Obstetrics

PA

TH

OLOGIC OBSTE

TR

ICS

BOARD

REV

IEW

QUESTIONS

From FEU

QUE

STIONS:

1. G2P1 PU 32 week s consulted beca use of va gin al bleeding .No uterine contractions noted. FHT -140/ minute.The initial proce dure that you will perf orm is Dx : Placenta Previa

a.g

entle

spec

ulu

m

examinati

on

b.internal exa mination c.t ransvag inal ultrasound d.tr an sabdomin al ultrasoun d

2.36 y /o,G 3P 2 PU 35 week s complain ed of vagi nal bleeding a nd abdominal pain.BP -150/ 100 mmhg.Uterine cont rac ti ons we re not ed every 1 -2 minutes 6 0 secs in duration.H er last ultrasoun d 2 weeks ag o was norma l.IE -cervix closed uneffaced .What is the d iagnosis? a.pr eterm labor b.vasa previa c.p lacenta pr evia (painless )

d.abrupt

io

pla

ce

nta

(painful)

3.36 y /o G4p3 PU 33 weeks , Previou s CS 2x has anterior pl acenta previa.What condition will you h av e to rule ou t in

this patient prior

to a repeat cesarean sect ion? a.va sa previa b.uterine dehiscenc e

c.placen

ta

accre

ta

d.adhesions

4.G1P1 postpartum 2 hrs was brou gh t by the midw ife because of profus e bleeding .She deliv ere d at home to a n 8 lbs . bab y.Placenta was spontaneou sly expelled after 10 mi nute s. On ex amin ation ,uterus is c ont ract ed and pal pat ed be low the navel .What is the diagn osis ? a.uterine atony b.retaine d placenta

c.lac

eratio

ns

d. uterine inv ersion

5.32y /o G3P 2 PU 30 week s complain s of moder ate va gin al bleeding .Ult rasound done revealed a pl acen ta total ly coverin g t he os.What is

the management for

th is patient? a.Be d rest an d g ive tocolytic b.Bed rest ,toc olytic,prog est er one

c.Bed

res

t ,

tocoly

tic,s

teroid

s

d. Steroids,t ocoly tic an d del ive r after 4 8 hrs.

6.36y/o G3P 2 PU 36 w ee ks compl aine d of vag inal bl ee ding a nd abdo mi nal pai n.BP -120 /80 mm hg but she is a known hyperten si ve fo r 2 years. Uteru s is woo dy wi th no FHT heard by dopple r.cervix is 3 cms dil ate d 1cm l on g , BOW inta ct,c eph al ic statio n -1,with mini mal ble edin g.What is t he BEST ma nage me nt ? a.e xpectant

b.amn

iotom

y

c.induce with oxy tocin d.im me dia te CS Dx : Abruptio

7. Wha t is the MOST dreaded complication of abruptio placenta? a.Hypo vol em ia b.Septic imia c.Em bolism

d.DIC

8.A 34 y/o G3P2 pos tpartum 1 hr was brou gh t by a mid wif e because of v ag inal bleeding a nd abdominal pain. On exa mination,a fles hy mas s was seen protr uding out of the introitus ,the fundus of th e uterus cann ot be palpated abdominally .What is cause of this condition? a.age and parity

b.strong

traction of

the

cord

c.s ize of the bab y d. leng th of labor

9.A G1P 1 complain s of v ag ina l bleedin g 2 hou rs

after she deliv

ered a 3.8k g bab y via NSD .Ut erus is sof t a nd bogg y palpated abov e the nav el.What is the initial manag ement for this patient?

