AMC MCQ Obstetrics and Gynaecology 2 — Questions and Answers
Question 1: A 28-year-old at 34 weeks presents with painless, bright red vaginal bleeding. What is the most appropriate next step?
- Digital vaginal examination
- Ultrasound to locate the placenta (Correct answer)
- Immediate artificial rupture of membranes
- Oxytocin induction
Correct answer: Ultrasound to locate the placenta
Painless antepartum haemorrhage suggests placenta praevia, where ultrasound localisation must precede any vaginal examination.
Question 2: Which finding is most characteristic of severe pre-eclampsia rather than gestational hypertension?
- BP 140/90 mmHg with no proteinuria
- Proteinuria with epigastric pain and visual disturbance (Correct answer)
- Isolated lower limb oedema
- BP 130/85 mmHg at term
Correct answer: Proteinuria with epigastric pain and visual disturbance
End-organ involvement such as epigastric pain and visual disturbance with proteinuria signifies severe pre-eclampsia.
Question 3: A woman with a previous classical caesarean section is most at risk of which complication during a subsequent pregnancy?
- Placenta praevia only
- Uterine rupture (Correct answer)
- Gestational diabetes
- Polyhydramnios
Correct answer: Uterine rupture
A classical (vertical) uterine scar carries a substantially higher risk of uterine rupture, so elective caesarean is recommended.
Question 4: What is the first-line management of shoulder dystocia?
- Immediate caesarean section
- McRoberts manoeuvre with suprapubic pressure (Correct answer)
- Fundal pressure
- Forceps delivery
Correct answer: McRoberts manoeuvre with suprapubic pressure
McRoberts manoeuvre with suprapubic pressure resolves most shoulder dystocias and is the recommended first step.
Question 5: A 32-year-old has a positive 75g OGTT at 26 weeks. What is the most appropriate initial management?
- Immediate insulin therapy
- Dietary modification and blood glucose monitoring (Correct answer)
- Metformin and induction at 34 weeks
- No intervention until symptoms appear
Correct answer: Dietary modification and blood glucose monitoring
First-line management of gestational diabetes is dietary modification with self-monitoring of blood glucose before pharmacotherapy.
Question 6: Which is the most common cause of primary postpartum haemorrhage?
- Retained placenta
- Uterine atony (Correct answer)
- Genital tract trauma
- Coagulopathy
Correct answer: Uterine atony
Uterine atony accounts for around 70% of primary postpartum haemorrhage cases.
Question 7: A rhesus-negative mother delivers a rhesus-positive baby. What is required to prevent sensitisation?
- Maternal blood transfusion
- Anti-D immunoglobulin within 72 hours (Correct answer)
- Exchange transfusion of the baby
- No treatment is necessary
Correct answer: Anti-D immunoglobulin within 72 hours
Anti-D immunoglobulin given within 72 hours prevents maternal alloimmunisation against fetal RhD antigens.
AMC MCQ Obstetrics and Gynaecology 2
A 28-year-old at 34 weeks presents with painless, bright red vaginal bleeding.
What is the most appropriate next step?