QUESTION BANK

PT WOMAN HEALTH
 Table of Contents
SECTION 1: CHOOSE THE BEST ANSWER
✓ Physiological changes during pregnancy & sheet ..............................................................................2
✓ Antenatal care ........................................................................................................................................4
✓ Exercise wellness ....................................................................................................................................5
✓ Hyperemesis gravidarum ......................................................................................................................7
✓ Risk pregnancy ......................................................................................................................................8
✓ Normal labor and episiotomy ...............................................................................................................9
✓ Cesarean section ..................................................................................................................................11
✓ Puerperium (normal and abnormal) .................................................................................................14
✓ Breast feeding.......................................................................................................................................18
✓ Rectus diastasis ....................................................................................................................................19
✓ Menopause ............................................................................................................................................20
✓ Hysterectomy .......................................................................................................................................21
SECTION 2: TRUE OR FALSE
✓ Physiological changes during pregnancy & sheet ............................................................................22
✓ Antenatal care ......................................................................................................................................23
✓ Exercise wellness ..................................................................................................................................23
✓ Hyperemesis gravidarum ....................................................................................................................24
✓ Risk pregnancy ....................................................................................................................................24
✓ Normal labor and episiotomy .............................................................................................................25
✓ Cesarean section ..................................................................................................................................26
✓ Puerperium (normal and abnormal) .................................................................................................26
✓ Breast feeding.......................................................................................................................................27
✓ Rectus diastasis ....................................................................................................................................27
✓ Menopause ............................................................................................................................................28
✓ Hysterectomy .......................................................................................................................................28
SECTION 3: CASE STUDY
✓ Antenatal care ......................................................................................................................................28
✓ Hyperemesis gravidarum ....................................................................................................................29
✓ Risk pregnancy ....................................................................................................................................30
✓ Normal labor ........................................................................................................................................30
✓ Cesarean section ..................................................................................................................................30
✓ Puerperium (normal and abnormal) .................................................................................................32
✓ Breast feeding.......................................................................................................................................34
✓ Menopause ............................................................................................................................................34
✓ Hysterectomy .......................................................................................................................................36

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SECTION 1: CHOOSE THE BEST ANSWER
Physiological changes during pregnancy & sheet
1) During pregnancy the venous pressure: (page 10)
a) Increased in upper extremities.
b) Significantly decreased in the lower extremities.
c) Returns to near normal in lateral recumbent position
d) Decreased in upper extremities.
2) Striae gravidarum during pregnancy is due to: (page 19)
a) Hormonal alterations
b) Mechanical Stretching.
c) Increased estrogen hormone.
d) Increased melanocyte-stimulating hormone.
3) Musculoskeletal or neuromuscular problems can be aggravated by pregnancy due to the effect
of (page 16 - 18)
a) Progesterone hormone
b) Oxytocin hormone.
c) Not related to hormonal change.
d) Prolactin hormone
4) All these factors can cause constipation during pregnancy EXCEPT: (page 16)
a) Pressure of enlarged uterus on the intestines
b) Relaxation of smooth muscles fibers by relaxin hormone
c) Sedentary habits during pregnancy
d) Heart burn and indigestion
5) Postural changes during pregnancy occur
a) In the early pregnancy.
b) In the third month of pregnancy only.
c) In the six months of pregnancy.
d) From the fourth month of pregnancy
6) Major hormones affecting musculoskeletal system during pregnancy are the following
EXCEPT
a) Estrogen
b) Progesterone
c) Relaxin
d) Insulin
7) Second zero of obstetric history means… (page 4 clinical)
a) Number of living children.
b) Number of previous abortions.
c) Number of full-term pregnancies.
d) Number of preterm pregnancies.
8) Musculoskeletal changes during pregnancy include: (page 16)
a) Elongated hip flexors.
b) Shortened lower back musculature
c) Shortened Abdominal muscles
d) Elongated pectoralis major muscles.
9) Placenta secretes all of these hormones during pregnancy EXCEPT: (page 13)

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 a) Progesterone.
b) Relaxin.
c) Human Chorionic Gonadotropin.
d) Prolactin.
10) In the third trimester of pregnancy, the pregnant woman is advised not to assume…….
Position to avoid changes in the venous pressure: (page 10)
a) Supine lying
b) Sitting
c) Side lying
d) Prone lying
11) Normal finding of fundus level test after two weeks postpartum is: (page 7 clinical)
a) Between umbilicus and symphysis pubis.
b) At the level of umbilicus.
c) Above the level of umbilicus.
d) Just behind symphysis pubis.
12) Which of the following cardiovascular changes during pregnancy is decreased? (page 9)
a) Plasma volume
b) Plasma fibrinogen
c) Hematocrit
d) Cardiac output
13) All of these cutaneous changes during pregnancy are due to hormonal alteration EXCEPT:
a) Chloasma gravidarum (midterm group B)
b) Linea nigra
c) Darkness of the primary areola
d) Striae gravidarum
14) Which is NOT correct about uterine growth during pregnancy? (Page1,2)
a) Uterine Weight Increase to reach 1000 grams at the term
b) Uterus become abdominal organ in fifth month of pregnancy.
c) Estrogen and progesterone causing myometrial hyperplasia.
d) The fundus height in 40th week is lower than in 36 th week of pregnancy.
e) Elongated pectorals major muscles.
15) Which is not correct about changes in vagina during pregnancy: (group A 2023)
a) Increased vascularity
b) Become soft, moist and bluish.
c) PH more than 7
d) The length of the anterior wall is increased.
16) Which is not correct about changes in the blood volume during pregnancy: (group A 2023)
a) Plasma volume increased by 45%
b) Plasma fibrinogen decreased.
c) The plasma protein concentration decreased.
d) Increase the demand of oxygen transport.
17) All these hormones increased during pregnancy Except: (group A 2023)
a) Progesterone
b) Relaxin
c) Estrogen
d) Oxytocin

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 Antenatal care
18) Usually, antenatal classes start at------ month of pregnancy. (page 24)
a) Fourth.
b) Second.
c) Third.
d) Fifth.
19) The pregnant woman is instructed to modify her diet as:
a) Increase protein intake.
b) Increase starch intake,
c) Increase fat intake.
d) Decrease vitamin intake.
20) The relation of the long axis of the fetus and that of the mother is known as (page 25)
a) Lie
b) Position
c) Attitude.
d) Presentation
21) All of the following can be used to treat carpal tunnel syndrome during pregnancy EXCEPT:
(page 29)
a) Contrast baths.
b) Continuous ultrasound.
c) TENS.
d) Pulsed ultrasound.
22) Teaching the pregnant woman panting breathing should be started from.......... Of
pregnancy: (page 25)
a) The 4th month
b) The 8th month
c) The 6th month
d) The last month
23) Abdominal exercises (page 24)
a) Not safe to be performed during pregnancy
b) Lead to precipitate labor.
c) Safe to be started during the 6 th month of pregnancy.
d) Practiced only post-partum.
24) During last month of pregnancy, female should perform all except (page 25)
a) Pelvic floor exercise
b) Posture correction exercise
c) Vigorous Abdominal exercise
d) Relaxation training
25) ...............is considered a method for controlling tension and pain: (page 23)
a) Postural correction.
b) Stress in all life situation.
c) Not applied during pregnancy.
d) Breathing awareness
26) Management of acute symptoms of carpal tunnel syndrome during pregnancy includes:
a) Circulatory exercise for wrist joint. (page 113)
b) Wearing a night splint

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 c) Both a& b.
d) Neither a nor b.
27) Teaching the pregnant woman diversion drill technique should be started from……… of
pregnancy: (midterm group B)
a) The 4th month
b) The 6th month
c) The 8th month
d) The last month
28) The passage of the widest transverse diameter of the fetal presenting part through the pelvic
inlet is known as: (page 25)
a) Engagement.
b) Attitude.
c) Crowning.
d) Position.
29) 28 years old, pregnant female suffers from pubic pain in the 27 week of gestation, This pain
a) May be due to diastasis of the rectus abdominis.
b) Cannot be treated by modified pelvic support.
c) Is better treated by pulsed US.
d) Can be treated only by TENS
Exercise wellness
30) Pregnant women should exercise at intensity on perceived rate exertion that corresponds to:
a) 8 (page 35)
b) 13
c) 15
d) 16
31) Fetal heart rate increases during exercises depends on the following EXCEPT: (page 44)
a) Type of exercise.
b) Intensity of exercise.
c) Frequency of exercise.
d) Duration of exercise.
32) Which of the following is false about the exercises effect on maternal cardiovascular system?
a) Increase in the maternal heart rate (page 43)
b) Decrease the utero-placental blood flow, due to blood diversion to the skeletal muscles
c) Increase in COP and slight increase in systematic BP
d) Increase in blood volume (within 10 min) with no further change whatever the
duration of exercise
33) What is the recommended guideline for the strength training exercise during pregnancy?
a) 3 sets of 10-12 repetitions of each exercise (page 40)
b) One to 2 sets of 10-12 repetitions of each exercise
c) 2 sets of 15 repetitions of each exercise
d) 2 sets of 15o 20 repetitions of each exercise
34) Exercise during pregnancy can affect the following EXCEPT: (page 43)
a) Baby weight
b) Baby length
c) Fetal heart rate
d) Parenchymal density of placenta

