OBSTETRICS & GYNECOLOGY OBSTETRICS & GYNECOLOGY 1.
1. WhWhich ich of tof the fhe follollowowining is tg is the che corrorrect ect floflow of w of bloblood fod frorom thm the ute uterierine wne wall all to tto the ehe endndomometretriumium??
A.
A.
Uterine arteryUterine artery arcuate arteryarcuate artery radial arteryradial artery straight & coiled spiral arterystraight & coiled spiral arteryB.
B.
Uterine arteryUterine arteryradial arteryradial arteryarcuate arteryarcuate arterystraight & coiled spiral arterystraight & coiled spiral arteryC.
C.
Uterine arteryUterine arteryarcuate arteryarcuate arterystraight arterystraight arteryradial & coiled spiral arteryradial & coiled spiral arteryD.
D.
Uterine arteryUterine arterystraight arterystraight arteryarcuate arteryarcuate arteryradial & coiled spiral arteryradial & coiled spiral artery 2.2. WWhahat it is ts thhe fe fununctctioionanal ll lifife se sppan an of of ththe ce cororppus us luluteteumum??
A.
A.
7 + 2 days7 + 2 daysB.
B.
14 + 2 days14 + 2 daysC.
C.
21 + 2 days21 + 2 daysD.
D.
28 + 2 days28 + 2 days 3.3. WhWhat at hohormrmonone ie is ss sececrereteted bd by ty the he dodomiminanant nt ovovarariaian fn fololliliclcle?e? A.
A. estriolestriol
B.
B.
estroneestrone CC.. eessttrraaddiiooll D
D.. pprroogegeststereroonnee 4.
4. DuDurinring thg the ee embmbryryononic ic peperioriod, d, whwherere ie is ts the he foformrmatation ion of of bloblood od firfirst st dedemomonsnstrtrablable?e? A.
A. bone mbone marrowarrow B B.. yyoollk sk saacc C C.. lliivveer r D D.. sspplllleenn 5.
5. DuDurinring thg the se sececreretotory ry phphasease, w, whahat it is ts the he upuppepermrmosost lat layeyer fr frorom tm the he ututererine ine cacavitvity ?y ? A
A.. ZZonona ca coommppacacttaa B
B.. ZZoonna ba baassaalliiss C
C.. ZZonona spa spoonnggioiossaa D.
D. DDececididua ua bbasasalalisis 6.
6. WhWhat at ststagage oe of hf humuman an dedevevelolopmpmenent is t is imimplplananteted id in tn the he ututererinine ce cavavitity?y? A.
A. blastomblastomereseres B B.. eemmbbrryyoo
C.
C.
blastocystblastocyst D D.. mmoorruullaa 7.7. HHow ow mmanany ny new ew prprimimarary oy oococyytetes as arre te thehere re duduririnng pg pububerertyty?? A. A. 00 B B.. 11,,000000 C C.. 1100,,000000 D D.. 110000,,000000 8.
8. WhWhat at is is ththe ie impmporortatant nt evevenent tt thahat ot occccururs ps pririor or to to imimplplanantatatitionon?? A.
A. FormatFormation of dion of daughter aughter cellscells B.
B. ExExtrtrusiusion on of of ththe pe polaolar br bodyody C.
C. AccAccumuumulatilation oon of flf fluid buid betwetween een blasblastomtomereseres D.
D. DiDisasappeppeararancance of the ze of the zonona pela pelluclucididaa 9.
9. AAt wt whhat at phphasase de doeoes rs regegreresssson on oof tf the he cocorprpus us luluteteum um ococccurur?? A.
A. At the At the end of end of the prothe proliferative liferative phasephase B.
B. At tAt the ehe end ond of thf the see secrcretoetory pry phahasese C.
C. DuDuriring ng memensnstrtruauatitionon D.
D. AAftfter er oovuvulalatitionon 10.
10. A 34 A 34 yeayear olr old G4d G4P4 dP4 delivelivereered vad vaginaginally ally an 8 n 8 lb blb baby aby at hat home ome assassististed bed by a hy a hilotilot. Th. The plae placencenta wta was das deliveliveredered without difficulty. However, a few minutes later, there was profuse vaginal bleeding and the patient wa rushed to 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 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
fundus was soft and above the umbilicus. There were no vaginal or cervical lacerations. What is the most probable diagnosis?
probable diagnosis?
A.
A.
uterine inversionuterine inversionB.
B.
retained placental fragmentsretained placental fragmentsC.
C.
uterine ruptureuterine rupture DD.. uuteterrinine ae attononyy 11.
