Please make a ten questions about ANC in which 3 will be recall based and 7 will be clinical scenario or logic base as i wanna make project on one teaching technique for mbbs students
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I have sufficient material from authoritative textbooks. Now I'll craft the 10 questions — 3 recall-based and 7 clinical/logic-based — on Antenatal Care (ANC).
ANC Question Bank for MBBS Teaching Project
Creasy & Resnik's Maternal-Fetal Medicine / Textbook of Family Medicine
SECTION A — RECALL-BASED QUESTIONS (3)
Q1. According to Naegele's Rule, what is the estimated date of delivery (EDD) for a woman whose last menstrual period (LMP) started on 1st August 2025?
A) 8th May 2026 B) 8th April 2026 C) 1st June 2026 D) 1st May 2026
Correct Answer: A
Explanation: Naegele's Rule = LMP + 9 months + 7 days (or: LMP − 3 months + 7 days). Aug 1 → subtract 3 months = May 1 → add 7 days = May 8, 2026.
Q2. Which of the following is a routine laboratory investigation recommended for ALL women at the first ANC visit?
A) Blood glucose level B) Gonococcal culture C) Hemoglobin and hematocrit D) Sickle cell screening
Correct Answer: C
Explanation: Hemoglobin/hematocrit and urine culture are recommended for all women at the first prenatal visit. Blood glucose, gonococcal culture, and sickle cell screening are selective, based on risk factors.
Q3. Which serum marker is offered to ALL pregnant women for screening of neural tube defects and aneuploidy during ANC?
A) Fasting blood glucose B) Maternal serum alpha-fetoprotein (MSAFP) / prenatal serum markers C) HbA1c D) C-reactive protein
Correct Answer: B
Explanation: All women should be offered prenatal serum marker screening for neural tube defects and aneuploidy. High-risk women are further offered amniocentesis or CVS.
SECTION B — CLINICAL SCENARIO / LOGIC-BASED QUESTIONS (7)
Q4. A 28-year-old primigravida at 10 weeks' gestation presents for her first ANC visit. Her uterine size on examination is consistent with only 7 weeks. She is certain of her LMP. What is the most appropriate next step?
A) Repeat examination after 4 weeks B) Order a serum beta-hCG only C) Perform an early ultrasonography to resolve dating discrepancy D) Reassure her that uterine size is unreliable in early pregnancy
Correct Answer: C
Explanation: When there is a discrepancy between menstrual age and uterine size, early ultrasonography should be obtained. Accurate dating is critical for timing screening tests and managing complications such as post-term pregnancy. After 24 weeks, ultrasound is less sensitive for confirming gestational age.
Q5. A 32-year-old woman at 27 weeks is found to have no documented GDM screening in her ANC records. She has no prior history of diabetes. At what gestational age should screening for gestational diabetes mellitus (GDM) have been performed, and which test is used?
A) 16–18 weeks; fasting blood glucose B) 20–22 weeks; HbA1c C) 26–28 weeks; 50-g oral glucose 1-hour challenge test D) 32–34 weeks; 75-g OGTT
Correct Answer: C
Explanation: Screening for GDM by a glucose challenge is recommended at 26–28 weeks of gestation. The USPSTF supports screening at this time. Earlier screening (before 24 weeks) has little evidence to support it in average-risk women.
Q6. A woman with a history of one prior spontaneous preterm birth at 30 weeks presents for her first ANC visit at 9 weeks. Her physician discusses progestin supplementation. Which of the following is the most logical reason to begin progestin prophylaxis before 16 weeks of gestation in this patient?
A) Progesterone prevents placental abruption B) Early initiation overcomes barriers to starting treatment and allows cervical sonography assessment C) Progesterone reverses cervical incompetence completely D) It is only effective when started before 10 weeks
Correct Answer: B
Explanation: Early entry into care creates the opportunity to identify candidates for progestin prophylaxis before 16 weeks. A key policy change improving outcomes was identifying progestin candidates before 14 weeks to overcome barriers to initiating treatment at 16 weeks — the critical window for cervical sonography and progestin initiation.
Q7. A 25-year-old at 22 weeks has placenta previa confirmed on ultrasound. She asks her doctor if it is safe to resume sexual intercourse. What is the correct advice?
A) Sexual activity is safe as long as no bleeding occurs B) Sexual activity should be avoided due to placenta previa C) Sexual activity can resume freely after 24 weeks D) There is no restriction on sexual activity in any trimester
Correct Answer: B
Explanation: Sexual activity can generally continue during pregnancy, but specific contraindications exist — including placenta previa and preterm labor. In these situations, intercourse must be avoided.
Q8. A 30-year-old pregnant woman at 20 weeks tells you she has been jogging 5 km daily since before pregnancy and wants to continue. She has no obstetric complications. What is the most appropriate advice?
A) Stop all exercise immediately to prevent preterm labor B) Restrict to walking only C) She may continue with mild to moderate intensity, avoiding supine position and hyperthermia D) She should perform only yoga and stretching
Correct Answer: C
Explanation: Established exercise routines can be continued at mild to moderate intensity during pregnancy. However, high-intensity/high-impact routines should be reduced, the supine position avoided in the 2nd/3rd trimesters, hyperthermia avoided, and adequate nutrition maintained.
Q9. A senior medical student argues that group prenatal care is superior to standard care in reducing preterm birth because it adds social support and education. How would you critique this statement based on current evidence?
A) Group prenatal care is always superior to standard care B) Randomized trial meta-analyses show no benefit of group prenatal care over standard care in preterm birth prevention C) Group prenatal care is only effective in low-income populations D) Group prenatal care is contraindicated in high-risk pregnancies
Correct Answer: B
Explanation: While observational studies suggested improved outcomes with group prenatal care, a meta-analysis of 4 randomized trials (N=1,350) found no benefit versus standard care in preterm birth prevention. This is a critical evidence-appraisal point for MBBS students.
Q10. A 19-year-old primigravida from a low socioeconomic background presents at 18 weeks for her first ANC visit. Studies show her risk of preterm birth is higher than average. Which of the following structural factors is most strongly associated with her delayed and inadequate ANC access?
A) Short cervix detected on ultrasound B) Economic, transportation, and cultural barriers to first prenatal visit C) Failure to take folic acid supplementation D) Elevated blood pressure at 12 weeks
Correct Answer: B
Explanation: Economic, transportation, and cultural barriers are key structural obstacles to early ANC access. While early entry is associated with lower preterm birth rates, the high preterm birth rate in women with no prenatal care is the main driver of this association. Accelerated first visits for women with risk factors are important to overcome these barriers.
Summary Table
| # | Type | Topic Tested |
|---|---|---|
| 1 | Recall | Naegele's Rule / EDD calculation |
| 2 | Recall | Routine 1st visit labs |
| 3 | Recall | Universal serum screening |
| 4 | Clinical | Dating discrepancy → USG |
| 5 | Clinical | GDM screening timing |
| 6 | Logic | Progestin prophylaxis timing |
| 7 | Clinical | Contraindication to intercourse |
| 8 | Clinical | Exercise in pregnancy |
| 9 | Logic | Evidence appraisal — group ANC |
| 10 | Logic | Socioeconomic barriers to ANC |
These questions are designed with Bloom's Taxonomy in mind — recall questions target Level 1–2 (Remember/Understand), while clinical and logic questions target Levels 3–5 (Apply/Analyze/Evaluate), making them ideal for a teaching project comparing active vs. passive learning methods in MBBS students.
Create an Excel tracker to evaluate student learning outcomes from your teaching project
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