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35) What is the absolute contraindication for engaging in exercises during pregnancy?
a) Severe anemia (page 32)
b) Chronic bronchitis
c) Morbid obesity
d) Incompetent cervix
36) Absolute contraindications of practicing exercises during pregnancy include: (page 32)
a) Significant heart diseases.
b) Severe anemia.
c) Intrauterine retardation.
d) Poorly controlled hyperthyroidism.
37) The minimum number of exercises sessions provided to achieve fitness benefits during
pregnancy is (page 31)
a) Four times per week
b) Every day
c) Five times per week
d) Three times per week
38) A pregnant woman at the second month of gestation. Which of the following exercises suitable
for her case to start with?
a) Postural correction exercise.
b) Pelvic rocking exercises.
c) Pelvic floor exercises.
d) No physical therapy for her case.
39) Absolute contraindications of practicing exercises during pregnancy include: (Page 32)
a) Incompetent cervix
b) Smokers
c) Poorly controlled hyperthyroidism
d) Chronic bronchitis
40) Exercise has no effect on the following EXCEPT: (Page 44)
a) Birth head circumference
b) Birth baby weight
c) Birth baby length
d) Fetal heat rate
41) To calculate intensity of exercise for the pregnant women, the following are used (Page 34)
a) Pregnancy target heart rate zone Both
b) Training heart rate
c) Talk test
d) B & c
42) A pregnant woman, with a history of habitual abortion; at the second month of gestation. Which
of the following exercises is suitable for her to start: (group A 2023)
a) Postural correction exercise
b) Pelvic floor exercises.
c) Pelvic rocking exercises.
d) No physical therapy for her case.
43) Warning signs during pregnancy include all of the following EXCEPT: (group A 2023)
a) Vaginal bleeding
b) Nausea and vomiting

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 c) Severe persistent headache
d) Swelling in lower limbs
Hyperemesis gravidarum
44) The following are 'TENS mechanisms in treatment of hyperemesis gravidarum EXCEPT:
a) Increase peristaltic velocity. (page 56)
b) Increase basal tone of esophagus.
c) Increase progesterone effect.
d) Accelerate gastric emptying time
45) The following are the mechanisms of acupuncture in treatment of hyperemesis gravidarum
EXCEPT:
a) Alter hemodynamics of the body that affect heart rate- cardiac output.
b) Decrease immune system.
c) Regulate biochemistry of the body.
d) Sedative effect.
46) The following are true in general treatment of hyperemesis gravidarum EXCEPT:
a) Walking in open fresh air. (page 58)
b) Avoid stimuli habits producing symptoms.
c) Little bits of liquids in between meals.
d) Diet decrease in protein& carbohydrates and increase in fat.
47) The application of TENS in treatment of hyperemesis gravidarum is one electrode above
thenar muscle, the other one is on: (page 55)
a) ST36 point.
b) SP6 point.
c) PC6 point.
d) B21 point.
48) Regarding the use of ginger in hyperemesis: (midterm group B) (page 54)
a) It decreases gastrointestinal motility.
b) Decreasing nausea requires daily administration for 2 weeks.
c) It has carminative and absorbent features.
d) It is not recommended due to its teratogenic effects.
49) The following is a risk factor for hyperemesis gravidarum: (midterm group B)
a) High maternal age
b) Low maternal body mass index
c) A female fetus.
d) Second-time pregnancy.
50) One of the risk factors for hyperemesis is: (Page 49)
a) Young maternal age
b) Multiparity.
c) Maternal underweight
d) Negative H-pylori findings.
51) In a female with severe nausea & vomiting, which vitamin would be deficient? (Page 51)
a) Vitamin A.
b) Vitamin D.
c) Vitamin B.
d) Vitamin E.
52) Which of the following elements is not affected in a case of hyperemesis? (Page 51)

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 a) Sodium.
b) Zinc.
c) Potassium.
d) Chloride
53) Regarding the TENS application in hyperemesis: (group A 2023)
a) It affects neurotransmitters
b) It doesn't affect intestinal muscles.
c) It is applied on P6 only.
d) It increases gastric acid secretion.
Risk pregnancy
54) ...... Is considered as fetal complications in gestational diabetes. (page 63)
a) Preterm labor.
b) Congenital malformation.
c) Postpartum hemorrhage.
d) Abortion.
55) Which is TRUE about intrinsic asthma? (page 65)
a) Characterized by severe attacks.
b) Occurs in childhood period.
c) Is known as allergic asthma.
d) Less dangerous than extrinsic asthma.
56) The best type of exercise in case of gestational diabetes is moderate type for------ Times/
week: (page 64)
a) Six.
b) Two.
c) Three.
d) Four.
57) Preeclamptic patient is instructed to avoid: (page 61)
a) Side lying position.
b) Valsalva maneuver.
c) Diaphragmatic breathing exercise.
d) Passive exercises.
58) All of the following are maternal complications for gestational diabetes EXCEPT (page 63)
a) Abortion
b) Postpartum hemorrhage
c) Congenital malformations
d) Caesarean section
59) Which is true about extrinsic asthma? (page 65)
a) Characterized by severe attacks
b) Occurs after the age of 35 years old.
c) Is known as non-allergic asthma.
d) Less dangerous than intrinsic asthma.
60) Severe preeclampsia is characterized by proteinuria more than ...gm/L (page 59)
a) 5
b) 0.3
c) 0.4
d) 3

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61) Which is true about chronic hypertension? (page 59)
a) Diagnosed before 20 weeks of gestation.
b) Is developed in a woman who is already hypertensive
c) Persists till the 1st 24 hours postpartum.
d) Diagnosed after 20 weeks of gestation.
62) All the following are fetal complications for gestational diabetes mellitus EXCEPT:
a) Congenital malformation. (page 63)
b) Hypoxia
c) Persistence of diabetes later in life.
d) Intrauterine fetal death.
63) In gestational diabetes, postprandial blood glucose level exceeds (page 63)
a) 300 mg/dl.
b) 100 mg/d.
c) 250 mg/d
d) 200 mg/dl.
64) Usually gestational diabetes is detected (page 63)
a) After 28 weeks' gestation.
b) At 24-28 weeks' gestation
c) At 20 weeks' gestation.
d) Before 20 weeks' gestation.
65) Which of following is true about gestational diabetes?
a) Usually detected before 20 weeks of gestation.
b) Usually detected at 24-28 weeks of gestation
c) Usually treated by severe type of exercise
d) Could be treated by hypoglycemic agents
66) Which of the following is true about pre-eclampsia?
a) Has only one type
b) Diagnosed after 20 weeks of gestation
c) Persistent till the 1 st 24 hours postpartum
d) Diagnosed before 30 weeks of gestation
67) Pre-eclampsia is usually diagnosed (page 59)
a) After 20 weeks of gestation.
b) At 20 weeks of gestation.
c) Before 20 weeks of gestation
d) At 24 weeks of gestation.
68) Which of the following can be performed by a Preeclamptic patient? (page 61)
a) Supine lying position.
b) Abdominal and pelvic floor contraction.
c) Calcium intake.
d) Valsalva maneuver.
Normal labor and episiotomy
69) Fetal distress means fetal heart rate is... EXCEPT (page 72)
a) Above 160 beat/minute
b) Below 100 beat/minute
c) Regular
d) Delayed to return to normal after uterine contraction

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70) Which of the following is INCORRECT about perineal trauma? (page 78)
a) The 3rd degree involves injury to the anal sphincter.
b) Anterior perineal trauma has an increased incidence.
c) Its incidence decreases when performing episiotomy.
d) It occurs during the late part of the 2 nd stage of labor.
71) Regarding the prolonged ice application for perineal incision, which statement is
INCORRECT?
a) It causes what is called counter-irritant effect.
b) It results in feeling numb, then dull pain.
c) It decreases the pain by stimulating mechanoreceptors.
d) It stimulates opioid and endorphins' release.
72) Regarding ultrasound application for perineal wound healing, which statement is
INCORRECT? (page 81-82)
a) Frequency used is 3mhz.
b) Ultrasound is applied in a direct contact.
c) The ultrasound mode is continuous.
d) Ultrasound is applied after pain subsides.
73) What is TRUE about TENS application for relieving perineal pain? (page 82)
a) Pulse width used differs with changing the frequency.
b) High frequency and low frequency are equally beneficial in pain relief.
c) TENS is used immediately after delivery.
d) Electrodes are placed on the area of lumbosacral nerve supply.
74) Which statement is INCORRECT regarding pelvic floor muscle contractions post
episiotomy? (page 80)
a) They are performed in the acute stage for pain relief.
b) They stimulate gate control mechanism.
c) They are painless especially when done at the first 3 days.
d) They relieve pain by stimulating endogenous opioids' release.
75) All of these methods used to relief labor pain EXCEPT:
a) Massage.
b) Laser.
c) TENS.
d) Breathing exercises.
76) The main force of labor is:
a) Abdominal muscles.
b) Diaphragm.
c) Pelvic floor muscles.
d) Uterine force.
77) Regarding ultrasound application in acute perineal pain, which statement is CORRECT?
a) Frequency used is 1 MHZ.
b) The application technique is direct contact
c) The ultrasound mode is continuous.
d) Ultrasound is applied in the first three days
78) Concerning TENS application in acute perineal pain: (page 82)
a) High frequency is better than low frequency in pain relief.
b) Intensity used is at submotor level

