OBSTETRICS & GYNECOLOGY
1. Which of the following is the correct flow of blood from the uterine wall to the endometrium?
A. Uterine artery arcuate artery radial artery straight & coiled spiral artery B. Uterine artery radial artery arcuate artery straight & coiled spiral artery C. Uterine artery arcuate artery straight artery radial & coiled spiral artery D. Uterine artery straight artery arcuate artery radial & coiled spiral artery 2. What is the functional life span of the corpus luteum?
A. 7 + 2 days B. 14 + 2 days C. 21 + 2 days D. 28 + 2 days
3. What hormone is secreted by the dominant ovarian follicle? A. estriol
B. estrone C. estradiol D. progesterone
4. During the embryonic period, where is the formation of blood first demonstrable? A. bone marrow
B. yolk sac C. liver D. spllen
5. During the secretory phase, what is the uppermost layer from the uterine cavity ? A. Zona compacta
B. Zona basalis C. Zona spongiosa D. Decidua basalis
6. What stage of human development is implanted in the uterine cavity? A. blastomeres
B. embryo C. blastocyst D. morula
7. How many new primary oocytes are there during puberty?
A. 0
B. 1,000 C. 10,000 D. 100,000
8. What is the important event that occurs prior to implantation? A. Formation of daughter cells B. Extrusion of the polar body
C. Accumulation of fluid between blastomeres D. Disappearance of the zona pellucida 9. At what phase does regresson of the corpus luteum occur?
A. At the end of the proliferative phase B. At the end of the secretory phase C. During menstruation D. After ovulation
10. A 34 year old G4P4 delivered vaginally an 8 lb baby at home assisted by a hilot. The placenta was delivered without difficulty. However, a few minutes later, there was profuse vaginal bleeding and the patient wa rushed to the hospital. In the ER, the patient was hypotensive, tachycardic and pale. On abdominal examination, the uterine fundus was soft and above the umbilicus. There were no vaginal or cervical lacerations. What is the most probable diagnosis?
A. uterine inversion B. retained placental fragments C. uterine rupture
D. uterine atony
11. A 33 year old G3P2 PU 18 weeks consulted at the ER because of watery vaginal discharge accompanied by hypogastric pain. Vital signs were normal. Speculum exam revealed pooling of watery discharge. I.E. revealed an open cervix, palpable fetal parts at the os, uterus enlarged to 18 weeks AOG. What is the most probable diagnosis?
A. Recurrent abortion B. Incomplete abortion C. Inevitable abortion D. Threatened abortion 12. At what part of the fallopian tube does tubal rupture occur earliest?
A. Interstitial
B.
B. Ampullary C. Isthmic D. Fimbria13. What is the most commonly associated condition for abruption placenta? A. External trauma
B.
Pregnancy- induced hypertension C. alcohol consumptionD. Short cord
14. Which of the following transvaginal utrasonographic cervical findings correlate positively with preterm delivery? A. negative transfundal pressure
B. funneling C. 2.7 cm cervical length D. T- shaped cervix 15. Preterm infant is an infant who is:
A. less than 2000 grams at birth
B.
less than 2500 grams at birth C. less than 37 weeks AOG D. less than 38 weeks AOG16. A 35 year old G1P0 had an infertility work-up fro which she was prescribed clomiphene citrate. She got pregnant and was diagnosed to have twin pregnancy. What is the most probable type of twinning?
A. Monozygotic
B.
Dizygotic C. Conjoined D. Locked17. Which of the following is the most important parameter in the assessment of patient in true labor? A. intactness of the amniotic membrane
B. cervical dilatation and effacement C. presenting part
D. bony pelvis
18. The level of the presenting part in the birth canal described in relationship to the ischial spines, which is halfway between the pelvic inlet and the pelvic outlet is called
A. position B. B. effacement
C. Dilatation D. station
19. The characteristic curve pattern of cervical dilatation in a normal labor is described as: A. A. hyperbolic
B. sigmoidal C. diagonal straight D. horizontal
20. A 30 year old G1P0, term was admitted for labor pains. FH- 34 cm, FHT- 140 bpm. IE- cervix is 4 cm dilated, 60% effaced, cephalic, station -2, rupture BOW. Uterine contractions every 2-3 mins, moderate. After 2 hours, IE- cervix 4-5 cm dilated, 70 % effaced, station -2. After 2 hours, IE- cervix is 5-6 cm dilated, 80% effaced, station -1.Describe the progress of labor.
A. Normally progressing B. Protracted cervical dilatation C. Protracted descent
D. Arrest in descent
21. What phase of the active labor reflects the feto-pelvic relationship? A. latent phase
B. B. acceleration phase C. phase of maximum slope D. deceleration phase
22. A 19 year old G1P0 PU 40 weeks, not in labor, was seen at the OPD for decreased fetal movement. She was hooked to an electronic fetal monitor and tracing showed: Baseline FHT- 140’s, good variability, with more than 2 accelerations of 20 bpm lasting for 20 secs. The tracing is interpreted as:
A. reactive B. non-reactive C. positive D. negative
Reactive Non-Stress Test – requires 2 fetal heart rate accelerations of at least 15 beats amplitude of 15 secs. Duration in a 20 min period. 23. Fetal tachycardia is defined as a baseline heart rate greater than:
A. 140 bpm B. 150 bpm C. 160 bpm D. 170 bpm
24. What is the presentation type when the fetal head is artially flexed with the anterior fontanel or bregma is presenting? A. face
B. vertex C. brow D. sinciput
25. You were the intern on duty in the ER and you did an abdominal exam on a 22 year old G2P1 PU 37 weeks who consulted because of hypogastic pain. You found out that the fundus is occupied by a hard ballotable mass. What Leopold’s maneuver did you perform?
A.
LM 1B. LM 2 C. LM 3 D. LM 4
26. There is an increase in the size of cardiac silhouette in X-ray during pregnancy because the heart is displaced to the: A. left and upward
B. left and downward C. right and dowmward D. right and upward 27. During pregnancy, the diaphragm rises by
A.
2 cmB. 4 cm
C. 6 cm D. 8 cm
28. Impaired gall bladder contraction during pregnancy is due to A. estrogen
B. estrogen and progesterone C. progesterone
D. anatomical change in gall bladder 29. Naegele’s rule is use to estimate the expected date of delivery by ____.
A. adding 3 days to the first day of PMP and count back 7 months B. adding 7 days to the first day of PMP and count back 3 months C. adding 7 days to the first day of bleeding and count back 3 months D. adding 7 days to the first day of LMP and count back 3 months 30. Which of the following is proven teratogen?
A. Vitamin A derivatives B. Metronidazole C. Cephalosporins D. Ampicillin
31. Which of the following vaccines is contraindicated during pregnancy? A. Pneumococus
B. Hepatitis B C. Influenza
D. Mumps, measles, rubella 32. The preferred method for the delivery of the aftercoming head is
A. Piper’s forceps extraction B. Mauriceau-Smellie-Veit Manuever C. Bracht maneuver
D. Prague maneuver
33. You were assigned to deliver the baby of a 25 year old G1P0 PU 38 weeks. You applied the forceps on the fetal head with the following findings: head was at station +2 with the sagittal suture at left occiput anterior position. This is classified as
A. outlet forceps delivery B. low forceps delivery C. midforceps delivery D. high forceps delivery
34. A 22 year old G1P0 patient at 39 weeks AOG was admitted for elective Cesarean Section for breech presentation. She requested to her obstetrician that a transverse suprapubic abdominal incision be done to her. This type of incision is called
A. Kerr B. Kronig C. Pfannensteil D. Classical
35. Which of the following is one of the requirements that must be present before obstetric forceps must be used? A. The membranes should be intact
B. Cephalic presentation C. The fetal head must be floating
36. The single most significant risk factor in the development of post-partum pelvic infection is A. early rupture of membranes
B. Prolonged labor C. Cesarean delivery D. Multiparity
37. The process by which the uterus returns to its normal size, tone and position after delivery is called A. involution
B. puerperium C. subinvolution D. atony
38. What is the mechanism behind the increase in cardiac output right after delivery? A. maternal exhaustion
B. increase caval compression C. sympathetic stimulation D. autotransfusion
39. Congenital rubella syndrome is more likely common during which AOG? A. 8-10 weeks
B. 12-14 weeks C. 16-18 weeks D. 36-38 weeks
40. What is the diagnostic procedure of choice for identifying gallstones in pregnancy? A. CT Scan
B. X-Ray C. Ultrasound
D. MRI
41. A patient consulted because her husband is a seaman and will be coming home in 2 months for a 1-month vacation. She just had her menses 2 days ago. What is the most effective reversible form of contraception will you give?
