RpMCH
Obstetrics Box Questions

Obstetrics Box Question which are very helpful for Medical Students in Bangladesh, Specially Rangpur Medical College Students. Today I am share some box Questions about Obstetrical conditions. Answer of the questions will being ready. As soon as possible I add the solution for Each question. You can also download as pdf From here.

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APH

An elderly multigravid patient of 35 wks pregnancy came to you with history
of recurrent painless p/v bleeding,
Q-1. What will be the possible diagnosis?
Q-2. Mention four D/D.
Q-3. Give the nianagement of such case.
1. Multigravida with 35 weeks pregnancy with APH due to planta Previa

A lady of 20 yrs having history of 34 wks pregnancy with H/O painless, causeless, recurrent bleeding per vagina.
Q-1. What should be the probable diagnosis?
Q-2. What are the relevant investigations you should suggest?
Q-3. Give the outline of management such a case.

A lady of 40 wks pregnancy came to you with history of labour pain for >12 hrs.
Q-1. What is your probable diagnosis?
Q-2. How will you proceed to mange this case?

A patient delivered a healthy baby 2 hours back, her placenta was expelled
out still there is severe per vaginal bleeding & the uterus found flaccid on
palpation.
Q-1. Give the probable diagnosis. Prumareyppy due to Atonicity
Q-2. What might be the causes?
Q-3. How will you manage the case?

A pregnant lady of 20 yrs age came to you with 28 wks gestational age with respiratory distress distress. On examination fundal height is more than period of gestation, abdomen is shiny and tense.
0-1. What is the possible diagnosis?
Q-2. What are the causes of such a case?
Q-3. Give the management.

A lady para 4+2 come to you with labour pain for 20 hours with H/O severe agonizing pain 6 hours back, O/G/E, she is dehydrated, severely anaemic, on
P/A/E abdomen is tender, foetal parts are superficiality palpable

Q-1. What is your diagnosis?
Q-2. How will you proceed to manage this case?
Q-3. What are the late complications can be occur in this case?

À pregnant lady at her 37 wks oſ pregnancy present to you with
breathlessness & generalized swelling of the whole body, O/E – she is anxious,
severely pale, BP-120/80 mmHg.
Q-1. What is your diagnosis?
Q-2. What investigation you do in this cascs?
Q-3. Give the treatment plan.

PPH

A multi gravid patient came to you with a history of home delivery by an untrained dai 2 hours back with shock with P/V bleeding, placenta is still undelivered.
Q-1. What will be the diagnosis? – PPH due to Retained placenta
Q-2. What may be cause of such cases?
Q-3. Give the treatment of such a case,
0-4. What will be the dangers of prolonged retention of placenta?

A lady at her 30 wks of pregnancy attend to you with internship inferior mi headache
blurring of vision, upper abdominal pain,
Q-1. What is your diagnosis?
Q-2. How will you investigate this case?
0-3. Give the principle of management in this case,

A lady of 30 yrs age, came to you with 34 wks pregnancy with severe dyspnoea,
palpitation, chest pain.
Q-1. What will be the possible diagnosis?
Q-2. What may be the other diagnosis?(mention 3)
Q-3. How will you proceed to mange her?

Delivered a healthy baby one hour back, her placenta was expelled out still there
is severe per vaginal bleeding & the uterus found flaccid on palpation.
0-1. Give the probable diagnosis.
Q-2. How will you manage the case?

A multigravid patient came to you with a history of home delivery by an untrained dai 2 hours back with shock, placenta is still undelivered.
Q-1. What will be the diagnosis?
Q-2.What may be cause of such case?
Q-3. Give the trentment of such a case?
Q-4.What will be dangers of such condition if untreated for prolonged period?

A grandmultipara, para 5+0, came to you with history of home delivery of big
baby one hour back & placenta was expelled after delivery. Now she has profuse PV bleeding,
Q-1. What will be the probable diagnosis of such case?
Q-2. Give ile immediate management to stop PV bleeding.
Q-3. Give the possible causes of primary PPH.

Eclampsia

A primigravid patient present as 36 wks of twin pregnancy with rapid gaining of weight with blurring of vision & intense headache, BP 160/100 mmHg.
Q-1. What is your diagnosis?
Q-2. How will you proceed to manage her?

A pregnant lady of 25 yrs of age came to you at 34 wks pregnancy with
repeated convulsion & her BP is 150/100 mmHg with gross albuminuria.
Q-1. What will be the probable diagnosis?
Eclampsia
Q-2. What will be the management?
Q-3. What might be the complications of such case?

A 35 years old lady para-(2+0), present to you at her 36 wks pregnancy with
severe abdominal pain. On examination, BP-210/110mmHg, severely anaemic
uterus is tense & tendes, FHS – Not audible & scanty per vaginal bleeding.
0-1. What is your probable diagnosis?
Q-2. How will you manage this case?

A pregnant lady of 25 yrs of age came to you at 34 wks pregnancy repeated convulsion
her BP is 150/100 mm
Q-1. What will be the probable diagnosis!
Q-2. What investigation will you do?
Q-3. What will be the treatment protocol?

A 25 years old lady came to you with H/O 36 wks, Pregnancy, para 0+0 following features and investigations report.
Bp – 180/110 mm of mg.
Oligouria Proteinurea > 5 gm/day
Q-1. What is your probable diagnosis?
Q-2. What complications may arise?
Q-3. What will be the definitive treatment?

