-section Answer: A) Administer corticosteroids and tocolytics 77. A patient at 38 weeks presents with a painful, ﬁrm uterus and dark vaginal bleeding. What is the most likely diagnosis? A) Placental abruption B) Placenta previa C) Vasa previa D) Uterine rupture Answer: A) Placental abruption 78. A 28-week pregnant woman presents with painless vaginal bleeding. What is the most appropriate next step? A) Perform a digital cervical exam B) Order an ultrasound to check placenta location C) Administer oxytocin for induction D) Perform immediate cesarean delivery Answer: B) Order an ultrasound to check placenta location 79. A patient at 41 weeks gestation presents for induction of labor. Which of the following Bishop score ﬁndings indicates a favorable cervix? A) Cervical dilation 1 cm, posterior position, ﬁrm consistency B) Cervical dilation 3 cm, 50% egaced, soft consistency, mid-position C) Closed cervix, thick, posterior position D) Cervical dilation 2 cm, ﬁrm consistency, posterior position Answer: B) Cervical dilation 3 cm, 50% egaced, soft consistency, mid-position 80. Which fetal heart rate tracing pattern is associated with fetal hypoxia due to placental insuNiciency? A) Early decelerations B) Late decelerations C) Variable decelerations D) Sinusoidal pattern Answer: B) Late decelerations 81. What is the most common cause of neonatal respiratory distress syndrome? A) Prematurity and lack of surfactant B) Meconium aspiration C) Transient tachypnea of the newborn D) Congenital diaphragmatic hernia Answer: A) Prematurity and lack of surfactant 82. A woman at 34 weeks with preeclampsia is given corticosteroids. What is the purpose of this treatment? A) Lower blood pressure B) Reduce risk of placental abruption C) Accelerate fetal lung maturity D) Prevent maternal seizures Answer: C) Accelerate fetal lung maturity 83. What is the major risk factor for shoulder dystocia? A) Preterm labor B) Breech presentation C) Macrosomia D) Polyhydramnios Answer: C) Macrosomia 84. A patient at 32 weeks presents with decreased fetal movement. What is the best initial test? A) Amniocentesis B) Biophysical proﬁle C) Contraction stress test D) Fetal ﬁbronectin test Answer: B) Biophysical proﬁle 85. Which of the following is the most common risk factor for preeclampsia? A) Maternal diabetes B) Nulliparity C) Multiple gestations D) Smoking Answer: B) Nulliparity 86. A woman presents in labor with her baby in breech presentation. What is the preferred mode of delivery? A) Spontaneous vaginal delivery B) Operative vaginal delivery C) Cesarean section D) External cephalic version at full dilation Answer: C) Cesarean section 87. A woman with a history of a prior cesarean section is undergoing labor. Which sign suggests uterine rupture? A) Fetal heart rate accelerations B) Sudden severe abdominal pain and loss of fetal station C) Painless vaginal bleeding D) Mild irregular contractions Answer: B) Sudden severe abdominal pain and loss of fetal station 88. A postpartum woman presents with a swollen, tender breast and fever. What is the most likely diagnosis? A) Engorgement B) Mastitis C) Breast abscess D) Fibroadenoma Answer: B) Mastitis 89. A patient at 38 weeks has fetal bradycardia, rupture of membranes, and a palpable umbilical cord in the vagina. What is the next step? A) Reposition the mother and prepare for emergent cesarean section B) Continue labor monitoring C) Administer oxytocin D) Perform an amniotomy Answer: A) Reposition the mother and prepare for emergent cesarean section 90. Which of the following best describes gestational diabetes mellitus? A) Insulin resistance due to placental hormones B) Autoimmune destruction of pancreatic beta cells C) Impaired fasting glucose prior to pregnancy D) Hyperglycemia present in the ﬁrst trimester Answer: A) Insulin resistance due to placental hormones 91. Which of the following is an indication for intrapartum antibiotic prophylaxis against Group B Strep (GBS)? A) GBS bacteriuria during current pregnancy B) Prior pregnancy with GBS-positive culture but negative in current pregnancy C) Planned cesarean delivery without labor D) GBS-negative culture at 36 weeks Answer: A) GBS bacteriuria during current pregnancy 92. What is the preferred ﬁrst-line treatment for a pregnant woman with chronic hypertension? A) Lisinopril B) Methyldopa C) Hydrochlorothiazide D) Warfarin Answer: B) Methyldopa 93. A pregnant woman presents with pruritus and elevated bile acids. What is the most likely diagnosis? A) Preeclampsia B) Intrahepatic cholestasis of pregnancy C) Acute fatty liver of pregnancy D) Hyperemesis gravidarum Answer: B) Intrahepatic cholestasis of pregnancy 94. A patient presents postpartum with heavy vaginal bleeding, a soft "boggy" uterus, and hypotension. What is the most likely diagnosis? A) Endometritis B) Postpartum hemorrhage due to uterine atony C) Retained products of conception D) Uterine rupture Answer: B) Postpartum hemorrhage due to uterine atony

Obstetrics and Gynecology Questions - PDF

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