a.bi

ma

nual

uterine

com

pression

b.ice pack c.ut erine artery lig ation d.hysterectomy

10 .36 y/o G3P2 PU 37 week s previou s CS 2x ha s an ultrasound findings of anterior placenta previa wit h absence of sonoluscent sp ace between the placenta and decid ua.How should this patient be man ag ed ? dx: Accreta a.CS wit h manua l remova l of the placenta b.CS ,leave the p lacenta in situ, methotrexate c.CS, removal of placenta ,hyster ectom y

d.CS

with hystere

ctomy

with

pla

ce

nta

in situ

11 .A G3P3 pos tpartum 6 months ago was selivered by NSD and complic ated by atony .She was tran sf used wit h 4 u PR BC .She has amenorrhea,failure to la ctate and loss of pubic ha irs. Wh at is the diagnosis ? a.asherm ans (adhesions )

b.s

hee

hans

c.Simmonds (non obstetric cause of pituitary failure) d. PC OS

12 . 3 6 y/0 G4P 4 patient ha d a CS due to ab ruptio placenta.The uterus was noted to be bluish wit h

hematoma on the anterior

and pos terior wall and well contracted .What is the management? a.expecta nt

b.ute

ri

ne

arte

ry

li

ga

tion

c.compression

suture

d.hysterectomy

All

are

po

ssible

answers

13 .G3P2 P U 38 week s Prev ious CS 2x was n oted to h av e p lacenta inv ading th e myometrium and bladder seros a.What lay er is def ective in this case ? Dx : accreta a.decidua ve ra

b.nitabuch

s

c.m yometrium d.peritoneum

14 . G1P 0 PU 32 week s ha s pla centa partially covering the os. Wha t is the BEST manag ement for this patient? a.w ait for spontaneou s labor b.Give steroids an d do CS after 48 hrs c.re peat the ultrasound at 35 weeks d. sched ule for C S at 38 week s If 36 -37 week s, do C S

15 .A patient who deliv ered by CS due to ab ruptio placenta was noted to hav e bleeding per va gin a and at t he incision sites .Platelet count -90,000,Prolong ed prothrombin time an d partial thrombopla stin time.Wha t is the BE ST component therapy for h er ? Dx : DIC a.w hole blood b.PR BC

c.f

res

h

frozen

pla

sma

d. platelet concentrate (<50,000)

QUE

STIONS:

1.Wh ich of th e following will put the patient at the hig hest risk for the development of P reter m La bor ? a.multip arity b.smoking

c.prior

preterm

birth

d. infection

2.G3P2 (0 -2 -0 -0) PU 32 week s ha s watery va gin al dis charge.Nitr azin e paper test – pos itive(yellow to blue).What is the manag ement ? d x: PP ROM a.toc olytic b.steroid an dtocolytic

c.e

xp

ec

tant,steroid

and am

picillin

d. st eroid,tocolytic .a mpicill in

3.Wh ich of th e following finding s is indicativ e of preter m labor ? a.uterine contractions wit h closed cervix

b.cervical

length of 20mm

c.f ibronectin -20 ng /ml d. hy pogastric pain Cu t of f is < 2.5 cm

4.30 y /o G4P3 PU 30 week s was seen.Preg na ncy tes t was positive at 4 w eeks AOG. Fun dic heig ht -24 cms FHT -140/ min.What is the asses sment o f this pregnan cy ? a.normal pregn an cy b.inaaccurate ag ing

c.in

trauterine

grow

th res

trictio

n

d. larg e for date pregna ncy

5.A 35 y/o G3P2 PU 41 week s ha s a n ultrasoun d findings of B PS -6/8 w ith AF I 4 cms .Cervix is closed and 1.5 cms long cephalic st ation 0.What is the best ma nag ement ? a.hy drate patient

b.CST

and induce

if ne

ga

tiv

e

c.c lose fet al su rvei llanc e d.ces area n delivery

6.Wh at is th e most common risk factor for the development of fet al macros omia ? a.obesit y

b.di

abet

es

c.m ultiparity d. nutrition

7.A G4P 3 PU 32 weeks ha s a fundic height of 24 cms .Biometr y revealed a BP D /f emur leng th compat ible wit h 30 week s and an abdominal circumf erence compat ible wit h 24 w eeks AOG .Which of th e following is the cause of th is condition? a.genetic (early in sult) b.chemic al exposur e