A. combined oral contraceptive B. calendar rhythm method C. Depo-Provera
D. combined oral contraceptives
42. A 30 year old G1P1 consulted at the OPD for Pap smear. According to her, she had an IUD in-situ for 1 year. On PE, you can not visualize the tail of the IUD string. What is the best thing to do for this patient?
A. Assume that the device has been expelled B. Assume that the patient is telling a lie C. Perform an transvaginal ultrasound
D. Assume that the device has been expelled and perform the Pap smear
43. A 35 y.o., G3P3 (3-0-0-3) complained of scanty menstrual flow and continuous severe cramping throughout the menstrual period after undergoing cryotherapy due to chronic cervicitis. What is the most likely cause of her complaint?
A. pelvic inflammation B. ectopic endometrial tissue C. cervical stenosis D. stress and tension
44. A 21 y.o. patient, nulligravid , single came in because of severe vaginal bleeding of 2 days duration. What is the management of choice in this case? A. D & C
B. High dose progestins C. High dose estrogen D. Hysteroscopy
45. The most common cause of DUB in the premenarcheal and postmenopausal woman is _____. A. Ovulatory
B. Anovulartory C. Organic D. Iatrogenic
46. A 32 y.o., G2P2 (2-0-0-2) consuted for amenorrhea since delivery up to almost 1 year after. Breastfeeding was not practiced.The last pregnancy was delivered via NSD with history of uterine atony and blood transfusion. What is the most likely cause of her amenorrhea?
A. Asherman’s syndrome B. Sheehan’s syndrome C. Simmond’s syndrome D. Polycystic ovarian syndrome 47. Menometrorrhagia is defined as:
A. Abnormal uterine bleeding occurring at regular intervals B. Prolonged uterine bleeding at irregular intervals C. Normal amount of vaginal bleeding at frequent intervals D. Decreased amount of vaginal bleeding at frequent intervals 48. Which of the following statements is true of DUB?
A. Anovulatory bleeding is the most common cause in the premenarcheal years B. There is continuous estrogen production without corpus luteum formation C. Halban’s syndrome is a common cause of DUB
D. It is usually associated with severe dysmenorrhea 49. The most common histologic type of vaginal cancer is:
A. Squamous carcinoma B. Adenocarcinoma C. Malignant melanoma D. Sarcoma
50. A 69- year old G4P4 (4004) consulted for an ulcerated mass on the right labium majus. She had been to several physicians who have prescribed unrecalled topical creams and solutions without relief. Upon seeing the patient, your recommendation would be:
A. Observation B. Steroid topical cream C. Excision biopsy of the mass D. Simple vulvectomy
51. The area of the cervix that is most prone to precancerous and cancerous neoplasms is the: A. Histologic portio
B. Transformation zone C. Histologic endocervix D. Isthmus
52. Which of the following HPV Types is associated with high oncogenic potential? A. HPV Type 1
B. HPV Type 5 C. HPV Type 6 D. HPV Type 18
53. A 37 year old, G3P3 was admitted because of vaginal bleeding. Pregnancy test is negative. She underwent diagnostic curettage. While doing the curettage humps and bumps were noted. What is the most likely diagnosis?
A. intramural myoma B. subserous myoma C. submucous myoma D. broad ligament myoma
54. A 68 year old woman has a biopsy result of atypical complex hyperplasia. What is the most appropriate treatment for her? A. Judicious observation
B. Repeat fractional D&C after 6 months
C. Give cyclic progestin therapy to promote monthly withdrawal bleeding D. Perform TAHBSO
55. This granulose-theca cell tumor has this characteristic inclusion body. A. Psamomma bodies
B. Call-Exner bodies C. Schiller Duvall bodies D. keratin pearls
56. A 33 year old nulligravid patient consulted in your clinic because of cervical mass. She was diagnosed as a case of prolapsed myoma . What is the best management for her case?
A. Do myomectomy by laparotomy B. Do subtotal hysterectomy
C. Do transcervical resection of the myoma D. Do total abdominal hysterectomy only
57. A 28 year old, single, nulligravid patient consulted in the OPD for the result of her pelvic ultrasound. It revealed a 18mm x 10mm x 14mm and a 13mm x 16mm x 10 mm intramural myomatas. She is asymptomatic.
58. How will you manage the patient?
A. Work up the patient , then schedule her for myomectomy B. Give her GnRH agonists
C. Reevaluate the patient at 6-month interval to determine the rate of growth D. Perform fractional D & C
59. This is the diagnostic procedure of choice for endometrial cancer. A. Progesterone challenge test B. Ultrasound
C. Pap smear D. Fractional D&C 60. This is the drug of choice for syphilis.
A. Oral doxycycline B. Oral tetracycline C. Oral Penicillin D. Parenteral Penicillin G
61. A 29 year old sexually active female consulted in your clinic because of vulvar lesion. History revealed that it started as paresthesia of the vulvar skin then papule and subsequent vesicle formation. Simple clinical inspection revealed ulcers which are painful when touched with cotton-tipped applicator. The most likely diagnosis is _____.