11. A 33 A 33 yeayear olr old G3d G3P2 PP2 PU 1U 18 we8 weeks eks conconsultsulted aed at tt the Ehe ER beR becaucause ose of waf watery tery vagvaginal inal disdischacharge rge accaccompompanianied byed by hypogastric pain. Vital signs were normal. Speculum exam revealed pooling of watery discharge. I.E. revealed an 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
open cervix, palpable fetal parts at the os, uterus enlarged to 18 weeks AOG. What is the most probable diagnosis?
diagnosis?
A.
A. RecurrRecurrent aboent abortionrtion
B.
B.
Incomplete abortionIncomplete abortion C.C. InInevevititabable le ababorortitionon D.
D. ThThrereatatenened ed ababorortitionon 12
12.. At At whwhat at papart rt of of ththe fe fallallopopian ian tubtube de doeoes ts tubaubal rl rupupturture oe occccur ur eaearlirliesest?t? A.
A. IntersInterstitialtitial
B.
B.
B. AmpullaryB. Ampullary C C.. IIsstthhmmiicc D D.. FFiimmbbrriiaa 13.13. WhWhat iat is ths the me mosost ct comommomonly nly asassosociaciateted cd cononditdition ion fofor ar abrbrupuptiotion pn placlacenentata?? A.
A. ExternExternal traumal traumaa
B.
B.
Pregnancy- induced hypertensionPregnancy- induced hypertension C.C. alalcocohohol cl cononsusumpmptitionon D
D.. SShhoorrt ct coorrdd 14.
A.
A. negative negative transfutransfundal prendal pressuressure
B.
B.
funnelingfunnelingC.
C.
2.7 cm cervical length2.7 cm cervical length D.D. T- T- shshapaped ed cecervrvixix 1
155.. PPrreteteerrm m iinnffanant it is as an n ininffaannt wt whho io iss:: A.
A. less thless than 2000 an 2000 grams grams at birtat birthh
B.
B.
less than 2500 grams at birthless than 2500 grams at birth C.C. leless ss ththan an 37 37 weweekeks As AOGOG D.
D. leless ss ththan an 38 38 weweekeks As AOGOG 16.
16. A 35 A 35 yeayear old r old G1PG1P0 ha0 had an id an infenfertilirtility wty workork-up f-up fro whro which sich she whe was pas prescrescribribed cled clomiomiphephene cine citrattrate. Se. She gohe got prt pregnegnantant and was diagnosed to have twin pregnancy. What is the most probable type of twinning?
and was diagnosed to have twin pregnancy. What is the most probable type of twinning? A.
A. MonozyMonozygoticgotic
B.
B.
DizygoticDizygotic C C.. CCoonnjjooiinneedd D D.. LLoocckkeedd 17.17. WhiWhich och of thf the foe followllowing iing is ths the moe most imst imporportantant pat paramrameter eter in thin the ase assessessmesment ont of pf patieatient int in trn true lue laboabor?r? A.
A. intactnintactness of ess of the amthe amniotic mniotic membraembranene B.
B. cercervicvical al dildilatatatation ion and and effeffaceacemenmentt C.
C. prpresesenentiting ng papartrt D
D.. bboonny y ppeellvviiss 18.
18. The The levelevel of tl of the phe presresentienting pang part in rt in the bthe birth irth cancanal deal descriscribed ibed in ren relatilationsonship thip to tho the isce ischial hial spinspines, wes, whichich is hh is halfwalfwayay between the pelvic inlet and the pelvic outlet is called
between the pelvic inlet and the pelvic outlet is called A.
A. positionposition B
B.. BB. e. effffaaccememeenntt C
C.. DDiillaattaattiioonn D
D.. ssttaattiioonn 19
19.. ThThe che charaaractcterierististic curc curve pve pattattern ern of cof cervervicical dial dilatlatatiation in a non in a normormal laal labobor is der is descscriribebed as:d as: A.
A. A. hyA. hyperbolicperbolic B
B.. ssiiggmmooiiddaall C.
C. didiagagononal sal strtraiaighghtt D
D.. hhoorriizzoonnttaall 20.
20. A 30 A 30 yeayear old r old G1PG1P0, t0, term erm was was admadmitteitted for d for labolabor par pains. ins. FH- 3FH- 34 cm4 cm, FH, FHT- 14T- 140 bp0 bpm. Im. IE- cE- cervervix is ix is 4 cm 4 cm diladilated, ted, 60%60% effaced, cephalic, station -2, rupture BOW. Uterine contractions every 2-3 mins, moderate. After 2 hours, 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- IE-cervix is 5-6 cm dilated, 80% effaced, station 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.