c.h

yp

erten

sion

(uteroplacental

insu

ff

icienc

y)

d. viral infection

8.A G1P 0 PU 38 weeks ha s a fundic height of 39 cms .Est imated fet al weight by ultr asound is 42 50 grams.H er 75 gms OG TT rev ealed FB S -105 mg/dl and 2 nd hr -160 mg/ dl.What is the man ag ement? a.w ait for spontaneou s labor b.induce labor wit h pros taglan din c.Wait for 39 week s and induce wit h oxy tocin

d.elec

tiv

e

CS a

t

39

weeks

(mature

lun

gs

firs

t)

9.G2P1 PU 34 weeks ,ceph alic ha s a fundi c heig ht of 26 cms .D oppl er velocimetry is requested every week to monitor the fet us. Which of the f ollowing findings will indicate severe fet al compr omise? a.increase resist ance index b.dias tolic notching c.abs ent end diast olic flow

d.rev

ersed

end

di

asto

lic

flow (severe)

Dx

: IUGR

10 .G1P0 P U 42 week s ha s a n AF I-2cms. cervix closed ,uneffaced but sof t.Which of the follow ing is the best to induce labor in this patient?? a.membrane sw eeping b.oxy tocin

c.prostagla

ndin

d. prim rose oil

QUE

STIONS:

1.G1P0 PU 38 weeks in lab or was admitted .Ut erine contractons occurred every 2 minutes 60 secs duration.Cervix 2 cm s dilated 1 cm long .Aft er 24 hours,c ervix is st ill 3 cms dilated 0.5 cms long .Wha t is th e best manag ement ? (dx: hy pertonic uterine dysfunct ion) a.oxy tocin

b.s

edat

ion

c.amniotom y d. cesarean sect ion

2.G1P0 39 week s AOG admitted at 5 cms cervica l dilatation 0.5 cms long cephalic st ation -1.Uter ine contractions -200 montevideo units. Amniotomy done rev ealed clear AF .cer vix dilated to 6 cms after a n hou r,cephalic station -1.H owever after 3 hours cervix remained at 6 cms .,cephali c st ation -1.What is the diagn osis ? a.pr olong ed active phase b.protracted activ e phase

c.arre

st

in cer

vical

dilat

atio

n

d. failure des cent

3.Fa ilure in descent can be diag nosed if there is no des cent during which phase of labor ? a.latent

b.acceleratio

n

c.act ive d. deceleration

4.Precipita te deliv ery can be diag nosed in a nulliparous patient if cervical dilatation is more than___ cms /hr (10 cm in multipara) a.2 b.3 c.4

d.5

5.Cli nical pelvi metry finding s of a nu lliparou s patient revea led a pr ominent ischial sp ines, converg ent sid ewalls ,narr ow sac ros ciat ic notch.Which pelvic plane is contracted ? a.inlet

b.mid

pla

ne

c.out let

6.Wh at plan e of th e pelvi s is tested by theMu eller H illis Maneuv er ?

a.inlet

b.mid plane c.out let

7.G1P0 38 week s AOG ha s thi s leopolds finding s: L1 -breech L2 -back on the right,s mall parts o n the left ,L3 -ceph alic L4 –cep halic pr om inenc e on the right.O n IE the mentum was direc ted at the sacrum.Wha t is the mann er of deliv ery? a.NSD b.f orcep s c.vacuu m

d.ces

arean

8.A multipa ra in lab or ha s thi s IE finding s. Th e fro ntal sutures ,anterior fo ntanel ,o rbit al ridges and root of the nose a re pal pat ed .What is the pres entation? a.sincipital

b.brow

c.f ace d.vertex

9.A multipa ra was a dmitted in activ e lab or.IE revealed a gridiron feel with back down pos ition.What is the best ma nag ement? a.external ceph alic version b.interna lpodalic ve rsion c.l ow segment cesarean