A. Syphilis
B. Granuloma inguinale
C. LGV
D. Genital herpes
62. What are the most important goals of the medical therapy of acute PID? A. prevention and treatment of the disease B. early diagnosis and prompt treatment of the disease C. prevention of the disease and preservation of tubal function D. resolution of symptoms and preservation of tubal function
63. This occurs when increased intraabdominal pressure is not transmitted equally to the bladder and the functional urethra. A. detrussor instability
B. urethral sphicteric dysfunction C. genuine stress incontinence D. true incontinence
64. This occurs when a bladder is overdistended because of its instability to empty. A. true incontinence
B. overflow incontinence C. genuine stress incontinence D. detrussor instability
65. A 35 year old G1P0 (0-0-1-0) consulted because failure to become pregnant 1 year after her abortion. Her condition is considered A. unexplained infertility
B. primary infertily C. secondary infertility D. normal after an abortion 66. The first drug to offer in women with anovulation is
A. bromocriptine B. GnRH C. Gonadotrophins D. clomiphene citrate 67. The most common cause of tubal/peritoneal factors of infertility is
A. surgery on the tubes B. tuberculosis
C. PID
D. endometriosis
68. Among the factors causing female infertility, the easiest to diagnose and manage is A. cervical factors
B. uterine factors C. ovulatory factors D. tubal/peritoneal factors 69. An absolute contraindication to hormone replacement therapy is:
A. Thromboembolic disease B. Bronchial asthma C. Diabetes mellitus D. Hypertension
70. Over the counter pregnancy test kits will test for which placental hormone? ((Baja-Panlilio Chapter 6, p. 64) A. estrogen
B. progesterone C. human placental lactogen D. human chorionic gonadotropin
71. Mefenamic acid taken by pregnant women may result in the closure of what structure? (Baja-Panlilio, Vol I pp. 82-83) A. ductus venosus
B. foramen ovale C. ductus arteriosus D. ventricular septal defect
72. Hydroureter during pregnancy is more marked on the right than on the left because of: (Baja panlilio Chapter 8 Page 107) A. renal artery crossing the ureter on the right
B. dextrorotation of the uterus C. sigmoid colon on the right
73. In which of the following are relatively low levels of hCG detected in maternal blood? (Baja Panlilio Chapter 6 page 64) A. Down syndrome
B. hydatidiform mole C. multiple gestation D. Impending abortion
74. The majority of spontaneous abortions are due to: (Baja-Panlilio, Chapter 27, p. 317) A. chronic infections
B. endocrine abnormality C. chromosomal defects D. uterine synechial
75. A 39 year old, G4P3 (3003) patient with a history of repeated episodes of pelvic inflammatory disease was diagnosed to have an unruptured ectopic pregnancy. The cause of her ectopic pregnancy is: (Baja-Panlilio, Chapter 28, p. 327)
A. uterine tumor B. adhesions C. ovarian tumor D. salpingitis
76. The best basis for the diagnosis of Preterm Labor in this patient is the presence of: (Baja Panlilio Chapter 37 , page 355) A. mucoid vaginal discharge
B. painful uterine contractions
C. contractions occurring every 10 to 15 minutes D. cervical dilatation and effacement
77. A blood pressure of 160/110 mmhg. Proteinuria of 4 gm/day, with elevated liver enzymes is classified as: (Baja-Panlilio, Chapter 35 p 231) A. preeclampsia mild
B. preeclampsia severe C. chronic hypertension D. gestational hypertension
78. A 29 year old G1P0, consulted for the 1st time on her 28 weeks AOG. Her BP was 160/120 mmHg. She had severe headache and her fundic height
was only at the level of the umbilicus. The appropriate laboratory exams to be done initially is: (Baja-Panlilio, Chapter 35 p. 337 A. non-stress test
B. doppler velocimetry C. biophysical profile D. liver enzymes
79. A 35 year old, G6P5 (5005) on her 12th week of pregnancy was diagnosed on ultrasound to have an h-mole. What will be the management for this
case? ((Baja-Panlilio, Chapter 30, p. 350)
A. single agent chemotherapy B. hysterotomy
C. suction curettage
D. hysterectomy, followed by prophylactic chemotherapy
80. When the long axis of the fetus parallels the longitudinal axis of the uterus, the lie of the fetus is called: (Panlilio, Textbook of Obstetrics (Pathologic and Physiologic) 2nd ed, Page 210)
A. transverse B. longitudinal C. cephalic D. breech
81. The tracings showed that the fetus: (Baja-Panlilio, Chapter 21 pp. 237
A. has normal tracings B. has a late deceleration C. has an early deceleration D. has a variable deceleration
82. In intrapartum monitoring, the management for severe bradycardia preceded by late deceleration and absent variability is done by: (Baja-Panlilio, Chapter 21 pp. 236
A. giving oxygen inhalation at 3-4 L/mins. B. infusion of intravenous fluids C. immediate termination of pregnancy D. placing patient at left lateral decubitus
83. A 25 year old G1P0, 38-39 wks. AOG consulted at the emergency room due to labor pains. She has no prenatal check-ups and family history revealed diabetes mellitus in sister and mother. Abdominal exam revealed fundic height = 40 cm, uterine contractions every 2-3 mins, 45-50 secs. duration. Internal exam has remained unchanged at 6 cms dilated, fully effaced, station -2, cephalic, (-) BOW for the past 2 ½ hrs. The serious complication during vaginal delivery of this baby where there is arrest in delivery of the shoulder is: (Baja-Panlilio, . 421-422)
A. Shoulder dystocia B. Deep transverse of the head C. Erb’s palsy
D. Prolonged second stage of labor
84. A well-nourished patient on her third trimester of pregnancy has a Hemoglobin value of 10.5 gms/dl. This low value could be explained by: (Baja Panlilio 2nd Ed Chapter 8 page 112)
A. iron deficiency anemia B. increase in blood volume C. no increase in RBC production D. bone marrow failure during pregnancy
85. Iron supplementation during pregnancy is mandatory because of: (Baja Panlilio 2nd Ed Chapter 8 page 112)
A. increased physiologic Fe loss during pregnancy B. poor Fe absorption during pregnancy
C. increased demand by the increased production of RBCs D. poor bone marrow response to anemia
86. Pregnancy is said to be a diabetogenic state because of: (Baja Panlilio 2nd Ed Chapter 8 page 114)
A. decreased insulin production B. increased caloric intake of the mother C. increased fat utilization
D. increased insulin resistance
87. An increase in the following hormone is an indication of Thyrotoxicosis during pregnancy: (Baja Panlilio 2nd Ed Chapter 54 page 595
A. free Thyroxine hormone B. total Thyroxine hormone C. thyroid Stimulating Hormone D. thyroid Releasing Hormone
88. A puerpera came for her postnatal follow up 2 weeks after an uncomplicated vaginal delivery. The following are expected findings on her physical examination: (Panlilio, Textbook of Obstetrics (Pathologic and Physiologic) 2nd ed, Pages 295-298)
A.
uterus at the level of the symphysis pubis B. lochia albaC. cervix open and thick D. bipedal edema
89. A week after delivery by emergency cesarean section after a prolonged labor, a patient came because of fever of 38 C. Puerperal infection is suspected if she has: (Panlilio, Textbook of Obstetrics (Pathologic and Physiologic) 2nd ed, Pages pages 556-561)
A. breast engorgement
B. foul smelling lochia and tender uterus C. milk fever
D. thrombophlebitis
90. A 42 year old G2P1 at her 32 weeks gestation with known renal disease and hypertension presents with BP of 220/120 mmHg but is asymptomatic. The diagnostic test you will perform to detect chronicity of her illness is: (Baja-Panlilio, Chapter 35 p. 342)
A. Doppler velocimetry B. urine protein C. fundoscopy
D. elevated serum creatinine
91. The monitoring done to detect increased severity of preeclampsia is: (Baja-Panlilio, Chapter 35, p. 336) A. maternal fibronectin
B. urine protein C. serum uric acid D. serum creatinine
92. The most common pathophysiologic mechanism in perimenopausal bleeding is: (Compre Gyne, 1082) A. cervical ancer
