Abortion and Medical Termination of Pregnancy MCQs

Obstetrics & Gynaecology · 90 free questions with answers & explanations.

  1. A 22-year-old woman presents with 10 weeks of amenorrhea, vaginal bleeding, and lower abdominal cramping. Cervical os is 2 cm dilated and products of conception are felt in the cervix. Ultrasound shows retained products. Which type of abortion is this?
  2. Under India's Medical Termination of Pregnancy (MTP) Amendment Act 2021, which of the following is CORRECT regarding termination of pregnancy beyond 20 weeks?
  3. Under the MTP Amendment Act 2021 (India), a woman who is a survivor of sexual assault or rape can terminate pregnancy up to:
  4. A woman at 8 weeks gestation requests medical abortion. She is prescribed mifepristone 200 mg orally followed 48 hours later by misoprostol 800 mcg vaginally. The mechanism of mifepristone in this regimen is:
  5. The MTP (Amendment) Act 2021 in India extended the upper gestational limit from 20 to 24 weeks for which category of women?
  6. A woman at 9 weeks gestation requests medical termination of pregnancy. She has no contraindications. What is the WHO-recommended protocol for medical abortion?
  7. The MTP (Amendment) Act 2021 in India extended the gestational limit for termination under specific circumstances. For women with substantial fetal abnormalities, the new gestational limit allowing termination with approval of a medical board is:
  8. In medical management of incomplete abortion at 10 weeks with 3 cm retained products on ultrasound, oral misoprostol is prescribed. The primary mechanism by which misoprostol promotes uterine evacuation is:
  9. Under the Medical Termination of Pregnancy (Amendment) Act 2021, India, a woman at 20 weeks of pregnancy who is a survivor of sexual assault requests termination. Which statement correctly describes the current legal framework?
  10. A 16-year-old at 8 weeks gestation requests medical abortion. She is given mifepristone 200 mg orally followed 48 hours later by misoprostol 800 µg vaginally. The mechanism of mifepristone in this protocol is best described as:
  11. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), termination of pregnancy up to 24 weeks is permitted for which of the following categories NOT previously covered in the 1971 MTP Act?
  12. Mifepristone (RU-486) acts as an anti-progestogen for medical abortion. Its mechanism of action at the cellular level is:
  13. Under the Medical Termination of Pregnancy (Amendment) Act 2021 in India, the upper gestational limit for MTP has been increased for specific categories. For a woman whose pregnancy results from contraceptive failure (married or unmarried), what is the current permissible gestational limit?
  14. Mifepristone (RU-486) is used in medical abortion. What is its mechanism of action and the physiological consequence of progesterone receptor blockade in early pregnancy?
  15. According to the MTP (Amendment) Act 2021 of India, which provision was newly introduced regarding the upper gestational limit for abortion in cases of fetal anomalies?
  16. In first-trimester medical abortion (up to 9 weeks) using mifepristone 200 mg + misoprostol, which route and timing of misoprostol administration is associated with the highest complete abortion rate and fewest side effects according to WHO 2022 guidelines?
  17. Post-abortion care after uterine evacuation for missed abortion at 10 weeks is being discussed. The patient is Rh D negative with blood group O-negative. The father's blood group is not known. What is the correct Rh immunoglobulin (RhIg) dose and timing?
  18. The Indian MTP Amendment Act 2021 extended the upper gestational limit for abortion from 20 to 24 weeks for specific categories of women. Which category is specifically included in the 20–24-week window under this amendment?
  19. In early medical abortion (≤9 weeks), the standard regimen per WHO 2022 guidelines is mifepristone 200 mg followed by misoprostol. The recommended dose and route of misoprostol at 24–48 hours after mifepristone for gestations ≤12 weeks is:
  20. The MTP Amendment Act 2021 in India extended the gestational age limit for termination with approval of one registered medical practitioner (RMP) to:
  21. Mifepristone works in medical abortion primarily by:
  22. A 10-week missed abortion is managed medically with mifepristone 200 mg followed by misoprostol 800 mcg vaginally 48 hours later. On follow-up at 2 weeks, ultrasound shows retained products of conception (RPOC) without signs of infection. The appropriate next step is:
  23. A patient at 9 weeks of gestation requests medical abortion. She has no contraindications. According to current WHO 2022 guidelines for first-trimester medical abortion, what is the recommended regimen?