d.class

ical

ce

sarean

10 .Wha t f orceps is used to rotate a persis tent occip ut transverse to a nterior pos ition? a.s imps ons

b.ki

elland

s

c.p ipers d. bartons

11 .In shoulder dystocia ,the procedure of hy perf lexin g the legs toward s the abdomen is called a.pinards b.rubin s

c.mc

roberts

d. zav anelli

12 .Ex ternal cepha lic ve rsion to convert a breech pres entation to cephalic is recomm ended at what week s age of g est ation? a.33 b.35

c.3

7

d. 39

13 .In partial breech ex traction,the procedure of lateral def lection of the thigh, pr es si ng on the poplit eal to f lex the legs and deliver the foot is called a.lov eset b.hibbard

c.pinard

(popliteal

fos

sa pres

sur

e)

d.zav an elli

14 .Which of th e following structures is NOT derived fro m the mullerian duct? a.uterus

b.hym

en

(lower

third urogenital)

c.up per third of the va gin a d. cervix

15 .A G1P0 PU 12 week s ha s a 15 cms asymptomatic ,ovarian cyst on the left adnexa .What is the manag ement? a.expectant b.immediate ex ploration

c.e

xp

lore

at 16

-20

weeks

d. explore after delivery

16 .Which of th e following is NOT used to deliv er an entrapped head in breech pres entation?

a.rubins

mane

uve

r

(s

hou

lder

dy

stocia

)

b.mauriceau smellie veit maneuv er c.s uprapubic pres sure d. durshs en inc is ion

17 .If th ere is no un ion of th e mulleria n duct ,the abn ormality pr oduced is a.unicornuate uterus b.bicornuate

c.u

terus

didelphys

d. sep tate uterus

18 .A 17 y ear old consulted beca use of primary amenorrhea and cyclic pelvic pain.On exa mination,bulgin g mass w as noted at the introitus wit h no va gin al opening .What is the diag nosis? a.endometr ial polyp b.pr olapsed myom a

c.imp

erforat

e

hym

en

d. va gin al sep tum

19 .19y /o G 1P 0 PU 34 weeks ha s pain ful myoma uteri for 1 week .What is the d egen eration of the myoma ? a.hyalin e (mos t common)

b.carn

eous

c.c ystic d. sarcom atous

20 .G3P2 P U 36 week s came in full y di la ted frank br eech pres entation ,s tation + 3.The attending physician waited for the sp ontaneous expulsion of the breech up to the nav el and assis t the deliv ery with man euv ers from na ve l up to the head.What is the des cr ibed typ e of extr act ion? a.Spontaneous breech delivery b.tot al breech extraction c.com plete breech extract ion

d.pa

rtia

l

bre

ec

h

extrac

tion

QUE

STIONS:

1.A G1P 1 PU 13 weeks ha s an ultrasoun d result twin pregnan cy wit h single chorion and 2 amnion.When does the division of the monozy gotic twin occurred ? a.0 -4 day s

b.4

-8 day

s

c.8 -12 days d.>13 day s

2.Wh ich of th e following must N OT be done in a monoamnionic monochorionic twins ? a.D aily CT G at s tarting at viability b.s teroids at 26 -28 week s

c.De

liver

at 3

8

weeks

(34

weeks)

d. term inate by CS

3.Wh ich of th e following chara cterizes the recip ient in twin to t win transf usion// a.anemic

b.hyp

erbiliri

bunemia

c.IUGR d. oligoh ydramnios

4.Wh ich of th e following presentations in multif etal pregnan cy can be delivered va gin ally in multiparous patient? a.tw in breech -cephalic

b.twin

-ce

phalic

breec

h

c.t win -cep halic -tr ansverse d. tripl ets all cephalic

5.21y /o G1P 0 PU 32 week s cephali c,compla ini ng of hea dache.BP -160 /100 mmhg.Urine protein +++ .What is the diagn osis ? a.gestational hy pertens ion b.chronic hy pertension c.t ransient hypert ension