-1.Describe the progress of labor. A.
A. NormaNormally progrlly progressingessing
B.
B.
Protracted cervical dilatationProtracted cervical dilatationC.
C.
Protracted descentProtracted descent D.D. AArrrresest it in dn desesccenentt 21
21.. WhWhat at phphase ase of of ththe ae actctive ive lablabor or rerefleflectcts ts the he fetfeto-po-pelvelvic ic rerelatlationionshship?ip? A.
A. latent platent phasehase B.
B. B. B. acacceceleleraratition on phphasasee C.
C. phphasase of e of mamaxiximumum sm slolopepe D.
D. dedececeleleraratition on phphasasee 22.
22. A 1A 19 ye9 year oar old G1ld G1P0 PP0 PU 40 U 40 weeweeks, ks, not not in lain laborbor, wa, was ses seen aen at tht the OPe OPD foD for der decrecreaseased fed fetal tal movmovemeement. nt. She She waswas hooked to an electronic fetal monitor and tracing showed: Baseline FHT- 140’s, good variability, with more than 2 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:
accelerations of 20 bpm lasting for 20 secs. The tracing is interpreted as:
A.
A.
reactivereactive BB.. nnoon-n-rreeacacttiivvee
C.
C.
positivepositive DD.. nneeggaattiivvee 23.
23. FeFetatal tl tachachycycardardia ia is is dedefinfined ed as as a ba baseaselinline he heareart rt rate ate gregreatater er ththan:an: A. A. 140 bp140 bpmm B B.. 11550 0 bbppmm C C.. 11660 0 bbppmm D D.. 11770 0 bbppmm 24.
24. WhaWhat is t is the the prepresensentatitation ton type ype whewhen thn the fee fetal tal heahead is d is artiartially ally flexflexed wed with tith the ahe antenterior rior fonfontanetanel or l or brebregma gma isis presenting?
presenting?
A. A. faceface
B
B.. vveerrtteexx C
C.. bbrrooww D
D.. ssiinncciippuutt 25.
25. You You werwere te the he inteintern rn on on dutduty iy in tn the he ER ER and and you you did did an an abdabdomiominal nal exaexam m on on a 2a 22 y2 year ear old old G2PG2P1 P1 PU 3U 37 7 weeweeks ks whowho consulted because of
consulted because of hypogastic pain. You found out that the fundus is occupied by a hard ballotable mass. Whathypogastic pain. You found out that the fundus is occupied by a hard ballotable mass. What Leopold’s maneuver did you perform?
Leopold’s maneuver did you perform?
A.
A.
LM 1LM 1 B B.. LLM M 22 C C.. LLM M 33 D D.. LLM M 44 26.26. TheThere is re is an ian incrncrease ease in thin the size size of e of carcardiac diac silhsilhouetouette ite in X-rn X-ray day durinuring preg pregnangnancy bcy becaecause tuse the hhe heart eart is diis displasplaced tced too the:
the:
A
A.. lleefft at annd ud upwpwaarrdd B.
B. leleft ft anand dd dowownwnwarardd C.
C. ririghght t anand d dodowmwmwawardrd D.
27
27.. DDururining pg preregngnanancycy, t, the he didiapaphhraragm gm ririseses s byby
A.
A.
2 cm2 cm B B.. 4 4 ccmm C C.. 6 6 ccmm D D.. 8 8 ccmm 2828.. ImImpapairired ged galall bll bladaddeder cor contntraractctioion dun duriring png preregngnanancy icy is dus due toe to A.
A. estrogeestrogenn
B.
B.
estrogen and progesteroneestrogen and progesterone CC.. pprrogogeessteterrononee D.
D. ananatoatomimicacal chl chanange in gge in gall ball bladladdeder r 29
29.. NaNaegegeleele’s r’s rule ule is uis use tse to eso estimtimatate the the exe expepectcted ded date ate of of dedelivliverery by by _y _______.. A.
A. adding 3 adding 3 days tdays to the fo the first dairst day of Py of PMP and MP and count bcount back 7 mack 7 monthsonths B.
B. addiadding 7 dayng 7 days to ths to the firse first day of Pt day of PMP anMP and coud count bacnt back 3 monk 3 monthsths C.
C. addiadding 7 dayng 7 days to ths to the firse first day of bt day of bleedleeding aning and cound count bact back 3 monk 3 monthsths D.