  24. A 20-year-old woman presents at 10 weeks gestation requesting termination under the MTP Act of India (amended 2021). Her partner requests she not have the procedure. What is the correct legal position?
  25. In India, the MTP (Amendment) Act 2021 extended the gestational limit for termination with approval of two registered medical practitioners from 20 to 24 weeks for specific categories. Which of the following groups is specifically included in this extended 20–24 week window under the MTP Act 2021?
  26. Mifepristone (RU-486) is a 19-norsteroid that acts as a competitive antagonist at progesterone and glucocorticoid receptors. In medical abortion, what is the specific mechanism by which mifepristone sensitises the uterus to subsequent misoprostol?
  27. A woman at 10 weeks of gestation undergoes medical abortion with mifepristone 200 mg followed by misoprostol 800 mcg vaginally 48 hours later. She returns 2 weeks later with persistent spotting. Ultrasound shows a 10 mm thick endometrium. Serum β-hCG is 110 mIU/mL. What is the most appropriate next step?
  28. Under the Medical Termination of Pregnancy (Amendment) Act 2021, India, the upper gestational limit for MTP has been extended to 24 weeks for specified categories. Which of the following is NOT included in the categories eligible for termination up to 24 weeks?
  29. In medical management of missed abortion at 10 weeks using mifepristone + misoprostol, which mifepristone-to-misoprostol interval and misoprostol route have been shown in RCTs to maximize complete evacuation rates?
  30. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), which of the following correctly describes the expanded provisions compared to the original MTP Act 1971?
  31. For medical abortion up to 63 days (9 weeks) gestation, the WHO-recommended regimen involves which combination and dosing?
  32. A woman at 9 weeks of gestation requests medical abortion. According to WHO 2022 abortion care guidelines, the recommended mifepristone-misoprostol regimen for medical management of first-trimester pregnancy up to 12 weeks is:
  33. A 19-year-old presents with 10 weeks of amenorrhoea and ultrasound showing an intrauterine pregnancy with fetal cardiac activity. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), up to what gestational age can a registered medical practitioner (single doctor) legally terminate the pregnancy in this unmarried woman under what clause?
  34. A 22-year-old with 8 weeks of amenorrhoea seeks MTP. She is given mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg vaginally. What is the mechanism by which mifepristone sensitises the uterus to misoprostol?
  35. Under the Medical Termination of Pregnancy Act (India), as amended in 2021, up to which gestational age can a registered medical practitioner terminate a pregnancy for a survivor of sexual assault or rape without requiring a second doctor's opinion?
  36. Mifepristone acts as a medical abortifacient primarily through which mechanism?
  37. The Medical Termination of Pregnancy (Amendment) Act 2021 in India extended the gestational limit for MTP. The gestational limit for women with special categories (rape survivors, differently abled, minors) under the amended act is:
  38. The Medical Termination of Pregnancy Amendment Act 2021 in India extended gestational age limits. Which of the following correctly states the upper gestational limit for termination for specific categories?
  39. Second trimester medical termination using mifepristone-misoprostol is planned at 16 weeks. The mifepristone 200 mg is given orally. After how many hours should vaginal/sublingual misoprostol be administered, and what is the standard dose?
  40. A 25-year-old woman at 8 weeks requests medical termination of pregnancy. She is given mifepristone 200 mg orally followed 48 hours later by misoprostol 800 mcg vaginally. The mechanism by which mifepristone sensitizes the uterus to misoprostol involves:
  41. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), what is the gestational age limit for termination requiring opinion of only ONE registered medical practitioner for a survivor of sexual assault or rape?
  42. A 28-year-old presents with 3 consecutive pregnancy losses, all occurring at 14–18 weeks, each preceded by painless cervical dilation without labour. Her systemic work-up for thrombophilia, antiphospholipid syndrome, thyroid disease, and karyotyping is normal. The most likely diagnosis and primary treatment are:
  43. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), a woman with a pregnancy resulting from rape can seek termination up to which gestational limit, and who gives the opinion?