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 c) Electrodes are placed on the area of lumbosacral nerve supply.
d) TENS is used immediately after delivery.
79) Regarding perineal trauma: (page 78)
a) Posterior perineal trauma has an increased incidence
b) Muscles are involved only in the 3 rd degree.
c) Anterior perineal trauma has an increased incidence.
d) It occurs during the first part of the 2M stage of labour.
80) Episiotomy may be essential in such cases EXCEPT (page 79)
a) Breach presentation
b) Elderly prim para
c) Before forceps application
d) Large size baby
81) Low level laser therapy can be used to assist perineal wound healing with the following
parameters: (page 82)
a) Wavelength 750-905 nm and intensity 4-6 ycm2
b) Wavelength 600-750 nm and Intensity 0.5-4 /cm2
c) Frequency more than 1000
d) Shorter wavelength and intensity 0.5-4 /cm2
82) The most effective methods for relieving chronic perineal pain:
a) Pulsed US and cold application
b) Continuous Ultrasound and stretching exercises
c) Neither a &b
d) Both a &b
83) Pelvic floor exercises after episiotomy should be included in the treatment program as it is:
(page 80)
a) Preventing constipation
b) Stretching pelvic floor muscle
c) Prophylactic against deep venous thrombosis
d) Relieving stiffness, promoting wound healing
Cesarean section
84) Physical therapy modalities used to relieve postoperative incisional pain include:
a) Hot packs.
b) Continuous Ultrasound (US).
c) TENS.
d) Infrared.
85) Physical therapy modalities used to promote healing of infected wound in cesarean section
cases include:
a) Ultraviolet (UV).
b) TENS.
c) High voltage current stimulation.
d) Both (A & C).
86) Regarding lower segment cesarean section, choose the CORRECT answer:
a) There is higher incidence of scar rupture.
b) Has fewer postoperative complications.
c) Lead to more blood loss.
d) Has higher incidence of wound infection.

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87) Which one of the following action mechanisms of laser is best related to wound healing?
a) Having photochemical and photo-biological effects.
b) Modulation of neurotransmitters as serotonin.
c) Turning the prostaglandins into prostacyclin.
d) Decreasing the release of substance P and cytokines.
88) In caesarean section cases, trunk flexion exercise can be started at: (page 91)
a) 3rd day
b) 4th day
c) 5th day
d) 7th day
89) Pelvic floor exercises are indicated in the postoperative cesarean section: (page 90)
a) 3rd day
b) 5th day
c) 1st day
d) 7th day
90) Which of the following exercises is contra-indicated following cesarean section?
a) Relaxation on face
b) Pelvic floor exercises
c) Static abdominal exercise
d) Respiratory exercises
91) Burst mode of TENS is used after cesarean section between episodes of pain with frequency
of (page 90)
a) 20 Hz
b) 120 Hz
c) 2Hz
d) 200 Hz
92) Mechanism of action of ultraviolet to promote wound healing following cesarean section
include: (page 93)
a) Destruction and removal of the slough
b) Enhance DNA &RNA synthesis
c) Micro-massage effect
d) Enhance protein synthesis
93) The true conjugate in extreme degree of contracted pelvis is: (page 83)
a) 10-11 cm.
b) 6-8 cm.
c) 8-10 cm.
d) 6 cm.
94) Implantation of placenta in the lower uterine segment is defined:
a) Placenta accrete.
b) Placental abruption.
c) Placenta Previa.
d) Retained placenta.
95) ------is one of contra-indications for cesarean section: (page 86)
a) Immature fetus
b) Malposition.
c) Dead fetus

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 d) Malpresentation.
96) Incidence of rupture of sear in upper segment cesarean section is: (page 87)
a) 0.4%.
b) 2%
c) 0.5 %.
d) 0.2%.
97) Disadvantages of lower segment cesarean section include: (page 88)
a) More blood loss.
b) More incidence for rupture of scar
c) More liable to chest infection
d) It needs more skill and experience
98) Indications for upper segment cesarean section include: (page 87)
a) Vertex presentation.
b) Longitudinal lie
c) Uterine inertia.
d) Invasive cervical carcinoma.
99) Pelvic rotation is indicated in the---------- postoperative: (page 91)
a) 5th day
b) 1st day
c) 6th day
d) 2nd day.
100) Modalities used to enhance healing of infected wounds include:
a) Transcutaneous electrical stimulation.
b) Ultrasound.
c) High voltage current stimulation
d) Interferential current
101) To manage paralytic ileus after cesarean section, mothers are advised to perform:
a) Breathing exercises
b) Static abdominal exercise
c) Circulatory exercises.
d) Leg exercises
102) To prevent post-operative intestinal complication, we do (page 93)
a) Early ambulation
b) Short wave diathermy
c) None of them are useful
d) Both of a & b
103) Laser may accelerate wound healing through
a) Decreasing protein synthesis
b) Increasing blood circulation
c) Accelerating the inflammatory phase
d) Decreasing DNA synthesis
104) Indication of classical operation include
a) Extreme degree of contracted pelvis
b) Pre-eclampsia
c) Cephalopelvic disproportion
d) Sever fetal distress

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105) Pre-operative physical therapy goals for cesarean operation include… (page 89)
a) Improve pelvic floor dysfunction.
b) Improve pulmonary function.
c) Correct posture.
d) Strength abdominal muscles.
106) All of these methods can enhance postoperative wound healing except:
a) Ultraviolet.
b) TENS.
c) High voltage pulsed galvanic current.
d) Laser.
107) Absolute indications for cesarean section include:
a) Previous uterine incision
b) Contracted pelvis.
c) Placenta Previa.
d) All of the above.
108) ..........is one of the most effective modalities used to promote post-caesarean section wound
healing (Page 92)
a) Ice application
b) TENS
c) Interferential current
d) Laser therapy
109) Early ambulation should be encouraged at ……… day post -operative to prevent respiratory
and circulatory complications. (Page 90)
a) First day
b) Fourth day
c) Second day
d) Third day
Puerperium (normal and abnormal)
110) The after pain is characterized by:
a) It is abdominal cramp like pain.
b) It usually occurs at late puerperium,
c) It decreases by breast feeding.
d) It increases by relaxation on face.
111) Daily time rest is used to:
a) Help retroversion flexion of the uterus.
b) Delay involution of the uterus.
c) Relieve after pain following normal labor.
d) Relieve incisional pain after cesarean section.
112) Cryotherapy is effective in relieving postpartum perineal pain due to: (page 101)
a) It increases the nerve conduction velocity.
b) It relieves edema and decrease swelling
c) It decreases the distal latency.
d) All answers are correct.
113) Which of the following is NOT advised for female suffering from back pain at the post -
partum period?
a) Feeding the baby from sitting with well supported back.

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 b) Feeding the baby from the breast at the same side of the baby's head.
c) Having any object from reachable and avoid not reachable height.
d) Lifting the heavy object from the ground with leaning forward.
114) For prevention of breast engorgement: (page 108)
a) Begin breastfeeding as soon as possible after the birth
b) Use bottles and pacifiers while the baby is learning to breast feed.
c) Always wean breast feeding sudden.
d) All answers are correct.
115) The following are good prophylactic measures against postpartum circulatory problems:
a) Avoid prolonged sitting or prolonged standing.
b) Apply well-fitted below knee support stocking.
c) Burger’s exercises (Circulatory exercises).
d) All answers are correct.
116) Physiotherapists have a role in the following case:
a) Post-partum female having hemorrhage.
b) Post-partum female having after pain.
c) Post-partum female having puerperal sepsis.
d) Post-partum female having deep venous thrombosis.
117) The first 24 hours after delivery at which acute post anesthetic and post-delivery
complications may occur is defined as... (page 94)
a) Early puerperium.
b) Immediate puerperium.
c) Remote puerperium.
d) Delayed puerperium.
118) What is TRUE about breasts during puerperium….
a) Colostrum is secreted in the first 3 days.
b) With the establishment of milk secretion at the 9 th day, the breasts become engorged.
c) Suckling stimulates prolactin secretion, which causes milk ejection.
d) Suckling stimulates oxytocin release, which causes milk production
119) Which of the following is a characteristic of breast engorgement? (page 108)
a) Has sensitive and painful breast lumps.
b) Pain, hotness, erythema and high-grade fever.
c) Has inflammatory process, commonly at upper left quadrant part.
d) Occurs in 2nd - 4th. Day postnatal, milk retention in the alveoli leads to milk flow
obstruction.
120) Which of the following is more relevant about breast mastitis?
a) It is inflammation commonly affect RT lower quadrant of breast.
b) Apply LLLT to decrease inflammation, increase protein and lactose production.
c) It is advised to keep lactation to the neonate to relieve the congestion.
d) Advised to apply the cold compresses before the breast feeding.
121) Women after delivery have tendency to constipation due to……
a) Atony of the intestine
b) Atony of the bladder.
c) Increase their weight.
d) Lactation.
122) Post-partum exercises program is contraindicated in the following cases.