d.severe

pre

ec

lam

psia

6.36 y /o G1P0 PU 36 week s was a dmitted because of blu rring of v ision. BP -150 /100 mmhg,urine protein +++ .Lab tests rev ealed low platelets ,incr eased LDH, SGPT and alkaline phosphata se.What is th e complete diag nosis? a.Pre eclamps ia non severe b.Pre eclamps ia,s evere

c.Pre

eclamp

sia,severe

, HELLP

syndrome

d. Pre eclamps ia ,severe,D IC

7.Wh ich of th e following is th e most effective in the prevention of pre eclamps ia ?

a.low

do

se

aspirin

b.high dos e calcium c.f ish oil d. antiox idants

8.G2P 0 PU 35 week s complain ed of epig astric pain .BP -190 /100 mmhg . Lab tes t rev ealed low platelets and increased LDH . Wha t is the def initive manag ement of this patient ? a.control hy pertension with hy dralaz ine b.pr even t convu lsion wit h MG SO4 c.w eekly surveillance tes ting

d.t

ermi

nate

preg

nancy

(definiti

ve

mgt

for preec

lam

psia,

deliv

er)

9.Wh ich forcep is described to ha ve a long er shank an d a d ouble pelvic curve? a.bartons

b.pi

pers

c.s imps ons d. kiellands

10 .In what diameter of th e pelvi s will the forcep fit s during application? a.biparietal b.occip itof rontal

c.oc

cipito

mental

d. suboccip itobregmatic

11 .How man y pop offs during va cuum ex traction before y ou will aba

ndon the procedure?

a.1

b.2

c.3

d.

12 .Which of th e following will qu alify a patient for a vag inal birth after a cesarean sect ion? a.one prev ious Cla ss ical CS b.no previous uterine rupture in last 2y rs c.c an be perf ormed in a lying in wit h physician av ailable

d.The

obstetrician

and

anesthes

io

log

ist

must be av

ai

labl

e

13 .Wha t is the MOST frequen t indicatio n for prim ary CS? a.malpres entation

b.dy

stocia

c.f etal dis tres s d. maternal ill nes s

14 .Which of th e following is a disadva ntag e of pfannesteil inc is ion? a.w eak b.more dehiscenc e

c.diff

icult

re e

ntry

d. faulty healin g

15 .Wha t is the most freque nt indicatio n for C S hy st erectom y?

a.at

ony

b.laceration of uterine vessels c.acc reta d. myoma

QUE

STIONS:

1.36y /o G3P 2 PU 33 week s ha s P PR OM f or 8 hours.She delivered after 24 hours of labor.On the third pos tpart um

day she dev

eloped va gin al bleeding ,f ever and hy pogastric pain.Cervix tender on wrigg ling ,uterus enla rged to 5 mo nths size and tender. Wha t is the diagn osis ? a.cyst itis

b.endom

etrit

is

c.p yelon ephriti s d. thrombophlebitis

2.Wh at is th e most importan t factor for the development of g enital tract in fec tion during puerperium ? a.number of cervical exa mination

b.route

of delivery

c.l eng th of labor d. anemia

3.34y /o G3P 3 post C S for 1 week due to prolong ed labor complained of v ag inal bleeding ,abdominal pain and foul smelling dis charge.What is the BE ST antibiotic manag ement ? a.ampicillin an d g enta mycin b.broad sp ectrum cephalospor in

c.c

lindam

ycin

and gentam

ycin

d.meropenem

4.Wh at is th e microorga nism implicated in To xic Shock syndrome?