  44. A 32-year-old with 9 weeks of amenorrhoea and confirmed intrauterine pregnancy chooses medical abortion. The optimal regimen for medical abortion up to 9 weeks in India is:
  45. Under the MTP Amendment Act 2021 (India), medical termination of pregnancy can be performed up to 24 weeks in which category of women without requiring the opinion of two registered medical practitioners?
  46. A woman at 8 weeks gestation opts for medical abortion. She receives mifepristone 200 mg orally, followed 24–48 hours later by misoprostol. Regarding misoprostol administration, which route has the highest efficacy with fewest GI side effects for this gestation?
  47. Under the MTP (Amendment) Act 2021 (India), up to what gestational age can termination be performed with the opinion of ONE registered medical practitioner?
  48. For medical abortion up to 63 days (9 weeks) gestation, the WHO-recommended regimen is mifepristone 200 mg followed by misoprostol. What is the correct timing and route of misoprostol administration?
  49. Under the Medical Termination of Pregnancy (Amendment) Act 2021 of India, the upper gestational limit for termination of pregnancy with the opinion of one registered medical practitioner is:
  50. A 10-week missed abortion is diagnosed on ultrasound. The woman opts for medical management. The most effective regimen for medical management of first-trimester missed abortion is:
  51. Under the Medical Termination of Pregnancy (Amendment) Act 2021 in India, termination of pregnancy up to 24 weeks is permitted for which category of women without requiring two registered medical practitioners?
  52. In first-trimester medical abortion using mifepristone-misoprostol, if the patient declines mifepristone, which misoprostol-alone regimen is considered acceptable by WHO for termination up to 12 weeks?
  53. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), termination of pregnancy up to 24 weeks without requirement for two registered medical practitioners' opinion is now permitted for which category of women?
  54. A woman at 9 weeks gestation requests medical termination. The recommended mifepristone-misoprostol regimen approved by WHO for complete medical abortion up to 70 days is:
  55. A 24-year-old woman undergoes first-trimester surgical abortion by suction evacuation. Post-procedure, she develops acute abdominal pain with a rigid abdomen and free air on X-ray. The MOST likely complication is:
  56. Under the MTP Amendment Act 2021 (India), up to what gestational age can a pregnancy be terminated with the opinion of TWO registered medical practitioners for a rape survivor?
  57. A 30-year-old woman has a missed abortion at 10 weeks. Ultrasound confirms no fetal cardiac activity with CRL 26 mm. She opts for medical management. The WHO-recommended regimen for medical management of missed abortion at this gestation is:
  58. A 26-year-old woman is diagnosed with a complete hydatidiform mole. Following suction evacuation β-hCG is 18,000 IU/L. Six weeks later β-hCG has fallen to 4,200 IU/L, continuing to fall by 30% per week. What is the recommended follow-up action?
  59. Under the MTP (Amendment) Act 2021 (India), medical termination of pregnancy up to 24 weeks gestation is permissible for which category of women requiring ONLY ONE registered medical practitioner's opinion (not two)?
  60. A 16-year-old girl presents at 8 weeks gestation requesting medical abortion. She is accompanied by her mother. The most appropriate medical abortion regimen and key legal consideration in India under MTP Act 2021 is:
  61. Under the Medical Termination of Pregnancy (Amendment) Act, 2021, India, termination of pregnancy up to 24 weeks requires opinion of TWO registered medical practitioners in which of the following categories?
  62. A woman at 8 weeks gestation opts for medical abortion. She is given mifepristone 200 mg orally, followed 24–48 hours later by misoprostol 800 mcg sublingually. Which mechanism makes mifepristone the sensitizing agent in this regimen?
  63. The MTP Amendment Act of India (2021) allows termination of pregnancy up to 24 weeks for which specific category of women with a single registered medical practitioner's opinion?
  64. The recommended regimen for medical abortion up to 63 days (9 weeks) of gestation as per WHO 2022 guidelines is:
  65. A 22-year-old presents with 8 weeks amenorrhoea and an intrauterine pregnancy on scan. She requests medical abortion. Her rhesus blood group is O negative. Regarding anti-D administration in medical abortion before 10 weeks, current guidance (RCOG 2023) recommends:
  66. Under the Medical Termination of Pregnancy (Amendment) Act 2021, India, MTP is now permissible up to 24 weeks for which specific category of women?