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 a) Puerperal fever
b) Puerperal back pain
c) Puerperal coccydynia
d) In all previous cases
123) Low level laser therapy can promote postpartum perineal wound healing through:
a) Decreasing immunoglobulin G (igg).
b) Accelerating the inflammatory phase of healing process
c) Inhibiting the protein synthesis (DNA & RNA).
d) Has no bactericidal effect.
124) Regarding the daily time rest:
a) Help discharge of blood clots and lochia
b) Help retroversion flexion of the uterus.
c) Help sub involution of the uterus.
d) Help women delivered by caesarean section.
125) For prophylactic management of postpartum circulatory problems:
a) Encourage prolonged sitting and standing
b) Encourage the prolonged cross sitting position
c) Encourage early walking following delivery
d) Encourage the recombined position at the bed.
126) Which of the following is TRUE about the management during puerperium?
a) Avoid the prone lying to facilitate the uterine involution
b) Rest in bed as long as the mother can after uncomplicated vaginal delivery
c) Eat plenty of carbohydrates and fat to avoid the constipation
d) Alternating contraction and relaxation of the pelvic floor muscles from 3 rd day
postnatal
127) The following are the causes of subinvolution of uterus, EXCEPT
a) Frequent suckling of the newborn
b) Bad general health of the mother
c) Over-distension of the uterus
d) Retained placental fragment
128) On initial investigation of a postpartum case, there were hotness, redness and edema of the
left lower limb as well as a positive Homan's sign test. What is the expectation of the therapist
about this case?
a) Gravitational edema
b) Varicose vein
c) Deep venous thrombosis
d) Pulmonary embolism
129) Which of the following will NOT prevent postpartum Constipation?
a) Sufficient fluids
b) Green vegetables
c) Fruits
d) Low fiber diet
130) Contraindications for postnatal exercises are EXCEPT
a) Anemia
b) Puerperal fever
c) Nephritis

16
 d) Post-partum hemorrhage
131) Predisposing factors for mastitis includes:
a) Poor positioning and attachment of the baby.
b) Restricted feeds.
c) Sudden weaning
d) All the above.
132) Management of puerperal carpal tunnel syndrome include:
a) Sleeping on the affected side.
b) Frequent repetitive motion of the wrist.
c) Myofascial release.
d) All of the above.
133) The following can increase the risk of puerperal carpal tunnel syndrome:
a) Gestational diabetes
b) Gestation hypertension.
c) Both a &b
d) None of the above
134) The following are effective in the management of post-partum carpal tunnel syndrome:
a) Avoid sleeping on the affected hand.
b) Wear night splint to maintain hyper-flexed position of the hand.
c) Vigorous resistive exercises of the affected hand to increase circulation.
135) All of the following are true in after pain except:
a) Cramp like pain in the lower abdomen.
b) More common in primipara than multiparas.
c) Increased during lactation.
d) Occurs for the first 2-3 days postpartum
136) Uterine involution is complete at:
a) 6 weeks after labour
b) 1 week after labour
c) 10 weeks after labor.
d) 4 weeks after labour.
137) After pains increased during lactation due to the release of:
a) Relaxin hormone
b) Progesterone hormone
c) Oxytocin hormone
d) Estrogen hormone
138) Which of the following statement about oxytocin hormone is FALSE? (page 99)
a) Suckling stimulates the release of oxytocin.
b) Oxytocin stimulates milk ejection.
c) Oxytocin causes milk production.
d) Oxytocin release stimulates uterine contractions
139) The following are contraindicated to physical therapy program EXCEPT:
a) Post-partum female having hemorrhage.
b) Post-partum female having after pain.
c) Post-partum female having puerperal sepsis.
d) Post-partum female having deep venous thrombosis.

17
140) A pregnant woman complaining from pain and tingling sensation in her hand and fingers.
Which is the best P.T electrical modality suitable for her: (Page 113)
a) Continuous ultrasound.
b) Pulsed ultrasound.
c) Interferential current.
d) Low level laser therapy.
Breast feeding
141) Advices to avoid postural problems to mothers from long hours of breastfeeding, EXCEPT:
a) Keep neck in a neutral position. (page 118)
b) Keep arms supported by pillows.
c) Keep the back straight and supported.
d) Keep the feet tipped-toes to raise the new borne up to the breast level.
142) Which of the following Is NOT considered as exercise intensity recommended for lactating
mothers? (page 121)
a) High intensity exercises, as it increases the production of the lactic acid
b) Walking is a common form of exercise can be recommended
c) Moderate/submaximal intensity exercises as it increases the production of the lactic
acid
d) Physical activity can be performed 4 days / week for weight loss of 0-5 kg /week
143) Which of the following is NOT recommended to overcome breast problems for lactating
mothers is------?
a) Manually express some milk before breastfeeding
b) Breastfeed on demand with using proper technique
c) Apply cold compresses for 30 minutes to reduce edema
d) Massage the breasts to stimulate the let-down reflex
144) Plugged ducts are characterized by the following EXCEPT (page 127)
a) High-grade fever
b) Patients have no other breast disease
c) Heat and erythema in the affected area
d) Sensitive and painful breast lumps
145) The following are the benefits of breast feeding on mothers, EXCEPT (page 120)
a) Reduces oxytocin hormone, which help in uterine Involution.
b) Reduces risk of developing Type 2 diabetes, breast cancer and ovarian cancer
c) Reduces body weight, as burns up to 500 calories / day producing breast milk
d) Reduces the postpartum depression, develops attachment between a mother and her
child
146) Advantages of Breastfeeding on Mothers are stimulation of different hormones as:
a) Oxytocin to have a peaceful and relaxed sensation (page 120)
b) Serotonin to help the uterine involution
c) Prolactin to develop a strong bond with neonate
d) Insulin sensitivity to improves glucose's metabolism
147) Which of the following is less relevant about colostrum?
a) Has very little milk protein.
b) Very rich in epidermal growth factor (EGF).
c) Its amount ranges between 500-600 ml.
d) It is more immunological rather than nutritional.

18
148) Which the following applies to ultrasound for breast engorgement treatment? (Page 109)
a) The head of US firmly towards the areola
b) The head of US firmly towards the chest wall
c) Pulsed ultrasound heats up the tissues
d) Continuous ultrasound improves ATP
149) Which of the following is not recommended in treatment of blocked ducts? (Page 110)
a) Massage the breasts to stimulate the let-down reflex
b) Apply hot application after or between feeding episodes
c) Wear supportive bra to keep the ducts in an anatomical position
d) Use proper breastfeeding aid as pumps and nipple shields
150) Which of the following is more relevant about breast mastitis? (Page 110)
a) It is inflammation commonly affect RT lower quadrant of breast
b) Apply LLLT to decrease inflammation, Increase protein and lactose production.
c) It is advised to keep lactation to the neonate to relieve the congestion
d) Advised to apply the cold compresses before the breast feeding
Rectus diastasis
151) Diastasis recti is common in: (page 127)
a) Multiple gestation with maternal overweight.
b) Primigravida.
c) Nullipara.
d) Postnatally
152) High voltage pulsed current can be used for treating diastasis recti with:
a) Quadri-polar technique with six electrodes four cathode electrodes and two anode
electrodes placed on the origin of each rectus abdominis muscle.
b) Quadri-polar technique with six electrodes four cathode electrodes and two anode
electrodes placed on the insertion of each rectus abdominis muscle.
c) The frequency 100Hz and maximally tolerated intensity of the patient, three sessions
/week each session 30 min. For 24 sessions.
d) Another placement, anode electrodes are placed over the motor point of each rectus
abdominis muscle.
153) The best assessment for a case with antenatal Diastasis Recti is: (Page114)
a) MRI
b) Biofeedback
c) Ultrasonography
d) CT scan
154) In Diastasis Recti, electrical stimulation and manual exercise can improve:
a) Fast twitch muscle fibers
b) Slow twitch muscle fibers
c) Pulmonary ventilation and inter-recti space
d) Intra recti space
155) The prime attention in Diastasis Reeti postnatal is:
a) Pelvic floor exercise
b) Abdominal training
c) Core muscle training
d) Posterior pelvic rucking exercise
156) The most suitable program for a Diastasis Recti? (Page132)

19
 a) Trunk flexors training.
b) Trunk rotators training.
c) Trunk side benders training.
d) Trunk flexors, rotators and side benders training
157) In Diastasis Recti case, the most suitable current is: (Page135)
a) High frequency tolerable intensity.
b) High frequency maximal intensity
c) Low frequency maximal intensity.
d) Low frequency tolerable intensity
158) Diastasis recti in antenatal cases is usually: (group A 2023)
a) Pathological
b) Naturally
c) Pathological & naturally
d) Absent
159) Muscle tone, individual exercise training frequency, weight gain during pregnancy & No. Of
pregnancies, all of that detect: (group A 2023)
a) Timing of rectus diastasis
b) Site of rectus diastasis
c) Timing & intensity of rectus diastasis
d) Severity of rectus diastasis
160) The abnormal space between a group of muscles cause rectus diastasis, this group includes:
a) Pelvic floor (group A 2023)
b) Abdominals
c) Pelvic floor and abdominals
d) Back ms
161) Abdominal training from sitting or standing position is mostly indicated: (group A 2023)
a) In all cases diagnosed with diastasis recti.
b) In severe cases with diastasis recti.
c) As progression of the ante natal program.
d) As start in prolonged abdominal weakness.
Menopause
162) General treatment for postmenopausal women should include: (page 140)
a) Reassurance,
b) Reduce obesity.
c) Care of general health.
d) Both a &b.
163) Safe duration to start exercise for postmenopausal women is (page 141)
a) 30 minutes.
b) 45 minutes.
c) 60 minutes
d) 90 minutes
164) Electromagnetic fields treat bone loss in post-menopausal Women via (page 143)
a) Increase calcium flux in osteoblast like cells
b) Increase osteogenesis.
c) Create a piezo electric potential.
d) All of the above.