B. endometrial cancer C. anovulation
D. abnormal pregnancy states
93. A 34 yo G3P3 (3-0-0-3) presents with episodes of missed period for 2 cycles then irregular and profuse bleeding for the past two weeks. Her pregnancy test is negative with unremarkable pelvic exam findings except for the moderate bleeding. What is the most likely diagnosis: (Compre Gyne, p. 1082-1083)
A. threatened abortion B. hydatidiform mole
C. dysfunctional uterine bleeding D. endometrial cancer
94. A 60 yo G5P5 (5-0-0-5) has been menopausal for the past 12 years presents with minimal vaginal bleeding. What diagnostic exam will you recommend? (Compre Gyne, p. 1082-1083)
A. colposcopy B. laparoscopy
C. diagnostic Dilatation and Curettage D. Transvaginal Ultrasound
95. An adnexal cystic mass was seen appreciated on TVS, 6 cm in diameter, in a 24 yo patient who presents with abnormal vaginal bleeding. What is the most likely diagnosis? (Compre Gyne, p. 506-507)
A. follicular cyst B. dermoid cyst C. serous cyst D. corpus luteum cyst
96. A 5 year old child was initially treated with antibiotics for purulent vaginal discharge for a week. On follow up, the discharge was noted to be foul smelling and bloody. The most probable cause is: (Comprehensive Gynecology, 4th ed, page 274-277)
A. monilial infection B. child molestation C. foreign body in the vagina D. precocious puberty
97. A mother is concerned with the appearance of whitish, non puritic vaginal discharge on her 11 year old child noted since 8 month preceding menarche. It is best to; (Comprehensive Gynecology, 4th ed, page 276)
A. do gram stain on the discharge B. advise vaginal douche C. prescribe oral antibiotics
D. reassure the mother and the child that the discharge is normal 98. The most frequent symptoms of endometrial hyperplasia is: (Compre Gyne, p. 870)
A. foul smelling vaginal discharge B. abnormal vaginal bleeding C. pelvic pain
D. alternating constipation and diarrhea
99. A 46 yo G4P4 (4-0-0-4) with a nodular uterus, enlarged to 20 weeks AOG presents with menorrhagia. What is the most likely diagnosis? (Comprehensive Gynecology Chapter 18 Page 502)
A. Subserous myoma B. Submucous myoma C. Adenomyosis D. Abnormal pregnancy
100. A 65 year old nulligravida consulted at the emergency room due to postmenopausal bleeding for 3 yrs. She’s obese and known to be hypertensive for 10 years. Her menstrual history revealed irregularly irregular cycles. She was treated for breast cancer 6 years ago and has been taking tamoxifen for the past 5 years. The most probable cause of her bleeding is a pathology in the: (Compre Gyne, p. 860-867)
A. Cervix B. Endometrium C. Ovary D. Vagina
101. A 35 year old, G6P6 (6006) wife of a seaman, consulted due to postcoital bleeding. Speculum exam revealed a flat warty lesion along the posterior cervical lip. Histopathology of cervical punch biopsy done revealed dysplastic cells involving nearly the whole thickness of the epithelium. The most probable diagnosis is CIN? (Compre Gyne, 802-803)
A. I
B. II C. III
102. A 65 year old nulligravida consulted at the emergency room due to postmenopause bleeding x 3 yrs. She’s obese and known to be hypertensive for 10 years. Her menstrual history revealed irregularly irregular cycles. She was treated for breast cancer 6 years ago and has been taking tamoxifen for the past 5 years. The most appropriate diagnostic test is: (Compre Gyne, 870-871)
A. Pap smear B. Cervical punch biopsy C. Fractional curettage D. Transvaginal ultrasound
103. A 25 year old, G6P0 (0060) consulted at the emergency room due to postcoital bleeding x 3 months duration. She’s a victim of child prostitution. On pelvic exam, there was a 2 cm cauliflower – like lesion on the anterior lip of the cervix. The vagina and parametria are smooth. What is the most appropriate diagnostic test? (Compre Gyne, p. 844)
A. pap smear B. colposcopy with biopsy C. direct punch biopsy D. cone biopsy
104. A 20 year old commercial sex worker presented at the clinic due to painful shallow ulcers in the vulva associated with burning sensation during urination. She also has multiple oral ulcers at the time of consultation. The most likely diagnosis is: (Compre Gyne, , Chapter 22, page 656)
A. Herpes simplex infection B. granuloma inguinale C. Lymphogranuloma venereum D. Syphilis
105. A 38 year old diabeteic patient presented at the clinic due to vaginal pruritus and whitish vaginal discharge. On examination, the vulva is beefy red in appearance with whitish curdled discharge. The most likely diagnosis is: (Compre Gyne, Chapter 22, page 669)
A. Trichomoniasis B. Candidiasis C. Bacterial vaginosis D. Mucopuruloent Cervicitis
106. The presence of heavy concentration of coccobacilli surrounding vaginal epithelial cells with loss of distinct cell margins is the appearance of; (Compre Gyne, Chapter 22, page 671)
A. Donovan bodies B. Clue cells C. chancre D. inclusion cells
107. A patient with chronic ulcers in the vulva had smears done taken from the ulcers. Findings shows presence of dark staining bacteria with a bipolar appearance found in the cytoplasm of large mononuclear cells .These are diagnostic of ; (Compre Gyne, Chapter 22, page 660
A. Granuloma inguinale B. Lymphogranuloma venereum C. Chancroid
D. Syphilis
108. A patient with painless vulvar ulcers came with a positive screening test for syphilis. Confirmatory test that should be done can either be any of the following except: (Compre Gyne, Chapter 22, page 664)
A. RPR
B. TPI C. FTA-ABS D. MHA-TP
109. According to CDC, treatment of patients diagnosed with HIV includes the following except: (Compre Gyne Chapter 22, page 686) A. behavioral
B. psychosocial C. emotional D. medical
110. A patient diagnosed with gonorrhea should: (Compre Gyne, Chapter 22, page 692) A. be treated with Chloramphenicol
B. also be treated for Chlamydia infection C. have follow-up cultures done for asymptomatic women
D. not have serologic test for syphilis if cultures for gonorrhea are positive
111. Linda, 65 year old, G7P7 came to your clinic complaining of vaginal itching with burning discomfort. This condition may be due to a decrease in what hormone? (Compre Gyne, p.1223)
A. LH
B. progesterone C. estrogen
D. FSH
112. Linda, 18 year old, delivered an 8 lbs baby. There was note of laceration on the lateral wall off the vaginal vault with profuse vaginal bleeding. There was a sudden drop of BP. Post partum there was note of amenorrhea. Lab examination shows destruction of the pituitary gland. Linda has what syndrome? (Compre Gyne p. 1116)
A. Simmonds syndrome B. Sheehan’s syndrome C. Edward’s syndrome D. Asherman’s syndrome 113. Factors promoting puerpueral infection include:
A. prolonged rupture of membranes B. limited number of vaginal examination C. normal hemoglobin levels D. normal labor
Textbook of Obstetrics (Baja-Panlilio, et al), p. 517-8
114. The fetal heart tones can be best heard in this area if the following were the Leopold’s findings: L1- large nodular mass
L2 – hard, resistant structure at the right side of the mother Small, irregular, mobile parts on the left side of the mother L3 – movable hard round mass
L4 – tips of the fingers able to meet
A. right lower quadrant B. left lower quadrant C. right upper quadrant D. left upper quadrant
Textbook of Obstetrics (Baja-Panlilio, et al), p. 122-123
115. The patient with abnormal uterine bleeding is a:
A. 18 y.o. whose interval of menses is 24 to 30 days B. 41 y.o. whose menses last 8 to 10 days C. 29 y.o. on DMPA with occasional vaginal spotting D. 22 y.o. leukemic patient with menstrual blood loss of 80 ml Compre Gyne 4th ed, p. 1079-80
116. A 55 y.o. G5P5 (5005) consulted for fish-wash like vaginal discharge and on-and-off vaginal bleeding. Pelvic exam showed the cervix to be converted to a 6 x 5 cm nodular, fungating mass extending to the R lateral fornix, the right parametria nodular and fixed while the left was free.