  67. A patient at 9 weeks gestation requests medical termination. She has no contraindications. The WHO-recommended regimen for medical abortion at this gestation is:
  68. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), up to which gestational age can termination be performed by a single registered medical practitioner?
  69. A woman presents at 9 weeks gestation requesting medical abortion. She is hemodynamically stable with no contraindications. The WHO-recommended regimen for medical abortion at this gestational age is:
  70. Which type of spontaneous abortion is characterized by a closed internal os, heavy bleeding, and severe cramping with the fetus still alive on ultrasound?
  71. Cervical cerclage (Shirodkar procedure) is indicated for which type of pregnancy loss, and when is it placed?
  72. The Medical Termination of Pregnancy (Amendment) Act 2021 in India extended the gestation limit to 24 weeks for certain special categories. Which category is NOT included in this expanded provision?
  73. For medical abortion in the first trimester (up to 63 days/9 weeks), the WHO-recommended regimen is mifepristone followed by misoprostol after how many hours, and by which route?
  74. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), which of the following statements is correct regarding termination beyond 20 weeks?
  75. A 10-week intrauterine pregnancy is to be medically terminated. The most effective combination regimen approved for medical abortion is:
  76. Under the Medical Termination of Pregnancy (Amendment) Act 2021 in India, the gestational age limit for termination of pregnancy for all women (beyond the survivor-of-rape or special category clause) has been extended from 20 to:
  77. A 10-week intrauterine pregnancy is confirmed on ultrasound. Medical termination using mifepristone + misoprostol regimen is requested. The standard WHO-recommended outpatient regimen is:
  78. Under the Medical Termination of Pregnancy (Amendment) Act 2021 (India), termination of pregnancy up to 24 weeks is permissible for which of the following categories of women?
  79. A 9-week pregnancy is being terminated medically. The standard regimen for medical abortion up to 9 weeks per WHO guidelines is:
  80. A 24-year-old woman with a 14-week incomplete abortion has minimal bleeding and stable vitals. Ultrasound shows retained products measuring 25 mm in AP diameter. The PREFERRED management is:
  81. A woman has antiphospholipid syndrome (APS) confirmed by laboratory criteria with recurrent early pregnancy loss. The RECOMMENDED treatment to reduce recurrent miscarriage in APS is:
  82. Under the Medical Termination of Pregnancy (Amendment) Act 2021, India, up to what gestation can termination be performed with one registered medical practitioner's opinion?
  83. A 24-year-old woman requests medical abortion at 8 weeks gestation. She has an intrauterine pregnancy confirmed on ultrasound. Which regimen is WHO-recommended as first-line for medical abortion at this gestation?
  84. A woman presents with incomplete abortion at 10 weeks (products of conception seen in uterine cavity, cervical os open, bleeding moderate). She is haemodynamically stable. What is the most appropriate management?
  85. The Medical Termination of Pregnancy (Amendment) Act 2021 in India extended the upper gestational limit for MTP by a single approved provider from 20 to 24 weeks for which category of women?
  86. In threatened abortion, which ultrasound finding MOST strongly predicts inevitable progression to complete abortion?
  87. Recurrent pregnancy loss (RPL) is defined by ESHRE 2023 guidelines as how many consecutive or non-consecutive pregnancy losses before 24 weeks?
  88. A 22-year-old woman at 9 weeks presents with heavy bleeding, pain, and passage of tissue. Ultrasound shows an empty uterus with no products of conception. β-hCG is 320 mIU/mL (was 3200 mIU/mL 48 hours ago). What type of abortion does this represent?
  89. According to WHO 2022 abortion care guidelines, what is the recommended vacuum aspiration method for first-trimester MTP up to 14 weeks?
  90. A woman presents with missed abortion at 9 weeks. Her cervix is closed and uterus corresponds to 9 weeks. What is the definition of expectant management 'success' in missed abortion, and within what period is it expected?
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