D. addiadding 7 dayng 7 days to the fs to the first dirst day of LMay of LMP and cP and count bount back 3 mack 3 monthonthss 30
30. . WhWhicich oh of tf the he ffolollolowiwinng ig is ps prorovven en teteraratotogegen?n? A.
A. ViVitatamimin A dn A dererivivatativiveses
B.
B.
MetronidazoleMetronidazole C.C. CCepephahalolospspororininss D
D.. AAmmppiicciilllliinn 31.
31. WhWhich ich of of ththe fe follollowowining vg vacaccincines es is is cocontntrairaindindicacated ted duduriring ng prpregnegnanancycy?? A.
A. PneumPneumococusococus
B.
B.
Hepatitis BHepatitis B CC.. IInnfflluueennzzaa D.
D. MuMumpmps, ms, meaeaslsleses, rub, rubelellala 32.
32. ThThe pe prefreferrerred ed memeththod od fofor tr the he dedelivlivery ery of of ththe ae afteftercrcomomining hg head ead isis A.
A. Piper’s Piper’s forcepforceps extras extractionction B.
B. MauMauricriceaueau-Sm-Smellellie-Vie-Veit eit ManManueveuever r C.
C. BrBracachht mt mananeueuvver er
D.
D.
Prague maneuver Prague maneuver 33.33. You You werwere asse assignigned ted to delo deliver iver the the babbaby of a y of a 25 y25 year oear old G1ld G1P0 PP0 PU 38 wU 38 weekeeks. Ys. You apou applieplied thd the fore forcepceps on ts on the fehe fetaltal head with the following findings: head was at station +2 with the sagittal suture at left occiput anterior position. head with the following findings: head was at station +2 with the sagittal suture at left occiput anterior position. This is classified as
This is classified as A.
A. outlet foutlet forceps orceps deliverydelivery B.
B. lolow fw fororceceps ps dedeliliveveryry C.
C. mimidfdfororceceps ps dedeliliveveryry D.
D. hihigh gh foforcrcepeps ds delelivivereryy 34.
34. A 22 A 22 yeayear old r old G1PG1P0 pat0 patienient at 3t at 39 we9 weeks eks AOG AOG was was admadmitteitted for d for elecelective tive CesCesarearean San Sectection fion for bror breeceech preh presensentatitation.on. She requested to her obstetrician that a transverse suprapubic abdominal incision be done to her. This type of She requested to her obstetrician that a transverse suprapubic abdominal incision be done to her. This type of incision is called
incision is called A.
A. Kerr Kerr B
B.. KKrroonniigg
C.
C.
PfannensteilPfannensteil DD.. CCllaassssiiccaall 35.
35. WhiWhich of ch of the the follfollowiowing is ng is one oone of thf the ree requirquiremeements tnts that hat musmust be t be prepresensent beft before oore obstbstetrietric foc forceprceps mus must bst be usee used?d? A.
A. The meThe membranmbranes shoues should be inld be intacttact B.
B. CeCephphalalic pic preresesentntatatioionn C.
C. ThThe fee fetatal hel head mad must ust be fbe floaloatintingg D.
D. The cThe cerviervix musx must be ft be fullully dily dilateated and d and retretracractedted 36.
36. The The singsingle mle most ost signsignificificant ant risk risk facfactor tor in tin the he devdevelopelopmenment of t of pospost-pt-partartum um pelvpelvic iic infecnfection tion isis A.
A. early ruearly rupture opture of memf membranesbranes B.
B. PProrololongnged ed lalabobor r C.
C. CeCesasarerean dean deliliveveryry D
D.. MMuultltiipparariittyy 37.
37. The The procprocess ess by wby whichich thh the ute uterus erus retureturns rns to ito its nts normormal sal size, ize, tontone ane and pod positisition aon aftefter der delivelivery iry is cas calledlled A
A.. iinnvvoolluuttiioonn
B.
B.
puerperiumpuerperiumC.
C.
subinvolutionsubinvolution D D.. aattoonnyy 38.38. WhWhat iat is ths the mee mechchananism ism bebehinhind thd the ine incrcreasease in ce in cardardiac iac outoutpuput rit righght aft afteter der delivliverery?y? A.
A. maternmaternal exhaal exhaustionustion
B.
B. increase caval compressionincrease caval compression C.
C. sympathetic stimulationsympathetic stimulation
D.