a.staphylo

cocc

us

aur

eu

s

b.s trept ococcus pyog enes c.Esc herichia Coli d. Pseudomonas

5.25y /oG1P0 PU 12 week s with RHD is comf ortable at rest b ut com plains of dys pne a while was hing the d ishes or ev en when b rushing her teeth. Wha t is the new York cla ss ificat ion of this patient? a.1 b.II

c.III

d. IV

6.Wh at is th e best mode of Deliv ery for a 21y /o G1P0 wit h RHD mitr al st enosis? a.NSD under sed ation b.ass isted va gin al under pudendal

c.f

orceps

extractio

n

un

der

epid

ural

d. cesarean sect ion

7.A G3P 3 asthmatic patient deliv ered to a live bab y .Which of the follow ing should NOT be giv en pos tpart um? a.antibiotics b.hy drocortisone c.t erbutaline

d.ergonov

ine

(PGF

2a)

8.Wh ich of th e following an ti TB medications is contraindicated during pregnan cy?

a.streptom

ycin

(aminog

lycoside

)

b.rif ampicin c.p yraz inamide d. ethambutol

9.23 y /o G4P1 PU 21 week s ha s a n asymptoma tic UTI .Ur inaly sis show ed plenty of pus cells however Urine culture is neg ative.What is the microor ga nism implic ated? a.E . C oli

b.ch

lam

yd

ia

c.p seudom onas d.bacterial vag inosis

10 .32y /oG2P1 PU 35 week s ha s recurrent UT I and complains of fever, upper back pain,nausea and vomiting.Wha t is the corners tone in the manag ement of this patient ? Dx : acute pyelo neph ritis a.request for creatinine b.emp iric antibiotics

c.h

yd

rat

io

n

wit

h IVF

d. antipyretic

11 .Wha t is / are the lab oratory tests needed to eva luate a patient wit h thyroid disease? a.MRI b.thyroid ultrasound c.TS H ,FT3F T4 d. thyroid scan

12 .23y /o G 1P 0 PU 16 weeks ha s diff use thy roid enlarg ement with exopthalmos. TSH is low while FT 4 is eleva ted. Wha t is the BE ST treatment for this patient? a.propanolo l b.iodine

c.prophylthiuracil

d.thyrox ine

13 .When is the recommended ag e of g estation to scr een for gestational D M based on A merican C ollege of OB –GYN ? a.f irs t trimes ter b.16 -20 week s

c.2

4-28

weeks

d. 30 -34 week s

14 .21 y/o G1P0 has a result of 14 5 gms /dl in the 50 gms OG CT .What is the nex t m ana gement for this patient? a.s tart oral hypoglyce mi cs b.start insulin

c.Do

100

gms

OGTT

d. manag e as norm al pregnan cy

15 .Which of th e following is NOT recommended in patients wit h Overt DM? a.alpha fet o protein at 16 -20 week s b.congenital scan a t 18 -20 w eek s

c.we

ekly

dopp

ler

veloc

imetry

d. regula r ultrasound for g rowt h

16 .Which of th e following va ccines must b e g ive n to a ll pregnan t patient? a.hepatitis A b.H PV

c.in

flu

enza

(type

A)

d. pneumonia

QUE

STIONS:

1.28 y /o G2P1 PU 25 week s deve lop low gra de fever followed development of tender, vesicular lesions along the dermatome at t he subcos tal area . Wh at is the ris k of the fe tus i n de velop ing the disease?

a

. n

one

b. 1 0% c. 20 % d. 30%

2.20y /o G1P 0 PU 12 week s ha s b een ex posed to a relative wit h va ricella infection 2 days a go . She mentioned that s he did not hav e the diseas e during childhood . How wi ll you manage this patient? a.reass urance b.vaccination c.im munoglobulin d. va ccination and immunoglob ulin

3.34y /o G3P 3 deliv ered to a l ive ba by with cataracts ,glaucoma and se ns ori neur al deafnes s. She mentioned that she dev eloped hig h grade fever with pos tauricular lympadenopathy an d g enera lized maculo papula r rashes during the firs t trimes ter of pregnan cy.What is the dis ease that s he had during the firs t trimes ter? a.Rub eola

b.Ru

bella

c.Varicella d. PUP P

4.Wh at will diff erentia te if the patient ha d a recent rubella infection? a.Ig M b.Ig G c. High av idity Ig M d. High av idity Ig G