20
165) Pathological menopause occurs in case of all except (page 137)
a) After age of 50.
b) Bilateral sulpingoophorectomy
c) Failure of ovarian function before 40
d) Congestive dysmenorrhea.
Hysterectomy
166) The following modalities increase wound healing after abdominal hysterectomy EXCEPT:
a) Laser (page 93)
b) Ultrasound (US)
c) High voltage current stimulation (HVCS)
d) Short wave diathermy (SWD)
167) Laser after abdominal hysterectomy is: (page 92)
a) Infrared laser
b) Gallium Arsenide laser
c) ND: YAG laser
d) CO2 laser
168) Laser therapy after hysterectomy, its wound healing effects through:
a) Gait control theory
b) Increasing erythrocyte rosette formation, igg and phagocytic index.
c) Increasing sensory nerve distal latency
d) Photochemical and photobiological effect.
169) Which of the following, structure will not be removed in Wertheim's operation?
a) Both tubes and ovaries (page 146)
b) The iliac and obturator lymph nodes
c) The bladder
d) Upper third of vagina
170) Post-operative paralytic ileus after abdominal hysterectomy could be managed through:
a) Short wave diathermy (page 108 clinical book)
b) Ultraviolet
c) High voltage current stimulation
d) Therapeutic ultrasound
171) Advantages of subtotal hysterectomy include all the following except (page 146)
a) There is less danger of injuring the bladder.
b) Provides better drainage of the operation area.
c) Less danger of pelvic infection.
d) The cervix discharge lubricates the vagina
172) Bilateral salpingo-oophorectomy is included in (page 146)
a) Subtotal hysterectomy
b) Total hysterectomy
c) Radical hysterectomy
d) All of the above
173) Vaginal hysterectomy includes the following except (page 146)
a) Has a lower incidence of Paralytic ileus
b) Can also be used to treat associated genital prolapse
c) It is safe in the presence of pelvic adhesion
d) Cannot be done if the uterus size is more than 14 weeks’ pregnant uterus

21
174) Pan hysterectomy is:
a) Removal of body of uterus and cervix.
b) Removal of body of uterus and cervix and Ovaries.
c) Removal of cervix.
d) None of above.
175) Physical therapy modalities that could be used to relieve incisional pain after hysterectomy:
a) Ultrasonic therapy 1-2w/cm2 for 10-15. (Page 91)
b) Ice for 10-15 min every 8 hours.
c) Abdominal exercise.
d) None of above.
176) Advantage of vaginal hysterectomy: (Page 147)
a) Absence of abdomen scar.
b) Vault prolapse less common.
c) Can be done if the size of the uterus is larger than a14 week of pregnancy.
d) None of above.
177) For exercises in case of hyperemesis, which statement is TRUE: (group A 2023)
a) Moderate activity increases symptoms.
b) Brisk walking is advised.
c) They cause fatigue.
d) Drinking plenty of fluids is discouraged.
178) Methods of pre-operative treatment of hysterectomy are the following Except: (group A 2023)
a) Deep breathing.
b) Ankle circles
c) Arm exercise
d) Abdominal muscles exercises
179) Disadvantages of vaginal hysterectomy: (group A 2023)
a) Absence of an abdominal scar
b) An associated genital prolapse can be treated at the same time.
c) Complications and peritonitis
d) Is larger than 14 weeks pregnant uterus
180) To treat dyspareunia, we use: (group A 2023)
a) Faradic stimulation.
b) Laser.
c) Ultrasonic.
d) Both a & c.

SECTION 2: PUT TRUE OR FALSE

Physiological changes during pregnancy & sheet
1) Constipation during pregnancy could be avoided by eating fresh vegetables, performing pelvic floor
exercise and taking mild laxatives. (TRUE)
2) Mitral valve prolapse is the most common cardiac problem of pregnancy. (TRUE)
3) Frequency of micturition increases early in pregnancy due to congestion. (FALSE) (pressure of
enlarged uterus on the bladder)
4) Breathing becomes more abdominal than costal during pregnancy. (FALSE) (costal then abd.)
5) During pregnancy, pelvic floor drops as much as 2.5 cm. (TRUE)

22
6) Melisma, considered as main physiological change that occurs in all pregnant females. (FALSE)
(amenorrhea)
7) Vaginal acidity decreased during pregnancy. (FALSE) (increased)
8) Musculoskeletal Changes during pregnancy include elongation of the abdominal and posterior
neck muscles. (FALSE) (anterior)
9) During pregnancy, plasma volume increases but more than the increase in rbcs causing hyperemia
physiological anemia (TRUE)
10) During pregnancy, Cardiac output increases up to 30%-50% due to increased stroke volume and
increased heart rate (TRUE)
Antenatal care
11) Pregnant woman should learn panting breathing from the 4th month of pregnancy. (FALSE) (last
month of pregnancy)
12) Moist heat is the management of choice to treat low back pain during pregnancy. (TRUE)
13) Aims of antenatal care include detecting any physical or psychological defect (TRUE)
14) Engagement is defined as the passage of the widest transverse diameter of the presenting part
through the pelvic inlet. (TRUE)
15) Occipito-anterior fetal position is more common due to better accommodation between the
concavity of fetal body and convexity of lumbar spine. (TRUE)
16) Pregnant female is usually advised to avoid walking in the last month of pregnancy. (FALSE)
(to walk)
17) Ante natal exercise has a positive effect on the course of labour. (TRUE)
18) Travelling should be completely avoided if the pregnant woman has a history of habitual abortion.
(TRUE)
19) Ante natal care in the form of small groups will aggravate the pregnancy common discomfort and
the pregnant women symptoms (FALSE)
20) Females with threatened abortion shouldn’t start antenatal care exercise before 4-month gestation.
(FALSE)
21) Leg cramp relives by slow sustained stretch for the affected muscle. (TRUE)
22) Relaxation training should be taught during pregnancy to alleviate pain. (TRUE)
23) When the female conceives her first child, the development of certain anatomical structure must
be explained to her during the pregnancy period (TRUE)
24) Continuous ultrasound can be used to treat carpal tunnel syndrome during pregnancy. (FALSE)
(pulsed)
Exercise wellness
25) All women without contraindication should be physically active throughout pregnancy (TRUE)
26) Antenatal exercise has no effects on fetal heart rate and breathing pattern. (FALSE) (increase
fetal heart rate)
27) Non-stationary cycling should be avoided during pregnancy (TRUE)
28) Severe anemia, cardiac arrhythmia, chronic bronchitis, morbid obesity, and poorly controlled type
I diabetes are absolute contraindications for practicing exercises during pregnancy. (FALSE)
(relative)
29) During maternal exercises, the acceptable increase in the fetal heart rate is more than 40
beats/minute (FALSE) (25-35)
30) Almost 100% of fetuses show an increase in the fetal heart rate either during or immediately after
maternal exercises (TRUE)
31) Maternal exercises usually produce changes in the fetal activities or breathing pattern (FALSE)

23
32) The babies delivered to females who continue to exercise throughout their pregnancy show slight
decrease in the body weight with decease skin fold thickness than those of sedentary mother
(TRUE)
33) Exercise during pregnancy can affect the length of gestation. (FALSE) (labor)
34) Regular exercise from 6 to 39 weeks' gestation may shorten the duration of labor and reduce the
risk of Cesarean section. (TRUE)
35) Exercise is not advised in cases of insulin dependent diabetes mellitus. (FALSE)
36) In Canadian guidelines, pregnant women should incorporate aerobic exercise only to achieve
greater benefits for her and her fetus. (FALSE) (variety of exercises)
37) Pregnant woman should start Arm exercises at 6 month of gestation. (TRUE)
38) All pregnant women with relative contraindications should not be engaged completely in exercises.
(FALSE) (group A 2023)
39) According to American College of Obstetrician and Gynecologist Pregnant women can engage in
exercise higher than 6000 ft (FALSE) (group A 2023)
Hyperemesis gravidarum
40) Neiguan acupuncture point located two fingers width below umbilicus and used to treat digestion
problems, edema and bloating. (FALSE)
41) Acupuncture needle is inserted on CV6 point in treatment of hyperemesis gravidarum. (FALSE)
(PC6)
42) Mash potato used in general treatment of hyperemesis gravidarum. (TRUE)
43) TENS in treatment of hyperemesis gravidarum has no complications except in cases with pace
maker. (TRUE)
44) The advantages of tens in treat hyperemesis gravidarum are being potable noninvasive and
causing no complications except is contraindicated with pace maker (TRUE)
45) Acupuncture at P6 Point can alleviate nausea and vomiting by altering hemodynamics (TRUE)
46) Morning sickness is treated properly by hot bags on area between 4 th to 8th thoracic vertebrae.
(FALSE) (ice application)
47) TENS is not effective in treating hyperemesis gravidarum. (FALSE) (effective)
48) Acupressure is not effective in treating hyperemesis gravidarum. (FALSE) (effective)
49) The emesis gravidarum is severe intractable form of nausea and vomiting in pregnancy with peak
incidence at 8-12 week of pregnancy. (FALSE) (hyperemesis)
50) The location of pc3 point is on palmer aspect of forearm, 2 cm above the transverse crease of the
wrist on line connecting pc6 and pc7. (FALSE)
51) Hyperemesis symptoms usually peek after 20th gestational week. (FALSE)
52) Decreased urine specific gravity is a sign for hyperemesis. (FALSE)
53) Relaxation techniques are effective in managing hyperemesis. (TRUE)
54) Hyperemesis is linked to altered zinc metabolism (FALSE) (group A 2023)
55) Thyroid dysfunction is a part of hyperemesis gravidarum pathophysiology (TRUE) (group A 2023)
56) Hyperemesis symptoms usually peak at the second trimester. (FALSE) (group A 2023)
Risk pregnancy
57) Severe preeclampsia is characterized by proteinuria less than (0.3 gm/ l) (FALSE) (more)
58) Chronic hypertension is diagnosed before 20 weeks of gestation (TRUE)
59) Resisted exercises are preferable in management of preeclampsia. (FALSE) (passive ROM)
60) Hypoglycemic agents are the most preferable medical treatment for gestational diabetes.
(FALSE) (are not recommended)