Based on the information given, this patient can be clinically staged as A. IIB
B. IIIA C. IIIB D. IVA Compre Gyne 4th ed, p. 897
117. A 53 y.o. G1P1 (1001) underwent exploratory laparotomy for an ovarian new growth. Intraoperative findings showed the right ovary to be converted to a 10 cm predominantly cystic mass with excrescences on its outer capsule. The left ovary was grossly normal. All other abdominopelvic organs were grossly normal. Based on the information given, the Intraoperative stage of this patient is
A. IA B. IB
C. IC
D. IIA Compre Gyne 4th ed, p. 966
118. Speculum exam of a 27 y.o. complaining of leucorrhea showed copious frothy greenish vaginal discharge with strawberry-like mucosa. This is most likely due to:
A. candidiasis B. trichomoniasis C. gonococcal infection D. bacterial vaginosis Compre Gyne 4th ed, p. 672-73
119. The main arterial blood supply of the uterus is a branch of : A. pudendal artery B. external iliac C. ovarian artery D. hypogastric artery 120. The uterus is derived from the:
A. Wollfian duct B. Gartner’s duct C. Mullerian duct D. Urogenital sinus
121. The violaceous discoloration of the vagina during pregnancy is called: A. Godell’s sign
B. Hegar’s sign C. Chadwick’s sign D. Pawlik’s sign
122. Which of the following is markedly increased by about 28 weeks gestation? A. fetal movement
B. plasma volume C. amniotic fluid
D. human chorionic gonadotropin 123. This maneuver is done to promote extension of the fetal head:
A. Wood’s maneuver B. Mauriceau’s maneuver C. Ritgen’s maneuver D. Robert’s maneuver 124. One of the following is a presumptive sign of pregnancy:
A. softening of the isthmus B. outlining of the fetus C. violaceous vaginal mucosa D. ballottement
125. The fundus of the uterus is at this level at 12 weeks gestation: A. Just below the umbilicus B. Above the symphysis C. At the level of the symphysis
D. Midway between the symphysis and the umbilicus 126. During the second and third trimester, daily caloric intake should be increased by:
A. 400
B. 300
C. 200 D. 100 127. Lightening is the result of :
A. dilatation of the cervix B. descent of the fetus
C. increase in Braxton Hicks contractions D. expulsion of bloody show
128. The relation of the point of direction to the right and left of the maternal birth canal is called: A. presentation
B. posture C. position D. station
129. Which ligament is considered as the strongest support of the uterus? A. Cardinal
B. broad C. utero-sacral D. round
130. Average duration of the first stage of labor in primigravidas: A. 24 hours
B. 12 hours C. 8 hours D. 5 hours
131. Average duration of the third stage of labor among multiparous patients: A. 5 minutes
B. 20 minutes C. One hour D. Two hours 132. Milk ejection is the result of the action of:
A. Oxytocin B. prolactin C. estrogen
133. Complete anesthesia for abdominal delivery necessitates a block from: A. T10 to S5
B. T10 to S1 C. T8 to S1 D. T8 to S5
134. The motor pathways to the uterus leaves the spinal cord at the level of: A. T9T10
B. T7T8
C. T6
D. T7
135. Phase 0 of parturition is characterized by: A. uterine tranquility B. ripening of the cervix
C. development of the lower uterine segment D. progesterone withdrawal
136. Secondary arrest of cervical dilatation is cessation of cervical dilatation for: A. one hour or more
B. two hours or more C. three hours or more D. 12 hours or more 137. TRUE of hypertonic uterine contractions EXCEPT:
A. absence of basal hypertonus B. usually respond to sedation C. distorted gradient pressure D. absence of fundal dominance
138. Method of delivery in a 19 year old primigravid patient, 39 weeks pregnant, transverse lie in labor:
A.
internal podalic version under general anesthesiaB. emergency low transverse cesarian section C. emergency classical cesarian section
D. internal podalic version with complete breech extraction
139. Significant oligohydramnios is defined as an amniotic fluid index of ____ cm. or less:
A. 20
B. 15
C. 10
D. 5
Normal AFI – 6 to 24cm
140. Patient with heart disease without any obstetrical indication are best delivered by:
A.
cesarian section under general anesthesia B. normal spontaneous delivery under pudendal block C. outlet forceps extraction under epidural anesthesia D. cesarian section under epidural anesthesia 141. Which antihypertensive is NOT recommended during pregnancy?A. methyl- dopa B. ace inhibitors C. hydralazine D. nifedipene 142. The following are beta agonist tocolytic agents EXCEPT:
A. Ritrodrine B. salbutamol C. indomethacin D. terbutaline
143. Which of the following is NOT true in the use of corticosteroids in premature labor?
A.
delivery is best delayed 24 hours after the last dose of the drug B. betamethasone is given at a dose of 12 mg. im every 24 hours X 2 dosesC.
it produces induction of fat cells that regulate fetal lung maturity D. it affects biochemical systems within type II cells that produce surfactants144. Complete expulsion of sperm stored in the reproductive tracr beyond the interrupted vas deferens takes about _____ ejaculations:
A. 2
B. 10
C. 20
D. 30
145. A form of gestational trophoblastic disease characterized by excessive trophoblastic proliferation and edema of the villous stroma without excessive local invasion is:
A. H. mole B. Invasive mole C. Choriocarcinoma
D. Placental site trophoblastic tumor 146. Internal examination in cases of abruption placenta maybe done to determine:
A. location of placenta B. if bag of water has ruptured C. cervical dilatation D. All of the above 147. In uterine atony, the source of bleeding is the:
A. uterine lacerations B. placental implantation site C. cervical lacerations D. myometrium
148. What maneuver in shoulder dystocia involves flexing the maternal thighs on the abdomen? A. Woods
B. Pinard C. Zavanelli D. McRoberts
149. A woman using the oral contraceptive pills for the first time should be advised to start taking it : A. on day 1 of menses
B. on day 5 of menses C. on day 7 of menses
D. anytime as long as she is not pregnant
150. Management of choice for procidentia uteri in a 60 year old multiparous patient with marked cystorectocoele: A. observation and close follow up
B. vaginal hysterectomy
C. vaginal hysterectomy with anterior-posterior repair D. total abdominal hysterectomy with anterior-posterior repair 151. The following are characteristics of Rokitansky syndrome EXCEPT:
A. phenotypically female B. normal ovaries C. normal uterus D. absent vagina
152. The following are congenital anomalies of the mullerian duct EXCEPT: A. imperforate hymen
B. transverse vaginal septum C. unicornuate uterus D. uterus didelphys 153. The so called psammoma bodies are found in:
A. serous cystadenoma B. mucinous cysadenoma C. clear cell carcinoma D. mucinous cystadenoma
154. Abnormal uterine bleeding during the pubertal and perimenarcheal period is due to: A. polycystic ovaries
B. failing ovarian function
C. delayed,aynchronous hypothalamic maturation D. exogenous estrogen stimulation
155. Most common cause of vaginal bleeding among postmenopausal women: A. endometrial carcinoma
B. endometrial hyperplasia C. endometrial polyp D. atrophic endometrium 156. A woman with postmenopausal bleeding warrants:
A. an endometrial biopsy B. observation and Pap’s smear yearly C. total hysterectomy
D. total hysterectomy with bilateral salpingooophorectomy 157. In Meig’s syndrome, the ovarian newgrowth is a:
A. Fibroma B. mature teratoma C. immature teratoma D. cystadenoma
158. Drug of choice for pregnant patients with Chlamydia infection: A. Doxycycline
B. azythromicin C. erythromycin D. ampicilin
159. The so called tobacco pouch appearance of the fallopian tube is seen in: A. gonorrhea infection with tubo ovarian abscess B. Chlamydia infenction with tubo ovarian abscess C. Pelvic tuberculos
D. Old tubal ectopic gestation
160. Type of endometrial hyperplasis which is most likely to progress to endometrial carcinoma: A. simple hyperplasis with atypia
B. cystic hyperplasia with atypia C. complex hyperplasia without atypia D. complex hyperplasia with atypia 161. A post coital test is best done:
A. pre menstrual B. right after menses C. periovulatory period D. anytime during the cycle 162. Hysterosalpingography is best done:
A. periovulatory period B. before menses C. after menses D. anytime during the cycle
163. Which of the following Pap’s smear will definitely require colposcopic examination of the cervix:
A. AGUS
B. ASCUS
C. LSIL
