cms 2016 ….

Q1. PROM
Mrs Lunda aged 25 years Para 2 , gravida three comes to antenatal ward
with complaints of per vaginal draining and a diagnosis of PROM is made
her LMP is 30th October, 2015.
a. What do the initials PROM stand for (5mks)
b. i. Outline five(5) predisposing factors to PROM (15mks)
ii. Calculate the EDD and The GA for Mrs Lunda today
the 17th May, 2016 (10mks)
c. Discuss the management of mrs Lunda from
Admission till discharge (50mks)
d. Outline five complications of PROM (20mks)

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cms 2016 ….

Q2. SEPTIC ABORTION

Mrs Mweetwa aged 23 years is admitted to gynae ward with complaints

of foul vaginal discharge and vaginal examination the os was open. A
diagnosis of Septic diagnosis is made
a. i. Define septic abortion (5mks)
ii. State five signs and symptoms of septic abortion (10mks)
b. With an aid of the diagram, explain the types/classification of
abortion (25mks)
c. Discuss the management for Mrs Mweetwa from admission till
discharge (50mks)
d. Outline five(5) ways of preventing abortions in the
Community (10mks)

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cms 2016 ….

Q3. ANTENATAL CARE

Mrs. Chimwendo aged 28 years gravida 3, para 2 is coming for

antenatal care for the first time. She gives a history of having her last
menstrual period on 28th October, 2015.

a. Define focused antenatal care (5mks)

b. i. Calculate the expected date of delivery (EDD) and the
gestation age today the 20th January, 2016 (10mks)
ii. Outline four (4) aims of focused antenatal care (20mks)
c. Discuss the antenatal booking for Mrs. Chimwendo (50mks)
d. Outline five(5) points you will include in your information,
education and communication (IEC) on prevention of
Malaria in pregnancy (15mks)
Q4. VESICO VAGINAL FISTULA (VVF)

Mrs. Kalaka, a 25 year old woman comes to gynaecological ward with

complaints of draining of urine per vaginal and a diagnosis of vesico
vaginal fistula is made.
a) Define Vesico vaginal fistula (5mks)
b) State five (5) predisposing factors to
Vesico Vaginal Fistula (15mks)
c) Discuss the pre-operative care of Mrs. Kalaka (50mks)
d) Explain five(5) preventive measures of Vesico Vaginal Fistula
in the community (25mks)
3
cms 2016 ….

Q5. CANCER OF THE CERVIX

Mrs Jeta aged 35 years Para 8 comes to Gynaecological ward with
complaints foul vaginal discharge and a diagnosis of cancer of the cervix is
made.
e. Define cancer (5mks)
f. i. Outline five(5) predisposing factors to cancer
of the cervix (15mks)
ii. Using five (5) points compare and contrast
between malignant and benign tumours (10mks)
g. Discuss the management of Mrs Jeta from
Admission till discharge (50mks)
h. Outline five complications of cancer of the cervix (20mks)

Q 6: MALARIA IN PREGNANCY

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cms 2016 ….
Mrs Chinyama is admitted in antenatal ward with fever and a diagnosis
of severe malaria in pregancy is made. She is in Gravida 2 and Para 1.
She is in unconscious state.

a) i. Define malaria (5mks)

ii. State five (5) signs and symptoms of malaria in pregnancy (15mks)
b) Explain how intermittent presumptive treatment is given
in Zambia (10mk
c. Discuss the management of Mrs Chinyama under
the following subheadings
i. Medical management
(15mks)
ii. Maternal wellbeing (30mks)
iii. Foetal well-being
(5mks)
d. Outline four(4) complications of malaria in pregnancy (20mks)

5
cms 2016 ….

Q 7: ANAEMIA IN PREGNANCY

Mrs Chama is admitted in antenatal ward with fever and a diagnosis of

severe anaemia in pregancy is made. She is in Gravida 2 and Para 1.
She is in unconscious state.

c) i. Define anaemia (5mks)

ii. State five (5) signs and symptoms of anaemia
in pregnancy (15mks)
d) Explain five(5) types of anaemia (10mks
c. Discuss the management of Mrs Chinyama under
the following subheadings
iv. Medical management
(15mks)
v. Maternal wellbeing (30mks)
vi. Foetal well-being
(5mks)
d. Outline four(4) complications of eclampsia (20mks)

6
cms 2016 ….