24
61) Transient hypertension is elevation of blood pressure in the 1 st 24 hours postpartum without other
signs of pre-eclampsia. (TRUE)
62) Extrinsic asthma begins after the age of 35-years old (FALSE) (intrinsic)
63) Relaxation training is effective in treating pre-eclampsia. (TRUE)
64) Relaxation exercise in the form of diaphragmatic breathing is beneficial for pre-eclamptic
patients. (TRUE)
65) Pre-eclamptic patient is instructed to avoid side lying position. (FALSE) (supine) (mid B)
66) Resisted exercises is preferable for gestational diabetic women X Intrinsic asthma is characterized by
severe attacks. (FALSE)
67) Moderate type of exercise is recommended in case of gestational diabetes (TRUE)
68) Gestational diabetes is usually diagnosed between 24-28 weeks of gestation (TRUE)
69) Insulin is the most preferable medical treatment for gestational diabetes. (TRUE)
70) Preeclampsia is diagnosed before 20 weeks of gestation (FALSE) (group A 2023)
71) Extrinsic asthma is characterized by severe attacks (FALSE) (group A 2023)
Normal labor and episiotomy
72) Sternal breathing is used in 1 st stage of labor as a key of relaxation (FALSE) (deep)
73) Diversion drill is used in 2nd stage of labor (FALSE) (1st)
74) Bearing down must not be avoided in 1st stage of labor. (FALSE) (be avoided)
75) True labor pain relieved by analgesics. (FALSE) (cannot be relieved)
76) Pelvic floor exercise after episiotomy reliving stiffness, promoting wound healing and restoring
function. (TRUE)
77) Therapeutic ultrasound can be used to decrease chronic perineal pain as it reduces edema,
facilitates healing of incision or perineal tear (TRUE)
78) Fourth stage of labour is the stage of expulsion of placenta. (FALSE) (third)
79) Precipitate labour is more frequent in primipara (FALSE) (multigravida)
80) Normal fetal heart rate is ranged from 90-160 beat / minute. (FALSE) (120-140)
81) Sternal breathing exercise is used in 2 nd stage of labor in-between uterine contraction as a key of
relaxation. (FALSE) (deep)
82) Bearing down is usually performed during 1 st stage of labor to assist cervical dilatation and help
expulsion of fetus. (FALSE)
83) When the duration of labor lasting more than 14 hours it is called prolonged labor. (FALSE) (24)
84) In true labor pain, the discomfort is in both the back and the abdomen. (TRUE)
85) At crowning deep breathing is advised to avoid laceration of the perineum. (FALSE) (sternum)
86) Infra-red is a good method to relieve acute perineal pain especially with hemorrhoids. (FALSE)
87) Shallow breathing is recommended infra nasally at crowning. (TRUE)
88) Retraction of the uterus control postpartum bleeding. (TRUE)
89) It is preferable for the mother to walk after rupture of the membrane to help expulsion of the fetus.
(FALSE)
90) Episiotomy is indicated in elderly primipara. (TRUE)
91) Extension through the anal sphincter and into the rectum is common in mediolateral episiotomy.
(FALSE) (median)
92) Greater blood loss is common in mediolateral episiotomy (TRUE)
93) Continuous US is effective in acute perineal pain (FALSE) (pulsed)
94) Low Level Laser Therapy is effective in relieving both acute and chronic perineal pain. (TRUE)
95) Presentation is defined as the part of the fetus related to the pelvic brim and first felt by vaginal
examination. (TRUE) (group A 2023)

25
 Cesarean section
96) There is high incidence of intestinal obstruction and adhesions in lower segment caesarean
section. (FALSE)
97) Uterine inertia means inability of the cervix to dilate in spite of uterine contraction (FALSE)
(Cervical dystocia)
98) Early ambulation should be encouraged at second day after CS to prevent circulatory
complications as DVT. (TRUE)
99) Chewing gum, drinking coffee, and electro therapy helps in recovery of bowel sounds after
abdominal operation. (FALSE)
100) Continuous ultrasound improves wound healing via increasing number of white blood cells.
(TRUE)
101) Early ambulation is postponed after abdominal operation (FALSE)
102) It is recommended to rest in bed for 8 days after uncomplicated vaginal delivery. (FALSE) (2)
103) The pre-operative physical therapy program is indicated for both elective and selective cesarean
section cases (FALSE) (elective only)
104) Ultraviolet can be used to promote the healing of both infected and non-infected post cesarean
section wounds (TRUE)
105) Elective cesarean section is indicated for diabetic mother (TRUE)
106) Upper cesarean section is more preferable than lower cesarean section (FALSE) ( ‫)العكس‬
107) The uterus during labor shows the phenomena of polarity in which the upper segment is passive
and the lower segment is active. (FALSE) ( ‫)العكس‬
108) Selective timing of cesarean section is done usually one week before the onset of labour.
(FALSE) (elective)
109) Ultrasonic therapy can be used daily over the suture site of the wound until complete healing.
(TRUE)
110) Sever fetal distress is managed by lower segment cesarean section. (FALSE) (upper)
111) Ultrasonic therapy can be used to treat infected cesarean wound. (FALSE) (ultraviolet)
112) Classical cesarean section is associated with the greatest blood loss. (TRUE)
113) The infected wound can be treated with HVCS. (TRUE)
114) Infrared laser wave length of 409 nm can be used to accelerate healing of cesarean wound
postoperative. (FALSE) (904)
115) Intrauterine fetal death is an indication for cesarean section. (FALSE) (contraindication)
116) Ice packs for 30 minutes on the treated area every 8 hours can relief postoperative cesarean pain.
(FALSE) (10-15)
117) Short wave diathermy (SWD) can be used to reduce post-operative paralytic ileus after
abdominal hysterectomy. (TRUE) (group A 2023)
Puerperium (normal and abnormal)
118) Painful uterine contractions occur in early puerperium increasing with suckling due to oxytocin
release. (TRUE)
119) Pelvic floor exercise is started in the 3 rd day postpartum if there is no perineal wound by
alternating contraction and relaxation of the pelvic floor muscles. (TRUE)
120) Women who are competitive athletes and those doing higher-intensity training before pregnancy
usually will never return to those levels. (FALSE) (will return)
121) Lochia is an alkaline genital tract discharge during puerperium, which composed of blood.
Decidual fragments, cervical mucus vaginal transudate and bacteria (TRUE)

26
122) Breast engorgement usually occurs in the 2 nd and 3rd weeks after delivery. And plugged duct
often is the precursor of this case (FALSE)
123) Puerperium is the 2:3 weeks following delivery during which the anatomical and physiological
changes of pregnancy regress (FALSE) (6:8)
124) TENS can be used to decrease after pain. (TRUE)
125) Uterine involution includes change of uterus in size, site and weight. (TRUE)
126) After pain is common in primipara and increase with suckling (FALSE)
127) Carpal tunnel syndrome occurs rarely in post-natal period. (FALSE)
128) Reactionary rise of temperature to 38 °C is common during early puerperium. (FALSE) immediate
129) Immediately after delivery the fundus can't be palpated at the abdomen as it lies behind the pubic
bone. (FALSE) (umbilicus level)
130) Absence of breast feeding is common cause of sub involution of the uterus. (TRUE)
Breast feeding
131) Losing more than 1 pound a week during lactation, may cause the toxins in body fat to move into
the bloodstream, and into the breast milk. (TRUE)
132) Therapeutic ultrasound to treat mastitis, is firmly moved from periphery towards the areola then
lightly back to the chest wall with 660 nm wavelength and 0.6 joules total energy. (FALSE)
133) In breast mastitis, sodium and chloride levels are elevated in milk whereas lactose levels are low
which makes the milk taste saltier and may be rejected by infant (TRUE)
134) Stage B. Lactogenesis II (secretory activation) of lactation starts at 20 weeks' gestation, where
alveolar cells become larger & secretory. (FALSE)
Rectus diastasis
135) Diastasis recti appeared in the first trimester of pregnancy & peaked in the third trimester where
it may measure 23cm at the umbilicus at full term (FALSE) (second)
136) Diastasis recti appears to be less common in women with good abdominal muscles tone prior to
pregnancy. (TRUE)
137) In postnatal program for treatment of diastasis recti, the pelvic floor should receive primary
attention while the abdominal muscles come second. (TRUE)
138) It is important to use cotton corset for women with diastasis recti because it acts as artificial
abdominal wall during second stage of labor where pushing became more effective & resulted in
normal delivery. (TRUE)
139) Large diastasis recti eventually cause backaches & possibly radiating leg pain just from moving
through the normal day's activities. (TRUE)
140) Diastasis recti produces musculoskeletal complaints as low back pain possibly as a result of
decreased ability of the abdominal musculature to control the pelvis & lumber spine. (TRUE)
141) Diastasis Recti is a separation of internal oblique muscles of more than 2.5 cm palpated above,
below or at the level of umbilicus. (FALSE) (recti muscles)
142) Thin & young pregnant woman with single fetus is more liable to develop diastasis recti.
(FALSE)
143) Keeping respiratory, abdominal & pelvic floor muscles strong before and during pregnancy can
decrease incidence of diastasis recti. (TRUE)
144) A specially designed cotton corset is used at 26 weeks of gestation & labour to treat diastasis
recti (FALSE)
145) Complete rest during pregnancy offered symptomatic relief for a case of diastasis recti. (FALSE)
146) External &internal rotation of hip joint increase the diastasis recti (TRUE)
147) TENS is a suitable electrical method for treating diastasis recti. (FALSE) (Faradic)