D. HSIL
164. Which of the following is considered a precursor of cervical carcinoma: A. Metaplasia
B. dysplasia C. eversion D. severe eroisions
165. Endometrial carcinoma is LEAST likely if endometrial thickness is:
A. 5 mm
B. <5mm
C. 10mm
D. <10mm
166. Cystocele and rectocele occur because of weakness of the (ANS: C page 44) A. uterosacral ligaments
B. anal sphincter C. endopelvic fascia D. cardinal ligament
167. The sequence of events leading to menstruation (ANS: C page 106)
A. coiling of the arteries, vasoconstriction, decrease in endometrial thickness, vasodilatation, menses B. coiling of the arteries, vasodilatation, vasoconstriction, decrease in endometrial thickness, , menses C. decrease in endometrial thickness, coiling of the arteries, vasoconstriction, vasodilatation, menses D. vasoconstriction, decrease in endometrial thickness, coiling of the arteries vasodilatation, menses 168. Thromboxane differs from prostacyclin in that it (ANS: A page 89-90)
A. causes vasoconstriction B. causes platelet aggregation C. is not formed from arachidonic acid D. is not an eicosanoid
169. A main action prostaglandin 2 (PGF2) is ( ANS: C page 89-90)
A. vasodilatation B. platelet aggregation C. bronchoconstriction D. smooth muscle relaxation
170. A Pap smear is likely to identify all the following except (ANS: B page 150-151) A. cervical squamous cell carcinoma B. gonorrhea
C. human papilloma virus D. inflammatory changes
171. Examination of a 3-year-old reveals labial adhesion. The child is able to void without difficulty. One should initially recommend (ANS: A page 278) A. topical estrogen
B. surgical separation C. a work-up for sexual abuse D. manual separation in the clinic
172. The major mechanism of DMPA, which accounts for its contraceptive effect, is the (ANS: A page 327) A. inhibition of the midcycle gonadotropin surge
B. production of unfavorable endometrial environment C. alteration of tubal motility
D. alteration of cervical mucus 173. The most commonly encountered cancer of the breast (ANS: D page 383)
A. lobular carcinoma in situ B. lobular infiltrating carcinoma C. ductal carcinoma in situ D. ductal infiltrating carcinoma 174. Fibrocystic breast change is characterized by (ANS: B page 364)
A. cyclic enlargement of the lymph nodes B. diffuse bilateral findings
C. blunted response to cyclic ovarian hormones D. uniform histologic changes
175. A 52-year-old woman has persistent, unilateral, spontaneous bloody nipple discharge and a cluster of microcalcifications identified by xeroradiography to be 3 cm deep under the nipple of the left breast. The next step in her management should be (ANS: B page 429-430)
A. needle aspiration under ultrasound guidance B. repeat mammography in 3 months
C. submission of the bloody discharge for cytologic examination D. open biopsy of the left breast on an out patient basis 176. The greatest lifetime risk of breast cancer is associated with a(an) (ANS: C page 430)
A. early menarche B. late menopause
C. history of oral contraceptive use longer than 10 years D. history of postmenopausal estrogen use longer than 10 years 177. Anitiphospholipid antibodies have been found in the circulation of women with (ANS: A page 425-426)
A. recurrent abortions
B. systemic lupus erythematosus only C. a history of thrombocytopenia D. a false negative result for syphilis 178. The most consistent symptom of ectopic pregnancy is (ANS: D page 456)
A. amoenorrhea B. vaginal bleeding
C. subjective symptoms of pregnancy D. abdominal pain
179. A morbidly obese woman undergoes preoperative evaluation for adenocarcinoma of the endometrium. Because of the high risk associated with an abdominal procedure, vaginal surgery is being considered. What tumor marker may be of help in her condition? (ANS D page 934-935)
A. human chorionic gonadotropin (hCG) B. carcinoembryonic antigen (CEA) C. alpha-fetoprotein
D. CA-125
180. The cell origin of the most common type of ovarian neoplasm is (ANS B page 958) A. germ cells
B. epithelial cells C. stromal cells D. lipoid cells
181. The most common cause of direct maternal deaths in the Philippines: (ANS: A p.4) A. Hemorrhage
B. Hypertension C. Infection D. Heart disease
182. Most perinatal deaths are due to the following maternal factors: (ANS: A p.8) A. Premature labor
B. Anoxia from maternal hemorrhage C. Postmaturity
D. Cephalopelvic disproportion
183. The placental circulation (feto-maternal) is established by this day after fertilization (ANS: D p.57) A. 12th day
B. 14-15th day
C. 10th day
D. 17th day
184. The greatest concentration of hCG in human plasma/urine is found in this age of gestation: (ANS: A p.63) A. 8-10 weeks
B. 12-20 weeks C. 5-6 weeks D. 20-36 weeks
185. This maneuver of Leopold is often called the umbilical grip and answers the question, “What side is the fetal back?” (ANS: B p.122) A. first maneuver
B. second maneuver C. third maneuver D. fourth maneuver
186. “Triple screen” as a diagnostic tool for the detection fof Down’s syndrome utilizes the following except: (ANS: D p.153) A. unconjugated estriol
B. alphafetoprotein
C. human chorionic gonadotrophin D. human placental lactogen
187. The earliest access to the prenatal diagnosis of heritable conditions is provided for by this technique: (ANS: B p.154) A. amniocentesis
B. chorion villus sampling C. cordocentesis D. MRI
188. Relation of the long axis of the fetus to the long axis of the mother; (ANS: C p.183) A. attitude
B. presentation C. lie D. position
189. A 28 y/o at 32 weeks age of gestation consults at a clinic. She had one set of twins both are alive and she had an abortion. Her OB code is: A. G3P2(2102)
B. G3P1(1012) C. G3P2 (2012) D. G2P1(1012) 190. The most common cause of arrest disorders in labor is:
A. CPD
B. Hypotonic uterine dysfunction C. Malposition
D. Excessive sedation/anesthesia
191. What is the maneuver were the index and middle fingers are applied over the maxilla in order to free the head? A. Bracht
B. Zavanelli C. Pinard D. Mauriceau
192. The following anti-TB drugs can be given in pregnancy except: A. rifampicim
B. pyrazinamide C. ethambutol D. isoniazid
193. The most common cause of direct maternal deaths in the Philipppines is: (p. 4) A. Hemorrhage
B. Hypertension C. Infection D. Heart Disease
194. Glucose transfer from the mother to the fetus is through: (p.110) A. Facilitated diffusion B. Simple diffusion C. Carrier system D. Pinocytosis
195. The “fern” formation of dried cervical mucus is due to the effect of: (p.116) A. Progesterone
B. Estrogen
C. Human placental lactogen D. Relaxin
196. “Quickening” refers to: (p.114)
A. Actual movements of the fetus seen sonologically B. Perception of first movement by the mother C. First documentation that the fetus is alive D. Rate of fetal movement
197. When is the earliest time that can hCG be detected in maternal urine after implantation? (p.116) A. 5-7 days
B. 14-16 days C. 8- 9 days D. 18-21 days
198. A woman who has had three consecutive abortions and no other pregnancies is called: (p.119) A. Nullipara
B. Multipara C. Primipara D. Primigravida
199. At what age of gestation should screening for glucose be done in a pregnant woman: (P. 125) A. 18-20 wks
B. 24-28 wks C. 30-32 wks D. 34-36 wks
200. The Biophysical Profile represents all of the following EXCEPT: (p.162) A. Accurate prediction of fetal well-being B. Indirect measurement of fetal oxygenation C. Fetal behavioral activities including fetal tone D. Status of fetal cardiac function
201. The fetus is described as complete breech presentation as: (p 185) A. Legs and thighs are flexed B. Legs and thighs are extended C. Legs are flexed, thighs are extended D. Legs are extended, thighs are flexed 202. Cervical softening and ripening is brought about by: (p. 196)
A. Collagen breakdown and rearrangement B. Decreased hyaluronic acid
C. Increased dermaton sulfate D. Increased collagen synthesis
203. The following characterize uterine changes during phase 2 of parturition: (p. 199)
A. The uterus is divided into an actively contracting upper part and a relatively passive lower segment B. The whole muscle contract simultaneously and with equal intensity thus increasing the expulsive force on the fetus C. After each contraction, the myometrium of the upper and lower segment becomes fixed at a shorter length and this is known
as retraction
D. After delivery, the uterus diminish in size and the placenta buckles because of limited elasticity