A primigravida 32 years attend at her 37 wks pregnancy with BP-160/110
mumlg with severe edemn with poroteinuria
Q-1. What is your probable diagnosis?
Eclampsia
Q-2.Give the principle of management in this case,

Q-1. Define eclampsia.
Q-2. How will you manage a case of eclampsia?
Q-3. What are the complications of eclampsia?
Q-4. What are the causes of death in eclampsia?

PROM

A pregnant lady, para 0+0, came to you with 34 wks pregnancy with history of
P/V watery discharge with less fetal movement.
Q-1. What is your probable diagnosis?
Q-2. How wiil you confirm your diagnosis?
Q-3. Give the treatnient of such a case.

A 25 yrs old lady came to you withi 34 wks pregnancy with history of per
vaginal water discharge for 3 days.
Q-1. What is your probable diagnosis?
Q-2. What are the possible causes of such cases?
Q-3. What are the differential diagnosis?
Q-4. How will you clinically confirm such case?

A lady of 30 years. Present at 36 weeks pregnancy with less fetal movement with H/O previous IUD.
Q-1. What might be the probable causes of less fetal movement of such case?
Q-2. What is your plan of management of this case?
A 25 yrs old lady came to you with 34 wks pregnancy with history of per vaginal watery discharge for 3 days.
Q-1. What is your probable diagnosis?
Q-2. What are the possible causes of such cases?
Q-3. What are the differential diagnosis?
Q-4. How will you clinically confirm such case?
Q-5. How will you manage such case?

Rh incompatibility 


A primigravide with 36 wks pregnancy, her blood group is Rh-ve, enme to you for ANC for first time.
0-1. How will your proceed to manage her?
0-2. What preotutions you will take during delivery?

A primi gravid lady came to you with H/O 20 wks pregnancy with Rh-ve blood group,
Q-1. How will you proceed to manage her?
Q-2. What precaution you will take during delivery?

Obstructed Labour


A short statured lady of 18 yrs having history of term pregnancy with labour pain for >24 hrs on pervaginal examination cervix full dilated & big capute is seen.
obs Labour
Q-1. What should be the probablc diagnoşis?
Q-2. What are the maternal & fetal effects of such labour?
0-3. Give the outline of treatment of such a case?

Pureperal Sepsis

A 30 yrs woman came with history of delivery by C/S 10 days back with the complain of
P/V bleeding with foul smelling discharge.
Q-1. What is the probable diagnosis?
0-2. What are the causes of it? – commm els
Q-3. How will you manage the case?
Puerperal sepsis

Labour pain


0-1. Define normal labour. Normal Labour
0-2. What are the features of true labour pain?
0-3. Give difference between true & false labour pain.
Q-4. What are the problems may arise in 1stage of labour & how
they can be overcome?

Episiotomy

Q-1. What is episiotomy? What are the types of it?
Q-2. What are the steps of repair of episiotomy?
Q-3. What are the Indications & Complications of episiotomy?

Vulval Haematoma


2 hours after vaginal delivery you found a patient is in shock with vulva e perineal
swelling
Q-1. What is your probable diagnosis? — Valval haematoma
Q-2. Mention the common cause of such swelling?
Q-3. How do you mange her?

Ovarian Lump

A lady of about 35 years Para 0+0 attained with the History of lump in lower abdomen for 1 year with mild abdominal pain. On examination there is a lump in the lower
abdomen which is freely mobile in all direction.
Q-1. What is yourprobable diagnosis?
Q-2. How will you proceed to manage this case?

Abortion

A lady of about 20 week’s amenorrhoea attained to you with the complaints of
P/V brownish discharge & regression of early pregnancy sign & symptom.
Q-1. What is your probable diagnosis?
Q-2. How will you manage this case?

A lady of about 10 weeks amenorrhoea attained to you with severe lower
abdominal pain, excessive P/V bleeding and passage of fleshy mass one days
back. Now she is having painless scanty P/V bleeding
Q-1. What is your probable diagnosis?
Q-2. How can you manage this case?

A lady P 0+4 came to you at her 20 weeks of pregnancy with pain in lower abdomen, on quarry all her previous abortion occur after 1 weeks.
Q-1. What is your diagnosis?
Q-2. How will you manage this case?

A lady at her 38 weeks of pregnancy admitted at RpMCH with pain in abdomen for 20 hrs. On examination, she is exhausted, On P/A/E FHR 184 b/min.
Q-1. What is your diagnosis?
Q-2. How can you snage this case?

Labour

A 18 years old pregnant women admitted with severe abdominal pain for last
12 hrs. On examination she is dehydrated, on P/A/E Fetal heart sound is not
audible & P/V/E vagina is hot, dry, edematous, membrane ruptured, caput
(++), cervix 8cm dilated.
Q-1. What is your diagnosis?
Q-2. How can you manage this case?

A patient at labour room at her 40 weeks pregnancy with labour pain in 1st stage of labour. On partographic finding FHR 190b/min, membrane rupture, liquor meuconium stained, cervix 6 cm dilated
Q-1. What is your diagnosis?
Q-2. How can you manage this case?

Carcinoma Cervix

A 45 years lady attained at Gynae OPD with the complaints of irregular PV
bleeding, excessive offensive altered color PV discharge.
0-1. what is you diagnosis?
0-2. How can you manage this patient?

Others

A 25 years old lady admitted to RPMCH with the history of 8 weeks amenorrhoea, scanty PV bleeding with H/O severe lower abdominal pain & fainting attack 24 hours back. On examination she is severely anemic.
Q-1. What is your diagnosis?
Q-2. How can you manage this case?

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