27
148) Tupler technique consisted of deep breathing, raising head off the bed and pulling the recti
muscles together with hands or by large towel. (TRUE)
149) All abdominal training, back muscles training and pelvic floor muscles training can improve pushing
in the second stage of labor especially in severe diastasis recti. (TRUE)
Menopause
150) Exercises can reduce depression in post-menopausal women (TRUE)
151) Liability for cardiovascular disorders increases with menopause (TRUE)
152) Bone loss is common to occur in postmenopausal women due to increased estrogen hormone.
(FALSE) (decreased)
153) Exercises at moderate intensity can be used safely in postmenopausal women (TRUE)
154) Bony pain is the only method to diagnose osteoporosis (FALSE)
155) Diet alone has a great effect in treating hot Flashes in post-menopausal women (FALSE)
156) Trunk flexion is the exercise of choice for Postmenopausal female. (FALSE)
157) Pulsed electromagnetic field can reduce bone loss post menopause by its piezo-electric effect.
(TRUE)
158) Hot flush is the feeling of heat which lasts for 10 min., centered on face and associated with
sweating and palpitations. (FALSE) (1.5-3 min)
159) Basal metabolic rate is dramatically decreased post menopause. (TRUE)
160) Forward flexion of the trunk should be avoided in post-menopausal osteoporotic women.
(TRUE)
161) Laser can be used, to reduce post-menopausal osteoporotic pain as with enhancing bone
formation. (TRUE)
162) Maximum heart rate is a method for calculating the intensity of exercise in post-menopausal
women. (FALSE) (target)
163) Menopause is defined as the wanning ovarian function which signals the end of the reproductive life
span (FALSE)
164) Post-menopausal osteoporosis is related to mineral content declines and not related to deformities of
vertebral column. (FALSE)
165) Exercise helps menopausal cases that can prevent or minimize many of these problems such as
cardiovascular disease, follicular depletion, Depression (FALSE)
166) The risk of cardiovascular disease increases in women after menopause, so regular aerobic exercise
may improve cardiorespiratory endurance and reduce the risk of cardiovascular disease. (TRUE)
167) The recommended exercise can benefit the post-menopausal women only in excessive body fat.
(FALSE)
Hysterectomy
168) Vault prolapse is likely to occur more after vaginal than abdominal hysterectomy (TRUE)
169) After total hysterectomy, menopausal symptoms may affect young patients. (FALSE)
(bilateral oophorectomy)
170) The effect of ultrasonic therapy with continuous mode for wound healing after hysterectomy, is
through vasodilation of blood capillaries and increasing number of white blood cells (WBC).
(TRUE)
171) Dyspareunia is a possible complication after hysterectomy. (TRUE)

SECETION 3: CASE STUDY

Antenatal care
CASE STUDY 1
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25 year's old pregnant female in her third trimester suffers from low back pain which is radiating
to the lower limb through the course of sciatic nerve associated with increased frequency of
micturition
PUT TRUE OR FALSE
1) TENS is a safe option for treating this case especially if its electrodes are more deviated away from the
spinal column and more near to the pregnant uterus. (FALSE)
2) Postural correction and abdominal exercises will be very helpful for such case. (TRUE)
3) We can safely use TENS electrodes through the course of the sciatic nerve to relieve the radiating pain.
(TRUE)
4) Laser could be used to treat the back pain. (FALSE) (TENS)
5) This pain is due to hormonal changes and excess relaxin and progesterone. (TRUE)
6) Increased frequency of micturition is due to pressure of the enlarged uterus on the bladder. (FALSE)
(head of the fetus)
7) This patient is instructed to concentrate on downward forward pelvic rocking exercises than upward
backward pelvic rocking exercises. (FALSE) ( ‫)العكس‬
CASE STUDY 2
A 25 years old pregnant woman, she is in the 7th month pregnancy. She was diagnosed with carpel
tunnel syndrome and referred to the physical therapy clinic for treatment.
PUT TRUE OR FALSE
1) The main cause of carpel tunnel syndrome in this case is water retention. (TRUE)
2) Pulsed ultrasound can be used in such case to decrease swelling and alleviate pain. (TRUE)
3) When using contrast baths for such case, the treatment should start and end with cold water. (FALSE)
(hot)
Hyperemesis gravidarum
CASE STUDY 3
A 28 years old pregnant woman came to the clinic, suffering from nausea and vomiting, the
examination showed that she is in the second trimester and she was diagnosed as having hyperemesis
gravidarum.
CHOOSE THE BEST ANSWER
1) Which of the following is best physiotherapy treatment for this case?
a) Aroma therapy.
b) Faradic stimulation.
c) Acupressure at p6 point.
d) Electromagnetic field.
2) What is TENS electrodes Placement to reduce hyperemesis gravidarum?
a) One electrode on thenar muscle, other above P6 point.
b) Top set of electrodes placed over T10-L1, lower set of electrodes.... (‫)مش كامل‬
c) Over the site of pain.
d) Paravertebrally over the corresponding nerve roots.
3) Where is Neiguan acupuncture point located? (2 cun = 3 cm)
a) 3 cun above the mid wrist creases.
b) 2 cun above the mid wrist creases.
c) 1 cun above the mid wrist creases.
d) 4 cun above the mid wrist creases.
4) What is TENS mechanism to alleviate the patient's nausea and vomiting?
a) Delay gastric emptying time.

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 b) Decreasing peristaltic velocity.
c) Accelerate gastric emptying time.
d) Decreasing the basal tone of esophagus.
5) What is the best Parameter of TENS to reduce hyperemesis gravidarum?
a) High frequency.
b) Low frequency.
c) High intensity.
d) High pulse width.
PUT TRUE OR FALSE
1) Modification of the amount and size of meals consumed during the day may help relieve the symptoms
of hyperemesis gravidarum (TRUE)
2) Human chorionic gonadotropins hormone is one of many causes of hyperemesis gravidarum (TRUE)
Risk pregnancy
CASE STUDY 4
32 years old pregnant woman in 28 weeks of gestation attended to the hospital complaining from
frontal headache and upper quadrant pain, by examination her blood pressure was 150/95 mmhg
and Proteinuria was 1 gm./Liter
PUT TRUE OR FALSE
1) Diagnosis of this case is mild Pre-eclampsia. (TRUE)
2) This patient should perform abdominal and pelvic floor contractions during bed mobility and transfer.
(FALSE) (avoid)
3) This patient should avoid Valsalva maneuver during exercises and adls activities. (TRUE)
4) Diaphragmatic breathing exercises and relaxation training are effective in lowering blood pressure.
(TRUE)
5) Regular aerobic exercise is recommended for this case. (FALSE)
6) This patient is instructed about salt restriction. (TRUE)
Normal labor
CASE STUDY 5
A pregnant lady in 36 weeks of gestation attended to the emergency clinic, she complains from severe
pain at the abdomen and referred to her back which is not relieved by sedation by examination, the
cervix was dilated 4 fingers.
PUT TRUE OR FALSE
1) This lady is in the process of 2nd stage normal labor. (FALSE) (1st)
2) This lady is instructed to bear down with uterine contraction in this stage (FALSE) (avoid)
3) This lady is advised to do shallow breathing (FALSE) (deep)
4) To control the patient's pain, physical therapist can apply massage on her back & use TENS. (TRUE)
5) This lady is advised to walk in the intervals between pains as she did not have gushing of water. (TRUE)
6) The pain felt in the lower back is due to stretching on uterosacral ligaments with cervical dilatation.
(TRUE)
7) TENS can be applied in V- shape on the lower abdomen to control this pain. (FALSE)
Cesarean section
CASE STUDY 6
A 30 years old diabetic woman gave birth after 37-weeks gestation through lower segment
cesarean section (CS). After recovery from anesthesia, she suffered from heavy cough, pain in
the site of the operation
1) What is the most relevant advantage of lower segment CS?

30
 a) More blood loss.
b) More postoperative complications.
c) Lower incidence of wound infection.
d) Higher incidence of scar rupture.
2) After recovery from anesthesia, what are the appropriate physical therapy exercises for such
case? (page 90)
a) Pelvic floor exercises.
b) Deep breathing exercises.
c) Pelvic rocking exercises.
d) Trunk flexion exercises.
3) The physical therapy modalities used to decrease incisional pain for such case include:
a) Continuous ultrasound.
b) Ultraviolet.
c) Ice packs.
d) Infrared.
CASE STUDY 7
A 30 years old diabetic woman in her 37th week of pregnancy gave birth for a large sized baby
through lower segment cesarean section. After recovery from anesthesia, she complained of
respiratory complications, pain in the site of operation and absence of bowel sounds.
1) The absence of bowel sounds after cesarean section indicated that this woman had:
a) Paralytic ileus.
b) Fecal incontinence.
c) Rectal prolapse.
2) To manage the absence of bowel sounds after cesarean section, this woman was advised to
perform:
a) Static abdominal exercise.
b) Leg exercises.
c) Circulatory exercises.
d) Breathing exercises.
3) Burst mode of TENS was used after cesarean section between episodes of pain with frequency of:
a) 120 Hz.
b) 2 Hz.
c) 200 Hz.
d) 20 Hz.
4) For management of respiratory complications, respiratory exercises were indicated in the
postoperative:
a) 1st day.
b) 4th day.
c) 2nd day.
5) Physical therapy modalities, that could be used to decrease the pain in the site of operation,
include:
a) Contrast baths.
b) Ice application.
c) Whirlpool.
d) Hot application.
6) The timing of cesarean section for this woman was:

31
 a) Emergency.
b) Elective.
c) Selective.
d) Unplanned.
Puerperium (normal and abnormal)
CASE STUDY 8
A 30-year-old female at 2nd postpartum day. Her chief complaint is abdominal cramp like pain
following her delivery that took place yesterday. This pain is lasting for 2 minutes and
spontaneously relieved and coming frequently. This pain usually increases with breast feeding.
1) What is the relevant technique for transcutaneous electrical nerve stimulation to relive this
pain?
a) Bilateral on acupuncture point of both lower limbs
b) V-shape on the lower abdominal area
c) Criss-cross on the Lumbo-sacral vertebrae
d) Criss-cross on the thoracic vertebrae
2) Which of the following is considered a cause of aggravating this type of pain with breast
feeding?
a) Release of follicular stimulating hormone
b) Release of estrogen hormone
c) Release of oxytocin hormone
d) Release of luteinizing hormone
3) What is the best diagnosis of this pain?
a) After pain
b) Colic pain
c) Chronic pain
d) Incisional pain
4) What is the recommended position for this female to relieve her pain?
a) Supine lying
b) Relaxation on face
c) Crock lying
d) Modified side lying
5) What about the recommended position to relieve such pain?
a) Supine lying position for 30 minutes, 3-4 times/ day.
b) Prone kneeling position for 30 minutes, 3-4 times/ day.
c) Relaxation on face position for 30 minutes, 3-4 times/ day.
d) Crock lying position for 30 minutes, 3-4 times/ day.
6) What is the most common electrical modality that can be used to relieve such pain?
a) LASER.
b) Ultraviolet.
c) Ultrasound.
d) TENS
7) The following are good advices for this female to relieve such pain EXCEPT:
a) Stop breast feeding.
b) Use hot hack at abdomen.
c) Evacuate her bladder frequently.
d) Avoid constipation by eating vegetables.

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CASE STUDY 9
A 25-year-old postpartum patient, she complains from numbness in the lateral three fingers,
wrists, and hands, which may worsen at night as well as swollen fingers. She is unable to perform
fine motor skills, such as buttoning a shirt.
1) What is the best diagnosis for this pain?
a) Maternal fatigue
b) Carpal tunnel syndrome
c) Epidural site pain
d) De-Quervain's tendinitis
CASE STUDY 10
22 years old woman at 1st day postnatal and complaining from abdominal cramp like pain that
increase with breast feeding.
1) Transcutaneous electrical nerve stimulation can be used to treat such pain through: (page 104)
a) Deep heating.
b) Increase serotonin hormones.
c) Increase beta endorphin hormone.
d) Increase prostaglandin hormones.
2) This type of pain is called:
a) After pain.
b) Chronic colic pain.
c) Perineal pain.
d) Incisional pain.
3) This type of pain can be treated with the following except:
a) Relaxation on face.
b) Heat application.
c) Transcutaneous electrical nerve stimulation.
d) Low level laser.
4) This type of pain is:
a) Due to perineal incision.
b) Continued till the end of puerperium.
c) Usually associated with sub involution of the uterus.
d) Due to release of oxytocin hormone.
5) The physical therapist should advise this female to .........to overcome this type of pain:
a) Avoid prone lying position.
b) Evacuate her bladder every 2 hours.
c) Take supine lying position throughout the day.
d) Stop the breast feed.
CASE STUDY 11
22 years old female attended to out-patient clinic complaining from numbness and tingling sensation
at right hand, inability to perform fine movement. On history taking this complain started since 5
months ago when she was at third trimester of last pregnancy.
1. What about the best anticipated diagnosis for such case?
2. What about the anticipated cause of such complain?
3. Construct a proper treatment program for such complain?
4. What about the advises for this female?

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 Breast feeding
CASE STUDY 12
A 26 Year-old female came to emergency room complaining from breast pain, high fever and
shivering. The history taking revealed that she underwent premature labor 2 weeks ago and her
baby currently is in the incubator. The examination showed body temperature 39° C and erythema
in left breast.
1) What is the cause of this case?
a) Local pressure on the breast.
b) Cream application on nipples.
c) Poor suckling of the baby.
d) Frequent nursing.
2) Which of the following postural positions, you may avoid for this patient to assume while feeding
her baby?
a) Stretch of Upper Trapezius Stretch.
b) Arms supported by the pillows.
c) Neck in a neutral position.
d) Slouching down to the baby.
3) The physical activity is recommended for the patient, because of the following benefits except:
a) Improve mental wellbeing.
b) Improve bone strength.
c) Improve Sodium and chloride in milk.
d) Improve heart health and general fitness.
4) What is the diagnosis of this case?
a) Plugged ducts.
b) Sored nipples.
c) Mastitis.
d) Breast engorgement.
5) What is the benefit of LASER application for this patient?
a) Improve the lactic acid.
b) Improve lactose in breast milk.
c) Decrease cytochrome C oxidative protein.
d) Reduce the let-down reflex.
6) Which of the following is less relevant treatment for this case?
a) Hot applications.
b) Low level laser therapy.
c) Cold application.
d) Transcutaneous nerve stimulation.
Menopause
CASE STUDY 13
60 years old female attend to P.T department, she complains from sudden severe low back pain when
she picks an object from the ground. Also, this woman is obese and she complains from inability to
sleep.
1) This female is at:
a) Reproductive period.
b) Premenopausal period.
c) Puerperium.

34
 d) Menopausal period.
2) The best method for weight loss for such case is:
a) Medication.
b) Acupuncture.
c) Diet.
d) Exercise.
3) The common cause for low back pain of such case is:
a) Muscle spasm.
b) Coccydynia.
c) Disc prolapse.
d) Compression fracture due to osteoporosis.
4) The best method for diagnosis of bone loss is:
a) Physical examination.
b) MRI.
c) X-ray.
d) DEXA.
5) The common cause of her sleep disturbance is:
a) Low back pain.
b) Depression.
c) Hot flashes.
d) Obesity.
CASE STUDY 14 (group A 2023)
56 years old post-menopausal women attended to out-patient clinic complaining from generalized
bone pain low back pain and, inability to perform her activity of daily living. After assessment this
pain mainly due to osteoporosis?
6) What are the clinical features of post-menopausal osteoporosis?
a) Bone pain.
b) Fractures
c) Loss of hight
d) Deformities of the vertebral column * Round kyphosis * Angular kyphosis
7) Enumerate the type of the suggested exercise for this patient?
Weight bearing exercise (walking, jogging and climbing stairs) and non-weight bearing exercise
(bicycle, specific exercise for spine and swimming). The recommended exercise training in post-
menopausal women to provide a protection against bone loss is 30 minutes/day, three times/week at
60% VO2max.
8) Discuss the biological effects of exercise used in maintaining bone strength?
Changes the biochemical structure of the blood by altering the level of its component which has a role
in the integrity of normal skeleton. Skeletal remodeling is modulated by the availability of calcium,
phosphorus and calciotropic hormones. Previous studies reported an increase in serum calcium
associated with a decreased parathyroid hormone level and a small increase in calcitonin levels during
and after exercise which explained how could exercise increase bone mineral density after exercise. In
addition, there is another hormone causing increased osteoblastic activity and affect bone metabolism
which is the estrogen especially in old age women. So, an intense interval exercise at 60% VO2max
produced significant increase in the plasma concentration of sex hormone bonding globulin and B-
estradiol. 2) Mechanical load of exercise which can modify and increase bone mass. The mechanism
by which physical activity prevents bone loss remains unclear. However, it is known that muscular

35
 contraction and gravity create piezo electric forces which affect bone remodeling. Therefore, continual
physical stress stimulates osteoblastic deposition of bone. The deposition of bone at points of
compressional stress has been suggested to be caused by piezo electric effect, as follows: compression
of bone causes a negative potential at the compressed site and a positive potential elsewhere in the
bone. It has been shown that minute quantities of current flowing in bone cause osteoblastic activity at
the negative end of the current flow; which could explain the increased bone deposition at compression
sites
9) Mention physical therapy modalities which help to maintain bone integrity?
a) Electromagnetic fields (emfs)
b) Pulsed ultrasonic (US)
c) Electrical stimulation
d) Ultraviolet (UV)
Hysterectomy
CASE STUDY 15
45 years old female, she was diagnosed with severe endometriosis. She was suffering from agonizing
abdominal pain and wickedly heavy bleeding. She underwent open Pan Hysterectomy 2 day ago.
Now she complains from incisional pain.
1) The following structures are removed in Pan Hysterectomy except:
a) Bilateral tubes and ovaries.
b) Body of uterus.
c) Cervix.
d) Upper third of vagina.
2) Laser therapy accelerates the wound healing after hysterectomy through:
a) Gait control theory.
b) Increasing erythrocyte rosette formation, igg and phagocytic index.
c) Increasing sensory nerve distal latency.
d) Photochemical and photo biological effect.
3) P.T Program of the second postoperative day includes these exercises except:
a) Static abdominal contraction.
b) Leg exercises.
c) Arm exercises.
d) Early ambulation.
4) The best treatment if the wound become infected is:
a) Transcutaneous electrical nerve stimulation.
b) Laser.
c) High Voltage Current Stimulation.
d) Ultrasound.
5) Remote complications of this surgery include:
a) Pulmonary complications.
b) Menopausal symptoms.
c) Infection.
d) Hemorrhage.
❤️ ‫تمت بحمد الله‬

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