204. The most ominous sign of fetal compromise: (p. 237) A. Early deceleration B. Late deceleration C. Variable deceleration D. Alternating deceleration
205. Failure to maintain temperature regulation in the newborn may lead to one or all of the following: (p. 246) A. Peripheral vasoconstriction
C. Acidosis D. All of the above 206. Puerperium lasts for how many weeks: (p. 251)
A. 4 wks B. 5 wks C. 6 wks D. 7 wks
207. What is the average maternal weight loss immediately after delivery? (p. 254) A. 4 kg
B. 5 kg
C. 6 kg D. 7 kg
208. The lochia consisting of cervical mucus and debris from healing tissues and leucocytes, lighter yellow and creamy in color: (p. 254) A. Rubra
B. Alba
C. Cervicosa D. Serosa 209. The advantage/s of home delivery is/are: (p. 259)
A. Emotional support from family B. Less expensive
C. Less tendency for nosocomial infections D. All of the above
210. This refers to 3 or more consecutive spontaneous abortions: (p. 274) A. missed abortion
B. serial abortion C. habitual abortion D. consecutive abortion
211. The implantation of a fertilized ovum outside the endometrium lining the uterine cavity is called: (p. 279) A. Eccyesis
B. Ectropion C. Endosalpingosis D. Blighted ovum 212. Most ectopic pregnancies are found in the: (p. 279)
A. Cervix
B. Tube
C. Ovary D. Omentum
213. The triad of symptoms of ectopic pregnancy are: (p. 282)
A. Amenorrhea, syncope and vaginal bleeding B. Abdominal pain, vomiting and vaginal bleeding C. Syncope, abdominal rigidity and amenorrhea D. Amenorrhea, abdominal pain and vaginal bleeding 214. The mechanism of preterm labor in chorioamnionitis is: (p. 294)
A. Stretching of the uterine wall due to inflammation B. Increased prostaglandin synthesis C. Increased neutrophilic infiltrates in the cervix D. Irritation of the fetal membranes 215. HELLP Syndrome is the pnemonic for: (p. 332)
A. Hypertension, elevated liver enzymes, low protein B. Hemolysis, elevated liver enzymes, low platelet count C. Hemoglobinuria, elevated liver proteins
D. Hyeprtensive encephalopathy, low liver perfusion
216. The anticonvulsant of choice control of convulsion secondary to pregnancy-induced hypertension is: (p. 339) A. Methyldopa
B. Hydralazine C. Magnesium sulfate D. Diazepam
217. Toxicity of magnesium sulfate therapy may be monitored using: (p. 339) A. Urine output
B. Deep tendon reflexes C. Respiratory rate D. All of the above
218. The most common cause of maternal morbidity in hypertensive disease of pregnancy is: (p. 342) A. Cerebrovascular accidents
B. Myocardial infarction C. Pulmonary edema D. Postpartum hemorrhage
219. In case of discordant twins resulting from “twin to twin transfusion”, the smaller twin usually presents with: (p. 348) A. Severe anemia
B. Growth retardation C. Oligohydramnios D. All of the above
220. The fetal mortality rate in multifetal pregnancy is highest in: (p. 348) A. Monozygotic, dichorionic, diamniotic B. Monozygotic, monochorionic, diamnionic C. Monozygotic, monochorionic, monoamnionic D. Dizygotic, dichorionic, diamnionic
221. A pregnancy is considered portterm if it lasts longer than: (p. 363) A. 280 days
B. 284 days C. 290 days D. 294 days
222. The most common cause of respiratory distress syndrome (RDS) in the preterm neonate is: (p. 395) A. Hyaline Membrane Disease
B. Bronchopulmonary Dysplasia C. Meconium Aspiration D. Pneumothorax
223. What antenatal procedure is used to detect fetal lung maturity? (p. 395-396) A. Cordocentesis
B. Amniocentesis C. Chorionic villus sampling D. X-ray of the fetal lungs
224. In breech presentation, engagement is considered to have occurred when this has passed the pelvic inlet: (p. 434) A. Biparietal diameter
B. Bitrochanteric diameter C. Knees
D. Navel
225. Which is considered an indication for internal podalic version: (p. 445) A. Oblique lie in case of fetal demise B. Delivery of second of twins
C. Fetal distress in cephalic presentation with fully dilated cervix D. Prolapsed cord with 8 cm dilated cervix, live, cephalic
226. A carefully monitored trial of labor may be undertaken in normal term pregnancies with average infants following a previous Cesarean section performed for the following indications, EXCEPT: (p. 458-459)
A. Abruption placenta B. Placenta previa centralis C. Contracted pelvis
D. Fetal distress due to prolapsed cord
227. Cesarean hysterectomy may be indicated as a lifesaving measure in cases of postpartum hemorrhage due to: (p.462) A. Retained placenta fragments
B. Abruption placenta C. Cervical lacerations D. Uterine atony
228. Postpartum hemorrhage is blood loss during the first 24 hours after delivery in excess of : (p.465) A. 100 cc
B. 300 cc C. 500 cc D. 1,000 cc
229. The following are viral infections known to be related to congenital infection syndromes, EXCEPT: (p. 524-525, 533) A. Herpes virus
B. Cytomegalovirus C. Toxoplasmosis D. Rubella
230. What is the daily minimum requirement for elemental iron in pregnancy? (p. 561) A. 4-6 mg
B. 6-8 mg C. 8-10 mg D. 10-12 mg
231. The principal cause of thrombocytopenia in pregnancy is: (p. 564) A. Idiopathic
B. Premature rupture of bag of waters C. Drug-induced from intake of prenatal vitamins D. Pre-eclampsia, eclampsia
232. A primigravid patient at 28 weeks AOG came in due to hypogastric and lumbosacral pain. On physical examination uterine contraction was noted occurring every 5 to 10 minutes. I.E.: cervix is noted to be 1 cm dilated, 50% effaced, intact bag of water. Which of the following is a β-adrenergic receptor stimulant that can be used to inhibit preterm labor in this patient?
A. Isoxsuprine HCL B. Magnesium Sulfate C. Indomethacin D. Nifedipine
ANS: A (APMC page 421) 233. This is the most critical issue in the management of postterm pregnancies? (page 431)
A. Number of pregnancies B. Confirmation of gestational age C. Maternal age
D. Estimated fetal weight
ANS: B (APMC page 431)
234. In all growth-restricted fetuses, which of the following biometric parameters will be the first to show discrepancy in measurement? (page 438) A. Head circumference
B. Femur length
C. Abdominal circumference D. Biparietal diameter
ANS: C (APMC page 438)
235. In a patient with monozygotic twinning, if cell division occurs about 8 days after fertilization, what type of twinning will develop? A. Monoamnionic, monochorionic twin pregnancy
B. Dichorionic, diamnionic twin pregnancy C. Diamnionic, monochorionic twin pregnancy D. Conjoined twin pregnancy
ANS: A (APMC page 411)
236. A patient at 38 weeks AOG came in labor. I.E. cervix is 5 cm dilated, 50% effaced, intact BOW, cephalic, station -3. Clinical pelvimetry shows the ischial spine is bilaterally prominent, pelvic sidewalls are convergent and concavity of the sacrum is shallow. With these findings, you suspect the presence of:
A. Pelvic inlet contraction B. Midpelvic contraction C. Pelvic outlet contraction D. Pelvis is adequate
ANS: B (APMC page 204)
237. When the fetal head is fully flexed, the chin lies in front of the chest and the presenting anteroposterior diameter is suboccipitobregmamtic. What type of presentation is this?
A. Vertex (occiput) presentation B. Sinciput Presentation C. Brow presentation D. Face presentation
ANS: A (APMC page 211) 238. Which Leopold’s maneuver will identify the location of the cephalic prominence?
A. Leopold’s maneuver 1 B. Leopold’s maneuver 2 C. Leopold’s maneuver 3 D. Leopold’s maneuver 4
ANS : D (APMC page 216) 239. The cardinal movements of labor were as follows:
A. Engagement, descent, flexion, internal rotation, extension, external rotation, expulsion B. Descent, engagement, flexion, internal rotation, extension, external rotation, expulsion C. Engagement, descent, extension, external rotation, flexion, internal rotation, expulsion D. Descent, engagement, extension, external rotation, flexion, internal rotation, expulsion
ANS : A (APMC page 242)
240. A multigravid patient at 39 weeks AOG came in due to hypogastric and lumbosacral pain. Which of the following additional statements will characterize that the patient is in true labor?
A. The cervix is dilated and effaced B. Contraction is stop by sedation
C. The interval in between contraction is longer D. The intensity of uterine contraction is unchanged
ANS: A (APMC page 248)
241. This type of deceleration is characterized by symmetrical fall in FHR beginning at or after the peak of a uterine contraction and returning to baseline only after contraction has ended.
A. Early deceleration
B.