Q (8): RUPTURED ECTOPIC PREGNANC

Miss Lwita, a 25 year old woman comes to gynaecological ward with

complaints of severe lower abdominal pains and a diagnosis of Ruptured
Ectopic Pregnancy
a) Define the following
i. Ectopic pregnancy (5mks)
ii. Salpingitis (5mks)
b) State five (5) signs and symptoms of ruptured
ectopic pregnancy (15mks)
c) Discuss the post-operative care of Miss Lwita
until discharge (50mks)
d) Draw a well labeled diagram indicating five (5)
possible sites

7
cms 2016 ….

(25mks)

Q 9: FIRST STAGE OF LABOUR

Mrs Banda come for admission in labour ward and a diagnosis of first
stage of labour is made. She is Gravida 5 and Para 4 .

a) i. Define normal labour (5mks)

ii. State four (4) signs and symptoms of onset of labour (20mks)
b) Outline five(5) differences between true labour and false labour(10mks)

c) Discuss the admission process of the woman in labour (50mks)

d. Outline five(5) contraindications of vaginal examination
in labour (15mks)

8
cms 2016 ….

Q 10: PELVIC INFLAMMATORY DISEASE (PID)

Mrs Banda comes to gynae ward and gets admitted due to Pelvic
Inflammatory Disease (PID).

a) i. List five(5) structures that are involved in pelvic inflammatory

disease(PID) (5mks)
ii. Draw a well labeled diagram of the pelvis and then
explain four (4) types of the pelvis
(25mks)
b) List five(5) signs and symptoms (5mks)

c) Discuss the management of Mrs banda from admission

till discharge of the woman in labour (50mks)
d. Outline five(5) complications of PID (15mks)

9
cms 2016 ….

Q11. FAMILY PLANNING

Mrs Mwenya Mutinta comes to maternal and child health services (MCH)
department seeking family planning services.
a. Define family planning (6mks)
b. i. Explain six(6) steps involved in counseling a new client
on family planning (30mks)
ii. Describe six(6) principles you will follow when counselling
Mrs Mwenya on family planning (24mks)
c. Discuss six(6) topics that should be tailored to the client
During family planning counselling (24mks)
d. Outline eight(8) advantages of low-dose combined
oral contraceptives (16mks)

10
cms 2016 ….

Q12. FAMILY PLANNING

Mrs Banda Lameck Mutinta comes to maternal and child health services
(MCH) department complaining of side effects of family planning services
she is receiving.
a. Define family planning (5mks)
b. With a well labeled diagram, explain the physiology of
Menstruation (30mks)
c. Explain five(5) types of family planning methods that
you may display to Mrs Banda during counselling indicating (50mks)
i. Name
ii. two ways of functioning
iii. two side effects
iv. two advantages
v. two disadvantages

d. Outline five(5) advantages of family to the family (15mks)

11
cms 2016 ….

Q13. POST ABORTAL COUSELLING

Miss Mutinta aged 18 years comes to maternal and child health services
(MCH) department after aborting seeking family planning services.
a. Define post abortal family planning counselling (5mks)
b. Explain the family planning method you will give to
Mrs Mutinta giving appropriate rationales for all your actions (30mks
c. Describe the components of post abortal care (40mks)
d. Explain (5) reasons why young ladies may have unplanned
Pregnancies (25mks)

Q14. MENSTRUAL DISORDERS

Miss Lunga aged 16 years is admitted to gynae ward due to severe
dysmenorrhoea with severe.
a. Define dysmenorrhea (5mks)
b. Explain five(5) types of menstrual disorders (20mks
12
cms 2016 ….
c. i. Describe the management you will give Miss Lunga
whilst in hospital (20mks)
ii. Describe the sanitary services that can be given to
adolescents in schools (30mks)

d. Explain five (5) reasons why young ladies may indulge in

unprotected sexual activities (25mks)

13