D. auautototrtranansfsfususioionn 39.
39. CoCongengeninital tal rubrubellella sa synyndrdromome ie is ms more ore liklikely ely cocommmmon on durduring ing whwhicich Ah AOGOG?? A A.. 88--110 w0 weeeekkss B B.. 1122--114 4 wweeeekkss C C.. 1166--118 8 wweeeekkss D D.. 3366--338 8 wweeeekkss 40.
40. WhWhat iat is ths the diae diagngnostostic pic procrocededurure of ce of chohoicice for e for ididenentiftifyinying galg gallstlstonones ies in prn pregnegnanancycy?? A.
A. CT ScaCT Scann B B.. XX--RRaayy C C.. UUllttrraassoouunndd D D.. MMRRII
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 carcinomaB.
Adenocarcinoma C. Malignant melanoma D. Sarcoma50.
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. Isthmus52. 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 1853. 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
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. Ul trasound 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 inguinaleC. 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 incontinence64. 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 instability65. 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.
endometriosis68. Among the factors causing female infertility, the easiest to diagnose and manage is A. cervical factors
C.
ovulatory factors D. tubal/peritoneal factors69. An absolute contraindication to hormone replacement therapy is:
A.
Thromboembolic diseaseB. Bronchial asthma
C.
Diabetes mellitusD.
Hypertension70. 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
D. majority of fetus staying on the right maternal side
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 1sttime on her 28 weeks AOG. Her BP was 160/120 mmHg. She hadsevere 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 12thweek 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) 2nded, Page 210)A. transverse
B.
longitudinalC. cephalic D. breech
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 2ndEd 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 2ndEd 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 2ndEd 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 2ndEdChapter 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) 2nded, Pages 295-298)
A. uterus at the level of the symphysis pubis B. lochia alba
C. 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) 2nded, 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)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, 4thed, 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, 4thed, 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 D. IV
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
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 4thed, 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 4thed, 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 4thed, 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 4thed, 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
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
D. human placental lactogen
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 dominance138. 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.
20B. 15 C. 10
D. 5
140. Patient with heart disease without any obstetrical indication are best delivered by:
A.
cesarian section under general anesthesiaB. 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- dopaB. 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 drugB. betamethasone is given at a dose of 12 mg. im every 24 hours X 2 doses C. it produces induction of fat cells that regulate fetal lunf maturity D. it affects biochemical systems within type II cells that produce surfactants
144. 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
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 mot likely to progress to endometrial carcinoma:
A.
simple hyperplasis with atypiaB. 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
A. causes vasoconstriction B. causes platelet aggregation C. is not formed from arachidonic acid D. is not an eicosanoid
169.
A main action prostaglandin 2α(PGF2α) 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
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.
12thdayB.
14-15thday
C.
10thdayD.
17thday184. 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. BrachtB. 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. HemorrhageB. 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. Carriersystem
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
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 daysB. 14-16days
C. 8-9days
D. 18-21days
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. 24-28wks
C. 30-32wks
D. 34-36wks
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
B. Hypoxia
C. Acidosis
D. Alloftheabove
206. Puerperium lasts for how many weeks: (p. 251)
A. 4 wks
B. 5wks
C. 6wks
D. 7wks
207. What is the average maternal weight loss immediately after delivery? (p. 254)
A. 4 kg
B. 5kg
C. 6kg
D. 7kg
208. The lochia consisting of servical 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. Lessexpensive
C. Less tendency for nosocomial infections
D. Alloftheabove
210. This refers to 3 or more consecutive spontaneous abortions: (p. 274)
B. serialabortion
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. Blightedovum
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. Alloftheabove
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. Alloftheabove
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. 284days
C. 290days
D. 294days
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
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. Uterineatony
228. Postpartum hemorrhage is blood loss during the first 24 hours after delivery in excess of : (p.465)
A. 100 cc
B. 300cc
C. 500cc
D. 1,000cc
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. 4-6mg
B. 6-8mg
C. 8-10mg
D. 10-12mg
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, eclampsia232. 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 4ANS : D (APMC page 216) 239. The cardinal movements of labor were as follows:
A.
Engagement, descent, flexion, internal rotation, extension, external rotation, expulsionB. 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 sedationC. 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. luteol ysis
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 30thweek 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.
1sttrimesterB. Midtrimester
C.
3rdtrimesterD. During labor
ANS: B (APMC page 107)
246.
Nayda, an 18-year old primigravida comes to the clinic on her 12thweek of gestation for her 1stcheck-up. She iscurious as to when she can start to perceive fetal movements. You will reassure her that this will occur : A. anytime now
B.
between the 16thand 18thweekC.
between the 18thand 20thweekD.
between the 20thand 24thweekANS: 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