Variable deceleration C. Late deceleration D. Sinusoidal patternANS: C (APMC page 268 242. This is considered as the most crucial event for the further development of an antral follicle
A. activation of the aromatase system by FSH B. activation of the aromatase system by LH C. luteinization of the granulosa cell D. luteolysis
ANS: A (APMC page 28) 243. Rubin’s pathologic criteria for cervical pregnancy include the following, EXCEPT:
A. there must be cervical glands opposite the placental attachment B. he attachment of the placenta to the cervix must be intimate C. fetal elements must be present in the corpus uteri
D. the whole portion of the placenta must be situated below the entrance of the uterine vessels ANS: B (APMC page 333)
244. A 28-year old primigravida comes to your clinic on her 30th week of gestation complaining of chest pain. Which of the following findings will strengthen
the diagnosis of heart disease in pregnancy?
A. an increase in the area of cardiac dullness
B. The left cardiac wall is displaced to the left by about ½ inch C. Cardiomegaly
D. ECG findings of slight axis deviation, occasional T waves and lowering of the waves ANS: C (APMC page 107) 245. The increase in plasma volume during pregnancy by about 50 to 65% reaches its peak during the:
A. 1st trimester
B. Midtrimester C. 3rd trimester
D. During labor
ANS: B (APMC page 107)
246. Nayda, an 18-year old primigravida comes to the clinic on her 12th week of gestation for her 1st check-up. She is curious as to when she can start to
perceive fetal movements. You will reassure her that this will occur : A. anytime now
B. between the 16th and 18th week
C. between the 18th and 20th week
D. between the 20th and 24th week
ANS: C (APMC page 127) 247. Which of the following immunizations is recommended for routine use during pregnancy?
A. Rubella B. Tetanus toxoid C. C. Varicella-zoster D. D. Hepatitis A
ANS : B (APMC page 197) 248. In vertex presentation, the posterior fontanel is lowermost and the presenting head diameter is the:
A. Occipitofrontal B. Biparietal
C. Suboccipitobregmatic D. submentobregmatic
ANS: C (APMC page 211)
249. This movement of the head refers to turning of the occiput from its original transverse oblique position towards the symphysis pubis or less commonly towards the hollow of the sacrum:
A. internal rotation B. extension C. external rotation D. flexion
ANS: A (APMC page 244) 250. Overt diabetes during pregnancy is diagnosed by:
A. random plasma glucose level > 126 mg/dl B. polydipsia, polyuria or unexplained weight gain C. fasting glucose of 105-125 mg/dl
D. fasting plasma glucose of 126 mg/dl or higher
ANS: D (APMC page 591) 251. Among mothers with thyrotoxicosis. Their neonates are usually
A. euthyroid
B. With goitrous thyrotoxicosis C. with nonimmune hydrops D. with hypothyroidism
ANS: A (APMC page 596) 252. Subclinical hypothyroidism is diagnosed when there is:
A. low serum thyrotropin level and low thyroxine level B. high serum thyrotropin level and normal thyroxine C. high serum thyrotropin level and high thyroxine level D. low serum thyroxine level and normal thyroxine level
ANS: B (APMC page 596)
253. A 38 year old G4P3 at 18 weeks age of gestation has BP of 150/100 mmHg with no other signs and symptoms. Her prepregnancy BP was 130-140 / 80-90 mmHg controlled by intake of a calcium channel blocker. Urinalysis is negative for proteinuria. The most probable diagnosis of this patient:
A. gestational hypertension B. pre-eclampsia C. chronic hypertension
D. chronic hypetension w/ supper imposed pre eclampsia
ANS: C (APMC page 393)
254. A 28 year old G1P0 at 35 weeks AOG consulted in the ER with chief complaint of severe abdominal pain. Accompanied by moderate vaginal bleeding. Her BP is 180/120 mmHg, PR-88/min, RR: 22/min. On palpation of the abdomen the uterus was tetanically contracted and the FHT was faint. The most probable diagnosis is:
A. placenta previa B. abruptio placenta C. acute abdomen D. uterine rupture
ANS: B (APMC page 374 & 376) 255. Pneumococcal vaccine recommended for
A. all pregnant patients B. immunocompromised patients C. pregnant patients with influenza pneumonia D. hypertensive pregnant patients
256. A G3P2 PU at 12 weeks is complaining of cough, weight loss and hemoptysis. The most important screening test at this time is A. chest X-ray with abdominal shield
B. tuberculin test C. sputum AFB smear D. sputum culture for TB
ANS: B (APMC page 586) 257. Among the anti-TB regimen, the drug which is contraindicated during pregnancy is
A. INH
B. Rifampicin C. Ethambutal D. Streptomycin
ANS: D (APMC page 586)
258. A 30 year old G3P2 at 24 weeks AOG complained of urinary frequency, dysuria, urgency, fever, chills and costovertebral angle tenderness. Urinalysis showed pyuria and bacteriuria. The most probable diagnosis is
A. asymptomatic bacteriuria B. cystitis
C. urethritis
D. acute pyelonephritis
ANS: D (APMC page 640-641) 259. This type of forceps has a double pelvic curve to facilitate application to the after coming head in breech presentation
A. Simpson forceps B. Barton forceps C. Piper forceps D. Kielland
ANS : C (APMC page 529) 260. The following are contraindications for vacuum extraction EXCEPT
A. fetal postmaturity B. prior fetal scalp trauma C. active bleeding D. nonvertex presentation
ANS: A (APMC page 533) 261. This is known as the low longitudinal incision of the uterus, used to delivery babies abdominally
A. Classical cesarean section B. Kerr incision
C. Kronig incision D. a and c
ANS: C (APMC page 541)
262. A 25 y/o G2P2, three weeks postpartum came in because of profuse vaginal bleeding. She was afebrile with a BP of 100/70 mmHg and pulse rate of 105/min. What is the most likely diagnosis?
A. subinvolution B. wound infection
C. post-partum ovarian vein thrombosis D. necrotizing faciitis
ANS: A (APMC page 560) 263. What is the first histologic indication of the effect of progesterone on the endometrium?
A. presence of mitotic figures B. glandular proliferation C. subnuclear vacuolization D. stromal edema
ANS: C (APMC page 44) 264. At this gestational age, gross examination of the external genitalia identifies the sex of the fetus:
A. 8 weeks B. 11 weeks C. 12 weeks D. 16 weeks
ANS: D (APMC page 81) 265. The most specific test for HIV is
A. Enzyme-linked Immunosorbent Assay B. Polymerase Chain Reaction C. Western Blot Technique D. Viral Culture
ANS: B (compre page 686)
266. A 26 y/o patient was seen in the OPD complaining of a vaginal discharge. The vaginal pH was 4.5. What is the most likely cause of the vaginitis A. Bacterial Vaginosis
B. Trichomoniasis C. Atrophic Vaginal Discharge D. Moniliasis
ANS: D (compre page 669) 267. Infections with this virus is strongly linked to CIN :
A. HSV II
B. CMV
C. HPV
D. HIV
ANS: C (compre page 868) 268. The least of the nodal involvement for distant metastasis of cervical cancer is via the:
A. Paracervical nodes B. Hypogastric nodes C. External iliac nodes D. Presacral nodes
ANS: D (compre page 898)
269. A 45 year old G2P2 female came in due to postcoital bleeding. Pelvic exam revealed a nodular cervix which bleeds to touch, sidewalls are free of lesion. What is the stage of the disease?
A. Carcinoma-in-situ B. Stage IB C. Stage IIA D. Stage IIB
ANS: B (compre page 899)
270. Operative treatment for cervical cancer that guarantees the removal of the entire cervix and uterus with the ureters undisturbed. A. Class I
B. Class II C. Class IV D. Class V
ANS; A (compre page 902)
271. A 54 year old G5P5 woman came in due to metrorrhagia. She’s of heavy build, and a smoker of the following risk factors, what would have the least risk for developing endometrial carcinoma?
A. Smoking B. Obesity C. Multiparity D. late menopause