5.30 y /o G5P3 PU 35 week s ha s u terine contractions .She mentioned that her last bab y died of seps is after delivery.What is the recomm ended antibiotic prop hy lax is ? a.amox icillin b.ampicillin

c.pen

icillin

G

d.clindamy cin

6.30y /o G3P 2 PU 14 weeks ,complains of pain less chancre at t he vu lva .The chancre has red an d firm border. Wha t is the mos t specif ic diagn ost ic tes t for the patient? a.RP R b.TP HA c.dark field ill umination d.EL IZ A

7.32 y /0 G2P1 PU 23 week s complain s of yellowish va gin al dis charge.On gram st ain,gram neg ative intracellular diplococ ci were seen.What is the management? a.Az ithromy cin plus clindamy cin b.cef triaxone plus metr onidazole c.cetriaxone pl us az ithromycin d.cef urox ime plus clindamy cin

8.36y /o G3P 1 PU 39 week s was a dmitted in early labor . On exa mination,t here are multiple painful vesicular lesions noted on the vu lva . What is the manag ement ?? (dx: HSV2) a.insert an interna l monitorin g device b.ask the nurse to p repare the f orcep s

c.prepare

pa

tient

for

ce

sarean

sec

tio

n

d. amnitomy and induce wit h oxy tocin

9.21 y /o G1P0 PU 12 week s complain s of v ulv ar itchiness .On inspec tion,t here are multiple small wart y outgrowths noted on the labia majora and perineum. Wha t is the BE ST manag ement? a.Podo phy lline

b.trichlorace

tic

acid

c.l aser d.imiquimod Dx : HPV 6, 1 1

10 .35 y/o G3P2 PU 34 week s complain s of premat ure uterine contractions .On sp eculum exa m,t here is a mode rat e amount o f gray ish homogenou s fis hy odored dis charge.Grams st ain done revea led a nu ge nt sc ore of 8.What is the manag ement? a.amoxicillin b.clindamycin c.m etronidaz ole d. cef uroxime

11 .31y /o G 2P 1 PU 38 weeks is positiv e for HIV infection wit h a viral load of 20 00 copies /ml.W hat is the BEST manag ement? a.D o amniotomy in early labor b.Deliver by f orceps during the second stage c.M onitor condition of fet us by s calp samp ling

d.Deliver

by

Cesarean

se

ction

12 .32y /o G 2P 1 PU 36 weeks ha s Immu ne thrombocytopenia . Wha t is the fet al complic ation anticipated if

this patient will

undergo va gin al delivery? a.verteb ral fr actur e

b.intracranial

hemorrhage

c.l iver rupture d.s plenic inj ury

13 .32y /o G 1P o PU 20 week s complain s of palpable breast mass .O n exa mination,a 2x 3 cm solid mass w as noted on the right upper qua drant of the breast. Wha t is the BE ST man ag ement? a.mammogram b.f ine needle aspir ation c.breas t ultrasound

d.core

biop

sy

14 .36y /o G 4P 3 PU 10 weeks complain ed of pos tcoit al bleeding . An ulcerat ed lesion was noted on the cervix at 3 o’ clo ck pos ition which bleeds to t ouch . Biopsy revealed squam ous cell carcinoma . Th e uterus is n ot enla rged ,movab le , both parametria are fre e and pliable . What is the manag ement ? a.chemotherapy and wait for via bility b.cone biopsy an d wa it for deliv ery c.c hemotherapy and radiotherapy after delivery d.radica l hysterectomy with bilateral lym ph nod e di ssect ion

15 .Which of th e following will NOT determine the manag ement of ova rian CA during pregnan cy?

a.ag

e

of pat

ient

b.s tage of disease c.gest ational ag e d. grade of the tumor